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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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Capturing reliable data from wearable health devices still a challenge for providers

Capturing reliable data from wearable health devices still a challenge for providers | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
While there may be an explosion of wearable health devices for consumers that bring them a multitude of new data streams, incorporating those devices and that data into a major health system’s EHR remains a daunting, slow-moving task.

That’s according to Martin Entwistle, director of Sutter Health‘s Innovation Center at the Palo Alto Medical Center, speaking on a panel with Validic CTO Drew Schiller at HealthBeat in San Francisco.

Among the biggest challenges, according to Entwistle, is capturing reliable data from wearables such as FitBit and matching it with clinical data.

“Much of what we have is structured data going into the medical record,” he said. “Now we have a whole new world of devices that are coming on that aren’t part of the ecosystem, and now we’ve got data all over the place.”

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The issue of too much data has been a central theme in the world of digital health, with providers noting the promise of so-called big data is great but currently disjointed and chaotic. Providers in particular have to be much more methodical in their acceptance of certain devices and ensuring it’s accurate data.

Sutter Health so far has limited its integration to to about four wearable devices.

“It has helped but some of the challenges are about the disparate nature of the data – in our work integrating the consumer-driven data, great though it is, we’ve come across issues,” Entwistle said.

Seemingly benign issues can impact a health system’s arraignment of data. In Sutter’s case, it was data that contained a time stamp from a different time zone in China, Entwistle said.

“Different time stamps, data that is incorrect that your write into the EHR and now you can’t remove it, all of that has to be addressed,” he said.

That’s where Validic hopes to come in, aiming to standardize the data from otherwise disparate and emerging sources.

“The goal is to be the digital health connector,” Schiller said, adding the hope is to make the data “easily digestable” for providers with any device.

But it’s been a challenge, he said, with most providers and payers just beginning to even consider utilizing such data.

“This is a fast growth world of messy data,” he said.

In the meantime, provider organizations are likely to move a slower pace than hoped for, but there is hope, Entwistle said.

“This is why we’re moving slowly and cautiously, but we’d like to move faster,” he said.


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IBM empowering citizens to report Ebola using text messaging

IBM empowering citizens to report Ebola using text messaging | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
IBM is analyzing text messages to map Ebola cases and enable better resource management. The post IBM empowering citizens to report Ebola using text messaging appeared first on iMedicalApps.
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Top 10 Medical Apps for Cardiology

Top 10 Medical Apps for Cardiology | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

When you search the term “Cardiology” in the iTunes app store and Google Play you get about 400 and 250 results respectively. Finding those needles in the haystack, those few apps that will actually help you deliver better care can be challenging to say the least. So leave that search to us.

Here’s a list of 10 great cardiology apps to get you started. The apps in this list are based on our experience reviewing over a thousand apps to date and my personal experiences using many of these apps as a cardiology fellow. We’ll be updating and amending this list in the future as we discover more new, innovative apps.

In this edition, you’ll notice a few themes including several apps for patient communication as well as a strong presence from professional societies.

DrawMD Cardiology

DrawMD has been an iMedicalApps favorite for some time. Designed to facilitate discussions between cardiologists and their patients, the Cardiology edition of the DrawMD series has several sketches of cardiac anatomy on which you can draw either free form or using “stamps.”

For example, one of the including drawings is an artery in cross-section. When explaining a focal stenosis, you can add a stamp that adds an atherosclerotic plaque to the vessel. When talking about pre-dilating the lesion, you can add a stamp that adds an intracoronary balloon inside the stenosis. There’s a library of stock images and stamps designed to faciliate common discussions cardiologists have with their patients.

One nice feature worth mentioning is the ability to import images or take pictures within the app that can then be drawn on. All of the images, including annotations, can be shared with your patient by email.

Price: Free
Platforms: iPad
iMedicalApps Review: Our review of this version is coming, but check out our prior reviews of DrawMD Surgery and DrawMD OB/Gyn.
Download: iTunes


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mHealth-Enhanced Support from Informal Caregivers Improves Medication Adherence

Speaker: James E. Aikens, Ph.D. Associate Professor of Department of Family Medicine and Faculty Affiliate, Center for Managing Chronic Disease University of Michigan, Ann Arbor, MI Description:...
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Health Wearables Still In Its Early Days, PwC Reports Reveals

Health Wearables Still In Its Early Days, PwC Reports Reveals | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Health wearables are still in the early stages of technology and product adoption cycles, according to PwC’s Consumer Intelligence Series – The Wearable Future report – an extensive U.S. research project that surveyed 1,000 consumers, wearable technology influencers and business executives, as well as monitored social media chatter, to explore the technology’s impact on society and business. In conjunction with The Wearable Future report, PwC’s Health Research Institute (HRI) also launched a separate report, Health wearables: Early days, further examining consumers’ attitudes and behaviors toward health wearable technology.

According to Greentech CEO Ian Clark, health wearables are “a bit trivial right now.” “I don’t doubt that the wearable piece is going to be a productive business model for people. I just don’t know whether it’s going to bend the curve in terms of health outcomes,” Clark said at the recent Rock Health Innovation Summit.

While fitness bands, smart watches and other wearables are already established in the market, many of them have under-delivered on expectations. Consider that 33 percent of surveyed consumers who purchased a health wearable technology device more than a year ago now say they no longer use the device at all or use it infrequently. Currently, only 1 in 5 American adults owns a wearable device with only 1 in 10 using it on a daily basis.

Key drivers of the low adoption rate include:

- Price

- privacy

- security

- lack of “actionable” and inconsistent information from such devices

In fact, 82 percent of respondents were worried that wearable technology would invade their privacy and 86 percent expressed concern that wearables would make them more vulnerable to security breaches.

In order for health wearables to take advantage of the $2.8 trillion healthcare opportunity, companies must better engage the consumer, turn data into insights and create a simplified user experience to improve consumer health.  Additional key findings and recommendations from HRI’s Health wearables: Early days report include:

- Consumers have not yet embraced wearable health technology in large numbers, but they’re interested. More than 80 percent of consumers said an important benefit of wearable technology is its potential to make health care more convenient. Companies hoping to exploit this nascent interest will have to create affordable products offering greater value for both users and their healthcare partners.

- Consumers do not want to pay much for their wearable devices; they would rather be paid to use them. Companies – especially insurers and healthcare providers – offering incentives for use may gain traction. HRI’s report found that 68 percent of consumers would wear employer-provided wearables streaming anonymous data to an information pool in exchange for break on their insurance premiums. Moreover, consumers are more willing to try wearable technology provided by their primary care doctor’s office than they are from any other brand or category.

- While employers and health company executives expect wearables to provide valuable insights, few consumers are interested in using wearables to share health data with friends and family, and, citing concerns about privacy, consumers trust their personal physicians most with their health data. Therefore, companies should ensure privacy policies are crystal clear. Physicians already have the trust of consumers, and healthcare organizations have expertise in protecting personal health information. Consumers will want to see those high standards applied to health wearables data, especially as they become integrated into electronic medical records.

- Consumers may need a human touch to help them choose a device and its associated apps. An “apps formulary” of apps vetted by medical teams (and available in a virtual apps pharmacy) could help consumers wade through the thousands of health apps and devices.

“For wearables to help shape the New Health Economy, next generation devices will need to be interoperable, integrated, engaging, social and outcomes-driven,” said Vaughn Kauffman, principal, PwC Health Industries. “Wearable data can be used by insurers and employers to better manage health, wellness and healthcare costs, by pharmaceutical and life sciences companies to run more robust clinical trials, and by healthcare providers to capture data to support outcomes-based reimbursement. But it will be critical to address the consumer concerns that we’ve identified, such as cost, privacy, and ease of use.” For more information,

Both reports are available for download at: 


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Daphne Press, RN LNC's curator insight, October 21, 8:40 PM

Coordinating the upcoming ABA Health Law Section FDA Medical Device Fundamentals webinar. So, radar tuned to devices.

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Panasonic Launches Tablet-based Telehealth Service for Seniors

Panasonic Launches Tablet-based Telehealth Service for Seniors | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Panasonic Corporation announced it will launch a tablet-based telehealth service in November called On4Today, a non-clinical telehealth service provided to long-term care and assisted living facilities. Designed as an ‘always on’ service, On4Today bridges potential communication gaps between assisted living facility residents and their families, friends and care providers. It delivers connectivity and easy-to-use communications intended to improve staff efficiencies, reduce anxiety for residents, promote peace of mind among family and friends and encourage stronger levels of resident engagement.

The new Health and Wellness Solutions business group is part of Panasonic’s ongoing business transformation and will deliver technology solutions to the healthcare market.

With the launch of On4TodayTM, Panasonic is demonstrating the types of solutions and new generation of networked health information technologies that are enabling providers to deliver cost-effective services. Health and Wellness Solutions will leverage Panasonic’s engineering roots and technology portfolio to address the challenges associated with individual and population health management. 

 How It Works

On4TodayTM is delivered on a tablet and the tablet connects through WiFi. The lightweight device is portable and gives residents options to manage daily activities with calendar appointments and reminders, view photos and videos, and participate in video chats and messaging. Large font size, audio and visual prompts and touch screen scrolling features simplify site navigation and message access. The service is intuitive and can be customized, depending on long care or assisted living facility needs or individual preferences. 

“Quality and reliability are essential attributes for any long-term care or assisted living facility,”said Bob Dobbins, Vice President, New Business Development, who leads Panasonic’s new Health and Wellness Solutions group. “Panasonic’s health and wellness solutions reinforce the importance of those characteristics by bringing advanced technology into the care continuum to create more meaningful interactions, generate higher levels of resident well-being and reduce facility costs.”


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The Promise of Mobile Tech in Focus During Flu Season

The Promise of Mobile Tech in Focus During Flu Season | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
According to a recent report by the CDC, from 1976 to 2006, between 3,000 and 49,000 people have died every year due to complications from the flu.

People 18 to 64 years of age accounted for nearly two-thirds of all flu-related hospitalizations and deaths in last year’s H1N1 epidemic.

Of course, flu outbreaks and death are nothing new. During the 1918 pandemic, more than 500 million people worldwide were infected and between 50 and 100 million died- nearly 5% of the planet’s population.

No effort to combat the flu has been as impactful as the flu vaccine in minimizing death, hospitalizations, and the costs of caring for flu patients. Fortunately, new technologies now aim to be just as beneficial in the war against flu.

A range of cutting edge apps as well as big-data mining and real-time interactive maps of outbreaks may revolutionize the public’s understanding of influenza and prevent its spread.

But it will take time to get there.

“I don’t think we have something of the magnitude of the vaccine, that’s a pretty fundamental change that suddenly your immune system can deal with the flu,” David Lazer, Northeastern professor of political and computer science, tells Gigaom. “I do think, however, that it’s clear that if we knew where and when the flu would be bad that we could intervene in ways that save lives, so I do think this kind of methodology offers an approach that could allow us to use our resources more efficiently to save more lives. That’s clearly the potential. And I don’t think we’ve realized that potential.”

Today, less than 50% of the population gets a flu shot. Apps can help people find nearby clinics with the shots, warn people about outbreaks, and serve to improve outcomes by getting people to protect themselves via vaccines or improving hygiene.

Technology, however, still has its fair share of struggles to overcome. Google Flu Trend’s estimation of flu cases based on search results overshot actual cases over several flu seasons. Doctors concluded that using weekly CDC reports from doctors on influenza-like illness, even though they lag by two weeks, outperforms Google Flu Trends as a predictor.

Lazer countered that “if Google were more transparent with its data, as Twitter is, scientists could develop algorithms that improve Google Flu Trends and provide finer granularity in their data.”

There are, unfortunately, also issues with this approach. The problematic matter with projects using Twitter data is that bots manipulate the data and people who are well enough to be tweeting about symptoms may not be suffering from the flu.

Flu Near You, on the other hand, is a community-driven tracker that offers real-time data based on weekly-reports provided by users. This can provide hyper-focused data about hospitalizations, immunizations, and symptoms. However, this does require active participation from users.

At the end of the day, Gigaom’s summary concludes, personal apps may truly hold the greatest non-medicinal potential, as they can offer symptom identification, prevention tips, recent flu activity, and vaccine finders which, all told, have the potential to reduce the spread and severity of flu outbreaks.


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How can clinicians actually evaluate mobile health apps?

How can clinicians actually evaluate mobile health apps? | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

While mobile healthtechnologies and companies offer great promise is reaching patients and consumers, perhaps the greatest challenge is quantifying actual success versus hype and simply touting the next app.

Partners Healthcare in a blog post notes that the success of mHealth platforms is increasingly difficult to gauge or is taken from a tiny sample size. Part of the issue, however, is the fast-moving world of mobile technology contrasted with the lumbering healthcare system that is often averse to change.

“mHealth represents the collision of two interesting worlds — mobile, which changes on what seems to be a daily basis, and health care, which changes infrequently, only after significant deliberation and usually much empirical analysis.”

The seeming breakneck speed of mobile technologies, and the entrepreneurs who tout them, make sense from a pure consumer point of view – get the minimally viable product out to market ASAP and see how often it’s downloaded. But that’s no so readily applicable with healthcare clinicians, at least not at the moment.

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“But does this work in health care? I’m not so sure. As clinicians, we’re trained to turn our noses up at this sort of measure of success. But maybe we’re the ones who are wrong.”

More specifically, the author notes that a recent mobile health company touted the success of its program, which wasn’t named, using a 10-patient sample size over three months. That exposes obvious issues like selection bias, regression to the mean, sample size bias and, lastly, a novelty effect.

The author posits that the reason for such a seeming disconnect between mHealth advocates and the staid clinical standpoint is not hard to figure out – lives can literally be at stake when it comes to healthcare.

“It is cliché to say it, but lives are at stake.  So we’re more careful and more demanding of evidence.  Is this holding us up from the changes that need to occur in our broken health care non-system?  Possibly.”

So how does one design a scientifically sound trial that can keep pace with the technology?

“One thing we’ve done at CCH is design studies that use a large matched data set from our electronic record as a comparator.  This speeds things up a bit, eliminating the need to enroll, randomize and follow a control group.  Results are acceptable to all but the most extreme purists.”

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Keith McGuinness's curator insight, October 15, 7:00 PM

We have to divide the discussion.   We must allow for apps that do not put ‘lives at stake’ to evolve separately from those that may.  mHealth is an unfortunate term.  The trustworthiness of a Mobile Diagnostic app or a Mobile Behavior Change app depends on very different realities.  Lumping them together burdens the progress of those apps that do not place lives at stake. 

 

Lets dissimilate mHealth.  Are we still interested in the prevention and management of chronic diseases?  Then lets promote discussion about the category of apps that may help with that.  And lets ask primary care providers to be direct about why they are less than enthralled about this category.  It would be most helpful if payers and providers paid enough attention to the potential of this category to confront downloads measurement and instead demand outcomes measurement.  Insist that the app sponsor measure the effect of the app on those health metrics that affect the health of the patient, the accountability of the physician and the cash flow of the payer.  If the app promises to improve blood pressure, then say, “show me the numbers.” 

 

Unless we demand that lifestyle apps measure outcomes, they will continue to measure downloads, that is what advertisers demand after all. 

 

Of course, this is not important if there is no one that believes behavior change apps may affect health outcomes.  But if we do believe it, then we should be using outcomes measures as the primary evaluation criterion.

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Infographic: 12 ways to put patients first in healthcare | mHealthNews

Infographic: 12 ways to put patients first in healthcare | mHealthNews | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
The Innovation HealthJam, a 3-day virtual brainstorm, identified potential solutions for some of the most pressing issues in healthcare today.

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Sensors in digital health: what do consumers want and need?

Sharing this nice deck from Maneesh Juneja (@ManeeshJuneja)


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Michael Seres's curator insight, October 14, 11:22 AM

Fascinating insight by @Maneesh Juneja the figures seem to correlate to much of the evidence out there

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Your Doctor Knows You're Killing Yourself. The Data Brokers Told Her

Your Doctor Knows You're Killing Yourself. The Data Brokers Told Her | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
You may soon get a call from your doctor if you’ve let your gym membership lapse, made a habit of picking up candy bars at the check-out counter or begin shopping at plus-sized stores.

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Ginny Dillon's curator insight, October 13, 3:07 PM

Patient Privacy is no laughing matter ...

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Will remote consultations lead to a substantial degradation of medicine?

“[ET @16min] when you get to this Deloitte recent survey (‘eVisits the 21st century house call’) that says by the end of this year one in six office visits between Doctors and Patients will be virtual and that with all these tele medical entities the majority of visits will be virtual. Do you think that’s going to lead to a substantial degradation of medicine?

[AV] I’m not sure. I’d love to see what that ultimately looks like. I do think that there’s a lot of visits where we can spare the Patient the hassle of you know parking, climbing up to the clinic and certainly many many things can be transacted not just with us (Doctors) but on telemedicine with the wonderful teams that we have of nurse practitioners, physician assistants, I’m a big believer in that and often they do the very things that we don’t do which is listen and touch and spend time. But I do think for many Patients there will be a moment in the trajectory of their illness where a face to face visit will be performed and be of importance“

Dr Eric Topol interrupts Dr Abraham Verghese from attending rounds for this unmissable Medscape interview in which he shares a few thoughts on the challenges we face as we move beyond the office visit with remote consultations.

mHealth Insights

“Visits will be Virtual”

I think it’s important that we all accept that the idea of one person virtually caring for another individual is nonsensical. Much more useful if we talk about providing care remotely (eg. remote consulting) unless of course we are talking about computers reading scripts to humans via avatars to deceive Patients into the illusion of being cared for.

Many Patients have already moved beyond the visit

One of the reasons I am confident that mHealth models that successfully aid Diabetics will create the template for most other chronic diseases to follow is that diabetics have already gone beyond the office visit (eg. Diabetics are self managing their care and routinely doing things that only a few years ago would’ve only been possible with a visit to a Doctors office).

A quote from Theophrastus Phillippus Aureolus Bombastus von Hohenheim

I think this Paracelsus quote shared by Dr Verghese makes a great screensaver:


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iPhone paired continuous glucose monitor device reveals FDA approval challenges - iMedicalApps

iPhone paired continuous glucose monitor device reveals FDA approval challenges - iMedicalApps | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
On October 20th, Dexcom announced FDA approval and immediate availability of the Share, a docking cradle for their G4 continuous glucose monitor that pushes glucose data through a nearby iPhone to the cloud. This data can then be pushed to up to 5 designated “followers” who have the Dexcom iPhone app.

share-banner-product

The Dexcom Share is an out-of-the-box, no-hassle solution for providing real-time glucose readings and emergency alerts for extreme hypoglycemia and hyperglycemia to loved ones and concerned family members.

However, the length of time it took for the Share to get approved reveals the struggles that the FDA faces in the brave new world of mobile and wireless health.

The Dexcom Share: Glucose In the Cloud

share-information-flow

Currently available for iPhone only, the Dexcom Share ($399; Product Link) is a cradle/dock for the G4. In addition to charging the G4, the Share cradle wirelessly transmits glucose data via bluetooth to a nearby iPhone, which in turn securely uploads the glucose data to the cloud.

The Dexcom Share is readily available now as an accessory to the G4 and does not require any prescription. Furthermore, the cloud service is entirely free from any monthly service fees.

Up to 5 other people can then follow the user’s blood sugars in real-time using the corresponding free Dexcom Follow app. In addition to viewing the glucose reading and glucose trend direction, the followers can each set up notification alerts that get pushed out to users.

Thankfully, using the free Dexcom Share app, the primary Dexcom user has full control over who can follow their sugar data, and can set different permissions and visibility levels to individual followers. For example, a college student can make it so that their parent can only be alerted when sugars reach critically low or high levels, without having access to their less severe daily variabilities.

A Seamless, Out-of-the-Box Solution for iPhone

Tech-savvy people with diabetes might be familiar with the Dexcom Share concept, as its not much different than the previously covered home-brew, do-it-yourself Nightscout solution.

One key improvement with the Dexcom Share is that it is useable out of the box, and requires little technological knowledge to setup. Furthermore, while the Nightscout requires a wired Android smartphone for uploading glucose data, the Dexcom Share uses bluetooth to wirelessly upload glucose data via an iPhone.

A significant downside of the Dexcom Share is that, unlike the Nightscout solution, it requires an iPhone for followers to view and monitor blood sugars from afar. (Nightscout data is accessible by any smartphone and even some smartwatches through a web-based interface).

The New Challenges of FDA Approval in the Wireless Health Era

Word of the Dexcom Share first started circulating in Spring 2013. A Dexcom executive proudly told me about the Share over a year ago, when it was fully functional and simply waiting for FDA approval.

When it comes to wireless transmission of sensitive patient data directly from a medical device, the FDA exercises extreme caution. Dexcom representatives are quick to remind readers that the Share is a transition step to the ultimate goal of glucose transmission directly from the continuous glucose monitor to the smartphone, without the need for a cradle/dock.

The FDA’s cautious approach is defensible, as strict regulations can protect the general population from unanticipated dangers from new medications and technologies. Surely, with something as valuable as glucose data in diabetes, the reliability, accuracy, and security of such information must be proven.

However, the fact that the home brew Nightscout solution beat the Dexcom Share to market by months represents the growing tension between an eager, tech-savvy diabetes community and wireless innovation. With medical apps and a burgeoning digital health industry with novel innovations in hardware and software, the FDA faces challenges that did not exist 10 years ago.

For now, let’s just be thankful that the Dexcom Share is finally available.
Author:
David Ahn, MD (@AhnCall)
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Report: Pharma companies have many apps, relatively few downloads

Report: Pharma companies have many apps, relatively few downloads | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Pharmaceutical companies have a lot of apps in the market, and have been making apps for a long time, but their apps aren’t seeing downloads and usage on par with the apps from other industries. That’s the conclusion of a new report from Research2Guidance (R2G), which analyzed more than 725 apps from 11 pharma companies.


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An app physicians should consider recommending for CHF and renal patients

An app physicians should consider recommending for CHF and renal patients | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
App by National Kidney Foundation helps with management of CHF and renal disease. The post An app physicians should consider recommending for CHF and renal patients appeared first on iMedicalApps.
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Connected health is progressing, but obstacles remain (and some of them are doctors)

Connected health is progressing, but obstacles remain (and some of them are doctors) | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Technological developments in the health care sector hold great promise for delivering a better standard of care in the United States. But just because you build it doesn’t mean they will come. Doctors, that is.

Electronic prescriptions are a good example. The majority of doctors in the U.S. have no idea if the prescriptions they write actually get filled by the patient. Surescripts, for example, has a platform that lets doctors send prescriptions electronically and track when and if they are picked up.

The technology is there. But Seth Joseph, vice president of corporate strategy at Surescripts, says doctors may be reluctant to access that data and check in on a patient outside of an appointment.

“We have doctors that say ‘what would it mean from a liability perspective if doctors had access to that info and don’t take action’,” says Joseph. There are also questions around how long a doctor should wait before getting in touch with a patient about not picking up medications, for example, or what other steps they should take.

The 2009 Health Information for Economical and Clinical Health Act (HITECH Act) incentivized health care providers to adopt electronic health records (EHR) systems and use them in specific and meaningful ways. One of these is for EHR systems in one office to connect with EHR systems in another — a hospital, for example.

As a testament to how well the incentives have worked, Joseph has noted a surge in the number of EHR providers alone. His company currently connects with over 300 EHR vendors — up from just under 100 in the first quarter of 2009. By 2012, the company had seen a flood of EHR vendors, which he documented in a recent study. Considering that Surescripts was founded in 2001 and active by 2003, that’s a significant bump in a three-year period.

Some of the brightest lights in digital health will be discussing connected clinical systems at VentureBeat’s HealthBeat conference on Oct. 28 and 29.

Some hospitals and emergency rooms can already query a network of health care providers about a new patient, to see if that patient has received any prescriptions in the last 13 months and from whom. Some of these networks even have email and chat functions.

But for the most part, doctors don’t coordinate care with caregivers at other facilities using electronic systems. A general practitioner may be able to make an electronic referral specialist, but they can’t manage a patient’s overall health regimen.

As it stands, doctors are paid mainly on a fee-for-service basis, which conflicts with the whole notion of coordinated, preventative care. Rather than making doctors responsible for a patient’s overall health and incentivizing them to provide follow-up care (like checking in with doctors or services they’ve referred patients to), the current system encourages doctors to provide as many single services in a day as possible — leaving little time for follow-up care.

“We need to see payment reform,” says Joseph. He goes on to say that new legislation needs to shift doctors away from a fee-for-service model and towards incentivizing ongoing care.

This would require Congress to enact new laws that enable doctors, nurses, or case managers to focus on the whole “patient journey” whether well or sick. Until then the movement to coordinate care is not likely to progress quickly, he says.

Still, there’s promise managed care will catch on without a new law, Joseph goes on to say. Federal Medicare programs are already offering accountable care pilot programs in which health providers are paid a set amount to manage the health of a given population. Experiments in public health programs often lead to broader changes in the market.

In the coming years, we’re likely to see the health care system moving away from the fee-for-service model and toward one that prioritizes preventative and managed care. As the system transforms itself, the people in it will have to answer questions about liability, reassess the role doctors play in a coordinated care schema, and potentially create the new role of a health care manager who can utilize digital records to better supervise patient health.


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Andrew Spong's curator insight, October 23, 9:44 AM

Healthcare professional reticence can have as much to do with concerns about patient safety as it can with personal skepticism.

 

Let's remember that the personalised medicine agenda extends to doctors, too. Many doctors do an outstanding job in terms of delivering exceptional care and supporting optimal patient outcomes without a battery of gizmos and gadgets.

 

Push through the legions of techno-zombies and wild-eyed advocates, and find the solution that works for you, in whatever combination of digital and analog forms, in tandem with your care team.

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mHealth Evidence

Mobile and Wireless technologies have the ability to enhance health because of frequent and less burdensome measurement and the ability to intervene in real time and in the context of a person's...
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Is Google Glass headed for extinction?

Is Google Glass headed for extinction? | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

Is Google Glass quickly falling into the waste bin of  seemingly great but ultimately futile ideas?

That’s the view from PC Magazine UK, which likens Glass, and it’s seeming drift toward irrelevance, to buzzword trends of technology and the internet of yore, including VCRPlus and “the once ubiquitous ‘keyword’ employed by AOL.”

The backlash that Glass felt was high-profile (especially here in Google’s backyard) and, in a lot of ways, understandable – people simply don’t like, appreciate, or are outright hostile to the idea that their every move and every word are being recorded and transmitted to some unsecured cloud controlled by Google. The difference is important, PC Magazine writer John Dvorka notes – while other technologies faded away because they were no longer useful, Glass’s issues lay with the public perception.

“It wasn’t outliving its usefulness like VCRPlus and keywords; it was negative social pressure that made them go,” Dvorka writes, predicting that Glass will be shutdown within a year.

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Importantly, he correctly notes:

“In some ways this is a shame since a number of Google Glass applications still being developed could be useful for customer service and other business applications. Now they’ll probably never see the light.”

One area that became obvious – and far less socially awkward – is healthcare. Glass has shown usefulness in aiding surgeons and communication between providers and ambulances, adding another tool in the growing field of medicine, among dozens of other potential applications.

Just this past September, Pristine, which specializes in developing wearable healthcare technology, raised $5.4 million to develop Glass into a “more manageable, hands-free approach to telemedicine,” esteemed MedCity News colleague Stephanie Baum reported.

And MedGift, a project at Switzerland’s Institute of Information Systems, shows medics using Glass to stream video of a patient while en route to be treated by a physician, who is then better prepared when the patient arrives.

There are literally dozens of potential applications within healthcare. It’s arguably too soon to say which ones will really stick and which ones, like Glass itself, are hype. Nevertheless, that the healthcare world is more willing to embrace Glass than the general public is an interesting role reversal: the American healthcare system traditionally has embraced consumer technologies at a far slower clip than the average consumer.

So who’s to blame? Dvorka posits that the problem resides with Google’s naiveté toward the public-at-large. Some might say arrogance.

“The company has exhibited a very cavalier attitude towards individual privacy,” Dvorka says.

It’s certainly a fair point and a widely held sentiment among those who view Glass with a disdainful eye. The writer goes on to predict that, in the near future, Google will abandon Glass due to slumping interest.

But if healthcare is any guide, perhaps it’s possible for Google to refocus the product toward those who want to work with Glass versus cavalierly trying to convince all consumers to walk around like robots recording conversations in bars and dismissing critics as mere Luddites. It’s one thing for a person in an ambulance to connect with an ER physician – that has huge potential benefit; it’s entirely another to wonder if that shot of Jameson you take at happy hour is on full public display because of some socially awkward cyborg.

“With security cameras everywhere combined with unapologetic government surveillance of law-abiding citizens, adding Glass is just too much. They turned out to be a straw the broke the back of the privacy camel’s back. … No one needs friends acting as if they were agents of the government, perhaps streaming your image and words directly to the cloud during what should be casual conversation.”

It’s perhaps time that Google and other tech behemoths wake up to this basic fact. To be fair, it’s not just Google; it’s just that Glass was and continues to be literally the most visible intrusion – real or perceived – into peoples’ personal lives.

The technology itself is not the problem; the application and tone-deaf roll out is what will doom Glass, and that would be a shame given that there is some promise.


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SelfEcho Launches Pilot Study Of New Mental Healthcare Mobile Platform ... - DigitalJournal.com

SelfEcho Launches Pilot Study Of New Mental Healthcare Mobile Platform ... - DigitalJournal.com | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
Mental Health Clinicians Enrolling in Study to Use Mobile Therapy System With Patients

PR Newswire

SANTA BARBARA, Calif., Oct. 7, 2014

SANTA BARBARA, Calif., Oct. 7, 2014 /PRNewswire/ -- For the first time, mental health clinicians have the opportunity to preview a new mobile platform that provides them with patient data between therapy visits to accelerate diagnoses and improve care.  SelfEcho, a leading developer of technology solutions for mental health, is launching and enrolling clinicians in a pilot study of its new Mobile Therapy system.  Mobile Therapy collects patient data on an ongoing, voluntary basis that clinicians can access through a centralized dashboard to monitor progress and enhance treatment.  The system also offers practice management tools for clinicians. 

SelfEcho is enrolling selected, licensed clinicians from various mental health practice areas in the pilot study, including professional counselors, clinical psychologists, clinical social workers and marriage and family therapists.  The pilot studies will be conducted in two groups of clinicians who will utilize the system within their practices, free of charge.  Licensed mental health clinicians treating adult patients are eligible to participate and can find enrollment information at http://pilot.mobiletherapy.com.

"Mobile technology has incredible potential to transform mental health care treatment and we're excited to be at the forefront of bringing new applications to professionals," commented Jacques Habra, SelfEcho's co-founder and CEO. "Our goal in launching the pilot study is to give clinicians a preview of the Mobile Therapy system and to solicit their input to ensure that we're meeting the needs of their practices."

SelfEcho's Mobile Therapy is designed to empower clinicians through mobile technology by collecting patient data in a scientifically validated manner, which is then analyzed by psychology-based algorithms.  Clinicians invite patients to utilize the system and then customize each user's account based on the patient's condition and treatment plan.  In full compliance with HIPAA requirements, Mobile Therapy collects data actively and passively via patient self-reports and smartphone sensors.  Mobile Therapy uses passive linguistic analysis technology, based on 20 years of research stemming from Professor James W. Pennebaker's work at the University of Texas at Austin.

Over time, clinicians can view metrics from Mobile Therapy's centralized dashboard that enables them to more efficiently diagnose, track patient progress, identify triggers and make more informed decisions about treatment planning.  The dashboard also provides clinicians with HIPAA-compliant note-taking tools and will soon offer variety of insurance, scheduling and billing features to streamline and centralize practice management.

According to a recent national survey commissioned earlier this year by SelfEcho, mental health practitioners believe mobile technology applications geared to mental healthcare treatment have the ability to improve patient care and practice management.  More than half of survey respondents (66 percent) believe that being able to obtain additional data on clients using mobile technology would improve their ability to treat them.  Furthermore, 68 percent of clinicians surveyed felt that integrating additional data from apps for mental health tracking into therapy practices would help clinicians advance their profession. 

"Many patients do not provide reliable or consistent information to their mental health professionals about their emotional well-being during the time between appointments," said Dr. Daniel Gilbert, a Professor of Psychology at Harvard University and a senior research director at SelfEcho.  "Mobile technology systems like Mobile Therapy give clinicians a powerful tool to better understand what is happening in their clients' lives so they can work together to tailor treatment to patients' needs."

About SelfEcho

Based in Santa Barbara, Calif., SelfEcho www.selfecho.com applies technology in creative ways to enhance well-being, mental health and productivity.  SelfEcho's suite of products includes Mobile Therapy, a web-based platform designed to empower clinicians to provide better patient care and UpJoy.org, a web-based corporate wellness application designed to improve employee positivity and productivity.  Its founders and employees are committed to the bridging the gap between clinical experts within the field of psychology and the business sphere.  SelfEcho's management team includes accomplished experts in psychology and award-winning entrepreneurs.  SelfEcho is a project incubated and funded through the Santa Barbara start-up incubator, Noospheric.

Photo - http://photos.prnewswire.com/prnh/20141007/150648-INFO


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Laureen Turner's curator insight, October 15, 4:54 PM

This is a great tech talk topic !!!! 

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Packing evidence-based medicine into mobile apps | mHealthNews

Evidence-based medicine has quickly moved from the background to the forefront as a determiner of treatment pathways, and the mobile health app marketplace has responded in kind.

Dozens of EBM apps are available in Apple’s AppStore and Google’s Android Play for smartphones and tablets, many from major medical institutions and most of them free or for a nominal fee. All are designed to help physicians make decisions at the point of care.

While none of these apps can substitute for a physician's judgment and professional expertise, they can be valuable in guiding clinical decision-making and eliminating errors such as “anchoring” - or making a diagnosis or assumption without having all the data - said Kulleni Gebreyes, MD, a physician and current director in PricewaterhouseCooper’s Health Industries practice. 

“When you use EBM it allows you to consider more comprehensive diagnosis possibilities and treatment options,” Gebreyes said.

[Roundup: 10 mobile apps for evidence-based medicine.]

When doctors are overwhelmed with data points and don’t have the time or bandwidth to read through all the journals and abstracts, these programs can separate the signal from the noise and allow them to focus on the most relevant information, as well as making sure they answer the right questions.

“They are useful if you know the right context,” Gebreyes said.

Disclaimers

Before browsing through the summaries of these 10 mobile EBM applications, bear in in mind that somewhere in the software itself or in the accompanying literature is this disclaimer:

The application … “is not a substitute for clinical decision-making. We make no claims of the accuracy of the information contained in this application. Clinicians should perform their own review of pertinent literature before making a clinical decision.”

This is more than just a legal notice like those seen on television for Viagra and other meds, said Greg Caressi, senior vice president of healthcare and life sciences at Frost & Sullivan. Rather, it's a statement of where we are in the industry.

“In this case we have to take these disclaimers more seriously,” he said. “We don’t have enough evidence and a high level of understanding that this application works better than others and will get better results in cost and outcomes. This is a challenge for clinicians.”

Not ‘cookbook medicine’ any longer

Challenges linger, but if EBM can minimize the variations that exist when hospitals and physicians practice from their own experience, then outcomes will improve and, in turn, costs will go down.

As far as outright opposition to the concept of EBM, one can only say that no one is calling EBM  ‘cookbook medicine’ anymore. Indeed, EBM is how the younger generation of physicians is being trained. 

That doesn’t mean clinicians don’t have some concern. But clinicians are worried about the payers, fearing that insurers will determine which treatment pathway is best and dictate that if doctors don’t follow the recommended treatment they had better have a great deal of backup as to why not, or the insurer won’t pay. 

“The question is how much will payers drive this?” Caressi said.

Both Caressi and Gebreyes believe that in time, these mobile EBM applications will improve outcomes and reduce costs.

Looking five years down the road, Caressi sees the day when a mobile application connected to an IBM-type Watson supercomputer will be used in emergency circumstances, with the doctor punching in the situation and the application immediately returning a clinical decision support response. Gebreyes, meanwhile, sees the day when these tools will be able to take population-based probabilities and translate them to individualized probabilities for patients based on their unique characteristics.

Ephraim Schwartz is a freelance writer based in Burlington, Vt. Schwartz is a recognized mobile expert and columnist, having spent 15 years as Editor-at-Large for InfoWorld, half of them covering the mobile space. Prior to that he was Editor-in-Chief of Laptop Magazine. 

Related articles: 

Top 10 mHealth stories of 2014 (so far)

Hospital-issued tablets target patient education, satisfaction

5 steps to get payers and providers to tap mHealth apps

Topics: Innovation, Clinical

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Is your health app tourist or local?

Is your health app tourist or local? | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

English is one of the most common second languages in the world, with its estimated one billion speakers equating to 14% of the world's population. However, if you are developing an app and think this means you can avoid having it translated into other languages, you might want to think again.

The reality is that only 6% of people on the planet speak English as their first language, while 22% will own a smartphone by the end of 2014. The ten countries with the highest smartphone sales in 2014 are China, India, the US, Brazil, Indonesia, Russia, Japan, Mexico, Germany, France and the UK. These simple statistics paint a clear picture of the need to localize and translate all apps for the global market.

Take the following scenario: wanting to improve its relationship with the end customer, a pharma company creates two apps. The one for the customer offers online help, easy daily monitoring of a condition and collection of data associated with it. The other app, for sales reps, is designed to help them present information and choices to HCPs. The English-language apps are launched across Europe but, after an initial burst of enthusiasm, there is little interest. Why?

The answer is simple: the apps aren't personal, and that's what mobile health is all about. It's about being accessible to customers at the touch of a button, 24 hours a day, and making their life easier. The key to providing a personal service is being able to communicate with the customer in his native language.

If you are going to be involved in your customer's daily life, you want the product to be easy to use and to fit seamlessly into his or her daily routine. For example, some apps monitor type and intensity of pain in order to give an indication of disease progress. Can you imagine waking up at 3 a.m. in excruciating pain and then trying to navigate through different pain assessments in a foreign language?

Health is a very personal issue and it is crucial that the information patients share with their doctors is accurate. Collecting information with an English-language app but discussing it in Spanish is far from ideal; misusing words with subtle differences in meaning could result in an incorrect or even harmful clinical decision, not to mention poor patient compliance.

If you really want your app to be successful on a global scale, you need to localize it and speak the language of the local market. This is where transcreation comes in – it's what defines you as a “local” rather than as just a “tourist.”

“Transcreation” combines “translation” and “creation” to provide tailored copy for a target market; in contrast with literal translation, transcreation takes into account local culture, tone and vocabulary. In the UK, “sick” means “vomit,” whereas in countries including the US and New Zealand it simply means “unwell.”

In order to create a global app, you need to ensure that the original version has been internationalized, which makes it easy to localize for a given market. Internationalization is a design principle which aims to produce software applications that can readily be adapted to other languages and regions without costly engineering changes. Internationalization has a few key characteristics, including using Unicode to make sure all characters are displayed correctly, options for formatting time and date according to local style and making sure that the correct currencies and measurement units are used.

In terms of translation, internationalization requires an app to be flexible enough to allow for discrepancies in word length, which can differ between languages by as much as 40%. There are also differences in character sizes (e.g., Latin characters require less space than Chinese ones). App creators should also pay close attention to layout, as this will be mirrored when working with languages such as Hebrew and Arabic that read right to left.

Of course, countries that primarily speak a single language still have regional differences, so pharma brands that don't want to seem like a tourist might want to take this into consideration. The British mental image of a vacationing American's “fanny pack” might be just as awkward as an American host's interpretation of a traveling Brit's “bum bag.” App creators should always use translators who are based in the country where the company is launching its app. Language changes quickly and it is vital for transcreation that writers are immersed in their local culture.

Finally, there are an estimated 50.5 million expats in the world, so it is increasingly important to avoid assuming a user's location from his language and vice versa. Expats are a prime example of people whose mother tongue differs from the native language of the country in which they work. An English native speaker in Italy, for example, would probably want an app in English but with Italian localization options.

The more flexible a pharma company is when designing its health app, the more effectively the app will fulfill its huge global potential. The key to success lies in effective internationalization and localization. To deliver a personal app that makes a customer feel connected and supported, transcreation is an essential task.  

Joanna Laurson-Doube, PhD, is group account director at Mother Tongue Life, the medical arm of transcreation agency Mother Tongue Writers


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Exclusive - Facebook plots first steps into healthcare

Exclusive - Facebook plots first steps into healthcare | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
SAN FRANCISCO (Reuters) - Facebook Inc already knows who your friends are and the kind of things that grab your attention. Soon, it could also know the state of your health. On the heels

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Ginny Dillon's curator insight, October 14, 11:24 AM

Anyone else concerned about patient PRIVACY on FaceBook?

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Google Glass app that transcribe spoken words and helps hearing-impaired users

Google Glass app that transcribe spoken words and helps hearing-impaired users | Mobile Health: How Mobile Phones Support Health Care | Scoop.it

A new app allows Google Glass to help the hearing-impaired with a real-time closed-captioning feature. Developed at Georgia Institute of Technology, the app can transcribe spoken words using the microphone of a paired smartphone.
  "Captioning on Glass provides real-time closed captioning allowing the deaf or those who are very hard of hearing to converse with others. Your conversational partner speaks into the phone using this application and the speech is converted to text and displayed in the companion Captioning on Glass Glassware," read the description of the app on Google Play. Work on the app started when School of Interactive Computing Professor Jim Foley learned he had trouble hearing. He said the system allows wearers to focus on the speaker's lips and facial gestures. Hard-of-hearing people who can understand the speech need not wait for the caption if they can understand what the speaker is saying. But a wearer who misses a word "can glance at the transcription, get the word or two I need and get back into the conversation," he told CNET. — Joel Locsin/JST, GMA News

 


 


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ChemaCepeda's curator insight, October 13, 10:45 AM

Interesante aplicación de ayuda a personas con problemas de audición, que transcribe la conversación en tiempo real y la muestra en forma de texto a través de las Google Glass.

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ePharma Summit: mHealth Explained in Facts

ePharma Summit: mHealth Explained in Facts | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
How do patients feel about mHealth?

78% of US consumers are interested in mHealth solutions. (Booz & Co.)
Which is part of the reason the U.S mobile health audience (those looking for health information through mobile web or apps) reached 95 million in 2013—Up 27% from the same point a year earlier. (Manhattan Research)
69% of US adults are willing to communicate with providers by email, 49% are interested in communicating via online chat or web portal, 45% by text message and 40% by mobile health applications. (PWC)
46% of people indicated they’re interested in using technologies such as smart phones and tablet applications to manage issues such as blood sugar or breathing function in the future. (Deloitte)
75% of Americans said they would check their vitals more often if it meant saving money on insurance premiums. (mHealth News)


What about physicians?

82% of healthcare professionals use a mobile device for professional reasons at least once daily. (eMarketer)
64% of HCPs use medical apps at least monthly. (eMarketer)
37% of physicians have already prescribed an app to a patient. (QuantiaMD)


Most agree: Mobile devices can expedite decision making

The result:

Health and wellness apps are growing 87% faster than the app industry as a whole. (Flurry)
In terms of year over year mobile spend, the pharma industry led the way with a 491% growth in Q1 2014 versus Q1 2013. (Millenial Media)
In 2014, there are projected to be over 100 million eVisits globally resulting in more than $5 billion in savings over face-to-face visits. (Deloitte)
The mobile health market is projected to reach $26 billion by 2017. (Mobile Health Market News)


How is the industry reacting?

More than $750 million in venture capital has been invested in mHealth apps since the start of 2013. (MIT Technology Review)
There are over 100,000 mHealth and fitness apps currently available for download. (mHealthWatch)
This year, researchers have developed technology capable of measuring heart rate through Wi-Fi signals with 99% accuracy. This technology has the potential to be used in health tracking apps. (Mobiloitte)


However,

Only about 7% of people use an app or tool on their phone to track the “health indicator they care about the most”. (Pew Research)
36% of healthcare companies currently have no mobile technology strategy. (Robert Half Technology)
More othan two-thirds who have downloaded a mobile health app have stopped using it. (MIT Technology Review)
One third of consumers who own wearable health devices stop wearing them after six months. (MobiHealthNews)


What are the issues?

Compliance: Only 1 in 1,000 mHealth apps are approved by the FDA. (mHealthWatch)

User Experience: Only 28% of physicians report being “very satisfied” with the quality of medical apps currently available (Booz & Co.). In addition, of this enormous group of health and fitness apps, more than half have generated less than 500 downloads. (iHealthBeat)

Data Security: 61% of internet users would stop using their favorite mobile health app if a data breach occurred. (HealthIT Security)



We'll have more on the latest in digital at this year's ePharma West. Join us September 22-24 in San Francisco, CA. Download the agenda to see what we've got on tap.

Now you can SAVE $100. Register here and use code XP1956BLOG.

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Health and wellness infographics

Health and wellness infographics | Mobile Health: How Mobile Phones Support Health Care | Scoop.it
How healthcare consumers connect and engage online // #healthcare #searchmarketing #socialmedia #infographic

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