How technology can help fight elder abuse–ethically

September 9, 2015 | by

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.

Telehealth patient engagement program improves orthopedic outcomes

September 5, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/orthocare_06.png” thumb_width=”150″ /]VOX Telehealth‘s patient engagement program with Bon Secours St. Mary’s Hospital in Richmond, Virginia, which was announced back in January [TTA 12 Jan], published results for its pilot last month, and they appear to be outstanding. VOX’s model is ‘episode of care’, over a 90-120 day span starting 30 days prior to surgery to 60-90 days post-procedure; the online/tablet platform delivers educational content, reminders and notes on potential symptoms that ties into a customizable by patient alert escalation and notification system. The goal is to reduce post-discharge complications and readmissions, in this case for hip and knee replacement patients, through managing expectations and better preparation by the patient. And the results reported are encouraging:

  • 92 percent of enrolled patients were discharged directly to home–the US average is only 30 percent
  • Length of stay dropped to 1.6 days, nearly 50 percent lower than the US average of 3.7 days. It is lower than Bon Secours’ average of two days.
  • There were 0 readmissions after 30 days, compared to the US average of 6 percent
  • Patient satisfaction was also high: (more…)

CVS puts a retail triple spin on telemedicine

September 1, 2015 | by

A definite boost to telemedicine providers American Well, now-publicly traded Teladoc and Doctor on Demand is retail drugstore CVS Health piloting their services through CVS MinuteClinics, starting in 2016. CVS’ release is disappointingly heavy on company quotations, light on specifics, but what can be determined is that CVS will test various arrangements, including onsite telemedicine in stores, through CVS ‘digital properties’ (presumably online or through apps) and MinuteClinic provider consults with telemedicine provider doctors. It carefully avoids referring to the three companies as ‘partnerships’ though it generically refers to them deep in the release. CVS currently has 1,000 MinuteClinic locations in 32 states and plan to grow by 50 percent by 2017; they have been testing telemedicine in about 50 clinics in Texas and California.

Annoyingly, both CVS and the three companies improperly use ‘telehealth’ in describing their services when correctly they provide only doctor-patient video consults, or telemedicine. The clinic providers (or individuals) may be reporting vital signs data as part of the visit, but tools are not integrated. Equally annoying is CVS, in the release and in conferences, citing a paywalled study (at the not inconsiderable sum of $39.95 / €34.95 / £29.95!) in the Journal of General Internal Medicine (JGIM) of their results. If you are touting that “95 percent of patients were highly satisfied with the quality of care they received, the ease with which telehealth technology was integrated into the visit, and the timeliness and convenience of their care.” –well, with results like that, make some arrangements and grant access to the study! CVS release, Medscape, FierceHealthIT

Telemedicine, telehealth underutilized in pediatric care

August 28, 2015 | by

In focusing on older adults on Medicare and secondarily the disabled, the use of telemedicine and telehealth is being overlooked for chronically ill children, especially those living at distance from specialized care. Children’s hospitals Many of these seriously ill children are either covered by parents’ employer plans or, if the family is low income, state Medicaid programs. This interview with Andrey Ostrovsky, MD, an attending physician at Children’s National Medical Center in Washington DC, notes the lack of incentive for innovative care which could utilize healthcare technology profitably. There is also a Medicaid waiver approval for telehealth reimbursement used for older person care, called the 1915(c) waiver for home-based and community services, which can be used for children. FierceHealthIT

Another Tunstall Americas distributor acquisition

August 26, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Another press release from Tunstall Healthcare Group is also about Tunstall Americas, in this case the acquisition of Syracuse NY (Central NY State)-based Health Care Monitoring Systems (HMS). This continues this year’s strategy of purchasing or partnering with local home care providers. Like Mountain Home and Kupuna Monitoring (previously in TTA), HMS’ website prominently features a competitor–Philips Lifeline. Notable in the spare release is that the HMS founder notes “strong relationships with referral partners and government agencies.”  Release

Unicorns to Series A–health tech funding gained in (perhaps) the nick of time

August 25, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/1107_unicorn_head_mask_inuse.jpg” thumb_width=”150″ /]Money, money everywhere–unicorns get the headlines, but the companies are still (largely) small

Up until early August, this Editor would have assumed that our Readers would look at this funding roundup as a bracing windup to a largely positive eight months and a veritable Corvette Summer for healthcare technology funding. We may have to give back the keys a little sooner than we imagined. Will the dropping market affect digital health as 2008-9 did–‘out of gas’ for years? Or will it barely affect our motoring onward? Despite the Dow Jones average hitting an 18 month low today, we hope it’s closer to the latter than the former. though the new and big entrant to digital health investing is the country most affected, China.

Our roundup of the August Action includes ZocDoc, Fitbit, Alphabet, PillPack, Owlet and more, along with a few comments:

**ZocDoc, a NYC-based online medical care appointment service that matches patients with doctors by location and schedule, had the most sensational round with last week’s Series D funding of $130 million, giving it a valuation of $1.8 bn. It took over a year after the filing (June 2014) and was led by two foreign funds (London-based Atomico and Edinburgh-based Baillie Gifford) with additional funding from Founders Fund, which previously participated in raises of $95 million.

Though it claims 60 percent coverage in the US  and ‘millions of users’ (numbers which have been quoted for some years), ZocDoc won’t disclose profitability nor volume–metrics that would be part of any IPO.

Direction? Points given for deciphering this windy statement (quoted from Mobihealthnews): (more…)

CAST-IAHSA Australia Technology Forum 31 August

August 18, 2015 | by

As part of the joint ACSA (Aged & Community Services Australia)-IAHSA (International Association of Homes and Services for the Ageing) conference 31 August-4 September in Perth, there will be a half-day session sponsored by LeadingAge CAST (Center for Aging Services Technologies) on 31 August. The conference will feature the tools which CAST has developed to help providers better understand, plan for, select and implement appropriate technologies to support self-management, independence and facilitate the delivery of services to the home. Featured speakers are from CAST–Majd Alwan–and from providers such as New York’s Selfhelp, The Salvation Army and It’s Never 2 Late. Session page. Conference information and booking.  Australian Ageing Agenda Technology Review

The NHS fail at encouraging digital health startups

August 18, 2015 | by

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

ATA Fall Forum updates

August 7, 2015 | by

If you are thinking about attending ATA’s Fall Forum sessions in Washington, DC this September, the early bird discount of $100 has a week to go–14 August is the last day. This year’s meeting also has, in addition to the conference, a National Telehealth Lobby Day (16 Sept) with short briefings on how to lobby, the key issues and a half-day to make those previously scheduled visits to your Senator or Representative. The updated schedule for the three-day conference is here.

Also for ATA 2016 in Minneapolis next 14-17 May, the call for presentations has just opened. See details here.

TTA is a media partner of ATA Fall Forum, and previously ATA 2014 and 2015.

Just one look to assess your health, emotional state (US, EU)

July 30, 2015 | by

Just one look, that’s all it took–Doris Payne, Gregory Carroll 1963 (covered by the Hollies, the Searchers, Linda Ronstadt…..)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/Wize-Mirror1.jpg” thumb_width=”150″ /]Healthcare professionals whether primary care/GP, psychiatrist or nurse, pride themselves on being able to make initial health assessments within seconds based on the patient’s physical appearance, manner and posture. It was only a matter of time before digital health aspired to ‘read’ the emotional or physical state remotely and deliver it as part of a virtual consult.

Boston-based emotional recognition software Affectiva has been around for awhile; it reads facial cues and claims it has the largest emotional data repository of over 2 million facial videos and 11 bn data points. It was developed for advertising research (backed by ad giant WPP) and now is moving into telemedicine. MedCityNews.

Compared to WizeMirror, that’s just surface. The mirror’s 3D scanners, multispectral cameras and gas sensors are able to look for stress or anxiety, over time look for weight gain or loss, evaluate skin tone, facial expressions, breath (for smoking and alcohol) plus monitor heart rate and hemoglobin levels. Originating at the National Research Council of Italy, it is being developed by a consortium from seven EU countries, SEMEOTICONS EU. Clinical trials will start next year at three sites in France and Italy. The mirror produces a score that tells the user how healthy they seem and personalized advice on improving health. New Scientist, MedCityNews, Daily Mail

However, standalone tech stands pretty much alone against a tide of partnerships. How they will integrate not only with telemedicine but also with telehealth, which could use this in mental health and pain management, isn’t addressed. 

(Graphic: Daily Mail)

‘Déjà vu all over again’ or critical mass? NYTimes looks at older adult care tech

July 28, 2015 | by | 4 Comments

“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…)

Can digital health solve China’s healthcare quality, distribution problems?

July 23, 2015 | by

Earlier this year [TTA 21 May] we noted China’s interest, governmental moves and private investments in digital health as part of ‘Internet Plus’: Tencent Holdings and Fosun International led the $35 million Series B round for ‘healthcare tricorder’ Scanadu; ZTE Health; Alibaba‘s investment in data cruncher CITIC 21CN. Now McKinsey partner Florian Then analyzed for Yahoo! Finance the promise of telemedicine and telehealth in that country, and the great problems they must solve. The huge disparity of care between urban and rural hospitals drives patients to the former, regardless of long distances and inconvenience. In population health, the unhealthy habits of much of China’s population make US/UK/EU concerns look unimportant: one of every three of the world’s smokers and 300 million hypertensives live in China.

A possible telemedicine-driven solution would be for urban hospitals to support via doctor consults and email rural hospitals to get patients into the medical system locally and earlier. Education would be delivered online, probably through those 847 million mobile phones on which 83 percent of Chinese Internet users access the web (market intelligence firm IDC). China also appears to be liberalizing (more…)

Digital health startups filling the gaps in Health Canada

July 22, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/RCAF_roundel_WWII.jpg” thumb_width=”125″ /]Canada’s health system is nominally nationalized, but in a way that leaves large gaps in coverage–for long term, in home, specialty care and prescriptions–as well as variable by province. According to this article in HIT Consultant, VC funding is also thin on the ground, which leads to a short-term outlook. Local governments are stepping into the gap with innovation funding (similar to the Partnership for NYC) and the national government has eased restrictions on foreign investment. EHRs haven’t been a priority (skipping the troubles experienced in the US) which leaves digital health–telehealth, telemedicine and diagnostic apps–to enjoy the available talent and funding. This Editor doubts that any of the 20 profiled here will be familiar names other than possibly InterAxon which we noted at last year’s NYeC Digital Health Conference, and many tread the familiar ground of genomics, social sharing of medical images, and gamification for behavior change, but there are three unique companies in the neurological area in nerve stimulation (MyndTec), nerve disorder diagnostics imaging (NerveVision) and pharma (Oxalys.) We salute the Royal Canadian Air Force with their WW2 roundel on the anniversary of the Allied invasion of Sicily, July – August 1943

HealthSpot, Rite Aid open 25 locations in Ohio

July 21, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/Healthspot-station.jpg” thumb_width=”150″ /]Telehealth/telemedicine kiosk HealthSpot and retail drug chain giant Rite Aid, which announced their partnership last November [TTA 11 Nov], have now set up shop in 25 locations in three Ohio areas–Akron/Canton, Cleveland and Dayton/Springfield. Since late May, the staffed stations have treated over 5,000 customers ages 3 and above for minor and common health conditions, including cold and flu, rashes and skin conditions, eye conditions, earaches and seasonal allergies. The kiosks combine video consults with hands-on assistance in vital signs measurement from a wellness attendant, and their recording software interfaces with insurance eligibility, electronic medical records and billing systems. The network of medical professionals on the telemedicine consults are from Cleveland Clinic, Kettering Health Network and University Hospitals, with pediatric specialists from UH Rainbow Babies & Children’s Hospital. According to HealthSpot’s CEO Steve Cashman, a significant portion of early visitors are Medicaid recipients, who through a $60 station visit may be avoiding a far more expensive (~$600) ER visit. For the early stage HealthSpot it’s a major rollout, but for Rite Aid, which is not known for being as cutting edge in location design as CVS or Walgreens, it represents a significant move forward into onsite wellness services. Cleveland.com, Drug Store News. Rite Aid/HealthSpot demo video. Business Wire release.

LeadingAge CAST updates its telehealth selection portfolio (US)

July 17, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/LeadingAge_Square_Logo_Large.jpg” thumb_width=”100″ /]LeadingAge, the association of over 6,000 non-profit providers of aging services (the US chapter of IAHSA), this week issued an updated version of its telehealth selection portfolio, adding six new products to the online selection tool and product matrix, in addition to a new interactive guide (requires log in). Developed by their Center for Aging Services Technologies (CAST), the selection tool and product matrix exhaustively compare 28 different products from 23 vendors across 220 different functionalities. An indispensable help for those involved in the selection and purchasing of telehealth for senior housing, post-discharge/rehabilitation and home health. LeadingAge release. Hat tip to Scott Code of CAST.

Blueprint Health’s 8 for Class 8

July 17, 2015 | by

Blueprint Health announced its Summer 2015 class of 8 on Thursday. The NYC-based accelerator, since its early startup days in 2011, now focuses on companies further along in the development continuum. Telehealth companies would find Oculus Health most interesting as Medicare chronic care management and telehealth reimbursement present opportunities for remote patient monitoring expansion.

Bind (Bind-Health.com) Helps prospective parents to make informed decisions about genomic testing and provides genetic counseling services
Crediyo (Crediyo.com) Decreases patient payment write-offs and improves cash flow for medical practices with turn-key patient lending products
Ekovia (Ekovia.com) Helps hospital hire top talent with the most robust database healthcare professionals and algorithms to predict who is open to new job opportunities
GetCompliant (HIPAAWithUs.com) Provides a full service platform for HIPAA compliance for physician practices (more…)