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Scanadu Medical Tricorder | Highlight HEALTH 2.0

Medical tech startup Scanadu has created a scanner called the Medical Tricorder, which measures key vital signs, reads simple samples and sends all information directly to your smartphone.
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EHR MU – Interoperability, But of What?

EHR MU – Interoperability, But of What? | Mobile Health Care | Scoop.it
Stage 2 of the federally defined Meaningful Use (MU) is now upon us (details here), and a recurring theme is clearly interoperability. But what this means, and to whom, has not always been clearly presented.
Luca M. Sergio's insight:

a good exposition of Stage 2 Meaningful Use and interaction between EHR and medical devices

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Sensor net to help monitor homebound seniors

Sensor net to help monitor homebound seniors | Mobile Health Care | Scoop.it
How to implement the medical home, using new #mHealth sensors ...Sensor network to help monitor homebound seniors (Sensor net to help monitor homebound seniors. May identify gait changes for early fall prevention.
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Global mHealth Industry Expected to Hit $23B by 2017

Global mHealth Industry Expected to Hit $23B by 2017 | Mobile Health Care | Scoop.it
Healthcare Technology (Global mHealth Industry Expected to Hit $23B by 2017 #mHealth http://t.co/gezb03GL)...Another referencing of this market sizing ....
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5 Healthcare predictions for 2013 

5 Healthcare predictions for 2013  | Mobile Health Care | Scoop.it
This would not be a normal Holiday Season if predictions for the next year to come have not started popping-up across the social media world. Well, I am not sitting on the sidelines.
Luca M. Sergio's insight:

some good predictions ... Specifically regarding #mHealth, I completely agree with his statement, "Physicians will flock to begin prescribing apps that are not just stand-alone silos of data, but can integrate into their workflow and improve patient care and decision making abilities."


The creation of disease/condiition specific, cloud-enabled workflows will drive success in this area.  A key will be to ensure that such workflows are constructed in a fashion that will permit future interoperability with broader EHR and HealthIT systems.

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iPhone App From Orion Health Connects Doctors to HIE Data

iPhone App From Orion Health Connects Doctors to HIE Data http://t.co/2hK09UYU
Luca M. Sergio's insight:

how to connect "bigger data" from HIE pools back to the provider level?  Here's an example ... If done well, this holds the promise of offering up deeper clinical insights at the point of care ...

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gary levin's comment, December 22, 2012 1:22 PM
This is a good idea, Patients too can benefit from their own PHR data
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IPS – Africa’s Mobile Health Revolution | Inter Press Service

IPS – Africa’s Mobile Health Revolution | Inter Press Service | Mobile Health Care | Scoop.it
Africa’s Mobile Health Revolution - A nurse working in a remote clinic in Mueda, a small town in northern Mozambique’s Makonde Plateau, receives a shipment of vaccines from the national health department.
Luca M. Sergio's insight:

frankly, how wonderful to be involved in a technology / change-of-practice movement that can help so many in need, while also innovating and leap-frogging the developed world ... many lessons to be learned

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“What’s The Future Of Doctors When Sensors In Your Electronics Diagnose Disease?”

“What’s The Future Of Doctors When Sensors In Your Electronics Diagnose Disease?” | Mobile Health Care | Scoop.it
“In a future where biometrics are measured constantly and interpretation is aided by algorithm, what do we want our health professionals to actually do?
Luca M. Sergio's insight:

resistance to change: as progressive as most providers are, the reality is that new tech emerges and instantly many feel threatened ... this will a core point of resistance to widespread adoption of #mHealth and broader #HealthIT solutions ... the key question for each new technology solution provider is: how to reach that tipping point of acceptance wherein doctors realize that these tools permit them to practice medicine at a higher level, synthesizing different data inputs into a holistic view of the patient ....

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Our augmented selves: The promise of wearable computing

Our augmented selves: The promise of wearable computing | Mobile Health Care | Scoop.it
By Donald Melanson and Michael Gorman It\'s been an interesting year for Google\'s most famous side project.
Luca M. Sergio's insight:

Google Glasses and other wearables are coming or are here ... They present so much opportunity to gather useful #mHealth data sets ... How to handle not only the workflow of gathering, routing and transmitting will be essential, but even more so, the ability to build intelligence into the systems so that only essential, out-of-norm data points trigger alerts to medical providers, promting their human intervention to drive patient behavioral change.

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mHIMSS and mHealth 2012 - the year in review | mHIMSS

mHIMSS and mHealth 2012 - the year in review | mHIMSS | Mobile Health Care | Scoop.it

Via Sam Stern
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a nice overview of advances in #mHealth
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Omada Health Takes the Diabetes Prevention Program Digital | HealthWorks Collective

Omada Health Takes the Diabetes Prevention Program Digital | HealthWorks Collective | Mobile Health Care | Scoop.it

The landmark Diabetes Prevention Program (DPP) study was published in the New England Journal of Medicine on February 7, 2002, a bit more than a decade ago.  It demonstrated conclusively that progression from prediabetes to diabetes could be prevented by weight loss and increased physical activity (oh no, not that again!).

The results of this study were impressive.  Individuals randomized to receive “intensive lifestyle modification” had a mean weight loss of 7%, reduced the prevalence of diabetes by 58% in the overall group and by 71% in the group over age 60. The now popular diabetes medication, metformin, also reduced the risk of developing diabetes, but not nearly as much as the healthy behavior changes.

So here we are, once again, facing the cold hard truth that when it comes to diabetes and obesity (aka “diabesity”), changing bad behavior is the essential work that needs to be done – by patients, their families, clinicians, and, I would add society as a whole, if we are going to make a dent in the epidemic.

It is not going to be easy and it is going to be expensive – but not, my dear readers, as expensive as continuing the status quo. A September 2011 paper in Health Affairs (30:9, 1673-1678), authored by Kenneth Thorpe and Zhou Yang, estimates that Medicare alone could save $1.8-2.3 billion over the next 10 years if prediabetics, aged 60-64, were enrolled in a community-based program similar to the National Diabetes Prevention Program.  Depending on how broadly program eligibility is defined, savings could be as high as $7 to $15 billion.  Failure to enact such a program means that we would spend that money.

So what exactly is “Intensive Lifestyle Modification?”

The original DPP intervention was a sixteen-lesson curriculum that covered diet, exercise, and behavior modification.  It was taught one-on-one over the course of 24 weeks by registered dietitians or trained case managers with master’s degrees (hmmmm, seems a bit of overkill to me – even my mama told me to eat my fruits and veggies.)  In addition to the personal trainers, participants received ~$100 per year to spend on exercise classes and videos, healthy cookbooks and the like.

I remember colleagues at the time the original DPP study was published saying, “interesting, but way too expensive to work in the ‘real world.’”  In an effort to make the DPP more affordable, the YMCA of the USA created community based programs that retain the principles of the original program, but reduce the cost by enrolling people in groups of ten to twelve in a 16 week program that cover the same material.  They also eliminated the subsidy for classes, videos and books.

A randomized trial (the DEPLOY pilot study) found the (pardon the pun) skinnier version of the DPP delivered almost the same results as the original, but it cost more than $1100 less per person per year (Am J Prev Med 2008, p 357-63).  But we are still talking about a relatively expensive brick and mortar program.   What if the DPP could be moved out of a building and onto the web?

Enter Omada Health

Today, December 11, 2012, is launch day for this Silicon Valley startup founded by CEO Sean Duffy and friends.  I first met Sean at FutureMed and later reconnected via activities at Rock Health – the San Francisco based startup accelerator where the company was incubating.  What he told me in our first conversation shocked me.  He was, he said, on a leave of absence from Harvard – one of the most prestigious Medical Schools in the country.  Not only that, he had been in the combined MD-MBA program.  In my medical school days, we would have considered voluntarily leaving such a program the act of a mad man.  Medical School was THE educational prize of my generation – you would have given your eyetooth to get in and you never, ever, ever would have dropped out (sorry, Sean, taken a leave of absence.)

But I soon learned that this guy was not and is not a mad man – he is a brilliant, hard-working entrepreneur who has taken on one of the most important health issues of our day and created a great digital solution.  It is aptly called Prevent.

 

 

Prevent combines the evidence-based approach of the original DPP with the convenience and efficiency of internet.  The Omada team worked with an interdisciplinary group of technologists, entrepreneurs and clinicians from Google, Amazon, IDEO, Harvard, Stanford, and Columbia to create an accessible technology with the potential to prevent disease and promote health.  They also attracted an outstanding group of Advisors, including endocrinologist Dr. Anne Peters, from USC and Dennis Boyle, Co-Founder of IDEO.

Like the original program, Prevent has a 16 lesson curriculum that, according to their fact sheet, is “scientifically-supported, and uses cutting-edge principles of behavior change in a way that’s fun and engaging.  Participants are divided up into small online groups based on age, BMI and location.  Each participant is mailed a “no-setup” wireless scale that automatically transmits daily weigh-ins to private personal profiles.  A pedometer tracks daily activity.  Each participant receives one-on-one telemedicine support from a professional health coach.

Sean told me, “this is not a static replication of the on-the-ground experience.“ Rather it paints a post digital post card for the patient of how they will look and feel after completing the program. “Imagine yourself in 16 weeks, he said, “new friends, new clothes, more energy…and we show you a structured timeline to get there.”

Getting the DPP to Scale

 

Although some people may prefer to have this intervention delivered in person, others may not.  Community-based, in person programs require centers to administer them, a population of potential clients located near those centers, and, of course all the overhead that goes with brick and mortor anything. The future of the DPP at scale, Sean said, is using the web.  This seems like a no brainer to me…think Amazon, Zappos, Kahn Academy, etc. etc. etc.

Part of getting to scale is finding the right reimbursement model.  Although Omada will be offering Prevent direct to consumer for $480 for the 4 months program (comparable to other leading weight loss programs), their biggest market will be insured people, particularly now that the Accountable Care Act is not as endangered as it was pre-election.

On this front, Omada has what appears to be almost perfect timing.  Senate bill 3463 was introduced on July 31, 2012.  This bill proposes that “a qualified diabetes prevention program” be offered as a Medicare covered benefit (100% coverage – no co-pay or deductible) if I am reading it correctly.  And, we all know that Medicare Advantage plans and commercial insurers are likely to follow Medicare’s lead on this.  According to Sean, United Health Care is already paying for on-the-ground DPP programs.

From a business perspective, THIS IS BIG.  Someone besides the consumer is going to pay for the program – this is the big jackpot all healthcare care entrepreneurs hope for (eat your hearts out, guys). Also good timing for this young company is the emergence of new models of care and reimbursement, such as Accountable Care Organizations, that will be rewarded for improved outcomes and lowered cost of care.

If Omada can meet the criteria to be a qualified program, they will have achieved the dream of every health care startup entrepreneur I have talk to  – being a coveted “covered benefit.”

So, Does it Work?

It is one thing to say you are going to build an online health program that mimics an in person program known to work.  But, if you build it, will they use it?  And if they use it, will it deliver the same results?  Omada smartly designed a study to test Prevent’s efficacy early on.  Although only a pilot – and not a “gold standard” randomized controlled design, the results of its recent 230 person trial resulted in an average weight loss of 13.7 pounds (or 6.5%) – almost the same as the original DPP study results.  Pretty good.  Of course, an important question is whether the weight loss is sustainable overtime – the company is in the process of evaluating their 6 months results.

mHealth – the Real Health Care Reform?

Ok, so I really like what Omada Health is doing.  It is not just a technology solution, as Sean told me, “it is really a human social connection solution – it brings together all of the elements that exist in our current siloed health care world.”  The Omada platform has the potential to be applied to other chronic conditions.  And, it isn’t just Omada that I am crazy about – it is the entire mHealth world of young (and not so young) entrepreneurs – physicians, nurses, physical therapists, pharmacists joining hands with software engineers and experts in design and user experience to create a new, more accessible, more consumer friendly and hopefully more effective health care delivery system.  Now that is real reform


Via Chaturika Jayadewa
Luca M. Sergio's insight:
an innovative approach to such a prevalent chronic disease
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High Quality, Low Cost HealthCare Video Interview Series: e-Patient Dave deBronkart

High Quality, Low Cost HealthCare Video Interview Series: e-Patient Dave deBronkart | Mobile Health Care | Scoop.it
Dave deBronkart is a cancer survivor, internationally known keynote speaker and author, the spokesperson for patient engagement and a key member of the Society for Participatory Medicine.
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Ginger.io Raises $1.7M for Mobile Health IT, Rides Wave of MIT Media Lab Startups Trying to Understand People | Xconomy

Ginger.io Raises $1.7M for Mobile Health IT, Rides Wave of MIT Media Lab Startups Trying to Understand People | Xconomy | Mobile Health Care | Scoop.it
First of all, the name is Ginger.io, not Gingerd. The latter is how the company was incorporated; but the former is its real name. And real is what Ginger.

Via Nancy Gertrudiz
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Mobile Devices, Imaging Apps, and the Future of Healthcare

Mobile Devices, Imaging Apps, and the Future of Healthcare | Mobile Health Care | Scoop.it
Physicians are incorporating iPads and other mobile devices into their practices at an unprecedented pace. A 2012 study conducted by Manhattan Research, involving 3,015 U.S.
Luca M. Sergio's insight:

nice discussion of PACS and diagnostic imaging, and improvements to doctor - patient communications

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Mobile Health Implementation in Asia : Issues & Action Plan for Sta...

mHealth (mobile health) implementation is changing the operating paradigm for relevant stakeholders: patients, care givers, and payors.
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an interesting #mHealth slide deck calling out two examples of malaria in Indonesia and diabtest in India

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Clinical trials still ripe for mobile-enabled innovations

Clinical trials still ripe for mobile-enabled innovations | Mobile Health Care | Scoop.it
Mobile technology presents a sorely-needed, long-awaited opportunity for innovating the clinical trial – making it cheaper, easier, and even more accurate.
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Deloitte | mHealth in an mWorld | How mobile technology is transforming health care

Deloitte | mHealth in an mWorld | How mobile technology is transforming health care | Mobile Health Care | Scoop.it
Report says mobile apps only scratch the surface of possibilities offered by mHealth.This is a good abstraction of overall trends and key dynamics.
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Transforming Health with Mobile Technology

Transforming Health with Mobile Technology | Mobile Health Care | Scoop.it
The evolution of how text messages can impact health around the world, especially for expectant mothers, is changing rapidly.
Luca M. Sergio's insight:

Let's hear it for continued efforts to employ simple #mHealth solutions to improve maternal health ... with just simple information, consistently provided, we can see major improvements in global health

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Monitor Vital Signs & Send Emergency Alerts Wirelessly with SecuraPatch & the SecuraFone Health Mobile App - PR.com

Monitor Vital Signs & Send Emergency Alerts Wirelessly with SecuraPatch & the SecuraFone Health Mobile App - PR.com | Mobile Health Care | Scoop.it
Monitor Vital Signs & Send Emergency Alerts Wirelessly with SecuraPatch & the SecuraFone Health Mobile App - on PR.com (Monitor Vital Signs & Send Emergency Alerts Wirelessly with SecuraPatch & the SecuraFone Health Mobile App
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great to see continued innovation in mHealth sensors to enable real-time alerts ...

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mHealth Summit 2012: Industry Volatile Over the Past Year: Float Mobile Learning

mHealth Summit 2012: Industry Volatile Over the Past Year: Float Mobile Learning | Mobile Health Care | Scoop.it
After reviewing the exhibitors at the 2012 Mobile Health Summit, Gary Woodill suggests the turnover rate shows the mobile health industry has changed dramatically in a year.
Luca M. Sergio's insight:

a great summary of the #mHealth Summit for those of us unable to attend this year...

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What mHealth Professionals Keep Asking: Don't Patients Want to Get Better?

What mHealth Professionals Keep Asking: Don't Patients Want to Get Better? | Mobile Health Care | Scoop.it
Combating the barriers to patient adherence requires a disciplined, and focused and cost-effective approach. This approach must encompass all the stakeholders in the healthcare equation including payors, pharmas and providers.  By looking at patient behaviors, motivations and understanding, we can effect change at the patient level.

Via Giuseppe Fattori
Luca M. Sergio's insight:

I couldn't agree more ... for all of us involved in #mHealth, it's not about the nifty tech, it's about driving meaningful behavioral change on the patient (and sometimes provider) level

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Luca M. Sergio's comment, December 21, 2012 4:36 PM
How key this is! The "secret sauce" must be in driving patient behavioral change.
gary levin's comment, December 22, 2012 1:24 PM
And that is the biggest challenge ! Perhaps we should offer a tax incentive for meaningful use by patients as well as provider
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Transforming Health with Mobile Technology

Transforming Health with Mobile Technology | Mobile Health Care | Scoop.it
The evolution of how text messages can impact health around the world, especially for expectant mothers, is changing rapidly.
Luca M. Sergio's insight:

the international development aspects of #mHealth are so compelling from a humanitarian standpoint, yet at the same time the point the way for the healthcare delivery systems of developing economies to leapfrog those of the G7

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Top CEOs Share how Big Data Is Transforming Our Health, Wealth and Security - Forbes

Top CEOs Share how Big Data Is Transforming Our Health, Wealth and Security - Forbes | Mobile Health Care | Scoop.it
In his book Managing in the Next Society Peter Drucker explains the nature of transformation. The Industrial Revolution of the 1820s occurred 40 years after James Watt’s steam engine; and the railroad concept pioneered in 1829 became transformative in the 1860s, setting the stage for national expansion in America. We see this same time pattern in the growth of data of the past few decades where now, in 2012, 2.5 quintillion bytes of data are created every single day. In the simplest terms, the reason it’s now called big data is because of two new elements 1. no-SQL data utilizes parallel processing instead of sequenced processing, which dramatically escalates speed and 2. non-structured data includes blogs, emails, web logs and social media etc., which when added to traditional structured data dramatically escalates data volume.

To gain perspective to the broad impact of big data, I reached out to leaders of healthcare, wealth management and security:

John Dineen, CEO, GE Healthcare

John Thiel, Head of Wealth Management, Merrill Lynch

Naren Gursahaney, CEO, ADT

We discussed how big data is enabling the creation of powerful business models of new services built on personalization for customers. They also warned about the increased need for verification of data. As I consider the parallels to Peter Drucker’s insights, I believe we are now, especially as analytical capabilities advance, taking our first steps into a new epoch … the age of big data transformation.
Via Tom Hall
Luca M. Sergio's insight:
the promise of #BigData should be married with resolving the "garbage in, garbage out" problem: "bigger" data must also be good data
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The Social Business of Fighting Disease

The Social Business of Fighting Disease | Mobile Health Care | Scoop.it

Whilst social media tools have primarily been used for commercial ends, there is a growing stream of evidence showing that it has scientific and social benefits as well. Nowhere is this more so than in the tracking and prevention of diseases.

 

For instance Google Flu Trends tracks search queries and applies its trending algorithm to gain an understanding of where flu outbreaks are occuring. A 21 month study by John Hopkins University found that the app was exceptionally good at predicting when hospitals would start to see people coming in with flu symptoms.

 

Primary investigator of the study, Dr. Richard Rothman, said that the results were promising for “eventually developing a standard regional or national early warning system for frontline health care workers.”

 

Social media context

 

It could be argued however that social media is a better method of tracking the spread of infection because it provides you with better context. Back in January the American Journal of Tropical Medicine and Hygiene reported that tweets and other public ‘status updates’ were a better way of determining the spread of cholera in post-earthquake Haiti than official channels. The research was conducted by scientists at Children’s Hospital Boston and Harvard Medical School and with over 6,000 people having died from the disease in Haiti, it has serious implications in terms of disaster prevention.

 

“When we analyzed news and Twitter feeds from the early days of the epidemic in 2010, we found they could be mined for valuable information on the cholera outbreak that was available up to two weeks ahead of surveillance reports issued by the government health ministry,” said Rumi Chunara, PhD, of the Informatics Program at Children’s Hospital Boston, Research Fellow at Harvard Medical School, and the lead author of the study. “The techniques we employed eventually could be used around the world as an affordable and efficient way to quickly detect the onset of an epidemic and then intervene with such things as vaccines and antibiotics.”


Via nrip
Luca M. Sergio's insight:
so much potential from the social space to identify disease trends and act at an early stage ....
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MHealth Summit 2012: Technology replaces doctors for some tasks

Technology replaced workers in sectors from manufacturing to the grocery store. One speaker at the mHealth Summit 2012 believes health care is next.
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