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Drinking During Virtual Visits?, Hospital Cyber Threats, Fitbit's Digital Plans-The HSB Blog 11/3/20

Patients Report Scrolling on Social Media, Exercising and Drinking During Virtual Doctor Appointments

Event: On October 28th, an article in Mobihealthnews reported that patients admit to often being distracted during virtual doctor appointments, with as many as 24% reporting multitasking during the visit. The article noted that new research from DrFirst showed the most common distractions were surfing the web, checking emails, or texting.

Description: Virtual doctors’ appointments have given patients the ability to consult with healthcare providers at their convenience. DrFirst surveyed 1,000 consumers nationally ages 18 and up in June of 2020. Of those surveyed, 73% of men and 39% of women said they had been distracted during a telehealth visit, and more than 24% of respondents admitted they had been distracted by things such as watching TV (24%), checking social media (21%), eating (21%), playing video games (10%), working out (18%) and even drinking (9%), The survey asked patients how telehealth can be improved, and responses indicated there could be higher-quality video, texting doctors before the appointment with any questions, the option to see their personal physician for telehealth visits and more user-friendly technology.

Implications: While research from Massachusetts General Hospital suggests that “virtual visits are just as effective as in-person visits.” Empirical survey research like the above challenge that assumption, especially when it indicates that patients are distracted and not fully engaged with their healthcare providers. In addition, although telehealth usage has increased dramatically with 22% of consumers indicating they have had a virtual visit in 2020 (up from 8% in 2019) and 80% of physicians reporting they have had a virtual visit in 2020 (up from 22% in 2019) quantity and quality are not the same. Although telehealth has made dramatice strides in 2020, when patients are multitasking and inattentive, they are less proactive about their health, potentially leading to lower quality care and poorer health outcomes.

FBI, HHS Warn of "Increased and Imminent' Cyber Threat to Hospitals

Event: On October 29th, Healthcare IT News reported that the FBI and HHS had issued a joint alert warning of ‘increased and imminent’ cyber threat aimed at healthcare providers and public health agencies via ransomware. The warning suggested hospitals, practices and public health organizations take "timely and reasonable precautions to protect their networks from these threats" – which they said include targeting with Trickbot malware, "often leading to ransomware attacks, data theft, and the disruption of healthcare services.

Description: The alert sent by the Cybersecurity and Infrastructure Security Agency (CISA), the Federal Bureau of Investigation (FBI), and the U.S.Department of Health and Human Services (HHS) state that malicious cyber actors indicated their desire to infect systems with Ryuk ransomware (responsible for 75% of attacks) at more than 400 healthcare facilities for financial gain thus, suggesting timely and reasonable precautions to be taken against these threats. The illegal cyber activities include credential harvesting, mail exfiltration, crypto mining, point-of-sale data exfiltration, and the deployment of Ryuk ransomware. The agencies advise patching operating software, changing passwords regularly, multifactorial authentication, disabling remote desktop assistance, and configuration check to prevent issues. These attacks have recently affected hospitals in upstate New York causing system failures. UNC1878 has disrupted hospitals throughout the U.S. with ransomware, forcing them to divert patients to other healthcare providers as the hospital networks go offline.

Implications: With Ransomware attacks on the healthcare system not only threaten the security of the institution in terms of medical data, but it will prolong patients' wait time to receive critical care as a result of hospital networks being taken offline. This could be especially troublesome with COVID cases on the rise. While these threats are still ongoing, hospitals and healthcare organizations need to take up precautionary recommendations suggested by CISA, FBI, and HHS in a timely manner and secure their systems. The warning also noted that the perpetrators were often demanding ransom payments both to preserve the data that had been compromised and a second ransom to decrypt it. Attacks such as these demonstrate the continued increase in risk of health data as a cyber target as well as the need for vigilance against multiple types of threats going forward.

Fitbit CEO Hints at Company's Telemedicine Plans

Event: A recent article in TechSpot reviewed an interview Fitbit CEO James Park gave to the Wall Street Journal where he discussed Fitbit’s strategy in wearables and telemedicine as it pursues its merger with Google, noting that Fitbit’s premium health and fitness service already has over 500K users worldwide. The article noted that although the company has experienced some hardship it has managed to remain among the top five wearable makers worldwide and hopes to have a more significant impact on healthcare with the addition of new software and services.

Description: One of the first developers of wearable technology, Fitbit has generally been focused around health and fitness, agreeing in 2019 to be bought by Google (the purchase still needs regulatory approvals). While Fitbit had expected demand for its devices to decline during COVID lockdowns, the company has noticed that business is doing better than expected and users remain connected to their devices and software services. In addition, earlier in 2020 Fitbit released results of a study with the Stanford Medicine Healthcare Innovations Lab and Scripps Research Translational Institute that validated an algorithm Fitibit had developed for the successful detection of COVID prior to the onset of symptoms. The company is doing additional research and is expected to seek regulatory approval for the device.

Implications: Upon completion of its merger with Google, Fitbit will have a solid and loyal user base combined with a generous balance sheet to continue to pursue innovations within health and fitness. In addition, aligned under the Google umbrella along with its other consumer brands such as Nest, and YouTube, Fitbit has the potential to leverage its consumer reputation along with its future parents to tap into the growth of telemedicine. However, given several data privacy miscues by Google, Fitbit will have to provide solid reassurances about data privacy in order to convince consumers to invest in tools like a connected thermometer and an otoscope with confidence.

Nutrium App, which links Dietitians and Patients, Raises $4.9M Led by Indico Capital

Event: In a recent article, Tech Crunch noted that Nutrium, a digital health startup which links dieticians and patients via an app had raised $4.9m. According to the article Nutrium now offers professional nutrition software to 80,000 nutrition professionals and 800,000 patients in more than 40 countries.

Description: Nutrium gives patients integrated nutrition counseling which combines professional advice, continuous monitoring, nutritional analysis, meal planning and access to commercial products all in one place. This app brings together nutritionists, patients, products and wellness data to enable healthier and happier lives. With this investment round, Nutrium plans to double the team size in the next 24 months in order to focus on platform development and expand global sales in markets like Spain, France, Italy, the U.S. and the U.K., where the company already has a strong customer base.

Implications: A healthy diet throughout life supports normal growth, development and aging, helps to maintain a healthy body weight, promotes healthy pregnancy outcomes and reduces the risk of chronic disease leading to overall health and well-being. This app, and others like it, which give the user critical tools for a healthy diet could be an essential part of maintaining a healthy lifestyle. In addition, poor diet and nutrition levels, particularly earlier in life have been linked to slower educational and emotional development in children which can often plague them later in life. Apps such as Nutrium, which expand access to easy and convenient nutritional counseling can help increase healthy lifestyles, particularly in underserved communities.

Fitness Wearable Whoop Joins the Unicorn Club with $1.2B Valuation

Event: MobiHealth News reports that the fitness wearable Whoop announced a $1.2 billion valuation following its $100 million in Series E Funding. Unlike many other fitness wearables, Whoop is available via a subscription service and measures sleep performance and heart rate variability, which is part of the information used to calculate a proprietary active recovery score called the Whoop recovery score.

Description: The WHOOP Strap 3.0 collects 24/7 physiological data including sleep, fitness and recovery to provide the most accurate and granular understanding of your body. That data is then sent to a corresponding app, which can give users insights about their training and recovery.

WHOOP Strap 3.0 also comes along with personalized coaching. The app will provide users with sleep recommendations and can measure the stress someone has over a 24-hour period. It's lightweight, waterproof, and features the new and improved 5-day battery life and bluetooth low energy connect.

Implications: Wearable device tech companies are growing, from Apple Watch, to Fitbit, to Amazon to now Whoop. Whoop uses its data to provide personalized coaching on sleep and stress as well as the amount of sleep and recovery a body needs from certain activities. Exercise technology which incorporates body feedback can be used not only to improve athletic performance but also to monitor and react to certain disease states. As a result, this will likely accelerate the pace of change in the traditional patient-doctor relationship due to the influence medical wearables have given their ability to automate processes, expedite diagnosis and treatment and allow people to monitor their own health.

Cross-border Collaborations Lead to Data Sharing Efforts During COVID-19

Event: A recent article in Mobihealthnews highlighted lessons learned from panelists who attended the World Health Summit, centered around the importance of global collaboration and data sharing during a pandemic. Among the conclusions noted was that in taking on a pandemic, “global collaboration and data sharing are key”. The panel also highlighted the importance of digital technology as the world tries to understand, manage, and overcome the impacts of the disease.

Description: The World Health Summit was held virtually October 25th-27th, with this year’s topic naturally being current knowledge about Coronavirus,new strategies in the worldwide fight against pandemics and the role of Europe and the WHO in global health. During the presentations, panelists noted, “in a pandemic there is no sense in having solutions which apply only within our national borders. You have to have solutions that work around the world because people are moving all the time." The panel also pointed out how digital solutions have become seamlessly crucial as the world continues to overcome COVID-19. Including the new European Union (EU) interoperability gateway system, which connects contact tracing and warning apps amongst participating EU countries. The system would notify a person of the possible risk of infection if they were around someone who was infected, regardless of their location [if participating]. While COVID is the Summit’s current focus, the article noted that participants were also joining forces to look ahead at pandemics of the future, including the UK’s Trinity Challenge.

Implications: The Summit clearly highlighted that “digital collaboration underpins the coordinated systematic approach we need to strengthen health systems and our healthcare.” However, panelists remained mindful of the need for data security, with the article pointing out that while the applications for digital are increasing, protecting patient privacy should still be front and center. Participants also concluded that although collaborating globally and accelerating interoperability, has the potential to improve response to future disasters, “the use of data and analytics in global public health, particularly the use of non-health data is not as good as it needs to be and varies across countries”. This clearly indicates the potential for strides to be made in all countries on the issue of social determinants of health data and solutions.


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