The King’s Fund videos, presentations online

The King’s Fund has posted video highlights from last month’s International Digital Health and Care Congress. Talks include those from futurist Ray Hammond, Kathleen Hammond (US Department of Veterans Affairs), Dr Ali Parsa (Babylon), Paul Rice (NHS England) and Sian Jones (NHS Bristol). Click on the tabs at top for presentation decks and posters. TTA was a media partner of the Congress. Hat tip to Mike Clark via Twitter (@clarkmike).

Data mining health records: the good, bad and ugly

Take your time this weekend and read this article from the Washington Post on the ‘brave new world’ of data mining health records. While those with experience analyzing real-world health data snicker at Larry Page of Google’s inflated claims of ‘saving 10,000 lives in the first year’ if only he could get his hands on that identified data (of course, then there’s the opportunity to make $£€¥, which is what Larry and Sergey are really interested in–count your Editor as a cynic!), the Health Data Analytics Express rolls on. The promise lies in more precision in treatment areas such as brain tumor radiology where sizing is critical (BraTumIA) and individualized genomics for disease. Yet the author does not touch on healthcare decision support systems best exemplified by IBM Watson, (more…)

House Bill introduced to improve Accountable Care Orgs (US)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/10/file0001205588090-doctor.jpg” thumb_width=”150″ /]A bill has been introduced in the US Congress with the aim of improving Accountable Care Organizations (ACOs). The cross-party bill HR 5558, to be known as the ACO improvement act of 2014, if passed, will amend the Medicare ACO Programs to permit the use of remote patient monitoring, deliver images to remote providers and improve the data sharing between ACOs and Medicare administration.

ACOs are groups of doctors, hospitals and other health care providers who come together voluntarily to give care to Medicare patients. The goal of the three ACO programs is to ensure patients, specially the chronically ill, get the right care at the right time avoiding duplication and waste. When an ACO succeeds in achieving savings for Medicare, that saving is shared with the (more…)

Smartphones, wearables are the future says NHS England

NHS England has sketched out the future of healthcare and it will be one using smartphones and wearable bio-sensors to monitor ourselves and alert clinicians. [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/09/NHS-England.jpg” thumb_width=”150″ /]NHS National Medical Director Sir Bruce Keogh has written to around 250 organisations across health, social care, industry and third sector asking them to support the Technology Enabled Care Services (TECS) programme which he says will take the NHS into this new technological era.

The TECS programme, born out of the Three Million Lives (3ML) initiative (which didn’t quite go anywhere after all the song and dance, including from Prime Minister David Cameron), was reviewed last year resulting in the change of focus to “address the demand for support and practical tools to commission, procure, implement and evaluate technology enabled care services” according to Sir Bruce’s letter as reported on the NHS England website.

The TECS Stakeholder Forum‘s views and proposals now form the TECS Improvement Plan for 2014-17. This is a broader group following the failure of the 3ML Stakeholder Forum, which consisted mainly big industry organisations, to achieve anything of substance.

According to the NHS England website posting, Sir Bruce explains: “To ensure continued progress, we have brought together a TECS Implementation Group consisting of experts and leaders from across these sectors whose remit is to support the strategic development and delivery of the proposals within the Improvement Plan. In addition, we have formed the TECS Executive Steering Group which meets regularly to provide clinical, technological and strategic leadership for the programme at a director level in NHS England.”

This all sounds like a lot of bureaucracy and a drawn out attempt to rescue what remains of the 3ML programme. I started thinking of the Titanic and deck chairs.

What do 65+ really want? Travel the world.

For those of us who develop and implement technologies to assist–and marketers who appeal to–the 65+ market (and in reality those 55+), the aspirations spotlighted in this ‘bucket list’ illustrate this age group’s current mindset a lot better than the usual picture sketched in much of the consumer and healthcare press of the obese, bundle o’ chronic conditions and chronically ‘needy’ older adult. Centra Pulse, the telecare arm of non-profit Circle Housing with 125,000 customers, surveyed over 2,000 65+ UK adults and came up with a ‘top 40’ (just like the old radio hit lists) must-do list. Some are ambitious (#1, 3, 4) and others are prosaic (#2, 9, 11). Listing top 15 here:

  1. Travel the world
  2. See my family settled
  3. Live to 100
  4. Write a bestselling novel
  5. Win the lottery
  6. Buy a house
  7. Learn a language
  8. Be financially secure (more…)

Change needed in ‘Keeping the NHS Great’

Technology enabled care services (TECS) are the key, according to this study headed by the Good Governance Institute (GGI) and supported by Tunstall Healthcare. Whatever your thoughts are about the latter, the problem pointed out in the study is valid; that TECS (another acronym to be added to the arsenal encompassing both telecare and telehealth; not a ‘telehealthcare’ in sight) is thought of as ‘too difficult’ and because the system has not changed, people are being denied life-changing support and technology. GGI surveyed healthcare professionals in its networks plus organized a workshop with the Tunstall Clinical Advisory Group for more qualitative information.

According to the report, 85 percent of respondents said that telehealth was “very important” (50 percent) or “important” (35 percent) in developing pathways for patients with long-term conditions and better management of their care in the community. The overwhelming majority (79 percent) responded by saying they would be prepared to contribute to some or all of the costs, or introducing telehealth from their own budgets. (more…)

2015: mHealth’s breakout year–or more of the same sideways?

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/09/the-thinker-statue-flickr-satyakam-khadikar-480.jpg” thumb_width=”150″ /]Adopting or Ditching It? We’re barely into September, yet the first 2015 prediction-of-a-sort is on the record from Center for Connected Health‘s Dr. Joseph Kvedar in The eHealth Blog. Does Apple HealthKit+Samsung‘s SHealth’s iterations+Google Fit+smartwatches everywhere (including LG’s G Watch R) equal $7.2 billion in wearables alone by 2018 as part of a mHealthy $49 billion by 2020? He’s optimistic, yet he hedges his bets with the caveat

“The challenge in health care is that, though we know what patients/consumers need to do to improve their health, most of them don’t want to hear about it.”

Which indicates that Dr. Kvedar has joined our small group of Thinkers puzzling out why health apps haven’t taken off beyond their Quantified Selfer early adopters and what Parks Associates termed ‘Healthy and Engaged’ [TTA 11 Aug]. With 1/3 of the purchasers of activity trackers putting them in the drawer after six months and the unstickiness of apps (80 percent are abandoned after a shocking two weeks), the winning combination isn’t obvious. But is it ‘focus on engagement’ and ‘personal, motivational and ubiquitous’? Certainly key factors, but how do we get the ‘Challenged but Mindful’ with a chronic condition–or two or three–to track and reward their real progress, even on a bad day–which an activity tracker which constantly presses you to exceed your performance has trouble gauging. (more…)

Bayer AG enters the healthcare accelerator game (DE)

Bayer HealthCare AG’s Grants4Apps program announced its support of five startups that, in their words, will support improved outcomes or pharmaceutical processes. Unlike companies like GE or Pfizer, Bayer is outright granting a substantial amount of cash to each–€ 50,000–and offering space plus 3 1/2 months of mentoring in their Berlin HQ in return for the usual small equity stake. Of 70 applications, five were granted to European companies which will have their Demo Day on 1 December:

  • Cortrium:  their C3 device is a state-of-the-art wearable tech sensor for clinical-quality hospital wireless monitoring of health data including electrocardiogram (ECG), body surface temperature, respiratory rate, and body posture/physical activity. Blood oxygen and blood pressure to come in 2015. (Denmark, spun off from Nokia R&D)
  • PharmAssistantself-management tool for chronic disease patients, consisting of a smart pill container and a remote cloud-based monitoring service (Portugal) (more…)

It’s official! mHealth in the ‘trough of disillusionment’

Gartner annually issues its Hype Cycle for Emerging Technologies in the Dog Days of August, perhaps not to burst too many bubbles, derail too many fundings?

  • Lo and behold, ‘mobile health monitoring ‘ is heading towards the bottom of the Trough of Disillusionment. Moreover, its recovery is projected at 5-10 years to move out of the Trough, whip through the Slope of Enlightenment and enter the sunny uplands of the Plateau of Productivity. See Gartner chart below.

Forced to wear a fitness tracker for insurance? (US)

For those covered by corporate health policies, the day is not far away where employee health insurance programs will require wearing a fitness tracker and meeting certain metrics, such as walking a million steps or sleep quality. Already some programs have the employee log food, exercise, blood glucose, heart rate and other vital signs to qualify for a discount. The trajectory is much like BYOD–once unheard of, now it is expected to be the norm in 50 percent of US companies by 2017, with a concomitant loss of personal security and privacy. CVS Caremark and other companies have already made the stick, not the carrot, the norm of employee wellness programs [TTA 12 April 2013]. Writer Adrian Kingsley-Hughes asks: “How much access do we want our employers to have to our medical data? How much access to our daily activities do we want our employers and insurers having?” And what about spoofing those Fitbits and Jawbones? His ZDNet article notes the interest that Apple (plus Samsung and Google, despite Sergey’s and Larry’s vapors–Ed.) has in health, then takes it out a few more yards with Wearables and health insurance: A health bar over everyone’s head (and do check out the comments.)

The smartphone as great healthcare leveler: Eric Topol

Eric Topol MD, cardiologist, Chief Medical Advisor for the rebooted (but so far quiet) AT&T ForHealth and Chief Academic Officer at Scripps Health, is no stranger to the ‘big statement’ and is well known as an advocate for all things mHealthy. For at least two years, he has been promoting the smartphone’s ‘equalizer’ capabilities in health not only via apps and ‘add ons’ but also as a storehouse or central repository for individual health information, including genetic screening, which can be transmitted onward to a practitioner, lab or PHR. Dr Topol’s ‘big statements’ were fully on display in his keynote at HealthLeaders’ CFO Exchange conference. A promoter of the ‘creative destruction of medicine’ (the title of his most recent book, WSJ article), he believes that everything from the office visit (virtualized) (more…)

Ding! Telecare developer Healthsense raises $10 million in 8th round

Sensor-based remote monitoring company and certified Grizzled Pioneer Healthsense has completed a raise of $10 million, its eighth round of funding since its founding in 2003. This round was led by new investor Mansa Capital with previous investors Radius Ventures and Merck Global Health Innovation Fund. Mansa has current investments in only two other companies–smartphone med adherence platform HealthPrize Technologies ($3 million from Mansa just yesterday) and employer behavioral health risk manager E4 Health (CrunchBase) with a third, Independent Living Systems, listed on its website, but was a prior investor in well-known Athenahealth. Earlier investors Ziegler HealthVest Management (2007) and West Health did not join in this round. The VentureBeat article alludes to home monitoring pilots with home health providers Humana Cares/Senior Bridge and Fallon Health–odd since Healthsense has always had units in home health. Last year Healthsense bought rival telecare company WellAWARE [TTA 2 July 2013] after the latter experienced difficulty (more…)

All that Quantified Self data? Drowning doctors don’t want to see it.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/08/reduce-documentation1.jpg” thumb_width=”150″ /]Our long-time readers will remember Questions # 3, 4 and 5 of The Five Big Questions (FBQ*). They have not lost their salience as doctors are rejecting the not-terribly-accurate ‘telehealth’ data [TTA 10 May] generated by popular fitness trackers such as Fitbit, Misfit Shine and Jawbone. We do note that Apple’s Health/HealthKit has trotted out alliances with Mayo Clinic and Epic Systems (EHR) on apps and integrating data into an PHR [TTA 3 June], as well as Samsung’s SAMI [2 June] funding a University of California (UCSF) research center and (of course) Google. But this article confirms (more…)

‘eVisits’ save $5 billion globally this year–but are they more effective care?

Deloitte and Towers Watson obviously disagree on the savings from eVisits (Deloitte) and telemedicine (Towers Watson). Deloitte’s study of eVisits projects a global savings of $5 billion in 2014. Towers Watson is estimating $6 billion in 2015 from US employers alone if there is full employee utilization of telemedicine. Deloitte is also more transparent in its estimating, for example on the $50-60 billion total addressable market for eVisits in ‘developed countries’. This Editor doesn’t see a major difference in definitions between the two; Deloitte defines eVisits as video consults plus the forms, questionnaires and photos that have become part of telehealth, but not the vital signs monitoring part.. Perhaps our readers, looking at both more closely, can discern, or confirm that Towers Watson has too rosy a picture? Deloitte‘s ’21st Century Housecall’ study (short paper) is also worth a read for presenting facts/figures on the global addressable market and for a surprising conclusion–that the ‘greater good (in developing countries) may come from saving tens of millions of lives’. Hat tip to reader Mike Clark. Clinical Innovation + Technology summary.

‘Virtual care is much more effective than brick-and-mortar care.” (Editor’s emphasis) A bold statement that Microsoft and the writer from Intel fail to back up with facts. The focus of this ‘In Health’ article is preventing readmissions. There are the usual Panglossian pointers  (more…)

‘Explosive growth’ for telehealth and telecare at last?

This sunny summertime prediction by Ephraim Schwartz, an editor-at-large for enterprise tech publication InfoWorld, outlines five main reasons why:

  1. Healthcare is broken, and because it is, finally there’s the financial commitment from providers.
  2. The base of home telehealth devices is now fairly large at 3 million in the US so that the projection by 2018 of 10.3 million in the US and 19.1 million worldwide doesn’t look improbable (Berg Insight).
  3. Cellular and digital phone networks are now ubiquitous. The conversion of existing POTS devices which account for 70 percent of existing telehealth users is underway. Mobile is driving developers to create smartphone health apps and devices. (more…)

Is this the last time the flat earth society will be celebrating? (UK WSD)

When this editor was running a telecare & telehealth programme in Surrey, there was always the dread when meeting professionals that one of the daily internet newssheets would publicise another paper about the Whole System Demonstrator (WSD) that ‘proved’ that one or other form of remote patient monitoring (RPM) cost more per QALY than a voyage on Virgin Galactic. The day was then spent unconstructively, making some or all of the points encapsulated in my original post on 22 July last year entitled “Time to bid farewell to the WSD”.

Thankfully the flow of WSD papers has since dwindled. Doubtless many hoped they had stopped for good, in view of their total irrelevance to the real world in 2014. However, on the offchance that some poor reader has found themselves being challenged about the abstract of a recent paper picked up by Pulse, on the high cost per QALY of telecare by one of the few professionals who still do not accept the value of appropriated technology, here is what you might tell them (more…)