In the US, as part of treaty obligations with Native American tribes, the Indian Health Service provides healthcare services for American Indians and Alaska Natives resident both on and off reservations. Shortcomings have been well-documented, but earlier this year in their Great Plains region, the Centers for Medicare and Medicaid Services (CMS) uncovered serious deficiencies in services, particularly in ERs, at the Pine Ridge and Rosebud Indian Reservations in South Dakota which led to CMS threatening to withhold payment for Medicare and Medicaid billings. While a remediation agreement was reached, IHS is now inviting telemedicine providers by June 6 to propose remote care at its seven hospitals and other facilities in Iowa, Nebraska, South Dakota and North Dakota, covering emergency services and specialty referrals services including an option for provider-to-provider consultations. Indian Tribes nationally, but especially in the Pacific Northwest and the Southwest, have long been active in telehealth as ‘rural’ is an understatement for many reservations and communities, specialty care is scarce even in hospitals and American Indians are overall underserved in healthcare services. IHS release, RFP information, Chron/Associated Press, mHealth Intelligence
It’s Alive! Augmedix’s $17 million raise raises Google Glass in medicine
Just when we thought that Google Glass was going to be a tax writeoff for Alphabet (the Google parent company), along comes Augmedix, a Google Developers/Glass At Work enterprise partner which has raised, without a lot of fanfare, a tidy $17 million in venture capital funding. The round was funded primarily from customers–in this case Sutter Health, Dignity Health, Catholic Health Initiatives (CHI), TriHealth Inc. and an anonymous funder, plus traditional VCs Redmile Group, Emergence Capital and DCM Ventures, the last two which were also in the $16 million Series A. Augmedix’s Google Glass is used during the visit by the doctor to connect to a remote scribe who enters patient data into the EHR instead of the doctor. Our Readers familiar with a typical doctor’s office can readily see this as a useful function, though the Glass itself might put off some patients. No word of the dramatic surgery/telesurgery consults this Editor has seen demonstrated. It also appears that Augmedix is the only enterprise developer of Glass that has stayed with medical use, shifting its focus to large healthcare organizations. Mobihealthnews. CrunchBase
State by State report on telehealth laws and policies (US)
A comprehensive scan of telehealth laws and Medicaid [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/05/State-telehealth-laws.jpg” thumb_width=”150″ /]program policies is available from the recently released report from the Center for Connected Health Policy, part of the Public Health Institute, a California based non-profit. This fourth annual review, State Telehealth Laws and Medicaid Program Policies, provides a current summary of telehealth policies and laws in all the states and the District of Columbia.
As we have covered in many previous articles, states are actively pursuing legislation to implement their own set of telehealth policies. This report is supposedly an up to date summary of these laws and regulations as of March 2016.
Some significant findings highlighted by the authors are
– 47 states and Washington DC provide reimbursements for some form of telemedicine video conferencing. This number is unchanged from last year.
– 9 states reimburse for store and forward services (e.g. medical images, documents and pre-recorded videos. Primarily sent between medical professionals)
– 16 states offer reimbursement for remote patient monitoring, unchanged from last year
The report is complemented by an interactive map located here.
Insurer launches telemedicine for Australian travelers
An Australian health insurance underwriter has announced that it is offering a telemedicine service for its traveling and expatriate policyholders, according to today’s Insurance Business. [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/04/Docto-logo.png” thumb_width=”150″ /] Accident and Health International (AHI) is offering access to Australian-trained emergency physicians via video, phone call, email or text 24 hours a day for these customers.
The service is being offered through Docto, which describes itself as “Australia’s first on-line telemedicine hospital”. CEO of AHI, Peter Banks, is reported to have said “the policy holder simply clicks a button on the AHI App or the Docto website and they can see a doctor from the comfort of their home or hotel room. Often when you are travelling in an unfamiliar place, it is the simple questions you want answers to. They can simply text, email, video or voice call AHI’s TeleHealth for an immediate answer.”
Dr John Field, founder of Docto, offers another scenario: “it is preventing a mother from having to go to a foreign hospital in the middle of the night with sick kids. She can press a button and see a doctor in real time, without leaving the house.” Docto website claims that its “Emergency Department” is staffed 24-hours a day by fully trained Australian Emergency Physicians. Access to medical specialist covering a wide range of areas are arranged via Telemedicine consultations on the next business day.
If the traveler requires repatriation back to Australia that is arranged via Dynamiq, a global emergency management company.
Expanding cross-state telemedicine licensure for nurses promoted (US)
In the US, nurses, like doctors, are licensed by state and cannot practice in others, unless they are separately licensed in that state, or licensed in one of the 25 member states of a compact permitting cross-state practice. Currently, it does not include the practice of telemedicine or in fact, telehealth monitoring across state lines. The new Enhanced Nurse Licensure Compact and Advanced Practice Nurse Compact includes telemedicine remote consults and was initiated by the National Council of State Boards of Nursing, a Chicago-based non-profit consisting of 59 nursing boards, last year. The objective is to further advance mobility and flexible practice for nurses. The new compact has been accepted by six states: Wyoming, Virginia, South Dakota, Idaho, Florida and Tennessee. Other states are considering via legislation. The NCSBN is boosting it with an event in Washington DC on Friday. ATA has supported the compact, as well as a similar one for physicians now valid in 12 states. mHealthIntelligence NCSBN release (which uses telehealth as term) ; they are also hosting a webcast from Washington on Friday morning from 8:30am to 1pm US EDT.
Abstracts for Med-e-Tel now online
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/04/Med-e-tel-logo.jpg” thumb_width=”150″ /]Med-e-Tel Luxembourg, one of the longest continuously running health tech conferences in Europe (from 2004, certainly enough to qualify it as a Grizzled Pioneer), will be on this week from Wednesday to Friday, but if like this Editor you’ll be unfortunately far, far away, Prof. Maurice Mars, Richard E. Scott and Malina Jordanova of the organizing International Society for Telemedicine & eHealth (ISfTeH), have published the speaker abstracts online and free (requiring only registration.) See them here.
The abstract researchers span the globe–Nigeria, Greece, Sweden, Czech Republic, Brazil, New Jersey (!)…plus several from UK (including Malcolm Fisk), Portugal, France, Spain, Italy, South Africa and Bulgaria. Orange Labs will present the data of their diabetic bike riders from the 2015 mHealth Grand Tour (MHT)–this was a high point of last November’s mHealth Summit/HIMSS Connected Health [TTA 13 Nov 15]. There’s also research on topics you don’t hear about in most conferences: smart cities, mHealth’s environmental impact, telenursing, adapting eHealth to serve those of differing abilities, even substituting smart technologies for physical restraints. So many unusual views are represented here. Also in this issue, Vol 4 (2016), is a wealth of research from Brazil.
More in the Med-e-Tel update press release.
Deloitte’s consumer view of technology acceptance in home health
The Deloitte Center for Health Solutions (DCHS), the research division of Deloitte LLP’s Life Sciences and Health Care practice, conducted six focus groups late last year to gauge the acceptance of technology in home health. They tested two main home health scenarios among 42 younger (<44) and older (45-64) adults, both drawn from healthy and chronic condition patients and with a mix of demographics.
In this qualitative study, the two scenarios tested were: technology that would help manage chronic conditions and tech to promote healthy living. The first scenario gives a very advanced vision of chronic care management that involves telehealth, telemedicine and residential monitoring in the management of chronic conditions (diabetes and CHF). The second involves lifestyle factors including eating, activity and exercise management and managing travel.
Some findings in the report summarized and linked for download here, including implications for companies:
- Overall they were open to and optimistic about using technology to enable better home care of older adults who require it–including embedded sensors.
- ‘Smart home’ has appeal, but there is a preference for the less intrusive (stove burner/cooking range sensors, fall detectors) and resistance to perceived invasions of privacy (sleep, bathroom and activity monitoring).
- They understood the balance of reward and risk in consideration of broad categories of nutrition, physical activity, prevention, and dealing with an acute episode (see quadrant below, click to enlarge)
Center Director Harry Greenspun, MD’s in his Health Care Current blog notes that TECS has the capability of providing services formerly provided only in a doctor’s office or hospital in the home, but “One question remains, “How quickly will consumers adapt and accept new technologies that bring care into their home?”–then answers his own question.
All of these innovations have given us a level of insight and capability we could not have imagined even a few years ago. At the same time, each raises privacy concerns.
So why do we do it? Because we get something out of it.
ATA 2016 announces keynoters
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/03/ATA2016Bannerv2-1.jpg” thumb_width=”200″ /]American Telemedicine Association 2016 Conference and Trade Show
Sat 14-Tues 17 May, Minneapolis Convention Center
ATA 2016 is the world’s largest and most comprehensive meeting focused on telemedicine, digital, connected and mobile health. Over 6,000 healthcare professionals and entrepreneurs in the telemedicine, telehealth and mHealth area are expected to attend the 75+ sessions and visit the over 300 exhibitors in the main hall. Keynote speakers announced are:
- Nicholas Negroponte, co-founder of the MIT Media Lab
- James Peake, former US Secretary of Veterans Affairs
- John Noseworthy, MD, President and CEO of the Mayo Clinic
- David Shulkin, MD, Under Secretary of Health for the VA
- Jack Resneck, Board of Trustees, American Medical Association
- Jonathan Perlin, MD, PhD, MSHA, MACP, FACMI, President, American Hospital Association
- Reed Tuckson, President, Board of Directors, American Telemedicine Association
Register today through 15 April to save $150. More information here on schedule, keynotes, housing and Minneapolis (which is lovely in the spring when the snow is all gone!). TTA is again a media partner of ATA’s annual meeting.
The big show begins: HIMSS 2016
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/02/HIMSS-2016.png” thumb_width=”150″ /]Now that Mobile World Congress, which increasingly features mobile healthcare tech like International CES, is wrapping, probably the world’s largest healthcare oriented conference, HIMSS, will be kicking off on Monday the 29th in Fabulous Las Vegas. ‘Connected health’ and security is a part of it, along with its traditional emphasis on HIT and traditional devices. If you are going, you’ve likely made your arrangements months ago. There’s a lot of guides out there on making the most of the conference, but this Editor recommends Roberta Mullins’ quick guide to HIMSS highlights in HIE Answers. For the fun parts of HIMSS and a link to the HIMSS16 mobile app, here’s Roberta again, plus HealthcareITNews’ roundup (though the chapter events are sold out).
We’ll be noting the news from our New York perch. If you have news, insights or comments you’d like to see here (objective and not promotional), please email this Editor. (These will be used at editorial discretion.) TTA has been for years a media partner of HIMSS Connected Health Conference/mHealth Summit (which, rumor has it, will happily be returning to December this year).
Upcoming will be the other US ‘big show’ in telehealth and telemedicine, ATA 2016, 14-17 May in Minneapolis, where we again are media partners. More on ATA in coming weeks!
Telehealth in Brazil: a special JISfTeH issue
The Journal of the International Society for Telemedicine and eHealth (JISfTeH) turns to Latin America in its latest issue with a focus on the versatile ways that telehealth has been used in Brazil. Nine papers range from distance healthcare education to store-and-forward imaging to building rural telehealth networks. Brazil’s government has supported remote care initiatives with the development and implementation of projects at the national, state and municipal levels. The telehealth model primarily has been connecting universities to primary care in remote cities (of which there are many!) with an emphasis on education and assistance. Topics include the nine-year-old telehealth project in Minas Gerais between Rio de Janiero and Brasilia, and its declining use; distance learning in dentistry; usage in the Amazon region and legislation. Registration required, but the journal is open access. Hat tip to its lead editor, Prof. Maurice Mars of the University of KwaZulu-Natal, South Africa.
The widening gyre of insurers covering telehealth (telemedicine?) (US)
Is a tipping point nearing? Soon? An article in Modern Healthcare that contains a heavy dollop of promotion headlines ‘telehealth’s’ adoption by insurers such as Blue Cross Blue Shield of Alabama, Anthem and Highmark. When read through, it’s mainly about telemedicine (video consults) but does touch on the vital signs monitoring that’s the basis of telehealth. Video consults through Teladoc and other services such as Doctor on Demand and American Well are gradually being reimbursed by private insurers, despite the concern that it would actually drive up cost by being an ‘add-on’ to an in-person visits. Medicaid increasingly covers it, and states are enacting ‘parity’ regulations equalizing in-office and virtual visits including, in many cases, telehealth. Yet the move for coverage is hampered by lack of reimbursement to doctors, or the perception of limited or no payment. Even Medicare, a big advocate for alternative models of care, currently pays little out for telehealth–$17.6 million on a $630 million+ program. The Congressional Budget Office is skeptical, despite the savings claimed by CONNECT for Health Act in both the Senate and House [TTA 12 Feb]. Virtual reality: More insurers are embracing telehealth
The evolution of Facebook: implications for social health
The Telegraph’s recent retrospective on Facebook and its evolution from 2004’s ‘Thefacebook’ of Harvard University students to the Facebook that many of us use now, with Chat, timeline and a converged mobile and desktop design, led reader Mike Clark to drop Editor Charles a line about how healthcare isn’t maximizing social media and internet-based innovation. Recent studies have indicated that these social patient communities benefit their members. Agreed, but there are increasing qualifications–and qualms.
Back in 2014, Facebook made some noises on forming its own online health communities, a move that was widely derided as Facebook monetizing yet another slice of personal (health) data from users. While Charles has made the excellent point that “almost all good health apps are essentially the tailored interface to an internet service that sits behind it, a fact often forgotten by commentators”, Editor Donna on her side of the Atlantic has seen concerns mount on privacy, security and the stealthy commercialization/monetization of many popular online patient support groups (OSGs) which Carolyn Thomas (‘The Heart Sister’) skewers here, excepting those with solid non-profit firewalling (academic, government, clinical). Example she gives: Patients Like Me, which markets health data gathered from members to companies developing products to sell to patients. How many members, with a disease or chronic condition on their mind, will browse through to this page that says in part: “Except for the restricted personal information you entered when registering for the site, you should expect that every piece of information you submit (even if it is not currently displayed) may be shared with our partners and any member of PatientsLikeMe, including other patients.”
We’ve also noted that genomics data may not be sufficiently de-identified so that it can’t be matched through inference [TTA 31 Oct 15], with the potential for sale. And of course Hackermania Running Wild continues (see here).
For now general information sites like WebMD and personalized reference sites such as Medivisor feel more secure to users, as well as small non-commercialized OSGs and ‘closed’ telehealth/telemedicine systems.
Mississippi to get VA telemed pilot amid controversy
Mississippi has led the way in telemedicine projects in southern USA for some time with the University of Mississippi Medical Center’s various successful projects [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/Dept-of-VA-logo.jpg” thumb_width=”150″ /]attracting well deserved funding. Now the US Secretary of Veteran’s Affairs has announced that a new pilot programme to use telemedicine to reduce wait times for new patients at VA hospitals will take place in Mississippi.
This pilot programme comes in the wake of the highly criticised wait times reported for new patients at VA hospitals in 2014. A CNN report based on internal VA documents claimed that thousands of veterans had to wait more than three months to see a specialist.
Australian healthcare fund takes stake in telemedicine startup
HCF, the oldest of the “Big Four” Australian health funds, has bought a 15% stake in telemedicine online doctor service startup GP2U. [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/01/HCF-logo.jpg” thumb_width=”150″ /]GP2U provide systems which helps to make remote consultations via video conferencing possible.
According to yesterday’s press release HCF will run a pilot to “ensure the service is scaled to the wider HCF membership as smoothly as possible”. In addition to providing the video conferencing platform, [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/01/GP2U-logo.png” thumb_width=”150″ /]GP2U also provides a prescription service that sends prescriptions directly from the GP office to pharmacy once the GP approves it. GP2U has agreements with three Australian pharmacy chains, Terry White Chemist, Chempro and Priceline.
HCF is a not-for-profit organisation founded 80 years ago and provides health cover for 1.5 million Australians and has a turnover in excess of AUD 2 billion. GP2U is very fortunate that such a large fund has taken a serious interest in it
Dubai starts telemedicine pilot
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/01/rp-vita-1-e1453251179139.png” thumb_width=”150″ /]I am somewhat baffled by the news this week of a telemedicine trial in Dubai. One of the seven emirates making up UAE, Dubai has an area of less than 1,600 square miles, which amounts to a square of about 40 miles – so not exactly far to travel from any place to any place else if you are in Dubai. Not the obvious place to benefit greatly from telemedicine. The press release two days ago said that the pilot will “significantly enhance the manner in which healthcare is delivered in the emirate”.
According to the release the project will use “robots” from In Touch Health (referred to as “RoboDoc” in the release). These are self-propelled six-foot tall units (similar to the one shown, I expect, which is from the In Touch Health website) with video conferencing capability so that staff in one hospital can consult experts in one or more other hospitals in real time at the patient’s bedside.
The full press release is available here.
HealthSpot closes the doors, shuts kiosks in Rite Aid, Cleveland Clinic (updated)
As we reported last July, HealthSpot, the Dublin, Ohio, based telemedicine health kiosk business which was [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/01/HealthSpot-logo-1.png” thumb_width=”150″ /]carrying out a retail trial with Rite Aid since November 2014, started commercial operations in 25 locations in three Ohio areas.
In October reports emerged of a patent infringement claim that has been ongoing since April 2014 against HealthSpot by Nevada-based Computerized Screening. (More on this ongoing series of lawsuits in Ohio and Nevada is here.)
According to reports in Columbus Business First, HealthSpot has now informed Rite Aid that it would cease operations as of 31 December last year and its telemedicine kiosks are reported to have shut down in Rite Aid pharmacies. HealthSpot has also notified Cleveland Clinic that it has discontinued operations, which shuts its pilot with Cleveland Clinic in northeast Ohio.
HealthSpot’s website remains live but the last entry in the press releases section is from September 2015 and is on events at which HealthSpot was to participate in September and November. The blog page on its website is well out of date with the last update dated as far back as March 2015. (Links for locations and patient log in were inoperable–Ed. Donna)
One recent news report stated that attempts to contact CEO Steve Cashman went unanswered.
In November 2014, HealthSpot received a major investment from Xerox on top of a $18.3 million springtime round [TTA 13 Nov 14].
Updated 13 Jan (Editor Donna)
The Columbus Business First articles that Editor Chrys has linked to, as of this point, are the most informative. Neil Versel and Stephanie Baum also have related articles in MedCityNews. They also chewed it over with HealthcareScene network’s John Lynn last Friday on video (starts at 26:30) with a surprising revelation that Mr Cashman had been in touch with Mr Lynn, to be published in one of their blogs (but not yet as of this update.) Thus the mystery remains.
Xerox has issued a statement of their continued interest and support of the healthcare sector which is covered in MedCityNews above. We also noted their diverse interests in healthcare quality management, data and analytics through through their Midas+ division here last year.
According to CrunchBase, HealthSpot received $43.81 million in financing since 2011, not including the undisclosed support from Xerox, with the most recent raise debt financing of $11.56 million in January 2015. One year ago, HealthSpot looked so promising. (more…)
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