Three keys to successful telehealth
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Tuesday, July 21, 2020

 
 
Dr. Lynae Brayboy
 

Bluetooth contact tracing apps built with Google and Apple's APIs still collect Android users' location data >>

 

BY DAVE MUOIO

Despite very public messaging that the Bluetooth contact-tracing tools for COVID-19 developed by Google and Apple would not track users' locations, its implementation within Android operating systems still collects GPS data that Google could use to determine the user's location, The New York Times reports.
 

The issue is driven by the operating system's device location setting, which must be enabled for the system to scan for other devices using Bluetooth. This requirement has been in place since 2015, because some apps will use Bluetooth as a means of understanding the user's location, according to a Google representative who spoke to the Times.
 

Google is able to use the activated setting to identify a user's location through non-cellular communications, such as WiFi and Bluetooth beacons. The company's representative said that apps built with the contact-tracing tools do not have access to these data without user permission.
 

WHY IT MATTERS
 

Google and Apple's contact-tracing technology has been employed in contact-tracing apps released by several countries – Austria, Germany, Japan and Switzerland , to name a few – and is being used or considered for tools being developed by a handful of  U.S. states. In some countries, these apps have been downloaded by the public millions of times.
 

Decisions to incorporate the technology or download those apps would have been heavily based on the companies' claim that a Bluetooth approach would require no location data to be logged. Numerous stakeholder groups, public health leaders and privacy experts have warned legislators of the unintended consequences of widespread location tracking, and in some cases questioned whether or not the tools would be effective to begin with.
 

National public health representatives from Switzerland and Latvia told the Times that they were aware of the setting and had pressed Google to make a change, while another from Denmark said that the country's health ministry was interested in speaking more with Google after learning of the active location-tracking capabilities.
 

THE LARGER TREND
 

Google and Apple's system-level tools were announced to much fanfare in early April and went live in mid-May operating system updates. Many public health bodies were fairly open about the reasons why they would incorporate the tools or develop their own approach in-house. Of particular note here is the U.K., which said in late April that it would opt for a more centralized digital contact-tracing system, but then backtracked last month and began work on an Apple-Google-based tool.
 

Still, homegrown COVID-19 contact-tracing apps have had their fair share of privacy hiccups as well.
 

Norway's contact-tracing app, called the Smittestopp, was temporarily banned due to privacy concerns from the Norwegian Data Protection Authority. Back in May, an Amnesty International investigation found Qatar’s mandatory COVID-19-tracing app had a weakness in its configuration that could have left it open to cyberattacks. And just today, another Times investigation described (now fixed) security flaws in South Korea's quarantine-enforcement app that would have allowed access to names, real-time locations and other personal information.


woman holding a cellphone
 

Study: Hinge Health's digital pain program reduces chronic lower back pain, disability >>

 

BY LAURA LOVETT

A 12-week, 177-participant trial of Hinge Health’s at-home digital program for chronic pain relief significantly reduced users’ lower back pain, disability and interest in surgery. The study, led by employees of the company, was published last week in npj Digital Medicine.
 

Hinge Health’s digital care program (DCP) is designed for numerous musculoskeletal conditions, and consists of app-based exercise therapy using wearable sensors, virtual cognitive behavioral coaching, and interactive patient education.
 

Topline data
 

Roughly three quarters of participants who completed at least one exercise with the DCP (n = 91) finished the full program (n = 69). Average weekly engagement was greater among the latter group (75 percent versus 90 percent), with those finishing the DCP also participating in an average 3.8 workouts per week as opposed to the 3.0 recommended by the program.
 

The researchers found that, compared to controls, participants provided with the DCP achieved significantly greater improvements on all primary and secondary study outcomes. These included, as measured using a visual analog scale, a 62 percent improvement in pain and a 64 improvement in how much the pain impacted their daily lives, compared to a respective 3 percent and 9 percent gain among controls. The intervention group also saw a significant improvement in pain (52 percent versus 3 percent) and disability (55 percent versus 9 percent) measurements using the Modified Von Korff scale, as well as an increased understanding of their condition (55 percent versus 19 percent) and a decreased interest in pursuing surgery (52 percent decline versus 53 percent increase).
 

How it was done
 

Researchers conducted a randomized, controlled, unblinded trial that recruited adult participants from US employer health plans with persistent non-specific lower back pain. The researchers enrolled these participants into a treatment group (n = 113) and a control group (n = 64), the latter of which received an email with three educational articles.
 

All but one of the study’s authors are employed by or hold equity at Hinge Health.
 

What’s the history
 

A range of digital pain management approaches have cropped up over the past few years, and several tout data supporting their efficacy. In September, a pilot of Kiio’s app-based digital back pain therapy demonstrated some success in a one-year pilot, while the beginning of that year saw the deployment of ManagingLife’s Manage My Pain app at four Ontario clinics. Other recent approaches to tech-driven pain management include peripheral nerve stimulation, virtual reality, and other pain relief wearables.
 

On the record
 

“Hinge Health is a rare digital health company to choose the higher hurdle of demonstrating statistically significant outcomes in a pre-registered randomized control trial,” Dr. Jeffery Krauss, Hinge Health’s chief medical officer, said in a statement. “The Hinge Health results published in Nature journal Digital Medicine is unique because there are few digital programs with randomized control trials and even fewer with conclusive evidence.”


 

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FUNDING AND IPOS

Sprout's in-home autism care platform launches with $10M seed funding >>

The startup combines free assessments and in-person therapy with telehealth and digital care-coordination.

 

ACTIONABLE INTELLIGENCE

Froedtert uses digital health therapeutics to improve patients’ mental health >>

The Wisconsin health network prescribes apps through its Epic EHR to help patients successfully combat depression and anxiety.

 

CONSUMERIZATION OF HEALTHCARE

SSIVIX Lab launches one-stop MyCLNQ app to meet digital healthcare needs >>

The startup has currently 15,000 users for its MyCLNQ app and plans to expand regionally in the next two years.

 

FUNDING AND IPOS

Roundtrip snags $4M to expand its geographical footprint >>

The new round was led by Motley Fool Ventures with participation from Zoll Medical Corporation, UH Ventures and Gray Ferry Capital.

 

HIMSS TV

Three keys to successful telehealth >>

Dr. Michael Zaroukian, VP, CMIO and CTO of Sparrow Health, discusses why patient centeredness, financial incentives and a turnkey system are needed for telehealth to work.

 

HIMSS INSIGHTS

COVID-19 and Beyond >>

The latest issue in the HIMSS Insights series focuses on the implications of the coronavirus crisis for healthcare and healthcare digitization. Several months into the crisis at the time of publication, we try to identify major trends coming out of COVID-19 and unmet digital needs that are being unmasked. The second area of focus is digital health technology assessment which is arising in several healthcare systems and remains highly relevant during the pandemic and beyond.

 

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Real-time analytics, during the pandemic and beyond >>

 

PUTTING DATA TO WORK

This month, we look at the lasting lessons from the COVID-19 crisis about how data is exchanged, how it's managed, how it's visualized, how it's put to work informing patient care decisions and population health.

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