Democrats expect key CMS initiative to survive Supreme Court

By: Brian Dolan | May 31, 2012        

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Brian Dolan, Editor, MobiHealthNewsWe first encountered plans for the Center for Medicare and Medicaid Innovation (CMMI) in early 2010, when many of the center’s goals were laid out in a 25 page (mostly mobile) health-focused chapter of the FCC’s National Broadband Plan. With the passing of the Affordable Care Act, Congress allocated $10 billion through the year 2019 to fund the creation of what was then called the CMS Innovation Center.

Dr. Mohit Kaushal, who in 2010 was leading the FCC’s policy team on the healthcare front — he’s since joined the West Wireless Health Institute — explained to the audience at the WLSA Convergence Summit in 2010 how the CMMI would be the single most important initiative for changing how payers reimburse for wireless health services.

Kaushal argued at the time that while CMS has traditionally been able to conduct pilots that tested out innovative payment models, it was hard for pilots to get implemented at “the macro level.”

With a Supreme Court ruling on the constitutionality of the Affordable Care Act’s individual mandate expected in the coming weeks, it has been suggested that the court could strikedown the entire legislation.

During a panel session convened by the American Center for Progress, Senator Sheldon Whitehouse (D-RI) said that “the only part of the massive bill being challenged is the individual mandate. That’s the only aspect that, some say, the federal government can’t do, only the states, which is a very narrow question,” he said. “So if the mandate falls, there is some logic — not great logic, but if you stretch, some logic — to that. But there is no logic” to going after the pilot programs that CMS is pursuing, a report in Government Executive quoted him as saying.

Whitehouse also said that some 45 sections of the health care law gave CMS responsibilities to conduct pilot programs, according to reports.

The director of the CMMI, Richard Gilfillan also participated in the panel, which was called “Obamacare at Work: Innovations to Deliver Better Care at Lower Cost.” As one example of the impact the CMMI has had, Gilfillan pointed to “the incredible response” that the CMMI received from private healthcare providers across the US to a CMS grant offer that sought models for interpreting data on cost savings from bundled payments, according to The New York Times. The CMMI received about 3,000 applications.

During his comments on the panel, Whitehouse predicted that the “delivery system reforms will survive, and we should not be stalling and dawdling because we are anxious about what the court will do.”

Matt Wiggins, CEO of Remedy Systems, which works with a number of insurance companies to create mobile tools for healthcare providers, hopes the CMMI survives.

“The CMMI designed policies that led to the creation of new types of customers for mobile entrepreneurs looking to solve the real cost problems in healthcare,” Wiggins told MobiHealthNews in an email. “By nurturing a market where modern technology — like iPad applications — can be used to coordinate care for ACOs and awardee conveners under Bundled Payments, the CMMI has made it exciting to work towards the construction of the future.”

On a somewhat related note, the MobiHealthNews team is looking forward to the HHS’s Health Data Initiative Forum III in Washington DC next week. The event is a public-private partnership that aims to enable the independent development of health applications through easier access to expanded, free data. See you there!

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By 2017: 50M consumer wireless health devices to ship

By: Brian Dolan | May 31, 2012        

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AliveCor's Dr David Albert and the iPhoneECG case (still pending FDA-clearance)

AliveCor's Dr David Albert and the iPhoneECG case (still pending FDA-clearance)

During the next five years more than 50 million wireless health monitoring devices for consumers will ship, according to a report from IMS Research. In 2016 about 80 percent of these consumer-facing wireless medical devices will be purchased by the consumers themselves, the firm predicts.

The demand for self-monitoring is outpacing telehealth implementations, according to IMS Research. Consumers are interested in self-monitoring and managing their own care at home despite the small number of healthcare systems adequately setup to support such tracking. Even so, the proportion of wireless devices used in managed telehealth programs is also set to grow from 5 percent in 2011 to about 20 percent in 2016, according to the report.

“Due to the relatively slow deployment of managed telehealth systems, which is in part due to a reluctance from health providers to move past trials, issues with reimbursement, and stringent regulations related to the use and storage of medical data, medical devices used by the consumer to independently monitor their health will provide the biggest uptake of wireless technology in consumer health devices over the next five years,” Lisa Arrowsmith, senior analyst at IMS Research, said in a statement.

“The increase in consumer familiarity with mobile applications as well as an increased awareness of the importance of monitoring health levels is driving the market for connected health devices,” Arrowsmith stated. “Many consumers already utilize smartphone apps to track their own health and fitness results, with devices such as activity monitors and heart-rate monitors. Now, there is increasing availability of health-related peripheral devices such as blood pressure monitors to track and upload information in real-time via a wireless or wired connection to devices such as smartphones and tablets.”

More details about IMS Research’s latest report in the press release below: Keep reading>>

Rock Health reveals six startups for its Boston class

By: Brian Dolan | May 31, 2012        

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BostonSan Francisco-based digital health incubator Rock Health revealed the six startups that will take part in its “pop up” incubator in Boston this summer. The Boston program is a bit different from those that took place at Rock Health headquarters in California: Those were five-month long spring and fall programs and the Boston program’s duration will be just under three months. The startups will present at a demo day on August 24, 2012. Harvard Medical School will play host to Rock Health’s third class and the institution’s community of clinicians and industry experts will work with the startups to refine their strategy.

Here’s how Rock Health describes the six startups (we had only heard of one previously) in its first Boston class:

HomeTeam Therapy merges the interactive gaming experience of Dance Central with the healing power of Physical Therapy to improve care and lower cost.

PrescribableApps is developing customizable, HIPAA-compliant SMS and mobile applications for users to track chronic illness longitudinally using their own experiential vocabulary. (Ed. note: This one we know of — founded by John Moore III, who works part-time as an mHealth analyst with his father at Chilmark Research.)

NeuroTrack Technologies has developed a suite of behavioral assessment tools that efficiently and effectively prognose oncoming Alzheimer’s disease and/or mild cognitive impairment (MCI) in individuals three to four years in advance of clinical diagnoses.

Neumitra develops develops data-driven technologies to measure and manage health under stress.

NoviMedicine has developed a web-based and soon-to-launch mobile device platform that allows a dermatologist to diagnose and treat skin conditions remotely.

ZeroSum Health is building a platform that empowers medical experts to create sophisticated mobile health interventions from scratch.”

More about Rock Health in Boston here.

Glooko syncs Roche meters, iPhones via infrared

By: Brian Dolan | May 30, 2012        

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Glooko IR AdapterGlooko, a mobile diabetes management startup, inked a deal with Roche Diabetes Care to extend the Glooko MeterSync to ACCU-CHEK meter users via an infrared data transfer adapter. The Glooko IR Adapter helps iPhone or iPod touch users who would like to more easily download blood glucose readings from their ACCU-CHEK meters to the Glooko Logbook app on their iOS device. The infrared adapter works with three ACCU-CHEK meters: ACCU-CHEK Aviva, ACCU-CHEK Compact Plus, and the ACCU-CHEK Nano SmartView Meter System.

Earlier this year Glooko raised $3.5 million in its first round of funding from an impressive group of investors, which included The Social+Capital Partnership, Bill Campbell, Vint Cerf, Judy Estrin and Andy Hertzfeld, Venky Harinarayan, Russell Hirsch and Xtreme Labs.

“Our goal at Roche is to give people with diabetes the tools they need to manage their diabetes in a way that is convenient for them,” Marc Gibeley, Head of Roche Diabetes Care North America said in a statement. “We want to give our customers choices, and the Glooko products nicely complement our current suite of information management solutions. It’s important for people to see their blood sugar patterns, and now our customers who prefer mobile Apple iOS devices can download readings and review trends on their iPhone or iPod touch to help them better manage their life with diabetes.”

The news follows the recent commercial launch of Sanofi’s iBGStar, an FDA-cleared glucose meter that connects directly to the iPhone and feeds data into a companion iPhone app. Sanofi’s device team estimates that some 1.6 million iPhone users in the US have diabetes, which also might point to the potential user base for Glooko’s connector cable and newly launch infrared adapter.

Glooko’s MeterSync cable costs just under $40 and is available through Amazon.com. ACCU-CHEK meter users can use the meter if they spend an additional $14.95 for the IR Adapter.

The company also announced updates to its free Logbook app. Glooko updated the app’s share function so that users could share their logbook by 2-week or 1-month PDF documents via email or efax. Glooko’s cable and app are also now available for the UK market, too.

As it has done in the past, Glooko promised that its product offerings will leverage more capabilities of smartphones and tablets and evolve into medical devices that require Class II clearance from the FDA.

The startup was co-founded by the head of a similar project at Johnson & Johnson’s Lifescan division, which demonstrated an iPhone hooked up to a glucose meter via a cable way back in 2009. The prototype demonstrated on-stage at Apple’s World Wide Developers Conference that year never actually launched commercially.

More in the press release below: Keep reading>>

VA worked around security rules in iPad, iPhone rollout, report says

By: Neil Versel | May 30, 2012        

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veteransaffairsipadDepartment of Veterans Affairs CIO Roger Baker may have circumvented around some federal protocols in deploying iPhones and iPads to VA personnel, but he did not violate strict security standards, according to an audit by the department’s Office of Inspector General.

In rolling out mobile devices to physicians and other VA personnel last year, the department knew that neither Apple iOS nor the Android operating system supported Federal Information Processing Standards (FIPS) 140-2 encryption, so Baker employed software work-arounds to assure that any sensitive data met government requirements for security. More than 200 Apple devices were distributed at VA facilities in Washington, D.C., Albany, N.Y., Chillicothe, Ohio, and Battle Creek, Mich., before a tipster reported the issue in confidence to a VA hotline in September 2011.

Sen. Jon Kyl (R-Ariz.) subsequently asked the OIG to investigate the practice and evaluate whether Baker violated any rules.

“Based on our results and in response to Senator Kyl’s additional request, we determined that VA’s approach of allowing only FIPS 140-2 certified applications to access or store sensitive encrypted data on the mobile device met [Federal Information Security Management Act] requirements for data protection,” a new report by Linda A. Halliday, the VA’s assistant inspector general for audits and evaluations, states. Halliday says that the 256-bit hardware encryption resident in Apple mobile devices “further minimized the risk of unauthorized disclosure of sensitive data” while federal officials test the Apple technology for FIPS 140-2 compliance.

However, the report found that the VA did not keep an accurate inventory of mobile devices using the enterprise’s network; two of the three iPads that the IT department supplied to OIG investigators did not have a federally certified security application installed, and the third was not configured properly, according to Halliday.

“We recommended that the Assistant Secretary for Information Technology [Baker] implement minimally acceptable baseline security configuration requirements for VA mobile devices in accordance with FISMA. We also recommended that the Assistant Secretary centrally manage the distribution of VA mobile devices will ensure that they are accurately inventoried and configured in accordance with minimum-security standards,” the report says.

The VA has agreed to have these plans in place by June, Halliday reports.

FCC MBAN plan called ‘step in the right direction’

By: Neil Versel | May 30, 2012        

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Darrell West Brookings InstituteLast week at a Brookings Institute forum examining how mobile technology influences health innovation, Brookings vice president and director of governance studies Darrell M. West repeatedly said that the Federal Communications Commission needed to open up dedicated wireless spectrum for healthcare use.

Two days later, the FCC approved a proposal to open up some of the spectrum—reclaimed when the nation switched from analog to digital television—for medical body area networks (MBANs) and for in-hospital wireless patient monitors. “The timing is really excellent. We really need more spectrum to support all the new technology that’s coming online,” West tells MobiHealthNews this week.

In West’s opinion, established wireless technology like Wi-Fi has its place for transmitting data, as does Bluetooth, but those technologies may not be sufficient for the pending explosion in mobile healthcare adoption. “We need something that is more reliable,” West says. “We need something that is dedicated for remote monitoring.”

According to the FCC: “The MBAN concept would allow medical professionals to place multiple inexpensive wireless sensors at different locations on or around a patient’s body and to aggregate data from the sensors for backhaul to a monitoring station using a variety of communications media. We conclude that an MBAN represents an improvement over traditional medical monitoring devices (both wired and wireless) in several ways, and will reduce the cost, risk and complexity associated with health care.”

GE Healthcare, which formally petitioned the FCC to allocate spectrum for MBANs, likened wireless medical sensor networks to “Facebook for the body.” In an interview with MobiHealthNews, West was pleased but more pragmatic. Keep reading>>