A newly-released Accenture study on US primary care estimates that savings of about $10 billion per year in US primary care could be achieved through use of ‘virtual health’, defined as “digital tools such as biometric devices, analytic diagnostic engine and a virtual medical assistant” that would allow much of the work of a typical office visit to be done prior to or separately from the visit, and follow up/check in tools such as video visits/telemedicine which would further offset costs. The cost savings were calculated by Accenture Insight Driven Health as a total of time-per-visit savings of five minutes–when aggregated, $7 billion, $300 million in telemedicine visits, telehealth self-management in diabetes alone $2 billion, health system savings $63 million. This could potentially solve the shortage of US PCPs now projected at 31,000 in the next ten years. Nary a mention of patient care savings, chronic care management or telecare for proactive behavioral home monitoring, however. Accenture release (BusinessWire), Accenture page and paper.
3 companies through to next stage in SBRI Telehealth/Telecare
Three of the eleven companies through to the next stage of the NHS Small [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/SBRI-logo.jpg” thumb_width=”150″ /]Business Research Initiative (SBRI) are in the “Telehealth/Telecare for people with Learning Disabilities” category, according to the latest news release on the SBRI website. Each will receive a further £1 million to continue with prototype development and product testing.
The three companies are Red Embedded, Maldaba and Cupris Health. The other companies going through to the next stage are BioSensors, Digital Creativity in Disability, Bering, Docobo, ADI, Folium Optics, Armourgel and MIRA Rehab.
SBRI Healthcare is an initiative from NHS England supporting a programme of competitions inviting companies to come forward with their ideas and new technologies for known NHS challenges. In the last year, SBRI Healthcare has launched 10 new clinically-led competitions and awarded £22.4 million to 60 companies to develop products focused on specific NHS unmet need.
Read the full news release at SBRI Healthcare Funds Companies to Develop Game Changing Technologies.
Soapbox: The burning technological platform for person-centred care
Rising demands of an aging population are putting increasing pressure on care providers across health and social care. But the technology and thinking that can help alleviate some of those pressures is analogue in a digital world, argues Tom Morton of Communicare247.
Analogue thinking in a digital world
Integrated, person-centred care is seen as a driving force for building public services around individual needs. It aims to bring care out of the hospital and into the community and home to cope with the growing burden of the 3 million people who will have over three long-term conditions by 2018. It will also help acute hospitals to address the ever increasing costs associated with our aging population.
Meanwhile life in our homes and communities is becoming fragmented. One in four (2.9 million) people aged 65 and over feel they have no one to go to for help and support, according to a 2015 report from Age UK and The Campaign to End Loneliness(1). With research indicating that social isolation leads to higher mortality, what point is there keeping people out of hospital, if only they are left home alone, and without the necessary support?
Person-centred care will have minimal success if we do not recognise this fact; people need someone to look out for them. And current approaches are not building the foundations that society needs to help grasp the nettle of providing round-the-clock personal care. (more…)
How technology can help fight elder abuse–ethically
The increasing awareness of abuse of older people by their caregivers, whether at home or in care homes/assisted living/nursing homes, invites discussion of the role that technology can play. This presentation by Malcolm J. Fisk, PhD, co-director of the Age Research Centre of Coventry University, in the BSG Ageing Bites series on YouTube looks at technologies viewed by level of control and intrusiveness:
- Social alarms, which include pull cords (nurse call) and PERS–what we think of as ‘1st generation’ telecare: high level of control, low intrusiveness–but often useless if not reachable in emergency
- Activity monitoring, which can be room sensor-based or wearable (the 2nd generation): less control, slightly more intrusive–also dependent on monitoring and subject to false positives/negatives
- Audio and video monitoring, while achieving greater security, are largely uncontrolled by the older person and highly intrusive to the point of unacceptability. (In fact, some feedback on tablet-based telehealth devices indicates that a built-in camera, even if not activated, can be regarded with suspicion and trigger unwanted reactions.)
The issues of consent, and balancing the value of autonomy and privacy versus factors such as cognitive impairment, personal safety and, this Editor would add, detecting attacks by strangers and not caregivers, are explored here. How do we ethically observe yet respect individual privacy? This leads to a set of seven principles Dr Fisk has published on guiding the use of surveillance technologies within care homes in the latest issue of Emerald|Insight (unfortunately abstract access only) Video 11:03. Hat tip to Malcolm Fisk via Twitter.
A trip back in time to telecare, circa 2009–and maybe the future
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/Cape-May-Point-fade-to-dark.jpg” thumb_width=”150″ /]As the season winds down, our thoughts turn backwards. Your Editor remembers Jersey Shore vacations, travel, great airshows, collector car shows, old friends and good times. She also remembers When Telecare Was New (2006-9) with Living Independently Group (now Care Innovations), helping to pioneer the QuietCare system in senior housing. At that time, universities like Virginia and Florida were on the cutting edge in developing smart homes and pioneering systems for monitoring health in older adults and the disabled. Those smart homes and research initiatives vanished years ago, replaced by incubators, accelerators, the size of your funding round, Big Data, wearables, IoT….
Sigh. Your Editor is in Error. The University of Missouri is still at it 12 years later with its sensor-based behavioral/activity/proactive care system in the Tiger Place assisted living community near Columbia. And it seems much the same: bed and residential motion sensors, fall detection tracked by a variety of sensors, gait analysis and analysis of activity changes (changes in behavior=changes in health, which still doesn’t excite those in senior care the way it should) . You have to admire the persistence of vision the founders/researchers have had (Marilyn Rantz, professor emeritus with the School of Nursing, and Marjorie Skubic, a professor with MU’s College of Engineering). Their research model has now spread to 13 communities and hospitals in Missouri, and they are commercializing it with a former student, George Chronis, with Foresite Healthcare to convert it into a reliable, robust assisted living/hospital monitoring/care transition system with a simpler, affordable ‘health at home’ version. Besides the nostalgia and supporting fellow ‘true believers’, what they have designed is still needed AND not achieved by RFID (a big fizzle) or ancient PERS. We can all wish them luck in a competitive and much changed market. MU researchers taking sensor system from lab to marketplace (Columbia Daily Tribune)
Previously in TTA: Quantifying early detection capabilities of telecare (July 2012) and Editor Steve’s first look in October 2009 at ‘magic carpet falls’.
The NHS fail at encouraging digital health startups
While Minister of Life Sciences George Freeman MP speaks very highly of the need for innovation and digital health in an NHS integrated health system, the reality is less encouraging for UK startups and their growth. The story of Big Health’s Sleepio and its move from the UK, told by Bloomberg, illustrates the difficulty that new companies and technologies have in fitting into a national framework, then selling into the 209 NHS regions plus related healthcare spenders. The long cycle and the narrowness of the frameworks are disincentives for many digital health technologies and their funders. Even if you win clients as part of being on the framework, when it expires after a few years, the business can be lost.
It’s hard to crack the code, and small companies are dependent on partners. A personal anecdote from this Editor’s time at Living Independently: the company achieved getting on a national framework with the QuietCare telecare product (2007) through partnerships with several larger telecare providers. We relied on them to offer QuietCare to the regions and councils. This had limited success and the US business far outstripped that in the UK.
Ten years ago, the situation was reversed. NHS, Government and council funding helped the earliest development and acceptance of telehealth and telecare, much as the Veterans Health Administration (VA) did with home telehealth and telemedicine in the US. Other European markets and Canada have established private spending in this area, but these smaller markets–and funders– don’t have the potential that is possible in the US private market, even without reimbursement. The trend is reflected in investment: $4 bn in the US, less than €100 million in Europe. US developers now have a bonus in the potential of Asia, with China having the greatest interest and now funding. [TTA 23 July]. How the NHS Is Locking Out Britain’s Digital-Health Startups
‘Déjà vu all over again’ or critical mass? NYTimes looks at older adult care tech
“It’s like déjà vu all over again” as Yogi Berra, the fast-with-a-quip Baseball Hall of Fame catcher-coach-manager once said. About 2006-7, telecare broke through as a real-world technology and the tone of the articles then was much like how this New York Times article starts. But the article, in the context of events in the past two years, indicate that finally, finally there is a turning point in care tech, and we are on the Road to Critical Mass, where the build, even with a few hitches, is unstoppable.
Have telehealth, telecare, digital health or TECS (whatever you’d like to call it) turned the corner of acceptability? More than that, has it arrived at what industrial designer Raymond Loewy dubbed MAYA (Most Advanced Yet Acceptable) in keeping older adults safer and healthier at home? The DIY-installed Lively! system keeps an eye on a hale 78 year old (more…)
Tunstall invests £100 m in ‘Connected Healthcare 2020’ strategy
Tunstall Healthcare Group in UK outlined today their five-year public, global strategic vision, along with a fresh investment of £100 million during this timeframe (~£20 m per year) to transition their connected care systems over to IP and cloud technology. The initiative, dubbed Connected Healthcare 2020, is centered on:
- Leading the switch to IP infrastructure–transitioning away from analogue (analog) services and devices to connected digital and mobile (cellular, Wi-Fi, Bluetooth)
- Extending managed services–offering a wide variety of services end-to-end including full outsourcing
- Developing new consumer propositions through innovation–tapping into demand, often private pay, for high quality home care not provided by carers (caregivers)
- Developing new models of care in the home through integration–coordination of social care and healthcare
The Yorkshire Post article also points out, through their separate comments with CEO Paul Stobart, that prospective markets include developing nations with aging populations such as Mexico, South Korea and Turkey. Tunstall claims market leadership in UK, Germany, France, Spain, the Netherlands, Belgium, Sweden, Denmark, Finland and Australia, as well as fourth position in the US. The TECS (technology enabled care services) initiative will create about a dozen jobs per year at the Whitley HQ, adding to their present 650 there and their total globally of 3,500. Tunstall release
We wonder if in the US we will see more of Tunstall at events like the mHealth Summit. Tunstall Americas has a refreshed website and communications as ‘The voice of connected health’, is more strongly promoting their call/contact services and its HQ location in New York City. We’ve previously noted their recent home care acquisitions and partnership with QMedic.
Tunstall adds services for Australian veterans, upgrades US call centers
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Tunstall has been quiet on the newsfront lately, so these two items from Australia and the US are to be noted. In Australia, the Department of Veterans Affairs (DVA) rehabilitation appliances program (RAP), which provides subsidized personal response systems to veterans, now includes Tunstall’s PERS, iVi fall detector pendant, PIR movement sensor and GPS watch. The program requires that veterans be evaluated for need by a qualified health provider. Tunstall has participated in the RAP program since 2002. Pulse+IT (Australasia) In the US, a significant part of Tunstall’s purchase of AMAC were medical answering service operations in Long Island City, NY, Pawtucket, RI, and Newington, CT. A $10 million upgrade of their 24/7 service includes CRM for healthcare providers for after-hours, overflow support, appointment reminders, insurance verification and help desk services. Release
10th Anniversary Article 1: The Next Ten Years of Telecare
This year, on the 10th Anniversary of Telehealth and Telecare Aware, we have invited industry leaders nominated by our readers to reflect on the past ten years and, if they wish, to speculate about the next ten. Here is the first article, with a UK focus, by Dr Kevin Doughty.
Many of us are frustrated at how little progress there has been in the deployment and acceptability of telecare during the past decade. Yet, despite warnings that an ageing population was about to bankrupt the NHS (and health insurance schemes elsewhere in the world), and that access to social care for older people was being withdrawn at such a rate that it could only be afforded by the wealthiest in society, our health and social care systems have just about survived.
But this can’t go on, and in England over the past 12 months: (more…)
‘Alarming deterioration in NHS finances’: The King’s Fund April report
The King’s Fund has prepared since 2011 a Quarterly Monitoring Report on the performance of the NHS as seen by its finance directors. It is a ‘regular update on how the NHS is coping as it grapples with the evolving reform agenda and the more significant challenge of making radical improvements in productivity.’ Report #15 does not bring auspicious news as the challenges deepen. 7 of 10 NHS trust directors are concerned about balancing their books next year, and 60 percent have either drawn down reserves or relied on additional financial support. In healthcare delivery performance, over 440,000 patients in this quarter spent more than four hours in A&E (US=ER or ED), the poorest performance since 2003. (more…)
ATA 2015: keynotes, concurrent sessions and trade show
Now available on the ATA 2015 website are the full speaker lineup, including keynote speakers Sanjay Gupta, MD, CNN’s chief medical correspondent and Yulun Wang, CEO of InTouch Health, Patrick Soon-Shiong, healthcare investor extraordinaire and Chairman/CEO of NantHealth and Reed Tuckson, ATA’s president elect. Click here to investigate the concurrent sessions. Speaker abstracts are helpfully compiled in Telemedicine & e-Health (PDF). There are also pre-meeting professional development certificate courses on Saturday and Sunday, a separate Telemedicine Investor & Strategic Summit on Monday and Industry Executive Sessions on Monday and Tuesday. TTA is a media partner of the 20th Annual Meeting ATA 2015.
A telecare device that may solve the ‘soft fall’ and unconscious problems (UK)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/MonitorGO-cropped-small-232×300.jpg” thumb_width=”150″ /]Guy Dewsbury of the eponymous Gdewsbury independent research consultancy brought to this Editor’s attention his recent commission for West Yorkshire-based MonitorGo in evaluating their new smartphone-based personal alarm. He analyzed the device’s features here in a comparison chart and writeup, versus what is commonly available in the market. If it reliably does what it says it does (our normal caveat), it could be a big step beyond the Ur-Pendant, addressing our (and Neil Versel’s) concerns earlier this week on the persistence of ‘ancient history’ PERS [TTA 31 Mar].
It goes well beyond common mPERS as well. There are 12 features, including GPS location, hard fall detection and 24/7 third-party help line monitoring (via Medvivo), but the key differentiating features are the soft fall detector, unconsciousness/inactivity detection and false alert detection/response–as well as usability as a simplified smartphone with unlimited calls to UK landlines and 250 mobile-to-mobile minutes. (more…)
“Data moves at the speed of trust”–RWJF report
The report issued today by the influential Robert Wood Johnson Foundation (RWJF), ‘Data for Health: Learning What Works’ advocates a fresh approach to health data through greater education on the value/importance of sharing PHI, improved security and privacy safeguards and investing in community data infrastructure. If the above quote and the first two items sound contradictory, perhaps they are, but current ‘strict’ privacy regulations (that’s you, HIPAA), data siloing and the current state of the art in security aren’t stemming Hackermania (or sheer bad data hygiene and security procedures). Based on three key themes, the RWJF is recommending a suite of actions (see below) to build what they term a ‘Culture of Health. All of which, from the 10,000 foot view, seem achievable. The need–and importantly, the perception of need–to integrate the rising quantity of data from all these devices, pry it out of its silos (elaborated upon earlier this week in ‘Set that disease data free!), analyze it and make it meaningful plus shareable to people and their doctors/clinicians keeps building. (‘Meaningful’ here is not to be confused with the HITECH Act’s Meaningful Use.)
But who will take the lead? Who will do the work? Will the HIT structure, infrastructure and very importantly, the legal framework follow? We wonder if there is enough demand and bandwidth in the current challenged system. Release. RWJF ‘Data for Health’ page with links to study PDF, executive summary which adds details to the recommendations below, more.[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/Data-For-Health-Advisory-Committee-RWJF.png” thumb_width=”400″ /]
3rings Plugs in to reassuring families
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/3rings-plug-default.jpg” thumb_width=”150″ /] Stoke-on-Trent’s 3rings, which we noted over a year ago [TTA 6 Feb 14] as a smartphone/call/text-based family alert system based on the older person’s phone check in, has developed a plug that will do this check in automatically. It’s based on behavior–an older person turning on or off an appliance as part of their daily routine (a tea kettle or TV), based on rules that the family sets up. The plug goes into the wall outlet with the appliance plugged into it. Usage sends a wireless signal to the 3rings portal and notifies family or neighbors that the person is active and moving about. Presumably this is a small appliance–there’s no tech spec that gives maximum wattage. (The plug may short out if Dad likes to get up to ‘Ride of the Valkyries’ on his McIntosh amplifiers driving two Klipschorn floor speakers.) A subscription service at £12 per month, with the plug at laddered prices of £79 inclusive of the first month, £183 with a 12 month subscription with the plug at half price plug and £288 with a two year subscription. Interestingly this Editor received this news (more…)
66% of ‘tech-savvy seniors’ dissatisfied with current health tech
Yes, those same people who–gee whiz–designed computers, did their own programs in MS-DOS and went from Palm Pilots to BlackBerries to iPhones, are already over or hitting 65 (3.9 million in US in 2015)–and they aren’t happy with what’s being served up to them in healthcare tech. The Accenture study across 10 countries and over 10,000 adults points out the demand–67 percent–and the dissatisfaction–66 percent. They want independent self-care tools, wearables to monitor themselves, online communities like PatientsLikeMe, patient navigators and health record tools. Moreover, the more comfortable they are with and value technology, the more likely they are already using technology for tracking weight and cholesterol levels. Couple this with the ‘Drawn and Quartered’ Parks Associates research [TTA 11 Aug 14] and moving past the mHealth hype earlier this week, the study points out a strong market for apps, online tools and other digital health–but designed not for a peer group of most designers, nor to be ‘cool’. Helloooo designers! Wake up! Laurie Orlov does point out on AgeInPlaceTech that there’s not much new here, but that we shouldn’t move on. Accenture release, Modern Healthcare, Fred Pennic in HIT Consultant, Stephanie Baum in MedCityNews
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