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Funding For Health Care Tech Companies Climbs

CHICAGO — With telehealth gaining momentum in the health care industry, funding for on-demand health care companies that provide services 24/7 is climbing drastically. The funding for these companies is expected to quadruple in the next couple of years, and by 2017, there will be more than $1 billion in investment capital, according to a report from Accenture. Companies like Kaiser Permanente have already invested approximately $4 billion in building the company’s “HealthConnect” platform, which will allow members to access real-time access to medical records as well as providing in-home monitoring and virtual consultants.

“On-demand health care is fundamentally changing — and enriching — the doctor-patient relationship, making the physician much more accessible to patients while simultaneously reducing costs,” Kaveh Safavi, M.D., J.D., senior managing director for Accenture’s global health business, said in a statement. “With no end to this type of investment in sight, there’s an enormous opportunity for companies to offer fast, convenient and customized user-experiences that ultimately improve the patient experience and outcomes.”

With the maturation of technology, on-demand health care has become a more cost effective and easy way to provide services to patients. According to Accenture’s research, approximately 190 million people in the United States use smart phones, and the number continues to rise. With a large population of people using smart phones, Accenture expects the demand for mobile health services to rise as well.

The on-demand health care system will not only allow patients to schedule their appointments online and reach their medical records in an instant, but it will also provide patients the opportunity to have video conferences with their physician as well as virtual therapy, according to Accenture. The technology will provide a cost effective, quick and convenient way to access health care.

Since 2000, the top 230 on-demand companies have raised more than $12.5 billion in funding, which is distributed across six main sectors; auto and transportation, food and drink, health, household chores, logistics, and professional services. Excluding the transportation industry, health care is the fastest growing on-demand sector and represents one-fifth of total U.S. funding. With that, the number of on-demand health care companies has grown from four in 2010 to 42 in 2014. Annual investment in on-demand health care is growing at approximately 224 percent annually, according to research from Accenture. Since 2010, primary care has totaled more that $638 million in funding. Also, specialty care, behavioral health care and wellness and veterinary companies have received approximately $68 million in funding from the U.S. since 2010.

The growth is caused by not only the younger generations interested in the benefits of on-demand health care, but according to Accenture’s research, approximately 57 percent of seniors are also interesting in the options that on-demand health care would provide. With virtual visits being less expensive for consumers, on-demand health care is also getting government support, with large payers reimbursing for virtual doctor’s appointments. Virtual visits are 40 percent less for primary care appointments, 28 percent less for urgent care, and three to seven percent less for extensive emergency-room visits.

“Investment in on-demand health care and collaboration between industries will ultimately precipitate a shift away from a goods and services model to a ‘life care’ model, providing patients with personalized services that addresses a multitude of daily needs,” said Safavi in a statement.

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Palos Community Hospital Invests in Disinfecting Robot

PALOS HEIGHTS, Ill. — Infections-treatment.com is investing in new technology to strengthen its infection control and ensure patient safety. The Palos Heights, Ill., hospital will be using a UV disinfection robot called TRU-D SmartUVC in patient rooms and surgical suites to eliminate harmful pathogens even after traditional cleaning routines have been performed.
"The efforts of housekeeping in implementing several new processes and technologies, such as TRU-D has really helped to reduce the incidence of health care-acquired infections,” said Anne Myron, infection control practitioner, in a statement. "Housekeeping is a key partner with infection control in providing a safe environment for our patients."
TRU-D (or Total Room Ultraviolet Disinfection) boasts a 99.9 percent disinfection rate of all viruses and bacteria, killing pathogens such as Clostridium difficile (C. diff.) and Methicillin-resistant Staphylococcus aureus (MRSA). After a hospital worker completes a routine disinfection, the remotely operated robot generates UV light energy to modify the DNA structure of remaining infectious cells so they can’t reproduce and colonize. The robot is equipped with iTRU-D, a cloud-based, secure usage-tracking program that provides customized real-time infection prevention reports via an iPad Mini to hospital staff.
Implementing such technology will help reinforce the hospital’s already outstanding reputation for keeping patients and employees safe. Palos Community Hospital has achieved an "A" Hospital Safety Score rating from watchdog The Leapfrog Group. The score covers 28 different data points, including how well a hospital protects patients from accidents, errors, injuries and infections.
TRU-D also offers an impressive background. In 2011, the Centers for Disease Control and Prevention awarded $2 million to Duke University Prevention Epicenter to help with its research in preventing health care-acquired infections (HAIs). The university selected the TRU-D germicidal disinfection system after internal trials and published independent data proved the technology is successful in mitigating the spread of infection. Five TRU-D instruments were deployed during the first two years of the grant, according to manufacturer Lumalier Corporation.
"With the migration of new viruses and pathogens, like MERS, from continent to continent, there are several variables left in question when it comes to terminal disinfection of patient areas in health care settings," said Lumalier President Chuck Dunn in a statement. "One variable that never changes is TRU-D’s ability to eliminate pathogens that cost hospitals and patients thousands upon thousands of dollars per HAI. Hospitals like Palos that invest in new technology are at the forefront of patient safety and infection prevention."

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CloudVisit Telemedicine Introduces Online Patient Care Tools

COLD SPRING, N.Y. — CloudVisit Telemedicine, a provider of telemedicine and telepsychiatry based in Cold Spring, N.Y., has introduced a new tool for efficient and cost-effective online patient care.

The web-based CloudVisit Connect allows doctors and mental health professionals to easily connect face-to-face with patients online. The HIPAA-compliant online video appointments are suitable for private practices and larger health care institutions to begin scheduling, conducting and invoicing secure telemedicine sessions with just a computer, webcam and broadband Internet access.

“Telemedicine is touted as the ultimate in health care accessibility,” said Daniel Gilbert, president and CEO of CloudVisit Telemedicine, in a statement. “Ironically, the majority of solutions are not financially accessible to smaller practices, most of whom have very tight budgets. We’re changing that with CloudVisit Connect.”

The product is convenient for both doctor and patient. Doctors benefit from the low-cost management tool while patients are able to receive more streamlined medical attention. The telemedicine platform is especially useful for patients that are unable to leave their homes, according to the company. Busy families as well as working adults can easily connect with their physicians from the convenience of their home or office.

“CloudVisit Connect quickly becomes an integral part of patient care and practice revenue,” Gilbert said. “We give providers the autonomy to manage appointments, patients and pricing.”

The tool offers an online appointment calendar for patients to view available dates and times. Physicians receive an appointment request via email that allows them to confirm or deny the request. Online video sessions are unlimited and secure in order for physicians to connect with their patients as often as desired. The tool also offers automatic patient credit card billing based upon the individual physician fees. Physicians have the opportunity to define the length and price of each session.

“The more technologically advanced our nation becomes, the more appreciation we seem to have for the comforts of home,” Gilbert said. “It’s hard to beat one-on-one therapy from the comfort of your favorite chair or a 7 pm pediatric check-in for a sore throat. CloudVisit is a win for providers and patients.”

CloudVisit Telemedicine has also produced CloudVisit Private Practice, which includes expanded features for multi-provider practices, as well as CloudVisit Institution.

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Avatars Enlisted to Track Patient Progress

SAN MATEO, Calif. — As the demand for health care rises, more medical facilities are turning to technology to pick up the slack. One such facility is San Mateo Medical Center, which enlisted an avatar named Molly to help gather information from patients.

Molly is a computerized “therapist” that asks physical therapy patients questions in English or Spanish to help determine their pain levels, while a video guides the patients through exercises and Microsoft Kinect 3D cameras measure their movements. Molly can modulate her tone of voice and facial expressions based on the conversation.

Under the supervision of Paul Carlisle, PT, MPT, GCS, the facility’s director of rehabilitation services, the pilot project is currently conducted on site in hopes that the avatar will eventually be available to patients remotely at their homes.

“Subjectively the patients appear engaged and intrigued by the device. Certainly, there is a buzz of interest in the gym when the avatar starts speaking. The real question is whether or not the patients will use the devices in their homes. I suspect there will need to be both a human and artificial correspondence to make this really work. Patients need to know that there is a substantive benefit before making the commitment to consistent interactions,” Carlisle said.

Remote medical care continues to increase with technological advancements. In fact, Sense.ly, the California company conducting the project, is one of more than 500 companies using health care tools from Nuance, a company that creates speech-recognition and virtual-assistant software, according to MIT Technology Review.

Using speech recognition, body recognition, augmented reality, video and medical devices, the Sense.ly platform allows patients to communicate their symptoms, medical history and recovery progress to an avatar via a phone, desktop or TV. If programmed by a doctor, the avatar can even answer simple questions from the patient. The software also collects data from the patient’s medical devices.

A report is then sent to the doctor, including any red-flag notifications that need to be taken care of immediately; charts, graphs and analytics that highlight the patient’s progress; and a transcript of the patient-avatar interaction.

As for the future of the technology, Carlisle said that the medical center staff is still developing the application with Sense.ly. “We believe there will be a place for using the system on a wider basis in the future. We’re particularly interested in how we can utilize the technology to remotely monitor patient progress for various diagnoses, including low back pain and frozen shoulder syndrome,” he said.

In response to the fear that the technology use will translate to the loss of a personal touch, Carlisle said, “There is still a need for therapists to evaluate the appropriateness and set the parameters of the program. There is no doubt in my mind that patient needs will continue to outweigh the human resources available to meet those needs, in which case we have a responsibility to explore technological solutions, but there is no substitute for the human touch.”

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Designing for Health Care Technology

In response to smaller reimbursements, greater operational costs and more demanding record-keeping requirements, the delivery of health care is becoming increasingly tied to technology. Because technology is now setting the pace in a large number of new construction and renovation projects, facility owners are finding themselves having conversations with architects and designers about technology much sooner in the building process. Technology such as wireless communications, medication bar coding, electronic medical records and RFID tracking will influence the design of a building. As the importance of health care technology grows, so does the interior design process required to incorporate that technology into a visually pleasing and highly functional way.
Begin at the Beginning
The most important step a facility owner can take to successfully integrate technology, architecture and interior design is to talk early and often about technology requirements. No longer can owners afford to treat technology as an afterthought. During new construction or a renovation, a facility’s IT department and technology planning team should have direct and regular input as design unfolds. This significant time investment up front will reap the rewards of a more seamlessly designed technology infrastructure and greater avoidance of expensive change orders.
Chief Areas of Integration
While technological innovation is now apparent wherever you look in a health care facility, there are a few areas where interior design is especially affected by technology.
1. The Hardware Store
The proximity and ubiquity of technology hardware drives a large amount of design decisions. Proper ventilation of computers, printers, charging stations and other hardware is critical for safety and maintenance. Counter space cannot be completely sacrificed for storage, and cabinet size will largely be limited by the ceiling and by accessibility requirements. Satisfying all these demands and arriving at a design that isn’t an eyesore is a challenge, to say the least. Facilities have had to get creative; one hospital tried multiple strategies to satisfy its hardware storage needs, finally deciding to install shower drains in the casework that were painted the same color to allow for ventilation and be aesthetically pleasing, too.
While some hardware can be stored inside a cabinet, some has to be readily accessible. To properly plan for monitors, input stations and other such devices, this kind of hardware should be known as far in advance as possible and measured so that it can be incorporated into counter and desktop configurations to allow those spaces to effectively service their other needs. With hardware storage planning, coordination with the project equipment planner is a necessity.
As the size and amount of A/V equipment and OR integration equipment has expanded, the size of its corresponding casework has also grown. To keep the equipment and its casework from eating up so much of the working space, some hospitals have created separate storage space with proper environmental control, adequate power and enough space for maintenance.
2. A Paperless Environment? Not Yet.
Although health care is moving toward a paperless environment, providers still rely on paper consent forms and other legal documents. A home for this paperwork and an adequate place for clinician and patient when these forms are signed may be overlooked in the planning phase.
3. Electronic White Boards
Electronic white boards are commonly used to track patient status, OR schedules and other rapidly changing data. When placing an electronic white board, the most important points to consider are workflow and visibility for the staff that reference the displayed information. Designing the interior space with staff visibility and functionality in mind can eliminate repositioning them after the facility opens.
Will multiple boards display the information, or will it be one board that scrolls? Will the boards be recessed or not? Having clinicians involved during the planning phase is key to minimizing repeat work — a point that speaks not just to this area, but all areas of health care technology planning. If possible, a 3-D model of the space will help clinicians advise the best placement of these screens.
4. The Key to Keyboard Placement
The placement of wired and wireless keyboards for staff and patient use require proper storage and easy access. Many systems in place today are not user-friendly or aesthetically pleasing. Working with the vendor selection and paying attention to details and accessories will pay off in the end.
5. Visitors Are Customers, Too
It is a given now that patients and family members will have some type of smartphone or laptop with them and will expect connectivity through Wi-Fi. Another expectation is that it will be possible to recharge personal devices in waiting areas and family-centered areas. Therefore, it is important to plan for ample outlets, logically placed near public sitting areas. Many facilities are specifying furniture that includes charging ports and outlets for electronics. Be mindful of future areas that might be converted to public waiting areas and plan for electrical outlets there as well.
6. Headwall Review
When considering headwall design and specialty casework, it is important to understand the functionality and power/data requirements necessary to create intentional placement and coordination with the architect, construction manager and technology project manager. Accessibility, ergonomics, functionality and emergency power are topics that need to be discussed when designing the outlets, data and electrical components of the headwall.
Many facilities are incorporating ceiling booms to hold outlets and equipment near the headwall. Equipment discussions and coordination will determine the space available at the headwall, and because the size and location of the equipment may change according to the specialty unit, having these discussions early will be valuable.
7. Access Versus Art
Placement of signage, artwork, donor plaques and the like can be difficult because they compete for wall space with access control devices like card readers and video intercoms. Similarly, modern nurse call systems have terminals that are mounted on the walls and provide challenges for the interior designer to incorporate them into the overall design of the room.
With so many items that are placed on the common area and patient room walls (clocks, artwork, casework, sharps containers, hand sanitizers), early coordination is necessary to implement an organized and thoughtful wallscape. It helps to fully understand the space requirements and workflow for all access control devices and nurse call systems, as well as getting input from clinicians on the most useful locations for such devices.

Behind the ceiling is a highly active community of wireless access points, paging speakers, nurse call dome lights, nurse call zone lights, RFID tracking sensors, air intake, exit signage and lighting and the community continues to grow. Careful planning is necessary to coordinate these systems in a cohesive and functional way, and in a way that doesn’t result in an unsightly and uncoordinated mess of a ceiling.
Looking Ahead
Understanding technology integration from an interior design viewpoint will keep you continually thinking about how your facility’s appearance and your facility’s performance can coincide. Because technology is changing at warp speed, and facility owners cannot possibly be expected to rebuild their facilities at the same rate, it’s important to plan with a high degree of flexibility.
It’s also a good idea to gaze down the road with regularity and consider how your existing facility will incorporate new technology without a renovation. Some trends to track include smartphone and tablet documentation and dictation, telemedicine, more “smart equipment,” more wireless ceiling access points and larger technology storage rooms.

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Emerging Technologies in Health Care Delivery

Managing one’s health in the future will involve an app, a “smart” device or a patient portal. The explosion of the mobile technology industry is fast and furious, and health systems are scrambling to keep up. These changes create both opportunities and risks; but by far the positives outweigh the negatives. The impact of this technology-driven era will provide more analytics, accountability and accessibility.
The emerging technologies that are changing the way we deliver health care include:

Smart Phones and Tablets Physicians have readily adopted the iPad as part of their medical practice, enabling them to securely search for lab values and X-rays, and to communicate with staff and patients. These consumer-grade devices are entering the hospitals most rapidly by way of patients and family, and from a facility utility standpoint, the need for electrical outlets for charging inpatient and family areas is a priority. Patients and family have an expectation of Internet access, and the growth of personal Internet devices is driving hospitals to provide more Wi-Fi access. Clinicians are slower to adopt mobile technology; they soon will follow. The tablets’ lightness, affordability and ability to be customized through apps make them ideal tools for the health care environment.

Health care Apps Mobile device apps provide rich information and health management tools. Among the custom apps that health systems are developing are a “wait time” app for the emergency department, a contractions monitor for patients in labor and delivery and facility maps with wayfinding to make it easy for patients and family members to navigate the hospital. Patients are monitoring their own blood pressure, air quality, blood glucose and weight loss, and these apps will only become more sophisticated, as will the consumers using them.

Electronic Medical Records EMR’s have been a large capital expense for health care facilities in recent years. Federally mandated requirements for clinical documentation have captured everyone’s immediate focus and budget, often derailing or postponing other critical facility needs and improvements. The EMR establishes a standard across all health care practices to enable data gathering, accessibility and eventually information exchange. Foundational to the EMR is that patients have access to their own health records and can access them through a hospital’s patient portal. A note to forewarn: as soon as the cloud of urgency passes and the electronic charting platform is in place, those projects that were postponed will manifest a new level of importance, and the demand may outstrip supply when the floodgates are initially opened.

RFID Tracking Radio Frequency Identification Tracking is being deployed across health systems to manage assets and staff. The return on investment has proven to be significant and immediate. According to the RFID Journal, Tufts Medical Center’s Cardiovascular Center in Boston saved $1.5 million for inventory management within its catheterization, electrophysiology and interventional radiology laboratories with the use of RFID labels. As more hospitals verify ROI and demonstrate various applications, RFID tracking will be an accountability necessity.

Operating Room Integration The advancement of video integration and image capture has set a new standard in the OR suite. This technology enables access to a full complement of video and data during a case to fully enable a surgeon’s ability to make decisions and act on the most relevant real-time data, as well as consult remote specialists via high-definition video conferencing. Further, a hospital’s ability to recruit surgeons today is largely based on the innovation and technology these systems offer. These high-tech OR suites command massive coordination between clinical staff, IT staff, clinical engineering, equipment vendors, design and construction staff and many others.

Wireless Medical Grade Utility Look for this term to become more common in the health care space. The West Health Institute, a non-profit medical research organization, recently formed the West Wireless Health Council and announced the creation of a medical-grade wireless open framework that effectively turns wireless into a common utility. Using best practices, the council developed a reference architecture that enables a wireless infrastructure to be incorporated into any health care system or hospital, much like air conditioning, heating, plumbing or electricity. Many health systems are beginning to adopt this architecture, paving the way for development of non-proprietary, lower-cost wireless devices and solutions along with improved management and performance of the wireless ecosystem.

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DPR Attempts to Predict Future of Health Care

SACRAMENTO, Calif. — Between electronic medical records, green technology and increasing attention from Washington in terms of new laws and regulations, health care is becoming an ever-increasingly complicated industry. Ironically, the phrase “it’s not like this is brain surgery” does not seem to apply to the industry that actually conducts those procedures. The actual act of carrying out complicated operations is merely one facet of a very complex organism.

Recently, DPR Construction, based in Sacramento, Calif., conducted a research project where the company interviewed 42 leaders in the health care construction industry, ranging from various medical system CEOs to design and construction directors, developers and hospital consultants. The idea was to predict the future; although one of the main take-home points from the study was that there is no consensus in the industry on what exactly that future holds. The construction company gathered the responses from the series of interviews and proposed a series of 10 conclusions.

1. Hospitals will be smaller and more integrated
DPR argued that hospitals would increase their emphasis on a holistic approach to practicing medicine, with a renewed commitment to prevention and wellness. Combining this finding with a prediction that procedures will become safer and less invasive, the company proposed that hospitals would shrink because hospitalizations would become less prevalent. If patients take better care of themselves and procedures become less risky, hospitals can cut down on their expense-laden bed counts.

2. Health systems are the future
The construction firm predicts that health systems will consolidate into larger entities and “community hospitals may cease to exist.” The report also indicated that the distinctions between for-profit and not-for-profit operations would shrink over time, possibly leading not-for-profits to lose their tax-exempt status.

3. Outpatient services drive growth
The report predicts that traditional medical office building formats will be phased out and replaced by new models like medical homes and accountable care organizations. DPR says the fact that the current model will change is the clearest part of the equation. What will replace it is the million-dollar question.

4. Profitability will drive specialty areas to prominence
DPR indicated that cancer, heart and neuroscience would continue to gain relevance, especially as baby boomers begin to interact with the system more regularly and the long-predicted “wave of patients” begins to arrive.

5. IT and EMRs demand attention
The report predicted that the incredible rate of technological advancement and the even more rapid increase in demand by patients for high-tech health care will take resources away from facilities in terms of funding and change the way hospitals are designed.

6. It’s the economy, but you knew that
DPR put it lightly when they explained, “we are moving into a cash-constrained period.” The report indicated the current boom in health care construction will not last forever and will eventually fall back to earth, shrinking the gap between the rest of the design and build industries.

7. The new car smell isn’t worth the price tag
The construction company explained the economy would lead more health systems to seek out existing building with “the right bones,” as renovating a building and updating it to look like what patients expect “is much cheaper” than building new structures.

8. Green will become the standard
DPR contended that LEED certification might not be the standard yet, but health care leaders expected to have some green selling points to show off, along with energy efficiency savings. “Clients want access to data and results, specifically operational savings. They are motivated by optimization.”

9. Collaborative process is an expectation
The report explained that collaborative was becoming a buzz-word used to describe successful projects, while delivery methodologies were still split based on regions and health systems. “Integrated Project Delivery (IPD) is more used and accepted in the West than in the East and is being enthusiastically greeted from the design community.”

10. Differences in age groups are stark
The construction company explained there was a very large dividing point around the age of 45, where customer expectations diverge drastically. Additionally, the baby boomer wave will create a dual effect, where there are too many patients and too few doctors.

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