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Health care without the doctors coming via kiosks in Walmarts - Kitsap Peninsula Business Journal

Health care without the doctors coming via kiosks in Walmarts - Kitsap Peninsula Business Journal | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
Health care without the doctors coming via kiosks in Walmarts Kitsap Peninsula Business Journal “There is a trend in general by retailers and health insurers to provide 'fluff' to consumers in the guise of real medical information as an advertising...

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Mobile Health: How Mobile Phones Support Health Care
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 | Scoop.it

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Dave Burianek's comment, May 15, 8:45 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, 10:24 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, 10:24 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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eHealth Network adopts guidelines ePrescriptions

eHealth Network adopts guidelines ePrescriptions | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

National health systems are moving more and more towards electronic systems for medical prescriptions. The European Commission and EU countries have a common goal to ensure that these electronic prescriptions can be used safely in another Member State.

This is why the eHealth Network, made up of representatives of all 28 EU countries and chaired by the Commission, has been working jointly on ePrescriptions.

The guidelines that were agreed on, lay out the type of data needed to share prescriptions across borders. They also describe how the data should be transferred, provided the patient has given his or her consent to use the ePrescription service.

The guidelines can be used by Member States on a voluntary basis.

The 6th eHealth Network meeting in Brussels took place on 18 November 2014 and was chaired by Austria and co-chaired by the European Commission.

Source: Website Health and Consumers, DG SANCO


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Hospital exec shares how to transform urban health care

Hospital exec shares how to transform urban health care | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Fifteen years ago, when John W. Bluford III became president of Truman Medical Center (TMC), the Kansas City hospital was facing serious financial problems, legal issues and low morale. People saw it as a place to be treated if you were poor, uninsured or had nowhere else to go, Bluford said.

By the time Bluford retired earlier this year, the institution had completely turned around. Nationally recognized for its standard of care, TMC has grown to include state-of-the-art centers for cardiology, diabetes, emergency medicine, obstetrics, oncology, outpatient surgery and radiology. Its annual net operating revenue has increased by $283 million, and with a broad range of community-based initiatives, TMC has become widely seen as a model for innovation and civic engagement.

“If you want to change the dance, change the music,” said Bluford, quoting an African proverb on campus Nov. 13 at Cornell’s inaugural Percy Allen II ’75 Sloan Lecture in Health Care Leadership in Urban Communities, hosted by the Sloan Program in Health Administration in the College of Human Ecology. “I like that. It’s got a nice rhythm to it that reflects what we need to do as an industry, as a field, to make a difference in the lives of the people we serve.”

In his lecture, “Thinking Outside of the Bed,” Bluford emphasized the importance of maintaining the health of the most vulnerable members of the community, beginning with early childhood education and continuing with programs to address drug addiction, mental illness, chronic disease, poor diet, lack of exercise and inner-city violence.

In response, TMC has changed the way people use their facility, adding a bank to the first floor and a seasonal produce market outside the building. At the same time, TMC has reached beyond the hospital grounds, sending fresh produce into surrounding neighborhoods on a mobile market, founding a wellness program at the public library, using unrented billboards to underline positive messages about health, providing home refrigerators for diabetic patients, co-sponsoring a family health festival with the Kansas City Chiefs, and making plans to build a full-service grocery store in the heart of the inner city.

“We’re talking about health versus care,” said Bluford. “That’s the transformative element. We need to go from giving care to maintaining health, and the challenge, among many, is how do you get paid for that? The system doesn’t reimburse us for keeping people healthy … yet.”

“This is what you’re going to be facing, and you’ve got to figure it out,” Bluford told students. “Make a difference. Because if you’re doing what you’re supposed to be doing, you won’t have a lot of patients.”

The lecture series, which brings leading health care administrators to campus to address the needs of underserved urban communities, honors Percy Allen II, MHA ’75, who serves as an executive-in-residence in the Sloan Program. Previously, Allen served as CEO of University Hospital of Brooklyn, CEO of the Bon Secours Baltimore Health System, and president of the National Association of Health Service Executives (NAHSE). He was inducted into the NAHSE Hall of Fame in 2006 and into the Modern Healthcare Hall of Fame in 2011.

Kenny Berkowitz ’85 is a freelance writer.


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ePatients: Changing healthcare with technology - mHealth

ePatients: Changing healthcare with technology - mHealth | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
To Dave deBronkart, known online as ePatient Dave (@ePatientDave), the movement towards the emancipation of patients is equivalent to the feminist, civil rights, or homosexual movements. "We're talking about a shift in the relationship between patient and health professional, and that is a cultural change." ePatient Dave. Photo by Roger Ramírez This new type of patient-informed, committed and used to manage their illness with new technologies-has been possible thanks to the Internet. On the one hand, due to the huge amount of medical information available-which 30 years ago was only accessible in research facilities or universities; on the other, because it allows patients to get in touch with each other and exchange information. However, the aim of ePatients is not only to become informed so that they can make decisions about their health, but to reshape the healthcare system. This is necessary because, very often, despite the fact that health professionals work for the patient, they do not really take patients into account. An example of the strength of patients' activism could be seen in the 90s, with the movement lead by patients with AIDS and HIV carriers. According to ePatient Dave, "they brought forward the launch of antiretroviral drugs by ten years, pressuring FDA because they were dying." Internet changed their life Let Patients Help To the ePatients interviewed in this article, Internet was essential during the course of their illness. Dave deBronkart was diagnosed in 2007 with stage 4 kidney cancer. He got in contact with other patients on the Internet and discovered a treatment which saved his life, despite the advance stage of his cancer. In his book, "Let Patients Help", explains how he became an ePatient and invites all patients to do the same as him. Internet also saved Andrew Schorr's life (@AndrewSchorr), a medical journalist who was diagnosed with chronic lymphocytic leukaemia (CLL). "Had I not connected with other patients on a simple blood cancer discussion group online in 1996 I would be dead", he stated. Andrew Schorr Andrew knew about a first rate specialist, to whom he asked for a second opinion. In the end, he became part of a clinical trial and, thanks to a new treatment-to which he had access 10 years before it became available to the public-his illness remains in remission. The story of Jan Geissler (@jangeissler) is not that different. In 2001, he was a young telecommunications executive in Germany when he was diagnosed with an atypical type of leukaemia (chronic myelogenous leukemia (CML)): "I was then consulting a number of hematologists in my area, however none of them told me about clinical trials or new drugs. Jan Geissler Then, thanks to the Internet, I found a number of very active patients in the USA and Asia who were knowledgeable about the results of phase III clinical trials that were demonstrating very promising results. I identified an investigator 400km away from my home who was running a small Phase II clinical trial, and thanks to having joined it I am still here today," explained Geissler to us. Casey Quinlan Casey Quinlan (@mightycasey) was diagnosed with breast cancer a few days before Christmas, in 2007. She was then a sport journalist for several TV channels. During her treatment she joined patients' communities and wrote in a blog about her experience, which later became the Amazon best-seller "Cancer for Christmas: Making the Most of a Daunting Gift." Casey has become a well-known ePatient and has founded Patients for Clinical Research, an organisation that seeks to facilitate patients' participation in medical research. Healthcare: Focused on the patient? To go through the experience of a serious illness made this people ask themselves if the current healthcare model is really benefiting patients. Dave deBronkart defends that it is necessary for doctors and patients to work together "to create a new dynamic in which healthcare makes patients feel they are well looked after. One of my principles is: "If the microscope is happy but the patient isn't, have we achieved care?" ePatient Dave at the TED Talk in Maastricht After his experience with cancer, Andrew Schorr founded Patient Power, an online community in which patients-and also doctors-can access information about the latest news about treatments for different types of cancer. The website contains interviews with oncology specialists and patients, who share their experience in order to help patients and family members. Schorr states that "politicians should not be afraid of the informed patient, on the contrary. Cancer patients are the same around the world, I think now it's the time for them, wherever they are from, to become empowered and take control of their illness. This is an unstoppable movement." The journalist, author of "The Web Savvy Patient", was diagnosed in 2011 with a second cancer-myelofibrosis-now in control through the use of a breakthrough medicine. Jan Geissler's activism is focused on research. He founded the European Cancer Patient Coalition (2003) with the aim that EU directives on regards to clinical trials and other health policies started focusing more on the patient. Apart from being an advisor of several public organisations, he is now coordinating EUPATI, the European Patients' Academy on Therapeutic Innovation, which educates patients so that they can become consultants in drug research and investigation. Jan states that: "Education and training provided to patient advocates is very important. There is a lot of talk about patient centricity, and for this to come true, we need more patients that understand how healthcare is being delivered, how medicines research and development works, and how health economics work, so patients can bring their unique insights into true patients' needs into the context of healthcare." Geissler's work has helped patients have more decision-making power in policies about clinical trials in Europe. He has also created Patvocates.net, a collaborative platform for activists for patients' rights. On the other hand, Casey Quinlan's objective is "to lead all patients into the light", particularly "the light of understanding that the choices about their healthcare are theirs." She also wants to open science and research to all the patients, "creating battalions of Citizen Scientists interested in creating and driving clinical research." The challenge: Train the patients To Dave deBronkart the main challenges are two: "that the two parts (patients and doctors) understand that the patient's input is valuable. And, second, find a way to make this input effective." Dave is working in order to accomplish that by attending medical congresses-we met him last September at the European Society for Medical Oncology (ESMO) congress-and preach about the importance of the patients' voice within the healthcare system. Furthermore, he is one of the most visible representatives of Society for Participatory Medicine, an organisation that promotes the concept of Participatory Medicine, according to which patients become responsible and leaders in the management of their health. "Some doctors say "don't look for medical information because you won't understand it", but it has been proved that well-informed patients have better results. What we need to do is develop their capacities. If we want better medical results, we need to trust more on the patients' capability", defends Dave. Casey Quinlan agrees with Dave and finds it rather "paternalist" the way doctors behave towards patients. Other challenges she considers important are "the lack of scientific information about the different treatment options, the lack of access to one's own data, and the lack of information about the treatment's cost"-important particularly in the North American system. Andrew Schorr states that "healthcare systems have not understood yet that we are living a revolution, and that patients/consumers want to be in control of their health, the same way they control other areas of their lives." What is clear is that, like Jan Geissler states, "Healthcare is in the middle of transformation, facilitated by the Internet, and even more driven by mobile services and smart phones which makes information ubiquitous." ePatients are leading this revolution which will put the patient at the centre of healthcare. Teresa Bau, Mobile Health Global Editor Related news: Breast cancer on the net: Information, support and involvement Interview with Angelica Frithiof Interview with Andrew Schorr Resources: Other ePacients: Kelly Young (@RAWarrio); Regina Holliday (@ReginaHolliday); Kerri Sparling (@SixUntilMe); Amy Tenderich (@AmyDBMine); Erin Moore (@EkeeleyMoore) Fundación Más que Ideas (Works in Spain to put the patient at the centre of healthcare)
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HIPAA Considerations For Video-Powered Medical Apps

HIPAA Considerations For Video-Powered Medical Apps | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

As more and more startups, such as Square and Uber, break through regulated industries, developers fearlessly take chances in the healthcare market. If this is you, you better take some time to read the rules before coding. For healthcare, rules are defined by the Health Insurance Portability and Accountability Act (HIPAA). HIPAA regulates how patients’ information must be handled by healthcare professionals (covered entities) and their partners (business associates). As an example, the covered entity could be a health insurance company while the business associate could be a startup that utilizes Protected Health Information (PHI) for its mHealth app.

Developers Hate HIPAA

The rules defined in HIPAA may be subject to many interpretations, making them challenging to translate into technical specifications. Although the U.S. Department of Health & Human Services clarified HIPAA with the publication of the Omnibus Rule last year, developers are still left with unanswered questions. Last September, ACT | The App Association called on Congress to adopt a more sensible implementation of HIPAA:

[…] the Office of Civil Rights (OCR) should provide implementation standards […] For example, cloud storage is essential for success in the new mobile, always-on world. However, we lack clarity when it comes to data in the cloud […] lack of clarity prevents new, and beneficial technologies from helping patients.

HIPAA compliant data storage is a hot topic for every mHealth startup handling PHI. Companies like TrueVault or Catalyze have already published good resources on the subject so I won’t expand on this point. In this article, I’ll answer the main question asked by developers building video-powered healthcare apps for telepsychiatry, teledermatology or online doctor consultation services, or teleconsultation. At SightCall, we talk with many developers who ask for advice regarding the use of video calling for their medical app. The most asked question is: “How can I add HIPAA compliant video conferencing to my app?”. If this is a question you have, read on to reach the light at the end of the tunnel.

Understanding HIPAA Compliance for Video Consultations

HIPAA is broken into several sections, the two main ones being the Privacy Rule and the Security Rule. While the former applies to PHI in all forms (paper, oral, electronic, etc.), the latter applies only to PHI in electronic form (E-PHI).

The Security Rule is the section that is most closely scrutinized by developers, as it sets security standards to protect any E-PHI created, received, maintained or transmitted by covered entities and business associates. Technical specifications such as authentication, unique user identification or encryption are discussed in the Security Rule. When it comes to video conferencing, the Security Rule has a straightforward answer:

“E-PHI does not include paper-to-paper faxes or video teleconferencing or messages left on voice mail, because the information being exchanged did not exist in electronic form before the transmission.”

Indeed, the Security Rule applies to electronic media, which as defined in HIPAA means (1) electronic storage media; or (2) transmission media used to exchange information already in electronic storage media. In other words, as long as your app does not record the consultation between the doctor and its patients, the video chat capability does not add additional requirements to meet in regards to the Security Rule.

Concerning the Privacy Rule that controls when and how PHI can be disclosed, it really boils down to one question: “who is dealing with PHI?” If your app does not create, receive, maintain or transmit PHI, there is no need to worry about HIPAA in the first place. In the opposite scenario, PHI may be shared with a third party, as telehealth apps often rely on a partner to power the video calling feature. If this happens, the third party (“subcontractor” in HIPAA terminology) becomes a business associate as well. As a consequence, you must obtain satisfactory assurances that your video calling API provider meets the requirements of the Privacy Rule. These assurances include a wide range of measures such as privacy policies, workforce training program, and data safeguards. Clearly, assessing these measures isn’t something startups want to spend their time on when choosing a provider.

The best way to reduce the burden of complying with the Privacy Rule is to choose a video conferencing service that does not require access to PHI. You may be wondering which patient health information is PHI and which information is not. The answer is simple: patient health information is considered PHI only if it can be linked to an individual who can be identified.

Taking the example of an online doctor visit app, you’ll want to make sure that both the doctor and the patient participating in the call have their authenticity verified based on their user ID. This means you’ll need to choose a video conferencing service that comes with an authentication mechanism calling user IDs from your app. You may want to use emails for user IDs; however, this means you’ll be sharing PHI with a subcontractor as emails allows tracing back to individuals’ identities.

So, how can you anonymously authenticate users to the video call?

The answer is to use opaque user IDs. Opaque IDs can be strings of random characters that are defined in your app and tied to a unique user. Your video chat API provider will use them to anonymously authenticate your users to its video cloud service. Bottom line: you don’t need to worry whether your subcontractor stores user IDs in a HIPAA compliant manner.

Making sure you are not sharing PHI with your video provider is really the most important point to consider, as it avoids extending the applicability of HIPAA to another party. That said, remember that all the above applies to a scenario where conversations are not stored. If you’re looking to add video recording, you’ll need to implement additional safeguards as defined in the Security Rule. The same is true if screen sharing and file transfer (often complementary to video conferencing) is used to share PHI.

Also, keep in mind that security measures required to be HIPAA compliant may not be sufficient to reach the level of privacy you aim for your app. For instance, I highly recommend considering end-to-end encryption of the media in transit even though it goes beyond requirements defined in the Privacy and Security Rule. This safeguard will prevent discussions between patients and doctors to be snooped on.

Hopefully this article has clarified your understanding of how HIPAA applies to video conferencing so you don’t pass on the opportunity to build the next $1 billion app! Indeed, the global telehealth market is estimated to reach $4.5 billion in 2018, growing tenfold from 2013. At the same time, six of ten doctors and patients claim not to be hesitant about using digital health technology. These numbers outline a steady base of users willing to adopt telemedicine!

Do you have other HIPAA related questions? Feel free to post a comment.

About the Author: Damien Espinasse

Damien was born again when he discovered growth hacking. Naturally, his interests converge at the crossroads of marketing, startups and technology. He thinks RSS will always be the best medium to eat up information no matter how many social networks are out there. His mantra is “Never stop learning from people and


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Survey: 31 percent of MDs use mobile to communicate with patients

Survey: 31 percent of MDs use mobile to communicate with patients | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Half of physicians and extenders said virtual visits could replace more than 10 percent of in-office patient visits, thus giving them more time during the workday, according to a PricewaterhouseCoopers survey of 1,000 physicians, nurse practitioners, and PAs.


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TU Delft - Ambulance Drone - YouTube

Each year nearly a million people in Europe suffer from a cardiac arrest. A mere 8% survives due to slow response times of emergency services. The ambulance-drone is capable of saving lives with an integrated defibrillator. The goal is to improve existing emergency infrastructure with a network of drones. This new type of drones can go over 100 km/h and reaches its destination within 1 minute, which increases chance of survival from 8% to 80%! This drone folds up and becomes a toolbox for all kind of emergency supplies. Future implementations will also serve other use cases such as drowning, diabetes, respiratory issues and traumas.

Project Creator: Alec Momont - alecmomont.com

Film Director: Samy Andary - samyandary.com
Cinematographer: Tomas J. Harten - vimeo.com/user12379455
Actress: Rebecca ter Mors - rebeccatermors.com
Actor: Roland van der Velden
Speed test drone clip: SkyHero - sky-hero.com

Project Sponsor: Living Tomorrow - livingtomorrow.com
Project Facilitator: TU Delft - tudelft.nl
Project Chair: Prof.dr.ir. Richard Goossens
Project Mentor: Ir. Kees Nauta
Project Supervisor: Peter de Jonghe
Project Coordinator: Jurgen de Jaeger

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Laurent FLOURET's curator insight, November 25, 11:15 AM

Very helpful for places not equipped already!

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Motivational Dynamics in Health Behavior Change 2014

Despite the wealth of technology-assisted advances in healthcare, human behavior continues to be the cause of great variance in health-related outcomes. Our h…

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Provider attitudes on digital health, big data more closely aligning with consumers

Provider attitudes on digital health, big data more closely aligning with consumers | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

While  big data has been a big buzzword in tech circles for some time, healthcare providers have been slower to embrace the promise. But the attitude is changing quickly among clinicians and is now more closely aligned with that of the consumer, according to a new report from PwC.

“Digitally-enabled care is no longer nice-to-have, it’s fundamental for delivering high quality care,” said Daniel Garrett, health information technology practice leader for PwC US, in announcing the report. “Just as the banking and retail sectors today use data and technology to improve efficiency, raise quality, and expand services, healthcare must either do the same or lose patients to their competitors who do so.”

The report, which surveyed more than 1,000 industry execs, physicians and other providers, found the following:

– About 42 percent of physicians are comfortable relying on at-home test results to prescribe medication.
– Half of physicians said e-visits, or telemedicine, could replace more than 10 percent of in-office patient visits, and nearly as many consumers indicated they would communicate with caregivers online.
– Twenty-eight percent of consumers said they have a healthcare, wellness, or medical app on their mobile device, up from 16 percent last year. Roughly two-thirds of physicians said they would prescribe an app to help patients manage chronic diseases such as diabetes.
– Nearly half of consumers and 79 percent of physicians believe using mobile devices can help clinicians better coordinate care.

Through its survey and interviews with 25 healthcare executives, the report found that leaders across health plans, hospitals, and the pharmaceutical industry all anticipate major shifts in how care is delivered. However, data-sharing, consumer consent, privacy and security, fragmented workflows and digital investment constitute barriers.

The report said  analytics, improving work-flow and targeting digital interventions will be key for providers going forward.

 
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Dr. Web: German Medical Start-Ups Aim to Digitalize Healthcare - SPIEGEL ONLINE

Dr. Web: German Medical Start-Ups Aim to Digitalize Healthcare - SPIEGEL ONLINE | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

With recent advances in technology, visits by patients to Germany's well provisioned physical therapy centers may soon become a thing of the past. Instead, they may find themselves completing their therapy at home -- in front of their televisions.

 

ANZEIGE

The respected Fraunhofer Institute in Berlin has developed MyRehab, a form of physical therapy that enables patients to conduct their exercises at home. The system uses a special camera, a television and sensors built into a chest strap. An avatar leads the patient through the exercises and cameras and sensors monitor whether the patient has completed them correctly. The platform even makes it possible for a doctor or physical therapist to communicate with the patient using a live Internet video connection.

MyRehab is just one example of what many believe will be the next Internet revolution: the digitalization of healthcare. After smartphones transformed the ways in which we communicate, move and shop, medicine appears to be next.

Internet giants like Google are currently preparing to make large investments in the sector. In the United States alone, some $3.5 billion ($4.38 billion) is expected to be invested this year in healthcare-related start-ups. The market is no longer limited to gimmicky items like health wristbands or Bluetooth-connected tooth brushes. New applications are focusing on real medical care, from giving birth to treating cancer.

There are numerous examples in Germany of companies taking advantage of the surge in information technology, particularly the rapid proliferation of smartphones, to explore the opportunities in what many believe will become a fast-growing sector.

A New Doctor-Patient Relationship

Thousands of health-related apps are already available on smartphones today. There are programs to measure blood pressure or to analyze a child's development. Some claim to be able to detect autism and one app called Clue even purports to be able to predict a woman's next period as well as her ovulation window for the sake of pregnancy planning. Another app can allegedly scan vacation photos for signs of a rare form of eye cancer.

A new era of online medicine is emerging, one that could provide a great deal of advantages to doctors and patients alike. But it is also likely to raise a number of important questions about which medical services can best be enhanced through digitalization. There are ethical issues, too, like who will be held liable if something goes wrong? Will the new digital services create greater transparency or will they just turn patients into data-obsessed hypochondriacs? And perhaps most pressing, will patients be required to pay for the online offerings themselves or will health insurance companies pick up at least part of the tab?

One thing is certain: Smartphone medicine is going to transform the relationship between doctors and patients.

Take the example of Klara, an app for skin conditions that operates under a simple premise. The patient takes two smartphone photos of the rash or liver spot in question, uploads them and answers a few questions. Within two days, patients receive a response, either a tentative diagnosis or even a warning from a doctor that, for example, skin cancer is a possibility and the patient should consult a physician within two weeks' time. The app has already been downloaded around 135,000 times, at a cost of €29.

Simon Bolz, a developer for the Berlin-based start-up, says that the company has succeeded in reviewing around 98 percent of all photos sent in. Currently, Munich's Technical University is also reviewing the reliability of the diagnoses provided. The company believes that a large share of its revenues in the future will come from customers outside of Germany. Already today, around 20 percent of requests have come from abroad. For its services, Klara takes a cut of a little less than 50 percent, with the slightly larger half going to dermatologists working with the company. Thus far, health insurers in Germany are not reimbursing their customers for using the Klara service.

When asked if he thinks algorithms will one day be able to replace doctors in diagnosing patients, Bolz says he doesn't know. Instead he prefers to discuss how much more comfortable the actual work of providing medicine will become in the future. "Soon, doctors might even be able to telecommute from home two days a week using a tablet," he says.

First, though, medical professionals will have to work through some prickly ethical issues. Currently, professional guidelines stipulate that doctors cannot act exclusively through "print or communications media," meaning virtual care may not replace a physical visit to a doctor. Klara skirts this problem by using vague language and describing a diagnosis as a "medical opinion".

Franz-Joseph Bartmann, a surgeon with the Chamber of Physicians in the northern German city of Flensburg, says his organization views businesses like this "openly, but critically." He doesn't see any need at the moment to take action to stop the companies from providing virtual medical services. Given that there are plenty of qualified doctors to go around, he believes few people are going to "give up personal contact with their doctor in favor of a smartphone."

New Generation

Still, a new generation of patients is emerging. Blogs about specific illnesses, X-rays posted to Instagram, Facebook groups dedicated to medical conditions: All of that has long since become commonplace. Furthermore, a large percentage of doctors have stated in polls that they have sought information about certain diagnoses on the Internet. Some say it has even prevented them from making mistakes. Patients too seek medical advice on the Web.

In response, start-ups like the Lübeck firm Patientus want to give doctors an office in cyberspace. Patientus provides an application that looks like Skype but can do considerably more. Company founder Nicolas Schulwitz originally wanted to become a doctor but ultimately wound up working for a health insurance company. He found it surprising that there was no video conferencing system in existence that was tailored specifically to healthcare professionals. He began developing one in 2011.

"With our service, the doctor pays for his ability to use the Web presence," says Schulwitz, adding that access to the platform costs medical professionals around €100 per month. He says that it is particularly helpful for acquiring new patients. "You could also pick up the phone, but being able to see each other is completely different," he says. The platform even includes a virtual waiting room that patients must visit before their consultation. The Patientus platform also can be used for check-ups, thus saving the patient time and the hassle of driving to the doctor's office. It also allows doctors to hold office hours from any location.

One Berlin start-up is working on an even wider-ranging service by providing a virtual personal physician who is available 24 hours a day, seven days a week.

Should the model become popular, algorithms could soon at least partially replace a doctor's assessment. An app called OneLife, for example, arose directly out of the delivery room. Developers learned from clinics that expecting mothers often ask about the availability of WIFI when choosing the hospital where they would like to give birth. "A generation is coming that doesn't even want to set aside their mobile phones while giving birth," says OneLife founder David Schärf.

When Berlin-based OneLife launches in December, its product will initially be little more than a digital pregnancy journal into which a mother-to-be can enter observations she deems pertinent, from mood swings to pain levels. There is also room for 3-D ultrasound scans, which can then, of course, be shared with friends. The app also provides suggestions, for example that smoking husbands try to quit. But the main attraction is that the course of the pregnancy can be searched for certain patterns, perhaps enabling the prognostication of potential complications. Should one be found, the app will be able to send warnings to users. Should, for example, a patient note that she is experiencing bleeding, the app will urge her to see her doctor right away due to the danger of a premature birth.

Ultimately, Schärf would like to see OneLife expand into a kind of life-long medical service, with checkups, blood tests, operation details and allergies being saved in the -- presumably secure -- cloud. This data will enable the recognition of patterns. As an extra, diagnoses and findings will be explained in language comprehensible to lay people. "We began with the issue of pregnancy because it is one that is fundamentally positive. But why shouldn't a cancer patient also be able to use this kind of app?" says Schärf.

Data Overload?

Analyzing large quantities of data has long since become something of a trend in medicine. The IBM super-computer Watson is able to search through 200 million pages of scholarly papers within three seconds on the search for information relevant to specific patients. "Thanks to computer capabilities like this, it will be possible in the near future to offer treatments to only those patients who will genuinely benefit from them and to protect others from the serious side-effects that such invasive therapies sometimes produce," says Chamber of Physicians official Bartmann.

But will it really make patients healthier to have a smartphone continuously collect data and monitor a person's health? Giovanni Maio, doctor and medical ethicist at the University of Freiburg, is skeptical. Data that is essentially collected at random is often only of limited use, he points out. "A good doctor collects a small amount of data, but the correct data," Maio says.

Fitness wristbands and smart watches that can count steps, measure heart rate and determine the amount of calories burned are relatively useless from a medical perspective. But the smartphones of today can already do much more than that -- at an affordable price. They can monitor glucose levels, for example. With the addition of a small clip, they can act as pulse oximeters, measuring the blood's oxygen content. A small, matchbox-sized attachment can even perform EKGs.

"Anyone suffering from heart disease gets extremely worried at even the slightest irregularity. But you also don't want to be calling the ambulance all the time either," says Jens Beermann, a cardiologist near Hamburg and the founder of Cardiogo. For a membership fee of €1,975 per year, patients receive a mini EKG device that can be carried in the pocket of one's pants. No matter where patients are in the world, they can perform a quick test as needed and send the results to a cardiologist.

Doctors on the other end can quickly access the patient's records and analyze the incoming EKG before calling the patient and explaining their findings. If needed, they can also provide necessary patient information to medical personnel on site. Two such calls per year are included in the subscription, with subsequent calls costing €95 each.

'Patients Want It'

 

 

Markus Müschenich is something of a thought leader in the German medical start-up branch. A pediatrician by training, he used to be a managing board member at Sana, a corporation that operates dozens of hospitals across Germany. He has since founded an association that is intended to support the application of digital technologies to healthcare.

"I have no doubt that good medical practice in the future will involve the Internet," he says. Online services, he adds, may make many elements of healthcare cheaper and they could offer the last resort for places where healthcare is unavailable. But he also sees another reason why the trend toward digital medicine is unstoppable.

"Patients want it," he says.


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dagautier's curator insight, November 21, 11:28 AM

An avatar leads the patient through the exercises and cameras and sensors monitor whether the patient has completed them correctly. The platform even makes it possible for a doctor or physical therapist to communicate with the patient using a live Internet video connection.

MyRehab is just one example of what many believe will be the next Internet revolution: the digitalization of healthcare. After smartphones transformed the ways in which we communicate, move and shop, medicine appears to be next.

 

Internet giants like Google are currently preparing to make large investments in the sector. In the United States alone, some $3.5 billion ($4.38 billion) is expected to be invested this year in healthcare-related start-ups. The market is no longer limited to gimmicky items like health wristbands or Bluetooth-connected tooth brushes. New applications are focusing on real medical care, from giving birth to treating cancer.

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#mhealth : New App Uses ‘Rewards’ to Monitor Mood Disorders

#mhealth : New App Uses ‘Rewards’ to Monitor Mood Disorders | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Adrian Cunning’s startup, ThriveStreams, has released its first product, according to CNET.

The newly released app takes a gamified approach to mood tracking for those with conditions such as depression and bipolar disorder. Cunning was diagnosed as bipolar in 2002 and has said that his own battle with the disorder inspired him to serve others with mental health struggles.

The app, ThriveTracker, collects data on activities such as meditation, exercise, journaling, as well as tracking therapy attendance and quality and amount of sleep. Users can chart their moods, anxiety, and irritable levels in order to analyze trends and make connections between moods and behaviors. Consistent users can earn rewards such as samples, gift cards, and MP3 downloads. The rewards are meant to incentivize consistent data entry.

The app is aimed at those whose moods vary more dramatically than usual, but can be used by anyone.

ThriveTracker app is free and compatible with iOS 7 and later, with Web and Android versions expected soon.


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Survey: Three-in-five Americans feel that intimacy health important to overall well-being

Survey: Three-in-five Americans feel that intimacy health important to overall well-being | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
Michael JohnsenA new national survey shows that while the majority of people (64%) believe sexual health correlates with overall satisfaction in life, more than a quarter shy away from addressing challenges with their doctor.  read more...

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Diabetes: Going Digital The role of technology in the prevention, treatment, and management of diabetes


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Artificial Intelligence, Really, Is Pseudo-Intelligence

Artificial Intelligence, Really, Is Pseudo-Intelligence | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

One reason I'm not worried about the possibility that we will soon make machines that are smarter than us, is that we haven't managed to make machines until now that are smart at all. Artificial intelligence isn't synthetic intelligence: It's pseudo-intelligence.

This really ought to be obvious. Clocks may keep time, but they don't know what time it is. And strictly speaking, it is we who use them to tell time. But the same is true of Watson, the IBM supercomputer that supposedly played Jeopardy! and dominated the human competition. Watson answered no questions. It participated in no competition. It didn't do anything. All the doing was on our side. We played Jeapordy! with Watson. We used "it" the way we use clocks.

Philosophers and biologists like to compare the living organism to a machine. And once that's on the table, we are lead to wonder whether various kinds of human-made machines could have minds like ours, too.

But it's striking that even the simplest forms of life — the amoeba, for example — exhibit an intelligence, an autonomy, an originality, that far outstrips even the most powerful computers. A single cell has a life story; it turns the medium in which it finds itself into an environment and it organizes that environment into a place of value. It seeks nourishment. It makes itself — and in making itself it introduces meaning into the universe.

Now, admittedly, unicellular organisms are not very bright — but they are smarter than clocks and supercomputers. For they possess the rudimentary beginnings of that driven, active, compelling engagement that we call life and that we call mind. Machines don't have information. We process information with them. But the amoeba does have information — it gathers it, it manufactures it.

I'll start worrying about the singularity when IBM has made machines that exhibit the agency and awareness of an amoeba.

There is another sense, though, in which we hit the singularity long ago. We don't make smart machines and we don't make machines likely to be smarter than us. But we do make ourselves smarter and more flexible and more capable through our machines and other technologies. Clothing, language, pictures, writing, the abacus and so on. Each of these has not only expanded us but has altered us, making us into something we were not before. And this process of making and remaking, or extending and transforming, is as old as our species.

In a sense, then, we've always been trans-human, more than human, or more than merely biological. Or rather, our biology as always been technology-enriched and more than merely flesh and blood.

We carry on the process that begins with the amoeba. Watson is our achievement. Its pseudo-intelligence is our genuine, 100 percent novel intelligence.

Alva Noë is a philosopher at the University of California at Berkeley where he writes and teaches about perception, consciousness and art. You can keep up with more of what Alva is thinking on Facebook and on Twitter: @alvanoe


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Pierre Tran's curator insight, Today, 8:49 AM

Pour Alva Noé, philosophe à l'Université de Californie, il n'y a pas lieu de craindre que les machines deviennent bientôt plus intelligentes que les humains. L'intelligence artificielle n'est qu'une pseudo-intelligence. Même un organisme aussi rudimentaire que l'amibe possède une intelligence bien supérieure au super ordinateur IBM Watson. On est encore loin de la singularité.

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New mobile app, TouchCare, enables video doctor-patient appointments via

New mobile app, TouchCare, enables video doctor-patient appointments via | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
Thanks to a new mobile app some patient appointments can now be as quick and personal as a Skype or FaceTime call.

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Patient Education Through EHRs

Patient Education Through EHRs | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

A Texas hospital invests in education to provide better patient experiences and, ultimately, better patient outcomes.

Evidence suggests when patients are engaged and educated about their healthcare decisions, there is a clear effect on both health and costs tied to their outcomes. The most innovative healthcare delivery systems recognize this and see their patients as assets who can help them achieve the goals of better health at lower costs. From this point of view, many argue investing in patient education to help them become more effective partners in care makes good sense.

To that end, Midland Memorial Hospital announced it is launching an interactive patient education and engagement program with the implementation of Allen Technologies’ electronic health record integration capabilities. Using Allen’s IPS integration with MedSphere’s OpenVista CareVue EHR, Midland Memorial Hospital’s nurses can select and assign patient educational videos directly from within the patient’s electronic record, making the process faster and more convenient for the nursing staff.

The new capability is just one piece of Allen Technologies’ suite of IPS clinical tools, including:

auto-assignment of important safety and infection control information to patientscustomized educational video libraryeducational pop-up reminders to patientspersonalized education in-boxes for patientsdrill-down educational usage reportingpatient access to health-related educational informationclinical education advisory servicesreal-time patient feedback and requests

Allen’s IPS patient education integration with OpenVista CareVue EHR reflects Midland Memorial’s commitment to continuous quality improvement and patient satisfaction. “We know that education can lead to a better patient experience, and ultimately better patient outcomes,” said Midland Memorial Hospital Assistant Director of Nursing, Cori Armstead.

In 1950, Midland Memorial Hospital, the only not-for-profit hospital in Midland County, TX was established by prominent community leaders with one mission: “To make quality healthcare available to all residents of Midland County.” Over succeeding decades, Midland Memorial Hospital has changed dramatically to meet the needs of a dynamic community. The hospital is licensed for 468 beds and offers several innovative programs, including the Heart Institute, Total Joint Center, women’s and children’s healthcare services and various rehabilitation programs.

SOURCE: PRWeb


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Les seniors et les objets connectés : enjeux et perspectives

Les seniors et les objets connectés : enjeux et perspectives | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
es seniors et les objets connectés : enjeux et perspectives

Selon une étude menée par le Ministère des Affaires Sociales et du Droit de la Femme sur la silver économie, on compte en France 15 millions de personnes de 60 ans ou plus et en 2030, elles seront 20 millions.

Dans cette perspective le gouvernement  a décidé au printemps 2013, de lancer la« silver économie », définie comme le regroupement de « toutes les entreprises agissant pour et avec les personnes âgées, avec la création de services personnalisés, de technologies pour l'autonomie ».
Le boom de la silver économieDu fait du vieillissement de la population, la demande d’aménagement du domicile et de services liés  au manque d’autonomie et au vieillissement devrait doubler en l’espace d’une vingtaine d’années. L’offre doit donc s’adapter considérablement pour répondre à l’ensemble de cette demande générant ainsi des emplois et une perspective de croissance importante pour l’économie française.
En effet, la silver économie est également un gage de forte croissance et d’emplois pour les années à venir. La Direction de l’animation de la recherche des études et des statistiques estime que cette nouvelle filière débouchera sur 300 000 emplois, d’ici à 2020.
Face à cette transition démographique les entreprises françaises se doivent d’anticiper les changements à venir. Il s’agit d’offrir aux entreprises les moyens de créer et de développer des produits qui faciliteront l’autonomie des personnes âgés de demain. C’est dans cette perspective que les IOT, objets connectés à destination des seniors ont fait leur apparition, rivalisant d’ingéniosité pour aider au mieux les personnes âgées.
Les seniors et les objets connectés (IOT)Les objets connectés ou IOT représentent les échanges d'informations et de données provenant de dispositifs présents dans le monde réel vers le réseau Internet. L'internet des objets est considéré comme la troisième évolution de l'Internet, baptisée 3.0. Rien de sorcier pour une majorité des seniors qui en a déjà entendus parlé. A juste titre, puisque ces derniers sont désormais qualifiés de « geekiors », fusion des termes « geek » et « senior » par les médias.
Piluliers, outils informatiques ou encore fauteuils roulants connectés, une large gamme de produits est proposée aux seniors  tels qu’un bracelet connecté qui permet d'alerter en cas de chute, malaise ou angoisse. Un système d'alerte permet de rendre compte du comportement « suspect » d'une personne âgée telle une absence prolongée ou l’absence d'ouverture de la porte du réfrigérateur. Un pilulier  connecté qui prévient un pharmacien, un médecin, ou un membre de la famille sur la consommation normale ou pas des médicaments. Il existe même une webcam qui permet d'assurer une surveillance visuelle  avec l’autorisation de la personne.
Pour une personne souffrant d’un handicap, un fauteuil connecté  peut être mis à leur disposition pour les aider dans leurs déplacements. Pour cela, il suffit de brancher un téléphone portable ou un ordinateur au système de commande du fauteuil roulant.
Les utilisateurs peuvent ainsi grâce au fauteuil connecté se diriger en toute autonomie, envoyer des e-mails, passer un coup de fil et même envoyer un message d’alerte à leurs proches si besoin.

 De nombreux Hespérides ou hôpitaux, utilisent les objets connectés. Certains ont déjà installés des solutions IOT connectées à une télévision permettent, en plus d’accéder aux chaînes de télévisions classiques, d’écouter la radio, de jouer aux échecs, d’écouter de la musique, de pouvoir communiquer avec son entourage par vidéo-conférence et de téléphoner de manière illimitée. Les résidents souffrent moins de solitude et se sentent également plus proches de leur famille. Pour les personnes à mobilité réduite ou cardiaque, il existe des télécommandes qui contrôlent l’ouverture et la fermeture des volets ou encore de portes, afin d’éviter que les personnes âgées ne se fatigues ou ne se blessent en circulant. Pour éviter les risques la nuit, et circuler en toute sécurité, des chemins lumineux peuvent s’activer grâce à un interrupteur connecté que la personne âgée garde avec elle.
Ainsi, les objets connectés se révèlent une chance, aujourd’hui, pour soulager les familles des malades ou toute autre personne en situation de handicap et leur permet d’une manière générale de conserver dignité et qualité de vie en toute sécurité.
L’avènement des seniors 2.0 est en marche, ils sont nombreux a avoir été initiés par leurs petits enfants et sont plutôt enclin à apprendre. Malheureusement il n’existe pas de pédagogie type qui soit adaptée à la compréhension de l’utilisation des IOT pour les seniors. De fait, certain seniors mal informés ont peur de se lancer et finissent par abandonner.
Quel avenir pour ce nouveau marché ?Emmanuel Macron, Ministre du Redressement productif et Laurence Rossignol, Ministre déléguée aux Personnes âgées et à l’Autonomie ont fait du développement numérique une priorité pour la croissance et Paris est aujourd’hui le plus grand centre technologique d’Europe après Londres. L'ambition nait alors de faire de la France, l'un des leaders de ce nouveau type d'activité qui pourrait représenter à terme, un facteur d'une nouvelle croissance. Pour cela, il faut se fixer deux objectifs.
Le premier : qualifier ces centaines de milliers de personnes qui auront cette vocation d'accompagner les personnes dépendantes et ceci nécessite un effort gigantesque.Le deuxième : Les technologies de silver économie sont balbutiantes, il faut aider à financer les développements, aider à la création de technologies, aider à la création de start-up : soit, permettre la naissance de nouveaux secteurs d'activité.Il faut faire de la silver économie une priorité nationale. Reste alors à réellement la développer et à la financer de manière à honorer cette nouvelle ambition porteuse d’avenir.Nous vous recommandons

Via Celine Sportisse, Senior, Personnes Agées & Silver Economie
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Senior, Personnes Agées & Silver Economie's curator insight, November 26, 6:59 AM

De gros enjeux économiques à la croisée des marchés des objets connectés et de celui de la Silver Economie

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Cloud and Data Security in Healthcare | HealthWorks Collective

Cloud and Data Security in Healthcare | HealthWorks Collective | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Many healthcare organizations are embracing cloud computing to improve data efficiency and reduce administrative costs. The cloud lets healthcare professionals access patient information from any Wi-Fi-enabled device at any location.

This ease of access makes it easier for health practitioners, medical facilities, and insurance companies to quickly share patient data. Emergency responders can provide patient care faster by accessing critical health information offsite. Physicians can review new patients' entire medical histories online without waiting for physical records to be transferred. Patients can have direct access to their health records online. The sharing of information through the cloud reduces administrative costs because of the reduced need for paper records.

These advantages and more have led to the growing popularity of cloud computing in the health care industry. However, cloud computing can only be successful if the cloud is secure and patient privacy is protected.

Importance of Cloud Security

Cloud security is important to protect patient privacy, comply with health care laws, and ensure that only authorized health care professionals access the correct data. Some health organizations are hesitant to adopt cloud computing because of the complexity of structuring cloud computing to comply with the Health Insurance Portability and Accountability Act (HIPAA), which regulates how health organizations protect private healthcare information. Others are resistant to adopting cloud computing due to concerns over unauthorized access to data. Patients are not always viewing their medical records online due to network security concerns.

A successful cloud healthcare network must use data security measures that comply with HIPAA, prevent unauthorized access, and protect authentic patient data. There must be no doubt of the authenticity of patient data, which can make the difference in effective medical treatment. Both healthcare professionals and patients must trust the cloud network security to protect personal data for it to work. Effective cloud security will gain this vital trust.

Challenges of Cloud Security

Effective cloud security must address key challenges in the following areas:

Preventing unauthorized access: It is critical that only authorized users access data in a healthcare cloud. This can be tricky in a virtual environment with so many remote users and multiple Wi-Fi devices.

Accessing data safely from mobile devices: Health professionals and patients should be able to access data securely from mobile devices like cell phones, tablets, or laptops. If network security isn't optimal, vulnerable data could be lost or stolen when accessed through an unsecured mobile device.

Protecting databases from malware and attacks: A cloud must have a secure database that effectively protects against cyber attacks and malware. Some popular security components like open-source software, which played a role in the Heartbleed bug breach at Community Health Systems, are not the safest options. It is also important to have an incident repair and response system in place to respond quickly to block any attacks or breaches.

Preventing data loss: A cloud has to have a good system to prevent data loss and a way to retrieve lost data when possible. A cyber attack, an encryption error, or a natural disaster are some of the ways data could be lost.

Overcoming Cloud Security Challenges

The healthcare industry can trust cloud computing to be a secure and effective tool to deliver professional services, share data, and store patient data. The key challenges to cloud network security can be overcome with encryption, two-factor identification, and security intelligence.

Encryption: Encryption changes data into a secure format that only an authorized user with the correct encryption key can access. Data should be encrypted when it is in use, in transit, and at rest to make sure that the data is unreadable if it is lost or stolen. Split-key encryption provides even greater network security because it is protected by two encryption keys, which are held by the healthcare organization and the cloud service provider. Both keys must be used in order to access data.

Two-factor identification: Unique usernames and passwords aren't enough to identify authorized users. Requiring a second form of identification like a fingerprint or specialized software token adds an extra layer of security to ensure only authorized users access the cloud data.

Security intelligence system: An effective security intelligence system that monitors the logs of all of the cloud servers and firewalls for any unusual activities can identify and block cyber attacks and malware and prevent potential data breaches or data loss.

With effective network security, cloud computing can revolutionize the healthcare industry by making it easier for health professional to share critical data, giving patients greater control over their own health records and making the healthcare workplace more efficient.


Via Philippe Loizon, Lionel Reichardt / le Pharmageek
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6 Statistics that Prove Telemedicine is Reshaping the Future of Healthcare

6 Statistics that Prove Telemedicine is Reshaping the Future of Healthcare | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Validating the potential of telemedicine by examining several promising numbers and statistics.

The forecast for telemedicine has always been based on the broad intentions of creating more convenient and accessible care. For years, that prognosis was widely regarded as a futuristic, yet implausible system. These days, however, that is not necessarily the case, as the arguments against telemedicine continue to dwindle with modern advancements in mobile technology.

“As we move to an outcomes-based model of healthcare provision in the U.S., remote monitoring and telehealth are going to drive an extension of the point of care. We’re seeing physician attitudes really align with policy.” - James Avallone, Director of Physician Research for Manhattan Research

According to Broadband & Telemedicine: Stats, Data, & Observations, broadband-enabled telemedicine encompasses five key features:

- Real-time remote patient consultations

- Remote monitoring of patients’ vital signs and conditions

- The storing and forwarding of critical health information for analysis and diagnosis (e.g. MRI results and EHRs

- The provision of specialized services over long distances (e.g. teledentistry, telepharmacy, telepsychiatry, and mHealth)

- The wide availability of health information to patients and caregivers

 

With the variety of services that can be incorporated into a system of care, it’s no surprise that so many healthcare providers are now looking to offer telemedicine. If you’re still not convinced that telemedicine is reshaping the future of healthcare, take a look at these statistics:

89% of healthcare executives said they expect telemedicine to transform the U.S. healthcare system in the next decade.

- Source: iHealthBeat

  

The global telemedicine market is expected to grow from $11.6 billion in 2011 to $27.3 billion in 2016.

- Source: BCC Research

  

Worldwide revenue for telehealth devices and services is expected to reach $4.5 billion in 2018, up from $440.6 million in 2013

- Source: IHS

  

The number of patients using telehealth services will grow to 7 million in 2018, up from 350,000 in 2013.

- Source: IHS

  

Telemedicine could potentially deliver more than $6 billion a year in healthcare savings to U.S. companies.

- Source: Towers Watson

  

The percentage of healthcare employers offering telemedicine is expected to increase by 68% by next year, from 22% in 2014 to 37% in 2015.

- Source: Towers Watson

Traditionally, healthcare providers have been hesitant to integrate telemedicine into their practice due to a reluctance to rely on technology, lack of funds and eagerness to train employees on new material, and concern that technological defects will result in malpractice suits. In this day and age, however, technological enhancements can justify the elimination of those fears. Telemedicine’s infusion into our healthcare system is eminent; it has transformed into a service that will revolutionize the way we are able to provide for patients – in a manner more convenient and accessible than ever before.


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Two-thirds of Americans willing to share health data with researchers

Two-thirds of Americans willing to share health data with researchers | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

According to a new survey from Truven Health Analytics and NPR, 68 percent of American consumers are willing to share health information with researchers, but this group of people is more likely to be wealthy, well-educated, and young.

Truven surveyed 3,000 Americans via landlines, mobile phones, and the web, with the group filtered by generation, education level and income level. They asked questions about physician connectedness and data privacy.

The survey found that overall, only 74 percent of respondents said their physician had an electronic health record. However, that figure includes 19 percent of respondents who said they don’t have a physician at all — only 6 percent reported having a physician with no EHR. Millennials were most likely to report not having a physician (36 percent) whereas those in the “Silent Generation” were the least likely (just 2 percent). Although 74 percent had an electronic health record, only 44 percent reported having accessed the health records their physician kept on them.

Other questions in the survey centered on privacy and data sharing. Respondents were asked whether or not they had concerns about the privacy of data they had already shared with healthcare stakeholders. Of the four groups — physicians, hospitals, employers, and health insurers, employers were the most trusted, with only 10 percent of participants expressing concern. That went up to 11 percent for physicians, 14 percent for hospitals, and 16 percent for insurers.

Those in the $100,000 a year or more income bracket were more concerned about privacy than others — 27 percent of them had concerns about their health insurer and 17 percent had concerns about their physician. By contrast, the most trusting group was those 65 or older: only 2 percent worried about their employer and just 12 percent distrusted their insurer.

The level of concern seems to match up with actual cause for concern: when participants were asked whether their medical information had ever been compromised, only 5 percent of the total group said it had, but that included 16 percent of the $100K+ earners and only 1 percent of the Silent Generation members.

Nonetheless, most survey participants were willing to share information anonymously with researchers. Some — 22 percent — were even willing to share credit card purchase information and social media information with their doctors if it would improve their health. This number broke down most strongly on generational lines, going up to 30 percent for millennials and down to 15 percent for baby boomers.


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Alex Butler's curator insight, November 25, 1:14 PM

According to a new survey from Truven Health Analytics and NPR, 68 percent of American consumers are willing to share health information with researchers, but this group of people is more likely to be wealthy, well-educated, and young.


Truven surveyed 3,000 Americans via landlines, mobile phones, and the web, with the group filtered by generation, education level and income level. They asked questions about physician connectedness and data privacy.

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Best Practices for Medical App Development Go Beyond Standard UX | UX Magazine

Best Practices for Medical App Development Go Beyond Standard UX | UX Magazine | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Mobile healthcare app development poses a set of challenges very different from mainstream apps. Not only is security an area that requires a considerable attention, compliance with regulatory standards is also absolutely crucial. Here are things app developers should pay close attention to during the development process.

1. Focus

A successful mobile medical application should be able to demonstrate clinical benefits and offer real value to its users—whether they are patients, healthcare practitioners, or both. Using medical apps for routine self-monitoring and feedback is a cost-efficient strategy for self-management. The app should have only those functions and features relevant to its audience. Therefore, it is extremely important to understand and master the needs of all relevant stakeholders, aggregate real-time usage data, and use this information in development.

App developers must resist the temptation to throw in additional features that don't add much value or, in the worst case, confound or scare the users. The medical app should build on existing user behavior—if the app demands significant efforts or behavioral changes, it will probably not be successful. Innovations are born from great observations, so app developers should frequently engage with users and study their approaches to improve existing solutions, or design new ones. Furthermore, the app should deliver significant improvements across releases or versions.

According to Stacey Chang, Association Partner and Director of Health & Wellness at IDEO, in aan interview on iMedicalApps: “We get a lot of proposed solutions that make an incremental difference. It's not enough to solve the problem, because there are so many stakeholders, and people focus only on what they can effect, and it's a challenge for entrepreneurs.”

2. Understand the Healthcare System

Medical apps should align with the healthcare systems to not only be in compliance with the legal and regulatory systems in the local markets, but also to demonstrate value to other stakeholders, such as payers, providers, and employers. For example, a developing country may have fewer doctors-per-capita compared to a developed economy. The doctor to patient ratio is estimated to be 1:1,500 in India and 1:1,000 in China, while this ratio is 1:350 in the U.S. The smart phone might be the only conduit for care in rural areas of developing economies, building a strong case for telemedicine.

You can’t rely on end-users' technical expertise with things like data privacy and securitytweet this

China has a less tortuous regulatory system and the Chinese government pays for the healthcare services. Although the Indian Government has implemented a variety of public healthcare systems and financing options to universalize healthcare services, out-of-pocket healthcare expenses continues to remain high. Understanding such demographic trends, patient psychology, local market conditions, and the healthcare systems is absolutely crucial in designing apps and mHealth services that resonate among the local populace.

3. Don't Rely on User Expertise

Not all users are alike and you can’t rely on end-users' technical expertise with things like data privacy and security. Over half of the patient population find passwords too cumbersome to remember, over 33% are not concerned with risks of data breaches, and over 55% of adults use the same password for nearly everything. Though pattern locks are less secure than pins—a five-digit pin has over 5 million combinations compared to only about 15,000 combinations with pattern combination—the latter is very popular among mobile users. In such cases, it's worthwhile to enforce stronger measures and eliminate options that could potentially compromise security. Complex functionalities should be abstracted from users wherever possible with proper validation checks to minimize data entry or usage errors.

4. On-Board Experts

When developing an app for a particular disease, it's mandatory that a medical expert with specialization in that disease be on-boarded and frequently consulted through the development cycle. Medical apps require deep and sometimes very specific medical knowledge that is beyond most developers. Field and beta testing using online, focus, or (ideally) patient groups is obligatory to ensure that the app has relevance with the target audience. A physician or specialist with a patient list populated by the target audience makes an invaluable ally. They can also direct field-testing as clinical trials and endorse the app to patients and colleagues.

5. Leverage Design Thinking Principles

According to Tim Brown of IDEO:

A lot of times we get a lot of proposed solutions that make an incremental difference. It's not enough to solve the problem, because there are so many stakeholders, and people focus only on what they can effect, and it's a challenge for entrepreneurs … Human-centered design thinking–especially when it includes research based on direct observation—will capture unexpected insights and produce innovation that more precisely effects what consumers want.

Medical apps should be powered by design thinking principles that revolve around a thorough understanding of customer needs gathered through direct observation—seeing what people want and need, how they use a particular product or service, and what they like or dislike about the way particular offerings are produced, packaged, delivered, and supported. Design thinking principles help overcome the “wicked problem,” which most medical app companies face. Wicked because the app company has too many options at its disposal and too many directions to explore—a situation that can potentially distract it from concentrating on the core activities that drive customer value. Design thinking offers a structured approach and a repeatable process framework that aims to discover and design feasible solutions that users appreciate. The focus on innovative product designs, humanizing technologies, and patient experiences is what propelled Apple into market leadership and what that GE Healthcare continuously pursues in areas that are intended to both improve care and make an emotional connection with patients.

6. Embed the App in Research

By its very nature, healthcare research is a long and convoluted process. The funding is front-loaded, but the impact can be assessed only after a substantial time lapse. An app development project embedded within a well-constructed and cost-accounted research project can build upon years of collective experience, development, and testing. A captive population of research participants and volunteers can accompany the development process as users, evangelists, advocates, testers, etc. From within the context and boundaries of an academic institution, the developer can forge industry partnerships, broker alliances, and scale the solution. Many medical apps were products of academic research and followed this strategy to success.

7. Get in the Trenches

To really understand stakeholder psychology, developers should entrench themselves in the worlds of both patients and physicians. The developer should understand and appreciate the utility of such knowledge. An app that accurately records real-time information from patients can be used by physicians to make crucial decisions and is far more useful and valuable than a tool gathering extraneous data. Moreover, patient-centric applications are systems built on partnerships among practitioners, patients, and other stakeholders, revolving around patients’ relationships, networks, needs, and preferences. Hence, app developers should solicit patients’ input to identify metrics that influence their decisions. Apps that bridge clinical and non-clinical sectors should include both individual- and population-oriented tools.

8. Test the Prototype

The medical app developer should take the time to thoroughly field-test the app before releasing it to the app marketplace. It's crucial to get the prototypes out among the target audience as early as possible. In other words, it's crucial to take the app for a spin in the real world. No matter how expensive this might seem, it is always better to budget some extra resources than compromise on app quality.

For example, mobile network availability is a factor that cannot be reliably predicted without rigorous field-testing. If the app requires constant online connectivity, but its users have only sporadic Internet connections, field-testing helps profile Internet availability to develop workarounds or alternatives. If the end-users experience difficulties using the prototype, the discovery can initiate the necessary changes and save considerable resources and frustration.

9. Data and Processes First; Then Logic

Traditionally, a lack of high quality data plagued the healthcare industry, leading to clinical trial delays and product failures. Today, however, high quality data is relatively inexpensive to acquire and use. Doctor's offices are also increasingly using electronic health records to closely monitor patients and deliver healthcare services. Most app developers, however, embrace approaches that involve logic- and rules-based clustering, expressing relationships between entities to articulate their app's value. Unless information about those entities is available, association maps, connections, and processes cannot be built. As more data becomes easily accessible for multi-application use, the key success strategy will be deploying these data assets with robust processes that create value. In other words, developers should cultivate process capabilities that demonstrate value and build competitive barriers.


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Consumer health big data needs clinical validation

Consumer health big data needs clinical validation | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

With millions of Americans using fitness apps and tracking devices that count thousands of steps, keep tabs on weight and diet information, and record other consumer behavior information, there’s more data than ever to enhance a person’s health decisions. But researchers at the National Cancer Institute are hesitant to say this wearable tech revolution is clinically effective.

James McClain, program director of NCI’s Risk Factor Monitoring and Methods Branch within the National Institutes of Health, said Thursday as part of a health IT panel that his institute is a major supporter of the growing infrastructure on connected health devices and applications, especially the data they generate. On a scientific level, though, he questioned, “Do we know if any of this works?”

“I would say anecdotally, we believe a lot of this works, and we have a lot of faith and confidence and belief,” McClain said. “But that doesn’t move the process forward as fast as it might.”

“It doesn’t take much to convince the consumer these days. Consumers believe, on a lot of these sorts of technologies and devices, that they will help them,” he said. “So there’s a lot of faith on the consumer side.” On the clinical side, however, it’s an entirely different story. “I think that’s why there’s some pause and some caution on the concept of patient-generated data,” he said. “How do we understand what it means?”

Rather, McClain said the focus should be on the “validation and evaluation of evidence generation,” and with the right funding, “that’s where a biomedical research institute like NIH can play a big role.”

“I’ve been pushing us to try to shift our focus in more of a clinical direction and less of a generalized public health assessment focus, cause we do, we support, we fund a lot of tremendous methodological work in those areas, and it’s probably time to turn it towards more of the individual user where we’re going to have this actionable data,” he said. That means setting up an IT and systems infrastructure that can process that data and make sense of it all. And in some cases, it could be as easy as inserting a clinical algorithm in the background of an app or device. It’s also scalable and replicable.

“A lot of that infrastructure, technology, systems, components we need to build, is identical when you look at cancer prevention or you look at heart disease, diabetes or any other chronic diseases we’re facing … any other health behavior,” McClain said. “What are the core components of analytic and IT systems we need to manage the data flows? We’re all talking about different sorts of data we want to potentially feed to clinical systems. But functionally, many of the components of that are sensible or usable and they are not something that have to be built a hundred times by a hundred different institutes or centers.”

The role NCI, other national health institutes and other federal health-focused agencies must take is complementary, building the systems to process that data — “Eighty to 100 Hz, just ridiculous data volumes, terabytes and terabytes of data,” McClain said — for their own purposes. Trying to standardize or change the consumer health industry will not help the cause.

“They’ll do greater things than we can do because they’re just going to have the venture capital investment and other sorts of things in that direction that drive innovation, and we don’t have that kind of money to put behind it,” he said.

But if NCI can capture more data, McClain said, he believes they might be able “to pick up the features and aspects of movement profiles, of sleep profiles, or other aspects of daily interaction that might actually be the signal rather than the noise.”

- See more at: http://fedscoop.com/nci-consumer-health-big-data-needs-clinical-validation/#sthash.lqZv5WBu.dpuf

With millions of Americans using fitness apps and tracking devices that count thousands of steps, keep tabs on weight and diet information, and record other consumer behavior information, there’s more data than ever to enhance a person’s health decisions. But researchers at the National Cancer Institute are hesitant to say this wearable tech revolution is clinically effective.

James McClain, program director of NCI’s Risk Factor Monitoring and Methods Branch within the National Institutes of Health, said Thursday as part of a health IT panel that his institute is a major supporter of the growing infrastructure on connected health devices and applications, especially the data they generate. On a scientific level, though, he questioned, “Do we know if any of this works?”

“I would say anecdotally, we believe a lot of this works, and we have a lot of faith and confidence and belief,” McClain said. “But that doesn’t move the process forward as fast as it might.”

“It doesn’t take much to convince the consumer these days. Consumers believe, on a lot of these sorts of technologies and devices, that they will help them,” he said. “So there’s a lot of faith on the consumer side.” On the clinical side, however, it’s an entirely different story. “I think that’s why there’s some pause and some caution on the concept of patient-generated data,” he said. “How do we understand what it means?”

Rather, McClain said the focus should be on the “validation and evaluation of evidence generation,” and with the right funding, “that’s where a biomedical research institute like NIH can play a big role.”

“I’ve been pushing us to try to shift our focus in more of a clinical direction and less of a generalized public health assessment focus, cause we do, we support, we fund a lot of tremendous methodological work in those areas, and it’s probably time to turn it towards more of the individual user where we’re going to have this actionable data,” he said. That means setting up an IT and systems infrastructure that can process that data and make sense of it all. And in some cases, it could be as easy as inserting a clinical algorithm in the background of an app or device. It’s also scalable and replicable.

“A lot of that infrastructure, technology, systems, components we need to build, is identical when you look at cancer prevention or you look at heart disease, diabetes or any other chronic diseases we’re facing … any other health behavior,” McClain said. “What are the core components of analytic and IT systems we need to manage the data flows? We’re all talking about different sorts of data we want to potentially feed to clinical systems. But functionally, many of the components of that are sensible or usable and they are not something that have to be built a hundred times by a hundred different institutes or centers.”

The role NCI, other national health institutes and other federal health-focused agencies must take is complementary, building the systems to process that data — “Eighty to 100 Hz, just ridiculous data volumes, terabytes and terabytes of data,” McClain said — for their own purposes. Trying to standardize or change the consumer health industry will not help the cause.

“They’ll do greater things than we can do because they’re just going to have the venture capital investment and other sorts of things in that direction that drive innovation, and we don’t have that kind of money to put behind it,” he said.

But if NCI can capture more data, McClain said, he believes they might be able “to pick up the features and aspects of movement profiles, of sleep profiles, or other aspects of daily interaction that might actually be the signal rather than the noise.”

- See more at: http://fedscoop.com/nci-consumer-health-big-data-needs-clinical-validation/#sthash.lqZv5WBu.dpuf

With millions of Americans using fitness apps and tracking devices that count thousands of steps, keep tabs on weight and diet information, and record other consumer behavior information, there’s more data than ever to enhance a person’s health decisions. But researchers at the National Cancer Institute are hesitant to say this wearable tech revolution is clinically effective.

James McClain, program director of NCI’s Risk Factor Monitoring and Methods Branch within the National Institutes of Health, said Thursday as part of a health IT panel that his institute is a major supporter of the growing infrastructure on connected health devices and applications, especially the data they generate. On a scientific level, though, he questioned, “Do we know if any of this works?”

“I would say anecdotally, we believe a lot of this works, and we have a lot of faith and confidence and belief,” McClain said. “But that doesn’t move the process forward as fast as it might.”

“It doesn’t take much to convince the consumer these days. Consumers believe, on a lot of these sorts of technologies and devices, that they will help them,” he said. “So there’s a lot of faith on the consumer side.” On the clinical side, however, it’s an entirely different story. “I think that’s why there’s some pause and some caution on the concept of patient-generated data,” he said. “How do we understand what it means?”

Rather, McClain said the focus should be on the “validation and evaluation of evidence generation,” and with the right funding, “that’s where a biomedical research institute like NIH can play a big role.”

“I’ve been pushing us to try to shift our focus in more of a clinical direction and less of a generalized public health assessment focus, cause we do, we support, we fund a lot of tremendous methodological work in those areas, and it’s probably time to turn it towards more of the individual user where we’re going to have this actionable data,” he said. That means setting up an IT and systems infrastructure that can process that data and make sense of it all. And in some cases, it could be as easy as inserting a clinical algorithm in the background of an app or device. It’s also scalable and replicable.

“A lot of that infrastructure, technology, systems, components we need to build, is identical when you look at cancer prevention or you look at heart disease, diabetes or any other chronic diseases we’re facing … any other health behavior,” McClain said. “What are the core components of analytic and IT systems we need to manage the data flows? We’re all talking about different sorts of data we want to potentially feed to clinical systems. But functionally, many of the components of that are sensible or usable and they are not something that have to be built a hundred times by a hundred different institutes or centers.”

The role NCI, other national health institutes and other federal health-focused agencies must take is complementary, building the systems to process that data — “Eighty to 100 Hz, just ridiculous data volumes, terabytes and terabytes of data,” McClain said — for their own purposes. Trying to standardize or change the consumer health industry will not help the cause.

“They’ll do greater things than we can do because they’re just going to have the venture capital investment and other sorts of things in that direction that drive innovation, and we don’t have that kind of money to put behind it,” he said.

But if NCI can capture more data, McClain said, he believes they might be able “to pick up the features and aspects of movement profiles, of sleep profiles, or other aspects of daily interaction that might actually be the signal rather than the noise.”
- See more at: http://fedscoop.com/nci-consumer-health-big-data-needs-clinical-validation/#sthash.lqZv5WBu.dpuf


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Why tablets - and apps - have a big future in pharma

Why tablets - and apps - have a big  future in pharma | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
Talent spotters from Novartis, charged with bringing new ideas into the organisation, are casting their net beyond biotech into the wider pool of wearable, or even edible, technology.

 

 

It's not that the world's biggest drugmaker by sales wants to make the next smart watch. Rather, its researchers are seeking fresh ways to monitor how the company's medicines are working and being taken by patients.

Chief executive Joe Jimenez, above, predicts this will be an integral part of running a big pharmaceutical company in the coming decade, as rising healthcare demand coupled with limited budgets force drugmakers to generate hard data to prove their drugs are delivering results.

The Swiss group has already taken tentative steps, signing a deal with Google in July to develop contact lenses to help diabetics track blood glucose levels or restore the eye's ability to focus.

It also has an agreement with privately held Proteus Digital Health to develop tablets containing embedded microchips that can tell if patients have taken their medication.

Its ambitions, however, stretch a lot further.

"We've done more than most but certainly not enough. You're going to see a continued focus from this company that will be quite technology agnostic," Jimenez said in an interview during a pharmaceutical conference in London.

"It may be niche today but in the future I think it is going to be front and centre as to how diseases are managed."

The interest comes at a time when technology companies are increasingly pushing from the other direction in an effort to find new ways for patients to monitor their own health and track chronic conditions using smart devices.

Businesses such as Apple, Samsung and Google are all trying to find health-related applications for their wearable products.

While drugmakers are certainly not short of demand for their medicines, as populations get older and sicker, finding the money to pay for costly new interventions is another matter.

Clashes between governments and drugmakers over pricing are becoming more common - most notably in cancer and hepatitis C treatment - and the industry acknowledges a need to move to a system of payment based on clinical outcomes, rather than a price per pill.

Jimenez is convinced remote monitoring technology will play a central role in this respect, both to help healthcare systems check if patients are improving and also to protect companies that need to ensure they are not penalised for a drug failing if a patient does not take his or her medicine.

The approach has potential to work well for a company like Novartis, which hopes to launch a new drug for the debilitating condition of heart failure next year.

"If there were a wearable device that could help the patient and their physician understand whether or not to come to the hospitals then that, together with our drug, could be a very potent combination," Jimenez said.

"It doesn't mean we will own the technologies, but it does mean the technologies will play an important role in the management of disease."

Indo Business


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WEARABLE TECHNOLOGY: SCOURGE OR SAFETY NET?

As governments address road safety issues with a view to reducing traffic-related injuries and deaths new wearable technologies are emerging that their backers…

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How Smartphone Apps Can Treat Bipolar Disorder and Schizophrenia

How Smartphone Apps Can Treat Bipolar Disorder and Schizophrenia | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

By Davey Alba  11.20.14  |  7:30 am  |  

Getty Images

Bryan Timlin always carries an iPhone and an Android phone.

The 57-year-old is an app and graphic designer with a Michigan company called OptHub, but he doesn’t carry two phones for work. He carries the iPhone because that’s what he likes, and he carries the Android because it’s what he needs.

The Android phone monitors his behavior. Five years ago, Timlin was diagnosed with rapid-cycling bipolar disorder, a mental illness characterized by four or more manic or depressive episodes a year. Some episodes, he says, can last as long as eight weeks. “Being bipolar is like jumping out of an airplane knowing you don’t have a parachute on,” he says. “You know you’re going to be hurt, but the high is so euphoric that it’s worth the risk. You can deal with the consequences later.” With his Android phone, he hopes to deal with these moments in other ways.

Bryan Timlin. courtesy Bryan Timlin

The phone, provided by researchers at the University of Michigan, includes an app called Priori that runs constantly in the background, using the phone’s microphone to analyze his voice and track when he is, and isn’t, speaking. Mania is typically marked by speech that’s loud and rapid, often with erratic leaps from topic to topic. Longer pauses or breaks can indicate depression.

At the moment, the app only collects data on his behavior. But the hope is that it eventually will use this information to warn Timlin and his doctor to an impending bipolar episode.

Priori is one of many efforts to address mental health through smartphone apps. Tools gestating within startups, academic institutions, and research clinics aim to help people manage everything from severe depression to bipolar disorder and schizophrenia. Through the discreet and continuous recording of social and physical behavior, these apps can detect changes in mental well-being, deliver micro-interventions when and where needed, and give patients a new awareness of their own illnesses. In the long run, they may even diminish the stigma attached to mental health disorders.

“The question isn’t whether or not this technology is going to be used in healthcare and monitoring individuals with psychiatric illnesses,” says University of Michigan psychiatrist Melvin McInnis, who developed Priori alongside computer scientists at the university’s College of Engineering. “The question is really: How?”

Most of these apps—which include CrossCheck, from Dartmouth Psychiatric Research Center, and Companion, from a Boston-based startup called Cogito—aren’t yet publicly available. But some projects have completed trials with small groups of patients, larger trials are underway, and preliminary results are encouraging. These apps are based on objective, contextual data, and they require little work on the part of patients.

But, certainly, there are many hurdles to overcome—most notably the potential for these tools to mislead patients and compromise their privacy. Finding ways of regulating such apps is as important as refining their technology.

“I think this will have a liberating effect, and will extend the boundaries of healthcare in a really enormous way,” says Dr. Jeffrey Lieberman, psychiatrist in chief at the New York-Presbyterian Hospital/Columbia University Medical Center. “But there are also ethical and legal principles that will need to be established.”

Companion. courtesy Cogito Corporation

A Look Into the Future

In April 2013, when a bomb exploded at the Boston Marathon, Cogito was running a clinical trial of its mental health app Companion that included 100 people who happened to be in the area. “It was a look into the future of how a tool like this could sense the effect of a traumatic event in a population,” says Joshua Feast, CEO of Cogito.

Joshua Feast. courtesy Cogito Corporation

Whereas Priori tracks only speech patterns, Companion taps a smartphone’s GPS location tools, accelerometer, and light and sound sensors to record movements, social interactions, the frequency and timing of phone usage, and speech behavior. It uses this data to create a profile that seeks to describe all sorts of things a patient may be dealing with. This might include physical or social isolation, sleep or mood issues, or, indeed, extreme trauma.

Like Priori, Companion does not yet use the data it collects to trigger a response, but the marathon bombing, Feast says, showed how well such a thing could work. “We don’t know for sure if someone has a certain condition,” Feast says. “But we know what the symptoms associated with those conditions are, and we can see when they’re going up and down.”

Dartmouth professor Dror Ben-Zeev says much the same thing in discussing his app, CrossCheck. He aims to equip the app with an alert system that will actively notify patients and their medical team when they experience certain episodes related to schizophrenia.

It too uses a wide array of smartphone sensors to track patient behavior over time, and the plan is to correlate this info with behavior reported by doctors and patients. “When there’s a relapse event—meaning, if they either self-report that their symptoms are getting worse, or if they wind up in the hospital—we track back and look at the sensor data for two to three weeks before that event,” Ben-Zeev explains. “We try to see: is there something that happened in those weeks that was different from their datastream up until that point?”

These markers constitute a patient’s unique “relapse signature,” and eventually, the system should recognize these signatures ahead of time, notifying the patient and the patient’s medical team before a major episode happens. Ben-Zeev’s ultimate goal is to not only reduce the number of relapses, but also prolong the period between relapses. “We can raise the red flag,” he says.

The Potential

These projects remain in the early stages. Researchers have completed a pilot study of Priori involving six people, for instance, and are now testing the app on another 30, including Timlin. They hope to gather data over the next two years.

But many researchers believe these tools can completely change how we examine and treat mental illness. Unlike with other illnesses, there is more of an ebb and flow to how patients experience symptoms, and the only way to capture it accurately is to track someone around the clock. “Otherwise, you’re getting these very blunt and all-encompassing summaries rather than the real flavor of what patients have experienced,” Ben-Zeev says.

More than 60 million American adults—or one in four individuals—live with some form of mental illness.

As Ben-Zeev points out, the rise of the smartphone has—for the first time—provided a reliable means of tracking behavior in full. “The intensity and creativity of these things that are infusing the mHealth field, both the research and private sector, are directly linked to this amazing penetration of mobile phones,” Ben-Zeev says. “That’s what we’re trying to piggyback on.”

At the same time, using smartphones as a sensing tool could reduce stigma. Research has shown that many individuals with mental illness are uncomfortable using wearable devices that are conspicuous and purpose-built for research. Smartphones can add a veil of privacy.

If Ben-Zeev and other researchers successfully tap the power of the smartphone, the impact could be enormous. More than 60 million American adults—one in four individuals—live with some form of mental illness, according to the World Health Organization. Of those, nearly 14 million suffer from a serious mental illness, including schizophrenia, bipolar disorder, deep depression, or post-traumatic stress disorder. According to one study, these adults die an average of 25 years earlier than the general population.

These illnesses also affect friends, family members, and others around them. In the US, annual healthcare costs associated with these conditions exceed $30 billion.

Thermometer of a Different Kind

Bryan Timlin compares Priori to a thermometer or insulin testers. It merely reads what his body is doing. And because he is aware of those readings, he’s more attuned to how he’s feeling in relation to his illness.

He also likes the app because it’s harder to cheat the thing. When he goes in for a clinical assessment, for instance, he could lie about how he’s doing to get a better evaluation—something he’s been tempted to do on occasion. And when he’s having a manic episode and feeling good, Timlin often stops taking his medication. In the moment, he believes he doesn’t need it. The app can show him that he does.

As it stands, there’s no way to ensure that an app really does what it says it does.

But he also believes the app can eventually serve as an alternative to over-medication in at least some cases. “We don’t need all that we think we need,” he says. Mental illness also can be managed through diet and exercise, and he says Priori could help him find the right balance between this and medication.

But Jeffery Lieberman, of the New York-Presbyterian Hospital/Columbia University Medical Center, is quick to point out the potential for abuse. As it stands, there’s no way to ensure an app really does what it says it does. There’s no “Good Housekeeping Seal,” so to speak, for these mental health apps.

Yes, those coming out of academic institutions or professional healthcare organizations are sure to be rigorously vetting, Lieberman says. But he’s watching the private sector more closely. That’s where all the entrepreneurial energy comes from, after all. “But this is happening kind of piecemeal and ad hoc, and the question is: how can it be done more effectively and systematically?” he says.

Today, there are hundreds of medical-themed apps cluttering Apple’s App Store and in Google Play. Many of their claims are untested, and that has many medical practitioners concerned. We need a means of distinguishing the real tools from the fly-by-night variety.

Last year, the FDA released a document for guidance on medical apps, but it merely stated that the agency would focus its oversight on apps and phone attachments that make a specific medical diagnosis or turn a smartphone into some kind of instrument, like an ECG machine. There is no mention of guidelines specifically for mental health apps.

Just Getting Started

Adam Haim, chief of clinical trials operations and biostatistics at the National Institute of Mental Health, says efforts to test—let alone regulate—these apps are only getting started. “You’re getting a whole host of new data from different sources, and if intervention can be made more efficient, I think practitioners would rally behind that,” he says. “But it would also require additional training, and it would be an iterative process.”

But he also says that these apps will eventually prove fruitful: “All signs are pointing toward the integration of evidence-based technology into mental healthcare.”

Timlin agrees. He’s unswervingly optimistic about Priori, and looks forward to the next six months, when he will continue to use the app as part of its clinical trial. “I’m always going to be bipolar,” he says. “But this condition can be managed.”

Wired businessEditorCade MetzWriterIssie LapowskyMarcus Wohlsen 
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Karin Benckert's curator insight, November 21, 7:46 AM

Otroligt - det här är verkligen något som kan göra skillnad i människors liv. Och inte bara för den som är sjuk utan för alla människor.

Arielle Gold's curator insight, November 24, 2:10 PM

This article discusses one of the many smart phone applications that has been created in order to help alleviate the symptoms of Schizophrenia, and other unpredictable mental disorders (Alba, 2014). The primary application that is discussed is called "Priori" (Alba, 2014). Priori is designed to monitor a patient's tone when he is speaking, along with the periods of time that he isn't speaking (Alba, 2014). It focuses on the speed and tone of his talking, and any rapid changes in topic that may occur (Alba, 2014). Any offsets that Priori records in the patient's regular way of communicating may help him to better predict an impending Schizophrenic episode. These sort of episodes can not only be dangerous to ones-self, but potentially to those around the individual experiencing the episode (Myers & Myers, 2008). Symptoms may include something as basic as laughing or crying at inappropriate times, or potentially as severe as immobility and even hallucinations (Myers & Myers, 2008). Schizophrenia is considered to be one of the most severe examples of "psychosis," or "a broad term for a disorder marked by irrationality, distorted perceptions, and lost contact with reality (Myers & Myers, 2008, p. 562)," because it may not necessarily be consistent, and can be onset at any given time (Alba, 2014). With that being said, although Priori is still in it's developmental phase, this application has the potential to warn patients and their doctors of an impending episode, so that they can better prepare, and ideally make the episode minimally damaging to the patient, and those around him/her (Alba, 2014).

 

This article is very well-written, and appears to be reliable because of several different sources cited throughout, including Dr. Jeffrey Lieberman, a psychiatrist in chief at the New York-Presbyterian Hospital/Columbia University Medical Center (Alba, 2014). Any scientific information that was included about Schizophrenia or other mental disorders seemed to be accurate because it was given to the author by physicians, and even an actual mental disorder patient, named Bryan Timlin (Alba, 2014). If I were to recommend any changes in order to help the author verify the accuracy of this article, I would suggest the inclusion of a full reference page that will give any contributors all of the credit that they deserve, while giving readers the tools to do some research on their own.

 

The following is the full-text citation of the textbook that I discussed in my review of this article, along with a citation for the article itself:

 

Alba, D. (2014, November 20). "How Smartphone Apps Can Treat Bipolar Disorder and Schizophrenia" - Wired. Retrieved from http://www.wired.com/2014/11/mental-health-apps/

 

Myers, D. G., & Myers, D. G. (2008). Schizophrenia. In Exploring Psychology in Modules(9th ed., pp. 562-568). Retrieved from http://books.google.com/books?id=ReckAAAAQBAJ&printsec=frontcover&authuser=2&source=gbs_ge_summary_r&hl=en&output=reader&pg=GBS.PA568

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Combining mobile health with artificial intelligence

Combining mobile health with artificial intelligence | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Mobile developer GreatCall , which makes both smartphones and applications, and artificial intelligence company Automated Insights said they are partnering on a health app that helps caregivers stay informed on the well-being of aging family members.

The GreatCall Link app will provide an alert when the user of a GreatCall device contacts a 5Star agent in an emergency, the companies said in an announcement. It will include the date, time of call and type of help provided. In addition, the app provides information on daily events such as current locations, power status, and a list of activities to ensure that daily routines are normal and the device is charged and in use. It also includes a weekly narrative.

Wordsmith, the natural language generation platform from Automated Insights, uses Link data to automatically write a weekly overview with personalized insights. The software writes in plain English. Here’s two examples:

Edward made four total calls to GreatCall last week, including an important one to notify 911.

Chris actively used his 5Star for six days last week and could contact help if needed during that time. He spent time at the farmer’s market, his daughter’s home and the coffee shop. He did a great job of charging the device regularly, never letting the battery power fall to a low level.

“Caregivers have told us they wish they had someone who could be there when they can’t,”Krijn van der Raadt, vice president of IT and software development for San Diego-based GreatCall, said in a statement. “This is why Link was created.”

North Carolina-based Automated Insights CEO Robbie Allen said Wordsmith will write over one billion narratives this year, ranging from finance applications to professional sports.



Via Alex Butler
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