In contrast to last week’s deletion of telemedicine by the House Energy and Commerce committee from ’21st Century Cures’, this past Tuesday’s Senate Commerce subcommittee on Communications hearing was far more cheering for both telehealth and telemedicine advocates. More than twelve Senators spoke on behalf of telehealth expansion, especially Medicare reimbursement for telehealth in rural areas where there is limited care access. Holding this expansion back, according to iHealthBeat, are four factors: the limited cross-state licensing for physicians; the sluggishness of the Federal Communications Commission–despite initiatives such as Connect2HealthFCC [TTA 6 Mar 14], the FCC has blocked subsidies for nursing home broadband; reimbursement and limited broadband access in the same rural areas (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 announces award winners, Strategic Summit companies
ATA announced the six winners of their Annual Awards recognizing innovators in telemedicine and telehealth for significant contributions, along with six new members of the ATA College of Fellows. One of the more intriguing winners (Innovation in Remote Care) is the US/UK company Sentrian which has built intelligent predictive data models (‘Remote Patient Intelligence’) that can monitor disease and co-morbidity in thousands of patients with the goal of preventing hospitalization and readmissions. Release. ATA has also selected 30 emerging companies to participate in the Telemedicine Investor and Strategic Summit (more…)
Women and eHealth on the international scale: JISfTeH explores
JISfTeH–the Journal of the International Society for Telemedicine and eHealth–published by the University of KwaZulu-Natal in South Africa, has an intriguing issue this quarter that focuses on the international role of women and eHealth, not only as recipients but also as developers, designers and integrators of what they term Information and Communication Technologies (ICTs). Encouraging a greater role for women in what we more commonly call HIT is the subject of various UN, academic and rural efforts. The articles here are about programs designed by, implemented and largely for women: the ‘Zero Mothers Die’ global initiative using mHealth to reduce infant and maternal mortality, using video games in structured exercise to prevent depression and anxiety among new mothers in the rural Philippines, telehealth in the monitoring of gestational diabetes (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.
CHF readmissions cut 53 percent with telehealth tablet
Favorable news for the growing area of tablet-based telehealth. A six-month trial of an tablet-based telehealth system for congestive heart failure (CHF) with patients at Philadelphia-area Penn Medicine’s (University of Pennsylvania) post-discharge program reduced readmissions from an already low 8 percent to 3.8 percent, a 53 percent positive change, versus the national average of 19.5 percent. The provided 4G tablet+app program through Health Recovery Systems is used by the patient for an average 85 days. He or she sends vital signs, symptoms, medication information (including side effects) to a nurse care coordinator; the app on the tablet provides coaching via patient education, instructional videos and individualized self-care plans coordinated with the telehealth nurse on the program. (more…)
‘Separating the wheat from the chaff’ in medical apps daunting: JAMA
Medical apps may not be strangers to doctors’ offices anymore but they also realize that apps are difficult to recommend responsibly to patients or even to find, because there is no real guidance or validation. This current article in JAMA online confirms the perception and the need for care integration that both Editors Charles especially and Donna have pointed out lo these many years. However this Editor is quite disillusioned at the attempts to date to ‘curate’ apps with the Happtique failure and the relatively low profile to date of IMS Health’s AppScript and professional review site iMedical Apps and the stated intentions of SocialWellth which purchased Happtique. The reality is that the numbers are against it–IMS Health in their study estimated 40,000 medical apps–in 2013. For apps that want to take the high road, it’s economically difficult, but could be rewarding in the long term. The WellDoc BlueStar diabetes tracking and management support app did with FDA clearance and prescription-only use, but few so far can see a revenue model there. Also MedCityNews.
Intended use determines degree of health app regulation–and also how you communicate your attributes and performance claims. Bradley Merrill Thompson, who performs an invaluable service by advising our field on regulation, compliance and interacting with FDA, demonstrates how a developer can determine where the intended use of an app might fall (more…)
Tunstall to demo mHealth Down Under at Connect Expo
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Breaking from our HIMSS coverage, Australia takes its turn in technology mega-events with the Connect Expo next week, 21-22 April, in Melbourne. It features one expo and 11 conferences, including the Future Health Summit covering telehealth, big data, analytics, wearables and robotics. Featured are speakers Tim Kelsey from NHS England and Dr George Margelis. Reports indicate that sponsor Tunstall will be debuting its mymobile telehealth app, which ties into their Integrated Care Platform, and the myCareTrack app, a mobile safety solution meant for lone workers, including health professionals on in-home patient care visits. The Tunstall website in its release also has presentation times. Pulse+IT (Australasia) (Returning to the US, we note that Tunstall was absent from HIMSS, and will also be from ATA2015 where they have been a major sponsor in the past. And we wonder how things are developing with mHealth platform designer Tactio.) Hat tip to Guy Dewsbury via Twitter
HIMSS Monday highlights
HIMSS is the largest US healthcare conference in the world, and Neil Versel, who has just joined the staff of MedCityNews, reported that registrations in this year’s event in Chicago were in excess of 40,000. He has a 37 minute interview with HIMSS Executive Vice President Carla Smith where they touch on CMS, Meaningful Use, EHR interoperability, data security, patient engagement and the empowered patient such as E-Patient Dave deBronkart (who will also be at The King’s Fund Digital Health conference in June). HIMSS is also showcasing on the show floor mobile health, interoperability, cybersecurity, disaster preparedness, intelligent health and the connected patient….Another sign that the Wild West days of digital health are over is the increasing oversight of the Federal Trade Commission (FTC) on non-HIPAA regulated health data collected by fitness and wellness devices. This is in addition to health apps making unsupported claims (see today’s and previous articles on melanoma detection apps) and the PaymentsMD patient billing software that was collecting a little extra patient data. This is both extra- and in addition to FDA. Mobihealthnews….. The Venture+Forum on Sunday discussed doctor burnout particularly in acute care and to ease this, focusing on the Holy Grail of proactive rather than reactive care and results rather than ‘shiny new objects’ (what this Editor has called Whiz-Bang Tech) “Doctors want clinical decision execution. Don’t give me any more tools.” Healthcare IT News….A survey by Accenture released today on doctors and EHR usage headlines good news–79 percent US doctors feel more proficient in their EHR usage than in their 2012 survey. The bad news is that other numbers are plummeting: fewer believe that EMR has improved treatment decisions (46 percent in 2015 vs. 62 percent in 2012), reduced medical errors (64 vs. 72 percent) and improved health outcomes for patients (46 vs. 58 percent). Familiarity breeds contempt? Buried way down in the release is that US physicians offering telehealth monitoring to patients has tripled since the last survey, from just 8 percent in 2012 to 24 percent now. Accenture surveyed over 2,600 physicians in six countries….HIMSS goes to Thursday, so more to come!
Capita announces partnership with Medibank Australia
Capita Healthcare Decisions is forming a partnership with Medibank, an Australian [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/Capita-logo.jpg” thumb_width=”150″ /]insurance and healthcare company, according to a press release issued by Capita. One of the areas highlighted in the announcement is that Capita will provide its TeleGuide product which [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/Medibank.jpg” thumb_width=”150″ /]Medibank has customised to the Australian market.
Capita, with 68,000 staff, is a UK company providing process management and professional support services in the UK, Europe, South Africa and India and has a checkered history with UK Government health service contracts.
In Nov 2008 Capita won the contract to run UK’s NHS Choices website which provides information on medical conditions, treatments and services to UK patients on behalf of the UK Department of Health. The Cabinet Office then refused to renew the £60m 3-year NHS Choices contract with Capita in 2013. (more…)
30 ways mHealth is impacting healthcare–and EHRs need to be
If EHRs were perfect, there wouldn’t be so many companies developing communication workarounds. And why does a HIT consultant play Blame The Doctor?
Practice Unite, an early-stage company fresh out of Newark (cross the Hudson, head south) that knits together patient and clinician communications in highly customized app platforms for healthcare organizations [TTA 11 Mar], has put together a thought-provoking and fully attributed list of 30 ways mHealth is impacting healthcare: the value for patients and clinicians, the need for mHealth apps as part of collaborative care platforms and communication, plus the investment trail towards digital health. Hat tip to @PracticeUnite via Twitter.
One notable point is the difficulty current systems have in integrating data and the increased administrative load (+10 percent more) physicians experience with EHRs versus paper patient records. Confirming this are two items in Thursday’s POLITICO Morning eHealth: one, the privately-driven workaround for universal health data interoperability that the CommonWell Health Alliance is seeking as a non-profit trade alliance. and two, what happened when the GE Centricity EHR used by MedStar Health group’s DC and Baltimore-area outpatient clinics crashed after a weekend upgrade and stayed down through Tuesday night. Weekend data was lost. One doctor’s reaction:
“They kept saying it would be back up in an hour, but when I left work Tuesday night it was still down.” This doctor told us that the outage was “disruptive and liberating at the same time. I wrote prescriptions on a pad for two days instead of clicking 13 times to send an e-script. And I got to talk to my patients much more than I usually do. But of course we didn’t have access to any notes or medication history, and that was problematic.”
Now this observation is neither petty nor isolated. Last Fall we noted a JAMA study of internal medicine physicians finding that for both experienced physicians and trainees, there was a loss of time across the board in taking notes, reviewing patient data and at least one data management function was s-l-o-w-e-r. [TTA 12 Sept 14] Houston, we have a problem.
Yet there are still the ‘nothing to see here, move along’ types sailing down A River in Egypt. Others blame the victims, as in the doctors, for their cloddish unwillingness to Get With The HIT Program. (more…)
NY Digital Health Accelerator 2015: call for applications
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/New_York_Digital_Health_Accelerator_534424_i0.jpg” thumb_width=”150″ /]Deadline: 18 May. The third annual call for applications for the New York Digital Health Accelerator is now open. NYDHA, a joint program run by the New York eHealth Collaborative (NYeC) and the Partnership Fund for New York City, is a five-month program for ten early- and growth-stage digital health companies in New York (or willing to locate in NY state). What makes the program distinctive in their view, in addition to being in NY, is that it offers unique exposure to top-level healthcare executives and venture capitalists while accelerating product development and access to capital. Certainly its 20+ partners come from the top level of NY healthcare companies and providers, such as Aetna, North Shore-LIJ Health System, Winthrop University Hospital, Rochester General, VNSNY, Mount Sinai and many others. 15 companies in the prior two years of the program have done extremely well, raising a total of nearly $41 million in additional capital post-program, securing 33 pilots and creating more than 120 jobs. Two were acquired: Avado and Remedy Systems. New for 2015: to encourage collaborative innovation, two companies can jointly apply to present a combined solution. NYDHA website, press release, FAQs on applying.
ELabNYC Pitch Day 2015
Thursday 3 April, Microsoft’s NY Technology Center, Times Square NYC
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/Elab.png” thumb_width=”100″ /]The third annual Pitch Day for the now 20 startup/early-stage life science, biotech and healthcare technology companies in the ELabNYC (Entrepreneurship Lab Bio and Health Tech NYC) is a culmination of their year-long program participation in this NY Economic Development Corporation (NYCEDC)-supported program. The entrepreneurs in the ELabNYC program primarily come from from the doctoral and post-doc programs from New York’s many universities, from CUNY to Columbia, from many parts of the world, and most have experience within the city’s multitude of major health research institutions from The Bronx to Brooklyn. New York is also a center of funding for life science and health tech ventures; it’s #2 with NIH awards totaling $1.4 billion. For the past few years, NYEDC has also supported these companies with finding access to capital, specialized space (e.g. wet labs such as the million square feet at Alexandria Center alone, plus Harlem Biospace and SUNY Downstate in Brooklyn) and partnerships with major companies such as Celgene, Eli Lilly, Pfizer and GE Ventures.This Editor will concentrate on health tech companies–eight, up from five last year [TTA 17 Apr 14]. Each company pitched for five minutes on its concept, its current state of advancement (including pilots/customers), its team and a funding timeline. It was a very different mix from last year’s class, which focused on compliance, diagnosis, dementia and concussion. These companies focused on niches which are either not being served well or to substantially reduce costs. Nearly half the entrepreneurs were women, a substantially greater number than one usually sees in the biotech/health tech area. Short impressions on our eight, with links to their Executive Summaries on the 2014-15 ‘class page’: (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″ /]
Regulatory action may strengthen telehealth take-off: PWC
PWC Health Research Institute has released a Spotlight Brief on the US telehealth (read telemedicine for telehealth) regulation which states that recent regulatory action may be the catalyst to spur the fledgeling telehealth market.
Expansions in Medicare reimbursements, Government telehealth grants amounting to several million dollars and legislative action in many States are all seen as supporting new entrants as well as traditional players and growing the US telehealth market that PWC says is estimated as high as $10 billion.
Benefit to consumers is of course lower costs and easier access. Challenges mentioned are licensing, reimbursement, privacy and security. Read the full report here.
Telstra expands telemedicine offering with acquisition
Following our report earlier in the month on Telstra’s success in winning the Western Australia telehealth [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/Telstra-Health.jpg” thumb_width=”150″ /]contract, Telstra announced the acquisition of UK based Dr Foster last week. Telstra has now announced that they are acquiring Medibank’s Anywhere Healthcare platform, further expanding its Telstra Health arm.
Since 2013 Telstra has had exclusive access to Dr Foster in Australia and supplies Dr Foster products to several health services in Australia.
Anywhere Healthcare is a middleman platform with specialists signed up to provide remote consultations and GPs signed up to use the services of those specialists. When a face-to-face consultation is considered not appropriate the GP can arrange for a remote consultation via Anywhere Healthcare. Typically, this has been used to date for patients in nursing homes.
The current Anywhere Healthcare directory lists 30 specialists covering 17 specialties and it is reported that there are 1600 GPs signed up to the service. Telstra have stated that they expect to expand the service, particularly into rural patient consultations.
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