The digital health space refers to the integration of technology and health care services to improve the overall quality of health care delivery. It encompasses a wide range of innovative and emerging technologies such as wearables, telehealth, artificial intelligence, mobile health, and electronic health records (EHRs). The digital health space offers numerous benefits such as improved patient outcomes, increased access to health care, reduced costs, and improved communication and collaboration between patients and health care providers. For example, patients can now monitor their vital signs such as blood pressure and glucose levels from home using wearable devices and share the data with their doctors in real-time. Telehealth technology allows patients to consult with their health care providers remotely without having to travel to the hospital, making health care more accessible, particularly in remote or rural areas. Artificial intelligence can be used to analyze vast amounts of patient data to identify patterns, predict outcomes, and provide personalized treatment recommendations. Overall, the digital health space is rapidly evolving, and the integration of technology in health

Saturday, January 31, 2015

Barak Obama's New Phrase of the Year

"Precision Medicine"


Precision medicine has given us one of the greatest opportunities that we have ever seen in medical research,” said Obama at a White House event kicking off the initiative. “The time's right to unleash a new wave of advances in this area.” 

Medicine has always been "precise",  based upon the standard of the times. However, in the past two decades mapping of the entire human genome has made it possible to locate specifc genes, including  those which initiate diseases.


  Modern Health reports


White House proposes $215 million, new regs for precision medicine

The White House is proposing $215 million in new funds and new regulations in a sweeping effort involving the National Institutes of Health, the Food and Drug Administration, and the Office of the National Coordinator for Health Information Technology to help fulfill the promise of what President Barack Obama has termed precision medicine.

“Precision medicine has given us one of the greatest opportunities that we have ever seen in medical research,” said Obama at a White House event kicking off the initiative. “The time's right to unleash a new wave of advances in this area.” 



The bulk of investment, $130 million, will be devoted to the NIH, which will stitch together existing cohorts of genomic database and recruit new volunteers in an effort to create a million-patient-strong cohort.

Another $70 million will go to the NIH's National Cancer Institute, to scale up current efforts to link genomic variation and cancer, along with potential treatments. The head of the NIH, Dr. Francis Collins, said during a conference call Thursday announcing the policy that the investment reflects the relative maturity of genomic efforts in cancer treatment. 

The FDA would receive $10 million to hire new subject-area experts. The agency, beginning with a public meeting in February, also intends to update its regulations to deal with the peculiar challenges posed assessing the safety and efficacy of genomic sequencers and tests that analyze their data.

The ONC would receive $5 million to promulgate new interoperability standards to make genomic data more shareable. Tales of researchers mailing thumb drives and compact discs, rather than sending data electronically, are common.

“We're far from unlocking precision medicine's full potential,” Dr. Jo Handelsman, the associate director for science in the White House Office of Science and Technology Policy, said Thursday. The intention is that the initiative will build the infrastructure that will support new insights into the genome, and consequently human health.

Obama agreed, saying that basic research sometimes fails–but when it succeeds, the payoffs are large, such as with longitudinal studies discovering the risk factors for heart disease, or federal funding setting up the later success of MRI scanning.

The NIH will be placing an emphasis on uniting private sector efforts to develop genomic cohorts. “We are aware that there are something like 200 cohorts that have at least 10,000 participants. There's a wealth of potential there,” Collins said. Central to that will be ensuring the data is interoperable, and ensuring that the data is “distributed” for easy access—rather than uniting the data centrally.

Furthermore, Collins emphasized the potential gains from ensuring that patients could be recalled. For maximum potential, he said, genomic researchers need to be able to recall patients and take laboratory measurements. That ensures a tight link between the genomic data and the eventual health outcomes of the patient, rather than a snapshot in time.

For some research, he said, it's particularly vital. Some researchers have been interested in rare genomic variants that appear to provide boosts in health, rather than lead to disease. Tracking those patients closely can allow for richer knowledge of that subset.

“We would expect that [re-contact] occurs because it makes it much more powerful,” he said.

FDA's role primarily will be in modernizing its regulations. Current diagnostics, said FDA commissioner Dr. Margaret Hamburg, tend to test for one disease or condition. That makes it easy for the agency to test the link between diagnostic and disease.

Next-generation tests, on the other hand, will tend to pass verdicts on multiple diseases, and so are more complex for the agency to assess. Starting with a February public meeting, the agency intends to mull over questions related to sequencers and tests, followed by regulatory changes.

Follow Darius Tahir on Twitter: @dariustahir

Friday, January 30, 2015

Meaningful Use Pushback

CMS announced a shortened period for attestation of Stage II of meaningful use, after the AMA and others asked for a delay in implementation and/or modify the criteria for meaningful use A large percentage of providers have not been able to certify and/or attest to Stage II of the Meaningful Use timetable.  The term Meaningful use defines the ability for a provider's data to be transmitted to CMS in a format recognizable to their analytics algorighms.















to quote CMS announcement on their blog

We are considering proposals to:
  • Realign hospital EHR reporting periods to the calendar year to allow eligible hospitals more time to incorporate 2014 Edition software into their workflows and to better align with other CMS quality programs.
  • Modify other aspects of the program to match long-term goals, reduce complexity, and lessen providers’ reporting burdens.
  • Shorten the EHR reporting period in 2015 to 90 days to accommodate these changes.
This shift in timing may just be a prelude for things to come. 

Wednesday, January 28, 2015

Innovation....What it is NOT

Innovation, Kickstarters, Disruptive technology, and Creativity in Health Care.

Few would argue that the past ten years of the introduction of  digital storage and other electronic devices has not empowered health care providers, hospitals and the health industry.

The promises have been many.  Some have taken root and will become a part of the new infrastructure of how medical care is delivered.

There are those who state that  HIT Venture Capital has peaked, after the Federal Funding by the  HITECH Act and Federal incentives have passed.  CMS Meaningful use has dampened any enthusiasm for meaningful advances in EHR since capital investment will now be diverted for a capability in which few clinicians are interested.

The fact is that most innovative ideas do not make it off the drawing board, attract capital, nor make it to a marketplace. Even after running that gauntlet the marketplace may not be favorable to develop a sustainable business model. Except for government, profit often is the measure of a successful innovator.

However even in government profit can be a motive, or at least reduce taxation and cut costs of operation. Our government functions wiith a contractual bidding system....ie, lowest bid...best product.  The two are not mutually exclusive. Risk to a government is different than risk to a business innovator.
The blend for success is a mixture of creativity, scientific breakthroughs, business acumen, and timing.

Innovation can be scientific, or even new business models for health care. Certainly the Affordable Care Act is an innovation. (more later).

Here are some possibilities:

Video Teaser



       Mobile Health App
       Graphical Display of Innovations   Innovator Gallery
Pharmaceuticals (Drug Development)
Devices
Organizations focused on Health Innovations
       University of California   Innovation examples 
       California Health Care Foundation
       Digital Health Space
       Center for Digital Health Innovations
       Public Health Innovation
       CMS Innovation Center   (detailed description)
     
Meetings
       Rock Health Summit

Blogs
       HealthIT Buzz
       RedBrick Health
       Innovating for Value in Health Care
       The Oliver Wyman Health Innovation Center
       Blog « Rock Health

       Center For Health Law Policy and Innovation | CHLPI Blog

     
Awards:
       CMS

Financial
      The Fund for Health Innovation
      Kickstarters (While there is no specific category for Health, there is a
      Technology category)

      HIT Venture Capital History and Future Outlook

                HIT venture capital funding jumps in 2014

                Digital Health Venture Capital: 4 Areas VCs Are Betting On 

                Venture capital in healthcare is flowing, but how long will it ...   

                Investing in Medical Devices  

                 The impact of the Affordable  Care Act,and increasing regulatory (details)

Compare Medical Devices and Equipment VC Firms           

               PSFK       Slideshare   The Future of Health

               Education and MOOC  Innovating in Health Care





                                 



     



Sunday, January 25, 2015

A Roundup of 2015 Technology Predictions

JANUARY 18, 2015 | BY 

The four horsemen of the digital business apocalypse -- Social, Mobile, Analytics, Cloud (SMAC) -- have been galloping around for several years, and many companies have now launched with or transformed existing business models.

Health care, providers and hospitals have in large part developed internet presence on the web, in social media, analytics and cloud (SMAC).

 At shows like the recent CES in Las Vegas, there was much talk of the Internet of Things (IoT) -- particularly wearables, connected homes and connected cars -- as well as 3D printing, robots (including drones) and virtual/augmented reality. Are these and other new technologies about to make their way into business? And what changes are afoot in the sector?

And there is no paucity of 'futurists', predicting their own version of transformation.  Will  reality follow fantasy ? Dreams are made of fantasies.






Saturday, January 17, 2015

Midnite Madness




I woke at 2 AM earlier today with a panicky feeling about what I may have been missing in Internet explorer and/or Firefox.  Spent that past two days recovering and installing a Vista 32 program on my vintageToshiba Satellite A215 laptop.  My son said the laptop was ‘dead’.  I found an excellent and cheap aftermarket multi-purpose power brick and adapters to fit almost any portable device ($ 9.00 on Amazon  Also went online to Toshiba to order a ‘recovery disk  ($29.95)  Fired it up...all went well.  Runs pretty fast, although it became very hot and shut down. Investigation revealed the cooling fan was not spinning. The problem was dirt in the heat dissipation sink  and stuck fan bearing fr om dried out lubricant.  I was happy to not have to tear the laptop down to replace the fan needlessly.


Back to my anxiety of last night.  For the first time in many years I used a non Chrome browser. I tried Internet Explorer (ver 7.0) first, then Firefox.  ehh !?  Neither of them ran well.  Much of the problem I believe is that the newer programs and add ons are not very backward compatible with Vista 32. and a great many add ons, plug ins would not run or appear at all. Back to Chrome….


browser wars.jpg windows vista experience.jpg


Other than the lag in the cloud at times, the “snap” crashes  it serves my purposes well.  For those of you who have sworn off IE or Firefox I agree.  My  assessment is definitely biased because I am using such an older version of Windows.  I noted that the boot times for Vista seemed to be much quicker on this old laptop with the clean install.


windows vista.jpg


Next step is to replace the HDD with an SSD. After using my chrome book now for several years, the Toshiba feels very very heavy...portable comptuer...my ass...it is all relative.


Chrome however will not run several web conferencing tools, nor zoom.info.


When I tire of this activity I will buy a new iMAC 5 K.  


I can now sleep better knowing what the ‘new Windows and Firefox look like.  Vista 32 would not allow me to upgrade  IE past ver 7.0 . either.  It is 6 AM, and time to start the day….I am going back to sleep. The sun is rising in the east, and the owls are hooting.

Our backyard alarm clock


Riverside CA looking North 7A.M.


Saturday, January 10, 2015

EHR adoption rises Meaningful Use Declines

Continued growth of physician office EHR use
Whatever the reasons behind these responses from SERMO members, physician office EHR adoption is on the rise. An ongoing study by SK&A indicates a ten-percent increase in physician office adoption of EHR technology between 2013 and 2014. What’s more, it provides a breakdown of the top-five EHR vendors nationally and regionally.
At the national level, Epic Systems controls 30 percent of the market followed by eClinicialWorks (22%), Allscripts (19%), Practice Fusion (16%), and NextGen Healthcare (13%).
The regional differences are quite small
A closer look by region shows a close competition between Epic Systems and eClinicalWorks for EHR selection by physician offices.
The former dominates the West, Midwest, and East regions of the United States. The latter holds sway in the South and New England regions. Here’s a region-by-region breakdown:
2015-01-08-EHRs-by-region
Interestingly, where neither is first both companies drop to the third or fourth spots. Considering that both companies specialize in working with health systems and hospitals, their domination of various markets may indicate the ownership of physician practices and use of that health system’s or hospital’s EHR technology.



Despite the increased implementation and use of EHR technology by physician offices, their physicians have a ways to go in order to keep pace with the evolution of the EHR Incentive Programs.

Related Resources:

Wednesday, January 7, 2015

Spectrum Health shuts down, reabsorbs digital health startup Ideomed

mHealth developers face several challenges for users and developers.

Interest in these applications is weak. Statistics reveal that 60% of the population have downloaded at least one mobile health application.  How long and how often they access the program is another story.

Whle the consumer market is potentially infinite, in real life things are quite different. Most of these apps are available free of charge or for a small fee. A few have monthly or annual  fees.

The Chrome store and iTunes (iOS) provide easy access to purchasing mHealth applications for desktops and also tablets.

Business sustainability is an issue in terms of acquisition and/or usage. Developers face ongoing expense in software applicaions with upgrades, new versions and staying current with preferred practice patterns for monitoring metrics such as weight, BMI, blood pressure,pulse rate and for monitoring blood chemistries as the technology advances.




Wearable devices are becoming more commonplace  and recent sensory and biochemical markets can be measured with these devices using non invasive skin sensors. The future for wearable sensors may also be combined with embeddable chips accessed by RFID devices, much like personal ID used for animals and  people. Technology also exists that precludes wearing an external device constantly Acquisition is possible just by walking near an RFID antenna embedded in the wall of a home or office. The potential uses are enormous, not just for measuring metrics, and also reminders for appointments, prescripton renewals.

The promises of nano-technology have already contributed to the development of drug delivery systems capable of going where 'no drug  has gone before'.

Spectrum Health faced these challenges of sustainability with their subsidiary Ideomed, a mobile health application. Their decision was to discontinue their mobile health applications associated with their health plan.




Tuesday, January 6, 2015

Emergency Regulations proposed for Covered California Is It ? Jones Releases Emergency Rule Over Narrow Provider Networks


Are you one of the hundreds of thousands who accepted the incompetent design of 'The Affordable Care Act ?  You are not alone.

It has taken more than one year of operation for state health officials to recognize this current disaster. 

The affordable care act has delivered an empty promise, deception, and a boiler plate plan that gives  you a health insurance card...Good luck after that.

Sick patients require help and assistance. Those who are well and especially those who have an acute or chronic illness have many challenges in life, should not and cannot negotiate the web sites, and even when they do, much of it is incomprehensible.  



Haste in signing up due to arbitrary guidelines and enrollment dates add additional challenges for those still uninsured, and those who have discovered just how terrible their new plans are presents challenges for most.

Help may be on the way now that State Commissioner for Health Insurance, Dave Jones is responding to complaints from California Consumers.  Jones is the head of the California Managed Care programs.





California State Health Commissioner, Dave Jones







a service of the California HealthCare Foundation












On Monday, the California Department of Insurance issued an emergency regulation that aims to address narrow provider networks in the state and improve residents' access to care, Capital Public Radio's "KXJZ News" reports. 

According to the state Department of Managed Health Care, several insurers, including Anthem, have violated state law by misleading consumers about the size of their provider networks  State Insurance Commissioner Dave Jones (D) said DOI has "received complaints from consumers across the state about long waiting times, about inaccurate directories of providers, about being charged out-of-network costs when there isn't an in-network provider. The list goes on and on and on" 



Details of Emergency Regulation

The emergency regulation requires insurers to:

  • Adhere to new standards for appointment wait times (DOI release, 1/5);
  • Offer an adequate number of physicians, clinics and hospitals to patients who live in certain areas;
  • Provide an accurate list of in-network providers ("KXJZ News," Capital Public Radio, 1/5);
  • Provide out-of-network care options for the same price as in-network care when the number of in-network providers is insufficient; and
  • Report to DOI information about their networks and any changes.
The emergency regulation will go into effect after it has been reviewed by the Office of Administrative Law. According to a release, emergency regulations often go into effect more quickly than standard regulations (DOI release, 1/5).


According to Jones, he can bar insurers that do not comply with the regulation from selling insurance in the state next year 






Monday, January 5, 2015

Health Apps Score 66.5 on Average in Consumer Reviews Report

Health Apps Score 66.5 on Average in Consumer Reviews Report



iHealthbeat entered 2014 with a wrap up of mobile health apps avalable to consumers.

Consumers on average gave health, fitness and medical mobile applications an average score of 66.5 out of 100, or "good,"according to a new report from app quality analysis vendor ApplauseHealth Data Management reports.

Report Details

The 2015 State of the U.S. Health & Fitness Apps Economy index was based off more than 200 million ratings and reviews for 39 health and fitness apps and 28 medical apps available in the Apple App Store and Google Play app store.
The researchers used Applause Analytics, a mobile app analytics tool, to calculate a quality score on a scale from 0 to 100. Specifically, apps that scored:
  • 0 to 39 were considered "poor";
  • 40 to 59 were considered "fair";
  • 60-69 were considered "good";
  • 70 to 89 were considered "excellent"; and
  • 90 to 100 were considered "winning."

Report Findings:  All mobile health apps are avalable in iOS and Android


Mobile Health software would be useless without mobile devices. The form factor and usability of numerous smartphones, tablets, and even newer human-machine interfaces all play a role, especially in wearable devices, where fashion may play a major role.

Wearable devices are still in their infancy in terms of development and deployment. Wearable devices fall under the domain of consumerism as well as a more professional scientific application such as ICU, Emergency Medicine, as well as remote monitoring f


Being produced by Zensorium and their partners in technology, biochemistry and sensors integrate as a platform many many uses in the future with their APK


Four apps received "elite" status, scoring higher than 70 based on more than 50,000 reviews. Those four apps were:
Android apps that scored 80 or above based on more than 20,000 reviews were:
iOS apps that scored 80 or above based on more than 20,000 reviews were:
The report also identified apps that scored below average and could do more to improve their quality, including:
Research Methodology
To build the health & fitness mobile app quality index, ARC 360:

■ Started with the list of 8,851 health & fitness and medical apps housed
within the two most popular U.S. app stores—Google Play and Apple App
Store. Google Play and Apple App Store health & fitness and medical app
store categories match identically.


1800Contacts
Blood Pressure Monitor BY TACONIC SYSTEM
Parenting Reminder BY AAWE DEVELOPMENT
Total Baby BY ANDESIGNED
Free Menstrual Calendar
Lady Pill Reminder BY SERGIO VIUDES
Home Remedies+ BY PROTHOUGHTS
Home Remedies (Lite) BY PROTHOUGHTS
Speed Anatomy Quiz Free
Beauty Tips Full BY HONGGANG LI
Feed Baby BY PENGUIN APPS
Leafly
Diseases Dictionary Medical BY ATOMICAPPS
Visual Anatomy BY EDUCATION MOBILE
Feed Baby Pro BY PENGUIN APPS
GoodRx Drug Prices and Coupons
Baby Nursing / Breast Feeding
Baby Care BY BRET.JIA
Know, Buy Medicines BY HEALTHKARTPLUS
Glucose Buddy: Diabetes Log BY AZUMIO
Test Your Hearing BY EPSILONZERO
I Can Be Free BY HUMANPROGRESS
Medscape BY WEBMD
Diabetes App BY BHI TECHNOLOGIES
iPharmacy Pill ID & Drug Info
Vision Test BY 3 SIDED CUBE
Epocrates
Weedmaps
 

Sunday, January 4, 2015

CES 2015.....Vegas Baby

What's happening in Vegas: the CES 2015 keynotes you won't want to miss


What dedicated health technologist can miss CES ?


The biggest day of CES is the day before CES. Come to think of it, the day before that (today, Sunday) is pretty big too. But Monday is press conference day

The day some of the industry’s biggest and most important companies get on stage and launch somewhere between five and five thousand new products. (Some of them will be washing machines.) If you’re excited about the future of technology and the gadget industry, there’s no bigger day than CES Day Zero.
That day is tomorrow. Monday, January 5th, 2015. We’ll be live all over Las Vegas, following every event, every announcement, every time Michael Bay melts down during a Samsung event because he forgot his lines and should probably stick to directing. For the biggest events, we’ll be on the scene liveblogging, bringing you everything in real time as it happens.

The best place to find everything at CES is the CES hub, which will reflect both the best and the newest things we’re finding at the show. But if you want to know everything that’s happening, as it happens, here are the events you’ll want to watch along with us.

Will we need our hands or fingers to use HIT in the future?

Video Interface Designs from Google Glass to Hand Gestures  more gestures   to Mind Control

SEE ALL THE LATEST CES 2015 NEWS HERE ›