Mobile Health: How Mobile Phones Support Health Care

rom eye-test machines to ultrasound probes, the smartphone is helping democratize all kinds of medical machinery. What used to be exclusive to well-resourced professionals is now open to many, including the very poor.

Here’s another example of the trend: a spectrometer that costs as little as $200. An iPhone cradle, phone and app, it has the same level of diagnostic accuracy as a $50,000 machine, according to Brian Cunningham, a professor at the University of Illinois, who developed it with his students (see video).

Using the phone’s camera and a series of optical components in the cradle, the machine detects the light spectrum passing through a liquid sample. By comparing the sample’s spectrum to spectrums for target molecules, such as toxins or bacteria, it’s possible to work out how much is in the sample. There you go, easy diagnosis.

Cunningham is yet to commercialize the device, and it isn’t very efficient: you can only work with one sample at a time, while an automated $50,000 machine could process up to 100. But potentially it could make spectrometry more portable. The expensive equipment weighs 50 pounds and "doesn’t go anywhere", as the professor puts it.

And, there’s no loss of accuracy. "We were using the same kits you can use to detect cancer markers, HIV infections, or certain toxins, putting the liquid into our cartridge and measuring it on the phone," Cunningham says. "We have compared the measurements from full pieces of equipment, and we get the same outcome."

We have compared the measurements from full pieces of equipment, and we get the same outcome.

Cunningham is currently filing a patent application and looking for investment. He also has a grant from the National Science Foundation to develop an Android version.

He doesn’t think smartphone-based devices will replace standard spectrometry machines with long track records, and F.D.A approval. But they could enable more testing--for example, in developing countries that currently lack equipment, or among people who want to check their health regularly.

"In the future, it’ll be possible for someone to monitor themselves without having to go to a hospital. For example, that might be monitoring their cardiac disease or cancer treatment. They could do a simple test at home every day, and all that information could be monitored by their physician without them having to go in."

Via hugh mcclung

The Quantified Self has been covered in many global publications recently, but most people still don't know what it is. In this guide, you'll learn everything y

Via Cecile Chelim - MS&QS, Lionel Reichardt / le Pharmageek

Figure1 is a free iOS app (Android to come) debuting today at the Apple app store that hopes to be a “crowdsourced medical image library that healthcare professionals can use to share, rank, and discuss images.” This editor sat down with Annie Williams and Gregory Levey of MovableScience, the company putting out Figure1, back at TEDMED and reviewed a pre-release version of the app.  In comparison to the MobileCT app we wrote about last week, this app is more focused on education and information dissemination rather than diagnosis. It is also not limited to radiology, since it is able to share images from the iPhone camera as well.

In an effort to drive home the privacy concerns of an app that is made to share patient images, immediately after making an account you get a Terms Of Service that is very privacy conscious. I was told that there was a lot of effort put into thinking of ways to protect physicians who use it, and so make it easier to grow the picture sharing community. To help determine the credibility of the description of the image there are different categories of users. When making an account physicians can present their credentials to the company to be identified as an MD user, giving certain posting and tagging privileges.

The app is optimized for the iPhone, but an iPad will work in the the 2X mode. The app uses the iPhone or iPad camera to take an image, lets you crop, annotate, or anonymize the image, and then uploads it to the secure Figure1 database. One of the most secure features of the password controlled app is that the edited images are not stored on the device itself. So if the iOS device is lost the images are not out in the wild and there’s no need to worry about a potential HIPAA violation from the images themselves. Emails and personal photos on the internal storage are another story.

Using the hashtags or image descriptions of existing images in the database users can search for diagnoses or notable findings. If no images that match the search terms exist in the database the app does an internet image search of curated sites to find an appropriate image. The app also tries to learn what the user usually searches for and suggests searches from previous tags and a medical dictionary database. Once an image is found comments can be made and further tags can be added that the rest of the Figure1 community can see. Users can also note “favorite” images to keep them accessible for ready reference.

The version of the app I reviewed was unable to share, but the company reps said the launch version would have two types of sharing. Public sharing with the entire Figure1 user base and private sharing that would work by sharing private images among individual or several users selected from your contact library, such as your study group or hospital colleagues. Once an image is uploaded to be shared, it is reviewed for appropriateness, but still becomes public immediately, and so at the moment it relies on the honesty of the user to prevent the “What is the rash in my private area?” postings, though the review process I was shown looks like it could delete offensive images pretty quickly.

Overall, the app seems most appropriate for medical educational environments or among physicians and healthcare providers who already tend to have their phone on them when they encounter interesting images or visual findings. When combined with the tools in the Smartphone Physical collection it might make for a diverse collection of medical images and findings.

Here’s a quick demo of Figure1:

Via Olivier Delannoy, Lionel Reichardt / le Pharmageek

The new course at Stanford Online, Mobile Health without Borders includes my video entitled "Postcards from Paris" presenting mobile health examples from outside the United States. 
 

 

Via Denise Silber

With the new app Glooko sees its customer base evolving. As always it aims to serve people with diabetes and their care providers, but in conjunction with those care providers or separately, Glooko sees an opportunity to work with disease management entities who can act like coaches to Glooko users. The company won’t comment on any particular deals yet, but it says one of its already announced provider customers, Scripps Health, is already using the Glooko platform to coach some of its patients.

Via Philippe Marchal/Pharma Hub

La santé numérique au coeur de la 1ère Conférence e-health organisée ce vendredi 7 juin au TechnoArk de Sierre. L'informatisation de la santé va en effet au-devant de nombreux défis, puisqu'elle doit permettre de rationaliser les soins et leurs coûts tout en garantissant la sécurité des données des patients. Des orateurs locaux, dont la nouvelle ministre de la santé Esther Waeber-Kalbermatten, interviendront. Mais aussi des représentants de grandes entreprises internationales ou institutions à l'instar de Microsoft, Siemens ou encore l'EPFL. La manifestation, 1ère du genre en Valais, est co-organisée par la Fondation TheArk et la HES-SO Valais.

Via IIG_HES

After mHealth adoption, Europe will save €100 billion in healthcare costs by 2017 as well as add €93 billion in GDP, a new report published by GSMA has revealed.

Via Vincenzo Storti

A new pill has been developed by Proteus Digital Health which sends an SMS alert to a designated mobile phone once the patient has ingested it

Via Olivier Delannoy

Economic Times Biosense's new healthcare app for iPhone under FDA scanner Economic Times Biosense has been asked to clarify why it did not seek prior approval from the regulator before the release of its iPhone app, uChek, the first time where a...

Via hugh mcclung

The conventional wisdom goes that health care is notoriously slow to adopt new technologies. The explosion in the past few years of sensor and app-filled health startups is starting to prove that wrong (emphasis on "starting").

Via TourdeForce

Consumer Health Startup Trends 2013 given by Jihoon Jeong at Health 2.0 Seoul Chapter's first event

Via Bart Collet

There is endless technology for ordering a burrito, turning off the air conditioning or turning on a security system from a cellphone. So why can't healthcare be this simple across the board?

Via Sam Stern

By Laurie Edwards, Next Avenue Contributor

When I received a diagnosis of primary ciliary dyskinesia, a rare genetic lung disease, 10 years ago, one of the first things I did was look it up on the internet. The disorder, known as PCD, is a rare or “orphan” disease, meaning it affects fewer than 200,000 patients in the United States. With only 400 appropriately identified PCD patients in the country, I certainly didn’t know anyone else with the condition. I was 23, I’d been seriously ill since birth, and I wanted to know what I could expect now that my symptoms finally had a label.

Enter the internet and its robust network of patient-to-patient groups. Within a few days of my diagnosis, I’d found listservs, Yahoo groups, a patient advocacy foundation and, later, Facebook groups for patients with my disease and related conditions. The majority of my basic medical knowledge about PCD came from my specialist and respiratory therapists. But I gained much of my insight into the emotional aspects of living with this incurable disease from the anecdotal experiences and shared wisdom of other patients, who answered such questions as: How long would it take my skin to adjust to daily chest physiotherapy, in which the lobes of the lungs are clapped vigorously to help break up secretions? How would this disease influence my mortality? Would I be able to have children? (After a long journey, I am now the parent of a healthy toddler, thanks in no small part to the support and advice of other PCD patients.)

Research from the Pew Internet and American Life project has found that 81 percent of healthy adults report going online regularly, compared with 62 percent of those living with at least one chronic condition. This disparity is attributed to lack of digital access, though, not a lack of interest. And once demographic variables are controlled, being chronically ill significantly increases the likelihood that a person will report working on a blog or contributing to an online discussion, listserv or other Web-based forum that helps people with personal or health problems.

In “Peer-to-Peer Healthcare,” another report from the Pew project, 1 in 4 patients living with high blood pressure, heart disease, diabetes, lung conditions, cancer and other chronic conditions reported turning to the Internet to connect with others who share the same diagnoses, illustrating the widespread desire we have to identify, learn from and support one another.

For the estimated 133 million Americans who live with at least one chronic condition, this shift to patient-centered networks represents a new, more empowering mode of communication, rather than the more narrow one-way dissemination of health facts from doctors alone. It was through a social media patient group that I was able to arrange an in-person meting with another PCD patient — it will likely be the one and only time I ever sit face-to-face with someone else who shares my diagnosis.

(MORE:When Medical Bills Pile Up, Can You Crowdfund Your Health Care?)

It was incredibly validating for me finally to have an accurate diagnosis of my condition and to have entry into a virtual community of people just like me. For millions of others who live with controversial, poorly understood or otherwise neglected disorders, particularly pain-related conditions like fibromyalgia, chronic fatigue and many autoimmune diseases, patient groups offer similar camaraderie and emotional support. Often, such patients feel disenfranchised from the medical establishment that is supposed to help them receive appropriate diagnoses and ongoing care. An “us versus them” mentality is, in many cases, inevitable.

In decades past, patients’ rights activism often included in-person protests and physical mobilization — the disability rights and women’s health movements of the 1960s and ’70s are compelling examples of this. Today, such advocacy groups have adapted particularly well to the virtual environment. These online platforms provide more than emotional comfort. They offer opportunities to get involved in clinical trials and disseminate (and sometimes finance) medical research. They can also be powerful advocates for new research, more effective treatment and improved social support systems for patients and families.

Again, for patients with more marginalized conditions — Lyme disease or chronic fatigue syndrome, for example — the sharing of information and virtual mobilization for research and acceptance is particularly significant. Illness can be incredibly isolating, especially for patients whose symptoms and diagnoses are routinely dismissed by the medical establishment. For these people, patient-to-patient networks don’t simply supplement more traditional support — often, they are the only sources of it.

(MORE:Stop Lying to Your Doctor)

Yet for all their benefits, virtual patient groups and networks also present challenges. Individual experiences that may be extreme examples of disease symptoms or trajectory may get amplified in an online echo chamber, and potentially misleading or confusing information may be repeated as if it is the norm. Alternative interventions may be perceived as accepted medical treatments, leading patients to adopt approaches that might not be fully vetted for safety or appropriate for all patients. Advocates who may lack the health literacy or research experience to interpret data might unwittingly misconstrue published results.

(...)

Via uri goren, Lionel Reichardt / le Pharmageek, Agathe Quignot

Medical centers are testing new, friendly ways to reduce the need for office visits by extending their reach into patients’ homes.

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Most patients who enter the gym of the San Mateo Medical Center in California are there to work with physical therapists. But a few who had knee replacements are being coached by a digital avatar instead.

The avatar, Molly, interviews them in Spanish or English about the levels of pain they feel as a video guides them through exercises, while the 3-D cameras of a Kinect device measure their movements. Because it’s a pilot project, Paul Carlisle, the director of rehabilitation services, looks on. But the ultimate goal is for the routine to be done from a patient’s home.

“It would change our whole model,” says Carlisle, who is running the trial as the public hospital looks for creative ways to extend the reach of its overtaxed budget and staff. “We don’t want to replace therapists. But in some ways, it does replace the need to have them there all the time.”

Receiving remote medical care is becoming more common as technologies improve and health records get digitized. Sense.ly, the California startup running the trial, is one of more than 500 companies using health-care tools from Nuance, a company that develops speech-recognition and virtual-assistant software. “Our goal is basically to capture the patient’s state of mind and body,” says Ivana Schnur, cofounder of Sense.ly and a clinical psychologist who has spent years developing virtual-reality tools in medicine and mental health.

Via Wildcat2030, petabush

Canada is proving to be fertile ground for mHealth.

Incredibly, approximately two out of every three Canadians now use smartphones and tablets to access mobile healthcare either for themselves or for their family members.

The findings of international consultancy PwC‘s new study – Making Care Mobile: Shifting perspectives on the virtualization of health care – indicate that mobile health is changing Canadian healthcare in a profound way.

Coverage of the new report from Beacon News, however, highlights why this is not all that surprising when you consider that 80% of those surveyed admit to being very comfortable with mHealth apps.

“Canadians are ready for the digitization of their care and the next wave of innovation for service delivery will need to put the patient at the centre of the solution,” explains Will Falk, managing partner of PwC Healthcare. “This means providing faster, more convenient access to care in the ways in which Canadians want it.”

Over one third of Canadians look forward to mobile health care apps making health care easier by 2016.

“There are countless mobile phone applications helping people manage their everyday life – ranging from personal finances to planning social activities. Canadians have clearly indicated their interest in accessing health services and their health information in a similar way,” adds Mark Casselman, who serves as director of PwC mHealth.

Via healthcare mobile, Philippe Marchal/Pharma Hub

One of the critical questions within the connected healthcare movement is whether or not personal health data will actually catalyze and then incentivize lasting behavioral change and better wellness. Will any kind of data serve to motivate behavioral change? Does it matter if we see our data on a smartphone versus a laptop screen? Do all people respond in the same way? Early on, we realized that our ability to transcend our customer base, from highly-engaged, “quantified self” early adopters to the mainstream world of the “frustrated sleepers”, would require far more than just the raw data itself. It turns out that the gift wrapping matters as much as the present inside.

Via ehealthgr

Trainee surgeons are using tablet computers as a way to practice surgery outside the operating theatre.

The surgery app was designed by four surgeons in London and can be downloaded on a variety of devices.

Dr Sanjay Purkayastha, one of its developers said they wanted to take surgical education to "another level".

The app has been downloaded worldwide more than 80,000 times in less than six months.

Via Alex Butler, Fabrice Vezin

Google Glasses, other wearable tech will yield wealth of valuable real-time data, but companies must protect users' privacy

Via Pierre Tran

Now that the shake-up at Happtique has called into question their future as a consumer-facing health app curator, it didn’t take long for another company to step up.

Via Olivier Delannoy

This infographic discusses the emerging trends within the healthcare industry towards the adoption of mobile technology, particularly with smartphones (Great #INFOGRAPHIC from @EntradaHealth regarding the US healthcare mobile revolution:

Via hugh mcclung