A fully loaded telehealthy clinic-on-wheels for rural medicine

November 27, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/11/wellcar-graphic3-588×379.jpg” thumb_width=”275″ /]The WellCar concept vehicle is mobile health on wheels. Based on a Ford Transit Connect wagon, this ongoing design project from the University of Kansas (KU) Center for Design Research incorporates technology practically in every corner to create a compact clinic that goes to patients rather than vice versa. The WellCar can be used by a nurse-practitioner team who can treat onsite, using onboard mobile telehealth devices sending to an EHR and virtual consult connectivity. A prototype is being constructed for test in 2014 to obtain National Institutes of Health and the National Science Foundation funding by fall 2014.  Partners include Ford, Abbott Point of Care, HealthSTATS, the National Nuclear Security Administration’s (NNSA) Kansas City Plant, Sprint (Wi-Fi), Voalté (telemedicine); KU Medical Center partners include the Diabetes Institute, Midwest Cancer Alliance and the Center for Telemedicine and Telehealth. According to MedCityNews, the WellCar is a reaction to ObamaCare in reducing readmissions, improving rural care and promoting telehealth/telemedicine–which is perhaps an overstatement. Also ‘Back to the Future’ (MedCityNews) and KU’s article. (Photo from MedCityNews)

Another House bill supporting telehealth and telemedicine (US)

November 22, 2013 | by

One of the two US House representatives behind the expansion of telehealth services for active duty and veteran military members [TTA 19 Nov], California Rep. Scott Peters (San Diego area), has just introduced a bill, HR 3577, the ‘Health Savings Through Technology Act,’ to “create a commission to inventory existing data, examine the cost-savings that can be achieved by increasing the use of wireless health technologies, and develop a comprehensive strategy for integrating these technologies into federal health care programs, including Medicare and Medicaid, which often serve the mobility-impaired and elderly.”  What is notable is the backing that the bill has from health tech ‘heavy hitters’ such as Qualcomm, American Telemedicine Association (ATA), CONNECT (a San Diego-based innovation catalyst and accelerator) and CHI-California Healthcare Institute, as well as life sciences industry groups BIOCOM (San Diego area) and BayBio (its Northern California counterpart). However, this commission will be studying a rapidly moving target and best get its skates on, fast. Not helping matters is that there is a long, long road between the introduction of a House bill and its joint passage by both House and Senate–if it ever passes. Release (Rep. Peters’ website) Hat tip to ATA (@AmericanTelemed) via Twitter.

Bill to expand military telehealth services introduced (US)

November 19, 2013 | by

Two House representatives from California, Mike Thompson (Congressional District 5) and Scott Peters (District 52) have introduced HR 3507, the 21st Century Care for Military & Veterans Act. This expands coverage of telehealth services (including remote monitoring and virtual consults/telemedicine) for active-duty service members, their dependents, retirees and veterans, including physician reimbursement for telehealth services under TRICARE (the health plan for active duty and military retirees) and the Department of Veterans Affairs (VA). (more…)

Telehealth saves $55 million in the Basque Country

November 16, 2013 | by | 3 Comments

Faced with an aging population (18 percent over 65) and a failing Spanish economy, the Basque Country Health System is testing telehealth systems to keep its older population healthier and out of the hospital (23 percent are readmitted to hospital). The Accenture-developed TEKI is based on a Microsoft Kinect and connects to a heart rate monitor, pulse oximeter and a spirometer, using the Kinect to evaluate their mobility and provide prescribed exercise therapy as part of rehabilitation. TEKI is part of an Accenture-developed ‘Multi-channel Health Service Center’ that provides a variety of counseling and education services to the local older adult population. The Kinect is also used as a telemedicine platform to communicate with the patients in the study. Results achieved by the program:$55 million saving in Year 1 through eliminating 52,000 hospital visits, a 7 percent cost reduction per patient. CNBC/Philips feature, MedCityNews, video of Osakidetza Hospital staff using TEKI with respiratory patients, Accenture paper.

Health tech enthusiasm ≠ implementation and scale

November 5, 2013 | by | 1 Comment

Laurie Orlov’s impressions of this year’s Connected Health Symposium, hosted as usual by Partners HealthCare in Boston, presents the conundrum that telehealth and health tech faces beyond the consumer segment, booming fitness trackers and the apps bought one day, discarded the next. How do you get telehealth beyond the pilot to a permanent program in a health system? Do these systems really want to move healthcare to the home? According to Ms. Orlov, there’s amazingly no change from last year on these questions. They are still testing, not broadly deploying (how do companies like Ideal Life and Care Innovations [ever-funded? really?] which aren’t near substantial adoption continue?); and health systems are moving care from brick-and-mortar to the home but slowly, still. Continuing too is the lack of focus on how technology can work best with older adults.  (more…)

Brief report on the European Telemedicine Conference, Edinburgh 29-30 October 2013

November 1, 2013 | by

The European Telemedicine Conference held in Edinburgh’s historic Assembly Rooms this week exceeded my expectations in many ways.

A vital requirement of all such events is good networking, which Edinburgh promoted most effectively. There was plenty of break time and lots of opportunity to see and meet people. There was a goodly number of stands too, where like-minded people could coalesce. For some there were personalised itineraries that helped as well. Then on the second day, a very deliberate effort was made (more…)

UCLA telemedicine platform connecting Army medicine and wounded warriors

October 29, 2013 | by

In a joint program instituted by UCLA Health, Brooke Army Medical Center (AMC), a burn and rehab hospital in San Antonio and the Veterans Administration Greater Los Angeles Healthcare System over the past six years, wounded soldiers undergoing major facial or burn reconstruction at UCLA have had access to telemedicine consults between UCLA and Brooke AMC. This is now being expanded to include other major reconstructions, such as orthopedic reconstruction for severely damaged limbs, urologic treatment, otolaryngological care, examination and treatment of reproductive issues, repair of airways and design of new prosthetic ears. In including Fort Irwin in the Mojave Desert, the program is now including TBI and PTSD.  FierceHealthIT on Operation Mend.

Can telehealth kiosks fill the treatment gap?

October 29, 2013 | by | 1 Comment

Telemedicine’s virtual doctor-patient consults have usually been positioned as computer (and now tablet/smartphone over Wi-Fi–American Well’s announcement earlier this month) driven. Kiosks provide an alternate model for a more detailed visit. The relatively new HealthSpot Station has secured a CMS Healthcare Innovation grant of $12.7 million to place kiosks in partnership with three Cleveland, Ohio hospital systems, including University Hospital and for Cuyahoga County employees through a partnership with MetroHealth. One of the UH kiosks is at the Friendly Inn Settlement House, a social services provider in a high-poverty neighborhood on the east side of Cleveland; visits are free for the next three months for kids between 3-18 (accompanied by a parent). (more…)

VA Department data breaches soar (US)

October 14, 2013 | by

If after the Healthcare.gov debacle, there’s still any confidence that centralized Federal systems are secure and trustworthy, please read this HealthcareITNews tally of the multiple data breaches and HIPAA violations taking place at the US Department of Veterans Affairs (VA).

From 2010 through May 2013, VA department employees or contractors were responsible for 14,215 privacy breaches affecting more than 101,000 veterans across 167 VA facilities, including incidences of identity theft, stealing veteran prescriptions, Facebook posts concerning veterans’ body parts, and failing to encrypt data, a Pittsburgh Tribune-Review investigation revealed.

The two-month investigation by the Pittsburgh Tribune-Review published this weekend found that the VA led the way in HIPAA violations–17 in the past few years–for reasons centering on lack of accountability, shoddy safeguards, sloppiness in handling data and failure to encrypt data even after the 2006 theft of a laptop put records of 26.5 million veterans in danger. There are few firings, disciplinary actions or HHS fines.

This should put telehealth and telemedicine providers on notice that their encryption will have to be ‘stronger than the VA’, as both they and Department of Defense (DOD) are the single largest users of telehealth in the US.

Hands-free telehealth-telemedicine crossover consult

October 14, 2013 | by

A neuroscience research team at the Medical College of Georgia (MCG) in Augusta has developed a way to decipher a video image of a person to measure a person’s heart and breathing rates. Using any single-channel video camera, including a web or cell phone cam, in day, low-light or even at night using near-infrared images, they have developed algorithms to track how the body moves slightly from the way light is reflected off of it and recorded. This can determine within fair clinical accuracy of physical measurements, with false positives only 3 percent of the time and false negatives less than 1 percent. If produced to work with systems to scale, this could vastly assist telemedicine consults especially at distance and facilitate hands-free in-person examinations. Research published in PLOS ONE with a summary in Healthline News. Philips in July started marketing a ‘Vital Signs Camera’ app for $1.99 in the iTunes Store that also measures heart and breathing, but not to clinical quality.

Doctor disciplined for using Skype for telemedicine consults

September 27, 2013 | by | 2 Comments

A family practice physician in eastern Oklahoma was disciplined by the state medical board for using Skype on initial mental health consults. Skype is not approved by the board for telemedicine; other factors were that the patients were not physically seen at any point and that they were prescribed controlled substances (including narcotics). Three of the patients died while under care but the deaths were not attributable to Dr. Trow. It is easy to score the doctor for what could be seen as bad practice in telemedicine, but a mitigating factor is his practice in a remote area of the state and the distance of the patients. Joseph Kvedar, MD of the Center for Connected Health/Partners HealthCare reviews the situation (more…)

Telehealth Soapbox: Medical device tax finally under fire; implications many (US)

September 26, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/09/gizmodo-the-top-10-rube-goldberg-machines-featured-on-film-rube-goldberg.jpg” thumb_width=”180″ /]A key part of the Rube Goldberg (or Heath Robinson)-esque funding of the Accountable Care Act (ACA, a/k/a Obamacare) is a punitive medical device tax of 2.3 percent levied on gross sales (not profits) of hip, knee, cardiac implants, many dental materials, diagnostics such as scanners, radiotherapy machines, catheters and more. Since it went into effect on 1 January, it has raised $1 billion according to the Medical Imaging & Technology Alliance, the Advanced Medical Technology Association and the Medical Device Manufacturers Association in July–for a program that does not start till 2014. According to The Hill, senior Senators Orrin Hatch, Barrasso and Hoeven are pushing for a repeal amendment to be attached to the stopgap spending bill. The reasons why the tax deserves to be tossed out on its ear are: (more…)

Telemedicine in the TIME Swampland

September 17, 2013 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/blue-blazes.jpg” thumb_width=”175″ /]TIME’s ‘Swampland’ section may be referring to the original siting of Washington, DC on reclaimed swamp land off the Potomac River, but this swampy article ultimately struggles to solid land. You will have to meander through the UVA Center for Telehealth, the Center for Connected Health Policy, WellPoint, the Institute for e-Health Policy and of course Partners Healthcare’s cardiac program [TTA 27 Aug] before addressing the real problem: the desirability of broader telemedicine reimbursement and a consistent policy in US Federal programs such as Medicare and Federally-subsidized Medicaid administered through the states. Currently Medicare reimbursement is restricted to specific rural areas, Native American territories/Indian Health Service, and of course the often-mentioned mess of cross-state physician licensing. However, the Accountable Care Act is not going to be the savior as its implementation is hardly going smoothly. Earlier CMS policies on 30-day same cause readmissions have had far more impact. There is the to-be-expected muddling of telemedicine (virtual consults) and telehealth (monitoring)–and robotics gets a ‘say wot?’ mention. The kicker is the headline and accompanying picture:

“Saving U.S. Health Care With Skype”

Skype, while used in ‘telemental health’ [TTA 11 May], is not HIPAA-compliant for patient privacy.  Were TIME’s famed fact-checkers asleep? 

Hat tip (and thanks) to reader Bob Pyke.

Virtual consulter Teladoc acquires Consult A Doctor

September 5, 2013 | by

Dallas, Texas-based telemedicine provider Teladoc yesterday announced their acquisition of Miami Beach, Florida-based Consult A Doctor.  Price was not disclosed nor the future of management and staff at Consult A Doctor. The release portrays the acquisition of small Consult A Doctor (below $1 million in sales, D&B) as reinforcing Teladoc’s 6 million member customer base and an estimated 125,000 annual consults with individuals and employees of small- to medium-size businesses. Teladoc is VC backed: Kleiner Perkins Caufield & Byers (2011) with $18.6 million; $9 million (2009) by HLM Venture Partners, Cardinal Health and Trident Capital. It offers internal medicine, (more…)

Journal of the International Society for Telemedicine and eHealth (South Africa)

August 24, 2013 | by

A heads-up to our readers: a new peer reviewed journal out of South Africa’s University of KwaZulu-Natal’s Department of TeleHealth is the Journal of the International Society for Telemedicine and eHealth. On its second edition, their content (in PDF or HTML formats) seems to be of general interest:

  • Editorial: Would a Rose By Any Other Name – Cause Such Confusion? (defining eHealth)
  • Original Research:
    • TalkMeHome: an in situ evaluation of a service to guide a lost person with dementia home safely
    • Assessing the development process of the eHealth strategy for South Africa against the recommendations of the WHO/ITU National eHealth Strategy Toolkit.
  • Invited Commentary: Telerehabilitation: Current Challenges to Deployment in the United States

The Editors are certainly an international mix: Prof. Maurice Mars, University of KwaZulu-Natal, South Africa; Prof Richard E Scott, University of of KwaZulu-Natal Director, NT Consulting, Canada; Dr Malina Jordanova, Bulgarian Academy of Sciences, Institute for Space and Solar-Terrestrial Research, Bulgaria.