Fewer doctors, more cameras to spur teledermatology

By: Jonah Comstock | May 7, 2013        

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Mole Detective

The Mole Detective App

Medical peripherals can combine with a smartphone to create the function of an ultrasound machine, an EKG reader, or an otoscope, to name just a few diagnostic devices. But without buying anything extra, nearly every consumer mobile device has a camera of some sort built-in. That means that when it comes to dermatology, most patients have, right in their pockets, the tools to gather much of the data their doctor needs to treat them.

Teledermatology was a major topic at the American Telemedicine Association conference in Austin, Texas, in particular the “store and forward” kind, which is teledermatology where patients take pictures and send them to their dermatologist, who sends a treatment plan back — rather than conducting the examination in realtime. Just as the country is experiencing a dermatologist shortage, sufficiently high quality cameras are becoming widespread enough to support remote skin care.

At ATA, a number of direct-to-consumer teledermatology providers spoke about their different approaches to teledermatology. Mark Seraly represented DermatologistOnCall, an online platform that connects patients to dermatologists, David J. Wong spoke on behalf of Direct Dermatology, an online dermatology practice, and Ryan Hambley talked about startup YoDerm which hones in on diagnosis, treatment and prescription for acne specifically. Jeff Benobio, a Kaiser Permanente dermatologist, rounded out the panel, but as an integrated healthcare system Kaiser Permanente’s stood out as the only one who wasn’t thinking in terms of D2C.

“Dermatology is all about what it looks like,” said Seraly, noting that most of a dermatologist’s early training is making diagnoses from photographs. “Every dermatologist, I am confident, when they leave their training they are already naturally trained teledermatologists.”

The presenters agreed that patients’ cameras are good diagnostic tools. Keep reading>>


Mobile health helps aphasia patients get longterm care

By: Jonah Comstock | May 7, 2013        

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The Lingraphica MiniTalk

For many telemedicine offerings, part of the problem that the technology helps solve is distance by connecting providers and patients even if they are miles apart. Telestroke diagnostic consultation between physicians has long been an established telehealth practice. For some of the effects of a stroke, however, it’s not so much distance or speediness that is an issue. It’s that the structure isn’t in place to help patients maintain access to a longterm treatment.

A stroke patient might receive a few days of acute care and a few weeks of therapy, but for some stroke patients who end up with aphasia, the loss of language can stick with them for the rest of their life. That’s where Lingraphica, a 23-year-old aphasia rehabilitation company that presented this week at the American Telehealth Association (ATA) annual meeting in Austin, Texas, comes in.

“What you need is a lifetime of inexpensive rehab,” said Lingraphica CEO Andrew Gomory. “What you get is a few weeks of expensive therapy.”

Lingraphica’s approach is different from the current standard of care since, among other things, it uses a combination of apps and software offerings to support aphasia patients. Devices like the AllTalk allow patients who can’t speak to communicate with friends and family depending on what speech abilities they still have. They can type and have the device speak for them, or choose their words from a database of pictures. The company has also begun offering a suite of apps for consumer devices with the same function.

Lingraphica iPhone appLingraphica’s devices have Skype built in so aphasia patients can stay in touch with friends and family far away, too. Other apps from Lingraphica provide or enhance ongoing speech therapy, providing videos of oral and tongue exercises or helping the user to work on affected reading or speaking skills.

At ATA, Goromy demoed a web platform the company uses to deliver one-on-one speech therapy over the internet for a monthly fee. The system incorporates video communication, but also screen-sharing and remote control so the therapist and patient can work together with software that presents therapeutic exercises and spelling games. The therapist can assign homework for the other six days of the week and can track the patient’s progress on it.

Goromy said that Lingraphica’s technology also allows the company to collect aggregated data about what works best in speech therapy.

“We capture every keystroke, every touch the user makes, and we get semantic data, to know if they answer right or wrong,” he said. “It allows us to get an understanding of what is effective so we can push speech therapy into a more data-driven practice.”

And, Goromy said, the company believes speech recognition technology has finally advanced to the point where it could be helpful in the treatment of apahasia, allowing for the creation of a much more effective therapy app. In addition, Lingraphica wants to create an online community of aphasia patients — a more difficult challenge than most online patient communities because the condition takes away people’s language and communication skills.

“These are folks who are not tech savvy. They know what they want to say but they can’t say it,” Goromy said. “This is a very frustrated group. Their main job after a stroke is to put their lives back together, but they can’t talk.”

Ex-Allscripts CEO Tullman confirms plans for mobile health startup

By: Neil Versel | May 6, 2013        

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Glen TullmanFormer Allscripts Healthcare Solutions CEO Glen Tullman confirms to MobiHealthNews what has been rumored for weeks: He is working on a mobile health startup through his 7Wire Ventures investment vehicle.

While he won’t fully tip his hand now, Tullman says he is involved in a venture that will help mobilize treatment of chronic diseases both from the consumer side and for the purpose of population health management. The technology will run on mobile phones, according to Tullman, whom Allscripts ousted in December after a tumultuous couple of years trying to integrate the acquisition of former rival EHR vendor Eclipsys.

Expect further details on the startup in the next three months, he says.

Tullman sold electronic health records for 15 years, but, with the advent of “meaningful use”, he believes EHRs are fast becoming a commodity. In his opinion, the most innovative health IT companies today — the ones that potentially will have the biggest impact on transforming a broken healthcare system — are looking at mobile technology.

“If you want to engage patients or consumers, you can either build a portal and hope they go to it, or you can go to them,” he says.

“Use a device that’s ubiquitous,” Tullman advises. Cell phones are pretty close to ubiquitous in the US, and since last year, the majority of those with mobile phones have had smartphones, according to comScore and other market researchers.

He wants 7Wire Ventures, the Chicago-based investment firm he formed with ex-Allscripts President and COO Lee Shapiro, to back innovators. Tullman says 7Wire will invest in – and consider outright acquisitions of – IT and communications-related startups and growth-stage businesses in healthcare. (Investments to date, however, include SoCore Energy, which provides solar panels and services to commercial properties, as well as a glassblowing studio in the Windy City and a local chain of tea shops.)

Tullman says he is focusing on concepts that serve what he calls the “intelligent, connected consumer of health,” not just a user of healthcare services.

The word “consumer” is key to Tullman. He wants to look beyond the third and final stage of meaningful use – which will not begin before 2016 – to what he calls “consumer engagement.” That is an important distinction. “We need to stop thinking of people as patients,” Tullman says. Keep reading>>

Nurse comms company Voalte promotes founder Trey Lauderdale to president

By: Aditi Pai | May 6, 2013        

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TreyLauderdaleSarasota, Florida-based Voalte, which offers a point of care communications application for nurses, recently named its Founder and VP of Innovation Trey Lauderdale as the company’s new president. Voalte’s longtime CEO Rob Campbell has since departed the company and is searching for other startup opportunities in the area.

Voalte provides nurses with voice, alert and text capabilities on a hospital-wide system. While the service is primarily used on iPod touch devises, it also works on iPhones and iPads.

Lauderdale began his company in 2008, shortly after the iPhone first launched, and before many other smartphone-based communication services were angling to get their products in the hands of healthcare providers. This early launch allowed him to secure pilot agreements with larger hospitals that saw the potential of smartphones in healthcare.

“When I look back at my first business plan, we thought we’d be where we were at now back in 2010, but we are where we are,” Lauderdale said. “It was a tough ride in the beginning but anytime you are a pioneer in a new market — it’s always tough in the beginning.”

At the end of 2012, Voalte raised $6 million from an undisclosed healthcare information technology leader with the intention of tripling their workforce of 50 to 150 employees, a jump from the 22 employees they had in 2011. A Sarasota Herald Tribune interview in 2012 quoted Campbell saying the company’s yearly revenue is “just shy of ten million”.

Voalte’s healthcare provider customers include Massachusetts General Hospital, Texas Children’s Hospital, and Nebraska Medical Center among others, while its developmental partners include Cedars-SinaiSarasota Memorial Health Care System, and Huntington Medical Center.  Most recently, nurses at Los Angeles Cedars-Sinai were inspired after working with Voalte to let mothers see their newborn babies in the NICU via iPads running FaceTime.

Lauderdale plans to continue forming “key alliances and partnerships” with EMR vendors and other healthcare information systems vendors to integrate Voalte’s communication services. As software companies continue to eat the world, Voalte still finds itself competing with hardware device companies.

“You know, Spectralink, Cisco, Ascom wireless phones — everyone is realizing those aren’t the future,”Lauderdale said. “Those are kind of the typewriters of communication.”

New Patient Privacy Rights CTO wants to shake group’s anti-tech image

By: Neil Versel | May 6, 2013        

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Adrian GropperThe Patient Privacy Rights Foundation, the organization founded by Texas psychiatrist Dr. Deborah Peel, is trying to shed the perception that it is anti-health IT by naming physician-entrepreneur Dr. Adrian Gropper its first-ever chief technology officer.

Gropper, who founded picture archiving and communications system (PACS) vendor Amicas in 1996 and launched ill-fated personal health records (PHR) company MedCommons in 2004, and has had a hand in the creation of the Direct Project for health information exchange, tells MobiHealthNews that he will be advocating for greater patient control over their own care. “I want to move to have patients being first-class citizens in everything that happens, and not just in health information exchange,” Gropper says.

Gropper has been advising PPR for more than a year, but the Austin, Texas-based organization recently decided to bring him on in a formal role as CTO. Like Peel, Gropper is working on a volunteer basis, he says.

Peel has been called a Luddite by some in the health IT industry who believe her relentless focus on patient control of health information and criticism of data mining has impeded progress toward building a connected health system. Gropper, who is based in Watertown, Mass., believes that perception is out of date. “I think that PPR has turned the corner [on health IT] as much as the world is turning the corner,” he says.

Gropper says a lot of his work on health IT standards and policy at the federal and state levels is facilitating this change. Gropper helped develop a secure email system for Direct and was involved in the creation of Blue Button+, an initiative to translate the plain text of the Blue Button format into a more user-friendly, patient-controllable format.

The Office of the National Coordinator for Health Information Technology (ONC) is considering whether to recommend Blue Button+ for Stage 3 of the “meaningful use” EHR incentive program.

Gropper calls transfers by Blue Button “patient-directed exchange,” while Blue Button+ is “patient-mediated,” in his opinion. Keep reading>>

Fitbit Flex commercially launches with Bluetooth 4.0, active minutes tracking

By: Brian Dolan | May 6, 2013        

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Fitbit Flex__ColorsSan Francisco-based Fitbit has commercially launched its first wristworn activity and sleep tracking device, Fitbit Flex, which it first announced at the Consumer Electronics Show in January. Fitbit Flex is now on sale for $99.95 at Fitbit.com and at other major retailers, including: Apple Stores, Best Buy, Target, Verizon, and AT&T stores.

While the Flex is the company’s first wristorn device — the others are clip-on smart pedometer form factors — its also the first tracker from Fitbit to wireless sync with Android and iOS devices via Bluetooth 4.0, according to the company. Samsung Galaxy S III, Samsung Note II, iPhone 4S and 5 users are all able to leverage the Bluetooth 4.0 syncing.

Fitbit confirmed that for NFC-enabled Android devices, Fitbit Flex users can just tap their tracker to their phone and “it will automatically launch your Fitbit stats.” Misfit Wearables made a somewhat similar move when it announced that its Shine tracker would handle data uploads through a similar but proprietary mechanism.

The Fitbit Flex also adds a new tracking metric to the mix, too: “active minutes.” Like its predecessors the Flex tracks steps taken, distance travelled and calories burned, but its the first device to track active minutes, which Fitbit defines as “moderate-intensity cardio minutes”. The CDC recommends the average person gets at least 150 active minutes per week, according to Fitbit.

The Flex is also unique in Fitbit’s portfolio of tracking devices for not having a traditional display. Instead it sports a series of five bright white LED lights that indicate how far along a user is to achieving their goals in 20 percent increments.

Like the Fitbit One, the Flex offers a Silent Wake alarm that vibrates the wristworn device at a set time to rouse the wearer, ideally without interrupting their partner’s sleep.

The Fitbit Flex sensor can be swapped into a handful of different color wristbands including black, slate, teal, tangerine, and navy blue. While the Flex is sold with black or slate colored bands, accessory packs for teal, tangerine, and navy are available for $14.95 apiece or $29.95 for all three.

Fitbit is facing mounting competition from rival Jawbone, which offers the UP, and recently announced the acquisition of longtime health sensor and activity tracker company BodyMedia. It’s also facing a lawsuit from lesser known tracker company Fitbug, which alleges Fitbit copied some of its marketing collateral among other claims. While the reports have not been confirmed by the company, it also supposedly raised $30 million earlier this year at a $300 million valuation.