Technology advancements are helping many industries thrive in the current Computer Age. One of these is the healthcare industry. The advancement in technology within healthcare is more noticeable today especially since some technology is wearable and can be seen on many different people. Some physicians are even monitoring their patients through their patients wearables. This article takes a look at the different types of wearable technology associated with keeping people healthy and examines how people can benefit from it.
One of the most common and noticeable wearable technologies is a fitness tracker. Since the release of the first Fitbit fitness tracker in 2015, people have incorporated these devices into their everyday lives. And since then, many companies have now invested in creating their own activity monitoring wearable devices. These activity monitoring wearable devices have gotten so big that they have even become a fashion statement. The Fitbit Versa, Garmin Vivoactive series, the Nokia Steel HR, and the Apple Watch are just some of the fitness trackers that can be seen on people no matter the occasion. Fitbit has taken it a step further and plans to use Google’s Cloud Healthcare API to help physicians manage their patients remotely.
Eyeglasses for the blind
Fitness trackers are not the only healthcare related wearable technology. Aira has created a pair of glasses to help blind people throughout their day. The Horizon is the first pair of smart glasses designed for remote visual assistance. The Aira kit comes with a pair of glasses, a phone, and accessories to help with connectivity. The glasses have a built-in camera that is connected to an Aira agent that can help walk the user through any obstacles they need assistance with. With a touch of a button, the user will get real-time assistance as needed. When at home, Aira, can help the user do everyday tasks such as sort mail and medications, read recipes, and separate laundry. When at school, Aira can help the user get around the campus, find a seat, choose food at the cafeteria, and read the whiteboard. While at work, Aira, can help the user operate office equipment, interpret presentation slides, and sort papers. Aira can also help users explore the world around them. Aira can help users go on a hike, sightsee a park or zoo, and even help find equipment at the gym. The Aira Horizon can help users enjoy everyday tasks with a different sense of freedom.
Breast cancer-detecting bra
The iTBra by Cyrcadia Health is more than a bra, but a piece of wearable technology that can help women detect breast cancer. Doctors advise women to have an annual mammogram, but many patients still fail to detect tumors early. The dual breast patches in the iTBra monitor circadian metabolic changes in heat, which is related to cellular activity found often in breast tumors. This data is sent to the users’ device, which can be easily shared with the users’ doctor. Cyrcadia believes that this method can help detect cancer in dense breast tissue four to six times better than mammograms. Cyrcadia believes that this can lower avoidable breast biopsies by 1.2 million.
Hip airbags for the elderly
Some companies are focusing their efforts on creating wearable technology for the elderly. Helite, the airbag technology expert, has created the Hip’Safe specifically with seniors in mind. According to the Centers for Disease Control and Prevention, over 300,000 people 65 and older are hospitalized for hip fractures. Helite’s Hip’Safe is a wearable fanny pack looking device that includes houses sensors, an air cartridge, and airbags. When the device detects the user is falling, the airbags on each side will deploy to prevent the user from a serious injury. The Hip’Safe comes at a hefty price tag of about $750, and the unnatural form factor of the product may deter some people from purchasing the product.
By Shane MacDougall, senior security engineer, Mosaic451
The other day I was asked what is the biggest information security threat facing any company in 2019. Is it ransomware? Some AI powered malware? Overpowering DDOS attacks? I didn’t hesitate – the answer is the same as it has been since I was first asked the question over two decades ago. The biggest threat to our infrastructure remains our users.
Social engineering, an attack where hackers extract information and access, not from traditional hacking attacks, but rather by interacting with a person in conversation, remains a devastatingly effective method of gaining unauthorized information or access to a network. It’s an attack vector that rarely fails. Unlike logical attacks, social engineering leaves no log entries to trip IDS or alert security admins. As organizations invest more dollars into security appliances and next-gen blinky boxes designed to harden their perimeter, attackers are increasingly opting to target the weakest link – the end user.
Recently, I was in Canada at the Hackfest hacker conference in Quebec, as host and organizer of the second installation of its social engineering “capture the flag” competition. The three part competition had the competitors first spend a week searching for specific pieces of information (flags) about their target company, from a list of items provided by Hackfest. The flags range from information that can be used for an onsite attack (who does your document disposal, what is the pickup schedule), those that can be used for a logical attack (type of operating system, service pack level, browser and email client information), networking information which gives the attacker information about the infrastructure (wifi info, VPN access, security devices), and finally information about the employee and the work environment, which could be used to help the attacker pose as an insider.
The second portion of the competition had the contestants hop into a sound proof booth, and were given 25 minutes to call their target company in front of an audience, and to gather as many flags as possible based on their dossier information. The third and final segment had competitors randomly draw a target, then each contestant had 30 minutes to use the audience members to search the web for flags or phone numbers to create a workable dossier. Each competitor was then put back into the booth to make another 25 minutes worth of calls in hunt of flags.
The results of this year’s contest were eye opening, but sadly reminiscent of last year’s event. Of the eight companies targeted, all gave out information that would give an attacker an advantage for a remote attack, on-site attack, or both. Specific breakdowns of results include:
75 percent visited a URL provided by their attacker
100 percent gave information about what version operating system/service pack version they were running
88 percent gave detailed information on what internet browser they were using
75 percent divulged information about Wi-Fi within their network
63 percent divulged information about secure document shredding, including their provider and the schedule for disposal
63 percent divulged detailed information about their email client
75 percent gave detailed information about the internal computer network
75 percent shared personal information about themselves and their work history
One of America’s oldest toy companies, Hasbro, recently gathered 150 developers and created 45 products that would have cost billions of dollars in a traditional research setup. How did they do it? They held a hackathon. When a traditional toy company sees the rewards of hackathons, everybody else should be paying attention.
And in some industries, they are doing just that. Hackathons have been taking place for years in tech, manufacturing and consumer goods markets, but then there’s healthcare: an industry known for its conservative, slow-to-adopt philosophy when it comes to new technologies. But the good news is that hackathons have now gone viral in healthcare—a market where innovation and talented minds are sparking the next wave of care transformation. The reason for this revolution is rather simple: When like-minded individuals across disciplines, with lots of energy get together, great things can happen.
So what exactly are hackathons all about?
New ideas, fast
Think of a hackathon as product ideation, development, and roll-out on steroids—often in a single day. Hackathons bring the adrenaline and clarity that comes from working under a tight deadline to a motivated group of individuals dedicated to a single task. The tight timeframes of hackathons compress grand ideas and distill them into an actionable approach that can be reasonably delivered.
And we’re talking about more than the creation of a simple app. A requirement for a hackathon can also be to define the business case behind a new product or to conceive of the infrastructure that will support it.
For example, the Icahn School of Medicine at Mount Sinai recently hosted its third annual Health Hackathon. With more than 100 participants from clinical, scientific, computer science, business and engineering backgrounds, this year’s theme was problems related to rare diseases, a major challenge in healthcare. Finalists presented solutions, such as a reinvention of the walker for patients with Huntington’s Disease, smartphone-based eye-tracking technology so immobile patients can interact with connected devices, and a smartphone app to provide diet-based tracking for those with metabolic disorders.
In another example, the Cleveland Medical Hackathon hosted at the HIMSS Innovation Center, produced revelations such as a wristband that senses stress levels in the blood and electrical activity in the heart to help a patient monitor cardiac activity at home; a health portal that rural patients can access without the Internet through an SMS-based interface; and headgear to help blind and visually impaired people navigate unfamiliar environments—created using $20 in parts and open-source technology.
Herald Health, a company recently acquired by Persistent Systems, also recently launched an intelligent workflow and care delivery solution to address the deluge of data overwhelming healthcare professionals. The solution was created at a hackathon sponsored by the Digital Innovation Hub (iHub) at Brigham and Women’s Hospital.
The value of perspective
Your internal teams may be excellent, but there’s something extraordinary in getting insight and inspiration from someone on the outside, with a new perspective, who is new to your particular challenge. And, with low cost of failure, a developer can pursue innovations that would be impossible with accountable budgets and board members to answer.
Chairman Lamar Alexander (R-Tenn.) welcomes Senators Mitt Romney (R-Utah), Mike Braun (R-Ind.) and Jacky Rosen (D-Nev.) to the Senate Health, Education, Labor, and Pensions (HELP) Committee, after Senate leaders announced committee assignments for the 116th Congress:
“I welcome Senators Mitt Romney, Mike Braun and Jacky Rosen to the HELP committee and look forward to working with them on reducing healthcare costs for Americans, making the cost of college worth it for all students, and continuing to work with the Trump Administration to help grow jobs and raise family incomes. The work we do in our committee touches the lives of virtually every American—former Chairman Ted Kennedy once said that the committee had 30 percent of the legislative jurisdiction of the Senate—so we are very fortunate to have such a talented roster of senators.”
The Senate HELP committee will be composed of 12 Republicans and 11 Democrats. Sens. Todd Young (R-Ind.) and Michael Bennet (D-Colo.) vacated the committee after the 115th Congress.
Below is the full list of the Republican members of the HELP Committee for the 116th Congress:
The approval of electrocardiogram’s (EKG) through the FDA that enables atrial fibrillation detection right from a patient’s watch band is just one example of how the digitization of medical devices, a part of the Internet of Things movement, is leading product development and innovation in medicine. However, while medical devices built on a connected services platform include components for data storage, security, accessibility, and mobile applications, along with advanced analytics, successfully implementing artificial intelligence to drive actionable intelligence remains a challenge from an execution perspective. According to Gartner, 85 percent of data science projects fail. Successful integration of data science into medical device development requires a rethinking around the role of data science in product design and life-cycle management.
Viewing data science as a product
While data science is rightly defined as the process of using mathematical algorithms to automate, predict, control or describe an interaction in the physical world, it must be viewed as a product. This distinction is necessary because, like any medical product, data science begins with a need and ends with something that provides clear medical utility for healthcare providers and patients.
It is erroneous to restrict the realm of data science to just the designing of algorithms. While data scientists are good at fitting models, their true value comes from solving real-world problems with fitted data models. A successful algorithm development process in data science includes business leaders, product engineers, medical practitioners, and data scientists collaborating to discover, design and deliver. For instance, a typical data science integration with a medical device product would include many of the following activities:
Identifying the medical need
Identifying proper data variables
Developing the right analytic models
Designing analytic algorithm integrations
Performing testing and verification
Deploying beta versions
Monitoring real-time results
Maintaining and updating algorithms
Considering data science as a product or feature of a product provides organizations with a different paradigm for execution focused on a tangible outcome. Data scientists are trained to develop accurate models that solve a problem, but the challenge many companies face is operationalizing those models and monetizing their outputs. Furthermore, conceptualizing data science as a product will ensure companies focus on its implementation, rather than just its development.
Advanced analytics: Part of the process, not an afterthought
Designing intelligence (even AI) into a connected medical device first depends on whether the data is being used to make a real-time decision or report on the outcome of a series of events. Most companies don’t realize the layers of advanced analytics that create actionable intelligence. By understanding these layers, which range from simple rule- and complex rule-based analytics to asynchronous event rules, complex event processing, and unsupervised learning models, companies can move quickly into developing mature analytics that have an impact from day one. As a company matures its analytics system from descriptive and diagnostic to predictive and prescriptive, it should also evolve to include strategic opportunities to provide business value, including automating decisions that can be delegated to a smart decision-support system.
Successful integration involves viewing advanced analytics as an architecture and not as a single solution to be implemented. The best way to make sure that you are successful in analytic development is to follow a continual process of discovery, design and delivery. For instance, data science architecture may begin with a business question, requiring you to determine if you have the right data and can actually leverage that data in the existing IT system. If you don’t answer this basic question, you will have challenges fully vetting the analytic opportunities available to you.
Recognizing common challenges in data science execution
Data science execution is often impaired by common missteps, like incongruence between customer and business needs and solving technical problems when it’s too late to have a positive impact. Another significant mistake from the business side is treating data science like a one-time accomplishment and not realizing it is a continuous process, or like a software development process with an unwarranted fixation on tools rather than skills and capabilities.
To use a common metaphor, data science is not a single moon shot, but laps around a track. Ultimately your goal is to run progressively faster around the track. An equally major drawback hindering execution is artisan thinking where design is seen as the ultimate end to the data science process. In fact, the most desirable approach is a modular system with emphasis on consistently maintaining and improving what has already been designed. This is particularly true for medical devices where innovation and changes in technology are continuing to better support and enable patients and practitioners.
Errors in prescription can happen for various reasons, like pharmacists’ incompetence, miscommunication between clinicians or doctor’s bad handwriting. Among medication errors, prescription inaccuracy is one of the major causes of concern for healthcare professionals. Today’s most effective technological solution is to implement an electronic prescribing system. With the help of e-prescribing software, prescription errors can be prevented in 80 percent of cases. It is also an actual solution for the opioid epidemic that puts Americans’ lives at risk.
The results, indeed, are impressive. But at the same time, eRx systems are considered inconvenient and costly for small practices. We’ve tried to explore e-prescribing market and identify the main problems of widespread system adoption.
Hitchhiker’s guide to eRx
Electronic prescribing (eRx) is a system that enables healthcare providers to generate digital prescriptions and send them to pharmacies directly from the point of care. e-Prescribing, in fact, improves accuracy, enhances patient safety and quality of care since there is no handwriting.
Systems integrated with EHRs, which include comprehensive patient data.
Stand-alone systems, which means that they can be used only for e-prescribing.
Some eRx systems offer advanced features that allow healthcare providers to access generic medication alternatives, insurance benefit info, and patient medication lists and histories. These extra features have the potential to improve physicians’ decision-making capabilities and increase the use of e-prescribing systems.
E-prescribing market analysis
A prospective EHR vendor has to comply with the regulatory requirements of their customers and know how to develop e-prescribing software. But is investing in eRx worth it?
According to the recent Transparency Market Research, the global market for e-prescribing is expected to reach a CAGR (Compound Annual Growth Rate) of 23.5 percent from 2013 to 2019. Persistent Market Research estimated that the market will reach $887.8 million in 2019.
While Europe holds the largest share in e-prescribing market, the US turned out to be the fastest-growing region. Indeed, increasing adoption of healthcare management software and extensive use of health IT for patient engagement are the key factors in industry growth. Furthermore, electronic prescribing is a requirement for healthcare providers aiming at achieving meaningful use under the Medicare and Medicaid EHR Incentive Programs.
What do prospective vendors need to begin with electronic prescribing?
Major players on e-prescribing market: Cerner Corporation, DrFirst, HealthFusion, Surescripts, Allscripts Healthcare Solutions Inc., Aprima Medical Software, eClinicalWorks, athenahealth Inc. and Relayhealth Corporation.
To show what usability results you can expect, we have chosen the case of Surescript as an “open-source” company. Surescript is a VA-based operator of a nationwide electronic network for prescription-related data and information. Its platform connects EHRs, pharmacy benefit managers (PBMs), pharmacies and clinicians, plus health plans, long-term and post-acute care organizations.
Their 2017 National Progress report shows that 13.7 billion secure health transactions took place via the Surescripts network including 1.74 billio e-prescriptions. This is a 26 percent increase from 2016. This improvement was owing to five key elements: Drug Description, Representative National Drug Code (NDC), RxNorm, Structured and Codified Sig and Potency Unit Code.
Moreover, the network connected 1.47 million healthcare professionals — 13 percent more than in 2016 — with secure patient data for 233 million Americans, or 71 percent of the population.
Various government initiatives which focus on reducing medical errors, and the need to cut escalating healthcare costs foster the growth of the eRx market. The increasing cooperation between software vendors and network providers and the vast untapped regions are expected to provide significant development opportunities for industry players.
Health Level Seven International (HL7), the global authority for interoperability in healthcare information technology with affiliates in 35 countries, announced that it has published release 4 of the HL7 Fast Healthcare Interoperability Resources (FHIR) standard. This new version is the culmination of 18 months of extensive work to finalize the base parts of the specification and incorporates changes and enhancement requests received from implementation partners around the world.
HL7 FHIR is a standards framework that leverages the latest web standards and applies a tight focus on implementation. FHIR includes a RESTful API, which is an approach based on modern internet conventions and widely used in other industries. The standard represents a significant advance in accessing and delivering data while offering enormous flexibility and ease of development. For patients and providers, its versatility can be applied to mobile devices, web-based applications, cloud communications and EHR data-sharing using modular components. FHIR is already widely used in hundreds of applications across the globe for the benefit of providers, patients and payers.
The most significant change in HL7 FHIR Release 4 (R4) is that the base platform of the standard has passed a normative ballot and will be submitted to the American National Standards Institute (ANSI) as a normative standard. This means that future changes should be backward compatible so applications that implement the normative sections of R4 no longer risk being nonconformant to the standard. The following portions of the standard are now normative:
The RESTful API, the XML and JSON formats, and the basic datatypes
The Terminology Layer (CodeSystem and ValueSet)
The Conformance Framework (StructureDefinition and CapabilityStatement)
The key resources Patient and Observation
Thousands of other R4 updates and changes have been made in response to implementation experience and quality review processes.
On December 2016, the 21st Century CURES Act was signed into law, resulting in new regulations for the home health industry. The CURES Act mandates the use of electronic visit verification, or EVV, for all Medicaid-funded personal care services. On Jan. 1, 2019, these new federal requirements for EVV went into effect for personal care services.
EVV is a method of utilizing electronic technology to capture point of service information related to the delivery of in-home services, such as:
Type of service performed
Individual receiving the service
Date of the service
Location of service delivery
Individual providing the service
Time the service begins and ends
Types of EVV
There are three ways through which Home Health Care provider companies can comply to the new regulations involving CURES Act. Let’s take a closer look at them.
This type of EVV solution uses a dedicated hardware device which is used to record caregiver’s scan of fingerprints or record voice samples to register visits.
Biometric recognition may seem like a good solution to comply with EVV at first, but this system has some drawbacks. These devices are expensive and each care recipient has to have a dedicated biometric device installed on their premises. It can be an inconvenience to both the business and the patient.
Telephony method is commonly used in the home setting and don’t require the companies to install or service any devices. To record a visit with this method, the caregiver uses a recipient’s landline phone to dial a toll-free number at the start and completion of service delivery.
Based on a recent National Health Interview Survey (NHIS), it was found that almost half of the US household do not have a landline and are rapidly losing relevance. Smartphones have taken over and landlines are becoming obsolete. The decline of landlines makes this option historical and therefore a weak contender as an effective EVV solution.
Mobile technology (phone and tablets)
The modern EVV solution for all types of caregivers uses the app on the mobile devices, specifically smartphones and tablets. Most modern mobile devices have GPS for location-based Electronic Visit Verification via GPS tracking and geofencing.
Smartphones and tablets are constantly evolving and are becoming more powerful, and with increasing affordability of key technologies like mobile apps, sensors and cloud technology, the mobile technology offers to be the most future-proof EVV option.
Mobile technology EVV solutions go far beyond simple proof of visit. These more comprehensive solutions frequently combine mobile applications with back-office portals, providing additional functionalities:
In the more than 20 years since the landmark passage of the Health Insurance Portability and Accountability Act (HIPAA), healthcare organizations have come a long way in protecting the security and privacy of patient data. Organizations now use sophisticated tools in the form of electronic health records (EHRs), online patient portals and virtual clinics that have elevated modern medicine to a new level of care. As a result, patients have come to expect a seamless interaction – whether digitally or in-person – with their healthcare provider, and trust that their personal information is safeguarded throughout.
But just as these new digital records and online portals make it easier to access and manage patient care and medical history, there still looms a security threat that organizations may not be as well-equipped to prevent. Despite the regulations put in place to guard against privacy violations and data theft, healthcare data breaches now occur at a rate of more than one per day, with nearly 60 percent of these breaches coming from insiders. You read that right. Unfortunately, the greatest threat to a healthcare organization may not always be from outside cybercriminals hacking into an organization’s network and stealing patient medical records. While the vast majority of healthcare workers are good and honest people, it only takes one employee succumbing to curiosity and taking a peek at a patient’s EHR without a valid reason, to violate HIPAA compliance laws and potentially cause a massive data breach.
Why are insider threats on the rise?
The healthcare sector employs tens of millions of people across the country, and organizations go to great lengths to hire quality employees. But the fact remains that access to sensitive information, coupled with large organizations that employ people with varying levels of commitment – whether full-time, part-time or as contractors – can present opportunities for unethical and unlawful actions.
For instance, I recently spoke with Phil Fasano, CEO and co-founder of Bay Advisors, LLC, and former executive at Kaiser Permanente, and he noted that the size of many large healthcare providers is more like a city than a business, and they often employ temporary staff and contractors. When he was executive vice president and chief information officer at Kaiser in the early 2000s, the organization employed more than 300,000 people, with some 60,000 to 80,000 being temporary, such as contact center workers, custodians and administrative staff. In high turnover roles and with temporary staff, not only may there be a lower familiarization with compliance regulations and data security protocols, there may also be a greater willingness to skirt the rules for short-term gain. Thus it becomes even more imperative for businesses to have the right tools, technology and training in place in order to ensure data security and privacy – not only to comply with the law, but to protect patients and the long-term viability of their business.
This issue is not hypothetical. There have been many high-profile examples in the news of healthcare insiders stealing patient data to use for fraudulent purposes, or simply viewing it out of sheer curiosity, which is still a major violation. In a recent case of identity fraud, UMass Memorial Healthcare had to pay $230,000 to settle a lawsuit that resulted from two employees stealing patient information to open credit card and cellular phone accounts. In a truly egregious example from several years ago, an employee of the UCLA Medical Center leaked the late actress Farrah Fawcett’s cancer diagnosis to the National Enquirer before she even had the opportunity to break the news to family and friends herself. These cases are unfortunately not isolated incidents. Shockingly, a recent survey of healthcare workers found that one in five would be willing to sell confidential patient data if given the opportunity.
How to mitigate insider threats
First and foremost, healthcare organizations should institute mandatory background checks on all full-time, part-time and temporary hires – no exceptions. They should also aim to improve employee awareness and understanding of the laws by conducting annual training sessions and refreshers on all relevant data security and privacy regulations, including HIPAA, the General Data Protection Regulation (GDPR) and the Payment Card Industry Data Security Standards (PCI DSS) – this last one being especially important for patient billing and contact centers that handle payment card data. There are also several advanced technologies and strategies that an organization can implement to improve its defenses from insider threats, namely:
Establish staff guidelines for patient record access
The best way to avoid an internal compromise of sensitive information is to establish and enforce the principle of least privilege user access (LUA) on all computer systems, which states that an employee should only have the minimum level of access necessary to do their job. For example, an agent in the health system’s contact center may need access to some patient data such as payment or scheduling information, but they may not need to see information about medical history. Creating LUA controls limits unnecessary access and adds a strong, first level of security.
Monitor and flag staff access to patient data
Systems can include various levels of protection, from asking employees to enter password information twice before accessing confidential patient information, to red-flagging abnormal activity. Red-flagging provides an alert to senior staff of suspicious behaviors in the cases where an employee may be accessing large amounts of patient information or performing irregular activities within the network.
If you are looking for good business ideas, the healthcare industry should be your first option. The industry is a fantastic place for individuals with healthcare-related business ideas as well as aspiring entrepreneurs to invest in. Exploring these ideas is excellent for many reasons. There is an opportunity to serve the aging population in the country and helping individuals who are struggling with the drug crisis.
Currently, there are many technological and medical advances as well as widespread interests in health and wellness. All these are great incentives for healthcare entrepreneurs. Also, combining all these factors means that there is a thriving market for the health-related businesses and medical staffing network.
Aspiring entrepreneurs can convert one of the many health-related business ideas into viable ways to make a living. But before getting started, they need to understand how staffing, liability, and HIPAA guidelines play into their decision making since non-compliance can result in closures and fines depending on the severity of the violation. Here are the main healthcare businesses ideas that can help you invest in the industry:
Medical mobile screening
When thinking about a new healthcare-related business idea, then medical mobile screening is a good option for you since it requires less investment. Medical mobile screening is nothing but a simpler version of booking a physician’s appointment, ordering medicines, and scheduling vaccinations through the use of digitized technology.
This means that an individual can do all these activities without visiting a doctor or queuing for long hours while waiting for their turn to come up. From the business person’s point-of-view, this simplicity means far less overhead. Better yet, a medical staffing agency can be used to find worthy candidates from around the globe, further reducing business expenses by removing the need to headquarter everyone in the same location. The staff, just like the patients, can be situated virtually anywhere with an internet connection.
Retail pharmacy business
This business is the simplest and easiest way to venture in the healthcare industry. It is among the most flourishing and productive healthcare businesses in the sector today. If you are looking forward to establishing your own drug store business, you must a abide by the current regulations of the retail pharmacy business that manage and guide the stockpiling, sourcing supply, sale and recording keeping in regard to the HIPAA compliance.
Retail pharmacy business is the best for individuals planning to open a store in the vicinity of medical facilities since demand is more in such locations. The retail pharmacy business is among the growing and profitable healthcare business opportunities that never go out of consumers since they have daily use products.