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Can Mobile Money Enhance Access To Healthcare?

Can Mobile Money Enhance Access To Healthcare? | Mobile Health: How Mobile Phones Support Health Care |

Mobile health (mHealth) deployments have grown dramatically in recent years, particularly in emerging markets, where base-of-the pyramid populations often lack access to basic health services, but possess a mobile phone. However, despite the proliferation of mHealth platforms, many remain limited in scale and are poorly integrated into existing healthcare systems. Introducing mobile financial services (MFS) within these platforms may offer a way to drive reduced costs and enhanced efficiency – resulting in more affordable, inclusive healthcare systems. 

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Very interesting !

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Mobile Health: How Mobile Phones Support Health Care
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89% of US physicians would recommend a health app to a patient

89% of US physicians would recommend a health app to a patient | Mobile Health: How Mobile Phones Support Health Care |

Via Andrew Spong
Dave Burianek's comment, May 15, 5:45 AM
I think this is interesting.. and as we think about the whole integrated care delivery model, this data and information will play a critical part. Of those practices that Humana will own or be part of in a significant way, I believe we can make this happen. For those docs with small practices, we would need to find the right motivation to have them leverage this info. Do we offer it to them? such as ipads for usage during an office visit? we have to make it simple yet provide the best information so they could provide the best quality of care.
Scott Normandin's comment, May 16, 7:24 PM
the question begs: is/are applications that make access to health care the domain of the younger generation, or as some would content, are applications an additional level of complication to our senior population. Personal experience from the lens of my parents is that "absent" a vetted and universally adopted application that supports a universal view for all, this may by perceived as the "new best new toy" and fade with time. Our seniors; albeit are digital immigrants, working their way into the development of new technologies clumsily, whereas Gen X/Y find the technology adaptable, available and importantly expendable when the next best thing comes available. What defines consumerization: speed of development and release, or the ability to support end users?
Scott Normandin's comment, May 16, 7:24 PM
the question begs: is/are applications that make access to health care the domain of the younger generation, or as some would content, are applications an additional level of complication to our senior population. Personal experience from the lens of my parents is that "absent" a vetted and universally adopted application that supports a universal view for all, this may by perceived as the "new best new toy" and fade with time. Our seniors; albeit are digital immigrants, working their way into the development of new technologies clumsily, whereas Gen X/Y find the technology adaptable, available and importantly expendable when the next best thing comes available. What defines consumerization: speed of development and release, or the ability to support end users?
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Sports App helps baseball athletes prevent Tommy John surgery

Sports App helps baseball athletes prevent Tommy John surgery | Mobile Health: How Mobile Phones Support Health Care |
This app can help protect against elbow injury. The post Sports App helps baseball athletes prevent Tommy John surgery appeared first on iMedicalApps.
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How young French oncologists are using medical apps

How young French oncologists are using medical apps | Mobile Health: How Mobile Phones Support Health Care |
#mHealth: How young French oncologists are using medical #apps via @MobiHealthNews


A new study in the Journal of Radiation Oncology looked at self-reported smartphone and tablet ownership and usage statistics in young, French, radiation oncologists. While the sample is quite specific and not necessarily generalizable, it does present an interesting look at the up-and-coming generation of physicians (most of the subjects had five years of experience or less).

The survey, conducted online among 131 members of a summer educational session for radiation oncologists, showed that 93 percent of the specialists owned a smartphone and 32.8 percent owned a tablet. The smartphone users were more likely to use their device at work than the tablet users: 78.6 percent of the residents owning a smartphone used it at work, while just 29.4 percent of tablet owners did so.

More than half of the residents (57 percent) used their smartphone more than five times a day, with another quarter reporting that they used it exactly five times a day. Most smartphone owners (91 percent) had at least one medical app on their phone, and 33 percent had more than five. Asked whether they had verified the validity of the apps on their phones, only 60 percent said they had. The survey also asked the oncologists which apps they used specifically. 

“A total of 78 percent of the residents used their smartphone to take pictures of lesions for diagnosis, follow-up, or second opinion,” the study authors wrote. “In line with this, 75.2 percent of them used utility apps for drug interactions, essential points, manufacturer contact, and so forth. Only 30 percent used their smartphone to search and read articles. In all, 68 percent of the residents also used their smartphone to calculate equivalent doses for radiation treatments. Even if these applications had been created for academic purposes only, 67.2 percent of the residents used them for medical purposes with direct consequences to the patients’ treatment, thereby breaching the apps’ End-User License Agreement.”

The study also looked at the operating system of smartphones and tablets used. Sixty-two percent of residents had iPhones, 26 percent had Android phones, and 11 percent had Windows phones, while on the tablet side 84 percent used iPads and 16 percent had Android tablets.

Researchers also delved into residents’ use of social media. They found that residents were much more likely to be on Facebook than Twitter, and most of them did not have contact with patients on these platforms. Seventeen percent had signed up for a dedicated physician social network, which they used to discuss cases anonymously with other physicians.

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Comprehensive review of concussion screening apps for the sidelines

Comprehensive review of concussion screening apps for the sidelines | Mobile Health: How Mobile Phones Support Health Care |
Review of current concussion screening apps for iOS The post Comprehensive review of concussion screening apps for the sidelines appeared first on iMedicalApps.
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PerfectServe DocLink: Talk and text in real-time

PerfectServe DocLink: Talk and text in real-time | Mobile Health: How Mobile Phones Support Health Care |

To contact another physician, users launch the PerfectServe mobile application or dial the toll-free 855-DocLink number. The only information they need to initiate communication is the name of the colleague the user wishes to reach. PerfectServe DocLink allows individual contact status control, so users can select the following settings based on how they prefer to be reached during certain days of the week or throughout the day: available for real-time calls and secure voice and text messages; available for secure voice and text messages only; or unavailable — voice and text messages stored without notification.

Market positioning (responses provided by PerfectServe DocLink):

How does this technology enhance the physician experience or business operations within a small-medium sized practice? Using PerfectServe DocLink, a small or midsize practice can establish a private and secure communications network that connects all medical staff member users by allowing both real-time conversations and secure text messaging in a HIPAA-compliant environment, resulting in significantly improved physician workflow. With PerfectServe DocLink, physicians connect with one another quickly without having to search for phone numbers or navigate through switchboards, answering services or front-office staff. PerfectServe DocLink provides one-step access to every referring physician and medical staff member — which means better quality of care.What makes PerfectServe DocLink unique in the market? It enables both secure text messaging and real-time conversations. Sometimes physicians want to send a text. Other times they need to have a conversation. With PerfectServe DocLink, physicians choose the best communication mode for each clinical situation.  What attributes interest your physician clients the most when it comes to messaging technologies? The ability to take nurses and staff out of the consult process by providing one-step, secure, real-time access to every referring physician and medical staff member (which speeds up cycle times). Other appeals include managing HIPAA-compliance risk across every communications mode; alerting multiple people simultaneously (which provides backup and quicker response time); determining how to receive different types of calls, giving personal control over how physicians are reached to the physician; automatically filtering all ePHI from the body of messages sent to non-secure mobile devices (e.g., pagers, email and SMS text); fewer interruptions for routine matters (nighttime messages can be held for morning delivery); and private phone numbers, which are kept private — an office caller ID can display instead of a personal cell number for patient calls.What are your development goals for this technology from now through the next two years? PerfectServe’s development goals are confidential but we continue to gather feedback from our users to guide our roadmap.Founded InWebsiteTwitterHeadquartersPricing1997Knoxville, TNN/A

Want more? Find out about other secure messaging solutions that made Medical Practice Insider's list: 

DocbookMD: Where over 300,000 docs connect

hippomsg: Communicating without the financial squeeze

Imprivata Cortext: Seamless, secure messaging on a range of devices

Medigram: Timely care team conversations

MedXCom: Virtual house calls, secure messaging and more

TigerText: Singularly focused on security

Vocera Collaboration Suite: Convenience via voice and text


Via Philippe Marchal/Pharma Hub
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Genomic Medicine is Just Beginning | Digital Health Post

Genomic Medicine is Just Beginning | Digital Health Post | Mobile Health: How Mobile Phones Support Health Care |

“A Decade Later, Genetic Map Yields Few New Cures,” said a New York Times headline in June 2010.  It declared the failure of the $3 billion Human Genome Project and claimed that medicine had seen none of the benefits that Bill Clinton had promised in announcing the first draft of the human-genome sequence in 2000.  According to the article, geneticists were “almost back to square one in knowing where to look for the roots of common disease.”

The New York Times judged the project too soon.

The cost of sequencing a human genome had fallen from about $100 million in 2001 to $30,000 when the article was written; today it can be done for nearly $1,000.  And the promise is coming true.

Hardly a week goes without the announcement of a major scientific breakthrough in genomics.  The March 6 edition of The New England Journal of Medicine detailed how human cells can be genetically engineered to make them resistant to the virus that causes AIDS.  A week earlier the journal published a finding that analyzing fetal DNA in a pregnant woman’s blood was a more accurate — and less intrusive — way of screening for Down syndrome and other chromosomal disorders than methods such as ultrasound imaging and blood tests.

Genome analysis is already being used to guide the treatment of cancers of the brain and the breast.  Eric Green, director of the National Human Genome Research Institute, explains that cancer is essentially a genomic disease: “Instead of classifying cancers by the tissue where they are first detected — colon, breast or brain, doctors are beginning to categorize cancer by its genomic characteristics and select treatments based on the signature of different mutations.  This approach promises to treat patients with the most effective medicines while minimizing undesirable side effects, especially when chemotherapy is unlikely to help.”

Green says that the end of the Human Genome Project was the starting point on the path to genomic medicine.  At first, a decade ago, scientists focused on using DNA-sequencing and computational technologies to interpret the genome and understand its biology.  Now they are using them to improve diagnostics, medicines, and clinical practice.  He predicts that before long, doctors will tailor treatment for many diseases on the basis of an individual’s genomic information.

The early triumphs are being seen with rare inherited diseases—which together afflict more than 25 million Americans.  Genomic strategies, driven by the plummeting cost of genome sequencing, have led to the identification of the genomic defects for more than 5,000 of the inherited diseases caused by mutations in a protein-encoding gene.  An intense four-year, more than $400 million, research program, the Centers for Mendelian Genomics, is working to find the genomic cause of the remaining 2,000–4,000 rare genetic diseases.

We may be predisposed to certain diseases because of our genes, but it is not only genes that determine our health. It is also our lifestyle, habits, and environment. These may cause genes to be switched on and off and even altered. There is also still a lot to be understood about what was once-called “junk DNA” — which is now known to contain important control mechanisms over the bits we recognize as genes. And then there is the microbiome – an ecosystem of microorganisms that live on and in the human body. So a lot more data are needed and much more research and analysis still needs to be done.

The good news is that other technologies are also rapidly progressing which will facilitate this. With the cost of genome sequencing dropping to affordable levels, there will soon be genome data available for millions of people. Additionally, the smartphones we carry are capturing information about our lifestyle and habits, location, and activity levels. Wearable medical devices, which many companies are developing, will record our vital signs such as temperature, blood oxygenation, and heart rhythm. When you combine these data, you gain the ability to rapidly analyze the correlation between our genome, habits, and disease—exactly what is needed to develop individualized treatments for disease.

This is the same type of data analysis that is done of social media streams and shopping and online-browsing data by Silicon Valley start-ups and marketers. In other words, we human beings have become data and software—and entrepreneurs can now do the work of pharmaceutical companies and medical research labs.

Indeed, one entrepreneur has declared his intention to do just that. Craig Venter, who used Human Genome Project data to compete with the project in sequencing the first human genome, 13 years ago, recently announced that he was starting a company called Human Longevity. This will focus on extending the healthy human lifespan by using stem cell therapies and genomics to tackle the diseases of aging. It plans to sequence 40,000, increasing to 100,000, human genomes per year. It will also sequence the microbiome of these patients.

No doubt many other start-ups will enter this field and accelerate the rate of medical breakthroughs. This means that medicine will, within a few years, start advancing at the same pace as the Internet and software. We will see a revolution in health care.

The government shouldn’t step out of the ring, however. It needs to keep investing in the types of basic research that led to genome sequencing and the Internet itself. Such technologies often take decades to bear fruit and there are many disappointments and failures along the way. There is also still much more basic research to be done in genomics—that entrepreneurs can’t do. Yet, the National Institutes of Health, of which the National Human Genome Research Institute is one of 27 institutes and centers, has experienced a research-funding decline of about 25 percent (in purchasing power) since the completion of the Human Genome Project in 2003. This doesn’t make sense. We are finally on the verge of ridding humanity of the diseases that have plagued it. It is time to double down on, not walk away from a great investment.


This article originally appeared in the Washington Post as “The triumph of genomic medicine is just beginning“, March 13th 2014 – Reprinted with permission of Vivek Wadhwa

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Ditch the spray: Apps to repel mosquitoes

Along with summer comes cookouts, swimming, and mosquitoes -- lots of them. Instead of slathering on repellent, turn to your smartphone to keep pesky critters at bay. In this Tech Minute,...
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Survey: 75 percent of patients want digital health services | mobihealthnews

Survey: 75 percent of patients want digital health services | mobihealthnews | Mobile Health: How Mobile Phones Support Health Care |

According to a survey of thousands of patients in Germany, Singapore, and the United Kingdom, the adoption of digital healthcare services remains low because existing services are either low quality or not meeting patients’ needs. The survey, conducted by consulting firm McKinsey, included responses from at least 1,000 patients in the three countries.

“Many healthcare executives believe that, due to the sensitive nature of medical care, patients don’t want to use digital services except in a few specific situations; decision makers often cite data that point to relatively low usage of digital healthcare services,” McKinsey analysts Stefan Biesdorf and Florian Niedermann wrote in a recent blog post. “In fact, the results of our survey reveal something quite different. The reason patients are slow to adopt digital healthcare is primarily because existing services don’t meet their needs or because they are of poor quality.” 

McKinsey found that more than 75 percent of respondents would like to use some kind of digital health service. Many are interested in “mundane” offerings, the firm wrote.



Via rob halkes, Lionel Reichardt / le Pharmageek, LA BLOUSE BLANCHE , Giuseppe Fattori
rob halkes's curator insight, July 16, 4:18 AM

Great Survey results, aligning with what experts already thought. Results generated by Germany, Singapore and the UK, but believed to be representative of patients in these advanced markets.

See my conclusions upon reading the report here

Honeywell HomMed's curator insight, July 25, 7:01 AM

With our LifeStream View, care providers can grant access to patient’s health information through the creation of patient portals, which can be configured for: Physicians, Care Providers and Families. Learn more:

Marisa Maiocchi's curator insight, July 25, 7:32 AM

Los resultados de una encuesta parecen derribar algunos mitos respecto de la "salud móvil" o m-health como "Esta tecnología solo la usan los jóvenes".

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3 advantages of using mHealth in the OR | mHealthNews

3 advantages of using mHealth in the OR | mHealthNews | Mobile Health: How Mobile Phones Support Health Care |

The perioperative environment is commonly acknowledged as one of the hospital’s most complex.


This condensed and complex environment is precisely why complete command and control of the OR is imperative – and why mobile technology is an optimal path for helping achieve it.


In particular, mobility offers three distinct advantages that support command and control and help ensure all parties have the information they need to keep workflow and patient flow moving:


1. A near real-time, patient-centric OR perspective 

During this highly compressed episode of care, a patient is treated by a team of clinicians who are often from different departments. In addition, supporting staff such as surgical scrubs and radiology play an important part in efficient patient movement. Having a single, shared view of patient milestones – for instance, when prophylactic antibiotics are administered, anesthesia is induced and the incision is made, or surgery is complete and the patient is on his way to PACU – allows the entire care team to know exactly what is happening which supports the delivery of more coordinated care. Giving everyone this same view on a mobile device can further synchronize care among disparate care providers.


As a result, the patient is more likely to move efficiently between care events, and clinicians are less likely to miss specific timing for milestones such as medication administration.


2. A comprehensive OR view supports better decisions with fewer interruptions


A patient-centric view enables the OR team to keep one patient on the most efficient, highest quality care path. Sometimes, however, this path requires an adjustment that can impact the entire OR.


more at


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Big Data in Health Care: Using Analytics to Identify and Manage High-Risk and High-Cost Patients -

Big Data in Health Care: Using Analytics to Identify and Manage High-Risk and High-Cost Patients - | Mobile Health: How Mobile Phones Support Health Care |
Big Data in Health Care: Using Analytics to Identify and Manage High-Risk and High-Cost PatientsDavid W. Bates, Suchi Saria, Lucila Ohno-Machado, Anand Shah, and Gabriel Escobar

A Health Affairs article explores the value big data and clinical analytics could bring to health care, especially under payment reform.

PrintEmailMore Sharing ServicesShare July 2014

As a result of greater adoption of electronic health records, health care organizations have increased opportunities to analyze and interpret large quantities of patient information, known as big data, to better manage high-risk and high-cost patients.

The July 2014 issue of the journal Health Affairs explores the promise of big data to improve health care. In one article, supported by CHCF, the authors examine six examples in which mining big data can improve care and reduce expenses in hospital settings:

Identifying high-cost patients can in turn determine which patients are most likely to benefit from interventions and which care plans can best improve care.Using predictive algorithms to foresee potential readmissions can enable more precise interventions and care coordination after discharge.Integrating triage algorithms into the clinical workflow can help manage staffing, patient transfers, and beds.Some ICUs are using analytics to evaluate multiple data streams from patient monitors to predict whether a patient's condition is likely to worsen.By uncovering unique data patterns, such as prescription drug use and vital sign changes,  other systems can help prevent renal failure, infections, and adverse drug events.Data from multisite disease registries and clinical networks will help manage patients with chronic conditions that span more than one organ system.

While big data and analytics are powerful tools, the authors say more systematic evaluation is needed to move from potential to realization in many areas. And questions remain on how to regulate analytics and provide adequate patient privacy.

The complete article is available free of charge on the Health Affairs site through the link below. Also available is a slide deck of a July 9, 2014, Health Affairs briefing on big data.

External LinksHealth Affairs — Big Data in Health Care: Using Analytics to Identify and Manage High-Risk and High-Cost PatientsHealth Affairs Briefing: Using Big Data to Transform Care (PDF)

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Can Mobile Technologies and Big Data Improve Health? #hcsmeu

Can Mobile Technologies and Big Data Improve Health? #hcsmeu | Mobile Health: How Mobile Phones Support Health Care |

After decades as a technological laggard, medicine has entered its data age. Mobile technologies, sensors, genome sequencing, and advances in analytic software now make it possible to capture vast amounts of information about our individual makeup and the environment around us. The sum of this information could transform medicine, turning a field aimed at treating the average patient into one that’s customized to each person while shifting more control and responsibility from doctors to patients.


The question is: can big data make health care better?


“There is a lot of data being gathered. That’s not enough,” says Ed Martin, interim director of the Information Services Unit at the University of California San Francisco School of Medicine. “It’s really about coming up with applications that make data actionable.”


The business opportunity in making sense of that data—potentially $300 billion to $450 billion a year, according to consultants McKinsey & Company—is driving well-established companies like Apple, Qualcomm, and IBM to invest in technologies from data-capturing smartphone apps to billion-dollar analytical systems. It’s feeding the rising enthusiasm for startups as well.


Venture capital firms like Greylock Partners and Kleiner Perkins Caufield & Byers, as well as the corporate venture funds of Google, Samsung, Merck, and others, have invested more than $3 billion in health-care information technology since the beginning of 2013—a rapid acceleration from previous years, according to data from Mercom Capital Group. 

  more at ;

Via nrip, Lionel Reichardt / le Pharmageek, IHEALTHLABS EUROPE
Paul's curator insight, July 24, 9:06 AM

Yes - but bad data/analysis can harm it

Pedro Yiakoumi's curator insight, July 24, 10:48 AM

Vigisys's curator insight, July 27, 1:34 AM

La collecte de données de santé tout azimut, même à l'échelle de big data, et l'analyse de grands sets de données est certainement utile pour formuler des hypothèses de départ qui guideront la recherche. Ou permettront d'optimiser certains processus pour une meilleure efficacité. Mais entre deux, une recherche raisonnée et humaine reste indispensable pour réaliser les "vraies" découvertes. De nombreuses études du passé (bien avant le big data) l'ont démontré...

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NHS tests 'plaster' patient-monitor

NHS tests 'plaster' patient-monitor | Mobile Health: How Mobile Phones Support Health Care |


The NHS is starting to test a sticking-plaster-sized patient-monitoring patch.

Placed on the chest, it wirelessly transmits data on heart rate, breathing and body-temperature while the patient is free to move around.

Independent experts say the system, developed in Britain, could ease pressure on wards and has the potential to monitor patients in their own home.

But the Royal College of Nursing says there is no substitute for having enough staff.

Routine checks for vital signs - including temperature, blood pressure and heart rate - are a key part of care and safety in hospitals.

Typically they may be carried out every four hours, depending on the patient's condition.

But patients can deteriorate between checks, putting them at risk.

Continue reading the main story“Start Quote

It gives us a bit more time with some patients when we know some patients do need that bit more time. ”

Victoria Howard Nurse

A hospital in Brighton run by the private healthcare firm Spire has been testing the battery-powered patch, which updates information on some of the vital signs every couple of minutes.

The wireless device, developed by the Oxford-based firm Sensium Healthcare, then issues an alert if the readings fall outside pre-set levels, indicating a potential problem.

The patch is placed on the chest just above the heart when the patient is admitted. There are no cables to any monitors. Instead, readings are recorded and transmitted to a box in each room that works like a wi-fi router, passing on data to the hospital IT system.

'Eases pressures'

It does not replace the routine checks, but staff say it does ease some of the pressures.

Victoria Howard, a staff nurse at the hospital said the system was working well.

"It gives us a bit more time with some patients when we know some patients do need that bit more time," she said.

"Without this monitor, you're constantly thinking what's happening in the next room, and I should go in there and check them.

"Knowing this is on and it works well, we're able to spend that bit more time."

Most of the patients at this hospital are in for routine surgery. Some are being treated for cancer.

The matron, Lynette Awdrey, said the patches helped staff focus their efforts on the patients who needed the most support.

"It prioritises you," she said.

"Nothing will ever replace compete with clinical observation and the assessment of the patients. What this does is alert you sooner, so you can fulfil those observations and assessments of the patient and activate the appropriate care and treatment for them."

So far, she said, the patches had provided early detection of deterioration in about 12% of patients who had worn them. That is in line with findings from a small trial with the patches at a hospital in Los Angeles.

Safety implications

This could have important safety implications. A study in the British Medical Journal in 2012 concluded that nearly 12,000 deaths in hospitals in England had been preventable. It said clinical monitoring had been a problem in nearly a third of these deaths.

Another advantage of the device is that patients can move around freely. This reduces the risk of complications such as infections, helping patients to recover more quickly, so they can go home sooner, saving on the costs of healthcare.

David Hardman, 71, is happy to wear the patch.

"It gives me reassurance that there's something, or some equipment looking at it all the time," he said.

"And I think when the nurse is with you her mind is perhaps a bit more with you rather than thinking about what's going on in the other rooms."

Each patch costs £35 and lasts for five days - long enough for most hospital stays.

Wear at home

Independent experts say we are witnessing the start of a revolution in wearable technology, with great potential benefits in healthcare.

Prof Timothy Coats, a consultant in emergency medicine at Leicester Royal Infirmary, said the patch could be useful in a variety of different settings.

"This certainly could have a use in the emergency department from the emergency care phase right through to the first couple of days in hospital when the patient is more liable to deteriorate.

"It also has potentially an application for looking after patients in their own home, because we could observe them remotely rather than in hospital."

However he points out there are limitations with the current model, which measures heart rate, breathing and body temperature. It is being developed to provide more information, on blood pressure and oxygen levels.

The company says the patch is about to be tested at one NHS trust and 20 more are in talks.

The Royal College of Nursing's chief executive, Dr Peter Carter, said new technology could be very helpful in alerting nurses and doctors to a patient who was starting to deteriorate - but he also expressed a note of caution.

"Anything which helps that process has to be a good thing," he said.

"However, we also know that there is no substitute for having enough staff with the right level of skill on every ward, able to give each and every patient the care and attention that critically ill people need."



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mHealth Comes to Zimbabwe

mHealth Comes to Zimbabwe | Mobile Health: How Mobile Phones Support Health Care |

IT Web Africareports that mHealth has officially come to Zimbabwe.

Although mHealth solutions are nothing new in Africa — in fact, mHealth solutions are growing at an accelerated pace throughout the continent today –  Zimbabwe has been a largely overlooked nation in recent years, relative to the immense growth documented in surrounding nations.

Zimbabweans are now gaining a service made possible by the nation’s top telecoms firm Econet Wireless.

“The Econet Health project plans to avail tips on how to manage stress, information about diseases such as diabetes as well as diet,” the report reads. “Expecting mothers are also to receive information about pregnancy.”

Econet chief executive officer Douglas Mboweni said on Friday that “mobile communication gadgets had become devices where people can also access information about health” and other areas.

“People should know how to deal with stress and pregnant mothers know of what to do through their mobile phones,” Mboweni is quoted in the report.

Via Emmanuel Capitaine
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HIPAA compliant text messaging app TigerText can make pagers obsolete

HIPAA compliant text messaging app TigerText can make pagers obsolete | Mobile Health: How Mobile Phones Support Health Care |
An app that enables secure communication with real potential to improve care. The post HIPAA compliant text messaging app TigerText can make pagers obsolete appeared first on iMedicalApps.
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HealthTap Wants To Be Your New On-Call Doctor

HealthTap Wants To Be Your New On-Call Doctor | Mobile Health: How Mobile Phones Support Health Care |

HealthTap, an app that lets users ask questions of doctors and get almost immediate answers in written form, is a hypochondriac's dream. (Sample question that pops up on my screen: What's the best way to increase and boost testosterone levels to the peak?") Over 100 million people have asked questions of the 60,000 doctors signed up to the service since its launch in 2011.

But founder Ron Gutman now wants to take HealthTap further, providing actual health care in addition to information. This week, he launched HealthTap Prime, a subscription program that includes video consults with doctors, constantly curated health news, and app recommendations from doctors, customized wellness checklists, and prescriptions. The basic HealthTap service will remain free.

Gutman divided the new service into three modules: learn, get help, and take action. The "learn" module includes customizable Facebook-like feeds for patients that offer doctor-recommended health news and apps. The "get help" module offers immediate access form any mobile device to licensed physicians using text, voice, and video. Appointments don't need to be scheduled in advance. Doctors can also prescribe medication.

We don't see ourselves as telemedicine. The idea here is that there's a much bigger end to end experience.

At launch, this feature will be available to about 70% of the U.S. population (doctors can only practice in the states where they're licensed, so the whole population will only be covered when HealthTap has on-call doctors in every state).

Finally, the "take action" module consists of checklists--for example, a list of ways to handle heart disease--offered up to patients by their HealthTap doctors, who have access to any health records the patients provide, along with their HealthTap history.

"We don't see ourselves as telemedicine," says Gutman. "The idea here is that there's a much bigger end to end experience."

Not every HealthTap doctor can participate in Prime; they have to apply and go through training. Gutman won't disclose how much they're paid. "They get paid for every consult. It's exactly like the real world," he says. They can practice from the app, do live video from an app, iPad, or iPhone."

It's not the only app offering remote consultations with doctors. For example, a startup backed by the prestigious Mayo Clinic launched its own service earlier this year. For HealthTap's service, patients pay $99 per month, plus $10 per month extra for each additional family member. Unlike most other services that offer video appointments with doctors, no one-off consultations are available.

"It's more than just transactional. We want people to stay in touch beyond the acute situation," says Gutman. It's kind of like the normal doctor-patient relationship, in other words--except without the commute and long wait for an appointment. We haven't had the chance to test out the virtual visits, however, so their utility remains to be seen.

[Image: Doctor via Shutterstock]

Via Sam Stern, eMedToday
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Updated PediQuikCalc app is a great tool for Pediatricians

Updated PediQuikCalc app is a great tool for Pediatricians | Mobile Health: How Mobile Phones Support Health Care |
PediQuikCalc Version 3.0 is a comprehensive pediatric and drug dosing calculator The post Updated PediQuikCalc app is a great tool for Pediatricians appeared first on iMedicalApps.
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Quatre applications destinées aux seniors

Quatre applications destinées aux seniors | Mobile Health: How Mobile Phones Support Health Care |
Quatre applications destinées aux seniors29 juillet 2014 Pas de commentaire  Les applications de santé à l'adresse des personnes âgées et de leur entourage sont de plus en plus nombreuses. — D. Closon / SipaMOTS-CLÉSDmd SantéDmdpost.comSanté connectéeCONTRIBUTEUR –  Le site de Dmd Santé teste les applications mobiles de santé connectée. Pour les lecteurs de Se Coacher, il revient sur les applications pour seniors.

Sur les stores, il n’y en n’a pas que pour les bébés, les femmes enceintes, et les sportifs. Les personnes âgées et leur entourage y trouvent également de quoi faciliter leur quotidien, s’informer ou simplement se tester.

Alzheimer Infos pour en savoir plus

La maladie d’Alzheimer apparaît plus fréquemment chez les personnes âgées. Editée par la Fondation Plan Alzheimer, l’application Alzheimer Infos donne accès de façon claire et synthétique aux informations récentes concernant l’avancée des recherches et des différents aspects de la maladie : origine de l’affection, diagnostic, thérapeutique, prise en charge médico-sociale et vie au quotidien. Des experts français ou étrangers interviennent et informent via des séquences audio ou vidéo.

Gratuite et disponible sur l’App Store.Diamon pour surveiller le diabète 

Elle recueille un enthousiasmant 17/20 sur L’application Diamon est un carnet d’auto-surveillance du diabète. Elle peut être très utile pour les personnes âgées atteintes de diabète de type 2. Disponible sur tablette, celle-ci a pour but de remplacer les carnets papiers.

Il est alors possible de consigner ses résultats des tests de glycémie et de bandelettes urinaires, le nombre d’unités et le type d’insuline de chaque injection, la valeur de son hémoglobine glyquée trimestrielle. Les données sont sécurisées et stockées sur des serveurs. Cloud oblige, le compte Diamon est accessible sur n’importe quel iPad.

On apprécie le design soigné dont le rendu visuel facilite le suivi de ses glycémies capillaires. Bénéficiant d’une prise en main facile, cette application conviendra aux seniors désireux de surveiller leur diabète au quotidien, et d’échanger avec son professionnel de santé.

Gratuite et disponible sur l’App Store.Mal de dos : soulager et prévenir la douleur avec Doctissimo

L’application développée par Doctissimo permet de comprendre la source des douleurs inexpliquées du dos, et de définir un programme personnalisé. Elle est particulièrement intéressante pour les seniors qui aimeraient apprendre quelles sont les bonnes pratiques quotidiennes qui soulagent et protègent efficacement le dos. Développée en collaboration avec François Stévignon, kinésithérapeute et ostéopathe, l’application délivre des conseils pratiques ainsi qu’un coaching de qualité.

2€99, disponible sur l’iOSTestez votre vue

Recueillant une note de 15,5/20 sur, l’application Testez votre vue permet, sans remplacer un rendez-vous chez un professionnel, de faire un état des lieux rapide de sa santé visuelle. Grâce à des tests qui prennent moins de 5 minutes à réaliser, il est possible de rechercher d’éventuels troubles d’accommodation comme la myopie ou astigmatisme, ou de la vision des couleurs (daltonisme). Une fonctionnalité géolocalise également les opticiens présents à proximité.

Il s’agit donc d’une application très bien conçue, qui invite à consulter un ophtalmologue en cas de test défaillant.

Néanmoins elle ne peut être utilisée qu’en supplément d’une consultation.

Gratuite et disponible sur iOS.
>>>Retrouvez les autres sélections d’applications santé de Dmd 
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Evaluation of an eHealth Intervention in Chronic Care for Frail Older People: Why Adherence is the First Target

Evaluation of an eHealth Intervention in Chronic Care for Frail Older People: Why Adherence is the First Target | Mobile Health: How Mobile Phones Support Health Care |

Older people suffering from frailty often receive fragmented chronic care from multiple professionals. According to the literature, there is an urgent need for coordination of care.


The objective of this study was to investigate the effectiveness of an online health community (OHC) intervention for older people with frailty aimed at facilitating multidisciplinary communication.


The design was a controlled before-after study with 12 months follow-up in 11 family practices in the eastern part of the Netherlands. Participants consisted of frail older people living in the community requiring multidisciplinary (long-term) care. The intervention used was the health and welfare portal (ZWIP): an OHC for frail elderly patients, their informal caregivers and professionals. ZWIP contains a secure messaging system supplemented by a shared electronic health record. Primary outcomes were scores on the Instrumental Activities of Daily Living scale (IADL), mental health, and social activity limitations.


There were 290 patients in the intervention group and 392 in the control group. Of these, 76/290 (26.2%) in the intervention group actively used ZWIP. After 12 months follow-up, we observed no significant improvement on primary patient outcomes. ADL improved in the intervention group with a standardized score of 0.21 (P=.27); IADL improved with 0.50 points, P=.64.


Only a small percentage of frail elderly people in the study intensively used ZWIP, our newly developed and innovative eHealth tool. The use of this OHC did not significantly improve patient outcomes. This was most likely due to the limited use of the OHC, and a relatively short follow-up time. Increasing actual use of eHealth intervention seems a precondition for large-scale evaluation, and earlier adoption before frailty develops may improve later use and effectiveness of ZWIP.

Keywords: eHealth, frail elderly, care coordination, chronic careGo to:Introduction

Chronic care for frail older people is fragmented, with involvement from a large and constantly changing group of professionals who are frequently unaware that they provide care to the same patient [1]. Such professionals include home care professionals, general practitioners (GPs), clinicians, physiotherapists, and case managers dedicated to long-term care of the patients in the community. Frail elderly often suffer from comorbidities, which results in care by multiple health care professionals [2]. Therefore lack of communication between professionals leads to a fragmented and ineffective health care delivery for frail elderly [3]. To reduce fragmentation and promote continuity of care, better coordination and communication between professionals and with patients is necessary. Online health communities (OHCs) have been recognized as an effective mechanism for supporting continuous care for frail older people [4], allowing better coordination and more efficient communication with patients and among professionals. OHCs consist of Internet-based platforms that unite groups of individuals with a shared goal or similar interest, including both professionals and patients [5]. The main strength of OHCs is that they allow communication between people who would not have met each other otherwise [5]. Thus, OHCs are particularly suited for improving the coordination of care for frail elderly who have multiple professional caregivers. For this purpose, we developed and evaluated the Health and Welfare Information Portal (Zorg en Welzijns Informatie Portaal, ZWIP, in Dutch) [1,6] on its effectiveness.

Go to:MethodsIntervention

ZWIP is an OHC [5] that aims to facilitate communication for patients, their informal caregivers, and their professionals. ZWIP contains a secure messaging system supplemented by a shared electronic health record. All messages shared in a patient’s ZWIP are visible for all users, thus stimulating involvement of and discussion between patients and a team of health professionals. All informal caregivers and health care professionals have access to the electronic health record. To ensure confidentiality, professionals can participate in a patient’s personal care network in ZWIP only at the invitation of the patient. Patients who were not able to manage their own ZWIP account could appoint an informal caregiver to act on their behalf. Figure 1 demonstrates the conceptual model underlying ZWIP, and the video in Multimedia Appendix 1 illustrates the use of ZWIP by a patient and an informal caregiver.

Figure 1A conceptual model of the ZWIP.Development and Implementation

The development of ZWIP and the process of implementation have been described elsewhere [1,6]. In brief, ZWIP was developed using intervention mapping [7], a stepwise approach for the systematic development of interventions informed by both evidence and theory [1]. Main steps of intervention mapping for ZWIP were (1) needs assessment in frail elderly, (2) developing program objectives, (3) selecting theory informed intervention methods and strategies, (4) creating and pilot testing program components, (5) planning program adoption and implementation, and (6) planning for evaluation [1]. Theoretically, ZWIP was based on social cognitive theory [8], with special attention paid to improving self-efficacy, the belief people have in their ability to complete tasks and achieve specific goals [9]. Following the steps of intervention mapping and as suggested in the guideline on development and evaluation of complex interventions [8], the ZWIP was piloted by 2 frail elderly and 7 professionals, including one GP. Furthermore, newly developed elements of ZWIP were regularly piloted by similar user panels.

To enhance implementation of the ZWIP, we used several strategies for professionals such as a continuing medical education (CME) accredited education program based on active learning theory [10], direct experience, and modeling [1]. Additionally, drawing from organization theory, we installed a telephonic helpdesk and provided e-coaching and financial compensation to support the uptake of ZWIP by professionals [7,11]. To facilitate the use of ZWIP among elderly patients, a number of approaches were used: flyers were distributed in the primary care centers, a hard-copy version of ZWIP was provided in order for patients to familiarize themselves with ZWIP, coaching on the use of ZWIP was made available, involvement of informal caregivers was encouraged, and the GPs actively advocated the use of ZWIP, thus drawing on modeling, guided practice, and tailoring support for use of the intervention [1,6]. During the implementation phase, we designated one key person in each family practice who coordinated implementation activities and helped colleagues with questions [6].

Inclusion and Design

Between July 2010 and July 2011, frail older patients were included in an observational, controlled before-after study with 12 months follow-up to investigate ZWIP’s effects on patient outcomes. Participating primary care centers were recruited from the university primary care network around the city of Nijmegen, the Netherlands. These centers identified their frail older people using the EASYcare Two-step Older person Screening (TOS) instrument [12]. Therefore, both intervention and control practices had to implement an identification scheme and redesign care for their frail elderly. Interventions centers were selected based on willingness to participate in ZWIP, whereas control practices were selected from a separate project: the EASYcare-TOS validation study [13]{van Kempen, 2013 #7718}. Frail status as determined by the EASYcare-TOS was the only inclusion criterion for included patients. Patients in the intervention group patients needed to agree to the creation of a ZWIP account. No exclusion criteria were specified.

All measurements were performed by trained nurses in the patients’ homes, using a face-to-face questionnaire at baseline and at follow-up. The study was exempt from ethics review by the local ethics committee because of its observational nature and nonintrusive data collection. Nevertheless, oral informed consent was obtained to analyze the data during data collection.


Primary outcomes were Activities of Daily Living (ADL) as measured by the Katz index [14], combined ADL and Instrumental Activities of Daily Living (IADL) as measured by the Katz-15, a combined measure of the ADL and Lawton-index [14,15], SF-36 mental health and social activity limitation dimensions [16]. The Katz index consists of yes or no responses on ADL items such as bathing or dressing. ADL scores range from 0-6 with higher scores indicating higher dependency. The Katz-15 consists of yes or no responses on ADL and additional IADL items such as using the telephone and managing money [14]. The Katz-15 scores range from 0-15 with higher scores indicating more limitations. Both scales are established in the literature and have adequate reliability and validity [17]. The SF-36 mental health dimension, consisting of the following subscales: happy, calm, blue, down, nervous scoring from 0-5 with higher numbers indicating a higher score. The scores were summed into a summary score ranging from 0-100, with 100 indicating full mental health, and 0 low mental health [16]. To assess differences in social activity limitations, the social activity limitation item from the SF-36 was used [16]. This item measures the frequency in which respondents experienced social activity limitations due to health. The item used in this current study is scored from 0 (none of the time) to 5 (all of the time). The various SF-36 subscales have excellent reliability and validity [17]. Secondary outcomes were several self-developed scales of patient satisfaction and GPs’ subjective experience with care coordination. Patient satisfaction items were scored on a 5-point Likert scale ranging from 1 (way too little or way too much) to 5 (optimal), similar to this article [18]. GP experience with coordination of care was scored between 1 (uncoordinated) to 10 (optimal coordination). Important covariates were measured including a frailty index based on the accumulation of deficits concept [19,20]. The frailty index is the number of deficits present divided by a total possible number of deficits [2]. As such, the frailty index can account for all kinds of health-related imbalances between the intervention and control group and provides an accurate measure of individuals’ frailty.


For comparing baseline characteristics, chi-square tests were used to compare nominal variables, and t tests were used for normally distributed continuous variables. Effects were determined using linear mixed models within a highly efficient analysis of covariance (ANCOVA) framework [21] to allow for clustering within a primary care center. Adjustments were made for frailty status and centered baseline status of the outcome variable and additional covariates with baseline imbalance. All analyses were performed with SAS 9.2.

Go to:Results

Overall, 290/622 (46.6%) of all frail persons identified within 11 practices participated in the intervention group. From 6 practices 392 frail older people participated in the control group. At 12-month follow-up, in the intervention group 179/290 (61.7% of original) patients provided data at follow-up, versus 270/392 (68.8% of original) patients in the control group. At baseline, participants in the intervention group were more likely to have completed primary education only, have more informal caregivers, and have higher complexity of care compared to the participants in the control group. Further, participants in the intervention groups also had a higher average frailty index score, and GPs had lower experience with coordination of care (Table 1).

Table 1Demographic and care-related characteristics in the intervention and control group.

One quarter 45/117 (25%) of all patients in the intervention group used ZWIP at least once a month during a period of 12 months. Controlling for frailty and other unbalanced baseline characteristics, we found no significant differences in primary patient outcomes (Table 2). Change in coordination of care as reported by GPs improved in the control group.

Table 2Change in outcomes by 12 months application of the ZWIP Web-based tool for patient-professional and interprofessional communication.Go to:DiscussionSummary of Results

There were 290 patients who participated in the intervention group and 392 in the control group. In the intervention group 76/290 (26.2%) of the patients actively used ZWIP. After a follow-up of 12 months, we observed no significant improvement on primary patient outcomes, ADL, IADL, and mental health.

Strengths and Limitations

The online ZWIP platform was specifically developed for reducing fragmentation of care delivery in older people. Almost half of a frail elderly population without exclusion criteria could be included in the intervention group for using the online ZWIP tool [6]. This is modestly higher than what can be expected in the Dutch context, where 39% persons older than 75 years report having Internet access [22]. This study has two important limitations that can impact results. First, due to the observational nature of the study, comparability between the intervention and the control groups was limited. Despite adjusting for a range of covariates, there may be residual confounding.

Observational, controlled before-after designs are common for complex interventions, where randomized controlled trials (RCTs) are often not appropriate or feasible for evaluation [23]. In the case of ZWIP, contamination between patients would have made individual-level randomization inappropriate. Cluster randomization was not feasible because the level of commitment required from a number of local stakeholders could not be sustained in the control group.

A second limitation was the fact that actual usage of ZWIP was low, even though the implementation of ZWIP was prepared systematically during the development of ZWIP, as this is a structural part of intervention mapping [1,6,7,24,25]. Additionally, implementation strategies were added or adapted when needed during the actual implementation phase. A wide range of implementation strategies were used to encourage uptake; for example, a training program was developed for professionals and an active recruitment phase led to a high participation of older persons. Therefore, low levels of use were attained not because of the lack of, but despite using state of the art implementation techniques. Failure to integrate eHealth interventions in health care is widespread [26], and therefore the low levels of use of these frail older subjects is not surprising. This is especially true for sustained usage of an eHealth intervention [27]. As in other studies [26], further efforts should be focused on improving usability of the intervention, in terms of compatibility for frail older people in chronic disease trajectories [28].

Future Directions

In addition to further refinement, it is essential to identify those who benefit most from ZWIP and eHealth applications in general. The use of eHealth applications in frail populations could be increased by first identifying frail people with a high likelihood of early adoption of the eHealth intervention, such as people with high computer literacy. Which frail elderly are likely adopters requires further research [26]. Therefore, we plan to perform a quantitative and qualitative evaluation of ZWIP usage as well, going beyond the scope of this paper. We must recognize that in the early stages of evaluation, we take more of an efficacy approach to the evaluation, rather than a pragmatic trial approach. Although the efficacy approach limits generalizability, it allows a thorough investigation of the intervention’s working mechanisms under more controlled, laboratory-like conditions. Such work may also reveal ideal levels of use of ZWIP, as it is possible that communication was already adequate in the case of some patients, making ZWIP usage superfluous. Using both quantitative and qualitative methods in this development phase may elicit remaining barriers and reveal more effective implementation strategies. Only after adapting to this group and proven efficacy is large-scale implementation warranted. Successful wide-scale implementation is a precondition for investigating the effectiveness of eHealth interventions. Otherwise finding no differences between treatment arms cannot be interpreted as a lack of effectiveness. These arguments show that, sufficient time and resources are required to develop, test, and retest new eHealth interventions before finally evaluating their effectiveness in pragmatic trials [29,30].


Overall, the study confirmed that introducing eHealth interventions in the elderly is a difficult task. Despite using a theory-driven intervention design and state of the art implementation techniques, usage remained low and effectiveness was not observed. Performing a thorough proof of principle study in early adopters may be crucial to improving the use of eHealth interventions in the elderly before evaluating effects on a larger scale.

Go to:Acknowledgments

This study was supported by the Netherlands Organization for Health Service and Development (ZonMw) project #311050201. The funder had no role in conducting the study, analysis of the data, or publication of the manuscript.

We would like to thank Wilma Derksen-Driessen, Emile ter Horst Mark Kuster, Charlotte Neger, Jean Nielen, Joep Scheltinga, and Leontien van Nieuwenhuijzen for their assistance in the development and implementation of the program. We would also like to thank Jennifer Lutomski for English editing.

Go to:AbbreviationsADLActivities of Daily LivingANCOVAanalysis of covarianceEASYcare-TOSEASYcare Two-step Older person ScreeningGPgeneral practitionerIADLInstrumental Activities of Daily LivingOHCOnline Health CommunityZWIPHealth and Welfare portalGo to:Multimedia Appendix 1

Short video of ZWIP in use.

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Stanford physician's startup makes it a breeze to build HIPAA-compliant mobile health apps

Stanford physician's startup makes it a breeze to build HIPAA-compliant mobile health apps | Mobile Health: How Mobile Phones Support Health Care |

A plethora of health-related apps and devices should be hitting the market in the next year or two. And the data that these apps and devices collect could help your doctor provide a more holistic picture of your health.

But, as I wrote a few weeks ago, when that health data crosses the line from consumer health cloud into the healthcare delivery system, HIPAA privacy rules will come into play.

One company, started by a Stanford physician, has foreseen this challenge to device and app developers, and is offering a way to easily comply with HIPAA’s often stringent rules. These “medical grade” apps can then safely share data with clinical systems.

“With Medable, mobile apps can make it easy for users to communicate with their doctors, nurses, and caregivers, and also to provide them with any kind of data originating from their mobile devices,” company co-founder Dr. Michelle Longmire tells VentureBeat. “That lets everyone receive the data, visualize it, and then communicate about it in a very natural way.”


Health app developers can use the platform to build new applications or to integrate Medable features into existing applications, Longmire says. Medable also offers numerous application features like patient and provider profiles, two-factor authentication, and “push” messaging. These features are delivered through a software development kit (SDK) and an application programming interface (API).

“If push messages are sent to care providers, they contain only the metadata, not any identifiable information,” Longmire explains. “So a physician might receive a message saying ‘an image is available for you,’ but the doctor would need to log in to get the image.”

Longmire says Medable uses the HL7 clinical data format, so it can integrate with, and exchange data with, any electronic health record system that uses HL7 format, and the majority of them do.

The main concern of HIPAA rules is guarding “protected health information” or “PHI” from the eyes of those who don’t need to see it for clinical purposes.

Longmire says the Medable platform encrypts all PHI in several ways — on the device, in transit and then on the Medable platform.

The Medable platform can also anonymize large amounts of clinical data so that researchers can study it. Additionally, Medable provides all of the capability needed for HIPAA auditing and clinical data reporting.

The bottom line is that Longmire’s platform gets app developers out of the privacy and compliance business, at least where it concerns sharing data with hospitals or medical groups.

“Medable allows developers to focus on the content of their apps, instead of on data security, which is not their specialty,” Longmire says.

The global health market was at $6 billion in 2013, but it’s projected to be a $26 billion market by 2017.

This article originally appeared on VentureBeat

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Add iPads to the rash of mobile devices implicated in allergic contact dermatitis

Add iPads to the rash of mobile devices implicated in allergic contact dermatitis | Mobile Health: How Mobile Phones Support Health Care |
In a recent issue of the journal Pediatrics, two dermatologists reported the first case of iPad associated contact dermatitis. This is not the first time a wearable or mobile device has been implicated in causing allergic contact dermatitis.
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How Apple and Google plan to reinvent health care

How Apple and Google plan to reinvent health care | Mobile Health: How Mobile Phones Support Health Care |

Mike Dittenber had always wanted to go skydiving. There was only one problem: “At my heaviest I clocked in around 330 pounds,” says Dittenber, a technical writer from Michigan. “That’s above the weight restriction for a tandem jump.” During a doctor’s visit last spring, he got some more bad news. “I had delayed getting a physical for a while, but eventually I had to. Turned out I was borderline diabetic and right on the cusp of hypertension.” His doctor warned him that if he didn’t get his weight under control quickly he would need to begin taking medication. “It was a wake-up call.”


Dittenber had previously tried Weight Watchers, which worked for a time, but didn’t last for long. This time he decided to take matters into his own hands withMyFitnessPal, a mobile app that helps users track their calorie intake and exercise. The app became a gateway to a universe of digital health products. “I ended up buying a Fitbit, because that pairs with MyFitnessPal,” he says. “Turns out I don’t hate running. I don’t love it, but I can take it.” He added the Runkeeper app to log his distance and purchased a Garmin Forerunner 220 to help him maintain the right pace. Since he began using the tracking his health data in June of 2013, Dittenber has lost 110 pounds.


Using a smartphone as the central hub for tracking, analyzing, and motivating exercise has become a phenomenon. MyFitnessPal, which now claims over 65 million registered users, is one of the most popular digital health apps. But its success is part of a much broader trend. Venture funding for startups in the sector reaching $2.3 billion in the first half of 2014, more than was invested in all of 2013. More importantly, three of the biggest players in tech — Apple, Google, and Samsung — have all thrown their weight behind platform plays aiming to aggregate and simplify the universe of devices and apps available to consumers.


“We could be at a real tipping point,” says Harry Wang, an analyst who leads health and mobile research for Park Associates. “Fitness devices and apps have been a fast-growing but still relatively niche market. These new ecosystems, if they gain traction, could finally push the industry into the mainstream.” Success isn’t guaranteed, but Wang says it makes sense for the fragmented digital health industry to rally behind powerful companies. Apple's Healthkit and Google Fit can help reach a broader audience and forge partnerships with the traditional health care industry that would be hard for startups to accomplish alone. “It would be a transformation, with a lot of big winners, and losers as well.”

 Hardware gets the squeeze

For many years the digital health industry has been driven by wearable devices like the Fitbit, Nike’s Fuelband, and Jawbone’s Up. But if the titans of the smartphone industry succeed in creating a dominant platform for health and fitness data, this business could be in trouble. "A lot of the basic functions we have seen in fitness wearables — tracking your steps, taking your heart rate — those functions will become basic features on a smartphone or smartwatch," says Wang.


Software’s turn to shine

While some big hardware players may get squeezed by the rise of mainstream smartphone platforms for digital health, app developers stand to make huge gains. "Devices like Fitbit and Jawbone have been essential to driving the industry forward, but they never got above 2 or 3 percent penetration with the general population," says Malay Gandhi, a managing partner at the venture capital firm Rock Health. "With smartphones as the central device powering this ecosystem, software companies will suddenly have access to tens of millions of new customers."



Gandhi believes this change will broaden the demographics in the digital health market. "Right now most of the people using this stuff are early adopter types, techies who are into the quantified lifestyle, or younger people who want to optimize their athletic performance." With just your smartphone as the baseline, he sees a chance to get older and less tech savvy people involved. "Your average consumer isn’t going to learn about pairing a wristband or managing a dozen different apps. But he or she might use the software that comes standard on their iPhone."



more at


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Six professionnels de santé sur 10 utilisent des applications mobiles pour leur pratique

CASTRES, 23 juillet 2014 (TICsanté) – Six professionnels de santé sur 10 déclarent utiliser des applications mobiles de santé, mais seulement 1% utilisent une application de relation médecin-patient, selon une enquête menée par Isidore santé, Vidal, Egora, Expansciences et IDS Santé.Cette enquête* a été présentée par le Dr Vincent Varlet, président du think tank Isidore santé et directeur exécutif des services marketing et communication de Novartis, à l'occasion de l'Université d'été de l'e-santé, le 3 juillet à Castres.

Six professionnels de santé sur 10 déclarent utiliser des applications mobiles pour leur pratique, montrent les résultats de l'enquête. 35% ont téléchargé ces applications car ils les utilisaient sur d'autres supports (web, papier, etc.), 24% en faisant une recherche au hasard, 18% car l'application leur avait été conseillée, 13% car ils en connaissaient l'éditeur ou l'auteur et dans 10% car ils en avaient vu la publicité.

Pour le tiers de professionnels qui n'ont pas téléchargé d'application, la raison principale est le manque d'équipement (36% d'entre eux n'ont pas de smartphone ni de tablette), devant le manque de temps (34%) et le manque de confiance (12%).

Près des deux tiers (64%) des sondés estiment que les applications mobiles de santé sont devenues "incontournables" pour leur pratique (dont 24% estiment qu'elles sont "tout à fait" incontournables et 40% "probablement").

Les bases de données médicamenteuses sont les applications les plus téléchargées et utilisées (respectivement 32% et 38%). Les applications de formation continue sont, elles, peu téléchargées (1,6%) mais font partie des plus utilisées (14%).

A l'inverse, seulement 2% des professionnels de santé ont téléchargé une application de relation médecin-patient et seul 1% l'utilise. 60% n'ont jamais téléchargé d'application destinée aux patients, et seulement 9% l'ont fait pour pouvoir la conseiller.

"Si les médecins sont devenus utilisateurs d'applications mobiles de santé pour leur pratique, ils ne se sont pas encore tournés vers les applis patients", a commenté le Dr Varlet. Il estime que "la fracture digitale entre les professionnels de santé et les patients risque de devenir une réalité si la France ne rattrape pas son retard en ce domaine".

* Enquête auto-administrée sur le web, du 17 mars au 21 avril 2014. 2.035 participants dont 1.670 retenus pour l'analyse (questionnaire intégralement complété). 92% de médecins (8% autres: chirurgiens-dentistes, pharmaciens, infirmiers, kinésithérapeutes).


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How to Boost Patient Portal Usage

How to Boost Patient Portal Usage | Mobile Health: How Mobile Phones Support Health Care |

Social network scientists have shown that emotions and values can spread in a community with the same patterns as infectious diseases. They have described how the people who are most connected to others may be the first ones to get hot gossip, but they are also most likely to get the scary new virus that has just shown up in town. These observations suggest an interesting opportunity for making health care better, and even more efficient – if health care organizations can figure out how to create an “epidemic of empathy.”

What would an epidemic of empathy look like? There would be a steady, relentless increase in the proportion of clinicians and other personnel who are clearly tuned in to what was really happening to patients and their families. Coordinated and empathic care would not seem to patients as miraculous and unpredictable as the lightning bolt of love (“un colpo di fulmine,” as the Italians put it). Instead, delivery of such care would become the norm; it would become increasingly fundamental to the way health care personnel saw themselves.

The time for such an epidemic has arrived. We certainly have the motivation – health care has become so complicated that patients constantly complain that they feel like they are lost in the chaos, and being treated like a collection of organs and diseases rather than human beings.   They worry that no one is actually looking out for them – their physicians are staring at computer screens during visits, trying to absorb the flood of data relevant the patient’s problems.

But I think we finally have the knowledge and the means to create an epidemic of empathy. Social network scientists – most notably, Nicholas Christakis and his colleagues – have shown that obesity, smoking, and even happiness spread in societies via interpersonal connections. If a friend of a friend gains weight, you are more likely to gain weight even if you have never met that person, because a norm is subtly developing around you that suggests that it is OK to eat super-sized fries rather than push them away. Christakis has shown that people copy the behaviors of people they know directly, and, amazingly, those of others who may be physically removed from them, but are just one or two degrees removed in their social networks.

Good habits can spread via social connections, too. Using experiments involving thousands of subjects, Christakis and his colleagues have shown that altruism (as reflected in charitable giving) also diffuses through social networks – and “diffuse” is the right word. Charitable giving is indeed contagious; we respond to peer pressure to contribute. But it also falls off as the connections to the recipient of largesse weaken. In their book, Connected, Christakis and his co-author James Fowler write, “we would rather give a gift to a friend who will never repay us than to give a gift to a stranger who will.”

Can health care organizations take these insights, and use them to spread compassionate and connected care, and make it the new norm? In fact, the work is well underway, in bits in pieces. The question is who will be the first to put those pieces together.

One critical step is to create the shared vision of what empathy means. The Cleveland Clinic empathy video, now viewed by millions around the world, is just one example of how health care organizations are finding new ways to remind their personnel of what their patients are going through. Use of the word “suffering” by clinicians and leading medical journals was rare in the past, because the term was considered overly-emotional, but “suffering” is being invoked with increasing frequency by health care providers – again, with the goal of reminding clinicians of the anxiety, confusion, and uncertainty that their patients endure.

A second critical step is to understand what drives patients’ suffering. The pain and disability that result from their diseases and their treatments are of course major factors, but so is the avoidable suffering that results from dysfunction of the delivery system – the long waits to be seen, the chaos that results when clinicians are not coordinating their efforts closely, the uncertainty about what is supposed to happen next, the dehumanizing impact of an impersonal bureaucracy. Issues like food and parking are trivial to patients compared to these concerns.

A third step is to collect enough data so that meaningful analyses can be performed at potential units of improvement – including the individual physician. That means using electronic surveying technologies, collecting email addresses on every possible patient, and sending surveys to seek information after every hospitalization or office visit. In this way (and only in this way) can enough data be collected to identify which clinicians are delivering care that is coordinated and empathic. In short, we need to deploy “big data” and crowd-sourcing techniques so that we can track individual patients’ experiences and then bring information that drives action from providers.

That brings us to the question of how to go about actually driving that action. To date, health care organizations have used “carpet bombing” strategies, in which all personnel are urged to be more sensitive to patients’ needs. With increasing ability to profile the performance of individual physicians, many organizations have been focusing on the physicians who seem to be doing worst – the “bad apple” approach.

But to create an epidemic of empathy, organizations need to use a complementary approach – find the personnel who have the best patient reports regarding the coordination and empathy of their care, and try to spread whatever it is that they are doing right. They can be identified using the same data used to identify the physicians who are not doing well. Then, the subset of “good performers” can be identified who are also well-respected by and connected to many of their colleagues.

The goal is to make these well-respected, connected personnel who understand what empathic care means the Typhoid Marys of the empathy epidemic. This Appreciative Inquiry approach can be accomplished through educational sessions – for example, Brigham and Women’s Hospital put on a session called “Love Stories: Deconstructing and Learning From Successful Doctor-Patient Relationships,” in which a highly respected physician and one of his patients were interviewed (in the When Harry Met Sally-style) about what made their relationship successful. This type of educational session can be used to identify and spread “techniques,” like asking patients the question, “Help me understand what I can do to help you.”

The adoption of these practices from the Typhoid Marys can be accelerated by the use of financial and non-financial incentive systems that remind clinicians that every patient encounter is a high-stakes event – the biggest thing that will happen to that patient that day, week, or month. For example, the University of Utah has led the way in putting all patient comments about every physician on-line on their Find-a-Doctor web site, and now others have or soon will be following suit. Knowing that every patient will likely have the chance to offer a comment on-line about their care has powerful effects. As one orthopedist put it, it forces him to be at “the top of my game” for every single patient. Such comments suggests that transparency closes the social distance between the physician and the patient, making it more likely that physicians’ empathic instincts will come out.

Despite the added pressure for compassionate and coordinated care, I haven’t met a clinician yet who thinks there is anything wrong with this. In fact, everyone in health care knows that we have a problem, and that even patients whose care is technically excellent often do not feel cared for. The cure for this disease is to create an epidemic of our own, and I think we know how.


Via NY HealthScape, Lionel Reichardt / le Pharmageek, eMedToday
ChemaCepeda's curator insight, July 22, 4:37 AM

Una página web o portal institucional orientada a pacientes no solo es un sitio donde ofrecer información de calidad en salud, sino que constituye una buena oportunidad para mejorar la relación y aumentar la confianza que las personas depositan en nuestros servicios. Comunicación, interacción y educación para la salud,... ¿estamos infrautilizando este recurso?

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Evaluating Health Promotion Social Media Strategies for Public Health Impact

Evaluating Health Promotion Social Media Strategies for Public Health Impact | Mobile Health: How Mobile Phones Support Health Care |

I recently spoke at an interactive workshop presentation at the 2013 Ontario Public Health Convention (TOPHC) looking at social media use in public health and the strategies available for evaluating those strategies in practice. The talk was focused on the tools, methods and approaches and the inherent challenges in dealing with a dynamic social communication environment.

Here are the slides from that presentation.

Evaluating Health Promotion Social Media Strategies for Public Health Impact

Image: Shutterstock (used under licence)

Evaluating Health Promotion Strategies for Public Health Impact from Cameron Norman
Via Emmanuel Capitaine
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Mobile Technologies Could Revolutionize Health Care If It Can Overcome Challenges

Mobile Technologies Could Revolutionize Health Care If It Can Overcome Challenges | Mobile Health: How Mobile Phones Support Health Care |

Among technologists, mobile health is thriving. Since the start of 2013, more than $750 million in venture capital has been invested in companies that do everything from turn your smartphone into a blood pressure gauge to snapping medical–quality images of the inner ear. Apple, Qualcomm, Microsoft, and other corporate giants are creating mobile health products and investing in startups. 

The idea is straightforward: the increasing number of smartphones means that small, inexpensive sensors, low-energy Bluetooth, and analytic software make it possible for patients and doctors to capture all kinds of data to improve care. Patients can play a more active role in their own health. Doctors and nurses can make house calls without ever leaving the office. 

One crucial group, however, remains unsold: the patients. Though one in 10 Americans owns the type of tracking device made by Nike, Fitbit, and Jawbone to monitor steps taken, quality of sleep, or calorie intake, more than half of those devices are no longer in use, according to Endeavour Partners, a consulting firm.  Of the 100,000-plus mobile health applications available for smartphones, very few have been downloaded even 500 times. More than two-thirds of people who downloaded one have stopped using it, according to a 2012 study done for the global accounting firm PWC.

“There are unrealistic expectations for when and how mobile health is going to come together,” says Patty Mechael, former executive director of the mHealth Alliance, which helped develop early standards for mobile health technologies. In the U.S. “we are somewhere between the peak of the hype cycle and the trough of disillusionment,” she says. 

Enthusiasm has been slow to build in part because the technology is often still not perfect, with seemingly simple functions like step counters lacking precision. Another problem is motivation. Many people simply don’t seem to like using these apps and devices. It is clear, though, that a well-designed mobile health system can help if patients use it.

At the Center for Connected Health at Partners HealthCare, a health-care network that includes Boston’s two leading hospitals, Brigham and Women’s and Massachusetts General, a number of mobile programs have been shown to offer strong payoffs both in quality and cost.

One recent study tested whether mobile phones could help increase activity among patients with diabetes. It’s an important way to combat the disease’s progression, but it’s something traditional programs have had little success achieving. Of a group of 130 patients with diabetes, half were given Fitbit activity monitors. By combining feedback from the Fitbit with existing patient records, an algorithm determined which text messages would be sent to the patients. Those falling behind on their goals got messages of encouragement; some messages included information about nearby Zumba classes or jogging paths, based on location data picked up from the patients’ mobile devices. On rainy days, the program might send a note about ways to exercise indoors. 

Doctors received progress updates via a stoplight system displayed on the patient’s electronic medical record. Green meant the patient was doing well. Yellow was caution. Red signaled the patient was not responding to the text messages.

After six months, the average patient was walking about a mile farther each day. In addition, the patients’ blood sugar control improved significantly—better results than might be expected with some FDA-approved drugs, says Kamal Jethwani, a doctor who ran the study as the center’s leader of research and program evaluation. 

For Partners, the program is successful on two counts: patients are healthier, and the cost of caring for them is lower. The payoff of better managing a chronic disease like diabetes comes over many years, but in Jethwani’s study, a number of patients have already had drops in blood sugar that equate to savings of $1,000 to $1,200 in doctor visits and other treatments. That’s a strong return on a program that costs $300 per patient to run, notes Jethwani.

These are the kinds of results that have enthusiasts convinced that mobile technology can not only fundamentally overhaul how health care is delivered, but also offer sufficient financial benefit to convince insurers and patients to pay for it.

John M. Halamka, a professor at Harvard Medical School and chief information officer of Beth Israel Deaconess Medical Center, expects this kind of technology–enabled monitoring to become standard practice within the next few years. One sign that a heart patient may be about to have a problem is rapid weight gain, he notes. A smart scale that picks up on that  could trigger a quick intervention from the doctor and avoid a visit to the ER.


At the University of California San Francisco, which recently announced an initiative to begin testing the effectiveness of mobile devices in health care, one of the biggest technological achievements to date was simply starting to get doctors to move beyond pagers. Now doctors access patient messages via a mobile or Web application, and the message automatically becomes part of a conversation. Under the new system, the whole care team is aware of what is happening, and the doctor has the patient’s history available when fielding questions. A program is being tested that would take this to the next level, allowing care providers to send messages to patients.

Getting mobile health technology right can be tricky, however. Fitbit makes some of the most popular activity trackers, but in February the company voluntarily recalled its top-of-the-line $129 Fitbit Force after users complained of skin irritation from the wristband. More serious technological problems have sidelined devices aimed at difficult tasks like measuring blood glucose levels without drawing blood, a desirable feature for people with diabetes.

For all the challenges in mobile health, one issue that dominates many discussions about the technology may fade rather quickly. Privacy concerns have yet to come up in the Partners trial, says Jethwani. “I’ve never heard any patient say, ‘How do you know so much about me?’ or ‘Why do you know so much?’” he says. “Instead, they say ‘Now that you know all this about me, can you give me more useful information?’”

Via Alex Butler, Philippe Marchal/Pharma Hub
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The Public Opinion of Telehealth, Telecare & mHealth |

The Public Opinion of Telehealth, Telecare & mHealth | | Mobile Health: How Mobile Phones Support Health Care |
Despite the proliferation of mobile devices, people have no idea about mHealth...

Via Emmanuel Capitaine