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Hopes for Big Impact from Validic: Making Use of Consumer Device Data

Posted on March 20, 2018 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Validic, a company that provides solutions in data connectivity to health care organizations, came to HIMMS this year with a new platform called Impact that takes a big step toward turning raw data into actionable alerts. I talked to Brian Carter, senior vice president of product at Validic, about the key contributions of Impact.

Routinely, I find companies that allow health-related monitoring in the home. Each one has a solution it’s marketing to doctors: a solution reminding patients to take their meds, monitoring vital signs for diabetes, monitoring vital signs for congestive heart failure, or something else fairly specific. These are usually integrated solutions that provide their own devices. The achievement of Validic, built through years of painstakingly learning the details of almost 400 different devices and how to extract their data, is to give the provider control over which device to use. Now a provider can contract with some application developer to create a monitoring solution for diabetes or whatever the provider is tracking, and then choose a device based on cost, quality, and suitability.

Validic’s Impact platform actually does many of the things that a third-party monitoring solution can do. But rather than trying to become a full solutions provider for such things as hospital readmissions, Validic augments existing care management systems by integrating its platform directly into the clinical workflow. With Impact, clinicians can draw conclusions directly from the data they collect to generate intelligent alerts.

For instance, a doctor can request that Impact sample data from a sensor at certain intervals and define a threshold (such as blood sugar levels) at which Impact contacts the doctor. Carter defines this service more as descriptive analytics than predictive analytics. However, Validic plans to increase the sophistication of its analysis to move more toward predictive analytics. Thus, they hope in the future not just to report when blood sugar hits a dangerous threshold, but to analyze a patient’s data over time and compare it to other patients to predict if and when his blood sugar will rise. They also hope to track the all too common tendency to abandon the use of consumer devices, and predict when a patient is likely to do so, allowing the doctor to intervene and offer encouragement to keep using the device.

Validic has evolved far beyond its original mission of connecting devices to health care providers and wellness organizations. This mission is still important, because device manufacturers are slow to adopt standards that would make such connections trivial to implement. Most devices still offer proprietary APIs, and even if they all settled on something such as FHIR, Carter says that the task of connecting each device would still require manual programming effort. “Instead of setting up connections to ten different devices, a hospital can connect to Validic once and get access to all ten.”

However, interconnection is slowly progressing, so Validic needs to move up the value chain. Furthermore, clinicians are slow to use the valuable information that devices in the home can offer, because they produce a flood of data that is hard to interpret. With Impact, they can derive some immediate benefit from device data, as the critical information is elevated above the noise while still being integrated into their health records. They can contract further with other application developers to run analytical services and integrate with their health records.

Key Articles in Health IT from 2017 (Part 2 of 2)

Posted on January 4, 2018 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The first part of this article set a general context for health IT in 2017 and started through the year with a review of interesting articles and studies. We’ll finish the review here.

A thoughtful article suggests a positive approach toward health care quality. The author stresses the value of organic change, although using data for accountability has value too.

An article extolling digital payments actually said more about the out-of-control complexity of the US reimbursement system. It may or not be coincidental that her article appeared one day after the CommonWell Health Alliance announced an API whose main purpose seems to be to facilitate payment and other data exchanges related to law and regulation.

A survey by KLAS asked health care providers what they want in connected apps. Most apps currently just display data from a health record.

A controlled study revived the concept of Health Information Exchanges as stand-alone institutions, examining the effects of emergency departments using one HIE in New York State.

In contrast to many leaders in the new Administration, Dr. Donald Rucker received positive comments upon acceding to the position of National Coordinator. More alarm was raised about the appointment of Scott Gottlieb as head of the FDA, but a later assessment gave him high marks for his first few months.

Before Dr. Gottlieb got there, the FDA was already loosening up. The 21st Century Cures Act instructed it to keep its hands off many health-related digital technologies. After kneecapping consumer access to genetic testing and then allowing it back into the ring in 2015, the FDA advanced consumer genetics another step this year with approval for 23andMe tests about risks for seven diseases. A close look at another DNA site’s privacy policy, meanwhile, warns that their use of data exploits loopholes in the laws and could end up hurting consumers. Another critique of the Genetic Information Nondiscrimination Act has been written by Dr. Deborah Peel of Patient Privacy Rights.

Little noticed was a bill authorizing the FDA to be more flexible in its regulation of digital apps. Shortly after, the FDA announced its principles for approving digital apps, stressing good software development practices over clinical trials.

No improvement has been seen in the regard clinicians have for electronic records. Subjective reports condemned the notorious number of clicks required. A study showed they spend as much time on computer work as they do seeing patients. Another study found the ratio to be even worse. Shoving the job onto scribes may introduce inaccuracies.

The time spent might actually pay off if the resulting data could generate new treatments, increase personalized care, and lower costs. But the analytics that are critical to these advances have stumbled in health care institutions, in large part because of the perennial barrier of interoperability. But analytics are showing scattered successes, being used to:

Deloitte published a guide to implementing health care analytics. And finally, a clarion signal that analytics in health care has arrived: WIRED covers it.

A government cybersecurity report warns that health technology will likely soon contribute to the stream of breaches in health care.

Dr. Joseph Kvedar identified fruitful areas for applying digital technology to clinical research.

The Government Accountability Office, terror of many US bureaucracies, cam out with a report criticizing the sloppiness of quality measures at the VA.

A report by leaders of the SMART platform listed barriers to interoperability and the use of analytics to change health care.

To improve the lower outcomes seen by marginalized communities, the NIH is recruiting people from those populations to trust the government with their health data. A policy analyst calls on digital health companies to diversify their staff as well. Google’s parent company, Alphabet, is also getting into the act.

Specific technologies

Digital apps are part of most modern health efforts, of course. A few articles focused on the apps themselves. One study found that digital apps can improve depression. Another found that an app can improve ADHD.

Lots of intriguing devices are being developed:

Remote monitoring and telehealth have also been in the news.

Natural language processing and voice interfaces are becoming a critical part of spreading health care:

Facial recognition is another potentially useful technology. It can replace passwords or devices to enable quick access to medical records.

Virtual reality and augmented reality seem to have some limited applications to health care. They are useful foremost in education, but also for pain management, physical therapy, and relaxation.

A number of articles hold out the tantalizing promise that interoperability headaches can be cured through blockchain, the newest hot application of cryptography. But one analysis warned that blockchain will be difficult and expensive to adopt.

3D printing can be used to produce models for training purposes as well as surgical tools and implants customized to the patient.

A number of other interesting companies in digital health can be found in a Fortune article.

We’ll end the year with a news item similar to one that began the article: serious good news about the ability of Accountable Care Organizations (ACOs) to save money. I would also like to mention three major articles of my own:

I hope this review of the year’s articles and studies in health IT has helped you recall key advances or challenges, and perhaps flagged some valuable topics for you to follow. 2018 will continue to be a year of adjustment to new reimbursement realities touched off by the tax bill, so health IT may once again languish somewhat.

Virtual Reality and Treating Dizziness

Posted on July 20, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Mark Cuban has a pretty amazing post that talks about his experience as an active, engaged patient in his care and how he found virtual reality helped him achieve the desired relief from dizziness that he desired. If you’ve stayed up with the virtual reality space, you’ll find this quite intriguing since virtual reality is often condemned because of the dizziness it causes. Obviously, what you’re watching on VR matters a lot.

Go ahead and read Mark’s full post to see his experience as an active patient trying to deal with his Dizziness. We’ll be here when you get back. You can also watch this video he made:

It’s pretty amazing how active Mark Cuban was in his care. Sure, he has the money to be as active as possible. He literally was looking at buying a massive medical device or even investing in a business to bring the treatment he wanted to Dallas. That’s extraordinary and something that most of us can’t do as patients.

For those who haven’t read the whole story, Mark Cuban was getting treatment in California that was helping him with his dizziness from Dizziland.com. However, he couldn’t stay in California to finish the treatment. That’s when he discovered that the Samsung VR set he had might be the solution to creating a portable solution for him. Turns out, it did the trick for him. As a true businessman, he’s now working with the company to commercialize the product.

To be clear, this device setup is not FDA approved. It’s something that Mark found and tried that worked for him. We won’t be seeing doctors prescribing this for a while to come. Although, it will be interesting to see if and how solutions like this do go to market. Will they need to be FDA approved? Will they be regulated? How much will they cost? Lots of interesting questions since the videos and technology to watch them are quite cheap.

I love the story of technology making an impact on someone’s health for good. I also love seeing an active patient taking a serious interest in their care. Although, it’s amazing how a billionaire’s interest in their health is similar to any person with a major health issue.

How Many Received Health Apps, Wearables or Other Health Related Gifts for Christmas?

Posted on December 25, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re basically taking this week off (like many of you) and enjoying time with family. However, I thought it might be fun to see what people have gotten as part of their Christmas haul.

How Many Received Health Apps, Wearables or Other Health Related Gifts for Christmas?

I’m sure the numbers will eventually come out, but you can be sure that it was a banner year for wearables this Christmas. I guess this really isn’t a change in our culture. Before we’d get treadmills, weights, and Jane Fonda videos. Now we get wearables to help us achieve the same goals. Sadly, I think most of them will end up like the other exercise equipment: gathering dust.

I hope you all have a Merry Christmas and a Happy Holidays!

Timex SmartWatch Doesn’t Need a Smartphone

Posted on August 20, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’ve been covering a lot of the movement in the SmartWatch space. It’s a really interesting set of technology since every one of them integrates some piece of healthcare into their technology. One of the features of pretty much every smartwatch out there is that they’re essentially just a second screen for your smartphone. That means you need a smartphone to be able to use the smartwatch. That’s not really too much of an issue since most of us have smartphones.

While it’s true that most people have smartphones, when it comes to health and fitness you often don’t want to carry around your smartphone while you’re running, swimming, biking, etc. With this in mind, I was intrigued by the announcement of the Timex Ironman smartwatch that doesn’t require a smartphone. Here’s a short description from the WSJ article:

The point, for Timex, was to create a device that could keep someone connected during hardcore workouts without having to bring along a smartphone or music player. It’s waterproof down to 50 meters, so it’s fine for swimming and even diving, and has a Qualcomm Mirasol display, which is more visible in direct sunlight than many LCD screens.

The watch tracks a user’s speed, distance traveled and pace in real time, and can share it with friends and family who want to follow along. The wireless connectivity enables the watch to send email messages, and a “find me” mode allows users to send an alert to emergency contacts such as friends and family if trouble arises.

I see this as another great evolution of the smartwatch environment. First, it provides a health and fitness alternative that makes a lot of sense. Second, it’s really interesting to see a company like Timex getting involved in the space. It will be really interesting to see how Timex does developing a touchscreen watch since that’s not their usual skill set.

EKG As A Password

Posted on April 3, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve heard a lot of different biometric passwords in my day, but I hadn’t heard of using your EKG as a password until Dr. Patricia Salber pointed it out on her blog, The Doctor Weighs In. Here’s a video of Dr. Salber talking about the new technology called the Nymi.

I can see problems with using the EKG as a password, but I still love that they’re working on it. Maybe it won’t be the cure to passwords that we all want, but this could also be a continuous EKG monitor, no? My feeling is that by digging into the uniqueness of the EKG for personal identification, we’ll discover and learn a lot about our personal EKG.

Qualcomm Toq Smartwatch

Posted on November 26, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Most of you will remember my post on the Qualcomm Toq Smartwatch announcement. I just got word that I’m on the list to get one of these watches. I can’t wait to try it out. In fact, I’m even more excited after watching this video demoing the smartwatch:

I can see a number of times I would love to have this smartwatch. I love having my calendar on it. Sure, I could pull out my phone, but a smartwatch right there seems a lot nicer for some reason. I also love the notification aspect of it. I often miss messages on my phone, but this would be easier to check and see if I need to address something or not. I also can see me reading my Twitter feed on it as well.

Of course, from a health perspective, I’m looking forward to see what health apps are built into the watches. I wonder if it and smartphones will replace all the other hardware based fitness trackers for example. Fred Wilson, a NYC VC, has a great post on Software vs Hardware startups. He asks an interesting question about whether the innovation will happen in hardware or software.

What do you think of the smartwatch?

FitBit Raises $43 Million

Posted on August 15, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

This is great news for FitBit the company. That should be enough cash to really aggressively go after the mobile health market. Of course, with $43 million of funding and their previous $12 million third round of funding, they have no choice but to hit it out of the park now.

One advantage that FitBit has over a lot of the mobile health industry is that the FitBit is now sold in 15,000 retail locations across the US. Getting that type of distribution takes time and is a very strong asset for the company.

I’ll be interested to see where they take the technology next. One problem with being a hardware company is that your next model has to be better than your previous model. I’ll be interested to see how well they can execute their next FitBit models. Will they continue to make huge step forwards in mobile health devices or will they be just an evolution of their current product? The answer to that will determine whether FitBit is a great investment or not.

My question for you is: Does this amount of funding help to legitimize the mobile health space?

BlueStar By WellDoc To Be First Mobile Prescription Therapy

Posted on June 19, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

You may be familiar with WellDoc already. They are distributors of a mobile app that was created to help manage diabetes, which has been very successful. And just a few days ago, they released something else that appears to be rather monumental.

The service is called BlueStar, and is the mobile version of the diabetes management program. What’s so monumental about this, is that it is the first disease therapy to be prescribed through an app. In addition to that, it is also the first that can be eligible for reimbursement through insurance. Not all insurance companies will cover it, but self-insured companies like Ford, Rite Aid, and DexCom have said BlueStar will become a part of their pharmacy coverage.

BlueStar features many of the same features that Diabetes Manager, the first WellDoc program, did which include getting alerts when their blood sugar level is too low or high and charts to detect trends. It suggests tips for getting blood sugar higher. However, what’s new is that BlueStar can provide feedback concerning medication dosage, give better coaching, and even recommendations to a doctor.

Just like any prescription, a doctor can prescibe BlueStar for a certain period of time in addition to medications. When a pharmacy receives that prescription, they will forward it on to WellDoc, who will have someone help the patient setup BlueStar on their device. BlueStar will calculate how much insulin a patient should take, depending on the attending physician’s recommendations, blood sugar levels, and how many carbs were eaten at a certain time. If a treatment regimen is deemed to be ineffective for a patient, a report will be sent to the doctor recommendation a new regimen.

Because diabetes truly affects so many across the country, this could mean a lot to many people. Of course, there are questions about how effective it can be, since many people may become unmotivated after using the app for a certain period of time. Time will only tell.

Lumosity: An Exercise Program For Your Brain

Posted on June 10, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

So often, we focus on our physical health, but neglect our mental health. All forms of dementia are devastating. Many people complain of brain fog. Thousands of people suffer from attention disorders. While I don’t claim to know the cure for any of these things (or even the cause) I do think that exercising the mind is just as important as exercising your body. I mean, if your brain fails, then your life ceases to exist. It’s a pretty important thing to take care of!

I saw a commercial today for a website called Lumosity.com. It sparked my interest, so I decided to check it out. The website says that it “turns neuroscience breakthroughs into fun, effective games” and it’s a way to “harness your brains neuroplasticity [the brain’s ability to grow and expand] and train your way into a brighter life.”

To be honest, it seems like it is set up a bit like an exercise website. When you sign up, you answer some questions about where you want changes to be made. Changes can be made in any of five categories, all of which have subcategories. These categories are memory, attention, speed, flexibility, and problem solving. You can select as many or as few of these categories as you want. After doing this, you can create an account and view your free and personalized training program, and you can personalize your training even further.

The program changes with you — as you get better at the challenges, you get newer ones. Each of the “sessions” include a variety of games to help you improve in the areas you initially selected. You get points very every game you do, to help you track your progress. The games are actually pretty fun, and challenging, and scientifically developed to help increase your brain function.

The basic version of Lumosity is free, but if you really want to get into the program, there are paid options. This gives you more games each day, more personalized training, and more. People spend hundreds, maybe even thousands, on personal training at a gym, as well as countless hours…so why not spend some of those valuable resources on making sure your brain is in tip-top shape? I thought this was a cool idea, and I think it could be a great resources for anyone wanting to exercise their mind. Apparently, 97% of Lumosity users improve after just 10 hours of training (which can be seen in the personalized tracking portion of the website.)_

Lumosity Brain Trainer is also available as a free download for iOS devices.