US Goverment encouraged to allow more telehealth in Medicare

March 19, 2014 | by

For those unfamiliar with the US Medicare programme, which provides healthcare benefits for over-65s, it is a tale of two halves. The first, or original, half provides funding for hospitals directly through Centers for Medicare and Medicaid Services (“CMS”). The second half of the tale is funding provided to insurance companies (known as Medicare Advantage Organisations or MAOs) to provide healthcare insurance cover. The details are complex and available on the official government site here.

Each year CMS sets the rates which the government will pay the MAOs and the proposed rates were published for consultation last month with the final decision being published next month. One of the respondents to the consultation was the Telecommunications Industry Association which strongly advised the CMS to support the use of telehealth within any MA plans as a means to reducing the cost of healthcare. While the TIA support is good news, and claims to be in the spirit of “long-time supporters of enhanced telehealth and remote monitoring services” I suspect the reasons are not entirely altruistic.

CMS says in its consultation document that some MAOs have asked CMS to include “remote access technology-furnished” services as part of MA plan basic benefits. However, as basic benefits can’t include anything not in the “original half”  (Parts A &B) CMS proposes to continue to include these as “mandatory supplemental services” in the coming year.

In this context remote access technologies are defined as Telemonitoring, Web- and Phone-based Technologies, Nurse Hotlines and other similar services. For 2015, CMS is also to allow MAOs to furnish medical services to beneficiaries via real-time interactive audio and video technologies as a mandatory supplemental benefit.

LeadingAge/CAST telehealth comparison tools; Independa whitepaper (US)

March 17, 2014 | by

A release from telehealth/TV + internet-based remote care services developer Independa drew this Editor’s attention to several useful new tools from non-profit aging services provider/supplier association LeadingAge‘s Center for Aging Services Technologies (CAST). If you are outside the US, the technologies may not apply, but it’s a useful model for comparing and evaluating telehealth technology and services in long-term care:

  1. The Telehealth and Remote Patient Monitoring (RPM) Selection Tool helps the user identify needs and provides choices of available products and the functionalities they offer.
  2. “Telehealth and Remote Patient Monitoring for Long-Term and Post-Acute Care” is a whitepaper which explains their methodology and defining telehealth and remote patient monitoring (RPM) technologies, uses and benefits.
  3. The Telehealth and RPM Selection Matrix has an extensive comparison of technologies with features detailed by business line (e.g. acute care), system type, embodiment (type of unit), program development and support, hardware and software (front-end and ancillary).

Independa in their release (PDF) highlights their inclusion in the CAST tools. The Independa TV with embedded remote care services, developed in partnership with LG, was also reviewed in a recent whitepaper written by aging services researcher Laurie Orlov, focusing on its potential utilization in post-acute care transitions to the home and skilled nursing.

One in Four Lives: the Australian 3ML

March 17, 2014 | by

Australia was delivering personal healthcare at a distance (by radio and plane) long before ‘telehealth’ and, indeed ‘telecare’ were coined. One therefore wonders in what way a consortium of Australian companies were inspired by England’s 3millionlives (3ML) in developing their own version: One in Four Lives. Perhaps they thought they could do better.

10 months after the One in Four Lives launch in May 2013, they have produced a white paper (PDF download) which is, in effect, a manifesto calling for government support. It has some well-respected authors who accurately opine that the real challenge is not technological but is in “…creating sustainable, profitable business models that can meet the needs of governments, services operators, clinical practice and patients.”

The telehealth-world politics of this consortium might make an interesting study. We can only scratch the surface and wonder… According to the UK’s Telecare Services Association, its chief executive Trevor Single attended the original kick-off meeting in Australia. Who is not ‘in’ is quite interesting. Tunstall, the instigator of 3ML in England and which has a strong presence in Australia, is notable by its absence. Also missing are significant providers such as Silver Cross and OzCare, and the leading Australian universities and institutions in telehealth research. The dominant partner appears to be BT which, as our UK readers will  be aware, led by its Clinical Director, Global Market Development at BT Global Services, Angela Single, has ambitions to dominate the telehealth world.

Related media items:
The Australian, May 2013: BT leads big push to roll out national telehealth services
 ARN, March 2014: Telehealth could save “unsustainable” federal health budget, according to a white paper

Tunstall Americas’ change at the top

March 14, 2014 | by

BREAKING NEWS EXCLUSIVE

Casey Pittock has been appointed the new President and CEO of Tunstall Americas, replacing Bradley Waugh. No official announcement yet by Tunstall, but there is a video on YouTube (below) from the Medical Alert Monitoring Association conference this past Wednesday (12 March) with Tunstall Healthcare Group CEO Paul Stobart (himself only about 100 days on the job–TTA’s exclusive in November) introducing his “three days in the job” Tunstall Americas CEO (at 03:41 to end). Mr. Pittock’s LinkedIn profile also reflects his new company and title.

Mr. Pittock’s prior positions were generally with smaller, entrepreneurial companies. He was previously VP Sales and Marketing with BAM Labs, developer of a ‘smart bed’ monitor partnering with Stanley Healthcare, acting President of BlueLibris digital health trackers (sold to Numera Health) and President-CEO of once-promising fall detector/alert Wellcore which formally closed down last year. He was a founder of alert company TelCARE, sold to Lifeline (now Philips Lifeline). Mr. Waugh had been President and CEO of NaviNet at the time of its purchase and joined Tunstall shortly thereafter in September 2012–a 19 month tenure. The Tunstall Americas leadership team webpage has not been changed as of Monday 17 March, 23:20 US-EDT. Tunstall is still officially headquartered in NYC (Long Island City), but while Mr. Waugh was from the Rhode Island area (and moved many Tunstall operations there), Mr. Pittock’s LinkedIn profile locates him in a posh section of Silicon Valley in California. It will be interesting to see if there’s also a HQ move in store for Tunstall.

[This video is no longer available on this site but may be findable via an internet search]

3D printed iPhone stethoscope–by 15 year old

March 14, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/product-img1.jpg” thumb_width=”150″ /]Give a 15 year old with a cardiologist father a 3D printer and voilá, you get a stethoscope that snaps on to the back of an iPhone. The diaphragm on the back of the Steth IO channels the low frequency sound of a heartbeat through a network of tubes leading to the microphone, and an app visualizes and records heartbeat. Data can then be sent to EMRs and telemedicine consults. Suman Mulumudi, the designer from Seattle, designed the first version of the case in two weeks and has now formed his own company, Stratoscientific. According to Digital Trends, the Steth IO is now going through FDA approval.

Hanover Housing Association enters Tunstall’s ‘world’ (UK)

March 10, 2014 | by

Tunstall‘s win of the Hanover Housing Association for their alarm call and door entry framework is highly significant beyond the initial installation of the Communicall Vi warden call system and Lifeline Vi dispersed alarm system (PERS). Hanover’s size makes this a major win for Tunstall. Their rationale is understandable: to rapidly replace current telecare equipment in eventually up to 17,000 properties, to build out for the future across a large portfolio and to work with Tunstall to offer a range of present and future integrated technologies including those represented by Tunstall’s ‘Lifetime of Care’ program. No mention here of Tunstall’s ‘my world’ premiered at last month’s Housing LIN Conference [TTA 21 Feb], but undoubtedly this will eventually be included. But here again is the Tunstall system; there’s no mention of partnership with other technology providers to provide innovation and ‘best in class’ service for Hanover residents. As this Editor asked at the end of the February article, ‘But is a closed system the best quality, most economic and effective arrangement for individual, a community’s or a council’s needs?’ Tunstall release

Editor’s Note: For non-UK readers to grasp the size of Hanover Housing, it has 600 estates with 19,000 properties and 22,000 residents, making it comparable in number of locations to Brookdale Senior Living in the US but far more dispersed. Brookdale concentrates its 52,000 residents in larger, mainly assisted living buildings (AL). Hanover focuses on retirement housing across England and Wales, a focus on what in the US we call IL (independent living), including the interesting notion of ‘downsizer homes’. They also have 2,500 ‘Extra Care’ properties with 24-hour care. It is also a not-for-profit, which perhaps makes it more comparable to Ecumen.

Scotland to invest additional £10m on telehealth

March 7, 2014 | by

The Scottish Health Secretary, Alex Neil, has announced the investment of an additional £10 million [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/Healthier-Scotland.jpg” thumb_width=”150″ /](about US $ 15 million) to support home health monitoring solutions across Scotland, the BBC has reported. This additional funding for the NHS Boards will enable people to use technology such as tablet computers and smartphones to monitor conditions such as diabetes, heart problems and lung problems at home, the report added.

In 2011, Nicola Sturgeon MSP, Cabinet Secretary for Health, Wellbeing and Cities Strategy in Scotland set out her strategic vision for achieving sustainable quality in the delivery of healthcare services across Scotland, in the face of the significant challenges of Scotland’s public health record, changing demography and the economic environment. The Scottish Government’s 2020 Vision is that by 2020 everyone is able to live longer healthier lives at home, or in a homely setting and, that Scotland will have a healthcare system where, amongst other goals, there will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission.

Mr Neil’s announcement was made during a debate in the Scottish Parliament entitled ‘Update on Delivering the 2020 Vision in NHS Scotland’. Mr Neil claims past efforts in telecare and telemedicine have meant that £2.8 million has been “ploughed back” into Scottish frontline services and reduced emergency admissions to hospital by 70 per cent.

Reflections on the NHS Innovation Expo (UK)

March 7, 2014 | by | 5 Comments

Editor Charles visited the Expo in Manchester on Tuesday 4th March – here are his personal reflections.

I decided to devote the one day I had to visit the NHS Innovation Expo to visiting stands to try to spread the word about DHACA that was launched last week.

The first thing I noticed about the event was that it seemed less crowded than previous ones. When passing them, I never saw the main auditoria full either, very much in contrast to earlier Expos.

The other principal observation was that (more…)

New industry group promoting telehealth in Australia

March 6, 2014 | by

A new group of industry stakeholders is asking the Australian Federal Government to adopt telehealth as a means to cut the growing national health budget. A whitepaper from the group was presented in Canberra on Wednesday to MP Steve Irons, chair of the House of Representatives Standing Committee on Health by George Margelis (who has previously contributed here at TTA) representing MPT Innnovation Group.

Members of the One in Four Lives group include the Australian Information Industry Association (AIIC), BT Australasia, Anywhere Healthcare, Philips, MPT Innovation Group and the University of Western Sydney (according to Pulse IT) and is chaired by Lisa Altman, Health Practice Director at BT Australasia (part of BT Global Services). The name One in Four Lives reflects that 25% of Australians have chronic health conditions.

Australia has widespread use of telehealth as the many news items we have reported bear out. However majority of these are video link type schemes and the new group is advocating greater use of more sophisticated telehealth schemes using home-based connected sensors and dedicated monitoring clinicians.

If, like me, you thought One in Four Lives sounded familiar, that is probably because the words “Three Million Lives” may have flashed through your mind. Three Million Lives, or 3ML, is a programme that was launched by the UK Goverment in 2011 to get that many people using telehealth. Just to complete the comparison, BT also happens to be the lead company in 3ML.

See also Australian Aging Agenda

The PROTECT Act for HIT doesn’t: mHealth Coalition

March 6, 2014 | by

The mHealth Regulatory Coalition, which is a four-year-old alliance of legal and software companies in the health IT/software area, and whose most vocal spokespersons are well-known industry legal counsels Brad Thompson and Kim Tyrrell-Knott of Epstein Becker Green, has come out against the PROTECT Act (S 2007). PROTECT, which was proposed by Senators Fischer and King, would limit FDA regulation of certain ‘low-risk’ clinical software in the interest of fostering innovation and reducing regulatory burden. Original reports indicated that this responsibility would be transferred to the National Institute of Standards and Technology (NIST) [TTA 28 Feb]. According to Mr. Thompson, “The rush to avoid expert reviews of complex technologies with far-reaching health ramifications ignores the fact that we cannot separate the high risk from the low risk apps using broad terms in legislation.” His example: a theoretical smartphone app designed to diagnose melanomas from photos. PROTECT is being supported by IBM, athenahealth, Software & Information Industry Association, Newborn Coalition and McKesson. The bill also would exempt certain health IT software from being charged a 2.3% medical device tax, which is perhaps the ‘long game’ being played here by the aforementioned companies, as most Washington watchers give the bill as it stands little chance of clearing both houses of Congress and a congressional committee, much less being signed into law. The question remains: how best to speed less clinically significant wellness software to market without logjamming FDA.  iHealthBeat summary, Clinical Innovation + Technology, MRC press release

Wearables solving real ‘jobs to be done’

March 6, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/orcam-device-web11.jpg” thumb_width=”200″ /]This Editor strongly believes that the heart of a great product is that it addresses, in Clayton Christensen’s terms, a ‘job to be done’–or as pre-social media marketing writing put it, ‘not a ‘nice to have’–a must-have’. Venture Beat, usually a facilitator of the D3H (Digital Health Hypester Horde), has an unusually sober and personal article from writer Christina Farr highlighting five wearable devices and how they could be ‘must-haves’, improving quality of life for significant groups of everyday people.

  1.  The OrCam computer-assisted vision device (above) for those with low vision, which interprets nearby visual inputs, including letters, faces, objects, products, places, bus numbers, and traffic lights–and describes them to the wearer through a bone-conduction device heard by the user only. From Israel and available only in the US at present, the initial pricing is around $2,500.
  2. Physician, surgical and law enforcement decision support may be the best use of Google Glass–not exactly the ‘hipster on the L train’ picture promoted by Google.
  3. Emotiv’s mind-controlled wheelchair, which is controlled by a headset (EPOC) capable of picking up electrical signals.
  4. For autistic children and adults, Neumitra and Affectiva are both bands that measure and alert for physiological stress that may lead to inappropriate wandering or acting-out.
  5. Red-green color blindness affects 1 in 12 men and 1 in 200 women. It can be dangerous–think of traffic lights and wiring–and EnChroma’s correcting set of glasses is a simple, useful solution. Reportedly there is a 30 percent improvement in color identification and a 70 percent improvement in color discrimination. The pricing is fairly standard at $375-460.

Telehealth awareness week in SW Victoria (Australia)

March 6, 2014 | by

Barwon South West is one of five regions in the most densely populated state in Australia, Victoria. [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/THAW2014.jpg” thumb_width=”150″ /]Starting on Monday 17th March Barwon South West is holding a week of telehealth awareness activities to coincide with the Australian Telehealth Conference 2014 (ATC2014).

Organised by Barwon Health, the Telehealth Awareness Week 2014 (THAW2014)  will consist of thirteen face-to-face and online events spread across the week, but excluding the two days of the ATC2014 conference.

Rebecca Eastgate, Regional Telehealth Program Manager for Barwon Health tells me that their week of activities including the webinars, “are probably too specific to our region and our local audience to be useful to those beyond Australian shores”. However if you are reading this in Australia, then you may want to look up the THAW2014 events list on Eventbrite and register for any of the meetings or Webinars that are of interest.

Inquiry into telehealth services in Queensland

February 28, 2014 | by

“A statewide healthcare system with new capacity, co-operation, transparent reporting systems, [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/02/Queenslqnd-goverment-logo.jpg” thumb_width=”150″ /]financial accountability and with patients the focus of attention—this is a vision all Queenslanders want to see.” So opened the message from Campbell Newman, Premier of Queensland, Australia, in Blueprint for better healthcare in Queensland in February last year. Turning to telehealth Mr Newman said “In remote communities, this government will work to provide 24-hour access to safe and sustainable care through a revised network of Telehealth facilities for the very first time. This is a 21st century solution to a problem long-regarded as impossible. Our plan will provide reliable health services in places where they were never previously available.”

A year on, the Health and Community Services Committee of the Queensland Parliament has opened an inquiry into telehealth services in the public sector health services in Queensland. The inquiry will consider the implementation of telehealth by the Department of Health and Hospital and Health Services, including the Rural Telehealth Service that was announced in the Blueprint for better healthcare in Queensland.

The committee will examine trials, pilots and other sites, consider the value for money of the delivery of telehealth services, examine the factors that support successful implementation of telehealth services, identify any barriers to successful implementation and consider strategies to address such barriers. The committee intends to visit some rural and regional telehealth sites and hold public hearings in Brisbane and other locations.

The committee will receive an initial public briefing from the Department of Health on Wednesday 5 March at 11.00am in Brisbane. The briefing program is available here. This public briefing will be broadcast live via the link http://www.parliament.qld.gov.au/work-of-committees/broadcast-committee/live, and a transcript of the briefing will be published here when available.

It’s iAwards time again!

February 28, 2014 | by

As the US East Coast faces low temps (down to 12 degrees again tonight) and another dumping of snow Monday, a small sign of spring, like flash-frozen daffodils and crocuses (crocii?), is the annual application call for the Triple Tree iAwards for Connected Health to be presented at the Wireless-Life Sciences Association (WLSA) 9th Annual Convergence Summit 14-16 May at the Omni in San Diego, California. Twelve finalists will be selected from applicants based on

criteria including the uniqueness of their solution; marketplace traction; clinical, operational or consumer relevance; size of addressable market and international presence across three categories:

    • Operational Effectiveness: Solutions that address the financial, compliance or operational needs of a healthcare organization.
    • Clinical Effectiveness: Solutions that address the care delivery and clinical effectiveness for a patient.
    • Consumer Engagement: Solutions that empower consumers to make better healthcare decisions.

Finalists attend not only a dinner, but also for the first time this year a private business review session. Online applications can be accessed at the TripleTree and Wireless-Life Sciences Alliance websites along with a $195 fee. Registration for the conference is here. Hat tip to Editor Charles and reader Mike Short.

‘Grizzled pioneer’ VRI receives major investment from Pamlico Capital (US)

February 28, 2014 | by

US telehealth monitoring and medical alert provider VRI (Valued Relationships, Inc.) of Franklin, Ohio earlier this month received a majority investment/recapitalization from Pamlico Capital, a Charlotte, North Carolina-based private equity firm. Terms of the transaction were not disclosed. Current lead executives CEO Chris Hendriksen and President Andy Schoonover will remain in active management and retain significant ownership in VRI, which they founded in 1989. Regarding the investment, Mr. Schoonover to this Editor stated that the funds will be used for expansion purposes. “It is another vote of confidence (alongside the Cardiocom acquisition) that telehealth is getting great results and is here to stay. The capital will support VRI’s growth objectives, particularly in executing a couple of large projects with health plans that VRI has booked for 2014, and the hiring of additional sales talent.” 

Despite being in a rather ‘non-buzzy’ area of telehealth, the investment attracted the interest of some major players. VRI was assisted in evaluating its options by well-known digital health financial advisor Triple Tree; legal counsels were McDermott Will & Emery for VRI and Alston & Bird LLP for Pamlico. Pamlico specializes in the ‘middle market’ and has previously invested selectively in mid-sized healthcare providers such as Greenway (EHR), Healthcare First (home health software) and Physicians Endoscopy (surgical centers). Overall, and interestingly, this appears to be a positive, long-term vote for telehealth and medication monitoring, as well as for the viability of traditional medical alerts and some of the patient engagement/hospital readmission reduction models VRI has been developing with major payers such as Humana. Pamlico Capital release, Triple Tree release.

Is *less* regulation the answer for mHealth? (US)

February 28, 2014 | by | 1 Comment

What if the solution to the mHealth/digital health logjam of approvals at the US Food and Drug Administration (FDA) is to take clinical and health software completely out of their approval purview–and hand it to the National Institute of Standards and Technology (NIST), which is not a regulatory body but a standards-development organization. That is the solution proposed by the PROTECT Act of 2014 (Preventing Regulatory Overreach to Enhance Care Technology), proposed by Senators Angus King (I-Maine) and Deb Fischer (R-Nebraska). It’s put some of the better known organizations into a swivet, along with high profile attorney and mHealth legal expert Bradley Merrill Thompson with Epstein, Becker & Green. Possibly little to no regulation would be applied to EMRs, clinical support software and wearables/fitness apps–which is promptly being conflated by the usual suspects to heavy-duty equipment such as CT scanners.  FDA also finalized its guidance last September on telehealth and telemedicine applications, which this would render irrelevant. The Washington betting is that this Senate bill will go exactly nowhere, but it’s indicative of the jockeying for position this Editor is seeing within the present government and now with advocates/lobbyists [TTA 13 Feb]. MedCityNews, FierceMobileHealthcare