Medtrade March2013


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Dr. Maheu presents a telehealth workshop to the Medtrade Spring Conference on March 20, 2013 in Las Vegas, Nevada. She presented, "Overview of Best Practices for Successful Legal and Ethical Telehealth."

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The above event is sponsored by the TeleMental Health Institute, Inc. We are the premier professional training site for professionals seeking training in telehealth. Our courses are offered in a state-of-the-art, 100% online learning environment that is fully mobile compatible. Professional training is now available from your desktop of mobile device, 24/7, at your home or office.

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Medtrade March2013

  1. 1. medrrode S I | '. “lh I: 1. ‘I IE IW Overview of Best Practices for Successful Legal and Ethical Telehealth Las Vegas March 2013 Marlene M. Maheu, Ph. D. mmaheu@te| ehea| th. org
  2. 2. Disclaimer <‘ WHO I AM: I am a licensed psychologist, not an attorney, physician, marketing or information technology (IT) professional. <‘ MY GOAL: My goal is educational only. I will outline the issues and alert you to what's happening in a way to help think through the issues, help you move forward, and protect yourself as well as your clients or patients. I hope to inspire you to use technology in ways that help you, your clients and our profession. No warranty, guarantee, or representation is made as to the accuracy or sufficiency of the information contained in my presentation for your specific circumstance. I assume no responsibility in connection therewith your choices. <‘ YOUR PART: You are encouraged to seek specific advice from your specific legal, regulatory, ethical and malpractice bodies before offering any online services or programs to consumers. Get all such opinions in writing, and have your informed, trusted, local, legal counsel review them for their full significance. 9/2 1/201 2 Copyright 2012 TeleMenta| Health Institute, Inc. All rights reserved.
  3. 3. med ii‘ ‘ 'l'‘. l l. l'>l | i'i www. te| ehea| th. org/ MedTrade2013 6 Resources: — Slides , " _' , . . . 1“-*‘— "c" "‘* * — Social Media Policy I . - Bibliography ‘P _ "‘7«’” V‘ T — Time-Limited Bonuses F, ‘” ‘ , _ __ l: . S g 4“ TMH Institute Website: 7:‘. www. te| ehea| th/ aca2013
  4. 4. We Are Re—too| ing
  5. 5. Telehealth vs. Telemedicine Telehea lth A Regional Health A Health Professions Information Education Sharing Consumer I Telemedicine Education Administration I Public Evaluation I Health Research ‘ Homeland Security
  6. 6. med u. i I i‘. .H.1 Reach 8». Benefits of Telehealth I’ Increased client satisfaction I‘ Decreased travel time Decreased travel, child & elder-care costs I‘ Increased access to underserved populations I‘ Improved accessibility to specialists Reduced emergency care costs I‘ Faster decision—making time I‘ Increased productivity / decreased lost wages Im roved o erational efficienc Efficacy is on par with in-person care for many groups Decreased hospital utilization
  7. 7. med ii«. ;:. »i‘li' i~. i»i Providing psychiatric services to anyone, anywhere, anytime using real-time video conferencing. About Us Services Success Stories Employment Resources Contact Us Y“: I v-. ‘II: M : VA's Telemental Health Efficacy Surpasses Face-to-Face Encounters 05/07/2012 Clinical Psychiatry News Digital Network PH1LADEl_PHlA — The rapidly growing telemental health program of the U. S. Veterans Affairs health ca system delivered more effective mental heaItl'i services to nearly 100,000 patients than standard, face-to-face encounters during 2007-2010, demonstrated by its slashing the rate of psychiatric hospitalizations. "This IS the first large-scale study to show that telemedicine dramatically reduced hospital admissions and total hospitalized days, ” Dr. Linda S. Godleski said May 6 at the annual meeting of the American Psychiatric Association. "The decreased hospitalization rate may be explained by increased access to services. Patients do not wait [to get mental health sessions] until fl'iey are completely decompensated” when mental health care services are more readily available by telemedicine, said Dr. Godleski, director of the national telemental health center for the Department of Veterans Affairs and a psychiatrist at Yale University in New Haven, Conn. She and her associates reviewed 98,609 VA patients who required mental heaItl1 services and were new to the agency's telemental heaItl1 program during 2007-2010. They found that the telemental health patients had 24% fewer psychiatric hospital admissions during, on average, their first 6 months in the program, compared with their immediately preceding 6 mond1s of care by conventional, face-to-face encounters with mental health clinicians, Dr. Godleski reported at the meeting and in a journal article by she and her associates (Psyclnatr Ser. 2012 63 3336). The analysis also showed that the first 6 months of telemedicine management produced a 27% reduction in total days of psychiatric hospitalization for these patients during 2007-2010, compared with their management history during the 6 months before ead1 patient entered the telemental health program. ,4.» These shifls were specific to patients who entered the telemental health Dr. Linda S. G'odleski' nrnnrzm niirinn H-in eama II. irn: r narinrl lI nzfinnfe whn did r-ml» euiifrl-i , . -1 '0 S I C H I TELEPSYCHIATRY, LLC A CFG Health Network Company 765 East Route 70. Building A Marlton, NJ 08053 Phone 856 797 4870 Email info@in-sightnet : r-Ir‘ii, =i'}"ia CFG and | nSight: One Company Many Examples of Innovation and Partnership 5./14/2012 May is Mental Health Month and lnSight Telepsychiatry has been chosen to be featured in this months issue of NJAMHAA News Read More VA's Telemental Health Efiicag Surpasses Face-to-Face Encounters 05/07/2012 PHILADELPHIA v The rapidly growing telemental health program of the US, Veterans Affairs health care system delivered more effective mental health services to nearly 100.000 patients than standard f Read More Teleifiychiam lndusm Leaders to Srgak at American Psychiatric Association's TeIe| §ychiat_ry Sympgsium 5/5/2012 Clinical and Academic Telepsychiatry Leaders Are To Discuss Successful Behavioral Health Telemedicine Applications at APA's Upcoming Telepsychiatry Symposium Dr James R Varrell Will Share his Clini Read More
  8. 8. Recent Supporting Research Backhaus and colleagues (May, 2012) reported in their abstract of a meta-analysis that: - 821 potential articles were identified, and 65 were selected for inclusion. - The results indicate that VCP is feasible, has been used in a variety of therapeutic formats and with diverse populations, is generally associated with good user satisfaction, and is found to have similar clinical outcomes to traditional face-to-face psychotherapy. — Videoconferencing psychotherapy: A systematic review. Backhaus, Autumn; Agha, Zia; Maglione, Melissa L. ; Repp, Andrea; Ross, Bridgett; Zuest, Danielle; Rice—Thorp, Natalie M. ; Lohr, James; Thorp, Steven R. Psychological Services, Vol 9(2), May 2012, 111-131. doi: lO. l037[aOO27924
  9. 9. med Sllilngie: :Hg: a;~: ;.*. ;:: The Is Video Teleconferencing (VTC) Effective? <‘ Yes — Medicare & Medicaid required to pay < Outcomes are relatively comparable, especially for follow—up care (intakes are still a matter of state law) C Literature for specialty groups is spa rser, but positive (pediatrics) — Also effective for supervision — Can improve some ways service is rendered — See www. te| ehea| th. ORG/ bibliography <* BUT, traditional VTC isn't the same as Skype Copyright 2013 Te| eMenta| Health Institute, Inc. All rights reserved.
  10. 10. med %%: i:~iilI”l<; Tl: ;r . & lA~v. lH. “~~l. -‘I ATA: Telemedicine Benefits from Supreme Court’s PPACA Ruling July 28, 2012 - Washington, DC) According to the American Telemedicine Association, today’s Supreme Court’s decision to uphold the Patient Protection and Affordable Care Act (PPACA) will have a positive impact on the development and adoption of telehealth. The ruling will further accelerate the deployment rate for telemedicine, mHealth and other remote healthcare technologies. T e SSOCIB |0l'l Cl 65 OUI’ reasons Of IS projec IOHI 1. The announcement lifts the cloud of uncertainty that has caused many health providers to delay decisions to modernize and invest in such areas as telemedicine and related technologies. 2. Upholding the PPACA protects valuable investments in telemedicine made by the Center for Medicare and Medicaid Innovation (CMM| .) Over the past two years, the CMMI has invested heavily in telemedicine pilot projects and other remote healthcare services. The funding status for these programs is unaffected. 3. The Court's affirmation does not affect any of the bipartisan drivers behind the growth and adoption of telemedicine, in particular the provisions for managed and accountable care, medical homes, and care coordination. Telemedicine, as a healthcare delivery service, is crucial to the success of these programs. 4. The fundamental value proposition of telemedicine remains strong. Telemedicine has consistently proven to deliver a wide-range of quality, cost-effective healthcare services, anywhere at anytime. Moreover, telemedicine enjoys high levels of patient satisfaction and customer demand. “Now that the Supreme Court has ruled, we can move forward with the modernization of our healthcare rlnliunnr euefnrn intnnralrinn fnlnrnnllirinn in iwwrIIn I-earn I-Arhu-A I-he}: and int-rnaen art-nee ‘AF AIAl'lIIln in
  11. 11. medtrode I K‘: e‘ ~‘. ~.f| : S. lull I: (If Patient-Centered Medical Home (PCMH) ° Hospitals are closing — Regarded as the most expensive part of the delivery system for health care in America ° Medical devices and telehealth are natural partners in helping patients with receiving care while at home
  12. 12. 3' D) (Ema-j. Existing Guidelines —— Many Cover Far llI lI)llllt'. ‘: More than Telehealth - 1998 American Psychiatric Association — Telepsychiatry via Teleconferencing - 1999 (2005) American Counseling Association — Ethical Standards for Internet On-Line Counseling - 2000 American Mental Health Counselors Association — Code of Ethics of AM HCA, Principle 14, Internet On-Line Counseling - 2000 American Medical Association — Guidelines for Patient-Physician Electronic Mail - 2001 National Board of Certified Counselors (NBCC) — Center for Credentialing and Education The Practice of Internet Counseling - 2001 Canadian Psychiatric Association (CPA) — Telepsychiatry Guidelines and Procedures for Clinical Activities - 2004 (2010) Australian Psychological Society — Guidelines for providing psychological services and products on the internet - 2006 National Association of Social Workers & Association of Social Work Boards — Standards for Technology and Social Work Practice - 2008 (2010) Ohio Psychological Association — Telepsychology Guidelines - 2009 Canadian Psychological Association — Ethical Guidelines for Psychologists Providing Psychological Services Via Electronic Media - 2009 American Telemedicine Association — Evidence-based Practice for Telemental Health — Practice Guidelines for Videoconferencing Based Telemental Health
  13. 13. . I , -“. - . .g g < ' . r . .‘ . I. , . . I - . - _ _‘ ' . I , ‘ 4 _A _ v . .. e - . - . ~ ‘ ~’ . - “ - v ' l. , . I . . W _, ~v. ~ n . . . - , V o . , ~ ’ - . . 1 - . ' ‘ ‘ . 0 ’_, ~ . ~ - 9‘ ' - - _, . ‘ u_ . o- ‘. ‘ I ' . , . . g . - - . A 1 , - 3‘. I - , -n_ _ v. ‘ .
  14. 14. med Sl3l’lflQl1£: :i"‘l; l4Iu‘; .‘. ;i. ’ Online Norm vs. Standard of Care I‘ Mostly Email & Chat vs. Video I‘ Anonymity/ No Patient Records I‘ Avoid Responsibility w/ Website Disclaimers I‘ lIo Clear Channels for Mandated Reporting
  15. 15. SDf| flgI‘. ‘.lTl‘I§IiFI‘§lb‘ Online Norm vs. Standard of Care - No Contact with Other Treating Clinicians - No Authentication of Consumer/ Professional - No Emergency Backup Procedures - Misunderstanding of Clinical Processes (suicide) - Operating w/ o Needed Research for Unsupervised Settings
  16. 16. IivAIusI'traIiIan Psychological Society (2011 revision of Internet Guidelines) I‘ Research—based protocols — 1.6 "Psychologists using the internet to provide a psychological service should be aware of the extent to which therapeutic interventions via the internet are supported by research or may be contra-indicated . ... ” Copyright 2013Te| eMenta| Health Institute, Inc. All rights reserved.
  17. 17. CLINICAL MODELS FOR SUCCESS SUPPORTED BY THE EVIDENCE BASE Coming next. .. Which models should we follow?
  18. 18. Video Teleconferencing (VTC)
  19. 19. I‘ llursing Homes
  20. 20. .. us
  21. 21. Hospitals
  22. 22. Rural Hospitals
  23. 23. eitgi‘ .132) . . i F‘5?? .iligf3l$, ;. . , ELI c
  24. 24. Home Health , : -I5‘. -. L .1’ rt - ill‘: It ‘ . .~, t*(%. l I‘ . I '7’ I A ‘LA _' .1’
  25. 25. Military & Veteran's Administration i l ‘ 7 Y . .4 «If I». I r ' , / -, / . 1 I I . A X , I ' I .
  26. 26. ValueOptions and American Well Partner to Deploy the First National Behavioral Telehealth Network f -~-3 mshuro g*1, NORFOLK, Va. and BOSTON, June 27, 2012 / PRNewswire/ — VaIueOptions®, a health improvement company that specializes in emotional wellbeing and recovery, and American Well” today announced a partnership to bring critically-needed behavioral healthcare to patients wherever they are, whenever they need it. Using American WeII's industry-leading Online Care telehealth solution, Valueoptions will transform behavioral healthcare by offering members immediate, live and clinically meaningful consultations. With American Well technology, VaIueOptions will develop a first-of-its-kind, national network of telehealth-enabled providers. Through Online Care, Valueoptions members will have secure and private access to skilled behavioral specialists from home, work or any location where they have Intemet connectivity. Telehealth removes many barriers to healthcare such as distance, mobility and time constraints and can help lessen the stigma sometimes associated with behavioral health. Online Care provides Valueoptions an efficient and convenient solution to dramatically enhance behavioral healthcare access and quality for its diverse membership, which includes both commercial and public sector employees and their families; military servicemen and women and their dependents; as well as Medicaid, Medicare and dual eligible populations. ‘With over 130,000 provider locations. we have one of the nation's largest behavioral health networks. However. the reality is that there are still not enough providers to serve the growing demand for quality behavioral health services in every comer of the United States. Access to care is an issue for many, " said Heyward Donigan, president and CEO of Valueoptions. "Growing demand for telebehavioral health services is evidenced by the speed at which reimbursement is accelerating. Today, 34 state Medicaid programs have recognized the need and the value of telehealth services. These 34 states already reimburse for such services, and 14 states are mandating telehealth reimbursement. Additionally, we continue to witness increased demand for telehealth in the Federal marketplace as well as a growing interest in our commercial business segments. " "OnIine Care telehealth allows us to bring behavioral health directly to our members, " adds Dr. Hal Levine, chief medical officer of Valueoptions. ‘Whether location or transportation inhibits access, or perhaps a member is simply having trouble taking that important first step toward engaging available services, telehealth enables us to connect with the member where they are — not just where they are located. but where they are in mindset when it comes to seeking treatment. " Valueoptions will harness telehealth to reduce the rate of missed appointments and increase compliance. Moreover, with Online Care, Valueoptions will build a more efficient, more convenient model for care delivery that will complement existing in-person services, lead to better health outcomes for members, enhance the bottom line for providers, and eventually, reduce costs flit the system of care.
  27. 27. med ll (_ ijrj, V. -. ~ -. .i I ‘at ‘Ii l: ..lEl‘‘. l l‘lll.3lI'. "i Migration Model Start with your current clients Select those who are reliable, have good support systems and with whom you have a good working relationship Consider their diagnosis Take the time to prepare them Plan in-person sessions at regular intervals Do not work through their secretaries or others
  28. 28. med 'l‘. I I. l'>I l: "i 4 Key Aspects of Risk Management ° Know the Applicable Standard of Care for , Your Patient Population , T — ‘r"_r: ,.-* . . . , i and within Your - , . - . qi . . . ‘~. “r~ 3 I ’ ‘ I Discipline IQ). ‘ ¢“-'~ ' ILL‘ , . _. z--»: i 6 Legal Code —«—---——————-—--—'~‘ 0 Code __-_____ . __, __, ,____, ,_ ‘‘ IF} s Malpractice insurance I
  29. 29. SD fl ll Q i‘l. l?Tfi‘r‘q [l): l(, I'lIf‘Ii| ' Risk Management ° Save all proof of training or consultation to prove you've ”sought the advice of your peers” ° Record Keeping: — Document, document, document I, " - Protocols Followed I V - Time in, time out I - - Dropped connections - Intrusions - Lighting - Adaptive Equipment - Assess progress Copyright 2013 Te| eMenta| Health Institute, Inc. All rights resen/ ed. - i I
  30. 30. med . .i- ‘ 'l'r‘. l l. l'>I | §'i APA Standard 10: Informed Consent ° 3.10 Informed Consent (d) Psychologists appropriately document ’ written or oral " consent, permission, an d assent. — http: //www. apa. org/ ethics/ c ode/ index. aspx l I la‘. 1
  31. 31. med Ijrwv. -.~ , -v, I: .,_I : I~. II l. ~|. ,I)l, I‘3 I I1!‘ . Risk Management I‘ Have an addendum to your informed consent — Include a social media policy I‘ Communicate often in writing to your local, state and national professional associations I‘ Have written emergency plans
  32. 32. Inter-jurisdictional Issues (practicing over state lines or national borders) Practitioner must be Hcensed: s In a state it In the local state of patient ~ Both Government House of Representatives Approve Internet Doctor Treatment State Representative Dan Winslow (R-Noi1oIl<) who represents Medfield saw his proposal to ease Access and reduce medical costs pass the House this past week June 16 2012 , !’Tweet 0 Email Print 6 COTTIITISDIS Editor's note The following was submitted by the Dan Winslow Coriiiriiiree In a move that could revolutionize the delivery / I access and cost of primary healthcare in Massachusetts. the House of Representatives ~ ’ approved a plan to allow doctors licensed ’. . . anywhere in the United States to consult ‘ H T , ' / M ‘, . Y" . 4 diagnose and treat Massachusetts residents by I ‘ ‘ , ‘ I" ' internet video examinations V i N I “Telemedicine will allow qualified physicians to be immediately available 24/7 and as near as your computer or smanphone "said Medfield's State Representative Dan Winslow (R—Norfo| k) who sponsored the legislation "If approved by the Senate and signed by the Governor this new technology will be a godsend to worried parents in the middle of the night to seniors who are confined to home to residents in rural areas who lack convenient access to primary care physicians and to anyone who can't wait a few days or a week to obtain a prescription " said Winslow (3) Upload Photos and Videos Under the plan as approved by the House Massachusetts‘ Board of Registration of Medicine will develop and implement standards for a "telemedicine" license for which physicians licensed in any state will be eligible to apply Massachusetts is home to a number of high tech companies that are developing telemedicine technology including Americariwell com which provides more than 100 jobs Telemedicine can range from computer or sman phone consultation to high tech video booths at drugstores that include blood pressure and temperature sensors Telernecl doctors can expedite referrals to specialists and in person examinations when needed Related TODICSI DBTI V)/ ll'lSl0‘iV HOUSE Ol REDIBSEUIEII‘/85 and IDISTHEI DOCIOI Ill
  33. 33. SD H g I i))i‘IiI. [' IiIi(§ IIlIlI‘II APA Ethical Standard 9: Assessment ° 9.01 Bases for Assessments ° 9.02 Use of Assessments ° 9.03 Informed Consent in Assessments ° 9.04 Release of Test Data ° 9.05 Test Construction ° 9.06 Interpreting Assessment Results ° 9.09 Test Scoring and Interpretation Services ° 9.10 Explaining Assessment Results - 9.11 Maintaining Test Security
  34. 34. Boundaries of Competence Racial, Linguistic, Gender, Religious & Cultural Diversity Copyright 2013 TeleMental Health Institute, Inc. All rights reserved.
  35. 35. l'T1 Q L) I . SC’ . . . . . . DI I I lIlI‘| I.I I)IllI | Il: I"II Client 8». Patient Selection People with almost all diagnostic symptoms have been treated with traditional telehealth I Treatment to the home has ~? { , , , - I‘, 3; not yet identified which I i_’ ~‘»_I _ ‘gr . ; ‘ groups are too risky I I; l ' J» Understand differences between treatment of individuals in 1 setting vs, another (hospital vs. car, park, bed etc. ) Consider compliance problems
  36. 36. med 8 I I I. I Iiils II i: EI. I L; Duty to Report / Duty to Warn California State Law I‘ (v) Failing to comply with the child abuse reporting requirements of Section 11166 of the Penal Code. I‘ (w) Failing to comply with the elder and adult dependent abuse reporting requirements of Section 15630 of the Welfare and Institutions Code. CA Business and Professions Code Sections 4989.54 (cont. )
  37. 37. med 8 l l | tlK l“>l‘~l‘ I; id) x4 APA Ethical Standard 6: Record Keeping <" 6.01 Documentation of Professional and Scientific Work and mi “ 4 Maintenance of Records l Psychologists create, and to ‘ , the extent the records are under their control, maintain, disseminate, store, retain and dispose of records and data relating to their professional and scientific work C http: //www. apa. org/ ethics/ code/ index. aspx
  38. 38. SDllHgl'fR? :*l§l%? i‘s%E‘¢ l OCPM Step 6: Direct Clinical Care 9 Contract for short, protoco| —driven tx 9 Authenticate & set ground rules at every session 9 Enforce boundaries (privacy, family, social media) 9 Evaluate at regular intervals 0 Have backup emergency plan
  39. 39. V‘ I I_ ‘In ISC: l {E l ll ilk ilrilx l iii‘ American Telemedicine Association Videoconferencing Guidelines — Emergencies (2009) r A patient site assessment shall be undertaken, including obtaining information on local regulations & emergency resources, and identification of potential local collaborators to help with emergencies
  40. 40. ll i(kiViili[ill? w({ lIl"d. American Telemedicine Association Videoconferencing Guidelines — Emergencies (2009) ° Emergency protocols shall be created with clear explanation of roles & responsibilities in emergencies
  41. 41. 577,90 ‘ , S l l l | tlK liililsv I‘ Id. ’ L; American Telemedicine Association Videoconferencing Guidelines — Emergencies (2009) (- Determine Outside <” Be familiar with local emergency Coverage civil commitment regulations and have arrangements where possible to work with local staff to initiate/ assist with civil commitments <" Establish guidelines for determining at what point other staff and resources should be recruited to help manage emergencies
  42. 42. Spflflgl{lI‘i“i‘§l»; ‘=‘; .‘i’$. ’ American Telemedicine Association Videoconferencing Guidelines — Emergencies (2009) ' Be aware Of the im|0aCt - Be aware of safety issues 0t tem0te Cate 0h with patients displaying provider's perception of strong affective or C0htF0l (OF laCl< th€F€0tl behavioral states upon 0Vet the Chhlcal conclusion of a session, interaction, and how and new patients may this might lm|0aCt then interact with |0F0Vi0l€F'$ maha8€m€ht- remote site inhabitants
  43. 43. med W" ' '-iii-x: ~~. ‘i ~», :,: ‘: SDI iiigiimi OCP| /I Step 6: Direct Clinical Care Explain & sign informed consent document Conduct a formal intake — no shortcuts «: - Meet in-person or video «: Take a full history, medications, illnesses, abuse, stressors, support system, use of other technology, drug/ alcohol use, suicide/ homicide intent, mental status «: Decide ifi then which technology is appropriate ¢: » Obtain names & contact information for all other key providers, get all appropriate releases to contact them
  44. 44. SD H g (l li: i‘l| ii[' iiii(§ lililiii OCPM Step 6: Direct Clinical Care 9 Explain & sign informed consent document 9 Conduct a formal intake — no shortcuts 9 Meet in—person or video, take full history, medications, illnesses, abuse, stressors, support system, use of other technology, drug/ alcohol use, suicide/ homicide intent, mental status 9 Decide iii then which technology is appropriate 9 Obtain names of all other key providers, get all appropriate releases
  45. 45. i i iiiiiiliili iiiix lilliii I Risk Management: Research-based Protocols & HIPAA-compliant Platforms 1000+ Reference Bibliography r” 6 6 i i” htt : te| ehea| th. or biblio ra h Ii, I i i-W--; --—-. ~;; :‘. } {.7 50+ Video Platforms I r / i ' http: //te| ehea| th. org/ video Copyright 2013 Te| eMenta| Health Institute, Inc. All rights reserved.
  46. 46. 9739* Arc of Decentralization Clayton Christensen, The | nnovator’s Prescription & Godfather of Disruptive Innovation “ Music example: —Music listeners go 4 to Carnegie Hall I‘ at t . —Get music and A’ it ii‘ - re ; Wit players at stores ~~‘g E r — Use mobile device ‘ to get and play music in the back of a taxi
  47. 47. Skype i’ No audit trails i‘ Poor Reliability is Video platform or social _ media platform? V i” Hacked 11/14/2012 http: //heartbeat. skype. com/2012/11/security_issue. html By _eonas Sendrauskas on November 14, 2012. We have had reports of a new security vulnerability issue. As a precautionary step we have temporarily disabled password reset as we continue to investigate the issue further. We apologize for the inconvenience but user experience and safety is our first priority ti ; o l:3:3iCiI: "‘i$ . .|. i. , . . _,i L". .. ‘i. -,. w-. --. ~,. -.v: i.. fii. ._«, _,
  48. 48. ’-: ‘ A , ‘i-E 11:59AM 9’?
  49. 49. ._. ,_ lRi'6 Personal Robots Group mil media lab in iria [it'. '!r, ’i' Lwri rribijitt Home Welcome to the Personal Robots Group
  50. 50. La‘ Wearable Computers (Glasses)
  51. 51. springi. :;i. ~:; iiii. i:. i.ii'» it it’ | fi‘i°= "”is Random People Vampires Animals Robots Vehicles I-‘ii Choose this Atatai This is how you Will initially appear in Second Lfle You can customize your appearance later
  52. 52. mHea| th (mobile health) i g-. ~,—~. u » . =.. ;i E; “;; »;: = . . - - . “""‘*"‘§' . §_. ..-r ’_’t"-‘V; - ; ° 55% of Americans owned a smartphone in March 6, 2013 (comScore) ' Up from 36% in 2/2011; Up 29% from 10/2010 - Reimbursement will soon make geography a non—issue Copyright 2013 Te| eMenta| Health Institute, Inc. All rights reserved.
  53. 53. med . ‘3l. ’iIiII"IifI'. . ; i.I Today's teens use media an average of: i“ 10 hours and 45 minutes i* every day i* 7 days per week* it Americans are already looking to their smartphones for health care
  54. 54. medtrode tt)Ni’l(. llN(i llll HMI INDUSTRY spring Weight Loss The BodyMedia Core 2 Armband (the Biggest Loser / 24-hr Fitness / Jenny Craig) but now has "jewe| ry-| ike" customization - Sensors: skin temperature, heat flux, galvanic skin response, and a 3- axis accelerometer (pedometer) - Optional add-on: a continuous heart- rate monitor using dry electrodes - Bluetooth Smart connectivity allows BodyMedia data to be uploaded to BodyMedia’s smartphone apps - Waterproof, can be worn for swimming / Size of iPod Nano - To release in August for $119 - $149
  55. 55. medtrode S l l ‘I it tiliiliii I i. i Ii litiili meet the ibitz it . IilltIfl: i ibitz PowerKey and ibitz Unity trackers measure the activity of the whole family kids’ data is transmitted into gamified apps — avatar character and physical activity can unlock levels or prizes parental appeal is having all of the family's data in the same app, where they can set up group accountability
  56. 56. med ii | i’t‘ul)li itfiiii Muse to Control Emotions (_ (_ (_ lnterAxon Muse monitors your brainwaves and transmits the readings to your smartphone "brain training” software designed to help people gain more control over their thoughts and emotions The device will sell for $199 when it launches in 2013
  57. 57. HAP| fork ° Fork with embedded sensors and a Bluetooth transmitter ii The fork ’”’knows” when you're eating too fast, and vibrates to alert you, as well as sending notifications to a companion app.
  58. 58. med Health & Behavioral Care in 20 Years ' Mobile devices and peripherals will deliver most health and mental health care —Sensor—based information gathering “ Mirrors, scales, vests, chairs, mattresses, steering wheels, exercise equipment, etc. —Se| f-report
  59. 59. l l ii 2‘ «dirt i 1‘. tits I‘ It it Health & Behavioral Care in 20 Years - Mobile devices will be networked into central database that will correlate all real—time data with your genetic profile: — as reported by you, family members, friends and neighbors who share your environment; and — demographics of people who share your habits, lifestyle, and personal preferences for food, drink, exercise; — medical conditions and medication; — combined with latest empirical evidence about each SOUFCG -— — I I
  60. 60. S l l ii i hit i L‘. ii7 It . i it Health & Behavioral Care in 20 Years ° Data will be complied into recommendations that will deliver medications, foods other ingestible substances and behavioral prescriptions in ways that will help remedy diseases and problems before they can even be noticed now.
  61. 61. SDIlIlgi‘I. l1Tt‘i'§tI%? i‘§ Ii't’i' Malpractice Insurance I . , - 1- W ‘s ' "f -n. it ‘ § m- ° Be careful / Get coverage in writing ° Probably won't cover you in ”criminal intent” is involved
  62. 62. medtrode Spi I ii git-lr: ilNi. '('iiTJi_i iiii Thonlt gm Marlene M. Maheu, Ph. D. Te| eMenta| Health Institute, Inc. Phone: 619-928-2627 Email: drm@te| ementa| hea| th. com