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From AARP To Pfizer, Partners Seek Optum Labs Big Data To Improve Health

From AARP To Pfizer, Partners Seek Optum Labs Big Data To Improve Health | Personalizations for the Aging | Scoop.it

A health care research initiative using tens of millions of health insurance claims and electronic health records is forming myriad partnerships with business, employers and the health care industry to improve health outcomes and potentially lower costs.

Optum Labs, the collaboration between UnitedHealth Group UNH -0.41%’s (UNH) Optum Health and the Mayo Clinic, has more than 20 partners looking for new ways to treat and prevent diseases as well as improve outcomes and lower costs of expensive chronic conditions like diabetes and high blood pressure.

In an interview at the Forbes Healthcare Summit, Dr. Paul Bleicher, Optum Labs CEO talks about some of these new partnerships that include working with health care companies like Pfizer PFE -0.06% (PFE), Boston Scientific (BSX) and Merck (MRK) to large employers and organizations like AARP, the giant association of seniors that is looking to help people live longer in their homes and comfortable community settings. The entire video can be seen below.

“Medical claims have a lot of information in them,” Bleicher said in his interview, which can be seen below in its entirety. “We can link that in a de-identified fashion with a bunch of demographics, with lab results, with medications. We can begin to look at how the medical care was delivered.”

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Here's to the leaders fostering collaboration in healthcare!

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Personalizations for the Aging
Highlighting Personalized Technology and Medical Solutions for the Aging as well as Solutions for Navigating Healthcare
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Pharma Companies Switch Gears: A New Market Emerges Called 'The Fountain Of Youth'

Pharma Companies Switch Gears: A New Market Emerges Called 'The Fountain Of Youth' | Personalizations for the Aging | Scoop.it

Allergan’s Botox was the first product to change the face of women and even men in the last decade. Today we are seeing a whole suite of companies coming up with pharmaceutical magic potions to keep people feeling and looking young forever. The search for a magical elixir to prolong life does not seem to be all that “magical” and impossible with our current technology. A host of companies from Novartis to Google GOOGL -0.13% are on a mission to conquer aging.

Imagine living 10 years more than your expected lifespan, feeling a few decades younger than your actual age, and having the mental and physical agility of someone half your age. Who wouldn’t want that? There is increasing evidence that our current biomedical science is capable of extending human life by approximately 10 years. And many companies are swarming to focus on this magic potion. When GlaxoSmithKline shelled out close to $720 million on Sirtris Pharmaceuticals, which said its drug could combat aging, the game was on. Even though this acquisition failed miserably, it started a race to create an anti-aging drug by large pharmaceuticals and young biotech companies like Google’s Calico. Calico has partnered with another pharma giant, AbbVie ABBV +0.75%, and is on a mission to reverse engineer the biology that controls lifespan and allow humans to prolong healthy lives with its $500 million investment into this project.

Currently, there are already over 100 drugs that have been found to combat aging. One such compound that achieved prominence in aging-related science was reservatrol. Reservatrol is the reason why many doctors encourage drinking red wine. Reservatrol activates an enzyme that is said to slow aging. Therefore, many pharmaceuticals saw this as a potential drug, like Sirtris. Although the effects of resveratrol in rodents have shown significant improvements, questions have emerged surrounding the effectiveness on humans. In recent years, another compound, rapamycin (TOR) kinase, has emerged as a key pathway that mediates life span extension.

One such company at the forefront of this research is Novartis. Novartis’s drug is a form of rapamycin, a compound that blocks genetic pathways that cause aging. According to its research with 200 volunteers who received the rapamycin treatment for a period of weeks, there was a 20% stronger immune response when the flu vaccine was administered. Although this drug will not be available for commercialization for at least 10 years, the potential for a viable product could create a new segment in the anti-aging market.

However, until then, the unregulated anti-aging market is bound to see many products like Elysium’s Basis, a blue pill that is believed to cause the same effects as a low-calorie diet and has proven to make mice live longer. The drug is expected to be profitable, despite the absence of human trials.

To date, it remains unclear whether reservatrol and similar compounds have significant effect on humans. Although marketing of unregulated “anti-aging” supplements that contain reservatrol has proven to be a lucrative business, there is very little evidence of the drug’s effect in combating aging. In contrast to reservatrol, there is abundant literature indicating that rapamycin has efficacy in people as both immune-suppressants and anti-cancer drugs. This compound has already gone through human trials for various diseases and shows better promise of getting FDA approval than reservatrol. The FDA-backed product will most likely eradicate the unregulated anti-aging market.

What does the future hold for this industry? Will these products be reimbursed or will we have to pay out of pocket? With the current crises in healthcare economics, it is very apparent that these pills will not be reimbursed, which calls into question the target segment for this product.

It is very likely that this drug will not be filed under cosmetics, and the FDA will scrutinize it under pharmaceutical drug regulations. What this means is that before the drug enters the market, it will need FDA approval, whereas current drugs like Basis, which falls under cosmetics, need no approval before product launch. It will not be possible for pharmaceutical companies like Novartis to commercialize the drug as a cosmetic, so the FDA will require long-term safety and efficacy tests before approval.

Now that living beyond age 100 can become a reality, we need to start looking at the implications of this progress. What would this mean for our society and, more importantly, to healthcare systems that are already under crises? The current trend of the aging population fueling medical costs will reverse. There is hope that with this preventative model of healthcare, costs will decline as people remain healthy as they grow older. But this delayed aging will also mean more people draw pensions and state benefits. Our economic system will have to change dramatically to accommodate the growing workforce, which probably will work longer than ever before. It presents an enormous opportunity for new industries to flourish and bloom by targeting the aging population, which will probably become the largest segment of all population demographics in the next 20 years.

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Stimulating article - which drugs and solutions will get approval? Who will pay? What are the implications of aging to economic our future as individuals, as a nation?

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11 Reasons 2015's Outlook For Women Entrepreneurs Is Coming Up Roses

11 Reasons 2015's Outlook For Women Entrepreneurs Is Coming Up Roses | Personalizations for the Aging | Scoop.it

Women entrepreneurs could boost the economy in a way that hasn’t been seen since women entered the workforce in mass numbers in the 20th century, according to Sources of Economic Hope: Women’s Entrepreneurship, a report by the Kauffman Foundation, which researches and advocates for entrepreneurship.

 

Women-owned businesses represent 30% of all firms, but only 16% of firms that have employees and 10% of high-growth firms, according to the Kauffman report. “If women were as economically engaged as gentlemen in the economy, our GDP would be 7 to 9 point larger,” said Sallie Krawcheck, a former investment analyst and chair of Ellevate, a global professional women’s network, on Bloomberg TV.

 

Women entrepreneurs have the goods. “Women are armed with more educational credentials than ever — increasingly in fields where entrepreneurialism is flourishing,” said Peggy Wallace, managing director of Golden Seeds, one of the most active early stage investment firms focused on women-led companies. Research consistently finds women entrepreneurs are more likely than their male counterparts to deliver a high return on investment, yet other research finds only one woman raises equity financing for every nine men that do.

 

Here are 11 reasons that 2015 will be another year of great strides for women entrepreneurs.

 

1.) Entrepreneurship makes women really happy.

American women entrepreneurs are among the happiest people in the world. Their happiness levels surge as they grow their businesses, according to the 2013 Global Entrepreneurship Monitor (GEM) U.S. Report. American women entrepreneurs ranked their well-being higher than other women in the U.S., higher than women entrepreneurs in other countries, and higher than men.

 

“The challenge many women face is that we are investing our time and energy in initiatives that don’t genuinely matter to us while living our lives on terms that don’t serve us,” said Marina Illich, an executive coach and leadership consultant, and former professor of religion at NYU, Columbia, and Barnard College in  The Shriver Report.  “That is a huge drain — to our joy, our ingenuity and, fundamentally, to our well-being. Women entrepreneurs are pointing us to an alternative. Do what you love and do it on terms that work for you, your family, your relationships, and your health. This isn’t easy, but it can be done and when we do it, we become self-authoring. What could be more joyful!”

 

“I can honestly say that the hundreds of women entrepreneurs I know are certainly a lot happier than my corporate colleagues and it’s certainly not about the paycheck,” said Amy Millman, president of Springboard Enterprises, an accelerator for women-led businesses seeking equity financing. They thrive on entrepreneurial endorphins that are produced when they are ‘creating the box’ rather than operating inside or outside the box.”

With job security being a thing of the past and a low likelihood of breaking through the corporate glass ceiling, controlling their own destiny is alluring for many. Women under 40 no longer aspire to the corner office as their top career choice, they want to strike out on their own, according to Cindi Leive, speaking on Bloomberg TV. Leive is editor-in-chief of Glamour and based her remarks on research her magazine undertook. Women are now starting nearly 1,300 companies a day, according The 2014 State of Women-owned Business Report. Nine of CNBC’s 20 hottest start-ups of 2014 are women-led.

 

2.) Women entrepreneur role models are increasing and becoming more visible.

Research by Gender GEDI finds that knowing other entrepreneurs plays an important role in directly enhancing aspirations of women to start their own businesses. As they say, seeing is believing.

 

As more women start high-growth companies, they will inspire more women to do so. I wrote about 10 awe-inspiring women in Forget the Glass Ceiling: Build Your Business Without One. I’m also heartened by the number of women who are now willing to be interviewed. When I started contributing to Forbes three years ago, it was struggle to find women entrepreneurs who were willing to have their story told. Now entrepreneurs seek me out.

 

Perhaps someday we won’t need media that cull content about women entrepreneurs so it is easy to find, but that day is not now. An analysis my company, Ventureneer, did reveals that, considering their numbers, U.S. and Canadian media are underreporting female small business owners by 34%.

Fortunately, some media make it easy for women to find great female role models. Bizwomen organizes coverage of women in business from The Business Journals, local business newspapers in 40 markets. Forbes Woman organizes content from its reporters and contributors about women in business. Fortune’s Broadsheet, an e-newsletter, curates from its own publication as well as from others. You can write your own stories or be written about in Women 2.0.

3.) A framework for scaling your business really big exists.

Entrepreneurial Winning Women is a national competition and executive leadership program that identifies a select group of high-potential women entrepreneurs whose businesses show real potential to scale — and then helps them do it. Already multi-million dollar companies, they typically grow on average 20% per year after the program. Impressively, in their second years of participation, these companies really internalize the information and best practices and have seen revenue growth of up to 50%.

Analyses of these women reveals the strategies that work for women who want to scale their businesses big, which have been compiled into two reports: Thinking Big: How to accelerate the growth of women-owned companies and Force Multipliers: How three fundamental adaptations can help women entrepreneurs scale up.

One strategy is evaluating financing. Access to capital is crucial to starting up and scaling companies. Undercapitalized companies have lower sales, lower profits, and generate fewer jobs. Later in the article, I’ll  touch on promising trends in financing women entrepreneurs.

4.) One city provides a blueprint for other cities.

Silicon Valley (and the rest of the world) should take a page out of New York City’s playbook. In just the last decade, it  has become one of the fastest-growing tech sectors in the world, and its growth has been led, in part, by hundreds of women entrepreneurs, according to The Power of Entrepreneur Networks: How New York City Became the Role Model for Other Urban Tech Hubs, a report by Endeavor, an organization supporting high-impact entrepreneurship.

In 2003, there were only 42 tech firms that were led by women in NYC, but by 2013 that number had grown to 457, representing more than 15% of the city’s tech companies. These companies employ more than 7,000 people and have attracted nearly $3 billion in investment.

These high-profile entrepreneurs include Arianna Huffington of The Huffington Post, Heidi Messer of Linkshare and Alexandra Wilkis of the Gilt Groupe. Some sell their companies, start new companies or help run even larger companies. These women also inspire, mentor, and invest in other women-led companies. “…the tech sector’s gender gap is closing because of the concerted effort of these trailblazers, who reinvest their success in the women entrepreneurs who are following in their footsteps,” writes Michael Goodwin, a project leader at Endeavor in The Huffington Post.

5.) New financing options as well easier access.

There’s no doubt about it: Women business owners face greater funding challenges than men. Research found that women are less likely than men to ask for outside funding for fear of being turned down. New forms of online fundraising make it easier to ask and the process is more transparent.

Title II of JOBS Act approved on September 23, 2013 allows private companies to tap into equity financing by publicly raising money. More than a year later, the percent of women raising money publicly is only 17% of all companies, according to Crowdnetic, which maintains an equity crowdfunding database.

That number is too small. Women dominate college graduates and purchase decisions, why not investments, writes Chance Barnett, CEO Crowdfunder, angel investor and catalyst in equity crowdfunding legislations and the JOBS Act in Forbes. To that, I’d add that they also dominate the internet and social media.

I’m committed to not only increasing the size of the slice of the equity crowdfunding pie that women are getting but the pie itself in 2015. NASDAQ recognized my ambition and put it in lights on its tower in Times Square.

Today I officially launched a crowdfunding campaign — THE VENTURE CROWD: Everything Ventured, Everything Gained, aimed at educating both sides of the financing equation — women entrepreneurs and investors — about this relatively new financing and investment option available to them. THE VENTURE CROWD will help fund actionable tools, including a guidebook and training that will show both entrepreneurs and investors how to take advantage of equity crowdfunding.

To provide this education for free, THE VENTURE CROWD will itself be funded out of Plum Alley, a reward-based crowdfunding platform. Yup, I’m walking the walk and taking the challenge myself, crowdfunding the project: I want to experience first hand what it’s like to undertake a crowdfunding project. While what you get in exchange for your money is different in equity crowdfunding versus reward (shares in a company versus a tangible item or service, respectively) the marketing tactics are similar.

Female small business owners are gravitating toward online marketplaces, such as Lendio, which match borrowers with the right lending instrument for their situation. Forty one percent of new small businesses searching for loans on their platform are owned by women, according Lendio.

6.) Angel-back women-led companies hit record-breaking levels.

Angel investors are breaking the financing barrier for women entrepreneurs. While the percent is still low — only 20% of all angel-backed companies were women-led in 2013 — for the second year in a row, a record number of women-led companies received angel funding, according to Jeffrey E. Sohl. director, Center for Venture Research, which researches trends in angel investments.

It’s should be no surprise that angels are increasingly investing in women-led companies, which outperform other companies, according to research conducted by Dow Jones VentureSource, Illuminate Ventures, Kauffman Foundation, and the SBA Office of Advocacy. With more women getting STEM (science, technology, engineering and mathematics) degrees, Sohl is cautiously optimistic that this trend will continue.

Educating women with the wherewithal to be angel investors has been key to growing the number of women-led companies that get funded. These women are more likely than their male counterparts to invest in women-led companies.

In 2005, Stephanie Newby started Golden Seeds to educate women about angel investing. She intuitively knew that the best way to get women involved in angel investing was to demystify the process through education. Research has since confirmed that women underestimate their financial knowledge. Providing education is the way to counteract that lack of confidence.

Women have decision-making power over $11.2 trillion or 39% of all investable assets in the U.S., according to Harnessing the Power of the Purse: Female Investors and Global Opportunities for Growth, a report by the Center of Talent and Innovation. Recognizing the trends in women’s wealth, many other groups are targeting them with increased education about angel investing.

This year Pipeline Fellowship, a training program aimed at women interested in investing in socially responsible women-led companies, increased from five to 10 markets.

37 Angels, a community of women investors who invest in early stage male- and female-led companies, also trains women to become angel investors.

Investor IQ is an online curriculum for very early stage investors from Kauffman available on entrepreneurship.org.

The Angel Resource Institute, which provides education and information on angel investing best practices, launched a new initiative called Women First Enterprises. It is an initiative of which is focused on educating and training women entrepreneurs and angel investors in the US and globally.

Common predictions for 2015 include that the stock market will go higher, according to NPR. The steady increase in angels during the past few years is a reflection of the stock market and improving economy, said Susan Preston of the Angel Resource Institute. When investors do well in the stock market, they diversify into additional areas, such as angel investing, she continued.

7.) Venture capitalists are getting with the program.

2014 was a banner year for venture capital, climbing to new highs — nearly $88 billion of venture capital invested globally, according to PitchBook, more than any other single year. During good times, industries and institutions are more open to diversity and inclusion initiatives; such is the case for the venture capital sector. Change is in the wind.

The venture capital sector took a well deserved pounding in 2014 for its gender imbalance at the partner level — only 4% of the top 100 on the 2014 Forbes Midas List are women. The list measures best-performing venture capitalists. Women represent only 4% of senior partners in venture capital firms with portfolios of $200 million or more, according to a Fortune analysis of data from Pitchbook, a venture capital research firm.

The industry is accepting that it must change. Yup, the National Venture Capital Association (NVCA) formed a Diversity Task Force in 2014 to facilitate that change. It’s leader, Bobby Franklin, is making his personal mission to improve diversity in gender and race in the sector. Finally, recognition that  diversity improves innovation, productivity, company performance, and the overall economy!

Some are dubious of the seriousness of NVCA’s intention, but Vivek Wadhwa, a vocal critic of the underfunding of women-led companies by Silicon Valley and a supporter of women-led businesses believes that the NVCA is sincere.

Others are stirring the pot, too. The National Women’s Business Council and the Small Business Administration Office of Investment and Innovation are holding a series of a roundtable discussion throughout the country to identify strategies to increase the participation of women in the funding side of the financial services industry.

Four percent won’t be 50% anytime soon as Kirsten Green, the founder of Forerunner Ventures noted in The Wall Street Journal. However, she is delighted that a list of potential co-investors for a current portfolio company of hers is dominated by qualified, sharp women with rising influence inside their firms and among founders.

8.) When men know there is a gender bias, they are more willing to take action.

Advice books, networking groups, and leadership conferences for women are increasingly common but, as Joanne Lipman former deputy managing editor of The Wall Street Journal points out in an essay in The Wall Street Journal, that’s only half the equation. Men are an untapped resource in helping women achieve success. Catalyst is talking about the corporate world, but the same holds true in the entrepreneurial world. When men know there is a gender bias, they are more willing to take action.

For those who have been shouting from the roof tops for years that there was a gender imbalance in entrepreneurship, it is probably unbelievable that men haven’t heard their cry before this. But because solid data now exits, media are covering the issue and men are finally listening. NVCA is an example.

Thanks to the ever growing list of men who actively support women entrepreneurs including Brian Cohen, angel investor; Rob Delman, angel investor; Doug Ellenoff of Ellenoff Grossman & Schole; Brad Feld, Foundry Group; Sam Guttmann, BassTech International; Nnamdi Okike, 645 Ventures; Adam Quinton, Lucas Point Ventures; David Rose, angel investor; Barry Schwimmer, the Stamford Innovation Center; David Teten, ff Venture Capital; Fred Wilson, Union Square Ventures, Babak Yaghmaie of Cooley; and Ed Zimmerman Lowenstein.

9.) Women get serious about building self confidence.

The first step is to identify what the problem is: Believing in yourself is the single biggest challenge women entrepreneurs face, said Fern Mandelbaum, a Stanford lecturer who teaches a class called Entrepreneurship from the Perspective of Women, entrepreneur, and venture capitalist in Insights by Stanford Business. “Confidence is key…Confidence is what allows you to try it in the first place — it enables risk-taking, thinking big, perseverance. If you don’t believe you can do it, how will others believe?”

The 10 women I wrote about in Forget the Glass Ceiling: Build Your Business Without One use three strategies to move past self doubt.

Use purpose to move you past self doubt.Passion for your purpose keeps you motivated so when obstacles get in your way you have the strength to go on. It pushes you forward and encourages you to think outside the box.

Seek role models. I’ve already touched on the importance of having role models. So instead I’ll focus on being a role model. When you’ve got it, flaunt it. Not because you’re bragging but because you’re an inspiration to other women. This is so important that even President Obama has formed an initiative, The Presidential Ambassadors for Global Entrepreneurship (PAGE). It is comprised of some of America’s most dynamic and successful businesspeople, including Tory Burch of Tory Burch; Steve Case of AOL; and Reid Hoffman of LinkedIn. An astounding five of the 11 PAGE ambassadors are women, including Nina Vaca one of the women I wrote about in my book. Examples of women starting successful companies should reassure aspiring entrepreneurs that women just like them have put the puzzle pieces together.

Connect and support each other. Women may not have all the power that they deserve but they have enough to make things happen for each other. Women can mentor and advise each other, they can open their Rolodexes to make introductions, and they can use their wealth to fund women entrepreneurs.

 All three of these  strategies are confirmed by Force Multipliers.

10.) Women are building a robust ecosystem.

I would be remiss if I didn’t  credit the myriad of organization that support women entrepreneurs and champion women’s economic empowerment. These organizations help women build networks. Yes, size matters, REALLY. So do people with influence in your network. Research shows that entrepreneurs with larger and more diverse networks grow bigger businesses.

Some of the organizations that include women entrepreneurs include

 

Accelerators: 500 Women, MergeLane, Springboard Enterprises, Upstart Accelerator and Women’s Startup Lab

Certification: Women’s Business Enterprise National Council (WBENC) and its regional affiliates

Leadership training focused on accessing equity finance: Astia and digitalundivided

Networking: Ellevate, Girls Raising, National Association of Women’s Business Owners and SheEO

Peer advisory groups (a.k.a. CEO roundtables or Mastermind): Women Presidents’ Organization

Public policy advocacy: Women Impacting Public Policy

Training for women to become angels: 37 Angels and Pipeline Fellowship

Women-led angel and venture capital funds: 1315 Capital, Aligned Partners Capital Efficient Companies, Aspect Ventures, Astarte Ventures, Astia Angels, BELLE Capital, BroadwayAngels, Canaan Partners, Cowboy Ventures, Double Bottom Line Venture Capital, ForeRunner Ventures, Golden Seeds, Illuminate Ventures, Kapor Capital, Launch Angels, Springboard Fund, Starvest Partners, Texas Women’s Fund, Women’s Capital Connection and Women’s Venture Capital Fund

 But, as I wrote earlier don’t forget men. Men control the vast majority of leadership positions. “I need to be strategic in getting to know and making an impression on those who may be able to help me and open doors for me,” said Jane Newton, partner and wealth advisor at RegentAtlantic and the founder of the Wall Street Women Forum. “That includes men.” We need men if we’re going to make the connections to money, markets, vendors and employees that will grow our businesses. This is a universal sentiment among everyone interviewed for my book, Forget the Glass Ceiling: Build Your Business Without One.

 

“Knowing that men are crucial to moving forward, we need to motivate and engage them, writes Catalyst about it’s research. Again it is speaking about the corporate world, but the advice is just as relevant to the entrepreneurial world.

 

Astia recognizes the importance of this. It’s network of 5,000 experts includes serial entrepreneurs, angel investors, venture capitalists, corporate leaders, bankers, accountants, and lawyers. The network is 50% men and 50% women.

11.) Creating legions of badass women for the future.

In the long term, as a society, we need to develop young girls into women with self confidence and interest in fields that are important to economic prosperity and the health of the world.

Patterns for handling failure and not being perfect start when women are young. The era of pushing Barbie’s unattainable perfection is finally over. She was deposed by Elsa, Frozen’s conflicted relatable princess whose doll became 2014’s “it” toy, wrote Hilary Burns, a Bizwomen reporter. “Gift-givers want to enable little girls to emulate not only princesses and their glamorous lives, but also girls who are brave and manage conflict, like Anna and Elsa do,” said Toy expert Melanie Notkin, who serves on the Toy Industry Association Toy of the Year nomination committee in Burns’s article.

With 47% of comic readers being female, it’s kind of shocking that it took so long for publishers to recognize the importance of this market and to begin to target it. Marvel has ramped up its female presence in a big way with 13 new series with female leads. These fictional characters show girls that life can be bumpy and it takes grit to overcome setbacks.

Women rule social media. 2014 was a breakout year for hashtag activism on issues around women and girls. Some have a professional women’s focus — #leanin, #changetheratio. Others focus on empowerment — #girlsrising, #womenshould — or girls in danger — #bringbackourgirls, #iammalala. You can check out these campaigns which rallied millions around the world in this article on Forbes.

Girls can learn to code through organizations such as Girls Who Code or get interested in STEM (science, technology, engineering and math) at even younger ages by playing with toys designed to educate. Women-led companies, such as Ayah Bdeir’s littleBits, Alice Brooks and Bettina Chen’s Rominate, and Debbie Sterling’s Goldieblox are engaging girls to build things with toys but also tell stories which girls love to do. “Don’t get me wrong,” Andrea Schwalm of Wired’s GeekMom blog has written cited in The New Yorker. “I don’t for a second believe that toy selection will turn kids into something they are not — but I suspect that toys (in combination with books, movies, teacher expectations, and family attitudes) do help foster interests that can turn into hobbies that can turn into careers.”

 So how are you going to help women entrepreneurs build a better economy?

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Here's to the entrepreneurial women (and men) who will build our economy!

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Could Plug-And-Play Be The Future Of Healthcare Diagnostics?

Could Plug-And-Play Be The Future Of Healthcare Diagnostics? | Personalizations for the Aging | Scoop.it

As healthcare is moving toward greater consumerization, devices used for diagnostics are keeping pace and becoming leaner, meaner and even cheaper. Radiology, the “darkroom” of the healthcare world, is now coming into the light and directly into patients’ hands… so as to speak.

New-age diagnostic devices are changing the way we have conventionally diagnosed and understood diseases, and are no longer restrained to “just diagnosis.” Traditional radiology diagnosis involving CT, MRI, ultrasound, etc., included bulky, room-size equipment costing millions of dollars. However, in the past decade or so, new technology has unleashed a wave of creativity and innovation for both software and hardware, and is reshaping these products significantly.

Traditional radiology diagnosis involving CT, MRI, ultrasound, etc., included bulky, room-size equipment. Source: Frost & Sullivan

The latest innovations at this year’s Radiological Society of North America (RSNA) Annual Meeting in Chicago were primarily focused on smarter and safer diagnosis using smaller equipment. For example, the ultrasound that used to be as bulky and heavy as a refrigerator is now the size of a handheld “phablet” (Philips’s VISIQ), and yet it does the same job it did before, if not more. How simple is that? As simple as plugging an iPod into a speaker.

The future of the ultrasound will be plug-and-play devices that capture exceptional quality images. In fact, ultrasound technology is becoming smarter with software enhancement tools (e.g., Toshiba’s premium ultrasound called Platinum).With such tools, an ultrasound scan can be used as an initial diagnostic tool for identifying cancer and other diseases, which was not the case before. As ultrasound doesn’t require surgery to obtain the cancer tissue (biopsy) or using radioactive contrast media in CT/MR (which is hazardous and unsafe), it will significantly reduce the pain and cost of treatment for cancer patients.

Clinicians, and in some cases patients, can now seamlessly upload any patient-related data, such as medical imaging files or picture, video and audio files, from any device (tablet, phone and personal computer) to digital patient records and view them on any device (tablet, phone and desktops/laptops). Such innovation will also reduce diagnosis errors and speed up the communication process between various departments in the hospital and outside. This is one more step toward digital health. These latest radiology innovations help improve efficiency, accuracy and workflow, thereby enhancing the lives of millions of patients.

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smarter and safer diagnosis using smaller equipment

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The Democratization of Finance

The Democratization of Finance | Personalizations for the Aging | Scoop.it

Think about the four main elements that impact our quality of life: our relationships, emotions, health, and money. The most difficult one for many people to manage — and a frequent source of widespread confusion and anxiety — is the money.

2015 is the year that will change.
The One Big Idea for 2015 is the democratization of financial services, which means that for the first time, everyone will have access to the unbiased advice and education they need to make confident, informed decisions about money and investing. Everyone will be able to find knowledge, tools and insights to help them achieve their financial goals.
The current financial system is opaque, complex, and designed to enrich and reward those on the inside. Average investors are so in the dark when it comes to the system that most don’t know just how much they don’t know.
For example: how is your financial advisor compensated? Do they have a legal duty to put your interests first, or are they primarily paid to distribute products? If you’re like most people, you don’t know.
The financial crisis in 2008 exposed many systemic problems at a devastating cost: individuals and families who thought they had made responsible financial decisions lost their savings, their homes and their faith in the financial system. But despite all this hardship and suffering, not much has changed. Proposed solutions like tighter regulations on Wall Street have failed to level the playing field. The average, individual investor remains at the bottom of the financial food chain — a fact that we find infuriating and are determined to change.
We’ve both been working for years to tackle this problem. Elliot built a company that champions independent financial advisors and was the first company to make the sophisticated systems work for the benefit of their clients. Tony spent four years writing a book to share insights he gathered from relationships built over decades of coaching business leaders and financial icons, including the likes of Paul Tudor Jones (one of the top 10 financial traders in history) and Ray Dalio (founder of the largest hedge fund in the world). We are both committed to driving the democratization of financial services by bringing to everyone the knowledge, strategies and tools that empower wealthy individuals and successful investors but are currently out of reach for most individuals.
Technology presents an enormous opportunity to materially improve investors’ relationships with their advisors, the markets and their investments. The emerging “robo-advisor” trend, which enables people to manage their investments via mobile app or web-based portal, is gaining traction. Thanks to the internet, people have more access than ever to education that can help empower them to make good judgments. Knowledge and tools that shine a light on the financial system are the first step in effecting change — and more investors are seeing the light every day.
The democratization of financial services is an idea whose time has come, and 2015 will be its tipping point.

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"everyone will have access to the unbiased advice and education they need to make confident, informed decisions about money and investing"

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Report predicts more cybercrime for healthcare

Report predicts more cybercrime for healthcare | Personalizations for the Aging | Scoop.it
The healthcare industry will continue to be a vulnerable and attractive target for cybercriminals in 2015, according to the second annual Data Breach Industry Forecast conducted by Experian.

The expanding number of access points to protected health information and other sensitive data via EHRs plus the growing popularity of wearable technology are what make healthcare so attractive to attack.

The report predicts that healthcare will continue to be plagued with data breaches in 2015. Healthcare organizations accounted for about 42 percent of all major data breaches reported in 2014 and “we expect this number will continue to grow until the industry comes up with a stronger solution to improve its cybersecurity strategies,” said Michael Bruemmer, vice president at Experian Data Breach Resolution, in a statement.

“Healthcare organizations face the challenge of securing a significant amount of sensitive information stored on their network, which combined with the value of a medical identity string makes them an attractive target for cybercriminals,” states the report. Adding to the problem is that many doctors’ offices, clinics and hospitals do not have enough resources to safeguard their patients’ PHI.

Patients’ Medicare cards are particularly vulnerable since they contain valuable information such as a Social Security number that can be used for fraud, according to the report. 

Healthcare organizations will “need to step up their security posture and data breach preparedness or face the potential for scrutiny from federal regulators.” Experian also forecasts that reported incidents may continue to rise as EHRs and consumer-generated data “add vulnerability and complexity to security considerations for the industry.”

Linda Holroyd's insight:

Healthcare organizations will “need to step up their security posture and data breach preparedness or face the potential for scrutiny from federal regulators.” 

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Mini lab-in-a-box tracks health at the molecular level

Mini lab-in-a-box tracks health at the molecular level | Personalizations for the Aging | Scoop.it

It’s inevitable that as health tracking becomes more mainstream, businesses will need to set themselves apart in order to win over consumers. We recently wrote about Bitbite the in-ear tracker that monitors jaw movements and tells diners when they’re eating too fast. Now Cue allows anyone to monitor their health at a molecular level through a small at-home lab that analyzes samples for various health metrics.
Taking the form of a small box that can fit onto a desktop, the device is able to track 5 different health metrics — inflammation, vitamin D levels, fertility, influenza and testosterone levels. Users take a tiny sample of blood, saliva or a nostril swab and place it inside the Cue box. It then analyzes the sample and produces data within minutes by sending the results to the user’s smartphone. The information is presented as easy-to-understand inforgraphics and also offers diet and lifestyle recommendations based on how the results differ from their usual stats.
Cue can be pre-ordered for USD 199, and customers will be able to monitor their health using similar technology as their GP, enabling them to self-diagnose illnesses or work out the cause of their symptoms. The portability and relative inexpensiveness of the device could also mean it has use as a healthcare tool in remote or poverty-stricken locations. Are there other ways to redesign professional-level equipment as a consumer product?
Website: www.cue.me
Contact: www.cue.me/contact

Linda Holroyd's insight:

Track inflammation, vitamin D levels, fertility, influenza and testosterone levels with blood, saliva or nostril swab

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Text Messages Can Increase Compliance With Taking Medications, Study Finds

Text Messages Can Increase Compliance With Taking Medications, Study Finds | Personalizations for the Aging | Scoop.it
Broad implications for health care providers and insurers

Nearly one third of patients taking medication to lower lipids and control blood pressure are noncompliant with their medications—medications that can be important for preventing progression of coronary artery disease or a preventing a stroke.

Some patients just simply forget to take their medications, or may be uncertain as to the potential benefits or harms.

Increasing compliance with taking medications is one of the most common problems healthcare providers deal with in trying to provide the best care for their patients.

As telemedicine in the US has become a viable method of healthcare, with e-visits becoming more popular, alternatives to traditional in-person visits have expanded ways to influence patient behaviors. Gentle reminders at in-person medical appointments may not be effective or adequate.

With the majority of US residents now owning a cellphone or having access to one, harnessing wireless technology may be a viable way to help reach patients to provide reminders to take medications and intervene when patients are not compliant.

And as smart phones have become more prevalent in our society–with more senior citizens adapting such technology—increasing compliance with taking medicines now becomes just a text message away.

The results of a new study published online in the journal PLOS One offer hope for healthcare providers who deal with this frustrating problem taking care of their patients.

“An important and overlooked problem in medicine is the failure to take prescribed medication. The results of this trial show that text message reminders help prevent this in a simple and effective way. More than just a reminder, the texts provided the link to identify patients who needed help,” explained lead author Dr. David Wald, a professor and cardiologist at Queen Mary University of London in England.

The study evaluated 300 patients who were already taking medications to treat high blood pressure and elevated cholesterol (statins). The study divided the patients into two groups: one group received text messages and the other did not.

The group receiving text messages were sent messages asking them if they had taken their daily medications. The messages were initially sent everyday for two weeks, then every other day for two weeks, followed by once a week for six months. Those patients who did not reply to the text messages received phone calls to investigate reasons and were offered assistance.

According to the results of the study, 25 percent of those who did not receive text messages stopped taking their medications completely or took less than 80 percent of it, compared with just 9 percent who received text messages.

“The health implications of these results are considerable from both an economic and a health gain perspective. The method is not limited to cardiovascular disease prevention and could be used for patients on treatment for other chronic diseases,” said David Taylor, professor emeritus, pharmaceutical and public health policy, University College London.

 Certainly patients with other chronic diseases including TB, HIV, as well as epilepsy could benefit from such technology, according to the authors of the study.

It’s important that this study be extended over a longer period to fully evaluate the health benefits of such technology, and to quantify blood pressure and lipid levels as a result of this intervention.

Engaging patients with text messaging has broad implications for improving healthcare in the US.

Addressing chronic medical illness through such technology can better connect patients with healthcare providers, while likely leading to reduced healthcare expenditures in the US.

Early adoption of this technology leading to downstream savings with improved outcomes makes this a win-win proposition.

 

 

Linda Holroyd's insight:

Broad and practical implications if text messages can help patients comply with medication regimens

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5 approaches companies are taking to build better pill takers

5 approaches companies are taking to build better pill takers | Personalizations for the Aging | Scoop.it

Ask a question like how many companies are chasing after the $300 billion market opportunity of medication adherence and you’re liable to discover that it’s easier to narrow down companies that aren’t pursuing a strategy tied to this complex problem. A better way to break down is by strategy. Looking back at the various approaches entrepreneurs have developed, they include a fairly broad range of strategies particularly combining text, emails and phone messages and apps that set off an alarm. There’s also plenty of interesting technology under development that offers an alternative perspective to the issue. This is far from an exhaustive list but it reflects how companies are thinking about this topic.

Video proof Although medication adherence is just part of mobile health business, Emocha takes an interesting approach to managing the problem of tuberculosis. A spinout of Johns Hopkins Center for Clinical Global Health Education, its MiDot app involves patients recording themselves taking their medication, a requirement for the tuberculosis medication regimen. Earlier this year it began a pilot with the Baltimore Health Department. About 10,000 people were diagnosed with TB in the U.S. in 2012. Other conditions the company is tackling include smoking cessation, weight management and diabetes. Although the company has been offering its app for free to get enough participants to demonstrate its impact, the plan is to eventually charge providers.

Smart pill bottles Adhere Tech has focused on specialty pharmaceuticals in areas such as cancer treatment and HIV where medications are accompanied by a high price tag. Its connected technology is tied to a pill bottle with a sensor that can detect when it’s been taken. It collect data and transmits reports to physicians. It also senses when a dosage has been missed and that can trigger alerts that can be customized to users, either in the form of an automated phone call and text messages and/or the pill bottle flashes and chimes. Common Sensing took the concept of embedding sensors in pill bottles to medical devices. Its GoCap on insulin pen caps tracks each dose and transmits that data to physicians. An LCD screen on Gocap shows the number of units and time since the patient’s last dose.

Artificial Intelligence The developers of AI Cure‘s technology liken it to a personal trainer in a gym working directly with a client to achieve their goals. It involves facial recognition and motion-sensors in a mobile device. It records patients taking their medication and transmits that data back to a clinician through a HIPAA-compliant secure network, who can then confirm that patients took their meds. It can also flag up adverse events or potential barriers and work with patients to overcome them. Although the company has focused on clinical trials and has worked with some health systems and pharmaceutical companies, a new pilot will monitor and intervene with patients seeking therapy for opioid addiction. Next IT’s Alme Coach talks to patients in the hopes of generating a conversation not only about a missed dosage, but also how they’re feeling. Although the service can be triggered by a missed dose or sleep alarm, the developers want it to have a conversation with users that goes beyond a yes or no interaction to generate insights behind what’s motivating patients’ behavior such as depression, financial concerns or side effects. Patient with chronic conditions are the primary interest for this platform because the patient population is so large and because so many things can contribute to someone’s worsening condition beyond medication, such as diet, sleep, emotional state and exercise.

Data aggregation One of the interesting issues in adherence is using the most up to date information about a person’s physical state to make observations and insights about their response to medication. The development of Proteus as a sensor that can be swallowed that works alongside a skin patch electrode has created the ability to track how medication is affecting vital signs, as well as adherence and other data to make more informed medical decisions on dosage levels. Glooko’s collaboration with Joslin is also pretty interesting because it offers a direct answer to the question of what problems can be solved by harnessing data from fitness trackers. They’ve created a way to inform diabetics based on their level of activity whether they are at risk for a hypoglycemic event and advising them what they can do to avoid it.

Low tech design PillPack takes a simple but elegant approach to ordering and packaging medication in daily packets to help patients take their medications. Customers enter their prescription, physician and insurance information on PillPack’s website and pay a flat fee on top of their standard co-pays. The company ships all of a customer’s prescriptions, over-the-counter medicines and vitamins in a 14-day supply of individual packets that come in a roll. Each packet is printed with the contents and instructions on when to take the pills.About one month before a customer’s prescription runs out, PillPack’s pharmacists contact a customer’s doctor and the insurance company, if needed. And if a customer needs to add a new prescription to an order, PillPack overnights an interim supply and then automatically includes the new drug in the next 14-day shipment. As of October its mail-order pharmacy was in 40 states but by the start of 2015, it wants to be nationwide.

Linda Holroyd's insight:

The range of options to engage medication adherence

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50+ demographic represents a $30 billion market opportunity | VentureBeat | Health | by debrasharp

50+ demographic represents a $30 billion market opportunity | VentureBeat | Health | by debrasharp | Personalizations for the Aging | Scoop.it
According to Jeff Makowka, Director of Thought Leadership at AARP, 80 percent of all healthcare assets and activities are focused on people over 50. Chronic disease as well as declining mobility, hearing, and eyesight all play huge factors in why delivery of health care is so skewed towards this older demographic.

It’s also why AARP estimates that over the next five years, there will a market of $30 billion in innovative products and services that will serve a boomer population highly motivated to keep living the way they always have.

He also has some thoughts about who’s doing the innovation. “A lot of people forget that the technology boom started in the 70s and some of those inventors, investors and venture capitalists back then are still in the game,” he says. “There’s a fair amount of wisdom out there with people who have launched more than one company, more than one set of devices or hardware, and people overlook that when they tend towards the stereotype of the hoodie-wearer.”

AARP still remains a champion of people over 50, but it’s now moved towards also being a partner in providing solutions for its constituency. And that means courting innovators, entrepreneurs and VC’s to capitalize on the enormous market opportunities in the two categories they call ‘care navigation’ and ‘aging with vitality’.
Linda Holroyd's insight:

AARP to fund care navigation and aging with vitality

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Creative agencies vision of for the future of retail in CVS Pharmacies

Creative agencies vision of for the future of retail in CVS Pharmacies | Personalizations for the Aging | Scoop.it

Strategy and innovation company co:collective reinvent pharmacy retail model to deliver a more personalized, health-centric experience
As part of the 2015 Future of Retail report, PSFK invited creative agencies from around the world to bring our trends to life for some of the most innovative brands in retail.  The team over at Co:collective took inspiration from PSFK recommendations  Be There and Everywhere, Be The Hub, Power To the People, and Everyone-of-a-Kind to re-invent how shoppers connect with their local CVS pharmacies.

Last winter, CVS took a bold stance when they decided to stop selling cigarettes. This move was projected to cost the company roughly $2 billion. A CVS spokesperson stated “cigarettes and tobacco products have no place in a setting where health care is delivered.” Going beyond saying they care about health and truly focusing on health is an action co:collective calls StoryDoing© and moved them to imagine how else CVS could continue their mission. In incorporating the trends, co:collective also shifted CVS’ focus to predictive and preventative care as opposed to a reactionary and reparative approach. Their two concepts – Life Prescription and Care Center – tie in numerous trends improving the lives those seeking healthier lifestyles.

Life Prescription is an ecosystem that allows CVS to be there and everywhere. Its features include:

Two-way communication between the CVS and shoppers
Personalized recommendations for pharmacy products from fitness tracker integration and contextual cues
Drug interaction warnings
Wellness goal setting, monitoring, and incentives from the store
Life Prescription
While Life Prescription uses data driven practices to bring a more human approach to health. Alexander Rea, co:collective’s technology experience lead asks retailers to:

“Imagine for just one moment, where in text-book Americana, a pregnant mother enters a CVS looking for an over-the-counter product. iPhone in hand, she wants to purchase a product but learns that she can’t use it because the app knows her medical situation, knows the product she wants, pings a CVS database and provides her with valuable information that advises her against it. Call it hyper-local or micro-targeted or simply, the future of better digital experiences.”

Care Center brings the pharmacy out of the back corner and places it at the heart of the store. The store transforms into a cultural cornerstone through personalized consultations with Healthmate care providers incentivized not through pushing products, but rather by providing quality care.

CVS Care Center
As CVS moves into the future, Gavin May, co:collective’s strategy lead, envisions “brick and mortar spaces will increasingly be imagined as more than just places to buy a company’s products but as places to enjoy an experience.”

See how their concepts play out for Mara – an active, health conscious 27 year old – and Karl – a 34 year old who has just come down with a cold.

Mara:
27-year-old Mara is a fitness conscious woman who connects her FitBit and MyFitnessPal to her Apple Health Account. She opens the Life Prescription app to add to her goals-driven shopping list. The app challenges her to reach small milestones to work toward her health goals.

After a long run, she gets a notification from the app that offers her contextual product recommendations based on the run she took.

Mara stops by her local CVS on her way home and stops by the Care Center to talk with a Healthmate about her goals.

After her next workout, Mara stops by the CVS Life Prescription bar at her local gym. A smart mirror syncs data to her Life Prescription profile. Based on the vitamins and supplements she will take that day, the app suggests a recipe to replenish her body post-workout.

Happy with the results, Mara incorporates suggestions into her monthly CVS delivery subscription. Based on her data, the app will also include her preferred allergy medication in the next month’s delivery.
Karl:


Karl is a generally healthy 34-year-old man who wears a Basis 1 smart-watch. Today he work up with a sore throat. CVS’s Life Prescription sends a checkin prompt and offers to connect him with a doctor.

Karl has a video consult through the app with one of the doctors on call at the CVS clinic. He shares his symptoms and the doctor prescribes an antibiotic to be delivered and suggests over the counter relief along with vitamins to boost his immune system

Karl purchases his prescription and the suggested over-the-counter medicine within the app. A local recommendation for soup deliver is also suggested through an app partnership.

An hour later, a Healthmate delivers Karl’s order. The healthmate talks though remaining questions turning the delivery into a house call.

A few days later, Karl gets a follow-up message from the Healthmate and is offered discounts for relevant products.

Linda Holroyd's insight:

Kudos to CVS, who's working on creating a personalized retail experience

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Wearable Technology And Digital Healthcare Strategies Should Shift Focus To Chronic Medical Illness

Wearable Technology And Digital Healthcare Strategies Should Shift Focus To Chronic Medical Illness | Personalizations for the Aging | Scoop.it

As we marvel at the gadgets that companies such as Nike, Fitbit, Jawbone and Apple have recently produced and brought to market–gadgets that can record our heart rate, calories expended, and steps taken—one can only think of how this technology could likely be used on a greater scale to help those who truly need it the most: people with chronic medical illnesses such as emphysema, diabetes, or congestive heart failure.
A recent article by J.C Herz in Wired Magazine provides an excellent beginning point to do just that: recognizing how we, as a society, have yet to harness such powerful and innovative technology to help millions with chronic medical illnesses.
As things currently stand, which Herz eloquently outlines in her essay, existing companies’ technology in wearables has for the most part been utilized by tech aficionados and athletes who marvel in tracking personal health data—but not ultimately benefiting society at large.
In her article, Herz makes clear references to multiple regulatory stumbling blocks, adding not only cost but logistical nightmares to pushing forward–including HIPAA and the FDA, to mention two big ones. She points out that so many of these nifty and innovative gadgets are often put away, gather dust, and may not outlast the novelty of a 6-month period.
In fact, a report last month by PricewaterhouseCoopers’ Health Research Initiative (HRI) evaluating the state of wearable digital technology and devices further supports our current dilemma: Less than half of people who own a wearable use it on a daily basis.
The report, which surveyed over 1,000 consumers, is sobering to say the least. Based on the report, 21% of people in the US have purchased such a device, with 52% of those persons neglecting to use it on a daily basis. Tucked into this 52% of persons are 10% who have stopped using their device altogether.
As a follow-up, HRI released a more recent report just days ago evaluating how the future paradigm of healthcare needs to catch up to other sectors of our economy to improve not only efficiency but quality of care. Entitled Healthcare delivery of the future: How digital technology can bridge the gap of time and distance between clinicians and consumers, the report provides a compelling argument for a change in how we monitor patients with chronic medical issues in the home setting, along with how patients communicate with their healthcare providers and the healthcare system as a whole.
The take-home of this report is that there is a growing acceptance among physicians, with a more open attitude toward adopting digital technology for their medical practices, with clear suggestions for insurers, healthcare companies, physicians and other stakeholders to explore and develop such technologies to help patients who suffer from chronic illness.
“Digitally enabled care is no longer nice to have, it’s fundamental for delivering high quality care,” said Daniel Garrett, Health Information Technology Practice Leader, PwC US.  “Just as the banking and retail sectors today use data and technology to improve efficiency, raise quality, and expand services, healthcare must either do the same or lose patients to their competitors who do so.”
The HRI survey spoke with over 1,000 industry leaders, physicians, nurse practitioners, and physician’s assistants.
The findings of the report:
1. Put diagnostic testing of basic conditions into the hands of patients:  Close to 42% of physicians are comfortable relying on at-home test results to prescribe medication.
2. Increase patient-clinician interaction:  Half of physicians said that e-visits could replace more than 10% of in-office patient visits, and nearly as many consumers indicated they would communicate with caregivers online.
3. Promote self-management of chronic disease using health apps: 28% of consumers said they have a healthcare, wellness, or medical app on their mobile device, up from 16% last year.  Nearly 66% of physicians would prescribe an app to help patients manage chronic diseases such as diabetes.
4. Help caregivers work more as a team: 79% of physicians and close to 50% of consumers believe using mobile devices can help physicians better coordinate care.

“The adoption and integration of digital technology with existing healthcare processes has not yet fulfilled its potential to transform care and value for patients,” said Simon Samaha, MD, Principal, PwC. “The next five years will be critical, with leaders emerging from those who use digital technology to innovate and revamp the interactions between consumers, providers and payers.”

It’s clear from HRI’s report that major stakeholders in the healthcare industry including hospitals, insurers and the pharmaceutical industry all believe that major changes will occur in how healthcare is delivered. However, several barriers exist in preventing the implementation of this new paradigm of healthcare. These include issues of security, privacy, consumer consent, data-sharing, fragmented workflows and digital buy-in.


HRI’s recommendations for healthcare stakeholders:

1. Generating actionable insights through analytics to yield better outcomes: Analytics allow healthcare providers to tailor unique care plans for patients while also managing care plans and improving patient health. Additional goals of treatment are to identify high-risk populations for focused care.

2. Using increasing amounts of data to rethink the workforce and workflows: Using technology to adjust the workforce, which can reduce costs and improve quality. The end result is to adjust staffing based on advances in technology. Digital technology can be used to ensure physicians are practicing at the top of their licenses and leverage care extenders, such as nurse practitioners, when appropriate.

3. Targeting digital interventions for where they make the most sense: Health systems need to figure out how and where digital technology may replace or augment traditional office visits based on a patient’s medical condition.

Sean MacLeod, President of Seattle-based Stratos, an incubator of healthcare technology for new product innovation takes a similar position with PwC’s report, urging the healthcare industry to make a greater commitment toward caring for an important segment of our population— aging baby boomers and those with chronic medical illness.

“On the wearable side, our market position here [at Stratos] is that this technology is great–Fitbits, mobile EKGs, pedometers, but ‘so what’–the only difference between this and technology 20 years ago is that connectivity and the cloud computing power that’s behind it. You are not getting any other actionable data than you could have acquired as a first user or early adopter from the late 1990s,” said MacLeod.

“We have always taken the approach that these are great enabling technologies and the adoption factor really points that the market is ready for this—but the market space that they are being applied to is somewhat arbitrary,” added MacLeod.


MacLeod asks the question: “Is there actionable data that really affects the healthcare system and the costs that are associated with it?”

“What about the diabetics, what about people with epilepsy, what about those with chronic mental illness? And those without resources that get trapped within the health care reimbursement cycle and don’t get predictive and preventable care on a regular basis that helps them through avoiding a worsening of a chronic disease, but also to allow them to manage the disease with their healthcare professional.”

“The big promise here,” explains MacLeod, “is that by implementing these devices in a meaningful way to truly address chronic or preventative medicine—that will be the way you will likely have a large impact on the cost structures of the system.”

“The way that the system is set up right know, it’s very hard to do an ROI calculation that is meaningful across the board, and as a country and you probably won’t get there unless you end up in a single-payer type of environment,” adds MacLeod.

In his view, “The system still hasn’t broken out of an acute-care type of engagement. As a typical healthcare consumer you see your doc for 15 minutes a year. There isn’t a viable or sustainable paradigm for monitoring and tracking the chronicity of care.”

So, the issue is whether we can implement wearable technology to make a meaningful change in how we approach caring for patients.

“There has been a paradigm shift in the marketplace currently from this acute-care setting to more of a chronic-care setting—but it hasn’t shifted yet to address the continuum of wellness. The ISB (Institute for Systems Biology) program in Seattle takes it further to do predictive medicine in such a way that evaluates leading indicators of decreasing wellness. It enables a physician, stakeholder or individual to take proactive measures to not only address a decrease it wellness, but to course-correct it back to a state of wellness,” said MacLeod.

Most medical technology companies today are also attempting to engage in chronic health management, so as part of that, they are pulling wellness apps and wearable technologies into their portfolios, as their “companion products” to their core business. (This could include a pharmaceutical, pacemaker, or healthcare customer relationship management system.)

“These companies are coming up to speed as how to apply the technologies—but they are not educated in the consumer market so they are bit uncomfortable with the “consumerization of their core competency,” believes MacLeod.


“It’s a slow-moving market, so until the consumers of these actionable data devices actually demand it, there is little likelihood that the system will change because of the lack of momentum due to inertia of payers, reimbursement systems and the cost structure that currently exist.”

There is a movement for comparative data that has been growing and this may be addressed by placing technology that is accessible to patients and medical providers in the home setting.

Readmissions of patients through the emergency department cost the healthcare system billions of dollars per year, so developing technology to monitor variations in parameters of chronic disease states may help reduce US healthcare expenditures. Monitoring blood glucose and changes in oxygen saturation, as well as changes in blood pressure, are simple things which can not only improve outcomes but help to reduce costs.

According to Rich Able, CMO and Founder of X2bio, a company dedicated to sensors for monitoring head injuries, “effectively utilizing wearable technology is the key to helping advance our healthcare system to reach the next level—detection and correction of course-based data, predicated on real-time  evaluation.”

Apple and Google, according to Able and MacLeod, serve as channels to the consumer side, but the innovation he feels needs to come from the medical technology space for long term chronic care or wellness paradigms to be successful, with reimbursement paradigms following close behind.

Novel Platform Developed by Stratos: Digital Health Feedback by Proteus Digital Health, a.k.a. HELIUS


Helius is an example of a unique technology incubated and refined by Stratos for Proteus Digital Health, based in Redwood City, California. The technology connects patients with their medical providers using novel ingestible sensors powered by the body’s natural compounds. A specialized wearable sensor attached to the body and then connected by Bluetooth technology to a smartphone or tablet can then provide real-time feedback relative to the effects of specific medications (heart rate, activity level). Helius received European regulatory approval (CE Mark) in August of 2010, and FDA market clearance as a medical device for co-ingested applications in July of 2012.

“Proteus has revolutionized a platform that completely digitizes the pharmacological response and compliance schedules in a living being, said MacLeod.  “It foresees the future of healthcare where clinicians, caregivers, and family members are connected to a patients’ well being.”

The end result is that “Proteus brings a positive paradigm shift to the notion of personalized medicine and the ‘Connected Human,’” added MacLeod.

Baby boomers driving a changing healthcare approach

Many believe that encouraging the use of connected devices, such as Proteus, may help decrease re-admissions rates, especially with an aging demographic. The new paradigms for health care of our aging population will have to involve the home-care setting.

Able stresses that “75 million baby boomers taxing on the healthcare system” will make treatment in the home using wireless and wearable technologies imperative.


So what will be the driver that will finally push technology into the home, making other approaches suboptimal?

“It’s a realization that the cost structures of today will ultimately bankrupt us as families, or us as a community, or us as a country,” according to MacLeod. “How many years in a row can you put up with double digit increases in your healthcare costs?”

If cities could embrace such technology, potentially in pilot programs to actually demonstrate economic advantages to an integrated system using wearables in a “connected home”, which then translate into improvements in prosperity, reduced cost of living, improved lifestyle and wellness, it is feasible that insurers and other stakeholders would take notice.

A National Initiative to Change How We Manage Chronic Disease?

An initiative from the White House might be the best way to approach integrating wearable technology and digital health to make the connected home the new paradigm to manage people in the outpatient setting.

Just as the electronic health record (EHR) became a national priority, so too should mobile and wearable technology invested in chronic medical care in the home setting become a top priority on the nation’s agenda.

“This is a point of national pride that we should do this,” urges MacLeod. “Lets create a brand new industry and own it.”

MacLeod sums it up another way: “This is the new moonshot for 2016. We will not only will put a man on the moon, but we will bring him back.”

Linda Holroyd's insight:

Look for wearables for diagnostics, self-management, interactions

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Caregiving Resource Center: Tips for the Long-Distance Caregiver, Comm... - AARP

Caregiving Resource Center: Tips for the Long-Distance Caregiver, Comm... - AARP | Personalizations for the Aging | Scoop.it
Caregiving from afar is no easy task. Here are some helpful tips to keep in mind while contemplating caring for your parent from a distance.

Create a Contact List
Assemble address and phone numbers of friends, neighbors, doctors, faith leaders and others in regular contact with your parents who can be reached in the event of an emergency. Include at least one person close by who can easily check in on your loved one. Consider giving this person a key to the home if your loved one approves. If you don’t already know them, introduce yourself during a visit to establish relationships should you need to reach out. Give one copy of this list to your loved one and keep a copy for yourself. These folks may also be able to help out with shopping, transportation or visits.

Collect Important Information Before a Crisis
Keep the following information organized and easy to reach in the event of a crisis.

Medical

  • Medical records.
  • Notes on their condition.
  • A list of medications they take.
  • Names and phone numbers of all doctors.
  • Name and phone number of their pharmacy.

Insurance

  • A list of insurance policies, the carriers and account numbers.

Utilities

  • Company names and phone numbers for all utilities, including electric, phone, cable and Internet.

Financial

  • A list of all assets and debts (include dollar values).
  • Yearly or monthly income.
  • Yearly or monthly expenses.
  • A statement of net worth.
  • Information on bank accounts, other financial holdings and credit cards.

Legal

  • Relevant legal documents your loved one has or wants to create (i.e. wills, advance directives, trusts, powers of attorney).
  • Location of important documents (i.e. birth certificates, deed to home).
  • Social Security numbers.


Make Visits Productive

Visiting your parent or loved one should be an enjoyable event. But take advantage of your time together to assess their changing needs.

  • Before your visit, decide together with your loved ones what needs to be taken care of while you’re there, including scheduling any necessary appointments.
  • Make a list of household items that need to be purchased and, if possible, go out and buy them.
  • Allow time to go through mail and old papers. 
  • Take note of anything out of the ordinary and of what they eat. Check to see what they have in their refrigerator and pantry and if it’s sufficient.
  • Look out for safety hazards such as loose rugs, missing handrails or poor lighting.


During your visits, you may start to realize that more help is needed on a regular basis. Think about your parent’s daily needs and whether they are still being adequately met.  Are they:

  • Socializing with friends and other relatives?
  • Attending religious services or other regular events?
  • Keeping up with chores or housekeeping?
  • Maintaining their personal appearance and hygiene?
  • Eating well with a variety of foods in the house?
  • Opening and responding to correspondence from insurers, banks or others?
  • Paying bills and balancing the checkbook?
  • Scheduling and getting to doctor appointments or other important visits?
  • Getting out to the store or recreational activities?
  • Maintaining the home?
  • Taking medication as directed?

If not, consider additional resources to ensure your loved one is maintaining their normal routine and staying on top of finances, mail and medications.

Be sure, however, to spend time enjoying each other's company, too. A visit that is all business won't be good for anyone.

Gather Information on Community Services
Based on your observations and discussions with your parents, you may want to look into services in their community that could help them.  Start by using the Eldercare Locator to determine which local agencies provide services where your parents live. It will refer you to the area agency on aging in your parent's community. Look for services that fit the needs of your loved ones as well as an organization that can work with you long distance. Take notes on the services offered, the application process, waiting lists and fees. If an organization requires an in-person interview with your parent, find out what documents you will need prior to the meeting and whether copies will be sufficient. If you can’t be with your parent at the meeting, consider having one of their emergency contacts stand in for you. You might be able to join the conversation by telephone. Make a list of questions you want answered and be sure to have a contact person to follow up with.

Look into Public Benefits Online
You can now go online and safely and conveniently get an idea of the different public assistance programs for which your parents might be eligible. By using Benefits QuickLINK you can find helpful state, federal and private benefits programs available where your parents live. By answering a few questions, you will get fact sheets, applications and websites for programs that can help them save money and cover costs of everyday expenses.

Get Help with Managing the Care
Most communities have professionals who can gauge your loved one’s abilities and needs and set up a plan for care. You can find this assistance through government-funded programs by using theEldercare Locator. Another option is to hire a private geriatric care manager. A number of employers are starting to pay for these services and, if your family member has long-term care insurance, this might be covered under the policy. For a list of local professionals, visit the National Association of Professional Geriatric Care Managersor the National Association of Social Workers.

Keep the Lines of Communication Open
Be sensitive to your parent’s view of the situation. At first they may not want strangers in their home, or they may have trouble facing change. Maintain a positive focus, explain how the services will work and that they are designed to help your parent remain independent. If possible, offer to contribute to the cost of care without appearing to offer charity. If your suggestions of service are rebuffed, you can have an objective third party — such as a doctor — recommend the service.

Don’t Forget Your Needs
Recognize the strain that long-distance caregiving causes, and take steps to reduce it.  Accept that it's impossible for you to provide all the help your parent needs. Give yourself credit for your efforts to determine needs, coordinate services and offer support by phone and occasional visits. Ask for help when you need it. If you don't feel that other family members are doing their share, consider a family meeting to help resolve any issues. Eat right, exercise and get enough sleep. For more tips on managing the stress of caregiving, click here.

Mail Carrier Alert Program
In some communities, mail carriers or utility workers are trained to spot signs of trouble through the Carrier Alert Program of the U.S. Postal Service. They report concerns, such as accumulated mail or trash, to an agency that will check on the older adult. This is a service of the USPS and the NALC (National Association of Letter Carriers) in collaboration with local non-profits. To find out if there’s a program in your area, contact the local post office or NALC branch office, or ask your mail carrier for information.

Linda Holroyd's insight:

Great tips and resource

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More parents move in with their kids

More parents move in with their kids | Personalizations for the Aging | Scoop.it

Extended families are moving in together for a variety of reasons.
Amy Goyer moved from Alexandria, Va., to Arizona about five years ago; her parents moved into a senior living community, and she moved into their home of 30 years.

But when her mother and father’s health required that they needed full-time care three years later, they moved back into the house with their daughter as a way to cut costs.

“If they moved in the house with me, they could save the housing expense, and their money went to pay live-in care workers [during the week],” said Goyer, who serves as AARP.org’s caregiving/grandparenting expert.

Plus, living in the home would be more comfortable for her mother, who had suffered a stroke and had other health issues, and her father, who is coping with Alzheimer’s disease. And it would be more convenient for Goyer to help on the weekends; instead of having to drive — even a couple of miles away — to see them, she could spend quality time with them and do her laundry at the same time. Her sister flies in to help when Goyer needs to be out of town.

While much has been written about millennial children boomeranging back to live with their parents, there’s another group of people who have been quietly doubling up: baby boomers and their own aging parents. And some expect this particular trend to hold even with an improving economy, as people live longer and require more care at the end of their lives.

A recent survey by the American Institute of Architects found that dedicated guest rooms, including in-law suites (that can be as simple as a secondary master bedroom suite with a bathroom), have been gaining in popularity over the past couple of years. In 2014, 39% of respondents in a group of more than 500 residential architecture firms said they were seeing more demand for this feature, compared with 26% who said the same in 2013 and 10% in 2012. Also getting hotter: Home features that accommodate multiple generations and age-in-place features.

“As many households become caretakers for aging relatives, separate living suites have become popular options for accommodations,” said Kermit Baker, chief economist for AIA,in a news release.

Boomers vs. Millennials: Buy music or stream it? (2:08)
Millennials stream music through sites like Spotify or Pandora. Boomers remember the time when most people bought vinyl records to listen to music.

What’s more, an analysis from real-estate website Trulia found that there has been an increase in the share of seniors living with relatives over the past 20 years. That’s largely due to the fact that more seniors today are foreign born, and that the average age of seniors has increased, said Jed Kolko, Trulia’s chief economist. Today there are more 80-somethings than in the past, he said.

“This is not a story about the housing bust. The increase of seniors living with relatives is a long-term demographic shift,” he said. Six percent of U.S.-born seniors live with relatives, while 25% of foreign-born seniors live with relatives. For those born in countries including India, Vietnam, Haiti and the Philippines, the share of seniors living with relatives is even higher than that, he added.

Looking to the future, there’s also this: As Americans age in the coming decades, there will be fewer family caregivers to help them, according to an AARP report. In 2010, there were a potential seven caregivers for every American over 80 years old; that ratio is expected to drop to four caregivers for every senior that age by 2030. That’s partly due to Americans having smaller families. As the caregiving burden for an aging relative falls on one or two people, it’s possible that more might consider this living situation.

Linda Holroyd's insight:

As there become more seniors and fewer caregivers, our prediction is that there will be many more seniors living with non-relatives/non-caregivers

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Who wants to live forever: How healthy choices today help avoid health problems later

Who wants to live forever: How healthy choices today help avoid health problems later | Personalizations for the Aging | Scoop.it

Many of us would like to reach an old age without being troubled by disease. How far can healthy habits take us? If you look at the lifestyle of people that get really old – and stay fit and relatively healthy — they have certain healthy practices in common. And there are ways technology can help integrate those practices into our everyday lives.

Blue Zones
A Blue Zone is a demographic or geographic area where people live longer. Much longer. Many become 100+ years, and remain in good health. These longevity hotspots are found in certain towns in Japan, Sardinia, Costa Rica, Greece, and California. The populations in Blue Zones share a number of lifestyle characteristics: they exercise constantly at a moderate level, they smoke less, and are semi-vegetarians with a diet rich in vegetables. The longevity champions are also family oriented, and lead an active social life.

If the Blue Zone lifestyle actually leads to longevity, it’s fair to assume these features would be key for all of us in living longer and healthier lives. So, where to start? This is how tech can help you adopt the Blue Zone lifestyle:

Get constant moderate physical activity: According to The Pew Research Center’s Internet & American Life Project, 60% of U.S. adults track their weight, diet, or exercise routine. Of these, 30-50% say that collecting this data has changed their overall approach to health, or affected a health decision. Sensors tracking activity, sleep and more are made by numerous developers such as Misfit and Fitbit. When activity data is shared with peers, social mechanisms driving behavior change kicks in.

Smoke less: E-cigarettes, such as V2 Cigs, replace the nicotine cravings, but let the user keep the ritual. To individualize quitting smoking, the MyQuit Coach app analyzes the user’s nicotine consumption, track cravings, and encourage resolutions that are meaningful. Peer pressure can be added by joining online quit-smoking campaigns such as Stoptober.

Become a semi-vegetarian: The app Is it vegan? lets the user screen the content in food, and makes it easier to get rid of unwanted animal products. If you need a guide on an animal-free lifestyle, the Go Vegan! app leads the way. And yes, the word “semi” implies that a burger is ok every now and then (but you probably want to think twice about a double-patty bacon cheeseburger).

Have an active family and social life: New in town? Go to meetup.com and make friends. Serial date with Tinder. And don’t forget to call your mother on Sundays.

Design critical wearables
Tracking personal activity data has been shown to motivate healthy behavior change. Maintaining such a routine can be challenging, and many people stop wearing a sensor after a few months. A wearable needs to be integrated in the user’s life. Design is also critical. Do you really want a yellow wristband with your business suit?

Sonny Vu, founder of Misfit Wearables, has identified three factors that motivate people to wear sensors: Comfort, utility and invisibility. When designing wearables, developers need to ask a couple of key questions: will it be comfortable enough that the user would wear the device if it didn’t measure anything? Does the device do something useful? Vu emphasizes that if the wearable is not going to be invisible, then it has to be good-looking, precious, and desirable.

No quick-fix
There is no quick-fix to living a long and healthy life. We do know that maintaining healthy habits increases the likelihood of having such lives, but there is certainly no guarantee for it.

Making significant life changes is difficult, especially since healthy habits have to be maintained over longer periods of time to have a positive outcome. Tracking activity, sharing progress with peers, and being challenged in games have been shown to be useful tools to change behavior. Integrating social platforms and game mechanisms is definitely important for every app looking to stay popular. And insurers like Humana are also making it easier with health and wellness programs.

Want to become a 100-year-old, and still be able to do those mountain hikes? App up and get your physical, dietary, and social patterns in order.

Or just relocate to a Blue Zone.

Learn more about Humana’s health and wellness programs.

Linda Holroyd's insight:

Move to a Blue Zone . . . or just exercise regularly and modestly, smoke less, be semi-vegetarian, and have an active family and social life

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10 Big Tech Trends in Healthcare

10 Big Tech Trends in Healthcare | Personalizations for the Aging | Scoop.it

We are living in exciting times. Technology is transforming every aspect of the way we live. Perhaps no area is more important or more profound than the innovations we are seeing in healthcare. As the industry looks to leverage technology to increase access to information, drive better patient outcomes and unlock mysteries hidden in plain sight, it is facing the enormous challenges of privacy and security that are perhaps more worrisome in healthcare than in any other industry.

With that in mind, we assembled some of the brightest minds in healthcare to share their views on the technology trends that are reshaping the industry for our latest issue of HP Matter. Below are the things on my radar. I would love to hear what is on yours.

1) Smartphones, apps, and wearables are empowering patients, doctors, and caregivers.

In today’s health-conscious world, it’s hard to miss the ubiquitous Fitbit and other personal monitoring tools that help people track fitness activities, sleep patterns, blood pressure and caloric intake. But these tools are just the beginning. Increasingly sophisticated apps and nanotechnology will not only empower individuals to track their own health, they will also deliver troves of actionable data to the medical community. The next step will be integrating all of that data into our healthcare system to help anticipate and prevent broader health issues.

2) Big Data will uncover patterns, problems, and opportunities in healthcare.

Harnessing health data allows doctors and researchers to improve collaboration, better understand illnesses, and more effectively allocate resources to get the right treatments to the right patients at the right time. It can also help identify diseases and outbreaks, helping to minimize – and even eliminate – pandemics. But capturing all of that data is not enough. To be truly useful, it must also be easily accessible, which is where the cloud comes in.

3) Cloud computing will unlock the valuable insights that live in healthcare data.

For researchers, cloud technology will make massive amounts of healthcare data easy to access and analyze, facilitating innovation and rapid response to warning signals. For doctors and patients, transitioning medical records from paper to digital and then moving them to the cloud, will improve the everyday needs of the medical community – streamlining billing, giving patients access to their information and providing doctors with a more complete picture of a patient’s medical history.

4) Security risks must be taken seriously.

According to the Identity Theft Resource Center, 44% of all registered data breaches in 2013 targeted medical companies. Cyber criminals can target healthcare companies just like they do retailers, with theft of patients’ identities, payment information, and even data from medical monitoring devices. With so much of our personal health information going into the cloud, we will need the technology – and the commitment – to properly protect it.

5) Computing power and energy efficiency will be star players behind the scenes of healthcare.

By 2020, 30 billion connected devices will generate unprecedented amounts of data, and the world’s data centers will consume up to 30% of the world’s electricity to support them. Simply put, the current course is not sustainable. For the first time since the 1940’s, HP is reimagining the fundamental computing architecture that will power the world of tomorrow with a groundbreaking new research project that we call The Machine.

A more tangible example of computing power in healthcare can be seen in artificial limbs. Icelandic company, Össur, has created the world’s first micro-processor joint system that continuously adapts to the user and the environment.

6) 3D Printing will spur a new wave of growth and innovation in healthcare.

As 3D printing technology advances, its medical uses are becoming increasingly clear. It will revolutionize the manufacturing of medical devices and surgical tools – personalized prosthetic limbs and other body parts, precision drug dispensing, fluidics modeling – the possibilities continue. And, I believe HP’s entry into the 3D printing space will spur this new wave of innovation in healthcare and other industries.

7) Telemedicine will expand healthcare into our homes and beyond.

Telehealth, which allows patients to connect with doctors using mobile devices and video chat, is gaining traction as a cost-effective way for patients to receive care and will completely change our view of the traditional doctor’s visit. As telehealth becomes more widespread, doctor-patient interactions will become more frequent and expand not just into our homes but also into remote areas of the world.

8) Global health will improve with the expansion of technology to developing countries.

Nowhere are these emerging technologies felt more profoundly than in developing countries, where medical attention is often delivered by volunteers with limited training. In sections of rural India, HP is helping deliver radically improved healthcare by transforming shipping containers into cloud-enabled, mobile eHealth Centers. The goal is to use these technological developments to offer care to nearly everyone, no matter where they live.

9) Technology will help us understand the brain.

Technology is not only saving lives, it’s opening up new frontiers that were previously unimaginable. In 2012, MIT researchers Xu Liu and Steve Ramirez found a way to implant memories into a brain, which has enormous consequences for mental health. And, a company called Emotiv has found a way to translate thoughts into action through neuro-headsets. These discoveries and cutting-edge tools will allow us to access brain information in noninvasive ways, opening up new spectrums of science and human understanding.

10) Innovation will unlock business opportunities.

With all of these technological advances before us, it’s time for bold ideas. In some cases, existing regulations will need to evolve to allow for the coming innovation. But the possibilities represent an enormous business opportunity. Those who can use technology to unlock solutions and provide better, lower-cost care to more people will thrive in this new world.

At HP, we’re leveraging 75 years of technology leadership to help drive the healthcare industry forward. You can read more about the biggest trends in healthcare and technology in the latest issue of HP Matter.

Linda Holroyd's insight:

HP and Meg Whitman 'get it'. What will HP do about it?

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This insurance startup will give you a wearable and reward you for hitting fitness goals

This insurance startup will give you a wearable and reward you for hitting fitness goals | Personalizations for the Aging | Scoop.it

Many in the health care industry believe that wearable devices can keep patients more engaged with their caregivers, and more mindful of their health in general.

The tech-focused health insurance startup Oscar is now ready to put some money behind that belief. The New York-based insurer says it will provide its members with Misfit fitness trackers and give them breaks on their premiums for healthy behavior patterns recorded on their wrists.

“The more steps they take, the more money Oscar will give,” the company says in a release.

Using the Misfit device, Oscar members will track their own health and transmit the biometric information to their medical timelines on Oscar’s mobile app.

Cofounded by venture capitalist Joshua Kushner, Oscar closed a $30 million funding round early this year, bringing its funding total up to $75 million.

A key part of Oscar’s marketing pitch is that technology will make it easier to connect with health care providers. The insurer’s site features an online search function that directs patients toward appropriate doctors after they type in their symptoms using natural language. Patients can also screen doctors to make sure they’re in the network prior to booking an appointment.

Oscar guarantees that a physician will return patient phone calls within 25 minutes — and it provides a handful of calls for free. It also offers free generic drugs and a number of free primary care appointments.

The insurer has some top-shelf investors behind it. They include Founders Fund (the venture capital firm cofounded by Peter Thiel), Thrive Capital, Khosla Ventures and General Catalyst Partners.

Linda Holroyd's insight:

Device meets communications meets health savings

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Kaiser Shares that 2,610 Hospitals will be penalized $428MM for Readmissions

Kaiser Shares that 2,610 Hospitals will be penalized $428MM for Readmissions | Personalizations for the Aging | Scoop.it

By Jordan Rau, Kaiser Health News

 Kaiser Health News (KHN) is a nonprofit national health policy news service. 

Medicare is fining a record number of hospitals – 2,610 – for having too many patients return within a month for additional treatments, federal records released Wednesday show. Even though the nation’s readmission rate is dropping, Medicare’s average fines will be higher, with 39 hospitals receiving the largest penalty allowed, including the nation’s oldest hospital, Pennsylvania Hospital in Philadelphia.

The federal government’s penalties, which begin their third year this month, are intended to jolt hospitals to pay attention to what happens to their patients after they leave. Around the country, many hospitals are replacing perfunctory discharge plans—such as giving patients paper instructions—with more active efforts, such as ensuring that outside doctors monitor their recoveries and giving supplies of medication to patients who may not be able to afford them. Others are still struggling to meet the new expectations. Before the program, some hospitals resisted such efforts because they weren’t paid for the services, and, in fact, benefited financially when a patient returned.

Last year, nearly 18 percent of Medicare patients who had been hospitalized were readmitted within a month. While that is lower than past years, roughly 2 million patients return a year, costing Medicare $26 billion. Officials estimate $17 billion of that comes from potentially avoidable readmissions.

Under the new fines, three-quarters of hospitals that are subject to the Hospital Readmissions Reduction Program are being penalized. That means that from Oct. 1 through next Sept. 30, they will receive lower payments for every Medicare patient stay —  not just for those patients who are readmitted. Over the course of the year, the fines will total about $428 million, Medicare estimates.

More than 1,400 hospitals are exempted from the penalties, including certain cancer hospitals and critical access hospitals, as well as facilities dedicated to specific services such as psychiatry or rehabilitation. Maryland hospitals are also excluded because the state has a unique payment arrangement with Medicare. The fines are based on readmissions from July 2010 through June 2013.

In New Jersey, every hospital but one will lose money this year. So will a majority of hospitals in 28 other states, including California, Florida, Georgia, Illinois, Massachusetts, New York, Ohio, Pennsylvania, Tennessee and Texas, as well as the District of Columbia, according to a Kaiser Health News analysis of the penalties.

While some penalties are as small as a hundredth of a percent, hospitals with the highest readmission rates are losing 3 percent of each payment, an increase from a maximum punishment of 2 percent last year. The increase brings the top penalties to the full force authorized by the federal health law.

The 39 hospitals where payments will be lowered by 3 percent include a number of specialty surgical hospitals, small community hospitals and the Pennsylvania Hospital, a major teaching facility. The hospital, founded in 1751 by Benjamin Franklin and Dr. Thomas Bond, is part of Penn Medicine. Hospital officials did not immediately respond to a request for comment.

Another 496 hospitals will lose 1 percent or more of their Medicare payments. Those include Northwestern Memorial Hospital and Rush University Medical Center in Chicago, Beth Israel Medical Center in Manhattan, Tufts Medical Center in Boston, and a few satellite hospitals owned by well-respected systems, including the Mayo Clinic and Geisinger Health System.

Medicare levied penalties against 433 more hospitals than it did last year. The average penalty this year is 0.63 percent, up from 0.38 percent last year, according to the KHN analysis.

Two More Conditions Added

One reason for the higher and more widespread fines is that this year Medicare began evaluating readmissions of two new categories of patients—those initially admitted for elective knee or hip replacements, and those suffering lung ailments such as chronic bronchitis. Those patients were assessed along with the heart failure, heart attack and pneumonia patients Medicare has examined since the penalties began in October, 2012.

A hospital was fined if it had higher than expected readmission rates in any category. Thus, a number of specialty hospitals that focus on hip and knee replacements received fines for the first time because readmissions of those patients are now being assessed, the KHN analysis found. Fines increased for each condition where rates were above Medicare’s expectations. “Every time they add conditions, the penalties go up,” said Nancy Foster, a quality expert at the American Hospital Association.

Dr. Stephen Jencks, a consultant who was one of the first researchers to document the nation’s high readmission rates, said he was impressed overall by how much the fines have prompted hospitals to concentrate on their patients’ health after discharge. “This really fairly modest step” of penalties has “persuaded a lot of hospitals to talk in ways they simply were not talking 10 years ago,” he said.

Dr. Don Goldmann, chief medical and science officer at the Institute for Healthcare Improvement, a Massachusetts nonprofit, cautioned against attributing the drop in readmissions only to the penalties, since the government also has other, less punitive programs underway. “There’s so much at play,” Goldmann said. “I’d be careful about imputing the reduction to any one intervention.”

As the penalties have played out, an increasing number of prominent experts are voicing concerns that the punishments are too harsh and doled out unfairly. For one thing, Medicare lowers payments to hospitals even if they have reduced their readmission rates from the previous year—so long as their rate is still higher than what the government believes is appropriate for that hospital. Medicare uses the national readmission rate to help decide what appropriate rates for each hospital, so to reduce their fines from previous years or avoid them altogether, hospitals must not only reduce their readmission rates but do so better than the industry did overall.

“You have to run as fast as everyone else to just stay even,” Foster said. Only 129 hospitals that were fined last year avoided a fine in this new round, the KHN analysis found.

Medicare officials, however, consider the competition good motivation for hospitals to keep on tackling readmissions and not to become complacent with their improvements.

Another concern about the program is that safety-net hospitals that treat large numbers of low-income patients have been more likely to receive penalties, in part because poor patients face financial and logistical challenges that make them more likely to get sicker after discharge than others, even if the hospital is trying to oversee their recuperations.

Much of the formula that calculates the fines was written into the health law, and Medicare has maintained it cannot unilaterally change it. The Medicare Payment Advisory Commission, which makes recommendations to Congress, has urged that the government compare hospitals to similar ones—academic medical centers to each other, for instance—when assessing penalties.

Experts convened by the National Quality Forum, a nonprofit that evaluates measures the government uses, also endorsed the idea of taking socio-economic status into account in creating many different health care metrics. The forum said it will test the approach. Meanwhile, bills are pending in both houses of Congress that would make Medicare consider socio-economic status of a hospital’s patients when calculating fines.

The Obama administration has raised concerns that assuming safety-net hospitals will do poorer in avoiding readmissions might encourage lower expectations for the quality of care for low-income patients. Some experts fear that hospitals with many readmissions are providing substandard care and should not be let off the hook.

“Low [socio-economic status] patients do often—but not always—have worse outcomes, and yet we know they are often exposed to lower quality of care, whether that’s the places that they go or the access to care that have,” said Dr. Susannah May Bernheim, director of quality measurement at the Yale School of Medicine’s Center for Outcomes Research and Evaluation, which created the method Medicare uses to count readmissions. However, she said, “it is important to understand that safety net providers both may be more vulnerable to payment penalties and may in fact need more than average resources to achieve good outcomes for their patients.”

‘It’s A Quagmire’

A study published this month in The Joint Commission Journal on Quality and Patient Safety examined eight safety-net hospitals to see how they were handling readmissions. The researchers found that most of the hospitals’ leaders were concerned about the penalties, with one telling interviewers that they expected “the penalty will get bigger and bigger and then other payers [such as private insurance companies] are going to pick up on it.”

The program was popular among nurses and doctors, with one saying “we understand, we know the importance of it,” that “in order to get a response from administration, you have to penalize.”

The researchers, led by Dr. Karen Joynt and other current and former academics at Harvard’s school of public health and the medical school, discovered that one of the eight hospitals was not trying to cut readmissions because its financial stability would be undermined by fewer patients.  “It’s a quagmire,” an anonymous hospital official was quoted in the study as saying. “If you affect the population correctly, you will reduce both readmissions and overall admissions, which is good for the patient but financially bad for the hospital.”

Gina Kaurich, director of client-care services at the Cincinnati-based FirstLight HomeCare, one of many companies offering to help hospitals prevent readmissions, said she has seen hospitals take various approaches in light of the penalties. Some have tried to care for returning patients without readmitting them overnight so Medicare does not count their cases, she said. Others have assigned their own nurses to visit patients at home shortly after discharge to ensure the patients are properly taking care of themselves. Still others hire private companies like hers, which sends nurse assistants to homes.

“Before the penalties and the focus, I believe the hospitals were quite well aware of this, and a readmission almost was something that was expected,” Kaurich said. “It was [considered] part of the disease process.”

Linda Holroyd's insight:

Fines for readmission will motivate hospitals to help ensure patients don't get readmitted

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Tech Trends Shaping The Future Of Medicine

Tech Trends Shaping The Future Of Medicine | Personalizations for the Aging | Scoop.it

Enormous technological changes in medicine and healthcare are heading our way.  If they hit us unprepared (which we are now), they will wash away the medical system we know, leaving a purely technology–based service without personal interaction.  By preparing and planning, we have the opportunity to consciously and purposefully redesign the healthcare sector piece-by-piece.  That’s the belief of medical futurist Dr. Bertalan Meskó, author of The Guide to the Future of Medicine: Technology and the Human Touch.

Part 1 of this column summarized the first set of tech trends that Meskó described as being already underway or those that will have an impact on us in the near term.  Now we take a look at the next set of trends that Meskó identifies as being in earlier stages of development and not quite yet ready for prime time.

Medical decisions via artificial intelligence (AI)
Watson, the IBM room-sized super-computer, beat Jeopardy’s all-time best contestants, Ken Jennings and Brad Rutter.  That’s just the beginning.  With virtual computer networks working together on a particular problem, Big Data is becoming Huge Data.  Healthcare is a prime candidate for making intelligent use of that data.  With new, relevant medical research being produced so quickly, it’s impossible for a human to constantly be up-to-date.  But a super-computer could, even to the extent of advising on medical decisions.  AI will offer many benefits, including generating insights for lowering costs and creating better outcomes.

The future of medicine will involve complex interactions between man and machine. (Image credit: B. Meskó)

Growing organs in a dish
Regenerative medicine seeks to aid those who suffer from organ failure or loss by providing them with artificially created replacement organs.  3D printers have already successfully produced organs, and stem cells can be used to grow some organs.  Eventually, these advances may eliminate the shortage of organ donations altogether.

Eating in the future
With instant content analysis, we will know exactly what we are eating and, hopefully, that will teach us how to eat properly.  Fast food will be defined by more than the local McDonalds, Wendy’s, or Burger King, as 3D printing begins to produce a variety of nutritional options.  This will become a norm to satisfy the ever-increasing population.

Augmented reality and virtual reality
Augmented reality through technology such as Google Glass will be increasingly streamlined into healthcare.  Currently, a surgeon can stream a live surgery procedure in order to create an enhanced learning tool for students who would have to typically watch over the doctor’s shoulder.  In the future, virtual reality will create environments that allow patients to share point-of-view information and concerns directly with medical caregivers.  It will also be applied to psychotherapy in order to let patients view scenarios or reprocess memories virtually.

The end of human experimentation
Computational cognitive architecture will simulate how human physiology works, detail-by-detail.  Virtual experimentation through this kind of simulation could test numerous samples on virtual patients in an extremely short time period.  Meskó describes one example: “A technique called organ-on-a-chip simulates the activities, mechanics, and physiology of entire organs and organ systems.”

Nanorobots living in our bloodstream
These microscopic robots will measure health parameters and diagnose disease.  They could also expand our knowledge of biology and anatomy, improve how we deliver drugs, or perform extremely localized surgery.  The nanorobots could eventually develop a network, communicate with each other, identify health concerns, and automatically take corrective actions.

Hospitals of the future
In the future, hospitals will be less about recovery from acute illness, and more about rejuvenating ourselves.  The shift will be comparable to the transition in the healthcare system from reactive to proactive care, from acute care to disease management and prevention.  Hospitals will become places to double-check that patients are on track to stay healthy.  Delivering care will be patient-centered, with intelligent designs to improve the healing process.

Virtual–digital brains
One day it may be possible to live forever – digitally.  The brain is the most unique organ in the body and circuit boards are being developed to imitate its behavior.  Hybrids of our brains, aided by integrated circuitry, could control prostheses, treat ADHD, improve memory and cognition.  Brain implants and neuroprosthetics could yield improvements to human senses, giving us perfect sight and hearing, or limitless memories.

The rise of cyborg culture
There will be a new generation of people who choose to live with technology inside their bodies.  Society’s perception of cyborgs will be controversial, but it will be increasingly difficult to refrain from the opportunity to augment human capabilities.

Cryonics and longevity

Our options regarding when we want to die will expand.  Small numbers of people are already contracted with companies that offer cryopreservation, in the hope that they will be unfrozen and brought back to life if and when aging and/or disease have been conquered.  Suspended animation has been successfully achieved with pigs.  These means for increasing longevity will be controversial, particularly while we continue to struggle with issues like overpopulation and extreme poverty.  Current surveys show that more than half of Americans would reject life extension treatments, and that less than 5% would opt for a lifespan lasting more than 120 years.
Considering all these trends, what will a brand new society look like?  With regard to healthcare, we have some clues.  As advanced technology takes over more of diagnosis and treatment, human caregivers at all levels will migrate more toward the emotional interface role.  Machines will do more of the analysis while humans will take a more interpersonal role.  Medical education will need to address the integration of new technologies quickly and efficiently.  Society will have to adapt to this new kind of healthcare.  It will be an exciting, transformative time of human achievement, mixed with numerous and difficult ethical issues. Buckle up and enjoy the ride!

Linda Holroyd's insight:

Mind-boggling implications of what our near-future will hold

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From AARP To Pfizer, Partners Seek Optum Labs Big Data To Improve Health

From AARP To Pfizer, Partners Seek Optum Labs Big Data To Improve Health | Personalizations for the Aging | Scoop.it

A health care research initiative using tens of millions of health insurance claims and electronic health records is forming myriad partnerships with business, employers and the health care industry to improve health outcomes and potentially lower costs.

Optum Labs, the collaboration between UnitedHealth Group UNH -0.41%’s (UNH) Optum Health and the Mayo Clinic, has more than 20 partners looking for new ways to treat and prevent diseases as well as improve outcomes and lower costs of expensive chronic conditions like diabetes and high blood pressure.

In an interview at the Forbes Healthcare Summit, Dr. Paul Bleicher, Optum Labs CEO talks about some of these new partnerships that include working with health care companies like Pfizer PFE -0.06% (PFE), Boston Scientific (BSX) and Merck (MRK) to large employers and organizations like AARP, the giant association of seniors that is looking to help people live longer in their homes and comfortable community settings. The entire video can be seen below.

“Medical claims have a lot of information in them,” Bleicher said in his interview, which can be seen below in its entirety. “We can link that in a de-identified fashion with a bunch of demographics, with lab results, with medications. We can begin to look at how the medical care was delivered.”

Linda Holroyd's insight:

Here's to the leaders fostering collaboration in healthcare!

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GTX Corp Partners with Life Button 24 for Emergency Response Services -

GTX Corp Partners with Life Button 24 for Emergency Response Services - | Personalizations for the Aging | Scoop.it
GTX Corp. (OTCBB: GTXO), a pioneer in personal location wearable technologies, is pleased to announce a strategic partnership with Life Button 24, a division of World Wide Security Group a leading provider of life safety, dispatch and monitoring services since 1979.  Under the strategic partnership, GTX Corp will offer Life Button 24 services to its GPS SmartSole customers, providing 24/7 access to live dispatch operators that can assist caregivers when a loved one goes missing.  The premium service will be offered through GTX on a monthly subscription basis as an “add on” to existing monthly tracking service plans provided by GTX.

“Our GPS SmartSoles were specifically designed for caregivers to be able to react in real time to find a loved one who has wandered off,” commented Andrew Duncan, Director of GTX Corp.  “By partnering with Life Button 24, we will now offer our U.S. customers an enhanced level of service and extra layer of protection.  The service will be able to provide a caregiver with the ability to contact a live person, who can assist in coordinating the successful search and rescue of the loved one, or assist in notifying the proper authorities if needed.  By offering this service, we enable individual caregivers and assisted living staff, among others, with an additional level of 24/7 human response, when critical support is most needed.”

“Life Button 24 is thrilled to provide 24-hour emergency response services in partnership with the GTX Corp SmartSole™ GPS system,” commented Jeff Katz, Director of Project Development for Life Button 24. “Addressing wandering issues of individuals afflicted with Alzheimer’s and Autism is a growing concern for the millions of families and caregivers. Life Button 24 looks forward to being part of a greater solution that delivers peace-of-mind through advanced tracking technology and customized emergency response services which were designed specifically to support applications such as the GPS SmartSole.”

“With initial delivery dates for our GPS SmartSoles to consumers being confirmed next week and several pilot agreements with large organizations kicking off this month, the timing of this partnership with Life Button 24 couldn’t be better.”  After several months of integrating and testing our platform and services and having socialized this new offering with some of our larger partners in law enforcement and the assisted living community, we are extremely excited to start offering this service and look forward to a successful partnership with the Life Button 24 team.”  Commented Patrick Bertagna CEO of GTX Corp.
Linda Holroyd's insight:

Life Button 24 and GTX Corp SmartSole GPS system - upcoming app and sensor solutions that provide that safety net for seniors and everyone

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Sleep Deprivation Is Killing You and Your Career | LinkedIn

Sleep Deprivation Is Killing You and Your Career | LinkedIn | Personalizations for the Aging | Scoop.it

The next time you tell yourself that you'll sleep when you're dead, realize that you're making a decision that can make that day come much sooner. Pushing late into the night is a health and productivity killer.

According to the Division of Sleep Medicine at the Harvard Medical School, the short-term productivity gains from skipping sleep to work are quickly washed away by the detrimental effects of sleep deprivation on your mood, ability to focus, and access to higher-level brain functions for days to come. The negative effects of sleep deprivation are so great that people who are drunk outperform those lacking sleep.

Why You Need Adequate Sleep to Perform

We've always known that sleep is good for your brain, but new research from the University of Rochester provides the first direct evidence for why your brain cells need you to sleep (and sleep the right way—more on that later). The study found that when you sleep your brain removes toxic proteins from its neurons that are by-products of neural activity when you're awake. Unfortunately, your brain can remove them adequately only while you're asleep. So when you don't get enough sleep, the toxic proteins remain in your brain cells, wreaking havoc by impairing your ability to think—something no amount of caffeine can fix.

Skipping sleep impairs your brain function across the board. It slows your ability to process information and problem solve, kills your creativity, and catapults your stress levels and emotional reactivity.

What Sleep Deprivation Does to Your Health

Sleep deprivation is linked to a variety of serious health problems, including heart attack, stroke, type 2 diabetes, and obesity. It stresses you out because your body overproduces the stress hormone cortisol when it's sleep deprived. While excess cortisol has a host of negative health effects that come from the havoc it wreaks on your immune system, it also makes you look older, because cortisol breaks down skin collagen, the protein that keeps skin smooth and elastic. In men specifically, not sleeping enough reduces testosterone levels and lowers sperm count.

Too many studies to list have shown that people who get enough sleep live longer, healthier lives, but I understand that sometimes this isn't motivation enough. So consider this—not sleeping enough makes you fat. Sleep deprivation compromises your body's ability to metabolize carbohydrates and control food intake. When you sleep less you eat more and have more difficulty burning the calories you consume. Sleep deprivation makes you hungrier by increasing the appetite-stimulating hormone ghrelin and makes it harder for you to get full by reducing levels of the satiety-inducing hormone leptin. People who sleep less than 6 hours a night are 30% more likely to become obese than those who sleep 7 to 9 hours a night.

How Much Sleep Is Enough?

Most people need 7 to 9 hours of sleep a night to feel sufficiently rested. Few people are at their best with less than 7 hours, and few require more than 9 without an underlying health condition. And that’s a major problem, since more than half of Americans get less than the necessary 7 hours of sleep each night, according to the National Sleep Foundation.

For go-getters, it's even worse.

A recent survey of Inc. 500 CEOs found that half of them are sleeping less than 6 hours a night. And the problem doesn't stop at the top. According to the Centers for Disease Control and Prevention, a third of U.S. workers get less than 6 hours of sleep each night, and sleep deprivation costs U.S. businesses more than $63 billion annually in lost productivity.

Doing Something about It

Beyond the obvious sleep benefits of thinking clearly and staying healthy, the ability to manage your emotions and remain calm under pressure has a direct link to your performance. TalentSmart has conducted research with more than a million people, and we’ve found that 90% of top performers are high in emotional intelligence (EQ). These individuals are skilled at understanding and using emotions to their benefit, and good sleep hygiene is one of the greatest tools at their disposal.

High-EQ individuals know it's not just how much you sleep that matters, but also how you sleep. When life gets in the way of getting the amount of sleep you need, it's absolutely essential that you increase the quality of your sleep through good sleep hygiene. There are many hidden killers of quality sleep. The 10 strategies that follow will help you identify these killers and clean up your sleep hygiene. Follow them, and you'll reap the performance and health benefits that come with getting the right quantity and quality of sleep.

1. Stay Away from Sleeping Pills

When I say sleeping pills, I mean anything you take that sedates you so that you can sleep. Whether it's alcohol, Nyquil, Benadryl, Valium, Ambien, or what have you, these substances greatly disrupt your brain's natural sleep process. Have you ever noticed that sedatives can give you some really strange dreams? As you sleep and your brain removes harmful toxins, it cycles through an elaborate series of stages, at times shuffling through the day’s memories and storing or discarding them (which causes dreams). Sedation interferes with these cycles, altering the brain's natural process.

Anything that interferes with the brain's natural sleep process has dire consequences for the quality of your sleep. Many of the strategies that follow eliminate factors that disrupt this recovery process. If getting off sleeping pills proves difficult, make certain you try some of the other strategies (such as cutting down on caffeine) that will make it easier for you to fall asleep naturally and reduce your dependence upon sedatives.

2. Stop Drinking Caffeine (at Least after Lunch)

You can sleep more and vastly improve the quality of the sleep you get by reducing your caffeine intake. Caffeine is a powerful stimulant that interferes with sleep by increasing adrenaline production and blocking sleep-inducing chemicals in the brain. Caffeine has a 6-hour half-life, which means it takes a full 24 hours to work its way out of your system. Have a cup of joe at 8 a.m., and you’ll still have 25% of the caffeine in your body at 8 p.m. Anything you drink after noon will still be near 50% strength at bedtime. Any caffeine in your bloodstream—the negative effects increasing with the dose—makes it harder to fall and stay asleep.

When you do finally fall asleep, the worst is yet to come. Caffeine disrupts the quality of your sleep by reducing rapid eye movement (REM) sleep, the deep sleep when your body recuperates most. When caffeine disrupts your sleep, you wake up the next day with a cognitive and emotional handicap. You’ll be naturally inclined to grab a cup of coffee or an energy drink to try to make yourself feel more alert, which very quickly creates a vicious cycle.

3. Avoid Blue Light at Night

This is a big one—most people don't even realize it impacts their sleep. Short-wavelength blue light plays an important role in your mood, energy level, and sleep quality. In the morning, sunlight contains high concentrations of this "blue" light. When your eyes are exposed to it directly (not through a window or while wearing sunglasses), the blue light halts production of the sleep-inducing hormone melatonin and makes you feel more alert. This is great, and exposure to a.m. sunlight can improve your mood and energy levels. If the sun isn't an option for you, try a blue light device.

In the afternoon, the sun's rays lose their blue light, which allows your body to produce melatonin and start making you sleepy. By the evening, your brain does not expect any blue light exposure and is very sensitive to it. The problem this creates for sleep is that most of our favorite evening devices—laptops, tablets, televisions, and mobile phones—emit short-wavelength blue light. And in the case of your laptop, tablet, and phone, they do so brightly and right in your face. This exposure impairs melatonin production and interferes with your ability to fall asleep as well as with the quality of your sleep once you do nod off. Remember, the sleep cycle is a daylong process for your brain. When you confuse your brain by exposing it in the evening to what it thinks is a.m. sunlight, this derails the entire process with effects that linger long after you power down. The best thing you can do is avoid these devices after dinner (television is okay for most people as long as they sit far enough away from the set). If you must use one of these devices in the evening, you can limit your exposure with a filter or protective eye wear.

4. Wake Up at the Same Time Every Day

Consistency is key to a good night's sleep, especially when it comes to waking up. Waking up at the same time every day improves your mood and sleep quality by regulating your circadian rhythm. When you have a consistent wake-up time, your brain acclimates to this and moves through the sleep cycle in preparation for you to feel rested and alert at your wake-up time. Roughly an hour before you wake, hormone levels increase gradually (along with your body temperature and blood pressure), causing you to become more alert. This is why you'll often find yourself waking up right before your alarm goes off.

When you don't wake up at the same time every day, your brain doesn't know when to complete the sleep process and when it should prepare you to be awake. Long ago, sunlight ensured a consistent wake-up time. These days, an alarm is the only way most people can pull this off, and doing this successfully requires resisting the temptation to sleep in when you're feeling tired because you know you'll actually feel better by keeping your wake-up time in tact.

5. No Binge Sleeping (In) on the Weekend

Sleeping in on the weekend is a counterproductive way to catch up on your sleep. It messes with your circadian rhythm by giving you an inconsistent wake-up time. When you wake up at the same time during the work week but sleep past this time on the weekend, you end up feeling groggy and tired because your brain hasn't prepared your body to be awake. This isn't a big deal on your day off, but it makes you less productive on Monday because it throws your cycle off and makes it hard to get going again on your regular schedule.

6. Learn How Much Sleep You Really Need

The amount of sleep you need is something that you can't control, and scientists are beginning to discover the genes that dictate it. The problem is, most people sleep much less than they really need and are under-performing because they think they're getting enough. Some discover this the hard way. Ariana Huffington was one of those frantic types who underslept and overworked, until she collapsed unexpectedly from exhaustion one afternoon. She credits her success and well-being since then to the changes she's made to her sleep habits. "I began getting 30 minutes more sleep a night, until gradually I got to 7 to 8 hours. The result has been transformational," Huffington says, adding that, "all the science now demonstrates unequivocally that when we get enough sleep, everything is better: our health; our mental capacity and clarity; our joy at life; and our ability to live life without reacting to every bad thing that happens."

Huffington isn't the only one. Jeff Bezos, Warren Buffet, and Sheryl Sandberg have all touted the virtues of getting enough sleep. Even Bill Gates, an infamous night owl, has affirmed the benefits of figuring out how much sleep you really need: “I like to get 7 hours of sleep a night because that’s what I need to stay sharp and creative and upbeat.” It's time to bite the bullet and start going to bed earlier until you find the magic number that enables you to perform at your best.

7. Stop Working

When you work in the evening, it puts you into a stimulated, alert state when you should be winding down and relaxing in preparation for sleep. Recent surveys show that roughly 60% of people monitor their smartphones for work emails until they go to sleep. Staying off blue light-emitting devices (discussed above) after a certain time each evening is also a great way to avoid working so you can relax and prepare for sleep, but any type of work before bed should be avoided if you want quality sleep.

8. Eliminate Interruptions

Unfortunately for those with small children, the quality of your sleep does suffer when it is interrupted. The key here is to eliminate all the interruptions that are under your control. If you have loud neighbors, wear earplugs to bed. If your mother likes to call at all hours of the night, make certain you silence your ringer before you go to bed. If you had to wake up extra early in the morning, make sure your alarm clock is back on its regular time when you go to bed. Don't drink too much water in the evening to avoid a bathroom trip in the middle of the night. If your partner snores . . . well, you get the idea. If you think hard enough, there are lots of little things you can do to eliminate unnecessary interruptions to your sleep.

9. Learn to Meditate

Many people who learn to meditate report that it improves the quality of their sleep and that they can get the rest they need even if they aren't able to significantly increase the number of hours they sleep. At the Stanford Medical Center, insomniacs participated in a 6-week mindfulness meditation and cognitive-behavioral therapy course. At the end of the study, participants' average time to fall asleep was cut in half (from 40 to 20 minutes), and 60% of subjects no longer qualified as insomniacs. The subjects retained these gains upon follow-up a full year later. A similar study at the University of Massachusetts Medical School found that 91% of participants either reduced the amount of medication they needed to sleep or stopped taking medication entirely after a mindfulness and sleep therapy course. Give mindfulness a try. At minimum, you'll fall asleep faster, as it will teach you how to relax and quiet your mind once you hit the pillow.

10. When All Else Fails: Take Naps

One of the biggest peaks in melatonin production happens during the 1:00 to 3:00 p.m. time frame, which explains why most people feel sleepy in the afternoon. Companies like Google and Zappos are capitalizing on this need by giving employees the opportunity to take short afternoon naps. If you aren't getting enough sleep at night, you're likely going to feel an overwhelming desire to sleep in the afternoon. When this happens, you're better off taking a short nap (even as short as 15 minutes) than resorting to caffeine to keep you awake. A short nap will give you the rest you need to get through the rest of the afternoon, and you'll sleep much better in the evening than if you drink caffeine or take a long afternoon nap.

Bringing It All Together

I know many of you reading this piece are thinking something along the lines of "but I know a guy (or gal) who is always up at all hours of the night working or socializing, and he's the number one performer at our branch." My answer for you is simple: this guy is underperforming. We all have innate abilities that we must maximize to reach our full potential. My job is to help people do that—to help the good become great by removing unseen performance barriers. Being number one in your branch is an accomplishment, but I guarantee that this guy has his sights set on bigger things that he isn't achieving because sleep deprivation has him performing at a fraction of his full potential. You should send him this article. It just might shake something loose.

After all, the only thing worth catching up on at night is your sleep.

Linda Holroyd's insight:

I hope this article helps you think about why you need sleep and what you can do to get more sleep. 

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Healthcare innovation, vital to Africa’s economic growth

Healthcare innovation, vital to Africa’s economic growth | Personalizations for the Aging | Scoop.it

HEALTHCARE INNOVATION, VITAL TO AFRICA’S ECONOMIC GROWTH
By: Rutendo Nyamuda

Poor healthcare remains an issue in Africa however, innovations aimed at tackling African focused issues could increase economic growth.

African health innovations could increase economic growth. 
Maarten van Herpen, head of Philips Africa Innovation Hub, says improving healthcare systems on the continent will provide business opportunities for many.  

“In Africa there is a huge shortage of doctors, and that is not going to change anytime soon. So we need to innovate to empower other health workers to become care givers, while at the same time lowering the cost of care,” he said.

One of the ways in which Philips is responding to the issue is through their partnership with the Kiambu County, in Kenya, where together they created the world’s first Philips Community Life Center. The center offers healthcare services as well as acts as a technology hub. 

“The impact of this innovation is huge. The number of patients visiting this clinic is now six times higher than earlier. In just a few months, over 70 mothers have safely delivered their babies at the new maternity ward.”

Collaboration between government and the private sector is of great benefit to innovation in the sector, especially socially.

“Business solutions have the potential to make a huge impact as they can be scaled to a large size, thus helping governments address these issues on a large scale. The role of government is to stimulate these inclusive innovations, and to give advice to business during the innovation process,” he said.

Van Herpen said that the healthcare challenges faced on the continent provide an opportunity for Africans to create solutions, through breakthrough innovations, that could possibly be used across the world.

“What I personally find exciting about doing innovation in Africa is that we have the opportunity to innovate and create completely new solutions and new ways of working; this makes it much easier to create breakthrough innovations.”

Linda Holroyd's insight:

great partnership between Philips and Kiambu County in Kenya

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A slap bracelet-inspired wrist bandage for wounds

A slap bracelet-inspired wrist bandage for wounds | Personalizations for the Aging | Scoop.it
Uflex snaps around wounds on your wrist and inflates to quell blood loss

Think about it.

You’re alone, and (hopefully this never happens, but) you get a deep wound cut. What do you do? Panic? Reach for your cell phone? Pass out? Scramble to take off your shirt to wrap around your wound?

Statistics say post-traumatic hemorrhage is responsible for over 35% of pre-hospital deaths, over 40% of deaths within the first 24 hours, and if pressure isn’t applied quickly, it can take just a few minutes to bleed to death.

To solve this problem and make it easier for people that encounter this issue, French product designers, Inès Le Bihan and Julian Loïs – with experience as lifeguards witnessing firsthand how difficult and how much distress wounds like this are to handle – have created an inflatable bandage that snaps around the wrist like a slap bracelet to be self-administered with only one hand.

The compress is made of non-woven swabs to absorb blood without sticking to the wound.



“Very quickly we were able to confirm our hypothesis with a quick and dirty mock-up: the retractable metal bands allowed the compress to lock on to the wound efficiently,” Le Bihan tells Dezeen. “This gesture works like the good old slap wrap – it had to be as intuitive as possible considering the stress level of our users.”

The inflating process is based on polyurethane foaming. The fabric is made of two compartments filled with polyol and isocyanate – types of plastic that expand when mixed together.

Once Uflex is rolled around the wound, the partition between the two compartments breaks and allows the two liquids to mix and inflate.
Linda Holroyd's insight:

Really cool and practical option

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3 Main Parts of the Brain | Alzheimer's Association

3 Main Parts of the Brain | Alzheimer's Association | Personalizations for the Aging | Scoop.it

1. Three pounds, three parts         

Your brain is your most powerful organ, yet weighs only about three pounds. It has a texture similar to firm jelly.

It has three main parts:

The cerebrum fills up most of your skull. It is involved in remembering, problem solving, thinking, and feeling. It also controls movement.

The cerebellum sits at the back of your head, under the cerebrum. It controls coordination and balance.

The brain stem sits beneath your cerebrum in front of your cerebellum. It connects the brain to the spinal cord and controls automatic functions such as breathing, digestion, heart rate and blood pressure.

 

2. Supply lines

Your brain is nourished by one of your body's richest networks of blood vessels.

With each heartbeat, arteries carry about 20 to 25 percent of your blood to your brain, where billions of cells use about 20 percent of the oxygen and fuel your blood carries.

When you are thinking hard, your brain may use up to 50 percent of the fuel and oxygen.

The whole vessel network includes veins and capillaries in addition to arteries.

 

3. The cortex: "Thinking wrinkles"  

Your brain's wrinkled surface is a specialized outer layer of the cerebrum called the cortex. Scientists have "mapped" the cortex by identifying areas strongly linked to certain functions.

 

Specific regions of the cortex:

Interpret sensations from your body, and sights, sounds and smells from the outside world.

Generate thoughts, solve problems and make plans.

Form and store memories.

Control voluntary movement.

 

4. Left brain/right brain

Your brain is divided into right and left halves. Experts are not certain how the "left brain" and "right brain" may differ in function, except:

The left half controls movement on the body's right side.

The right half controls the body's left side.

In most people, the language area is chiefly on the left.

 

5. The neuron forest

The real work of your brain goes on in individual cells. An adult brain contains about 100 billion nerve cells, or neurons, with branches that connect at more than 100 trillion points. Scientists call this dense, branching network a "neuron forest."

Signals traveling through the neuron forest form the basis of memories, thoughts, and feelings.

Neurons are the chief type of cell destroyed by Alzheimer's disease.

 

6. Cell signaling

Signals that form memories and thoughts move through an individual nerve cell as a tiny electrical charge.

Nerve cells connect to one another at synapses. When a charge reaches a synapse, it may trigger release of tiny bursts of chemicals called neurotransmitters. The neurotransmitters travel across the synapse, carrying signals to other cells. Scientists have identified dozens of neurotransmitters.

Alzheimer's disease disrupts both the way electrical charges travel within cells and the activity of neurotransmitters.

 

7. Signal coding

100 billion nerve cells. 100 trillion synapses. dozens of neurotransmitters. This "strength in numbers" provides your brain's raw material. Over time, our experiences create patterns in signal type and strength. These patterns of activity explain how, at the cellular level, our brains code our thoughts, memories, skills and sense of who we are.

The positron emission tomography (PET) scan on the left shows typical patterns of brain activity associated with:

Reading words

Hearing words

Thinking about words

Saying words

Activity is highest in red areas and then decreases through the other colors of the rainbow from yellow to blue-violet.

Specific activity patterns change throughout life as we meet new people, have new experiences and acquire new skills. The patterns also change when Alzheimer's disease or a related disorder disrupts nerve cells and their connections to one another.

 

8. Alzheimer's changes the whole brain

Alzheimer's disease leads to nerve cell death and tissue loss throughout the brain. Over time, the brain shrinks dramatically, affecting nearly all its functions.

 

9. More brain changes

In the Alzheimer's brain:

The cortex shrivels up, damaging areas involved in thinking, planning and remembering.

Shrinkage is especially severe in the hippocampus, an area of the cortex that plays a key role in formation of new memories.

Ventricles (fluid-filled spaces within the brain) grow larger.

 

10. Under the microscope

Scientists can also see the terrible effects of Alzheimer's disease when they look at brain tissue under the microscope:

Alzheimer's tissue has many fewer nerve cells and synapses than a healthy brain.

Plaques, abnormal clusters of protein fragments, build up between nerve cells.

Dead and dying nerve cells contain tangles, which are made up of twisted strands of another protein.

Scientists are not absolutely sure what causes cell death and tissue loss in the Alzheimer's brain, but plaques and tangles are prime suspects.

 

11. More about plaques

Plaques form when protein pieces called beta-amyloid (BAY-tuh AM-uh-loyd) clump together. Beta-amyloid comes from a larger protein found in the fatty membrane surrounding nerve cells.

Beta-amyloid is chemically "sticky" and gradually builds up into plaques.

The most damaging form of beta-amyloid may be groups of a few pieces rather than the plaques themselves. The small clumps may block cell-to-cell signaling at synapses. They may also activate immune system cells that trigger inflammation and devour disabled cells.

 

12. More about tangles

Tangles destroy a vital cell transport system made of proteins. This electron microscope picture shows a cell with some healthy areas and other areas where tangles are forming.

In healthy areas:

The transport system is organized in orderly parallel strands somewhat like railroad tracks. Food molecules, cell parts and other key materials travel along the "tracks."

A protein called tau (rhymes with wow) helps the tracks stay straight.

In areas where tangles are forming:

Tau collapses into twisted strands called tangles.

The tracks can no longer stay straight. They fall apart and disintegrate.

Nutrients and other essential supplies can no longer move through the cells, which eventually die.

 

13. Progression through the brain

Plaques and tangles (shown in the blue-shaded areas) tend to spread through the cortex in a predictable pattern as Alzheimer's disease progresses.

The rate of progression varies greatly. People with Alzheimer's live an average of eight years, but some people may survive up to 20 years. The course of the disease depends in part on age at diagnosis and whether a person has other health conditions.

Earliest Alzheimer's - changes may begin 20 years or more before diagnosis.

Mild to moderate Alzheimer's stages - generally last from 2 - 10 years.

Severe Alzheimer's - may last from 1 - 5 years.

 

14. Earliest Alzheimer's stages

In the earliest stages, before symptoms can be detected with current tests, plaques and tangles begin to form in brain areas involved in:

Learning and memory

Thinking and planning

 

15. Mild to moderate Alzheimer's

In mild to moderate stages, brain regions important in memory and thinking and planning develop more plaques and tangles than were present in early stages. As a result, individuals develop problems with memory or thinking serious enough to interfere with work or social life. They may also get confused and have trouble handling money, expressing themselves and organizing their thoughts. Many people with Alzheimer's are first diagnosed in these stages.

 

Plaques and tangles also spread to areas involved in:

Speaking and understanding speech

Your sense of where your body is in relation to objects around you

As Alzheimer's progresses, individuals may experience changes in personality and behavior and have trouble recognizing friends and family members.

 

16. Severe Alzheimer's disease

In advanced Alzheimer's disease, most of the cortex is seriously damaged. The brain shrinks dramatically due to widespread cell death. Individuals lose their ability to communicate, to recognize family and loved ones and to care for themselves.

 

 

 

Linda Holroyd's insight:

Simple, understandable language about the brain and the impact of Alzheimers 

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Medicare Mistakes to Avoid - Top 10 Costly Errors - AARP

Medicare Mistakes to Avoid - Top 10 Costly Errors - AARP | Personalizations for the Aging | Scoop.it

Medicare is uncharted territory for most of the 10,000 people a day who currently come into the program. It's not a minefield exactly, but lurking in the undergrowth are pitfalls and traps that can be costly unless you take care to avoid them. Here are the top 10 Medicare mistakes to beware of:

 

Mistake No. 1:

Assuming you don't "qualify" if you haven't worked long enough

 

Earning 40 credits through paying payroll taxes at work — about 10 years' work — ensures that you won't have to pay premiums for Part A services (mainly hospital insurance) when you join Medicare. But you don't need any work credits to qualify for Part B (doctors' services, outpatient care, medical equipment) and Part D (prescription drugs), provided that you're 65 or older, and a U.S. citizen or a legal resident who's lived in the United States for at least five years. You may also qualify for Part A benefits on your spouse's work record, or you can pay premiums for them. But if you wait to sign up until you've earned 40 credits (pdf), you may end up paying permanent late penalties.

 

Mistake No. 2:

Failing to enroll in Part B when you should

 

Enrolling at the time that's right for you is critical. If you don't, you risk late penalties, in the form of surcharges added to your premiums for all future years, and delays of several months before coverage kicks in. If you have health coverage, beyond age 65, from an employer for whom you (or your spouse) actively work, and the employer has 20 or more workers, you can delay Part B enrollment without penalty until the employment ends. Otherwise, you need to sign up during your seven-month initial enrollment period, of which the fourth month is the one in which you turn 65.

 

Mistake No. 3:

Assuming you don't need Medicare Part B if you have retiree health coverage

 

Part B is optional, but you should carefully check with your retiree plan to see how it fits in with Medicare. In many such plans, Medicare automatically becomes primary coverage and the plan pays only for a few services that Medicare doesn't cover. So if you fail to sign up for Part B when you're required to, you'll essentially have no coverage.

 

Mistake No. 4:

Thinking you must reach full retirement age before signing up

 

Full retirement age for most people is now 66. But to avoid late penalties you need to sign up for Medicare at age 65, unless you have health coverage from your own or your spouse's current employment. You don't need to be collecting government retirement benefits to enroll in Medicare.

 

Mistake No. 5:

Not signing up for Part D because you don't take any prescription drugs

 

Why pay Part D premiums if you need no medicines? Because you don't have a crystal ball and can't be sure that you won't get some unforeseen illness or injury that takes expensive drugs to treat. (Some cancer drugs cost thousands of dollars a month.) Part D, like all insurance, provides coverage when you need it, but doesn't allow you to wait to sign up until the need becomes urgent. One solution (if you don't have drug coverage from elsewhere): Pick the plan with the lowest premium, so you get coverage at the least cost.

 

Mistake No. 6:

Picking a Part D drug plan on the basis of its premium or its name or because your best friend chose it

 

The best way to pick a plan is according to the specific drugs you take, because Part D plans do not cover all drugs and they charge widely differing copays, even for the same drug. You can compare coverage and costs for your own drugs among different plans by using the plan finder program on Medicare's website or by calling Medicare at 800-633-4227.

 

Mistake No. 7:

Misunderstanding enrollment periods

 

You may have read about "open enrollment" and gotten the idea that this is the only time you can sign up for Medicare. Not true! In Medicare, open enrollment (Oct. 15 to Dec. 7 each year) is only for people who are already in the program and want to change their coverage for the following year. If you're coming into Medicare for the first time, you get your own enrollment period — either around the time you turn 65, or throughout the time you have health coverage from your own or your spouse's employment and for up to eight months after it ends. So if you miss your personal deadlines because you're waiting for open enrollment, you risk delayed coverage and permanent late penalties. (Note: Different enrollment periods apply in some other situations, including when people qualify for Medicare due to disability.)

 

Mistake No. 8:

Being too late to buy Medigap with full protections

 

Medigap supplemental insurance is extra coverage you can choose to buy privately to cover some or most of your out-of-pocket expenses in traditional Medicare, such as deductibles and copays. But to get the full federal protections, you need to buy it at the right time and be 65 or older. (See Choosing a Medigap Policy.)

 

If you buy a Medigap policy within six months of enrolling in Part B or in a few other specific circumstances, Medigap insurers can't deny you coverage or charge higher premiums based on your current health or preexisting medical conditions. Outside of those time frames, they can do both. (Note that people under 65 don't get this federal umbrella, though some states provide similar protections.)

 

Mistake No. 9:

Failing to read your Annual Notice of Change

 

This important document comes in the mail each September if you're enrolled in a Medicare Advantage plan (HMO or PPO) or a Part D prescription drug plan. It specifies what changes the plan will make in its costs and coverage for the following year. You can then compare it with other plans during open enrollment (Oct. 15 to Dec. 7) and switch if you want. Failing to read the notice can result in nasty shocks on Jan. 1 if you stay with a plan that hikes its charges.

 

Mistake No. 10:

Not realizing that you may qualify for help to lower your costs

 

Medicare comes with many expenses — premiums, deductibles, copays — that many people find hard to pay. So if your income is limited, be sure to check out two programs that can reduce those costs if you qualify. Under a Medicare Savings Program, your state pays the Part B premiums and maybe other expenses. Under the federal Extra Help program, you get low-cost Part D prescription drug coverage.

 

Patricia Barry writes the AARP Ask Ms. Medicare column and is the author of  Medicare for Dummies.

Linda Holroyd's insight:

Guidance from Ms. Medicare

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