Increasing Understanding of Technology and Communication

Ineffective EHRs and Inaccurate Wearable Gadgets


If there was a wearable that could alert you and your doctor if you were in danger of having a heart attack, would you want it? I sure would. But apparently, not everyone feels the same way, just because most current wearables are not accurate enough.

Take Dr. James Madara, CEO of the American Medical Association, for example. Earlier this month, he took time to explain how inaccurate wearable devices are overrunning healthcare in his speech at the AMA annual meeting in Chicago.

“From ineffective electronic health records (EHR), to an explosion of direct-to-consumer digital health products, to apps of mixed quality,” said Madara, according to his prepared remarks, "this is the digital snake oil of the early 21st century.”

Certainly, much of the U.S. healthcare system now has electronic health records. And it’s largely ineffective.

According to a survey released early this year by HIMSS, a health IT trade group, only 29% of physicians report positive benefits from electronic health records. And an AMA survey found that nearly one-half of physician’s report implementing the technology has resulted in a higher cost, lower productivity and reduced efficiency.

So it’s not hard to understand why many healthcare providers have a jaundiced view of the technology, and why they bristle at the notion of funneling oceans of remote patient monitoring data into the system.

Caregivers resist

To the extent that electronic health records have been ineffective, I believe it’s due more to a failure of our system of care than it is of the technology. Because while most facilities met their obligation to install electronic health records, few have embraced it.

I can tell you that from personal experience.

Recently, I got an email from an outpatient facility asking me to input my medical data into their system. This was weeks ahead of a planned arthroscopic procedure. I dutifully took the time to gather the information and enter it into the portal. So I was surprised a couple weeks later when, during my pre-op appointment, the doctor asked me what meds I was taking. And then, just after surgery, he gave me pictures from the procedure and told me to bring them to my follow-up appointment so they could explain to me what they did.

So much data. So little access. I’d have to agree, that’s pretty ineffective. It’s also pretty common.

I do understand why some healthcare providers resist electronic health records. Change is difficult. And time consuming. They already have taxing jobs. They’re busy, stressed. And they may have a bad taste in their mouths from previous forays into technology.

But guess what? Sooner or later, they will have to take the plunge, and incorporate the technology into their workflow. And they will have to incorporate remote patient monitoring devices into the records. Because wearables, connected scales, glucometers and blood-pressure cuffs will be what give healthcare professionals the insight they need to make better decisions.

The practice of medicine urgently needs to make better decisions. Because the $3 trillion US healthcare system is beginning to bow under the weight of an aging population that needs increasing care and attention. It will only get worse if they don’t get better.

Think about this: the meteorologist on the Weather Channel has far better tools at her disposal to forecast whether it will rain on your upcoming trip to Boston than your doctor does to assess whether you might need medical attention while you’re away.

Let that sink in for a second. The meteorologist has sophisticated, self-adjusting computer models, fed by streams of data from satellites, weather balloons and weather stations that detail temperatures, atmospheric pressure and the state of approaching systems.

And your doctor? All she has to go on are a few bloodwork reports, a few sets of vital signs recorded during your office visits and some insight you’ve chosen to share in the examination room – accurate or no. In climatic terms, it would be like forecasting rain armed with little more than yesterday’s highs and lows.

To make the best medical decisions, physicians need insight gleaned during the eleven months, 29 days and 22 hours you’re not in their office each year. Insight akin to what meteorologists have. Fortunately, that’s starting to come.

It’s coming in the form of stick-on patches, injectable biosensors and smart clothing, They’re typically paired with companion hardware, smartphones apps and cloud services to monitor the steady stream of data, make suggestions for improving the results and notify caregivers at the first hint of a problem.

In the past few weeks alone:

  • Medtronic and Qualcomm announced they are partnering on next-generation continuous glucose monitors, or CGMs. A CGM pairs a monitoring patch with a device that constantly records blood sugar levels, giving diabetics and their caregivers much finer control over their condition.
  • Startup VitalConnect unveiled VitalPatch, a stick-able device that continuously monitors heart patients’ condition. The device has been tested in Europe and is beginning trials in the US this summer.
  • Startup Profusa announced the Lumee, an injectable biosensor that sits in the tissue just underneath the skin and a companion reader to collect measurements from the device. The first product is called the Lumee Oxygen Sensing System, which will be available in Europe later this year to help monitor recovery after vascular surgery.

Devices like these, I believe, will prove to be the Doppler Radar of medicine. Because what they bring to the practice of healthcare is a healthy injection of insight.

That’s not snake oil. It’s science. And it’s long overdue.

Read Article (name | domain | 03/11/2016)

First, let’s set the record straight about these devices the marketing strategist author talks about. There are two groups of medical devices available, one group has been through trial testing with proven published results. The other group has not gone through trail testing and has no proven published results. (Snake oil)

Meteorologist use devices from the first group, proven electronics with published results. It’s no secret that unproven devices are not accurate enough for doctors to rely upon their data, yet. Some manufacturers are finally starting to provide the needed testing results that will garner that trust, which is needed to accurately diagnose a person’s health.

Many of the devices from these startups will go down the same path as lumosity and for the same reason, unproven technology.

Wearables have many downsides other than accuracy such as limited functions or no cellular connection.

A paid lobbyist is no substitute for trial testing and published results.

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Internet Access Not Technical but Civil Rights Issue


In major metropolitan areas across the U.S., unequal access to the Internet is cutting some people off from a better future. Many are also cut-off from learning how to fully utilize this marvel of the digital era. Citizens on the wrong side of the digital gap are losing out on economic, educational and social opportunities.

It’s not just a technical problem for the 21st century. “This is a civil rights issue,” said Bill Callahan, director of Connect Your Community.

“Low-income people, people with less than a high school education and older people are the groups in any population who are least likely to have an Internet connection at home,” he said.

Callahan’s group advocates for digital access and literacy in greater Cleveland and Detroit. In those cities — and others from Baltimore to New Orleans, from Miami to Glendale, Arizona — as many as 30 to 40 percent of residents can’t easily get online, according to 2013 data.

Rural areas have a fairly well-known set of digital access problems that include high cost and sluggish speeds due to the lack of broadband infrastructure. But in suburban and metro areas, libraries are typically cited as the saving grace for residents who lack online access at home.

That’s not good enough in our wired world. “If the best someone can do is point you to the library, that’s basically ‘separate but equal,’” said Callahan, making a pointed reference to the very argument that the Supreme Court once declared didn’t justify segregated schools.

In Detroit, nearly 40 percent of residents have no Internet service, not even via smartphones. That appalling rate was noted in a recent New York Times story detailing how the lack of access has stymied economic recovery for some people.

Detroit resident Julie Rice told the paper about her struggle to network, complete training videos and fill out online job applications with her limited connectivity. “I’ve come to believe Internet is a human right,” Rice said. “It’s clearly a huge disadvantage if you don’t have it.”

Underscoring the importance of universal access, the Federal Communications Commission last year declared that broadband service is a public utility akin to electricity or telephone service.

In all but the most rural areas, the problem isn’t a lack of infrastructure, said Callahan. As with so many other civil rights issues, the problem is economics. “The idea that you can’t get Internet connection in a city because there’s no Internet available is almost never true,” he said. “People can get AT&T DSL in their homes any place in Detroit — they just can’t afford it.”

Without the Internet, poor people can be stuck on the wrong side of the door to opportunity. “The 40-year-old guy who can’t apply for a job now because he can’t get online would have no problem 10 years ago,” Callahan said. “He can still do the job. All that’s changed is the system to get the job.”

This hypothetical man all too often gets blamed for not being employed. Yet Callahan said, “This is not a failure on his part.”

Robert Shimkoski of the Detroit Employment Solutions Corporation, which helps connect jobseekers with employers in that city, said a lack of Internet access can trap low-income people in a vicious cycle.

“It’s increasingly difficult to find an employer who will take a physical application over an online app,” Shimkoski said. “And if you can’t get online, you can’t get the resources to understand where you can go to get that connection to help.”

Callahan said Internet access rates have remained largely the same in the two years since the U.S. Census Bureau last released figures. But the digital divide keeps getting wider, he said, as more systems across every industry — from health care to education — go completely online.

For example, Callahan cited a major change to the GED that went into effect in 2014. In theory, the second chance at a high school diploma can be a lifeline for struggling Americans. But now, he said, “All GED testing is in a computerized environment, though not online. Most of the models by which you can prepare depend on having access to online resources.” (And you must know how to use these resources.)

The shift to digital is one of the reasons, Callahan argued, that the success rate for GED candidates in Cleveland — where more than 33 percent of residents lack Internet access — plummeted by an estimated 85 percent that year.

“[Digitalizing systems] is progressing very quickly, and they’re essentially being put in a walled village, and you need to pay to get past it,” Callahan said. “And no one is willing to spend money to help the people on the outside get in.” Ensuring that there are community access points, like libraries and technology hubs, is important, but ultimately they’re no substitute for reliable Internet at home.

Callahan and Shimkoski are both optimistic about pilot programs from Comcast and AT&T that provide basic broadband access — and in some cases web training and low-cost laptops — to low-income residents.

Comcast in 2011 began the Comcast Essentials program to offer Internet access (without setup fees or contracts) to families who have at least one child who qualifies for the National School Lunch Program. The company’s most recent report indicated that more than 17,000 residents had taken advantage of the program in Detroit.

AT&T launched a similar program last month. It dropped the price to as little as $5 a month and widened the pool of eligibility to anyone in the Supplemental Nutrition Assistance Program, formerly known as food stamps. But CNN reports that Internet access under the AT&T program is at speeds considered below the threshold of broadband and there are data caps.

Still, Callahan said the programs are a digital step in the right direction.

Read Article (Kim Bellware | | 05/23/2016)

The plan is simple but effective; Currently they are quickly Digitizing Systems, while there is a push to connect everyone to the Internet. By the time everyone is connected to a reliable Internet, not much will change because they will not be proficient enough in its usage. Therefore, they will blame the individuals for not striving enough towards improving their own wellbeing.

Internet availability and access is important without a doubt, but knowing how to fully utilize the constantly evolving devices that connect to it and the Internet itself, is an issue just as important if not more.  Our instructional webinars are the long-term solution for addressing device usage, and we need your support.

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Wanted: Senior-Savvy Technologies


All hail, the Internet of Things! 2015’s wild, wacky foray into the connectedness of everything was both inspiring and laughable, especially through the lens of the senior demographic. While most seniors don’t need a talking toaster or a refrigerator that knows when the ketchup is almost gone, they certainly do need reliable and transparent technologies that can help them stay connected in ways that matter.

Amid what is increasingly being called “Silvertech,” what’s needed most is to get past the shiny, whiz-bang aspects of the gadgets and reach deeper into understanding what kind of technology seniors really need—and how they need it to work.

Using a wearable to track a few vital signs or record a sleep pattern? That’s so 2015. Using portable, easy-to-use technology platforms to encourage seniors to engage with others? Been there, done that. Many seniors, including my 72-year-old mother, use tablets, social media applications and digital communications platforms (think Skype and FaceTime) more than I do.

Senior tech startups are now trying to harness cloud computing, wireless data transfer and the growing acceptance of wearable technology in a grand convergence of capability, accessibility and acceptability.  New apps for tablets and smart phones will increase the functionality of a device a person already owns. The possibilities are tantalizing.

In some cases, the most-craved senior technology is about figuring out how to bridge the gap between A and B. For example, we all know that remote monitoring technology needs to be an added dimension of resident safety and falls prevention—not a substitute for human monitoring. So, how best to bridge the communication gaps between a senior who has fallen, the emergency responders, the family and the primary care provider?

At LeadingAge’s Hackfest, a competition to develop senior care-related technology applications, nearly all of the entrant prototypes were designed to be wearable or at least portable. Developers also will be integrating anywhere, anytime personal emergency response systems (PERS) and proximity sensors into pervasive consumer devices like cell phones and iPads, predicts Laurie Orlov, founder of Aging in Place Technology Watch, in a recent blog.

She also thinks voice activation will be a big part of senior tech’s future—being able to “converse” with a device means no more squinting at a minuscule smartphone screen or trying to get a Parkinson’s–wracked hand to push tiny buttons.

As senior monitoring technology continues to climb out of the IT department servers and adorn the resident’s wrist (or pocket or shoe), what we’ll need next is a reputable organization that is willing to start reporting on features relating to senior tech wearables--a huge lacuna in today’s market. “What we need is a Consumer Reports for Silvertech,” writes Paula Span in a New York Times article.

Then we need the Centers for Medicare & Medicaid Services to realize that quality telehealth and remote health monitoring should be encouraged (i.e. reimbursed) everywhere, not just in rural regions and Accountable Care Organization contexts.

2016 will surely be an exciting year to see who comes up with the hottest app or bridge capability. Over the next few months, we’ll be taking a closer look at what’s happening in the senior technology field, so stay tuned for Long-Term Living’s new series on senior care startups!

Read Article (Pamela Tabar | | 02/02/2016)

Reading an article like this about seniors and how technology is benefiting their lifestyle just kind of gets many of us all warm and fuzzy inside. But the truth of the matter is that many seniors do not have a warm relationship with technology. In fact, unless it’s a medical requirement, they choose to distance themselves from them.

We believe our face-to-face instructional webinars can change this awkward relationship by helping older adults understand more fully, just how they work and what they do to benefit us. All we ask of you is to help provide us the opportunity, the chance to make a difference in so many lives.

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Connect Everyone to Internet & Gain $6.7 Trillion


Bringing internet access to the 4.1 billion people in the world who do not have it would increase global economic output by $6.7 trillion (£4.6tr), and raise 500 million people out of poverty, according to a study by PwC’s strategy consultants.

The report, titled Connecting the world: Ten mechanisms for global inclusion, was prepared for Facebook.

Getting everyone in the world online is not as tall an order as one might think, according to the company: affordability, rather than infrastructure, is the main barrier to internet adoption in most areas. More than nine-tenths of the world’s population live in places where the infrastructure exists to get them online, but the majority of them cannot afford to do so.

For 66% of the world, a 500MB data plan costs more than 5% of their monthly income, the level the report’s authors describe as “unaffordable”. But some people decide to get online despite the cost – in China, just 22% of people can have a high enough income by that measure to make internet access affordable for them, even though 46% of the population is online. Even if it’s expensive, if there’s enough of a reason for someone to get online, they may look past the cost.

By contrast, in most of the developing world, the necessary infrastructure is already in place to get internet to the whole population, if they could afford it. China, Brazil and Indonesia all have 100% of their populations covered by internet-capable infrastructure.

While cost reductions sound easier to achieve than total infrastructure creation, that can understate the magnitude of the reductions needed. To get 80% of their populations online, for instance, Ethiopia, Nigeria and the Philippines would all have to see a cut in the price of internet access by well over 90%.

Improvement of existing technology, or even simply installing existing technology in developing nations, will suffice to bring about much of this cost reduction. For instance, the vast majority of the world’s mobile spectrum is being used to deliver 2G internet: if it was upgraded to 3G or 4G, the cost of mobile data would plummet. But such an upgrade requires money spent upfront, not only by carriers, but also by users, who must buy (comparatively) more expensive phones.

The focus on cost reductions marries with Facebook’s own project, which is aimed at partnering carriers in developing nations to give low-cost internet access. It has come under criticism, however, from web luminaries such as Tim Berners-Lee, who dislike Facebook’s approach of limiting the low-cost access to a subsection of the web.

So-called zero rating, which lies at the heart of efforts by to expand web access, involves allowing internet users to access some websites, such as Wikipedia and Facebook, without paying for the data they use. But the approach is criticized by net neutrality advocates like Berners-Lee, who said: “I tend to say ‘Just say no.’ In the particular case of somebody who’s offering … something which is branded internet, it’s not internet, then you just say no.”

But Jonathan Tate, technology consulting leader at PwC, argues that Facebook’s approach is worth it in the long term. While zero rating provides access to a slimmer version of the internet than the full web, he says it’s a crucial stepping stone to full access. “The important thing here is to get things moving,” he added.

Facebook’s motivation for paying for is partially explained by PwC’s estimates of where the benefits of new access accrue. While most of the economic benefits of new internet access come to those freshly online, the consultancy estimates that content providers such as Facebook stand to gain a $200bn (£138bn) opportunity over the next five years.

But new technology will still be needed to achieve total connectivity. The reports’ authors estimate that the last 500 million people to get online won’t be able to rely on piecemeal improvements. Instead, they’ll need new “disruptive technologies” being created by companies like Google, with its Project Loon plan to mount internet access points on balloons, and Facebook, with its solar-powered, laser-armed 4G drone called Aquila.

Read Article (Alex Hern | | 05/17/2016)

Though self-serving Facebook does stand to gain monetarily over those five years, the access all those individuals will gain is worth it, I believe. And as they’ve already said, it’s an important stepping stone to full access. It’s also better than doing nothing at all.

But even though Internet access is without a doubt important, knowing how to fully utilize the constantly evolving devices that connect to it and the Internet itself is an issue just as important, it not more. Our instructional webinars are the long-term solution for addressing device usage, and we need your support.

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Potential Emergence of a New Digital Divide


The sharing economy and on-demand services are weaving their way into the lives of (some) Americans, raising difficult issues around jobs, regulation and the potential emergence of a new digital divide. While other Americans seemingly watch from the side-lines, struggling with terminology and usage.

A number of new commercial online services have emerged in recent years, each promising to reshape some aspect of the way Americans go about their lives. Some of these services offer on-demand access to goods or services with the click of a mouse or swipe of a smartphone app. Others promote the commercialized sharing of products or expertise, while still others seek to connect communities of interest and solve problems using open, collaborative platforms.

These services have sparked a wide-ranging cultural and political debate on issues such as how they should be regulated, their impact on the changing nature of jobs and their overall influence on users’ day-to-day lives.

A national Pew Research Center survey of 4,787 American adults – its first-ever comprehensive study of the scope and impact of the shared, collaborative and on-demand economy – finds that usage of these platforms varies widely across the population. In total, 72% of American adults have used at least one of 11 different shared and on-demand services. And some incorporate a relatively wide variety of these services into their daily lives: Around one-in-five Americans have used four or more of these services, and 7% have used six or more.

At the same time, around one-quarter of Americans (28%) say they have not used any major shared or on-demand platforms, and many are wholly unfamiliar with the tools and vocabulary of the new digital economy. For instance, 15% of Americans have used ride-hailing apps like Uber or Lyft, but twice as many have never heard of these apps before. Similarly, 11% of Americans have used home-sharing platforms like Airbnb or VRBO, but roughly half have never heard of home-sharing sites. In addition:

  • 61% of Americans have never heard of the term “crowdfunding.”
  • 73% are not familiar with the term “sharing economy.”
  • 89% are not familiar with the term “gig economy.”

Each of these individual platforms has its own unique user base. Still, exposure to these shared, collaborative and on-demand services at a broad level is heavily concentrated among certain demographic cohorts. In particular:

College graduates – 39% of college graduates have used four or more of these services, compared with just 8% of those with a high school degree or less. At the same time, around one-quarter of college graduates have used none (11%) or only one (15%) of these services.

Those with relatively high household incomes – 41% of Americans with an annual household income of $100,000 or more have used four or more of these services, three times the proportion among households earning less than $30,000 annually.

Those under the age of 45 – Exposure to these shared and on-demand services begins to drop off rapidly starting at around age 45. Around one-third of those ages 18-44 have used four or more of these services, and relatively few in this age range have no exposure at all to these services. By contrast, 44% of Americans ages 50 and older (and 56% of those ages 65 and older) have not used any of these 11 platforms.

A number of these services – though by no means all of them – are offered primarily in and around urban population centers. And urban and suburban residents are around twice as likely as those living in rural areas to use four or more of these services. At the same time, around one-quarter of urban and suburban dwellers have not used any of the platforms measured in this survey.

This report offers a detailed examination of three different services that exemplify the shared, collaborative and on-demand economy: ride-hailing apps, home-sharing platforms and crowdfunding services. Key findings about each of these three services are discussed in more detail below.

Read Article (Aaron Smith | | 05/19/2016)

Isn’t this just great! Technology has already left nearly a billion people behind with the first digital divide and now here comes a new one. Now, how the hell are they supposed to catch-up?

Donate to our startup and we promise to do all we can to address the catching-up of those left behind. I can only campaign in my spare time and I’ve been yelling for attention as loud as I can, I’ve posted hundreds of articles to bring attention to the situation. But alas, a new digital divide now looms on the horizon and this campaign is still waiting for funds. Come on, we can do this.

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