Monthly Archives: February 2014

data saving lives, file note, healthcare, policy, politics

Senior Doctors rorting Queensland Health

  • double-billing
  • charging but not present
  • overtime while on holidays

Queensland auditor-general refers some public hospital doctors to CMC over possible fraud

By Melinda Howells

Updated Tue 11 Feb 2014, 7:15pm AEDT

The Crime and Misconduct Commission (CMC) has been asked to investigate whether some senior doctors have defrauded Queensland Health by claiming excess overtime and double-billing.

The auditor-general investigated 88 of the state’s 2,500 Senior Medical Officers.

He found that seven of them did not attend work during their rostered hours for more than 30 days, and that doctors who were on leave were paid $500,000 in overtime.

Health Minister Lawrence Springborg says the evidence gathered warrants further investigation.

Mr Springborg says the report shows systemic failings and ‘double-dipping’ by some doctors in the state’s public hospitals.

“The report highlights gaps in both rostering and attendance processes and treatment and billing practices, which have been open to exploitation,” he said.

He says some doctors were paid overtime while on holidays, turned up late but claimed overtime, or billed patients privately when they had no right of private practice.

“Inadequate oversight and administration, and we’ve had double dipping and we’ve had people that have taken advantage,” he said.

Mr Springborg admits better checks are needed.

“I’m talking here today about a small number of doctors – the majority of people are doing the right thing,” he said.

“Matters are going to be referred to the Crime and Misconduct Commission in Queensland.

“Also there are a number of recommendations which have been made to improve scrutiny and oversight in the system, which will all be implemented and adopted by the Government.”

Report a ‘smokescreen’ amid contract push

Alex Scott from the Together Union says the report comes as the State Government pushes for individual contracts with doctors.

“This Government is trying to use a smokescreen of this auditor-general’s report to completely misrepresent the true state of affairs in relation to the hours of work for doctors, the private practice arrangement for doctors,” he said.

Dr Shaun Rudd from the Australian Medical Association says it is an attack on the profession.

He says only a small percentage of Senior Medical Officers appear to be involved.

“If that’s correct that’s very worrying,” he said.

“However again it’s usually a system problem in the fact they’re probably working somewhere else in the public system, or it’s not been recorded what they’re actually doing.

“The problem with the Queensland Health system has been that it is a system which has been very difficult.

“It’s had its problems as well with the payroll system etcetera.

“The vast majority of doctors in the public system work long and hard.”

The report comes amid a dispute between the State Government and unions about putting senior doctors onto individual work contracts.

healthcare, nutrition, politics

Liberal Chief of Staff with extremely close ties to food lobbying company

Just disgraceful…

http://www.smh.com.au/federal-politics/political-news/government-official-who-opposed-healthy-food-website-owns-shares-in-food-lobbying-company-20140212-32h83.html

Government official who opposed healthy food website owns shares in food lobbying company

Date 

Senator Nash reveals staffer’s lobby links

Assistant Health Minister Fiona Nash tells the Senate her chief of staff, Alastair Furnival, owns shares in a company that lobbies for the junk food industry.

A senior government staffer who demanded a healthy food website be taken down owns shares in a company that lobbies for the junk food industry.
Assistant Health Minister Fiona Nash revealed in a late-night statement to the senate on Tuesday that her chief of staff, Alastair Furnival, owns shares in the lobbying company Australian Public Affairs – only hours after she had first told Parliament there was “no connection whatsoever” between her chief of staff and the company.

Assistant Health Minister Fiona Nash allegedly intervened to have food ratings site pulled down.Assistant Health Minister Fiona Nash is under fire over the withdrawal of a food rating website. Photo: Katherine Griffiths

Australian Public Affairs is listed on the lobbyist register as representing the Australian Beverages Council and Mondelez Australia, which owns the Kraft peanut butter, Cadbury and Oreo brands, among others.

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The latest development comes after Fairfax Media reported Mr Furnival is also married to the head of the company. A spokeswoman told Fairfax Media that Mr Furnival had “no role whatsoever in his wife’s business”.

In Parliament last night, Senator Nash stated that “for the sake of completeness” she was updating her earlier statements to include Mr Furnival’s shareholding.

A screen grab of the website before it was discontinued.A screen grab of the website before it was discontinued.

She said that he had no active involvement with the company, and “arrangements” had been put in place so that his business activities would not conflict with his role. His wife had committed to not lobbying the health minister, assistant health minister or health department.

Health groups have condemned the intervention of Senator Nash and Mr Furnival in the health star rating food site, which set up a system that enabled food manufacturers to label their products with easy-to-understand nutritional information.

The site was developed through a Council of Australian Governments process run by state ministers, and was launched last Wednesday with the wide support of health groups, including the Heart Foundation, CHOICE, and the Public Health Association of Australia.

Fairfax Media understands that Mr Furnival insisted staff take the website down – a directive that was refused, only to have Senator Nash intervene with the same request. The site was taken down by 8pm that same night.

Public Health Association head Michael Moore said the decision to take down the site was inappropriate.

“The disappointing thing to me was that it was a unilateral decision that overrode a decision of the food ministers,” he said.

 

http://www.medicalobserver.com.au/news/withdrawn-food-rating-website-linked-to-lobbyist

Withdrawn food rating website linked to lobbyist

12th Feb 2014

LABOR is claiming a conflict of interest and possible breach of parliamentary conduct on the part of a senior federal government staffer over his links to the junk food industry.

Late on Tuesday, Assistant Health Minister Fiona Nash told the Senate her chief of staff Alastair Furnival remains a shareholder of Australian Public Affairs (APA), a company operated by his wife, Tracey Cain.

The business represents the Australian Beverages Council, Mondel?z and Cadbury which opposed a new website providing nutritional information about food.

The website was removed 20 hours after it began operation last week and Labor have questioned Mr Furnival’s involvement.

“Prior to working for me Mr Furnival was APA’s chairman and because of that previous position he has a shareholding in the company,” Senator Nash told the Senate.

But before his parliamentary appointment “arrangements were put in place” to prevent his work history conflicting with his obligations under the Statement of Standards for Ministerial Staff, she added.

Ms Cain subsequently gave undertakings that neither her nor APA would make representations to Health Minister Peter Dutton, the health department, or any commonwealth minister in relation to the health portfolio, Senator Nash said.

“On the advice available to me these undertakings have been honoured in full.

“Indeed, neither he nor my office has met with Mondel?z, formerly Kraft, and owners of Cadbury with whom he worked as a chief economist,” Senator Nash said.

Opposition Senate leader Penny Wong said Senator Nash’s response required further explanation.

“She’s in fact conceded that her chief of staff had a direct pecuniary interest in a firm which… had a commercial interest in the policy decisions in her portfolio,” Senator Wong said.

“There are some very serious questions to be answered by the minister, and frankly by the government, about how that arrangement can possibly comply with the ministerial standards and the standards applicable to ministerial staff.”

Senator Wong said Mr Furnival’s involvement in the website removal is yet to be explained.

She also asked to be told when Mr Furnival declared his interest to Senator Nash, the health department and the prime minister’s office.

business, entrepreneurship, management and leadership, quotes & aphorisms

The Way A Cheetah Would Pursue A Sickly Gazelle – Jeff Bezos

The company’s relationship with those publishers was called the Gazelle Project after Mr. Bezos said Amazon “should approach these small publishers the way a cheetah would pursue a sickly gazelle.” A joke, perhaps, but such an aggressive one that Amazon’s lawyers demanded the Gazelle Project be renamed the Small Publishers Negotiation Program.

http://www.businessinsider.com.au/sadistic-amazon-treated-book-sellers-the-way-a-cheetah-would-pursue-a-sickly-gazelle-2013-10

‘Sadistic’ Amazon Treated Book Sellers ‘The Way A Cheetah Would Pursue A Sickly Gazelle’

JIM EDWARDS     
BezosjeffJeff Bezos

Amazon was so ruthless with small book publishers that its pursuit of new, more favourable contract terms with them was “sadistic,” according to Brad Stone’s books about the company, “
The Everything Store.”

Basically, small publishers leaped at the chance to get better distribution through Amazon in the early 2000s. But once they became dependent on Amazon for sales, Amazon turned the screws, Stone claims, demanding longer pay periods and lower discounts. Publishers who didn’t “pay to play” would get unfavorable treatment on Amazon, making their books more expensive and harder to find.

CEO Jeff Bezos regarded the publishing business as a “sickly gazelle,” Stone writes, according to a review in the New York Times:

The company’s relationship with those publishers was called the Gazelle Project after Mr. Bezos said Amazon “should approach these small publishers the way a cheetah would pursue a sickly gazelle.” A joke, perhaps, but such an aggressive one that Amazon’s lawyers demanded the Gazelle Project be renamed the Small Publishers Negotiation Program.

Mr. Stone writes that Randy Miller, an Amazon executive in charge of a similar program in Europe, “took an almost sadistic delight in pressuring book publishers to give Amazon more favourable financial terms.” Mr. Miller would move their books to full price, take them off the recommendation engine or promote competing titles until he got better terms out of them, the book says.

“I did everything I could to screw with their performance,” Mr. Miller told the writer. The program was called Pay to Play until the Amazon lawyers changed it to Vendor Realignment.

 

 

 

 

A New Book Portrays Amazon as Bully
By DAVID STREITFELD
Jeffrey P. Bezos, the founder of Amazon.com.David Ryder/Getty ImagesJeffrey P. Bezos, the founder of Amazon.com.

 

It was perhaps inevitable that Amazon would have a rocky relationship with book publishers. Publishers are analog, Amazon is digital. Publishers are New York, Amazon is Seattle. The large publishers traditionally did not know much about their customers, and did not really care. Amazon knew a lot about customers and made the most of it.

As for smaller houses, they were among Amazon’s most fervent early supporters. Amazon talked a lot in the beginning about leveling the playing field for small publishers. It did, but then things went south.

Brad Stone’s new book, “The Everything Store: Jeff Bezos and the Age of Amazon,” vividly documents just how troubled the Amazon/publisher relationship became by about 2004. The retailer’s critics, who worry about a culture where Amazon has eliminated all gatekeepers except itself, will not be reassured by this book.

In negotiations with larger publishers, Mr. Stone writes, Amazon kept demanding more as it got bigger: steeper discounts, longer periods to pay and better shipping. Mr. Bezos, Amazon’s chief executive, then turned up the heat on the most vulnerable publishers — those most dependent on Amazon.

The company’s relationship with those publishers was called the Gazelle Project after Mr. Bezos said Amazon “should approach these small publishers the way a cheetah would pursue a sickly gazelle.” A joke, perhaps, but such an aggressive one that Amazon’s lawyers demanded the Gazelle Project be renamed the Small Publishers Negotiation Program.

Mr. Stone writes that Randy Miller, an Amazon executive in charge of a similar program in Europe, “took an almost sadistic delight in pressuring book publishers to give Amazon more favorable financial terms.” Mr. Miller would move their books to full price, take them off the recommendation engine or promote competing titles until he got better terms out of them, the book says.

“I did everything I could to screw with their performance,” Mr. Miller told the writer. The program was called Pay to Play until the Amazon lawyers changed it to Vendor Realignment.

Even some Amazon employees were literally sickened by how they had to behave, Mr. Stone writes. One book group employee said he had post-traumatic stress disorder for a year after quitting. Another was fired after he said it would be unethical to revisit a contract that had already been negotiated with Oxford University Press.

Nearly a decade later, Amazon’s hold on the bookselling market, both print and digital, is much greater than it was in those early days. An Amazon spokesman declined to comment on Mr. Stone’s book, which was written with the cooperation of Mr. Bezos.

 

 

entrepreneurship, healthcare, management and leadership, quotes & aphorisms

38 lessons from Digital Health CEOs

My favourites from the list (bolded):

7. “If I wanted to be a doctor today I’d go to math school not med school.” Vinod Khosla

12. “One of the best things data can enable us to do is to ask questions we didn’t know to ask.” Vinod Khosla

16. “Turn your HIPAA status into marketing materials and put it in the sales deck with the goal pre-empting the Chief Security Officer or the like. Otherwise, you spend most of a sales conversation fighting them off with compliance questions.”

21. “When considering an acquisition, on either end, make sure your missions and operations are tightly aligned; it will make the onboarding process that much easier, and the long-term success of the marriage much more likely.”

24. “After 5 deals, start to get your pricing right. Ask a trusted internal champion (that you’ve already sold to) if they would’ve paid more.”

28. “Build trust with potential customers by teaching them about the market.”

29. “Get out of R&D, they tend to just kick around the tires.”

30. “The first hospital customer is really difficult. By 10 it gets easier. At 25, you should know how to scale.”

31. “Early on, find a ‘development partner’ hospital to work with. Find a hospital that’s well respected as well as progressive.”

33. “Don’t give away your product for free (to a hospital), or they won’t value or use is.”

35. “Find an influencer in the industry to serve as your ‘reference customer.”

36. “You can hide from the FDA until you impinge on an incumbent’s business. They’re going to point you out very quickly to the FDA if they feel threatened. Startups are always carrying that risk, and thus it’s better to be proactive.”

http://rockhealth.com/2014/02/top-quotes-lessons-digital-health-ceo/

38 lessons from digital health CEOs

Mollie McDowell
February 09, 2014

 

With keynotes from healthymagination VP and CEO Sue Siegel, prolific VC Vinod Khosla, Oscar Insurance founder Joshua Kushner, and TechCrunch Managing Editor Leena Rao on top of 20 breakout sessions with leading digital health executives, our 2014 CEO Summit covered everything from hardware pro-tips to selling tactics and ‘Fun with the Feds’.

 

Relive the magic and dive into the top 38 quotes and lessons learned throughout the day, as told by digital health CEOs.

 

The state of things

1. “Healthcare is yet to be transformed by technology.”
Joshua Kushner

 

2. “The state of healthcare today is that we are busy in the practice of medicine vs. being in the science of medicine.”
Vinod Khosla

 

3. “We humans think linearly but tech trends are exponential.”
Vinod Khosla

 

4. “People like Congress more than their health insurance companies.”
Joshua Kushner

 

5. “People don’t really understand the difference between health coverage, benefits, plans, services, etc. That’s not the way consumers think—it’s all wrapped up together.”
Alternative Delivery Models / Insurance Reform

 

6. “The net promoter score of health insurers averages 4/100. Amazon is 74/100.”
Joshua Kushner

 

Breaking in

7. “If I wanted to be a doctor today I’d go to math school not med school.”
Vinod Khosla

 

8. “You need a degree of foolishness to cause disruptive change in healthcare. Dare to dream.”
Vinod Khosla

 

9. “Learn to cold call.”
Selling to Hospitals session

 

10. “If you’re going to re-invent healthcare you have to start from scratch.”
Vinod Khosla

11. “Spreadsheets are fiction. Believing in what you’re doing and what you’re building is what’s important.”
Vinod Khosla

 

12. “One of the best things data can enable us to do is to ask questions we didn’t know to ask.”
Vinod Khosla

 

Business

13. “A great CFO can make going public all the easier; make sure you’re under good leadership, because the experience is extraordinarily difficult.”
Steps to an S-1 session

 

14. “Find your competitor’s FDA consultants (look at the predicates for your own device). A lot of times the academic site where the clinical testing was done is a good lead.”
FDA session

 

15. “HR is a cost center, a burden on the organization and getting squeezed.”
Selling to Employers session

 

16. “Turn your HIPAA status into marketing materials and put it in the sales deck with the goal pre-empting the Chief Security Officer or the like. Otherwise, you spend most of a sales conversation fighting them off with compliance questions.”
HIPAA session

 

17. “Find P&L owners (Brand Managers or Directors of Wellness); just don’t get stuck in the ‘Innovation’ group”
B2B Partnerships session

 

Money, money, money

18. “Don’t bother with crowd-funding schemes that involve selling equity in the company, they’re very confusing.”
Navigating Funding Channels session

 

19. “Do not apply for grants that are not perfectly aligned with your business. Grant writing can take hundreds of hours.”
Free Money session

 

20. “Know your ROI and how it will reduce costs.”
Selling to Employers session

 

21. “When considering an acquisition, on either end, make sure your missions and operations are tightly aligned; it will make the onboarding process that much easier, and the long-term success of the marriage much more likely.”
Building, Transforming and Disrupting Through M&A session

 

22. “It’s important that you choose investors that trust you. If you pivot or if make other wild changes, you need to know that they have your back.”
Navigating Funding Channels session

 

23. “There are so many factors that aren’t in your control when trying to go public. If the window presents itself and you have done the necessary preparations, go for it. You never know when the window will close or the market becomes too inhospitable, and you may lose your chance.”
Steps to an S-1 session

 

24. “After 5 deals, start to get your pricing right. Ask a trusted internal champion (that you’ve already sold to) if they would’ve paid more.”
Selling to Hospitals session

 

Making good products

25. “No old person wants to buy tech thats made for old people.”
AARP

 

26. “The key to good product is invisibility for the user.”
Converting Skeptics session

 

How to play well with others

27. “Partnership is going to be absolutely key to taking healthcare to the next transition in evolution.”
Sue Siegel

 

28. “Build trust with potential customers by teaching them about the market.”
B2B Partnerships session

 

29. “Get out of R&D, they tend to just kick around the tires.”
B2B Partnerships session

 

…especially hospitals

30. “The first hospital customer is really difficult. By 10 it gets easier. At 25, you should know how to scale.”
B2B Partnerships session

 

31. “Early on, find a ‘development partner’ hospital to work with. Find a hospital that’s well respected as well as progressive.”
Selling to Hospitals session

 

32. “Avoid academic medical centers early on. They move too slowly and are full of committees. For-profit hospitals move faster.”
Selling to Hospitals session

 

33. “Don’t give away your product for free (to a hospital), or they won’t value or use is.”
Selling to Hospitals session

 

34. “Typical sales cycle to a hospital is 3-18 months.”
Selling to Hospitals session

 

35. “Find an influencer in the industry to serve as your ‘reference customer.”
Selling to Hospitals session

 

Keeping the Feds happy

36. “You can hide from the FDA until you impinge on an incumbent’s business. They’re going to point you out very quickly to the FDA if they feel threatened. Startups are always carrying that risk, and thus it’s better to be proactive.”
FDA session

 

37. “You have to get the lingo down. There’s no such thing as ‘HIPAA-compliant’ unless you are the Covered Entity. You (as a startup) are HIPAA-secure.”
HIPAA session

 

38. “Go above and beyond HIPAA-secure. There’s a distinction between ‘security’ (actually secure) and ‘compliance’ (checking the boxes).”
HIPAA session

 

recipe

Barbecued Lobster Tails

Haven’t tried, but looks terrific…

http://allrecipes.com.au/recipe/909/barbecued-lobster-tails.aspx

Video: https://www.youtube.com/watch?v=sc-wQgD1qGk

Barbecued Lobster Tails

Recipe by: Joe Nekrasz

AllRecipes

(6)

Saved as a favourite by 34 cook(s)

Easy

 Ready in 25 minutes
Picture by: AllrecipesVideo
You just can’t beat a barbecued lobster tail for the ultimate barbecue treat! Watch this recipe being made in the Allrecipes Barbecued Lobster Tails Video.

Ingredients

Serves: 2
  • 1 lemon, juiced
  • 110ml olive oil
  • 1 teaspoon salt
  • 1 teaspoon paprika
  • 1/8 teaspoon white pepper
  • 1 fresh garlic clove, crushed
  • 2 (250-300g) lobster tails
  • oil for barbecue

Preparation method

Prep: 15 minutes |Cook: 10 minutes

1. Preheat barbecue to high.
2. Pour lemon juice into a small bowl, and slowly whisk in olive oil. Whisk in salt, paprika, white pepper and garlic. Split lobster tails lengthwise with a large knife, and brush flesh side of tail with marinade.
3. Lightly oil the BBQ hotplate. Place tails, flesh side down, on preheated barbecue. Cook for 10 to 12 minutes, turning once and basting frequently with marinade. Discard any remaining marinade. Lobster is done when opaque and firm to the touch.
data saving lives, healthcare, policy, startup

Rock Health: Treating patients like consumers

White House’s “Consumer Privacy Bill of Rights”

keep your product dialed on:

  • Focused Collection
  • Transparency
  • Access, and
  • Control

http://www.gocovered.com/

http://rockhealth.com/2014/01/why-patients-need-to-be-treated-like-consumers-qa-noah-lang/

Why patients need to be treated like consumers

Sonia Havele 

January 28, 2014

Noahlang

We sat down for a little Q&A with Rock Health entrepreneur and Covered CEO and privacy expert Noah Lang.  You can catch Lang at Rock Health’s CEO Summit next week, where he’ll be diving into privacy issues on his panel, Privacy by Design.

What was your inspiration for Covered?

A year ago, I needed to select a health plan from my wife’s employer options.  There were only 4 choices, and we’re pretty healthy people, so it couldn’t be that hard, right? I searched for our favorite doctors, but had to do it in four different places. I tried to search for some preferred drugs to figure out what they would cost and found it nearly impossible to compare.  In search of an apples-to-apples comparison, I built an excel model to figure out what might happen if I tear my knee up skiing again or one of us needed emergency care, but very quickly realized it takes more data than a single person can wrangle with to find the answer to those questions. And that data is very hard to get.

Everybody told me there were already tools out there to help consumers with their coverage decisions. I tried all of them. None of the tools gave me confidence in my decision or helped me understand the product I was purchasing. In fact, none treated health insurance like a consumer product at all. The average consumer is willing to spend 9 minutes choosing a plan so often ends up taking an “educated guess.” It was clear to me that it was time for a new vocabulary: insurance in the context of the individual.  I set out to ensure consumers can make a logic-driven decision in that amount of time, or less—without picking up the phone, without confusion, and without resorting to educated guesses.

 Why must health transactions become more accessible to consumers?

 Nobody uses the word consumer in healthcare.  It’s a patient, an employee, an insured.  Healthcare companies are focused on the traditional “payers,” not the consumer.  Well, guess who pays the bills at the end of the day?  Us.  We are customers and deserve to be treated like we’re buying expensive, complex products.

Not only does health coverage come in just behind housing and transportation as one of the largest personal investments of the year, it’s the hub-of-the-wheel that impacts every downstream health transaction that a family makes. This is the reality in a world where only 14% of the employed population are able explain the four key concepts of insurance (deductibles, co-pays, co-insurance, and out-of-pocket maximums). When consumers don’t understand their own coverage, they’re not equipped to understand each subsequent transaction in their doctor’s office, the pharmacy, or the hospital.  As a result, we as Americans often under-use, overpay, and remain in a general state of confusion.

255M Americans see a doctor every year. Most have no idea how much they’ll pay.  150M Americans take a drug every month, but only 19% mail-order those drugs to save 30% of costs. Why? Because the matrix of plan “benefits” from our carriers and employers is pure cognitive overload for most of us. I believe in speaking the language of the consumer—not the insurance carriers—so I set out to simplify the experience, ensure product comprehension, and save consumers money.  At Covered, we translate coverage into a language everybody can understand.

 

How has your background in data collection and tracking influenced your approach to Covered?

Prior to founding Covered, I built and sold privacy products at Reputation.com for 5 years.  In the midst of the social media revolution, I witnessed both the underbelly of the personal data trade and the beautiful experiences that can be built when that data is used effectively.

Personalization is not a commonly used word in healthcare. The “payer” focus is traditionally on the population, rather than the individual. I think it can be done a different way, particularly if we want to liberate individuals and families to direct their own health spending. Covered borrows from streamlined consumer experiences in recommendation engines like Netflix and Amazon, and delivers them to health insurance transactions. Users can enjoy personalized experiences by sharing data with us, but we can only succeed so long as we’re honest about what we know about you as a consumer and how we use that information. The value at Covered for the user is explicit: you’re not wasting time starting from scratch filling out an overwhelming form. Covered uses your shared data to make the process easier and provide high-confidence recommendations. Then, we earn your trust for the long run by responding with value every time you share information, never asking for more information than we need at that point in time (“Focused Collection”), and never sharing it with 3rd parties unless you ask us to.

What role does privacy protection play in the digital health space?

 We have to start thinking of it in terms of the consumer perspective on privacy rather than just falling back on HIPAA as our only guide. Consumers stand to benefit from health data collection and analysis with tangible improvements to their health shopping experiences, but each individual must decide if they are comfortable with the trade-off. At Covered, there’s a lot of good we can do with personal health information.  The more a family shares with us the more refined a plan recommendation we can deliver.  But the only way to trump very real privacy fears and execute on our responsibility to protect your data is to design a privacy-centric experiences from the ground up (“Privacy by Design”).

In digital health today there’s an attitude we’ve seen before: collect as much information as you can about this person and there will be some way to monetize it later. The last go-round, many multi-billion dollar brands like Facebook and Experian were tarnished by personal data privacy fiascos in the social revolution.  Let’s make sure this doesn’t happen in the health tech revolution, I’d highly recommend reading the White House’s “Consumer Privacy Bill of Rights” to any consumer health entrepreneurs out there—keep your product dialed on Focused Collection, Transparency, Access, and Control.

—-

Noah Lang is the Founder and CEO of  Covered, Inc., aiming to translate health coverage transactions into simple language. He is a recognized expert in online behavioral tracking, consumer data collection, and digital PII publication, and he sits on the DMA’s Data Governance Advisory Board. Before Covered, Lang was a founding VP of Business Development at Reputation.com and in 2011, he was selected as a “Privacy by Design Amabassador.”

data saving lives, healthcare, healthy habits, quantified self, rapid learning health systems

Apple stalking wearable opportunities

 

http://rockhealth.com/2014/02/five-signs-apple-creating-health-product/

Five signs that Apple is creating a health product

Malay Gandhi
February 03, 2014

Last week, Apple announced record quarterly revenue and earnings and was subsequently rewarded with almost 10% of its stock value being wiped out. Analysts cited anemic growth for the tech giant, and apparent saturation in the high-end smartphone market. Not surprisingly, many investors are wondering whether the category invented by the iPhone was a once in a lifetime opportunity. In fact, smartphones represent an era of computing that has far exceeded the previous era of personal computers in both install base and usage. Apple seems less concerned, perhaps because their eyes are set on the next era of computing—wearables.

Over the past year, Apple has been quietly building up the resources necessary to release a health product of their own. If the past continues to repeat itself, the digital health landscape could see a huge shift as the standard setter works to create a product that consumers love and use. Culminating in a meeting late last year between senior Apple execs and the FDA, here are five signs that a potentially game-changing digital health product is on the horizon.

1. “The whole sensor field is going to explode.” -Apple CEO Tim Cook

Tim Cook has indicated that wearables are an area of intense interest for Apple, labeling it as a “key branch of the tree” for the post-PC world at D11 last year.

2. The M7 coprocessor.

Apple has already released dedicated hardware for tracking health. The M7 coprocessor is included in every iPhone 5s and has been designed specifically to monitor physical activity, using motion data from the phone’s embedded sensors. The chip has been engineered from the ground up to sip power, extending battery life while allowing for high resolution capture of activity data. Leading fitness apps including Moves, Nike+ Move and Fitbit’s MobileTrack feature take advantage of the new hardware.

Shipping this component in the high volume iPhone product category has allowed Apple to bring the M7 to scale much faster than if they had initially released it within a new product category. The company’s relentless focus on integrated hardware and software experience has allowed them to achieve unmatched performance, and battery life is likely to be one of the keys to winning in wearables.

Bonus: With its “secure enclave” in the A7 processor designed for managing fingerprint data, Apple has also proven it can manage biometric data that is intended to be kept highly secure.

3. They’re hiring medical device experts.

  • Ravi Narasimhan, a Stanford PhD with expertise in “biomedical algorithms, data analysis and wireless technologies” and former VP of R&D in Biosensor Technologies at Vital Connect joined Apple in December 2013 (LinkedIn).

  • Nancy Dougherty, who previously worked at digital health sensor startups Proteus and Sano Intelligence, was hired in December (LinkedIn).

  • Michael O’Reilly, the former CMO of Masimo, developers of a pulse oximeter for the iPhone, joined Apple in July (LinkedIn).

  • Dr. Todd Whitehurst, a self-proclaimed “medical device R&D professional” and former VP of Product Development of Senseonics, a developer of glucose sensors, joined Apple 8 months ago as a Director of Hardware Development (LinkedIn).

  • Ueyn Block who was formerly with C8 MediSensors developing “non-invasive measurement of substances in the human body” joined 10 months ago as a Technical Lead for Optical Sensing (LinkedIn).

  • Yuming Liu, who previously worked at O2MedTech and Accuvein, was hired as an Analog Engineer (LinkedIn).

  • Bob Mansfield, Apple’s longtime lead for hardware engineering, was lured out of retirement to develop unspecified “future products.” The New York Times reports that Mansfield has been exploring sensor technologies for health and is directly involved with the future smartwatch project.

4. Intellectual property.

In 2009, Apple filed a patent for a “seamlessly embedded heart rate monitor” and was ultimatelyawarded the patent by the United States Patent and Trademark Office (USPTO) in late 2013. The patent covers the use of embedded sensors to measure a user’s heartbeat, heart rate, or other cardiac signals. The patent further covers locating the leads in accessories, such as headphones (or perhaps a wearable device).Embedded Heart Sensor

Source: USPTO, annotations by Rock Health

Apple has also explored using personal area networks that would cover items such as the “event monitor device” (EMD) that would include an adhesive strip, a processor, a detector, and a communications port. The patent provides an example of monitoring an individual’s heart rate for events over a threshold (e.g., 180 beats per minute). While such a device sounds familiar to iRhytm’s Zio patch, the patent suggests Apple is looking more broadly into the development of an ecosystem of products that would be anchored by a single wearable platform device (likely wrist-worn), and augmented through various hardware sensors that could live in, on, or around the body and communicate with the primary device.

EMD Heart Rate Monitor Patch

Source: USPTO, annotations by Rock Health

Most recently, Patently Apple has uncovered a patent application for a medical app that can monitor physiological data (e.g., arrhythmias), and either store it on a device like an iPhone and/or transmit the data to health facilities via a communication network. The patent was filed by Naeem Ansari, who was also behind a recent financial system patent that was ultimately assigned to Apple.

5.  Check-in with the Food and Drug Administration (FDA).

Senior Apple executives met with FDA leadership, including the Director of the Agency’s Center for Devices and Radiological Health, which has oversight of medical devices, and Bakul Patel, the author of the FDA’s guidance on mobile medical applications. Patel’s guidance indicates that any mobile technologies which are intended for use in the diagnosis of a medical condition, or in the cure, mitigation or treatment of one will be regulated as medical devices.

cool, data saving lives, healthy habits, quantified self, rapid learning health systems

Twitter can tell when you’re depressed

  • Eric Horwitz leading the way on mining twitter feeds for signs of depression
  • He muses on looking at the impact of news on mood at a population level
  • Conway’s team is looking at some of the tough ethical questions involved, by “investigating public attitudes towards the ethics of using social media for public health monitoring,” he says. “This ethical component of the work is particularly important given the evolving role of social media in society and concerns regarding the activities of the NSA.”

http://business.time.com/2014/01/27/how-twitter-knows-when-youre-depressed/

How Twitter Knows When You’re Depressed

Scientists can now accurately predict if you have the blues—just by looking at your Twitter feed

FRANCE-TECHNOLOGY-BLOGGING-TWITTER-FEATURE
AFP/Getty Images / AFP/Getty Images

With its 230 million regular users, Twitter has become such a broad stream of personal expression that researchers are beginning to use it as a tool to dig into public health problems. Believe it or not, a scientist out there might actually care about the sandwich you ate for lunch—even if most of your followers don’t.

“Our attitude is that Twitter is the largest observational study of human behavior we’ve ever known, and we’re working very hard to take advantage of it,” explains Tyler McCormick of the Center for Statistics and the Social Sciences at the University of Washington.

What if, for example, an artificial intelligence model could scan your Twitter feed and tell you if you’re at risk for depression? And what if you could receive notices from third parties, for instance, that warned you that you may want to seek help, just based on an automated scan of your tweets? Eric Horvitz, co-director of Microsoft Research Redmond has helped pioneer research on Twitter and depression. He says that could one day be a possibility.

“We wondered if we could actually build measures that might be able to detect if someone is severely depressed, just in publicly posted media. What are people telling the world in public spaces?” asks Horvitz. “You might imagine tools that could make people aware of a swing in mood, even before they can feel it themselves.”

Horvitz and a team of researchers helped develop a model that can scan tweets and predict depression in Twitter users, with an accuracy they claim to be 70%. Researchers say the system is still far from perfect. When the model scans your tweets, it misses some signals and doesn’t diagnose many people—about 30%—who really will get depression. And the system has a “false positive” issue, Horvitz said, causing it to incorrectly predict that healthy Twitter users will get depression in about 10% of cases.

The Microsoft team found 476 Twitter users, 171 of whom were seriously depressed. They went back into users’ Twitter histories as far as a year in advance of their depression diagnosis, examining their tweets for language, level of engagement, mentions of certain medications, and other factors, using computer models to sift through a total of 2.2 million tweets. By comparing depressed Twitter users’ feeds with the non-depressed user sample class, they came up with a method for predicting depression diagnoses before they happened. When they tested the model on a different set of Twitter users, it showed 70% accuracy in predicting depression before its onset.

Some tweets the scientists looked at in the depressed group pretty obviously indicate some level of emotional distress. For example, the study cited tweets like these from their depressed user group:

“Having a job again makes me happy. Less time to be depressed and eat all day while watching sad movies.”

“I want someone to hold me and be there for me when I’m sad.”

“‘Are you okay?’ Yes… I understand that I am upset and hopeless and nothing can help me… I’m okay… but I am not all right.”

Not all users’ feeds are so clear. Microsoft’s researchers looked at factors like the number of tweets users made per day, what time of day users tweeted, how often users interacted with each other, and what kind of language tweeters were using. For example, seemingly depressed tweeters were more likely to post messages late at night (between 9pm and 6am) compared with healthy tweeters, who were most active during the day and after work hours.

The team also noticed that certain isolated words in Twitter posts also were characteristic of depression. Words like anxiety, severe, appetite, suicidal, nausea, drowsiness, fatigue, nervousness, addictive, attacks, episodes, andsleep were used by depressed users, but more surprisingly, words like she, him, girl, game, men, home, fun, house, favorite, wants, tolerance, cope, amazing, love, care, songs, and movie could be indications of depression as well.

The volume of tweets mattered too, as did the percentage of exchanges—users who are depressed begin to tweet less, and tweet less at other people, indicating a possible loss of social connectedness, said Horvitz. Of course, just because a Twitter user makes a post that includes the word fatigue and house at 4am, that doesn’t mean they’re depressed. The Microsoft team’s classifier looked at users’ feeds over long periods of time and incorporated many factors. A second Microsoft study that focused more on broader populations using slightly different methods achieved similar results, determining depression in tweets with around 70% accuracy.

One area of public health where this kind of research could come in handy is in measuring public reactions to events. Tracking public Twitter feeds after profound or traumatic events could help scientists understand how we’re affected by the news. “We really didn’t used to have many tools available traditionally for that kind of fine-grained analysis,” says said Horvitz. “Now there’s a new direction for doing the science.”

McCormick, of the University of Washington, said part of the research he and his team is now doing will involve improving earlier Twitter depression models, by weeding out false or misleading data and figuring out areas where depression-related data is being underreported. His team has also identified a group of first-year students at a number of colleges across the country based on their Twitter feeds—hashtags, posts relating to orientation—and is following them for “red flags” that could indicate emotional issues.

A study by University of California San Diego will also build on that research. Funded by the federal government’s National Institute of Health, UCSD’s Michael Conway is creating models that will eventually track depression in communities and figure out how to apply mental health resources better assess public health. “The ultimate goal of this work is to provide a cost-effective, real-time means of monitoring the prevalence of depression in the general population,” Conway said in an email.

In a post-Snowden era, privacy is a major concern facing any kind of mass-data collection. The Twitter users in the Microsoft study permitted Horvitz and his team to examine their tweets, but a possible future in which computer programs  automatically sift through your tweets to make judgments on your health could understandably set off alarms with big data skeptics.

Conway’s team is looking at some of the tough ethical questions involved, by “investigating public attitudes towards the ethics of using social media for public health monitoring,” he says. “This ethical component of the work is particularly important given the evolving role of social media in society and concerns regarding the activities of the NSA.”

It may be some time before the research is developed enough for Twitter to warn individuals at risk for depression to seek help. Horvitz says part of what’s driven his research is the staggering number of suicides in the United States every year due to depression: 30,000. “If we can even save through interventions a few of those 30,000 people each year, it will make this research well worth it,” he said.

healthy habits

Shivering increases brown fat

Seems like they’ve been reading four hour body…!

http://www.medicalobserver.com.au/news/shivering-may-burn-more-kilojoules-than-workout

Shivering may burn more kilojoules than workout

Lynnette Hoffman   all articles by this author

TEN to 15 minutes of shivering in the cold may be as good as an hour of moderate cycling when it comes to converting energy-storing ‘white fat’ into beneficial energy-burning ‘brown fat’, according to research from the Garvan Institute.

The two activities increase levels of two hormones known to be instrumental in that process —irisin, produced by muscle, and FGF21, produced by brown fat.

People with more brown fat tend to be slimmer and have lower glucose levels than those who have less.

Endocrinologist Dr Paul Lee showed that when 10 healthy adult volunteers were exposed to temperatures cold enough to make them shiver, which occurred between 14°C and 16°C, they produced the same amount of irisin in less than 15 minutes as was produced after an hour of moderate exercise.

“We speculate exercise could be mimicking shivering because there is muscle contraction during both processes, and that exercise-stimulated irisin could have evolved from shivering in the cold,” Dr Lee said.

While 50g of white fat stores more than 1255.2 kilojoules (300 kilocalories) of energy, that amount of brown fat can burn up to the same number of kilojoules, he said.

“White fat transformation into brown fat could protect animals against diabetes, obesity and fatty liver,” Dr Lee said.
But don’t dive into the cool room just yet.

“Cold exposure is a bit like exercise in that perhaps it requires training at the start too, so for instance, you could consider wearing a light jacket rather than a big jumper on a cool day, or not turn the temperature on the heater too high in winter. This is similar to how one would train running shorter distance first before attempting a marathon,” he said.

Cell Metabolism 2014; 19(2):302-309