Eighty-six percent of physicians said they are interested in using mobile technology to access electronic health records, 83% said they would like to prescribe medication wirelessly and 60% are interested in using mobile technology to communicate...
For more than a year now the Pew Research Centers’s Internet & American Life Project has been tracking the adoption of health apps by adults in the US. In September 2010 Pew found that about 9 percent of all adult mobile phone users in the US had downloaded an app that “helped them track or manage their health.” In its most recent surveyin August 2011 Pew found that about 11 percent of all adult cell phone users having downloaded an app that helps them manage their health. While that is a slight increase over last year’s number, Pew characterized it as “a statistically insignificant difference.” App adoption, therefore, has been largely stagnant over the past 12 months.Pew writes that “health apps” include those that capture “a wide range of software applications, from those that count calories and help manage an exercise routine, to more advanced apps that monitor vital signs and help individuals manage serious health conditions.”
The survey conducted this past August, however, was conducted a bit differently: “In August 2011, the question was asked of adults who have downloaded an app to a cell phone or tablet computer, rather than all cell phone users. More than a quarter of this population (29 percent) report downloading a health app. Looking just at adults who download apps to a cell phone, this translates to 11 percent of all adult cell phone users having downloaded an app that helps them manage their health, a statistically insignificant difference from the 9 percent of adult cell users who reported having a mobile health app in September 2010,” Pew writes.
Pew also found that the new survey results show little change among health app adoption rates among different racial/ethnic groups.
Be sure to check out Pew’s entire report, which focuses on overall cell phone and apps adoption — not just for health. Full report freely available here. If you’d like to learn more about health apps, be sure to register for MobiHealthNews’ webinar: What Makes A Health App Effective? (Complimentary Registration Here)
A new interactive mobile phone app called DiabetesIQ, released this week, challenges people to test their knowledge of diabetes and to compete with one another as they learn about the complexities of the disease, which affects more than 25 million Americans, including 4 million Californians.
Developed as a free download by the University of California, San Francisco (UCSF) Diabetes Teaching Center and QuantiaMD, a company headquartered in Waltham, Massachusetts, the new app is intended to help improve human health by turning the task of managing diabetes into an interactive game experience and bringing it to users of the Droid, iPad, iPhone and iPod Touch.
The new game follows a quiz-show format where players answer multiple-choice questions about diabetes and then see how their answers compare to the other users in real time. Users are asked specific questions, ranging from, “How does regular daily exercise affect insulin?” to “What happens when you combine dancing with alcohol?”
In health care we face numerous challenges. One that is being tackled by the FCC, Department of Justice and the Department of Transportation is the limited nature of our emergency 911 system. Currently, if one is dialing from a cellphone, chances are that 911 cannot automatically find their location. And the only way to contact 911 is the traditional way — by telephone.
All of that is about to change. Next Generation 911 will allow for communications to be made by voice, video or text. Location will automatically be appended to voice calls, saving time and confusion when the caller doesn’t know where they’re location is — or isn’t able to verbally communicate it.
As someone who analyzes health policy (with a focus on long-term services and supports), I believe that Siri, Apple’s recently introduced natural language voice technology, has the potential to change not just our 911 system, but also to be one of the biggest consumer-facing technologies in health care that we’ve seen in decades.
Emergency health care today
Imagine this scenario: an elderly person is having a cardiac event. She is having trouble breathing and is unable to complete a sentence. Dialing 911 is possible, but if the caller is unable to narrate the condition, first responders would still be in the dark until they arrive.
Even after they do arrive, information still eludes them: some critical — including prior medical history, current medications and allergic reactions to medicines — and some logistical, such as health insurance and next of kin.
The future: A Siri-enabled 911
Siri’s main features – its ability to understand natural language and its quick and contextual deep search, information retrieval and task completion – could drastically change all this.
Once the word “emergency” is spoken to Siri, a range of beneficial activity could commence. First, the phone could video call 911 utilizing Skype or a similar VoIP video service. This would allow first responders to have a much better context of the emergency at hand. Armed with a live video and audio feed of the event, visual cues could assist the first responders as they deconstruct the problem. Second, Siri could send the GPS location of the caller.
Third, an app could automatically transmit critical information to the nearest hospital. First Choice Healthcare already has an app that gathers this information – primary care physician, current medications and any drug allergies – for a patient heading to the ER. Depending on the patient’s physician, it’s possible that the patient’s entire electronic health record (EHR) loaded into the app (or otherwise shared with authorized medical personnel) as well.
Lastly, Siri could send a text or email to the chosen next of kin, letting them know that an emergency has transpired and their family member is being transported to the closest hospital (with the address included).
That may sound a bit out of place considering Siri can’t even dial 911 right now. But the reason for that is simple: Apple hasn’t instituted a way of authenticating that a call is real and not a prank. However with video and the additional information appended to the call (again, including location), the chances of a prank dial are miniscule.
Now compare the two pictures. Which patient has a better chance of surviving the cardiac event? More than 300,000 people die from sudden cardiac events each year in the U.S. A large portion of these are preventable, not only due to lifestyle changes but also, in part, because of the nature of the emergency response and the preparation on the part of the individual. These are both areas where Siri, along with Next Generation 911, could play a fascinating role.
Siri beyond 911
But it’s not just emergency care that could be transformed with Siri. a few other uses also come to mind. Such challenges include home health monitoring and assistance.
Millions of elderly adults are living at home and are unable to fully complete needed daily tasks. They may receive some assistance for a portion of the day from a licensed health care professional, but many still only have a family member or friend stop by and assist. Regardless of what kind of help they get, after the help leaves, they may struggle to remember when to take prescribed medication and treatments, they could forget doctors’ appointments, and they may not be able to keep their family fully in the loop (until the next visit or major event happens). Worst of all, they are more susceptible to injury or worse when a medical emergency transpires.
Siri and the convergence of disparate tools
There are numerous gadgets geared toward this population. But not only are they pricey, they are also far less personal and much harder to use than Siri. Siri requires holding down the home button (the only button available on the face of an iPhone) and speaking. Who couldn’t remember to do that?
At the tap of a button, Siri will be able to set and vocalize reminders for when to take pills, can initiate video check-ups with family and care providers, and can begin a smooth chain reaction of events that would otherwise require far more time and energy to do — two things our elderly, chronically ill population have the least of.
This transition to home health care will only become more common as states look to pivot from providing the bulk of the care in institutions to care being provided in homes and communities. People not only are happier when they live at home but they also live longer, feel better, and react better to treatments. If that were not enough, institutional care is far too costly. Long-term services currently account for, on average, “one-third of state Medicaid budgets,” and 58 percent of it is spent on institutional care, according to Lewin Consulting, a preeminent health consulting firm (PDF download).
Clearly it won’t just be Siri alone in this revolution of health care. Many more services will be created, and many more similar innovations are on the horizon. But every revolution needs its leader, and Siri is undoubtedly it.
John S. Wilson is a health policy analyst and editor of PolicyDiary, a weekly health policy blog. He can be reached at firstname.lastname@example.org or on Twitter: @johnswilson1.
After peeling off the protective film from one side, the patch – which is about the size of a postage stamp – is pressed onto the forearm of a young child. Hundreds of tiny microneedles located on the surface of the patch painlessly enter the upper layers of the child’s skin, where they quickly dissolve. Made of a medical polymer, the needles carry vaccine particles directly to the specialized cells used by the skin to battle invading microbes.
This is one scenario that Georgia Tech researchers envision for using the microneedle-based vaccine patch they are developing with immunology experts at Emory University. The patch, which could be available within five years, might be administered by persons without medical training, providing a simple way to rapidly immunize large populations during pandemics.
Microneedles are just one example of the medical devices under development at Georgia Tech, often in collaboration with institutions such as Emory. By harnessing its engineering, scientific and computing capabilities and its entrepreneurial tradition, as well as the Atlanta medical community, Georgia Tech is advancing the field of medical device design and bringing new devices to market.
Makers are change agents. As a group, they make because they like to fix things, adapt things, hack things to improve them. As individuals, each is a problem solver. Some solve problems for other makers or people in their niche area.
Patients are rapidly getting onboard with mobile health technology, according to a study released yesterday by the Consumer Electronics Association. The general message from the study, The New Role Read more...
Health Games Research is a national program that provides scientific leadership and resources to advance the research, design, and effectiveness of digital games and game technologies that promote health. It is funded by the Robert Wood Johnson Foundation’s Pioneer Portfolio and headquartered at the University of California, Santa Barbara. The Pioneer Portfolio supports innovative projects that may lead to breakthroughs in the future of health and health care. There is both an art and a science to designing health games that are appealing, engaging, and impactful. Health Games Research provides the science.
Mobile apps in healthcare and radiology are very important, according to Rick Jennings. He believes mobile apps can be especially useful for physicians referring patients for radiology exams. The ability to be notified in real-time, as soon as a radiology report is done is helpful for patients and referring doctors. The radiology report can be immediately shared with the patient and patients can see their images as well as the radiologist’s annotations. Rick says mobile apps are key to improving turnaround times, patient experience, and ultimately healthcare.
Without actually trying it out, an early critic may have faulted the first automobile for not having a horse to pull it. After all, how else would a vehicle of the day transport a person from one location to another? Horses were a necessary part of the equation back then; the rubric of the day made their participation mandatory.Such may be the state of mobile health efficacy studies.
Before we go any further, it’s worth noting that I applaud the research discussed below for tackling the efficacy of health apps, especially since this study began at a time when mobile health was a largely unknown field discussed as a fringe topic in some healthcare circles. To be sure, the efficacy of mobile health services needs more attention, but I believe it requires a deeper study than the one discussed below.
A recent paper published in the international, peer-reviewed Translational Behavioral Medicine journal found that of the 204 “weight loss” apps available from Apple’s AppStore as of September 25, 2009, not a single one adhered to all 13 of the evidence-informed practices for weight loss programs suggested by government agencies at the time. The 13 practices researchers looked for among the apps were at the time common to all of the following governmental agencies: the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), the Food and Drug Administration (FDA), and the US Department of Agriculture (USDA).
The study checked whether the apps adhered to these 13 evidenced-based practices: (1) Provide BMI assessment and explanation. (2) Recommends a diet rich in fruits and vegetables. (3) Recommends certain amount of physical activity each day. (4) Recommends certain amount of water consumption. (5) Encourages user to keep a food diary. (6) Tracks calorie balance of calories in vs. calories out. (7) Recommends a weight loss goal of 1 to 2 pounds a week. (8) Recommends portion size control. (9) Recommends users to read nutrition labels. (10) Provides a means to track weight. (11) Keeps a physical activity journal. (12) Provides a way to plan meals. (13) Provides a way to seek social support.
This study, which was conducted by researchers at Duke University and George Washington University, found that only one app adhered to 12 of these evidence-based practices and 50 apps adhered to exactly none of them. These evidence-based practices, of course, were developed before the creation of smartphone medical apps. They are not best practices for smartphone-based weight loss apps, but rather best practices for weight loss programs in general. Might they still apply to smartphone apps? Sure. Are they the be-all-end-all litmus test for weight loss apps? Of course not.
It’s important to note that the researchers never tested these weight loss smartphone apps. They never downloaded them. (We have seen this head-scratching method of study before.) The analysis of the weight loss apps’ adherence to these 13 evidence-based practices was based solely on the apps’ descriptions in the iTunes AppStore. The researchers acknowledge in their paper that the apps may adhere to more or less of them than their descriptions let on.
If you’re going to make a claim that an app is ineffective, at least test it with a patient population first.
It is also frustrating that this study only saw publication last month, yet the research includes apps published more than two years ago. It is frustrating that the researchers do not take into account how efficacy may be affected by the unique qualities the smartphone platform provides — qualities that are impossibly represented in a evidence-based guideline list conceived before smartphone apps existed.
Should the efficacy of mHealth rest on the shoulders of researchers that never take the time to download the apps they critique? Should the efficacy of apps be subject solely to a study of whether they adhere to evidence-based practices conceived prior to their platform existed?
Making electronic record-keeping systems easier for health providers to use can help prevent dangerous or even fatal mistakes, says the draft of a project by the National Institute of Standards and Technology (NIST).
The draft, titled “Technical Evaluation, Testing and Validation of the Usability of Electronic Health Records,” is available for informal public comment until Nov. 10, 2011. It provides guidance from NIST, a technical research agency within the Department of Commence, for testing electronic health record-keeping systems to make sure they are understandable for health care practitioners. The draft was released last month.
One of the aims of simplifying the devices is to avoid potentially dangerous medical errors, says the report. At the moment, though, there is no government agency specifically directed to regulate or enforce the safety of the devices being sold to medical offices.
“We didn’t specify in the report who should use the guidelines,” said Svetlana Lowry, NIST’s project leader on usability for health information technology. “This is for anybody who would like to apply the structure — government agencies, industries, academia — anyone involved in the development of electronic health records.”...
As previous studies have shown, a new survey conducted by the Consumer Electronics Association, which puts on the big Consumer Electronics Show (CES) each year, has found that 36 percent of consumers are interested in using wireless health technologies to better communicate with their physicians.The CEA told MobiHealthNews in an email that the study included responses from 1,679 US adults who participated in an online poll. The qualitative portion of the survey included responses from 60 in-depth interviews conducted by the CEA research team.
The CEA included a few other sample metrics in its press release that it gleaned from the study, called The New Role of Technology in Consumer Health and Wellness, more charts and graphs from the report’s executive summary to follow:
33 percent are interested in managing their health records online32 percent would be willing to consult with a doctor via online video44 percent of consumers are interested in connected weight scales40 percent are interested in vital sign monitors37 percent are interested in devices that track fitness metrics51 percent have downloaded a nutrition tracker mobile app36 percent have downloaded a fitness-related workout app32 percent have downloaded customized music apps for exercise
Next, which type of consumer was most likely to use a health monitoring device?
This question tracked responses from three different types of consumers: those with the highest concern for their own health, those with a moderate concern, and those with the lowest concern. As expected, those with the highest concern for their health also had the highest adoption for health monitoring devices.Next, which kinds of devices are consumers most interested in?