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Mike Dittenber had always wanted to go skydiving. There was only one problem: “At my heaviest I clocked in around 330 pounds,” says Dittenber, a technical writer from Michigan. “That’s above the weight restriction for a tandem jump.” During a doctor’s visit last spring, he got some more bad news. “I had delayed getting a physical for a while, but eventually I had to. Turned out I was borderline diabetic and right on the cusp of hypertension.” His doctor warned him that if he didn’t get his weight under control quickly he would need to begin taking medication. “It was a wake-up call.”
Dittenber had previously tried Weight Watchers, which worked for a time, but didn’t last for long. This time he decided to take matters into his own hands withMyFitnessPal, a mobile app that helps users track their calorie intake and exercise. The app became a gateway to a universe of digital health products. “I ended up buying a Fitbit, because that pairs with MyFitnessPal,” he says. “Turns out I don’t hate running. I don’t love it, but I can take it.” He added the Runkeeper app to log his distance and purchased a Garmin Forerunner 220 to help him maintain the right pace. Since he began using the tracking his health data in June of 2013, Dittenber has lost 110 pounds.
Using a smartphone as the central hub for tracking, analyzing, and motivating exercise has become a phenomenon. MyFitnessPal, which now claims over 65 million registered users, is one of the most popular digital health apps. But its success is part of a much broader trend. Venture funding for startups in the sector reaching $2.3 billion in the first half of 2014, more than was invested in all of 2013. More importantly, three of the biggest players in tech — Apple, Google, and Samsung — have all thrown their weight behind platform plays aiming to aggregate and simplify the universe of devices and apps available to consumers.
“We could be at a real tipping point,” says Harry Wang, an analyst who leads health and mobile research for Park Associates. “Fitness devices and apps have been a fast-growing but still relatively niche market. These new ecosystems, if they gain traction, could finally push the industry into the mainstream.” Success isn’t guaranteed, but Wang says it makes sense for the fragmented digital health industry to rally behind powerful companies. Apple's Healthkit and Google Fit can help reach a broader audience and forge partnerships with the traditional health care industry that would be hard for startups to accomplish alone. “It would be a transformation, with a lot of big winners, and losers as well.”
Hardware gets the squeeze
For many years the digital health industry has been driven by wearable devices like the Fitbit, Nike’s Fuelband, and Jawbone’s Up. But if the titans of the smartphone industry succeed in creating a dominant platform for health and fitness data, this business could be in trouble. "A lot of the basic functions we have seen in fitness wearables — tracking your steps, taking your heart rate — those functions will become basic features on a smartphone or smartwatch," says Wang.
Software’s turn to shine
While some big hardware players may get squeezed by the rise of mainstream smartphone platforms for digital health, app developers stand to make huge gains. "Devices like Fitbit and Jawbone have been essential to driving the industry forward, but they never got above 2 or 3 percent penetration with the general population," says Malay Gandhi, a managing partner at the venture capital firm Rock Health. "With smartphones as the central device powering this ecosystem, software companies will suddenly have access to tens of millions of new customers."
Gandhi believes this change will broaden the demographics in the digital health market. "Right now most of the people using this stuff are early adopter types, techies who are into the quantified lifestyle, or younger people who want to optimize their athletic performance." With just your smartphone as the baseline, he sees a chance to get older and less tech savvy people involved. "Your average consumer isn’t going to learn about pairing a wristband or managing a dozen different apps. But he or she might use the software that comes standard on their iPhone."
Via nrip, eMedToday
CASTRES, 23 juillet 2014 (TICsanté) – Six professionnels de santé sur 10 déclarent utiliser des applications mobiles de santé, mais seulement 1% utilisent une application de relation médecin-patient, selon une enquête menée par Isidore santé, Vidal, Egora, Expansciences et IDS Santé.Cette enquête* a été présentée par le Dr Vincent Varlet, président du think tank Isidore santé et directeur exécutif des services marketing et communication de Novartis, à l'occasion de l'Université d'été de l'e-santé, le 3 juillet à Castres.
Six professionnels de santé sur 10 déclarent utiliser des applications mobiles pour leur pratique, montrent les résultats de l'enquête. 35% ont téléchargé ces applications car ils les utilisaient sur d'autres supports (web, papier, etc.), 24% en faisant une recherche au hasard, 18% car l'application leur avait été conseillée, 13% car ils en connaissaient l'éditeur ou l'auteur et dans 10% car ils en avaient vu la publicité.
Pour le tiers de professionnels qui n'ont pas téléchargé d'application, la raison principale est le manque d'équipement (36% d'entre eux n'ont pas de smartphone ni de tablette), devant le manque de temps (34%) et le manque de confiance (12%).
Près des deux tiers (64%) des sondés estiment que les applications mobiles de santé sont devenues "incontournables" pour leur pratique (dont 24% estiment qu'elles sont "tout à fait" incontournables et 40% "probablement").
Les bases de données médicamenteuses sont les applications les plus téléchargées et utilisées (respectivement 32% et 38%). Les applications de formation continue sont, elles, peu téléchargées (1,6%) mais font partie des plus utilisées (14%).
A l'inverse, seulement 2% des professionnels de santé ont téléchargé une application de relation médecin-patient et seul 1% l'utilise. 60% n'ont jamais téléchargé d'application destinée aux patients, et seulement 9% l'ont fait pour pouvoir la conseiller.
"Si les médecins sont devenus utilisateurs d'applications mobiles de santé pour leur pratique, ils ne se sont pas encore tournés vers les applis patients", a commenté le Dr Varlet. Il estime que "la fracture digitale entre les professionnels de santé et les patients risque de devenir une réalité si la France ne rattrape pas son retard en ce domaine".
* Enquête auto-administrée sur le web, du 17 mars au 21 avril 2014. 2.035 participants dont 1.670 retenus pour l'analyse (questionnaire intégralement complété). 92% de médecins (8% autres: chirurgiens-dentistes, pharmaciens, infirmiers, kinésithérapeutes).
Via TéléSanté Centre
Via NY HealthScape, Lionel Reichardt / le Pharmageek, eMedToday
Evaluating Health Promotion Strategies for Public Health Impact from Cameron Norman
Via Emmanuel Capitaine
Among technologists, mobile health is thriving. Since the start of 2013, more than $750 million in venture capital has been invested in companies that do everything from turn your smartphone into a blood pressure gauge to snapping medical–quality images of the inner ear. Apple, Qualcomm, Microsoft, and other corporate giants are creating mobile health products and investing in startups.
The idea is straightforward: the increasing number of smartphones means that small, inexpensive sensors, low-energy Bluetooth, and analytic software make it possible for patients and doctors to capture all kinds of data to improve care. Patients can play a more active role in their own health. Doctors and nurses can make house calls without ever leaving the office.
One crucial group, however, remains unsold: the patients. Though one in 10 Americans owns the type of tracking device made by Nike, Fitbit, and Jawbone to monitor steps taken, quality of sleep, or calorie intake, more than half of those devices are no longer in use, according to Endeavour Partners, a consulting firm. Of the 100,000-plus mobile health applications available for smartphones, very few have been downloaded even 500 times. More than two-thirds of people who downloaded one have stopped using it, according to a 2012 study done for the global accounting firm PWC.
“There are unrealistic expectations for when and how mobile health is going to come together,” says Patty Mechael, former executive director of the mHealth Alliance, which helped develop early standards for mobile health technologies. In the U.S. “we are somewhere between the peak of the hype cycle and the trough of disillusionment,” she says.
Enthusiasm has been slow to build in part because the technology is often still not perfect, with seemingly simple functions like step counters lacking precision. Another problem is motivation. Many people simply don’t seem to like using these apps and devices. It is clear, though, that a well-designed mobile health system can help if patients use it.
At the Center for Connected Health at Partners HealthCare, a health-care network that includes Boston’s two leading hospitals, Brigham and Women’s and Massachusetts General, a number of mobile programs have been shown to offer strong payoffs both in quality and cost.
One recent study tested whether mobile phones could help increase activity among patients with diabetes. It’s an important way to combat the disease’s progression, but it’s something traditional programs have had little success achieving. Of a group of 130 patients with diabetes, half were given Fitbit activity monitors. By combining feedback from the Fitbit with existing patient records, an algorithm determined which text messages would be sent to the patients. Those falling behind on their goals got messages of encouragement; some messages included information about nearby Zumba classes or jogging paths, based on location data picked up from the patients’ mobile devices. On rainy days, the program might send a note about ways to exercise indoors.
Doctors received progress updates via a stoplight system displayed on the patient’s electronic medical record. Green meant the patient was doing well. Yellow was caution. Red signaled the patient was not responding to the text messages.
After six months, the average patient was walking about a mile farther each day. In addition, the patients’ blood sugar control improved significantly—better results than might be expected with some FDA-approved drugs, says Kamal Jethwani, a doctor who ran the study as the center’s leader of research and program evaluation.
For Partners, the program is successful on two counts: patients are healthier, and the cost of caring for them is lower. The payoff of better managing a chronic disease like diabetes comes over many years, but in Jethwani’s study, a number of patients have already had drops in blood sugar that equate to savings of $1,000 to $1,200 in doctor visits and other treatments. That’s a strong return on a program that costs $300 per patient to run, notes Jethwani.
These are the kinds of results that have enthusiasts convinced that mobile technology can not only fundamentally overhaul how health care is delivered, but also offer sufficient financial benefit to convince insurers and patients to pay for it.
John M. Halamka, a professor at Harvard Medical School and chief information officer of Beth Israel Deaconess Medical Center, expects this kind of technology–enabled monitoring to become standard practice within the next few years. One sign that a heart patient may be about to have a problem is rapid weight gain, he notes. A smart scale that picks up on that could trigger a quick intervention from the doctor and avoid a visit to the ER.
At the University of California San Francisco, which recently announced an initiative to begin testing the effectiveness of mobile devices in health care, one of the biggest technological achievements to date was simply starting to get doctors to move beyond pagers. Now doctors access patient messages via a mobile or Web application, and the message automatically becomes part of a conversation. Under the new system, the whole care team is aware of what is happening, and the doctor has the patient’s history available when fielding questions. A program is being tested that would take this to the next level, allowing care providers to send messages to patients.
Getting mobile health technology right can be tricky, however. Fitbit makes some of the most popular activity trackers, but in February the company voluntarily recalled its top-of-the-line $129 Fitbit Force after users complained of skin irritation from the wristband. More serious technological problems have sidelined devices aimed at difficult tasks like measuring blood glucose levels without drawing blood, a desirable feature for people with diabetes.
For all the challenges in mobile health, one issue that dominates many discussions about the technology may fade rather quickly. Privacy concerns have yet to come up in the Partners trial, says Jethwani. “I’ve never heard any patient say, ‘How do you know so much about me?’ or ‘Why do you know so much?’” he says. “Instead, they say ‘Now that you know all this about me, can you give me more useful information?’”
Via Alex Butler, Philippe Marchal/Pharma Hub
ProTransport-1, a Northern California based medical transport provider has announced a software partnership with CrowdOptic, maker of mobile and wearable broadcasting solutions to deploy the CrowdOptic Google Glass broadcasting solution in its ambulances and mobile medicine units.
ProTransport-1 will use CrowdOptic’s software solution that will allow paramedics and nurses to broadcast through Google Glass a live view of complex cases from the ambulance to medical teams at the receiving hospital during transport. According to the press release, the companies aim to “improve documentation and expand medical consultative opportunities for patients en route.
“CrowdOptic’s see-what-I-see technology allows paramedics and nurses on our ambulances to broadcast the live view of complex cases to medical teams at the hospital”, said Glenn Leland, Chief Strategy Officer for ProTransport-1.
Additionally, ProTransport-1 envisions multiple opportunities to utilize CrowdOptic’s software particularly in the mobile medical setting by enabling a two-way educational forum between a patient in their home and providers. “We additionally envision a variety of dispatch, navigation, documentation and operational processes will migrate to CrowdOptic and Google Glass over time” said Glenn Leland, Chief Strategy Officer for ProTransport-1.
more at http://hitconsultant.net/2014/07/18/protransport-1-to-deploy-google-glass-in-ambulances/
Insights from our international survey can help healthcare organizations plan their next moves in the journey toward full digitization. A McKinsey & Company article.
The adoption of IT in healthcare systems has, in general, followed the same pattern as other industries. In the 1950s, when institutions began using new technology to automate highly standardized and repetitive tasks such as accounting and payroll, healthcare payors and other industry stakeholders also began using IT to process vast amounts of statistical data"
Researchers from MIT’s Laboratory for Information and Decision Systems have developed an algorithm in which distributed agents — such as robots exploring a building — collect data and analyze it independently. Pairs of agents, such as robots passing each other in the hall, then exchange analyses.
In experiments involving several different data sets, the researchers’ distributed algorithm actually outperformed a standard algorithm that works on data aggregated at a single location, as described in an arXiv paper.
Machine learning, in which computers learn new skills by looking for patterns in training data, is the basis of most recent advances in artificial intelligence, from voice-recognition systems to self-parking cars. It’s also the technique that autonomous robots typically use to build models of their environments.
That type of model-building gets complicated, however, in cases in which clusters of robots work as teams.
The robots may have gathered information that, collectively, would produce a good model but which, individually, is almost useless. If constraints on power, communication, or computation mean that the robots can’t pool their data at one location, how can they collectively build a model?
At the Uncertainty in Artificial Intelligence conference July 23 to 27, the researchers will present the new algorithm. “A single computer has a very difficult optimization problem to solve in order to learn a model from a single giant batch of data, and it can get stuck at bad solutions,” says Trevor Campbell, a graduate student in aeronautics and astronautics at MIT, who wrote the new paper with his advisor, Jonathan How, the Richard Cockburn Maclaurin Professor of Aeronautics and Astronautics. “If smaller chunks of data are first processed by individual robots and then combined, the final model is less likely to get stuck at a bad solution.”
Campbell says that the work was motivated by questions about robot collaboration. But it could also have implications for big data, since it would allow distributed servers to combine the results of their data analyses without aggregating the data at a central location.
“This procedure is completely robust to pretty much any network you can think of,” Campbell says. “It’s very much a flexible learning algorithm for decentralized networks.”
To get a sense of the problem Campbell and How solved, imagine a team of robots exploring an unfamiliar office building. If their learning algorithm is general enough, they won’t have any prior notion of what a chair is, or a table, let alone a conference room or an office. But they could determine, for instance, that some rooms contain a small number of chair-shaped objects together with roughly the same number of table-shaped objects, while other rooms contain a large number of chair-shaped objects together with a single table-shaped object.
Over time, each robot will build up its own catalogue of types of rooms and their contents. But inaccuracies are likely to creep in: One robot, for instance, might happen to encounter a conference room in which some traveler has left a suitcase and conclude that suitcases are regular features of conference rooms. Another might enter a kitchen while the coffeemaker is obscured by the open refrigerator door and leave coffeemakers off its inventory of kitchen items.
Ideally, when two robots encountered each other, they would compare their catalogues, reinforcing mutual observations and correcting omissions or overgeneralizations. The problem is that they don’t know how to match categories. Neither knows the label “kitchen” or “conference room”; they just have labels like “room 1” and “room 3,” each associated with different lists of distinguishing features. But one robot’s room 1 could be another robot’s room 3.
With Campbell and How’s algorithm, the robots try to match categories on the basis of shared list items. This is bound to lead to errors. One robot, for instance, may have inferred that sinks and pedal-operated trashcans are distinguishing features of bathrooms, another that they’re distinguishing features of kitchens. But they do their best, combining the lists that they think correspond.
When either of those robots meets another robot, it performs the same procedure, matching lists as best it can. But here’s the crucial step: It then pulls out each of the source lists independently and rematches it to the others, repeating this process until no reordering results. It does this again with every new robot it encounters, gradually building more and more accurate models.
This relatively straightforward procedure results from some pretty sophisticated mathematical analysis, which the researchers present in their paper. “The way that computer systems learn these complex models these days is that you postulate a simpler model and then use it to approximate what you would get if you were able to deal with all the crazy nuances and complexities,” Campbell says. “What our algorithm does is sort of artificially reintroduce structure, after you’ve solved that easier problem, and then use that artificial structure to combine the models properly.”
In a real application, the robots probably wouldn’t just be classifying rooms according to the objects they contain: They’d also be classifying the objects themselves, and probably their uses. But Campbell and How’s procedure generalizes to other learning problems just as well.
The example of classifying rooms according to content, moreover, is similar in structure to a classic problem in natural language processing called topic modeling, in which a computer attempts to use the relative frequency of words to classify documents according to topic. It would be wildly impractical to store all the documents on the Web in a single location, so that a traditional machine-learning algorithm could provide a consistent classification scheme for all of them. But Campbell and How’s algorithm means that scattered servers could churn away on the documents in their own corners of the Web and still produce a collective topic model.
“Distributed computing will play a critical role in the deployment of multiple autonomous agents, such as multiple autonomous land and airborne vehicles,” says Lawrence Carin, a professor of electrical and computer engineering and vice provost for research at Duke University. “The distributed variational method proposed in this paper is computationally efficient and practical. One of the keys to it is a technique for handling the breaking of symmetries manifested in Bayesian inference. The solution to this problem is very novel and is likely to be leveraged in the future by other researchers.”References:Trevor Campbell, Jonathan P. How, Approximate Decentralized Bayesian Inference, arXiv, 2014, arxiv.org/abs/1403.7471Related:Collaborative learning - for robots
Via Pierre Tran
On Indiegogo there is a campaign for a health education tool that has already reached its goal in less than a week — it’s a bear that teaches kids how to manage diabetes.
Those of us who have diagnosed a child with type 1 diabetes know how difficult of a diagnosis it is not only for the child, but for the family. Education for how to manage diabetes is a large task, but one most hospitals have great protocols for. Much of the education is aimed at the parents, with the hopes it gets reinforced to the child at home.
The company behind Jerry the Bear is Sproutel, and their hope is the toy bear will educate kids in a way that is not being done right now though positive reinforcement.
The below video shows how Jerry the Bear works:
Sproutel was hoping to raise $20,000, but has exceeded expectations by receiving almost $30,000 with more than 50 days remaining.
It would be interesting to see a study done in hospitals and outpatient settings where Jerry the Bear was compared to traditional diabetes teaching mechanisms. Either way, it’s definitely an innovative approach.
Indigogo campaignAuthor:Iltifat Husain, MD
Founder, Editor-in-Chief of iMedicalApps.com. Emergency Medicine Faculty and Director of Mobile App curriculum at Wake Forest University School of Medicine.Follow MeNo comments yet.
Via Emmanuel Capitaine
Researchers in Ireland evaluated the use of an Android smartphone app to increase patients’ activity levels, as measured by step count.
When it comes to tackling the epidemic of obesity and its associated morbidities, promoting active lifestyles is key. For many patients, setting specific achievable goals is a helpful tool in accomplishing that.
Here, researchers from the National University of Ireland and University of Aberdeen selected an app to trial among patients followed at three primary care centers to evaluate whether it could be effective in increasing activity levels. Over the roughly two month period, they found a 22% increase in basal activity levels.
A total of 90 patients using Android devices were randomized to either an intervention group which used the smartphone app or a control group. To pick the intervention app, researchers scored available pedometer apps based on three general criteria includingAutomatic feedback and trackingVisually appealing displayGoal setting functionality and feedback
Based on these criteria, they selected the Accupedo-Pro Pedometer app. All patients received up front education and counseling. After a one week run in period, patients in the intervention group were taught how to use the app. Beyond that, all patients received the same education and follow up including sharing data at the same intervals.
They found a mean difference in improvement in step count between the intervention and control groups of 2017 steps, or a 22% increase in mean step count. Other parameters followed including BMI and blood pressure did not significantly change however.
Interestingly, they found that both groups had an initial increase in step count but the control group quickly returned essentially to baseline while the intervention group continued to improve.
There are several useful takeaways from this study. First, it suggests that use of a low-cost smartphone app can help reinforce and sustain behavioral interventions. Second, it highlights the importance of “app training,” or helping patients understand how to use an app to achieve a specific goal.
As the researchers noted, 90% of Americans who own mobile phones carry their devices 24 hours a day. Here, they demonstrate how some of that time can be used to make meaningful improvements in health.Author:Satish Misra, MD
Satish is a Cardiology Fellow at the Johns Hopkins Hospital in Baltimore, Maryland. He is a founding partner and Managing Editor at iMedicalApps. He believes that mobile technology offers an opportunity to change the way health care is delivered and that iMedicalApps is a platform through which clinicians can be empowered to lead the charge.
Glynn LG, Hayes PS, Casey M, Glynn F, Alvarez-Iglesias A, Newell J, OLaighin G, Heaney D, O’Donnell M, Murphy AW. Effectiveness of a smartphone application to promote physical activity in primary care: the SMART MOVE randomised controlled trial. Br J Gen Pract. 2014 Jul;64(624):e384-91. doi: 10.3399/bjgp14X680461.
According to a survey of thousands of patients in Germany, Singapore, and the United Kingdom, the adoption of digital healthcare services remains low because existing services are either low quality or not meeting patients’ needs. The survey, conducted by consulting firm McKinsey, included responses from at least 1,000 patients in the three countries.
“Many healthcare executives believe that, due to the sensitive nature of medical care, patients don’t want to use digital services except in a few specific situations; decision makers often cite data that point to relatively low usage of digital healthcare services,” McKinsey analysts Stefan Biesdorf and Florian Niedermann wrote in a recent blog post. “In fact, the results of our survey reveal something quite different. The reason patients are slow to adopt digital healthcare is primarily because existing services don’t meet their needs or because they are of poor quality.”
McKinsey found that more than 75 percent of respondents would like to use some kind of digital health service. Many are interested in “mundane” offerings, the firm wrote.
Via rob halkes, Lionel Reichardt / le Pharmageek, LA BLOUSE BLANCHE , Giuseppe Fattori
The perioperative environment is commonly acknowledged as one of the hospital’s most complex.
This condensed and complex environment is precisely why complete command and control of the OR is imperative – and why mobile technology is an optimal path for helping achieve it.
In particular, mobility offers three distinct advantages that support command and control and help ensure all parties have the information they need to keep workflow and patient flow moving:
1. A near real-time, patient-centric OR perspective
During this highly compressed episode of care, a patient is treated by a team of clinicians who are often from different departments. In addition, supporting staff such as surgical scrubs and radiology play an important part in efficient patient movement. Having a single, shared view of patient milestones – for instance, when prophylactic antibiotics are administered, anesthesia is induced and the incision is made, or surgery is complete and the patient is on his way to PACU – allows the entire care team to know exactly what is happening which supports the delivery of more coordinated care. Giving everyone this same view on a mobile device can further synchronize care among disparate care providers.
As a result, the patient is more likely to move efficiently between care events, and clinicians are less likely to miss specific timing for milestones such as medication administration.
2. A comprehensive OR view supports better decisions with fewer interruptions
A patient-centric view enables the OR team to keep one patient on the most efficient, highest quality care path. Sometimes, however, this path requires an adjustment that can impact the entire OR.
Big Data in Health Care: Using Analytics to Identify and Manage High-Risk and High-Cost PatientsDavid W. Bates, Suchi Saria, Lucila Ohno-Machado, Anand Shah, and Gabriel Escobar
Via Bernard Strée
After decades as a technological laggard, medicine has entered its data age. Mobile technologies, sensors, genome sequencing, and advances in analytic software now make it possible to capture vast amounts of information about our individual makeup and the environment around us. The sum of this information could transform medicine, turning a field aimed at treating the average patient into one that’s customized to each person while shifting more control and responsibility from doctors to patients.
The question is: can big data make health care better?
“There is a lot of data being gathered. That’s not enough,” says Ed Martin, interim director of the Information Services Unit at the University of California San Francisco School of Medicine. “It’s really about coming up with applications that make data actionable.”
The business opportunity in making sense of that data—potentially $300 billion to $450 billion a year, according to consultants McKinsey & Company—is driving well-established companies like Apple, Qualcomm, and IBM to invest in technologies from data-capturing smartphone apps to billion-dollar analytical systems. It’s feeding the rising enthusiasm for startups as well.
Venture capital firms like Greylock Partners and Kleiner Perkins Caufield & Byers, as well as the corporate venture funds of Google, Samsung, Merck, and others, have invested more than $3 billion in health-care information technology since the beginning of 2013—a rapid acceleration from previous years, according to data from Mercom Capital Group.
Via nrip, Lionel Reichardt / le Pharmageek, IHEALTHLABS EUROPE
The NHS is starting to test a sticking-plaster-sized patient-monitoring patch.
Placed on the chest, it wirelessly transmits data on heart rate, breathing and body-temperature while the patient is free to move around.
Independent experts say the system, developed in Britain, could ease pressure on wards and has the potential to monitor patients in their own home.
But the Royal College of Nursing says there is no substitute for having enough staff.
Routine checks for vital signs - including temperature, blood pressure and heart rate - are a key part of care and safety in hospitals.
Typically they may be carried out every four hours, depending on the patient's condition.
But patients can deteriorate between checks, putting them at risk.Continue reading the main story“Start Quote
Victoria Howard Nurse
A hospital in Brighton run by the private healthcare firm Spire has been testing the battery-powered patch, which updates information on some of the vital signs every couple of minutes.
The wireless device, developed by the Oxford-based firm Sensium Healthcare, then issues an alert if the readings fall outside pre-set levels, indicating a potential problem.
The patch is placed on the chest just above the heart when the patient is admitted. There are no cables to any monitors. Instead, readings are recorded and transmitted to a box in each room that works like a wi-fi router, passing on data to the hospital IT system.
It does not replace the routine checks, but staff say it does ease some of the pressures.
Victoria Howard, a staff nurse at the hospital said the system was working well.
"It gives us a bit more time with some patients when we know some patients do need that bit more time," she said.
"Without this monitor, you're constantly thinking what's happening in the next room, and I should go in there and check them.
"Knowing this is on and it works well, we're able to spend that bit more time."
Most of the patients at this hospital are in for routine surgery. Some are being treated for cancer.
The matron, Lynette Awdrey, said the patches helped staff focus their efforts on the patients who needed the most support.
"It prioritises you," she said.
"Nothing will ever replace compete with clinical observation and the assessment of the patients. What this does is alert you sooner, so you can fulfil those observations and assessments of the patient and activate the appropriate care and treatment for them."
So far, she said, the patches had provided early detection of deterioration in about 12% of patients who had worn them. That is in line with findings from a small trial with the patches at a hospital in Los Angeles.
This could have important safety implications. A study in the British Medical Journal in 2012 concluded that nearly 12,000 deaths in hospitals in England had been preventable. It said clinical monitoring had been a problem in nearly a third of these deaths.
Another advantage of the device is that patients can move around freely. This reduces the risk of complications such as infections, helping patients to recover more quickly, so they can go home sooner, saving on the costs of healthcare.
David Hardman, 71, is happy to wear the patch.
"It gives me reassurance that there's something, or some equipment looking at it all the time," he said.
"And I think when the nurse is with you her mind is perhaps a bit more with you rather than thinking about what's going on in the other rooms."
Each patch costs £35 and lasts for five days - long enough for most hospital stays.
Wear at home
Independent experts say we are witnessing the start of a revolution in wearable technology, with great potential benefits in healthcare.
Prof Timothy Coats, a consultant in emergency medicine at Leicester Royal Infirmary, said the patch could be useful in a variety of different settings.
"This certainly could have a use in the emergency department from the emergency care phase right through to the first couple of days in hospital when the patient is more liable to deteriorate.
"It also has potentially an application for looking after patients in their own home, because we could observe them remotely rather than in hospital."
However he points out there are limitations with the current model, which measures heart rate, breathing and body temperature. It is being developed to provide more information, on blood pressure and oxygen levels.
The company says the patch is about to be tested at one NHS trust and 20 more are in talks.
The Royal College of Nursing's chief executive, Dr Peter Carter, said new technology could be very helpful in alerting nurses and doctors to a patient who was starting to deteriorate - but he also expressed a note of caution.
"Anything which helps that process has to be a good thing," he said.
"However, we also know that there is no substitute for having enough staff with the right level of skill on every ward, able to give each and every patient the care and attention that critically ill people need."
IT Web Africareports that mHealth has officially come to Zimbabwe.
Although mHealth solutions are nothing new in Africa — in fact, mHealth solutions are growing at an accelerated pace throughout the continent today – Zimbabwe has been a largely overlooked nation in recent years, relative to the immense growth documented in surrounding nations.
Zimbabweans are now gaining a service made possible by the nation’s top telecoms firm Econet Wireless.
“The Econet Health project plans to avail tips on how to manage stress, information about diseases such as diabetes as well as diet,” the report reads. “Expecting mothers are also to receive information about pregnancy.”
“People should know how to deal with stress and pregnant mothers know of what to do through their mobile phones,” Mboweni is quoted in the report.
Via Emmanuel Capitaine
Any views expressed in this article are those of the author and not of Thomson Reuters Foundation.
Jerusalem, 17 July 2014 – CARE and its partners are preparing to provide emergency mobile health teams to serve people affected by the violence in Gaza. Needs are particularly high for pregnant women and for those who can’t travel to hospitals or medical clinics. Pregnant women are travelling to hospitals in the midst of the bombing to get medical support, while other people are unable or unwilling to leave their houses for anything other than life-threatening injuries.
“We are getting reports from our partners that pregnant women are risking their lives to get to hospitals, because they feel they will be safer there than in their homes,” said Theo Alexopoulos, with CARE’s Emergency Team in Jerusalem. “But they can’t stay in the hospitals forever. Then where do they go? There is no safe place in Gaza.”
As soon as the security situation allows, CARE and it partner, Palestine Medical Relief Society (PMRS), are planning to run two mobile health teams that would visit an average of 200 patients per day, providing basic health care to people living in affected communities by the ongoing violence. The teams will include medical staff and a psychosocial worker to help traumatized families, and will focus in particular on women’s health needs, particularly pre- and post-natal care for pregnant women and new mothers with infants.
“If pregnant women can’t get the health care they need, if newborns can’t get the health care they need, there is an increased risk of medical complications, which could put the lives of the baby or the mother at risk,” said Alexopoulos.
Thursday’s ceasefire provided a brief window for people to safely get medical support, and to get food and supplies for their families. But a few hours without bombs is not enough; a permanent ceasefire and a resolution to the conflict is needed immediately, or people will continue to suffer.
The health system in Gaza is under enormous strain and is in desperate need of supplies, particularly fuel for generators, drugs, and medical supplies. Some hospitals are already reporting that they don’t have basic materials such as sutures to treat wounds of people injured.
About CARE: CARE is one of the world’s largest humanitarian aid agencies, providing assistance in nearly 70 countries. CARE has been working in Israel, West Bank and Gaza since 1948 (with a short break from 1984-1994), initially implementing programs to help immigrants after the Holocaust. Today, our programs focus on economic empowerment (including livelihoods and gender equality) in Gaza and the West Bank to assist the most vulnerable residents in meeting their basic needs. With the current fighting, CARE has temporarily suspended its programs until the security situation improves. Find out more at www.care-international.org.
Melanie Brooks (Geneva): +41 79 590 3047, firstname.lastname@example.org
Via Alex Butler
Cardiologists in Los Angeles have developed a gene-therapy technique that allows them to transform working heart-muscle cells into cells that regulate a pigs’ heartbeat. This procedure, described today in the Science Translational Medicine, restored normal heart rates for two weeks in pigs that usually rely on mechanical pacemakers. The experiment, researchers say, could lead to lifesaving therapies for people who suffer infections following the implantation of a mechanical pacemaker.
"We have been able for the first time to create a biological pacemaker using minimally invasive methods and to show that the new pacemaker suffices to support the demands of daily life," Eduardo Marbán, a cardiologist at the Cedars-Sinai Heart Institute and lead author of the study, told the press yesterday. The approach is practical, added Eugenio Cingolani, a cardiogeneticist also at Cedars-Sinai and a co-author of the study, because "no open-heart surgery is required to inject this gene."
In the study, researchers injected a gene called Tbx18 into the pigs’ hearts. This gene, which is also found in humans, reprogrammed a small number of heart-muscle cells into cells that emit electrical impulses and drive the beating of the heart. The area in which this change occurred — about the size of a peppercorn — doesn't normally initiate heartbeats.
"We were able to get the biological pacemaker to turn on within 48 hours," Marbán said. To get the gene to the heart, the researchers sent a modified virus into the right ventricle through a catheter. The viral vector isn’t harmful, the researchers said, because the virus they employed was engineered to be "replication deficient" — meaning that it will not reproduce and spread beyond the heart.
This year represents a turning point for wearable health trackers, out of which an obvious next one could be a gadget that delivers drugs through the skin when needed. ChronoDose now delivers nicotine for those who would like to stop smoking but the patches didn’t really seem to be working. Users can teach the gadget when it is the hardest to resist the temptation therefore it can add the next dosage in the right time.
ChronoDose is a programmable transdermal drug delivery system that’s worn as an armband. The ChronoDose will someday offer many different drugs the ability to be programmed, and administered via this transdermal device, but the buzz is all about it’s use as the world’s first programmable nicotine replacement method. ChronoDose’s use with SmartStop™ gives the device the ability to be programmed to anticipate the users cravings, and offer nicotine dosing scheduled to take effect before the urge to smoke strikes.
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Via Emmanuel Capitaine
With the unveiling of a new clinical operating system for medical devices, BlackBerry is once again making a play for mHealth.
QNX Software Systems, which was acquired by BlackBerry in 2010, has released a new operating system that's billed as being IEC 62304-compliant. With its sights set on alleviating the regulatory and financial burden for device manufacturers, the operating system supports both single- and multicore devices based on ARMv7 and Intel x86 processors. The OS also features an application programming interface to make it compatible with other QNX operating systems, officials said.
"When it comes to medical device software, the OS sets the tone: Unless it provides the architecture to enable reliable operation and a clear audit trail to substantiate claims about its dependability, the entire process of device approval can be put in jeopardy," said Grant Courville, QNX's director of product management, in a July 15 press statement. "By providing an OS that has been independently verified to comply with the IEC 62304 standard, we are helping manufacturers reduce the cost and effort of developing devices that require regulatory approval from agencies such as the FDA, MDD and MHRA."
This is far from BlackBerry's first big move into the healthcare space. In April, the telecommunications behemoth lent financial support to cloud-based health IT company NantHealth, a startup spearheaded by billionaire healthcare mogul Patrick Soon-Shiong, MD.
"We've built supercomputers that can do the genomic analysis in real-time; we've built super computers that can actually take feeds of CT scans from EMRs and feed it directly to mobile devices. All of that, regardless of where it comes from, regardless of the EMR, regardless of the device, whether it be via ventilator, or IV tube, we're agnostic to, and it speaks to this operating system," said Soon-Shiong.
JOIN For ME Engages and Educates Kids about Weight Management
We’ve all been in the same boat – you’re running on the treadmill, seemingly for ages, yet you glance at the clock and it’s only been three minutes. We want to live a healthy lifestyle, but sometimes it can be so boring. We especially want to set a good example for today’s youth, as childhood obesity rates are soaring and children are at a higher risk for developing dangerous health issues like diabetes. The question is: if we are bored with our attempt at a healthy lifestyle, why should we expect children to embrace it?
It’s true that an overwhelming majority of children today spend their time sitting in front of televisions and computers. They cling to their electronics as a drowning man would cling to a life raft. Parents become frustrated when their attempts to engage their kids in a more active lifestyle result in failure. How can you interest your child in going for a run when they are completely enthralled in a group chat on their phone about the doubtlessly dramatic occurrences of the day at school? How do you pull a kid out of a virtual world where they are saving soldiers or fighting monsters to toss around the old football? Why not incorporate the technology that kids love so much into a new, healthy lifestyle? The answer to the challenge of getting our kids to embrace physical activity is to offer them this activity in a package that will appeal to them. We’ve seen a great gamification example in Zamzee, and, very recently, LeapFrog, both in the kids’ wearables category. What
Study: Does Gaming Help Obese Children Increase Physical Activity?
Many health care groups have recognized the benefits of games in health. UnitedHealth Group recently participated in a pediatric study of the benefits of gaming in their weight-management program, JOIN for ME. JOIN for ME encourages overweight children to engage in physical activity and set realistic goals that help to reach a healthy weight. Half of the participants in JOIN for ME’s program received an XBox Kinect console and two games in order to evaluate the effects that physical gaming can have on weight loss.
The program was effective for both groups in the study, but the group using the Xbox Kinect had higher weight loss. The children enjoyed the use of the games, and did not feel as if they were being forced to exercise while they were playing. They had not been given any specific amounts of time that had to be dedicated to the games, so all of the time spent on the physically active gaming was done of their own accord. Deneen Vojta, a UnitedHealth Group executive physician, spoke highly of the study’s results:
One participant, Ravyn Hill, liked the fact that the games provided a way to exercise without being bored:
Ravyn lost almost 8 pounds during the four-month study period.
JOIN for ME is also educating children who have excessive weight and their families on healthy eating habits, choosing the right foods and portion sizes through classes at community centers and schools nationwide.
Several games have been launched in recent years to help motivate Americans to live a healthy lifestyle. Many of these exercise-based games are still geared toward adults, though, and we still struggle to implement higher levels of activity in children. Researching and using the technology that so interests youth is a very successful answer to the problem.
Via Alex Butler, ChemaCepeda