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Infographic: Patients Want Access To Their Electronic Medical Records

Infographic: Patients Want Access To Their Electronic Medical Records | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
84 percent of US consumers believe they should have full access to their electronic medical records while only a third of physicians (34 percent) share this belief, according to an Accenture survey.

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rob halkes's curator insight, October 8, 2013 12:40 PM

Good to se that patient empowerment is growing!

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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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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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Obama confident as Healthcare.gov 2.0 launches - Healthcare Dive

Obama confident as Healthcare.gov 2.0 launches - Healthcare Dive | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
Dive Brief:The Affordable Care Act's second enrollment period began Saturday, Nov. 15, and had a lot to prove, with memories of last year's flawed technological launch of Healthcare.gov top of mind. 100,000 Americans signed up for coverage on Saturday, with many qualifying for federal subsidies that kept their premiums under $100 a month. "The vast majority of people coming to the site were able to get on and do what they were intending to do," Health and Human Services Secretary Sylva Burwell said Sunday. A total of 500,000 people signed onto the website in its first day. Speaking after midterm elections when Republicans regained Congress, President  Obama said the Americans who "sat on the sidelines, in part because of our screw-ups on Healthcare.gov" now have the opportunity to partake in a working system that got a makeover after lessons learned from early failures last year.Dive Insight:

Reviews of Obamacare 2.0 have been pretty positive so far, even by former naysayers and skeptics, so it's fair to say the health IT team running the show should be applauded. Visually, Healthcare.gov looks different. But more importantly, the application is much shorter, condensed from 76 screens of individual questions to just 16, with sets of questions on each page to cut down on load numbers. The made-over Healthcare.gov is cosmetically pleasing, better equipped to handle high volumes of traffic and comes with lots of user-friendly features. Among them: a window shopping option that allowed consumers to see what plans would be available in their area, so they could compare price, benefits and physician and hospital networks before the open enrollment period started on November 15. While the updated version of Healthcare.gov won't guarantee that everyone will find their health insurance options truly affordable, it's certainly a step in the right direction. 

Recommended Reading

FedScoop.com: Focus Returns to Healthcare.gov Tech This Weekend


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Samsung wants its sensor-packed Simband to change your life for the better - Digital Trends

Samsung wants its sensor-packed Simband to change your life for the better - Digital Trends | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Samsung has uncovered the Simband, the result of several months development following the announcement of its health-focused SAMI platform back in May, when the wearable was only seen as a concept. The wristband has been redesigned, and it’s based on Samsung’s Gear S smartwatch, only loaded with extra sensors for monitoring many different aspects of your health.

Sensors are dotted around the strap, and include the now expected heart rate sensor and accelerometer, plus sensors to take the temperature of skin, blood pressure, and even how much sweat your body is producing. The six sensors are modular, and developers can swap them out for alternatives.

Related:Samsung’s future wearables will tell your doctor when you’re ill, before you know yourself

Data collected by this sensor array is displayed on the large touchscreen, along with the date and time, plus a few cool new features. The first is a dashboard, where information collected on blood pressure, a step count, and your heart rate is shown, along with a comparison to stats taken over the past week.

The Simband can activate all its sensors at once, and show a real-time feed of how your body is functioning, while a “spot check” gives a 20-second overview of the same stats, and compares them to the last quick check the device performed.

Samsung wants to emphasize the difference between the Simband and a regular fitness band. During the developer conference where its plans were discussed, Samsung invited insurance company Kaiser to talk about how lifestyle change is more important than looking at a daily step count, in the quest for improving health. Quoted by GigaOm.com, a Kaiser executive said data collected by wearable health devices like the Simband should “allow them to take action, instead of being focused on isolated metrics.”

Related:Microsoft’s Health band works with Android and iPhone

The Simband and the cloud-based SAMI platform to which it will be connected are key to this philosophy. Data is supposed to be shared with healthcare professionals, who can then create personalized diet, fitness, and health plans.

However, it’s still not quite ready for general sale. The Simband demonstrated is a development unit, but Samsung has now opened the device up to developers, and produced a software development kit with a set of APIs to incorporate existing software into the system.


Read more: http://www.digitaltrends.com/wearables/samsung-simband-health-wristband-news/#ixzz3JMFG1xAq
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Karin Benckert's curator insight, November 19, 5:21 AM

Ser bra ut. Men min handled är så smal så jag undrar om det finns plats för all data? Finns det en dam-modell månne?

 

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App uses Watson to answer health questions using genetic data

App uses Watson to answer health questions using genetic data | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

IBM recently announced a partnership with upstart genetics company Pathway Genomics to create a Watson-powered app to provide personalized health information based on a patient’s genetic profile, data collected from personal health trackers, medical literature, and whatever other information it can get its hands on.

As described in a recent Popular Science article, it would go something like this. A diabetic patient would open the Panorama app and ask it a question. Using its natural language processing capabilities to process the question, Watson would then come up with answer based on information it retrieves from published medical literature & guidelines as well as patient specific genomic data, health history, and even personal health data like recent activity information or blood glucose measurements. Pathway’s CEO Michael Nova describes it like this,

Called Pathway Panorama, the smartphone app will make it possible for individuals to ask questions in everyday language and get answers in less than three seconds that take into consideration their personal health, diet and fitness scenarios combined with more general information. The result is recommendations that fit each of us like a surfer’s wet suit…[Say] you’re diabetic and you’re in a city you have never visited before. You had a pastry for breakfast and you want to know when you should take your next shot of insulin. In an emergency, you’ll be able to find specialized healthcare providers near where you are who can take care of you.

That’s a pretty impressive claim, highlighting both the remarkable potential and apparent risks with an app like Pathway. Nova suggests that the app will be available some time in the middle of 2015. While its possible that there is extensive testing being undertaken now to ensure the safety of an app that could provide such specific and potentially high risk recommendations, its more like that this app will be crafted to avoid FDA oversight.

And while some may point to the implementations of Watson in supporting care decisions elsewhere in medicine like oncology, there’s one big difference here. Those applications give recommendations to a “learned intermediary” like a physician or nurse – someone who takes this advice in conjunction with clinical specifics and their own knowledge to make the actual decision. Here, the recommendation would be going directly to the patient and is slated to be highly personalized, unlike say a simple Google search.

Regardless of what the actual scope and capabilities of the released app end up being, the integration of the veritable mascot of “big data” with the smartphone is something of which healthcare professionals should take note.

Author:

Satish Misra, MD

Satish is a Cardiology Fellow at the Johns Hopkins Hospital. He is a founding partner and Managing Editor at iMedicalApps. He believes that mobile technology can change the way healthcare is delivered and that iMedicalApps is a platform through which clinicians can be empowered to lead the charge.

 

 


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What do patients and carers want from health apps?

What do patients and carers want from health apps? | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
Visit the post for more.

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COM SALUD's curator insight, November 11, 3:53 AM

La tecnología ha dejado de ser un obstáculo para los pacientes, incluso para los mayores, debido a la generalización de los smartphones y a los dispositivos wearables, que se integran en la ropa y complementos, y que no necesitan conocimientos tecnológicos del usuario para poder monitorizar la salud y comunicarse con los profesionales sanitarios. En el I Congreso de Wearables y Big Data en Salud se presentarán ejemplos de esta tecnología intuitiva y útil para pacientes crónicos o dependientes, así como para quienes apuestan por la prevención.

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Research2guidance mHealth App Developer Economics 2014 Study

This is the fourth edition of our yearly study on the state and the future of mobile healthcare. In this year’s report we have asked more than 2,000 mobile health app developers, health managers, project managers etc.

Our free report contains an in-depth market analysis on the current status and future impact of mHealth app publishing, a breakdown of different app stores, breakdowns of who is publishing mHealth apps today, the business aspect of publishing healthcare apps and and outlook of how the market will look like in the future.Questions answered:

How is the mHealth market’s status quo?
What is the future of mHealth apps?
How does the choice of your business models, app category, publisher type effect downloads or revenue?
What are the most important revenue sources today?
How will the market look like in 5 years’ time?
Which disruptive changes can be expected for mobile healthcare?
Which factors will have the biggest impact of mHealth on healthcare costs, diseases, regions, distribution, patient outcome?
Who is publishing mHealth apps today and what are typical app developer profiles?
What are the main differences between typical app developers (company size, medical background, motivation, business models, etc.)?
Apart from simple health trackers and fitness apps, what kind of other apps are out there (e.g. remote monitoring, medical compliance, etc.)?
How are APIs, sensor aggregation services and big data changing mobile healthcare?
Is the mHealth app business sustainable today? What are sustainable mHealth business models?
What is the poverty line in mHealth app development?


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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.



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In-Depth: Analysis of 137 HealthKit-enabled apps

In-Depth: Analysis of 137 HealthKit-enabled apps | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
This week MobiHealthNews once again rounded up an up-to-date list of health and wellness apps that connect to Apple’s HealthKit, a health and fitness data exchange that makes it easier for iOS apps to share data with each other. For this week’s in-depth report, MobiHealthNews analyzed the ways in which these 137 health and wellness apps are integrating with HealthKit. Some only pull data from HealthKit, while others only push data into HealthKit for other apps to use. A good number — about 20 percent — do both.

This is almost certainly not an exhaustive list — apps continue to add HealthKit integrations everyday and Apple is slowly adding new fields to its platform. We also found two or three apps that claimed to connect to HealthKit but didn’t make clear exactly what kinds of data they were sharing or pulling. We left these puzzling apps out of our analysis.

While HealthKit makes it possible to share dozens of different types of health and fitness data, most HealthKit-enabled apps are making use of the same few data points. Active calories and weight data are both among the top three most popular data types to push or pull from HealthKit. Heart rate data and step count is right up there, too.

Based on MobiHealthNews’ analysis, here’s a quick breakdown of the top 10 most popular data types pushed to HealthKit and the top 10 most pulled: 

Number of apps pushing various kinds of data (or “writing”) to Apple HealthKit.

34 percent of HealthKit apps (46) are pushing active calories data.20 percent of HealthKit apps (28) are pushing weight data.18 percent of HealthKit apps (25) are writing heart rate data.18 percent (24) are pushing workouts data to HealthKit, even though the Apple Health app doesn’t have such a field.15 percent of HealthKit apps (21) are feeding step count data into the platform.15 percent (20) are sharing walking and running distance data with HealthKit.10 percent of HealthKit apps (14) are pushing out sleep analysis data.9 percent (12) are sharing nutrition data with the HealthKit ecosystem.8 percent (11) are pushing out blood pressure data with HealthKit.7 percent of HealthKit apps (9) are writing cycling distance data.

Number of apps pulling various kinds of data (or “reading”) from Apple HealthKit.

23 percent of HealthKit apps (32) are pulling weight data.16 percent (22) are integrating step count data from HealthKit.12 percent (17) are using active calories data from the platform.10 percent of HealthKit apps (14) are using heart rate data pulled from the system.10 percent (14) are pulling down blood pressure data from HealthKit.9 percent (13) make use of walking and running distance data retrieved from HealthKit.9 percent (13) are pulling nutrition data from HealthKit.9 percent of HealthKit apps (12) are using sleep analysis data from the platform.7 percent of HealthKit-connected apps are using the platform to pull in a user’s height.7 percent (9) are pulling in a user’s birthdate from HealthKit.

We’ll share topline metrics on pricing data for these 137 apps later in this in-depth. 


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Doctor Prescribed Apps May Soon Be the New Norm in British Healthcare

Doctor Prescribed Apps May Soon Be the New Norm in British Healthcare | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

According to the U.K.’s Telegraph, soon British doctors might be “prescribing” more apps than medications.

A new government strategy calls for a National Health Service (NHS) app store in which approved applications that purportedly improve health and lifestyles would be kitemarked (a UK product and service quality certification mark) by the health service and may also be provided for free to those trying to improve their wellbeing.

For example, overweight patients may be recommended an app that tracks their diet and exercise and those suffering from diabetes could use an app to monitor blood sugar.

The best technology developers and chosen apps would be branded with the NHS logo. Apps currently being used include mobile systems that give parents access to their children’s immunization records, allow adults and elderly persons to schedule care visits, and offer assistance to those trying to quit smoking.

Other public health campaigns have also offered apps with recipes to encourage families to eat healthy.

Details will be announced later as part of a strategy — Personalized Health and Care 2020 – focusing on how to tailor information for patients’ needs.


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Laurent FLOURET's curator insight, November 14, 9:29 AM

"The best technology developers and chosen apps would be branded with the NHS logo."

Keith McGuinness's curator insight, November 14, 8:12 PM

Until apps measure and report their effect on specific relevant health outcomes, the word "prescribe" must remain in quotation marks.  


A doctor does not prescribe a drug without trustworthy evidence of effectiveness.  Why is an app different from a drug in this respect?  Because apps are not a safety risk?  Effectiveness is still the objective; is it not?

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Wearables Are Totally Failing the People Who Need Them Most

Wearables Are Totally Failing the People Who Need Them Most | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

As the Internet of Things becomes an actual thing, more steps are being counted, more sleep patterns are being logged, more activities are being app-ified. What isn’t appearing in the data is much common sense or ambition. Instead, developers continue flocking to a saturated market filled with hipster pet rocks, devices that gather reams of largely superficial information for young people whose health isn’t in question, or at risk.

It’s a shame because the people who could most benefit from this technology—the old, the chronically ill, the poor—are being ignored. Indeed, companies seem more interested in helping the affluent and tech-savvy sculpt their abs and run 5Ks than navigating the labyrinthine world of the FDA, HIPAA, and the other alphabet soup bureaucracies. This may be their own undoing, as there is a very real—and potentially lucrative—potential to shake up the healthcare system and frack the $2 trillion annual cost of chronic disease.

Bangled with Fitbits and Jawbones and peering through their augmented reality spectacles, the audience at D.C.’s Wearables + Things conference saw the hype cycle of the industry buckle in on itself. Peter Li, a twenty-something inventor who studied biomedical engineering at Johns Hopkins, demonstrated a fitness watch that accurately detected and counted the push-ups and jumping jacks he performed onstage. Nike’s chief scientist pooh-poohed smart watches’ most commonly collected biometrics—steps, temperature, and blood oxygen—as irrelevant to athletic performance, while promoting the importance of smart algorithms for analyzing human performance. Adidas demonstrated a heart rate monitor that clips onto its biometric sports bra. At least someone finally figured out that women already run with a band around their chest.

But then there was Kabir Kasagood, director of business development for Qualcomm Life, which manufactures the semiconductors used in many wearable gadgets. He exhorted developers to stop screwing around in a saturated market for activity trackers and embrace the red-tape and regulatory friction of the healthcare industry. “Go from the children’s table to the grown-up table,” he said. “If you’re serious about this, embrace the FDA. Learn how HIPAA works. Make sure it’s connected to the [electronic medical record] and that all the health laws are observed. There’s a tremendous dearth of innovation here. I would move away from fitness and go hardcore into health. That’s where the money is.”

Dorthy, iStrategyLabs’ shoe clip device. Maggie Winters/iStrategyLabs

The audience response was lukewarm. After all, regulation is yucky. Clinical trials are a drag. Integration with legacy systems is boring. Security requirements and limitations on how user data can be monetized? Meh. As if to prove the point, minutes later, the marketing director of iStrategy Labs demonstrated “Dorothy,” a shoe clip that allows you to click your heels together three times to call Uber. By far the biggest hit of the conference, this hacked-together prototype snowballed into an appearance on Good Morning America.

As of September 30, there were 266 wearable devices on the market (including 118 fitness wearables), with 23 slated for release before the year is out. From Silicon Valley and San Francisco to Austin and MIT, young, healthy, highly educated, mostly male entrepreneurs are developing marginally useful apps and gadgets for people just like themselves. And indeed, most of the information technologies we currently use started this way, from personal computers to the Internet and social media. The alpha geeks home-brew technologies that are taken up by early adopters and spread until your mom is on board. The Silicon Valley assumption is that health and wellness will follow that same path.

But if you follow the money, and you really understand the population with the most to gain from improvements health and wellness, that assumption falls apart. It turns out the wave of wearables adoption isn’t rolling out the same way as the web or smartphones. More than half of US consumers who have owned an activity tracker no longer use it. A third of them took less than six months from unboxing the device to shoving it in a drawer or fobbing it off on a relative.

Test For Diabetes Elderly Person, Everyday life of an independent nurse, Bagnolet, France. Diabetic patient. BSIP/UIG/Getty Images

So who’s made a long-term commitment to measuring and tracking their health? People with two or more chronic diseases. According to a Pew Foundation survey, 45 percent of US adults are dealing with at least one chronic condition. While only 19 percent of people with no chronic conditions track their health indicators, 40 percent of adults with one chronic condition do so, and 62 percent of adults with two chronic conditions do so. So far this year $2.8 billion has been spent on wearable medical devices, and that’s expected to grow to $8.3 billion in the next five years. If you took all the fitness bracelets and smart watches sold in 2014 and multiplied that retail number by six, it still wouldn’t match the $6.3 billionUS market for blood glucose test strips.

People with chronic diseases don’t suddenly decide that they’re over it and the novelty has worn off. Tracking and measuring—the quantified self—is what keeps them out of the hospital. And yet there are more developers who’d rather make a splash at a hackathon than create apps and devices for people who can benefit hugely from innovation in this area.

At some point, you’ve got to ask yourself whether it’s just the friction created by health-industry regulation—the HIPAA security rules and FDA approval (or waiver) process and the hassle of integration with legacy systems. Or is it too daunting for a twenty-something engineer to develop technology for people who aren’t like them at all? An obese diabetic on a motorized scooter? Or a frail old lady with memory loss? Or her caregiver? Someone who’s three bus transfers away from a doctor’s office?

Can our innovators rise to the challenge of an aging, chronically ill society whose medical costs are swamping our economy? Or will techies just click their heels together three times, and call Uber?

J.C. Herz is the author of Learning to Breathe Fire.


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ChemaCepeda's curator insight, November 14, 10:37 AM

La ley de los 'wearables' inversos, o como los que más se podrían beneficiar de esta tecnologías no la reciben

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Survey: One third of physicians use telemedicine, one fifth are reimbursed

Survey: One third of physicians use telemedicine, one fifth are reimbursed | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
Most healthcare practitioners are either using telemedicine or planning to use it soon, but less than a fifth of them are being paid for those services.

That’s according to a survey recently conducted at the Academy of Integrative Health & Medicine (AIHM) annual conference in San Diego. AIHM surveyed 754 practitioners, 78 percent of whom were physicians. Neither the academy nor the conference is specifically focused on telemedicine or technology, but rather on acute care, a spokesperson told MobiHealthNews, so there is no obvious sampling bias toward telemedicine.

Overall, 33 percent of physicians surveyed said they were using some form of telemedicine and another 29 percent said they were planning to, making a total of 62 either using or considering telemedicine, defined as “care via telephone, video visits, web cam visits – or other consultations not in person”.

However, when practitioners were asked “[d]o you have a mechanism to get paid for telemedicine services — are you in a network that will reimburse for that?”, only 19 percent said yes. 

“When we have technology that can drive down the cost of health, and help improve patient outcomes, providers need to be reimbursed,” Nick Jacobs, a board member of AIHM, said in a statement. “In this case, 33 percent of physicians are delivering service using telemedicine right now, yet just 19 percent say the service is covered. We find the same issue in integrative care – where for example, acupuncture, proven effective, is not covered by some health insurance providers. We need to open up all the options for healthcare to providers and patients. It drives down costs and improves patient outcomes.”

Survey participants were asked whether they thought telemedicine technology was ahead of the state medical board guidelines used to regulate it. A majority — 56 percent — said it was, 34 percent said it wasn’t, and 10 percent weren’t sure.

Additionally, doctors were asked what percentage of initial and follow-up visits they conduct are appropriate for telemedicine. Doctors were much more likely to consider telemedicine for follow-up visits — 68 percent of doctors said that zero percent of initial visits were appropriate for telemedicine, and another 18 percent said one fifth or less of initial visits were appropriate for telemedicine, whereas only 8 percent said zero follow-up visits were appropriate. A plurality (29 percent) said between 1 and 20 percent of visits were appropriate for telemedicine, 24 percent said 21 to 40 percent would be appropriate, and 21 percent said 41 to 60 percent would be appropriate.

Telemedicine reimbursement is gradually gaining steam. Just this month CMS released a final rule that will expand the range of telehealth services that can be reimbursed under Medicare starting in 2015. In July a House bill was proposed that would also expand reimbursement by Medicare; it’s currently in committee.


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This Device Diagnoses Hundreds of Diseases Using a Single Drop of Blood | WIRED

This Device Diagnoses Hundreds of Diseases Using a Single Drop of Blood | WIRED | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
Right now, rHEALTH is reliable for cell counts, HIV detection, vitamin D levels, and various protein markers in the body. The next challenges, according to Chan, are adding more tests, scaling up production, and going through the laborious process of getting the rHEALTH commercialized. The company is manufacturing three different models: the rHEALTH One, which will be used for translational research; the rHEALTH X, meant to be used as a kind of power tool for clinicians; and the rHEALTH X1, which will be available for consumers.

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dagautier's curator insight, November 12, 8:17 AM

"Right now, rHEALTH is reliable for cell counts, HIV detection, vitamin D levels, and various protein markers in the body. The next challenges, according to Chan, are adding more tests, scaling up production, and going through the laborious process of getting the rHEALTH commercialized. The company is manufacturing three different models: the rHEALTH One, which will be used for translational research; the rHEALTH X, meant to be used as a kind of power tool for clinicians; and the rHEALTH X1, which will be available for consumers."