After repeatedly failing to pass a law to formalise payments for telehealth, Florida State [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/Florida-House-of-Representattives.jpg” thumb_width=”150″ /]legislature is to try again this year, according to Florida state senator Aaron Bean. Moderating the Telemedicine and Telehealth session at the Florida Health Care Affordability Summit on Monday, 8 February, Sen. Bean has suggested that the latest bill, highly focused on telehealth, will be only 3 pages long. Attempts to legislate in in the previous session of the Florida House of Representatives resulted in failed bills in both chambers due to the inclusion of many controversial items.
FDA final guidance on mHealth eases regulation of MDDS, mHealth (updated)
As anticipated, FDA issued final non-binding recommendations for guidance yesterday (Monday) that ease regulatory oversight of medical device data systems (MDDS), including image storage and communication devices, and mHealth devices.
In the MDDS guidance document, “(FDA) does not intend to enforce compliance with the regulatory controls that apply to MDDS, medical image storage devices, and medical image communications devices, due to the low risk they pose to patients and the importance they play in advancing digital health.” It defined MDDS as “a device that is intended to provide one or more of the following uses, without controlling or altering the functions or parameters of any connected medical devices: (i) The electronic transfer of medical device data; (ii) The electronic storage of medical device data; (iii) The electronic conversion of medical device data from one format to another format in accordance with a preset specification; or (iv) The electronic display of medical device data.” along with their hardware and software. It specifically excludes devices that are used in active patient monitoring.
Mobile health apps were covered in a separate and highly detailed guidance document, “Mobile Medical Applications”.
- FDA will regulate only “those mobile apps that are medical devices and whose functionality could pose a risk to a patient’s safety if the mobile app were to not function as intended.” (more…)
State of telehealth in Australia – a GP’s view
As we have noted in the past, Australia has provided incentives for GPs to implement videoconference telehealth [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/AFP2.jpg” thumb_width=”150″ /]consultations in remote rural areas. Simple though it may be from a conceptual point of view, providing the ability for people in isolated communities to have access to specialists can make an enormous difference to the healthcare they receive.
Dr Ewen McPhee, a GP from rural Queensland, writing in the Australian Family Physician’s December issue (“Telehealth: the general practice perspective”) briefly looks at the state of videoconference telehealth in Australia 3 years after the current incentives were implemented. “Three years later, the implementation of telehealth videoconferencing has been inconsistent and patchy, yet to be normalised as part of primary care practice” says McPhee.
Living in cities like London or New York it can sometimes be hard to imagine (more…)
Blueprint Health’s latest class tackles nosocomial infections, transitional care
The New York-based Blueprint Health accelerator announced this week its Winter 2015 class of seven: GlucoIQ, GroupHub, HealthyBytes, Limestone Labs, Moving Analytics, Signifikance and TapGenes. Most have a genetic analytics or payer emphasis. Of special interest to our readers are:
- The home-based cardiac rehabilitation system of Moving Analytics, which uses a smartphone app, Movn, to guide patients through their care plan, joined with active patient management engaging them with nurses who call weekly to review progress.
- Toronto-based Limestone Labs‘ UV-C sanitization system for portable devices (the ubiquitous tablets and smartphones) which aren’t being cleaned effectively with wipes, and are becoming a new vector for hospital-based infections. They claim 99.99 percent kill rates with treatment of only 30 seconds. It started piloting last month in healthcare settings.
- Healthy Bytes’ food management app, engaging patients with dieticians to monitor food intake with photos, time and other comments plus coaching.
The public demo day for this class will be 24 April. Blueprint Health is now taking applications for their summer class to be launched on 13 July. MedCityNews
News highlights for Friday
AnthemHealth didn’t encrypt, Blueprint Health collects, HealthSpot funds again, Sense4Baby goes to Europe, Apple Health pilots in hospitals and buddi gets bigger still.
Another hack attack claimed major US health insurer AnthemHealth, the former WellPoint. It’s estimated that 80 million of its customers, former customers and employees had data breached: names, addresses, dates of birth, emails, employment information, income, medical IDs and SSIs. The Wall Street Journal reports that Anthem didn’t encrypt data for analytics reasons. It’s unconfirmed where the hackers originated but Bloomberg’s latest report tags the usual Chinese state-sponsored suspects. Unusually, it was reported within days of discovery; Anthem has called in Mandiant (FireEye) to beef up its cybersecurity. Other reports: WSJ, Modern Healthcare….The Blueprint Health accelerator has a new initiative, the Collective. It is designed to pair up major healthcare providers and payers with startups and early stage companies. So far signed up are Aetna, AstraZeneca, HP, Montefiore, North Shore LIJ, New York-Presbyterian, Samsung, EmblemHealth, Philips and Razorfish Healthware. More information here….The HealthSpot Station telehealth/telemedicine kiosk is readying a $11.6 million funding round from four investors soon, based on (more…)
TMD–too much data–going nowhere
Here is a tech-savvy person lamenting (ranting?) in Venture Beat that there’s no one place to put all of his health data that he needs–weight, PHR (personal health record), his spin class and aerobic training data. AppleHealth/Apple HealthKit? Only the weight via a Withings scale maps to it, and you have to scroll past oodles of data categories, such as your molybdenum levels, to get to more vital things like weight and heart rate. FitBit lasted three months in his life before being tossed in a drawer. What took center stage at International CES were more devices dumping more data that doesn’t map into a central database. He acidly notes that Apple HealthKit is free because it is is worthless. Is there something broken here that we in telehealth need to deal with, quickly? My health data is killing me (figuratively) Hat tip to Tom Greene posting in The King’s Fund LinkedIn group Digital Health and Care Congress, this year 16-17 June. A reminder–call for papers closes 13 Feb!
Is how we are treating patients for chronic diseases (and pre-diseases) all wrong?
A look again at minimally disruptive healthcare. In June 2013 we wrote about a contrarian approach to treating chronic disease–and now the ‘pre-diseases’ which have been discovered, like Columbus with America, with all good and proactive intentions for the patient. There’s increasing pressure, and rigidity in applying, guidelines and quality standards which are both performance and financially based. Measure, measure, measure!! Prescribe, prescribe, prescribe!! Is your patient at goal? Yet we are losing the Battle of Real Results and improved health. Telehealth and telemedicine are being touted as ways to increase compliance, but do they complicate matters and add to–not reduce–the burden?
We return to the originator of this minimally disruptive approach to care, Victor Montori MD, an endocrinologist at Mayo Clinic, via a MedCityNews article by cardiologist John Mandrola MD and this video from a primary care conference, the NAPCRG annual meeting in New York. (At 45 minutes, you’ll want to save it for later).
Key points:
Dr Topol’s prescription for The Future of Medicine, analyzed
The Future of Medicine Is in Your Smartphone sounds like a preface to his latest book, ‘The Patient Will See You Now’, but it is quite consistent with Dr Topol’s talks of late [TTA 5 Dec]. The article is at once optimistic–yes, we love the picture–yet somewhat unreal. When we walk around and kick the tires…
First, it flies in the face of the increasing control of healthcare providers by government as to outcomes and the shift for good or ill to ‘outcomes-based medicine’. Second, ‘doctorless patients’ may need fewer services, not more, and why should these individuals, who represent the high-info elite at least initially, be penalized by having to pay the extremely high premiums dictated by government-approved health insurance (in the US, ACA-compliant insurance a/k/a Obamacare)–or face the US tax penalties for not enrolling in same? Third, those liberating mass market smartwatches and fitness trackers aren’t clinical quality yet–fine directionally, but real clinical diagnosis (more…)
An interesting COPD telehealth pilot, mangled in the reporting
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/10/blue-blazes.jpg” thumb_width=”150″ /]Our first ‘Blue Blazes’ of 2015 is the kind of press coverage that makes a PR pro or marketing director cringe.
Intel-GE Care Innovations along with OSF (Order of St. Francis) HealthCare and the University Of Illinois College Of Medicine at Peoria, the latter which have an interestingly named collaborative called Jump Trading Simulation and Education Center, are using the home telecare activity tracker Lively in a COPD patient tracking pilot. Reading the two articles found to date, one can eventually glean that vital signs like weight, blood pressure, O2 levels, lung capacity and qualitative feedback questions, as well as activity, is being tracked. The combination of activity + vital signs is interesting and different, but it takes detective work–viewing the video on the CIProud.com website (which charmingly turns sensors into senors in the headline)–to discover that the activity tracker is Lively, a CI partner. Lively does not report vital signs. How they are being collected remains a mystery as the Peoria Public Radio website article doesn’t furnish details other than a picture with an unidentified desktop hub/display (Health Harmony? It doesn’t look like it). Lack of detail + abundance of typos = bad reportage. In any case, the pilot of 30 patients continues into March, when it will be expanded to 200. Related: OSF/Care Innovations announcement from June 2014.
Looking back over Telehealth & Telecare Aware’s predictions for 2014, part II
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/01/magic-8-ball.jpg” thumb_width=”150″ /]Editor Charles has treated you to a look back on his 2014 predictions, daring Editor Donna to look back on hers. Were they ‘Decidedly so’, ‘Yes’, ‘Reply hazy, try again’ or ‘My sources say no’? Read on…
On New Year’s Day 2014, it looked like “the year of reckoning for the ‘better mousetraps’”? But the reckoning wasn’t quite as dramatic as this Editor thought.
We are whipping past the 2012-13 Peak of Inflated Expectations in health tech, diving into the Trough of Disillusionment in 2014.
There surely were companies which turned up ‘Insolvent with a great idea’ in Joe Hage’s (LinkedIn’s huge Medical Devices Group) terms, but it was more a year of Big Ideas Going Sideways than Crash and Burns.
Some formerly Great Ideas may have a future, just not the one originally envisioned. (more…)
Tunstall’s challenging year: results reported
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Breaking News. The topline of Tunstall Healthcare Group’s 2014 results (through 30 Sept 14) is now (partly) public thanks to the Yorkshire Post, Tunstall’s ‘hometown paper’. (We do note that it was published on 23 Dec, in the ‘dead of night’ rolling up to the Christmas holiday.) Notably, there is no report on the Tunstall website and it is too early to show on standard corporate reporting sites such as DueDil and CompanyCheck. The YP article appears to be written partly in press release-speak, which we do not fault them for on limited news available. In summary:
- In the 2014 FY ended 30 September, revenues were £215 million. FY2013 was £221 million, a decrease of £6 million (2.7 percent).
- A corresponding but greater EBITDA (earnings before interest taxation depreciation and amortization) drop to £43.0 million. FY 2013 was £52.7 million, a decrease of £9.7 million (18.4 percent).
- The good news: revenues up 6.8 percent in the Nordics, Southern Europe, Central Europe, and Australasia; Spain’s Televida as a market leader also a bright spot [TTA 19 Dec].
- No such good news in UK and the US (more…)
Qualcomm (Second) Life: a conversation with Jim Mault
One of the surprises for this Editor, and for others attending the mHealth Summit, was to see the sizable presence of Qualcomm Life on both the exposition floor and during the sessions. From a near-nil presence at ATA 2014 and gone dark on news, the floodlights snapped on last week with new partners and a new emphasis: coordination of chronic and transitional (hospital to home) care management (CCM/TCM).
On the show floor, the spotlight was on the partner companies which mixed the established with (mostly) the early and mid-stage. Readers will recognize names such as AliveCor, Telcare, OMRON, Nonin and Airstrip; not so well known are Vaica, Orion Health, Monitored Therapeutics, IMPak Health, Vital Connect, Care Connectors, toSense (CoVa), Dexcom, InteliChart, TruClinic, ForaCare, VOXX, vitaphone (outside of Europe), Propeller Health and Noom Health (a NYeC Digital Health Accelerator 2014 graduate). The partners occupy different parts of the management continuum, integrating communications, record sharing, population health management, sensor-based monitoring, traditional and non-traditional vital signs monitoring, medication management, behavioral change methodologies and PHRs. The 2net Hub is still present for data transmission, sharing and storage, but more prominent is Qualcomm Life’s HealthyCircles platform which provides the clinical management ‘glue’: secure communications, record sharing and care team coordination. HealthyCircles was purchased in mid-2013. Founder James Mault, MD, FACS joined Qualcomm Life as VP/Chief Medical Officer.
We had some post-mHealth Summit reflection time by telephone this Wednesday while Dr Mault was in Boston. (more…)
Breaking news out of the mHealth Summit
mHealth Summit this year had an abundance of digital health company news announcements, not only from the conference but also timed to coincide with the heightened interest around it. Your Editor looks over the most interesting of them, briefly. Thanks to Ashley Gold of Politico’s Morning eHealth (@ashleygold, daily reports archived here), Stephanie Baum of MedCityNews (@stephlbaum) and Anne Zieger of Healthcare Dive for their coverage and their company in the press room!
Partners HealthCare researches, Validic expands, AliveCor and Omron ally, Happtique sells out, Doctor on Demand is telemental, Orange goes dental, VA Innovation Rocks
- Partners HealthCare/Center for Connected Health’s cHealth Compass will use panel and other research to help companies, device manufacturers, startups and investors determine what end users–consumer and provider–want out of personal health tech. Focus groups, interviews and usability testing will help to determine product design, evaluation, assess applications and feasibility as well as interim/final product testing. Partners is already organizing in Massachusetts a 2,000-patient database which rewards participants $50 on registration and $110 annually to be in a monthly survey panel. cHealth Compass website, BetaBoston (Boston Globe)
- Health data connector/aggregator Validic demonstrates the attractiveness of Anything Big Data on with new clients including the Everyday Health consumer/professional website and the adidas Group’s sport and fitness apps. Recently they added WebMD, Pfizer, University of Pittsburgh Medical Center (UPMC), NexJ Health and MedHost to their client list. The company claims that their ‘ecosystem’–probably the most popular buzzword at this year’s conference–of healthcare companies and tech developers now reaches over 100 million people with devices such as Omron, Alere, Qardio, Telcare, Jawbone and Withings. Release
- AliveCor accentuates the retail with Omron. AliveCor, which developed the first FDA-cleared ECG for smartphones and gained clearance for an atrial fibrillation algorithm in August, is collaborating with Japanese device manufacturer Omron on developing its retail presence. Omron’s devices are available in major drugstores such as Walgreens, RiteAid and Walmart so certainly AliveCor is due to benefit. AliveCor is also part of a revived QualcommLife (more on this in an upcoming article) Release, Mobihealthnews (Your Editor had the pleasure of meeting at last AliveCor’s CMO and founder Dr. Dave Albert.)
- Happtique sold to SocialWellth. Last year’s floor talk was about Happtique’s first class of certified apps and a security expert’s untimely discovery of major flaws (more…)
Care Innovations harmonizes and validates
Updated 27 November
In what seems to be a repackaging and repositioning of their remote care management/telehealth services, Intel-GE Care Innovations is now orchestrating Health Harmony. It appears on their promotional web page to be a bundling into that latest rave, the care continuum, but also a refreshing of separate systems developed since 2011: for the patient, an in-home tablet hub/portal for monitors and PC-based content portal once known as Connect; and for the clinician or caregiver, what was formerly called the Intel-GE Care Innovations Guide (which succeeded the Intel Health Guide). According to the CI website and press release from earlier this month, Health Harmony is an ‘optimized experience” that promotes collaboration among the patient, family, friends and care professionals and will “organize caregiving tasks, coordinate schedules, track medications, monitor vital signs and crucial health information, and quickly share information.” The release gives the impression of a launch but no information on cutting over current clients to the new system.
Update: A test of the Health Harmony system in a hospital environment to reduce readmissions is underway with liver transplant patients at the University of Cincinnati Medical Center. The shocking fact is that 50 percent of transplant readmissions occur within seven days of discharge. Instead of being discharged with a booklet and an exam one week later, the patients daily self-monitor vital signs (blood pressure, glucose, temperature), pain level and answer programmed questions. The clinical team reviews their data for 90 days post-discharge and can also do video consults. Currently eight patients are being monitored in the program with up to 20 projected through April 2015. Liver transplant bundled payments are approximately $250,000 with surgery being $180,000 of it, so there is an immediate benefit to the hospital system.
Another interesting development in Roseville, California is the expansion of the CI Validation Institute, announced in June, (more…)
Tunstall adopts new Tactio in patient management
Tunstall Healthcare is partnering with Canadian mHealth developer Tactio Health Group in what is a distinct first for them: creating a mobile care management system that is 1) smartphone-based for the patient and 2) prominently integrates non-Tunstall apps and devices. The patient uses the smartphone and the Tactio-developed mTrax app to collect a wide spectrum of data–everything from activity, sleep, pregnancy, body fat and mood tracking to the traditional constellation of vital signs. This uploads to the care provider’s tablet mPro Clinical App which overviews, details and reports the data for each patient and patient groups in care. The data comes from well-known mHealth apps outside the Tunstall world: BodyMedia, Fitbit, Fitbug, Garmin, Jawbone UP, Medisana and Wahoo Fitness, as well as connected (presumably Bluetooth) medical devices from A&D Medical, Mio, iHealth, Telcare, Withings and Nonin. Tunstall has also added two-way patient coaching and health journal features.
Tunstall’s positioning for what they call Active Health Management or AHM is “supported self-management” and “shift(ing) from reactive care to cost-effective active care.” (more…)
Telehealth kiosk HealthSpot gains trials with Rite Aid, Mayo Clinic
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Healthspot-stationbooth.jpg” thumb_width=”150″ /] HealthSpot Station, which was one of the higher points of this past May’s ATA, in the past month has announced two significant pilots. The retail pilot is with Rite Aid, the US’ third largest drug store chain (4,600 stores), with telehealth/telemedicine kiosks located in select Rite Aid locations in Ohio–Akron/Canton, Cleveland and Dayton/Springfield areas. The usage of the kiosks will be limited to common health conditions, such as cold, earaches, sore throat, sinus infections, upper respiratory infections, rashes, skin and eye conditions. HealthSpot Station kiosks are enclosed, free-standing units which use both video consults and real-time interaction with telehealth devices for remote diagnosis. They connect to a network of board-certified medical professionals at Cleveland Clinic and other major health systems across Ohio. Start date and duration were not disclosed.
This follows the October announcement with Mayo Clinic of an in-house pilot in Austin and Albert Lea, Minnesota with approximately 2,000 Mayo Clinic Health System employees (more…)
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