Smartphone Technology Acceptable for Telemedicine, Mayo Clinic Study Confirms

Monday, October 01, 2012

PHOENIX — A new Mayo Clinic study confirms the use of smartphones medical images to evaluate stroke patients in remote locations through telemedicine. The study, the first to test the effectiveness of smartphone teleradiology applications in a real-world telestroke network, was recently published in Stroke, a journal of the American Heart Association.

 

“Essentially what this means is that telemedicine can fit in our pockets,” says Bart Demaerschalk, M.D., professor of Neurology, and medical director of Mayo Clinic Telestroke. “For patients this means access to expertise in a timely fashion when they need it most, no matter what emergency room they may find themselves.”

 

Click here for a video of Dr. Demaerschalk talking about the study.

 

Mayo Clinic was the first medical center in Arizona to do pioneering clinical research to study telemedicine to serve patients with stroke in non-urban settings. Today, Mayo Clinic is the hub in a network of 12 other spoke centers, all but one in Arizona. In telestroke care, the use of telemedicine platforms or robots located in a rural hospital lets a stroke patient be seen in real time by a neurology specialist who typically is working from a desktop or laptop computer in Phoenix. The Mayo Clinic stroke neurologist, whose face appears on a computer screen, consults with emergency room physicians at the rural sites and evaluates the patient.

 

Patients showing signs of stroke can be examined by the neurologist who can also view scans of the patient’s brain to detect possible damage from a hemorrhage or blocked artery. If necessary patients can be administered clot-busting medications within the narrow window of time necessary to minimize permanent injury to the brain.The study compared the quality of medical images using a particular smartphone application to the same types of information and images typically viewed via desktop computers. Mayo Clinic neurologists worked with emergency physicians and radiologists at Yuma Regional Medical Center to compare brain scan images from 53 patients who came to that medical center with stroke.

 

The scans were reviewed by radiologists in Yuma and a separate adjudication panel of stroke neurologists to determine the level of agreement between these traditional interpretation routes and new images and scans on smartphones interpreted by telestroke doctors. The study shows there was a high level of agreement (92 to 100 percent) among all the reviewers over the most important radiological features.

 

“Smartphones are ubiquitous, they are everywhere,” Dr. Demaerschalk says. “If we can transmit health information securely and simultaneously use the video conferencing capabilities for clinical assessments, we can have telemedicine anywhere, which is essential in a state like Arizona where more than 40 percent of the population doesn’t have access to immediate neurologic care.”

 

The study was funded by the Arizona Department of Health Services and the technology and technical assistance was provided by Calgary Scientific, the maker of ResolutionMD.

 

The Mayo Clinic Telestroke Network includes hospitals in Kingman, Flagstaff, Parker, Cottonwood, Show Low, Globe, Yuma, Bisbee, Casa Grande, Tuba City and Phoenix, all in Arizona; and a hospital in St. Joseph, Mo. To date, more than 1,000 emergency consultations have taken place for stroke between Mayo Clinic stroke neurologists and physicians at the spoke centers. Such comprehensive evaluation techniques lead to appropriate life-saving treatment for stroke, and have resulted in significant cost reductions by not requiring ground or air ambulance transfer of the patient to another medical center.

LAUNCH OF THE EUROPEAN DIRECTORY OF HEALTH APPS -A review by patient groups and empowered consumers

Foreword by Robert Madelin, Director General, DG CONNECT
Launched at the media partner’s event, European Health Forum Gastein (EHFG) 2012
In partnership with: How are you?; GSK; Novo Nordisk; and SanofiA full copy of the European Directory of Health Apps can be downloaded from http://bit.ly/HEALTHAPPS
As of Oct 3rd 2012, the European Directory of Health Apps will be available in the public domain on the PatientView website:
http://www.patient-view.com/-bull-directories.html

 


The European Directory of Health Apps 2012-2013 is the first-ever directory of its kind. It contains key facts on 200 health-oriented apps that are all recommended by patient groups and empowered consumers.The 200 apps are also categorised in the Directoryaccording to the service they provide the patient/consumer, and according to the language/s in which the apps are available.*Special effort was made in include apps devised by patient groups and other consumer organisations

Each app has a one-page entry in the Directory, containing the actual patient group/consumer recommendation/s, the cost of the the app, its developer/s (including some brief details about the developer/s), and the weblinks from which the app can be downloaded. Information and references are hyperlinked in the online PDF version of the Directory, to enable easy access.*All information in the Directory ireferenced and can be downloaded
WIDE RANGING AND IN MANY LANGUAGESThe variety and the international remit of the 200 patient/consumer apps in the Directory is impressive. PatientView has identified apps in 62 very-different health specialties. Until recently, most apps have been the creation of US developers. But PatientView has found that European developers of health apps are quickly catching up—the apps in the Directory are available in as many as 32 different European languages.
Click on links below for :Chart on specialties in the European Directory of Health Apps. Title of chart is “Number of apps for the following medical specialties/conditions in the European Directory of Health Apps.”http://bit.ly/SPECIALTIESChart on languages in the European Directory of Health Apps: Ttle of chart is “Number of apps in the following languages in the European Directory of Health Apps”

http://bit.ly/LANGUAGES

HEALTH APPS REPRESENT A NEW AND POTENT ‘E-TOOL’Health apps are capable of helping patients to self-manage their medical conditions round the clock. Apps provide support for patients (whether at home, at the doctor’s office, at hospital, at work, or travelling/on holiday), and cater for a wide range of their healthcare needs. Health apps can even be invaluable for patients and members of the public who are traditionally hard for national healthcare systems to reach—such as homeless people.
SOME CASE STUDIES A few examples of the types of apps in the Directory are mentioned below:

• Apps that support self-management of a medical condition. U-Turn, developed in Northern Ireland, is an app to help people addicted to opiate drugs. The app advises the user on how to recognise the symptoms of an opiate overdose. The Scotland-based NGO that recommended the app, the Scottish Drugs Forum (SDF), describes it as “an excellent naloxone training aid and resource”. The app is available in English.• Apps that allow patients to report adverse events. Fodspor [Footprints] was developed by a Denmark-based patient group specialising in patient safety, the Dansk Selskab for Patientsikkerhed, to “make it possible for patients and relatives to write their own hospital experience ‘footprints’ on the phone.” Patient comments about their experiences are emailed to hospital managers, who gain unbiased, truthful accounts of patients’ experiences of care in the managers’ hospitals. Available in Danish.• Apps that support the homeless. UK charity, the Amber Foundation, commissioned its Amber Homeless Helper app to provide young homeless people throughout the UK with information on the many local services available to them. The Devon-based local NGO that recommended the app, Young People’s Housing Advice, says that the app “is designed to provide as much information as possible to help people find the right support.” Available in English.
• Apps to support patients when they travel. ICE 112 is an app developed in Iceland that utilises a smartphone’s GPS system to enable the user to be tracked while they are travelling. The app alerts the emergency services if the traveller is in trouble. 112 is the EU-wide emergency number, and this app is recognised by the Belgium-based European Emergency Number Association (EENA). The app is available in English and Icelandic. Such apps are invaluable for people living with a chronic condition, giving them the confidence to go abroad. A similar approach is utilised by an award-winning app developed in Portugal, AlzNav. The app is intended to help guide people with dementia back to their home, and will call for help if the user becomes lost or disoriented. The app is available in English. Wheelmap, winner of the Smart Accessibility Awards 2011, helps people with impaired mobility: thanks to crowdsourcing it lets users of the application rate the accessibility for wheelchair users of public places”.  The app is available in English, German and Japanese.

• Apps that support the clinical-trial process. Developed by Stephane Dufau of the University of Aix-Marselle, France, Dys is a learning tool for children with dyslexia, and also comprises part of a scientific programme at the University. Users e-mail their responses to the app, giving scientists insights into the letter spacing that will most help children with dyslexia to read. The French health NGO that recommended the app, ANAPEDYS [National Association of Associations of Parents of Children with Dyslexia], hopes “that this study, and the app, will bring real results for people with dyslexia.” The app is available in English and French.

NEED FOR SOME SCRUTINY The importance of the European Directory of Health Apps lies not just in its categorisation of health apps, but also in its reviews of the apps. As Robert Madelin, Director General of the European Commission’s DG CONNECT, notes in his foreword to the Directory:“From DG CONNECT’s perspective, consumers and patients need guidance and support in finding useful and reliable apps. Scrutiny of these apps by informed users (such as empowered citizens and patient groups) could be one way forward. I am certain that this Directory will prove useful, not only to users of healthcare systems throughout Europe, but to the many European citizens who live or strive to live healthy lives as well as for everybody who needs such information in their everyday work.”

FUTURE PLANS PatientView hopes to expand on this initial exercise in collating patient perspectives on health apps by increasing the number of apps and international scope it covers. PatientView will also shortly post on its website a link to an online survey in which developers of health apps can leave details of the apps they have created—if they want these apps reviewed by patient groups or empowered consumers. (All entries will be treated seriously, and every developer will get a reply about the outcome of the review process.) Finally, PatientView would also welcome the opinions of health professionals on the subject of health apps that help patients self-manage their medical conditions. Even apps are, in the end, no real substitute for proper clinical care. They are, though, an important healthcare tool, providing support to patients and public—a point that patient groups and empowered consumers are already emphasising.

 

About PatientView
Views of patients should be considered in all important healthcare decisions (whether a new healthcare product is being developed, or whether a government is instituting changes to a healthcare system). PatientView was formed in response to the emerging powerful new global patient movement. PatientView has worked to build bridges worldwide with the health NGOs that comprise the patient movement, to help define and support one of the most important phenomenon changing healthcare in the 21st Century. Today PatientView has the capacity to reach out to 120,000 such groups (covering over 1,000 specialties, and from most countries in the world). The patient movement grows continually in numbers and scale of influence.

Health Informatics Scotland sold out

Health Informatics Scotland sold out – our conference in Glasgow next week is now sold out with over 330 attendees expected.  Never fear you can watch and participate live online via our virtual conference environment (firewalls and security permitting).

You can visit it at

http://hostavirtualevent.com/bcsscotland

where after registration you can setup your avatar and try out walking around the virtual world.  On the days of the conference it will be fully live where you can meet and talk to people and watch live online presentations.

Paul Woolman

Chair Health Informatics Scotland

www.hiscotland.info

 

2012 Scottish eHealth Awards – Shortlist Announced

  • Best NHS Scotland use of innovative IT for patient care

This award goes to the NHS Scotland team demonstrating the most innovative product in use within a clinical setting for direct patient care.  The product maybe entirely new or a radical redesign of something existing.  The Judges were looking for something proven to work in a health board clinical setting, though it may be a pilot stage, and demonstrably bringing benefits to patients.

Shortlist:

  • Pilot PatientTrack Electronic early warning scores; with Track and Trigger (NHS Fife, Ronnie Monaghan)
  • The Learning Arcade (NHS Fife, Norma Clark)
  • Access for All – Delivery of the Healthy Outlook health forecasting service in Moray (Moray Community Health & Social Care Partnership, Lorna Bernard)

 

  • Best NHS Scotland IT service delivery team

This award went  to the NHS Scotland team with an excellent record of delivering services that improve clinicians working lives, enhance patient care and increase efficiency in their own NHS Scotland board.  Entrants were judged on evidence of their record, effectiveness of communications to and within their own board clinicians, success in engaging other colleagues across the wider NHS, evidence of fulfilment of service agreements, and lastly examples of service ‘above and beyond the norm’.

Shortlist:

  • Migration of all NHSFV Acute & Mental Health Services to new-build acute site (NHS Forth Valley, Ann Crowe)
  • Implementation of ISO27001 (NHS Fife, Donald Wilson)
  • SCI-Diabetes Collaboration (NHS Tayside, Scott Cunningham)

 

  •  Best NHS Scotland use of Mobile technology in NHS Scotland

This award went to the NHS Scotland team demonstrating best use of mobile technology that helps improve the ways in which clinicians work and the benefits and improvements to patient care. Judges were looking for evidence of benefits they are achieving (eg reduction in errors, savings to the board, improvements to working practices).

Shortlist:

  • Patient Safety – Hospital@ Night Safe Hand (NHS Dumfries & Galloway, Graham Gault)
  • EMRS iOS Apps – (Emergency Medical Retrieval Service, Dr Dave McKean)
  • NHS Scotland Digital Television and Mobile Service (NHS 24, Lynne Huckerby)

 

The awards will be presented at the Health Informatics Scotland Conference 2012 in Glasgow on the 21st of September 2012. You can find out more information at http://hiscotland.info/

 

 

Scottish Diabetes Campaign Launched

Diabetes campaign launched

20/08/2012

People with diabetes will now be able to monitor their own condition through an innovative online service.

scottish healthcare

A new campaign – run in partnership with Diabetes UK- shows how a new online tool called ‘MyDiabetesMyWay’, will help people with diabetes manage their conditions more effectively through videos, educational tools and games containing information about diabetes.

In a world first, the interactive website also allows people with diabetes to view their up-to-date clinic results, treatments and advice online.

Figures published in the annual Scottish Diabetes Survey today, show that the number of people with diabetes in Scotland continues to increase by around 10,000 each year. There are now over 247,000 people with diabetes in Scotland – 4.7 per cent of the population.

The majority of those people – 217,500, or 88 per cent – have type 2 diabetes which can often be caused by unhealthy lifestyle choices and is also more common in older people.

Public Health Minister Michael Matheson said:

“Diabetes is a growing problem for Scotland – around £300 million of hospital expenditure relates to diabetes treatment and the management of its complications.

“Now, everyone living with diabetes in Scotland has the opportunity to view their own clinical diabetes data online. And by having access to the right information, people can be supported to self manage and radically reduce the risk of developing complications and serious health problems.

“I would strongly encourage people living with diabetes to sign up and see for themselves how this valuable resource can support them to self manage their condition. Not only will this mean they can live longer, healthier lives it will also protect NHS resources.”

Chief Medical Officer Sir Harry Burns said:

“The Scottish Diabetes Survey published today highlights the increasing number of people with diabetes that is directly related to the ageing of the population and unhealthy lifestyle factors such as obesity.

“We also need to maintain focus on preventing diabetes by tackling the underlying risk factors. Stopping smoking, eating better and taking regular exercise is something we can all do to make sure we are as healthy as possible.”

Director of Diabetes UK Jane-Claire Judson said:

“The relentless rise in people diagnosed means that diabetes deserves immediate attention as a major public health concern. Meeting the challenge of diabetes requires the NHS, Government and society overall to take action to improve our nation’s health and together we need to ensure that those already diagnosed have the best support and care available.”

“Even with the pressures of ever increasing numbers, as indicated today in the new Scottish Diabetes Survey, everyone diagnosed with diabetes is entitled to the best diabetes care possible. Diabetes UK Scotland has developed a set of 15 Healthcare essentials that all those living with the condition should receive. Making sure everyone with diabetes has access to these key services and support systems in place is vital for all those diagnosed.”

HEI Inspection Report: Scottish Ambulance Service

HEI Inspection Report: Scottish Ambulance Service

The Healthcare Environment Inspectorate (HEI) today (Monday) published its report relating to an unannounced inspection visit of the Scottish Ambulance Service on 12-14 June 2012.

Scottish Ambulance Service
Scottish Ambulance Service

HEI has been set up to help reduce healthcare associated infection risk to patients through a rigorous inspection framework. The HEI inspection team examined the Scottish Ambulance Service’s self-assessment information and then inspected ambulances at various accident and emergency (A&E) departments to validate this information to assess how clean they were and if they were meeting national standards.

The findings from the visit are set out below, and cover eight requirements that the Scottish Ambulance Service is fully expected to address, plus two recommendations for improvement.

The full HEI inspection report and an improvement action plan developed by the Scottish Ambulance Service to address the identified issues are available to view at

www.healthcareimprovementscotland.org/HEI.aspx

Speaking of the report, Susan Brimelow, HEI Chief Inspector, said “We observed staff complying with hand hygiene practice after they had been in contact with patients and there was good provision of alcohol hand rubs. However, overall we found that infection control is not fully embedded into all aspects of the Scottish Ambulance Service. In particular we found poor communication between the infection control team and staff, and there was inconsistent completion of documentation relating to the cleaning of vehicles. We expect the Scottish Ambulance Service to address these issues as a matter of priority.”                                                         

Requirements

The Scottish Ambulance Service must:

  1. Ensure that all staff groups adhere to standard infection control precautions to ensure the risk of infection to patients and staff is minimised. This was previously identified as a requirement in the June 2011 inspection report for the Scottish Ambulance Service.
  2. Liaise with ambulance control and health and social care providers to ensure that there is robust risk assessment and communication about patients’ infection status. This will ensure additional precautions can be taken as required when in contact with a patient. This was previously identified as a requirement in the June 2011 inspection report for the Scottish Ambulance Service.
  3. Ensure that all staff are aware of and implement the policy for station and vehicle cleaning. This should reflect the frequency stated within the NHSScotland National Cleaning Services Specification (2009). This will ensure that all vehicles are clean and maintained ready to use at all times. This was previously identified as a requirement in the June 2011 inspection report for the Scottish Ambulance Service.
  4. Ensure that documentation relating to vehicle cleaning is consistently completed.
  5. Ensure that they effectively communicate and implement the policy, with regards to the provision and use of mops, to staff and other NHS partners. This was previously identified as a recommendation in the June 2011 inspection report for the Scottish Ambulance Service.
  6. Review existing internal and external communication methods to ensure that there is effective communication on matters relating to healthcare associated infection.
  7. Ensure that sufficient resources are in place to support education provision.
  8. Ensure that all staff have a specific objective for healthcare associated infection within their personal development plan, and that they understand what this is and how it will be achieved. This was previously identified as a requirement in the June 2011 inspection report for the Scottish Ambulance Service.

Recommendations

The Scottish Ambulance Service should:

  1. Consider how it works with other NHS boards to use existing compliance monitoring data to identify areas for improvement and provide feedback to staff.
  2. Consider how to strengthen awareness of the role of the infection control advisor and other members of the infection control team. The infection control team should also consider working directly with ambulance staff at sites.

What to do when you don’t have Telehealth?

In April, 29th, 1961 a doctor of the 6th Soviet Antarctic expedition Leonid Rogozov aged 27 felt pain in a right lower belly and fever. The next day brought only exasperation. Having no chance to call a plane and being the only doctor at the station “Novolazarevskaya”, at night, in April, 30th the surgeon made an appendix removal operation on himself using local anesthesia. He was assisted by an engineer and the station’s meteorologist.

Leonid Rogozov aged 27

In 1959 Leonid Rogozov graduated from the Institute and was immediately accepted to the surgery clinical residency. However, his studies at the residency were broken off for some time due to Leonid’s trip to Antarctica in September, 1960 as a doctor of the 6th Soviet Antarctic expedition to Novolazarevskaya station.
During this expedition there happened an event that made a 27-year old surgeon world-famous.
In the 4th month of the wintering, in April, 29th, 1961, Leonid showed disturbing symptoms: weakness, nausea, fever and pain in a right iliac region. The following day his temperature got even higher. Being the only doctor in the expedition consisting of 13 people, Leonid diagnosed himself: acute appendicitis. There were no planes at any of the nearest stations, besides, adverse weather conditions would not allow to fly to Novolazarevskaya anyway.

In order to save the sick member of a polar expedition there was needed an urgent operation on site. And the only way out was to operate on himself.

At night, on the 30th of April, 1961, the surgeon was being helped by a mechanical engineer and a meteorologist who were giving him the medical instruments and holding a small mirror at his belly. Lying half bent on the left side, the doctor made a local anesthesia with novocaine solution and made a 12cm incision in the right iliac region with a scalpel. Either watching in the mirror or by touch he removed an inflamed appendix and injected antibiotic in the abdominal cavity.

In 30 or 40 minutes from the beginning of the operation there developed a faint and giddiness and the surgeon had to make pauses for some rest. Nevertheless, by midnight the operation lasting 1 hour and 45 minutes was over. In five days the temperature normalized, in two days more – the stitches were taken out.

In the St. Petersburg Museum of the Arctic and the Antarctic there is an exposure of surgical instruments that Leonid Rogozov applied for this uneasy operation.

LifeWatch V: State-of-the-Art Smartphone with Healthcare Capabilities Empowering Patients and Consumers

NEUHAUSEN AM RHEINFALL, Switzerland —LifeWatch AG (SIX Swiss Exchange: LIFE), the leading wireless cardiac monitoring service and home sleep test provider in the U.S., presents today LifeWatch V, the world’s first-of-its-kind healthcare smartphone. The fully featured state-of-the-art smartphone allows patients as well as health- and wellbeing-conscious consumers to self-operate a wide range of highly valuable embedded medical sensors, wellness-related applications, cloud-based services and 24/7 call center support.

As a next step of its product and geographical diversification LifeWatch presents today LifeWatch V, the world’s first fully featured smartphone which operates on an android OS. The state-of-the-art solution offers multiple sophisticated embedded medical miniature sensors, wellness-related applications, cloud-based services and 24/7 call center support. By using the barely visible sensors on the phone’s frame, patients as well as health- and wellbeing conscious consumers can track, capture, collect and analyze their health and medical measurements anywhere anytime. The features include ECG, body temperature, blood glucose, heart rate, blood oxygen saturation, body fat percentage and stress levels (heart rate variability). All collected data can be retrieved from the cloud for a follow-up anytime anywhere. Users can thus take corrective action, plan their diets and activities, securely share the information with a health provider or family member, trend and analyze the data and more. Patients are also able to program the unit to remind them of their drug type, dose and intake time.

LifeWatch V with add-on service offering

LifeWatch V was designed with a flexible service-product ecosystem in mind, allowing easy integration of services. The LifeWatch V handset unit includes a service enablement platform to support the transmission of medical data to be analyzed, evaluated and communicated to health professionals and call center personnel around the clock. The device wirelessly interacts with a cloud-based environment allowing users direct access to a wide range of valuable complementary medical and wellness related services.

Strategic alliances with local partners

Smartphones are positioned to overtake many computing functions that were reserved to computers alone. More importantly, the smartphone has emerged as an intimate device consumers carry with them anywhere and anytime, making it an ideal vehicle to let users self-test their health, especially users with an interest in the medical field. Recent market developments have witnessed the emergence of health-dedicated cellular phones.

For more healthcare smartphone information click here

Healthcare across the UK: A comparison of the NHS in England, Scotland, Wales and Northern Ireland

29 June 2012

The National Audit Office has today published a report highlighting key trends and variations in the delivery of healthcare across the four nations of the UK. The report finds that, despite the shared history and similarities between the four nations, there are considerable variations in areas such as health outcomes, spending, staffing and quality.

Life expectancy varies significantly across the UK – from 75.9 in Scotland to 78.6 in England for men, and from 80.4 in Scotland to 82.6 in England for women. Spending on health services in the UK more than doubled in cash terms in the last decade. The rate of increase has been broadly similar in all four nations but spending per person continues to vary. In 2010-11, despite devoting a higher proportion of total public spending to health, England spent the least on health per person.

In line with the rise in spending, the number of NHS staff has increased over the last decade. Scotland has the most GPs per person (80 per 100,000 people in 2009 compared with 70 in England and 65 per 100,000 in both Wales and Northern Ireland). Scotland also has the most medical hospital staff and nursing, midwifery and health visiting staff per person.

Comparable data on the efficiency and quality of healthcare are patchy. In 2008-09, average hospital lengths of stay varied from 4.3 days in England to 6.3 days in Wales.  Hospital waiting times have fallen in all four nations in recent years, although there are notable variations in how long patients wait for common procedures. In 2009-10 waiting times tended to be lower in England and Scotland than in Northern Ireland and Wales. Across the UK, there have been significant improvements in levels of healthcare associated infections. For instance, in the four years to 2010-11, rates of MRSA infection dropped by a third or more in all nations.

Amyas Morse, head of the National Audit Office, said today:

“We publish this report at a time when the NHS across the UK is under increasing pressure to use resources more efficiently. Funding is tighter while the demand for healthcare continues to grow as a result of an ageing population and advances in drugs and technology.

“We consider that there would be value in the health departments in the four nations carrying out further work to investigate the variations in performance and identify how they can learn from each other to achieve better value for money for taxpayers and better care for patients.”