Doctors Monitor Patients Remotely Via Smartphones And Fitness Trackers

As reported by PBS NewsHour: Dr. Eric Topol, a cardiologist at the Scripps Clinic in San Diego, knows when his patients’ hearts are racing or their blood pressure is on the rise, even if they’re sitting at home.

With high-risk patients hooked up to “personal data trackers” — a portable electrocardiogram built into a smartphone case, for instance — he and his researchers can track the ups and downs of patients’ conditions as they go about their lives. “It’s the real deal of what’s going on in their world from a medical standpoint,” says Topol, whose work is part of a clinical trial. “The integration of that with the classical medical record is vital.”

Similar efforts are underway around the country, as physicians and other providers seek to monitor patients remotely through new technologies, aiming to identify problems early and cut costs and inefficiencies in the healthcare system. The approach is a key focus of the nation’s Affordable Care Act, and the influx of data frominternet-connected devices could be a valuable tool for health systems, helping them to maximize resources and target interventions toward patients who will benefit most. It’s also a huge potential boon for companies that manufacture these technologies and have the know-how to store and wring value from the data they generate.

Already, mobile apps, scales, and activity trackers that beam data they collect to the cloud are helping some doctors and hospitals keep tabs on their patients and inform treatments. Insurance and electronic medical records companies are investing in and partnering with tech outfits like RedBrick Health and Audax Health, which encourage consumers to use activity and health tracking tools and upload the data to their platforms.

Apple, Adidas, Samsung, GPS maker Garmin, audio tech company Jawbone, and gaming hardware manufacturer Razer are developing products that measure biological functions at ever faster clips. Startups across the country are creating gadgets such as pill boxes that can monitor whether patients are taking their meds and under-the-mattress sensors that measure heart rate, breathing and movement. Microsoft HealthVault — Microsoft’s web-based electronic health records platform — lets doctors access data from fitness trackers like Fitbit or Nike+ Fuel Band and glucose and heart monitors that patients have uploaded themselves. It’s an attempt to create a one-stop shop for health information.

Many medical professionals have been slow to embrace the concept of patient-generated data — partly because many are skeptical of information they don’t collect themselves and because many consumer-grade apps and gadgets aren’t approved by the U.S. Food and Drug Administration, the agency that regulates medical devices. In addition, some doctors and other patient advocates are concerned that internet-based systems aren’t secure and that patient privacy might be breached, intentionally or not. But there are signs that resistance to patient-generated data systems is eroding as the healthcare system shifts to focusing on outcomes, and institutions look to web-based solutions to expand their reach and save money.

Thinking Outside the Silo

Last week, Practice Fusion — the fourth largest vendor of electronic medical records in the country, according to Bloomberg Businessweek — announced a partnership with AliveCor, Inc., maker of a smartphone heart monitor, and Diasend, an online diabetes management system. When patients approve sharing data from these FDA-approved services, their information will start flowing into their Practice Fusion medical records. The company plans to integrate more devices that help consumers track their health, according to Matt Douglass, the company’s co-founder and vice president of platform.

Scripps’ Topol called the announcement an important but “baby” step toward making data-powered medicine a reality. “It’s the future,” he said. “But we've got a long way for this to become routine.” Integrating data into medical records can be clunky. Topol’s patients, after all, must still email him screenshots of their information before it can be put into their records.

Companies like AliveCor and Diasend require FDA clearance for medical use because they provide diagnostic services. But others — like Nike+ FuelBand and Fitbit, which work essentially like pedometers, or Wellframe, an app that guides patients through a cardiac rehabilitation program — are meant to foster healthful habits. For now, that distinction saves companies from the drawn-out and expensive process of applying for FDA approval.

Integrating data into medical records can be clunky. Topol’s patients, after all, must still email him screenshots of their information before it can be put into their records.

“Right now, there’s a void in the industry in terms of what do you do with this information,” says Tapan Mehta, the chief of global healthcare marketing for networking giant Cisco. “How do you take this data and synthesize it and make it into knowledge, which can then be used at the point of care?”

Another roadblock to making all this patient-generated information medically relevant is that it’s in silos controlled by the companies that collect it. Plus, analyzing it can be pricey. What’s needed, some experts say, is a system that aggregates and distills data into easily digestible nuggets of information for both patients and their doctors. For consumers to buy in, the interface needs to be as simple as signing into services with your Facebook account, says Guido Jouret, Cisco’s Internet of Things general manager.

Google Health was an early attempt at integration that failed because uploading the data was a hassle, he says. Now Practice Fusion is making a go of it. The company already brands itself as a “physician-patient community,” allowing patients to directly manage their health and find providers. Integrating consumer-grade health products was a logical next step. For now, patients must come into their doctors offices to upload data to the platform wirelessly through the cloud, but there are plans to let patients upload their own data from home in the future. The idea is to leverage the power of the internet to increase social interactions and productivity and provide users seamless, on demand data access from any device.

“If you look to 2020, there’s no way electronic medical records are not running primarily in the cloud,” Douglass recalls Ryan Howard, his co-founder, saying when he approached him in 2005 and sold him on the idea of starting a web-based electronic health records company. “All medical information had to be instantly accessible.”

The Privacy Problem

In the long-term, Douglass says, the company could develop “fairly complex algorithms that are looking at trends across patient populations — who’s healthy or who can be healthier and whether recommendations are actually making them better.” Like Google and Facebook, the San Francisco-based startup acts as a marketplace for information. Its services are free to the more than 100,000 medical professionals who use its product. The company makes money by partnering with diagnostic labs, imaging centers and drug companies and through targeted advertising.

Practice Fusion has to play by federal rules governing patient privacy under the Health Insurance Portability and Accountability Act. It says all its data is aggregated and stripped of anything that would identify patients. Privacy advocates are concerned, however, the federal privacy law doesn’t apply to the growing volume of data produced by many health consumer apps and devices. Even outside a medical context, web titans like Google, Microsoft, Amazon and Facebook have faced criticism when using their customers’ activities to target them with ads for products and services. Using health data to target patients makes the stakes even higher, some privacy advocates argue.

Privacy advocates are concerned, however, the federal privacy law doesn't apply to the growing volume of data produced by many health consumer apps and devices.

“The big concern with services that collect or aggregate health data from multiple sources is that many of them will not be covered by health privacy laws,” says Deven McGraw, the director of the Center for Democracy and Technology’s Health Privacy Project. “Consequently, how they collect and use health data is going to be governed by the companies’ internal privacy policies, which they write.”

Bob Kocher, a partner at venture capital firm Venrock and a former special assistant to the President for healthcare on the National Economic Council, says medical data today is more secure than ever. “We lost paper charts all the time,” he says. “Now we actually know which servers they’re on, and we can even document if there was a breach.”

Plus, he says, health data hasn't yet proven all that valuable for hucksters. The bad guys don’t care about your health: They want your identity, and they can piece that together from your birthday, social security, e-mail and address — information they can get from variety of sources including bank statements, he says.

For physicians, on the other hand, the information can be invaluable. “We’re getting data that we've never had before,” Topol says. “It’s quite extraordinary.”

GPS May Be No Help in Finding Missing Malaysia Airlines Jet

As reported by NBC News: The pervasiveness of consumer technology that can track our every move has left some people scratching their heads as to why something so much more technically advanced, like the Malaysia Airlines jet carrying 239 people, could just disappear from the sky.

Experts say the technology used to track an airplane like the Boeing 777 is state of the art, and leaps and bounds more sophisticated than anything you’ll find in a consumer device. But it could have the same weakness that consumer technology has.

“GPS and tracking devices only work if they’re turned on or if they’re not destroyed,” said Scott Hamilton, aviation analyst for the consulting firm Leeham Co.

No one yet knows what happened to Malaysia Airlines flight 370. Hamilton said it’s possible the pilot or someone else turned off the transponder, or that the plane was destroyed in a sudden, violent event that also knocked out the tracking system.

There are also secondary radar systems, but Hamilton said those have some dead zones, particularly over large bodies of water.

William McCabe, president of the aviation safety consultancy The McCabe Group, said it’s very rare in the modern era for air traffic controllers and others not to know exactly where an aircraft is at all times, because of the overlapping technologies and procedures designed to make flying safe.

“It’s hard to know why that stopped,” he said. “Normally you can track an airplane extremely precisely, much more than a car.”

Still, there has been some discussion about augmenting existing technology with even more advanced systems, such as technology that would transmit in real time all the detailed information experts usually find in a black box long after the catastrophic event.

McCabe said that for now, such technology is quite expensive and may seem cost prohibitive given all the other technology that is used to track aircrafts’ whereabouts – and all the other costs associated with running profitable airplanes.

“What is the likelihood that whatever data is there would be needed on all those airplanes flying?” he said. “It turns out, one of the thousands of airplanes in the sky that day needed it.”

Stolen Construction Trailer With GPS, Leads Deputies To Suspects

As reported by WBRC Fox 6: A man used GPS to track down his stolen trailer and lead authorities to the suspects, the Jefferson County Sheriff's Office said Monday.

Anthony Sears, 53, and Fred Bufford, 52, are both charged with receiving stolen property.

Jefferson County deputies say they got a call from a man Sunday morning reporting his work trailer with $50,000 worth of tools and equipment had been stolen from his work site off of Lakeshore Parkway.

The trailer had a GPS and the victim used that to track it to a residence in the 200 block of Allegheny Drive. He drove past the home and saw the trailer in the back yard.

The man then called authorities who came to the home and arrested two suspects. The trailer and equipment were returned to the original owners, and the suspects were booked into the Jefferson County Jail.

Sears posted a $10,000 bond. Bufford is still in jail on a $10,000 bond.

UK and Germany to collaborate on 5G

As reported by ZDNet: Britain and Germany will team up to work on developing the next super-fast mobile network, 5G, United Kingdom Prime Minister David Cameron told the opening of the world's biggest high-tech fair.

Cameron said the initiative is one of three areas that he wants Britain and Germany to collaborate on to "pool ideas, share data, innovate, and to lead on the next big ideas" in what he dubbed as being "a world on fast forward".

The future fifth-generation, or 5G, network will enable a full-length film to be downloaded on the internet in one second, Cameron said at the official CeBIT inauguration in the northern city of Hanover, attended also by Chancellor Angela Merkel.

"This is a prize that researchers all over the world are going for," he said, unveiling the new collaboration between Germany's Dresden University and Britain's King's College University in London and the University of Surrey.

Britain is CeBIT's partner country this year at the five-day event, focused on the theme of "datability": The ability to use vast amounts of data quickly and responsibly.

Amid global debate about data security following revelations of mass US and British online snooping, a key CeBIT theme this year is how to keep data secure.

Berlin and London have both been caught up in the surveillance scandal revealed by rogue US intelligence analyst Edward Snowden.

Cameron made no mention of the data prying.

However, Merkel stressed the importance of making progress on Europe's common rules for data protection, but said that this must also be the subject of intensive talks with the United States.

Cameron said he is eyeing closer German-British collaboration on improving Europe's telecommunications single market and the Internet of Things, or getting everyday objects to talk to each other over the internet.

"This has enormous potential to change our lives," he said, outlining examples such as health monitors that keep an eye on the heart rate or blood pressure.

"We are on the brink of a new industrial revolution and I want us, the UK and Germany, to lead it," he said, announcing £73 million in funding to boost research on the Internet of Things.

Merkel, who will again join Cameron on Monday for a tour of the sprawling CeBIT halls, described it as a "miracle" that former foes Germany and Britain could today talk about closer collaboration on the basis of democracy and freedom.

Wireless Bills Go Up, and Stay Up

As reported by the Wall Street Journal: Competition in the U.S. wireless market has increased over the past year, but so have Americans' overall phone bills.

While carriers have trimmed the price of their plans here and there in recent months, billings per user continue to grow amid a shift to smartphones and a surge in wireless Internet use.

The results call into question the notion of a price war in the U.S. market. Rather than aggressively compete outright on price, carriers are tailoring their moves to accomplish other goals as well, like weaning customers off expensive smartphone subsidies and encouraging them to use more data.

T-Mobile US Inc. raised the cost of its core unlimited data plan on Friday. The carrier says it has been competing more effectively by doing away with subscriber "pain points" like service contracts and international data fees. But its executives have also been signaling that they don't plan to start a price war.

"When you really analyze a lot of the pricing moves that have been made, there has not been a significant repricing," Chief Financial Officer Braxton Carter said at a Morgan Stanley conference last week.

To be sure, subscribers can find deals that weren't available before. AT&T Inc. on Saturday said it will cut the price of plans offering unlimited voice and text with two gigabytes of wireless Internet use by $15. A subscriber who brings or buys his own phone can pay as little as $65 a month, about 19% less than previously.

Last month, Verizon Communications Inc. raised the wireless-data allotments on similar plans, effectively lowering their cost. T-Mobile made that same adjustment to its tiered data plans on Friday, even as it raised the price of its unlimited plan by $10 to $80 a month for a single user.

Still, billings for the industry's lucrative postpaid customers are continuing to rise.

Average monthly revenue per postpaid customer across the industry rose 2.2% to $61.15 in the fourth quarter, according to New Street Research. That is up more than $5 per user from the first quarter of 2010, when the same measure was at $55.80.

New Street's data adjusts for the fact that T-Mobile generally doesn't subsidize phone purchases. In the past, carriers would pay hundreds of dollars of the cost of new phones then recover it over the life of a two-year contract by adding it into subscribers' bills.

With that embedded subsidy gone, monthly service fees are lower. Customers aren't actually turning over less money, however, because they typically now pay off their phones in monthly installments using carrier financing plans. Mr. Carter, the T-Mobile CFO, said in an interview last month that the total amount the carrier is collecting from its customers on average has gone up.

The high cost of smartphones and data plans means Americans are on average spending more every month on their phones.

Drone pilot wins case against FAA

As reported by CNN: In a David vs. Goliath battle that pitted the Federal Aviation Administration against the operator of a small model airplane, a federal administrative judge has sided with the aircraft's pilot.

The judge has dismissed a proposed $10,000 fine against businessman Raphael Pirker, who used a remotely operated 56-inch foam glider to take aerial video for an advertisement for the University of Virginia Medical Center.

The FAA alleged that since Pirker was using the aircraft for profit, he ran afoul of regulations requiring commercial operators of "Unmanned Aircraft Systems" -- sometimes called UAS or drones -- to obtain FAA authorization.

But a judge on Thursday agreed with Pirker that the FAA overreached by applying regulations for aircraft to model aircraft, and said no FAA rule prohibited Pirker's radio-controlled flight.

Thursday's ruling is believed to be the first to address the issue, but it was not immediately clear whether the FAA would appeal, or what impact it would have on others hoping to use drones for profit.

As recently as last week, the FAA had publicized its restrictions on commercial use of drones. In a press release headlined "Busting Myths about the FAA and Unmanned Aircraft," it stressed that UAS enthusiasts could not use drones for commercial purposes.

"A commercial flight requires a certified aircraft, a licensed pilot and operating approval. To date, only one operation has met these criteria, using Insitu's ScanEagle, and authorization was limited to the Arctic," the FAA's Busting Myths release said.

"There are no shades of gray in FAA regulations," the FAA continued. "Anyone who wants to fly an aircraft-manned or unmanned-in U.S. airspace needs some level of FAA approval."

The FAA could not be reached Thursday night for comment on the Pirker ruling.

Pirker's attorney, Brendan Schulman, called it "a tremendously significant decision for model aircraft and commercial drone operators."

"As a general matter, the decision finds that the FAA's 2007 policy statement banning the commercial use of model aircraft is not enforceable. It would appear to me to have a very significant impact on other operators," Schulman said.

Pirker's flight occurred Oct. 17, 2011, when he remotely piloted a $130 RiteWing Zephyr II aircraft at the campus medical center.

The FAA investigated, and the following April it proposed a $10,000 civil penalty, saying that Pirker operated the plane "in a careless or reckless manner so as to endanger the life or property of another."

Pirker operated the aircraft within about 50 feet of numerous individuals, about 20 feet of a crowded street, and within approximately 100 feet of an active heliport at UVA, the FAA alleged. One person had to take "evasive measures" to avoid being struck by the aircraft, the agency said.

Pirker appealed the case to the National Transportation Safety Board, where Judge Patrick Geraghty ruled Thursday, dismissing the FAA order.

Schulman said Thursday night that his client had not yet learned of the ruling.

"I think he's still asleep. He lives in Hong Kong and they're 12 hours off," Schulman said, adding, "I'm sure he'd be happy about it." 

BP Splitter Refinery Seen Skirting U.S. Oil Export Ban

As reported by Bloomberg: The oil industry is pressuring President Barack Obama to end the 41-year-old ban on most crude exports. BP Plc (BP/) isn’t waiting for a decision.

The British oil giant has signed on to take at least 80 percent of the capacity of a new $360 million mini-refinery in Houston that will process crude just enough to escape restrictions on sales outside the country.

Amid a flood of new U.S. oil, the demand for simple, one-step plants capable of transforming raw crude into exportable products such as propane is feeding a construction boom along the Gulf Coast. If the new processing units continue to multiply, they could render moot the politically sensitive debate over whether to ease the restrictions in place since the Arab oil embargo of 1973.

“It’s a relatively inexpensive way around the export prohibition,” said Judith Dwarkin, chief energy economist for ITG Investment Research Inc. “You can lightly ruffle the hydrocarbons and they are considered processed and then they aren’t subject to the ban.”

BP and other producers will also be able to sell the lightly refined products to a variety of domestic markets.
The first of the units, built by Kinder Morgan Energy Partners LP (KMP) for use by BP, is scheduled to come online in July. Three additional plants have been proposed by other pipeline or trading companies, and refiners including Valero (VLO) Energy Corp. and Phillips 66 said they may follow suit. The plants, built for 1/10 the cost of a complex, full-scale refinery, take advantage of the law that allows products refined from oil to be sold overseas, though not the raw crude itself without rarely granted government permission.

Gasoline Prices

Supporters of the export ban say keeping U.S.-produced oil at home helps lower fuel prices for industry and consumers. Building enough mini-refineries designed for export could have the opposite effect, said Daniel Weiss, a senior fellow at the Center for American Progress, which supports the limits.

“It could be a way of getting around the oil ban and therefore could have an impact on the price at the pump,” he said.


Kinder Morgan, run by billionaire Chief Executive officer Richard Kinder, expects to open the first phase of its 100,000 barrel-a-day crude processing plant in July, located along the Houston Ship Channel. BP has signed a 10-year contract to use the facility, which is designed for further expansion.

“The export of refined products is increasingly in vogue,” Rich Kinder told analysts on a Jan. 15 conference call for the Houston-based company. “We’ll be able to continue to benefit from what we see is a significant trend.”

Creating Value?

Kinder Morgan’s plant is designed to help BP in “creating more valuable products or getting to where we could export,” said Ronald McClain, the company’s president of products pipelines.

“BP complies with all federal regulations regarding imports and exports,” Scott Dean, a spokesman for BP, said in an e-mail response.

BP’s American depositary receipts fell three cents to $48.79 and shares of Kinder Morgan Inc. rose 0.3 percent to $32.29 at the close in New York.

The company has the ability on its pipeline network to sell products from the Kinder Morgan plant both inside the U.S. and for export. BP lost its access to Gulf Coast markets when it sold its 450,000 barrel-a-day refinery in Texas City, Texas, to Marathon Petroleum Corp. last year. The new plant can help the company serve some of those customers.

Oil Glut

For producers such as BP and ConocoPhillips, the plants help solve one of the more vexing challenges of newly abundant oil in the U.S.: the more they produce, the cheaper it gets. That’s because of energy policies that prevent them from selling their crude to overseas markets, while applying no such limits to products that are processed in refineries, such as gasoline or diesel.

The result is that refiners so far have reaped the greatest rewards of the U.S. oil renaissance, exporting record amounts of gasoline while the drillers who created the boom have been forced to contend with a glut of unrefined oil and depressed prices. New discoveries and advanced drilling techniques helped produce more than 1 million barrels last year of a purer, lightweight oil that’s closer to gasoline than darker, heavier crudes. Production of the light oil, known as condensate, doubled from 2011, according to RBN Energy LLC.

New Splitters

The glut, in turn, is leading producers to turn to the new plants, called splitters because they split off gassy molecules in a distillation process that is far less complex than that of a typical refinery. The tower-like facilities can turn the condensate into liquid fuels such as kerosene, propane, butane, and naphtha, an ingredient in gasoline.

Refiners including Valero and pipeline operators including Magellan Midstream Partners LP have so far discussed plans for a dozen such plants, with the total potential to process more than 460,000 barrels of condensate a day -- almost half last year’s production, according to a Feb. 5 note from analysts at RBC Capital Markets led by Leo Mariani.


“The international buyers of these products will likely need to refine them further, so this is basically a veiled form of condensate exports,” wrote Mariani, who’s based in Austin, Texas.