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Doctors will be encouraged to prescribe smartphone apps to help patients manage conditions ranging from diabetes to depression, the Government has announced.
Andrew Lansley, the Health Secretary, has compiled a list of nearly 500 tools which will be recommended by the NHS after a public appeal for the best new ideas and existing mobile phoneapps.
GPs will be asked to recommend apps that are free or cheap for their patients to use, in an attempt to give patients more power and reduce visits to doctors.
Among the apps available is a tool for food allergy suffers that scans bar codes on shop products to warn them if they contain dangerous ingredients.
A new diabetes app from Diabetes UK gives people reminders on checking blood sugar levels and taking medication. Information can then be sent electronically to the patient's surgery or clinic.
Other popular choices include tools to help people deal with post-traumatic stress, to spot breast cancer, track and monitor blood pressure and the NHS Choices app, which help people find NHS services and offers practical advice.
There is now a variety of tools available to enable the user to manage his own physical and mental well-being. The technology is fun to use and can make a real difference, helping people to become aware of new issues.
Interview with Robert Picard, health expert at the General Council on Economic Affairs, Industry, Energy, and Technologies, under the aegis of France’s Ministry for Economic Affairs, on the sidelines of the annual European Congress on Health Information Technology (HIT), which took place in Paris on 22-25 May.
L'Atelier: How has technology changed our relationship with our well-being?
Robert Picard: I would rather talk about ‘living well’. Well-being tends to focus more on the individual, whereas living well is more about being a part of society, about participating. As regards the new tools, the fact is that anything to do with health is constantly in our minds. And technology helps us to get a better grip on our health, enabling us to follow, on a screen, how our weight is changing, or to actually work on our physical condition. So there’s an individualistic aspect, since these innovations mean we can take charge of our own condition without putting ourselves in anyone else’s hands. And the technology works on a smartphone, which is a very personal possession, an intimate device that we keep with us. It allows us to keep in touch with family or friends and ascertain whether what we’re doing is the right thing or obtain some support, irrespective of time or place. Nowadays there’s a very wide range of products of this type on offer.
L'Atelier: But can we say that these things have become part of daily routine?
Robert Picard: It’s true that we can’t yet say these products are a real success, but we can observe real enthusiasm for these solutions, though they may still not be widely used.
There are two criteria for making this type of technology work. Firstly, its appeal. An application, for example, must be enjoyable to use. It must also meet the basic needs of human beings, such as eating well. In order to achieve this, developing a solution will be based on the advice of all the people involved, the Living Labs, as we call them. When finalising the product we add a dimension which appeals to the user and so makes him or her want to engage with the technology. If s/he doesn’t, you’ll mostly be just wasting your time. So, for instance, the sensors on games consoles have become more and more sophisticated. This means you can expend some energy, check your weight, and see how the results measure up to your targets. Of course, after the two criteria of human appeal and results, there’s the security aspect. When it comes to applications which record personal data, users must be able to trust that the data will remain confidential, and this requires total transparency about what’s happening.
L'Atelier: Will these technologies induce behavioural changes?
Robert Picard: Yes, they’ll help to instil good practices, and will raise people’s awareness. Let’s take the example of a person who uses a menu management application. This person will find the app entertaining, s/he will start to count calories and this will already have an impact on his or her condition. And then we can imagine a solution which can indicate whether you’re diabetic, and then adjust the menus provided accordingly. Thus we move from a trendy gizmo to a solution providing real support or therapy. And this will also have an impact on the healthcare profession. Healthcare professionals will be able to concentrate on diagnostics and more complex problems; and their influence will grow as their skills become more appreciated.
IN A windowless room on a quiet street in Framingham, outside Boston, Rob Goudswaard and his colleagues are trying to unpick the knottiest problem in health care: how to look after an ageing and thus sickening population efficiently. The walls are plastered with photographs of typical patients—here a man who exercises occasionally, there a woman with many chronic ailments. Big sheets of paper chart each patient’s course from the hospital back to a comfortable life at home, with divergent lines showing all the problems that might arise and ways to handle them. To map the many paths to health in this way Mr Goudswaard’s team interviewed a lot of patients and nurses.
But this “war room” does not belong to a hospital. It belongs to Philips, a Dutch electronics company. Mr Goudswaard, the head of innovation for Philips’s home-monitoring business, has no medical training. His speciality is the consumer.
In this section»Squeezing out the doctorIs there a doctor in the country?
Related topicsBusinessEconomicsEconomic developmentJapanGeneral Electric
The past 150 years have been a golden age for doctors. In some ways, their job is much as it has been for millennia: they examine patients, diagnose their ailments and try to make them better. Since the mid-19th century, however, they have enjoyed new eminence. The rise of doctors’ associations and medical schools helped separate doctors from quacks. Licensing and prescribing laws enshrined their status. And as understanding, technology and technique evolved, doctors became more effective, able to diagnose consistently, treat effectively and advise on public-health interventions—such as hygiene and vaccination—that actually worked.
This has brought rewards. In developed countries, excluding America, doctors with no speciality earn about twice the income of the average worker, according to McKinsey, a consultancy. America’s specialist doctors earn ten times America’s average wage. A medical degree is a universal badge of respectability. Others make a living. Doctors save lives, too.
With the 21st century certain to see soaring demand for health care, the doctors’ star might seem in the ascendant still. By 2030, 22% of people in the OECD club of rich countries will be 65 or older, nearly double the share in 1990. China will catch up just six years later. About half of American adults already have a chronic condition, such as diabetes or hypertension, and as the world becomes richer the diseases of the rich spread farther. In the slums of Calcutta, infectious diseases claim the young; for middle-aged adults, heart disease and cancer are the most common killers. Last year the United Nations held a summit on health (only the second in its history) that gave warning about the rising toll of chronic disease worldwide.
But this demand for health care looks unlikely to be met by doctors in the way the past century’s was. For one thing, to treat the 21st century’s problems with a 20th-century approach to health care would require an impossible number of doctors. For another, caring for chronic conditions is not what doctors are best at. For both these reasons doctors look set to become much less central to health care—a process which, in some places, has already started.
Make do and mend
Most countries suffer from a simple mismatch: the demand for health care is rising faster than the supply of doctors. The problem is most acute in the developing world, though rich countries are not immune (see article). It does not help that health care is notoriously inefficient. Whereas America’s overall labour productivity has increased by 1.8% annually for the past two decades, the figure for health care has declined by 0.6% each year, according to Robert Kocher of the Brookings Institution and Nikhil Sahni, until recently of Harvard University. But it is in poor countries that interest in alternative ways of training doctors and in alternatives to doctors themselves has produced the most innovation.
One approach to making doctors more efficient is to focus what they do. India is home to some of the world’s most exciting models along this line, argues Nicolaus Henke of McKinsey, who leads the consultancy’s work with health systems. Britain has 27.4 doctors for every 10,000 patients. India has just six. With so few doctors, it is changing the way it uses them.
Your correspondent recently watched Devi Shetty, chief executive of Narayana Hrudayalaya hospital in Bangalore, making careful incisions in a yellowed heart, pulling out clots that resembled tiny octopuses. It looked difficult. Some of the other tasks at Narayana Hrudayalaya hospital do not, and are not. Dr Shetty’s goal is to offer as many surgeries as possible, without compromising on quality. To do that, he ensures that his surgeons do only the most complex procedures; an army of other workers do everything else. The result is surgeries that cost less than $2,000 each, about one-fifteenth as much as a similar procedure in America.
The trick is repeated in other areas of health care. India’s LifeSpring hospitals slash the price of childbirth by augmenting doctors with less expensive midwives. The costs are about one-sixth of those in a private clinic. The Aravind Eye Care System offers surgery to about 350,000 patients a year. Operating rooms have at least two beds, so surgeons can swivel from one patient to the next. Most important, for every surgeon there are six “eye-care technicians”—young women recruited and trained by Aravind—who perform the myriad tasks in the operating room that do not require a surgeon’s training.
Other problems have inspired other solutions, with technology filling gaps in the labour force. The Bill and Melinda Gates Foundation supports a programme that uses mobile phones to deliver advice and reminders to pregnant women in Ghana. In December the foundation and Grand Challenges Canada, a non-profit organisation, announced $32m in grants for new mobile tools that will help health-care workers diagnose various ailments. In Mexico, worried patients can phone Medicall Home, a “telehealth” service. If a patient needs care, Medicall Home can help to arrange a doctor’s visit. But about two-thirds of patients’ concerns can be addressed over the phone by a doctor (often one only recently qualified).
These programmes are expanding. Medicall Home is rolling out its service in Colombia and plans to be operating in Peru by the end of the year. Aravind has exported its training model to about 30 developing countries. Dr Shetty already has 14 hospitals in India. He plans to add 30,000 hospital beds in big health complexes and small hospitals there over the next seven years, as well as build a hospital in the Cayman Islands.
Technology does not just allow diagnosis at a distance—it allows surgery at a distance, too. In 2001 doctors in New York used robotic instruments under remote control to remove the gall bladder of a brave woman in Strasbourg. Robots allow doctors to be more precise, as well as more omnipresent, making incisions more neatly than human hands can. As yet they are enhancements for surgeons more than they are replacements, but that may change in time. Military drones started off being flown by officers who had gone through the expensive rigours of flight school; these days other ranks with far less exhaustive training can take the controls.
Less flashy technology, though, could make the biggest difference by reducing the number of crises which require a doctor’s intervention. Marta Pettit works on a programme to manage chronic conditions that is run from Montefiore Medical Centre, the largest hospital system in the Bronx, a New York borough. Ms Pettit and a squadron of other “care co-ordinators” examine a stream of data gathered from health records and devices in patients’ homes, such as the Health Buddy. Made by Bosch, a German engineering company, the Health Buddy asks patients questions about their symptoms each day. If a diabetic’s blood sugar jumps, or a patient with congestive heart failure shows a sudden weight gain, Ms Pettit calls the patient and, if necessary, alerts her superior, a nurse.
Other tasks are simpler, but no less important. Montefiore noticed that one old woman was not seeing her doctor because she was scared of crossing the Grand Concourse, a busy road in the Bronx. So Montefiore found a new doctor on her side of the Concourse. Together, such measures make a difference. Diabetics’ trips to hospital plunged by 30% between 2006 and 2010; their costs dropped by 12%.
Similar programmes will become even more sophisticated as monitors evolve. Patients are much happier to monitor themselves at home with gadgets bought online than they used to be, and gadget-makers think there is a huge potential for growth in taking the trend further. Philips, General Electric (GE) and others are all upping their investments in home health, and widening the markets in which they sell their existing products (Philips is trying to crack Japan with emergency-alert devices for the elderly). GE’s design gurus predict that a patient’s overall condition will soon be measured as easily as a thermometer measures his temperature.
Such technologies have long seemed promising; recently the promise has begun to be borne out. Britain has completed the world’s biggest randomised trial of telehealth technology, including gizmos from Philips. The study examined 6,000 patients with chronic diseases. According to preliminary results of a study by Britain’s health department in December 2011, admissions to the emergency room dropped by 20% and mortality plummeted by 45%.
Nursed back to health
Changing health systems is tortuous. Reformers are stymied by medical lobbies, nervous patients and heaps of regulations about who may do what and where. But there is movement, particularly in the lower ranks of the labour market. India’s health ministry has proposed a new three-and-a-half-year degree that would let graduates deliver basic primary care in rural areas. Dr Shetty thinks his hospitals could benefit from a broader range of training programmes, to create workers with a wider array of skills.
Workers with a lot less training than doctors can still be highly effective. Physician assistants in America can do about 85% of the work of a general practitioner, according to James Cawley of George Washington University. A pilot programme of rural health-care workers in India—the type that the health ministry wants to expand—found that the workers were perfectly able to diagnose basic ailments and prescribe appropriate drugs. In some areas non-doctors actually look preferable. A review of studies of nurse practitioners in Britain, South Africa, America, Japan, Israel and Australia, published in the British Medical Journal, determined that patients treated by nurses were more satisfied and no less healthy than those treated by doctors.
But expanding the supply of non-doctors is not, in itself, enough. America has led the world in developing the roles of nurse practitioners and physician assistants. Other, less trained workers are proliferating there too. The number of “diagnostic medical sonographers”, who have two years of training, is expected to jump by 44% between 2010 and 2020, according to the Bureau of Labour Statistics. Yet productivity still falls. This seems to be because new ways of doing things, and of managing health teams, have not kept pace—and are still under the control of doctors.
The doctors’ power rests on their professional prestige rather than managerial acumen, for which they are neither selected nor trained. But it is a power that they wish to keep. The Confederation of Medical Associations in Asia and Oceania, a regional group of doctors’ lobbies, wants “task-shifting” limited to emergencies. Japan’s medical lobby has vehemently opposed the creation of nurse practitioners. India’s proposal for a rural cadre outraged the country’s medical establishment, and legislation to create the three-and-a-half-year degree has gone nowhere.
In 2010 America’s respected Institute of Medicine (IOM) called for nurses to play a greater role in primary care. Among other barriers, nurses face wildly different constraints from one state to another. But any change will first require swaying the doctors. The American Medical Association, the main doctors’ lobby, greeted the IOM’s report with a veiled snarl. “Nurses are critical to the health-care team, but there is no substitute for education and training,” the group said in a statement.
As doctors become scarcer and health costs continue to rise, more and more systems will seek to innovate, and the successes they have will become ever more widely known. Already, programmes such as Montefiore’s are becoming the paradigm for keeping patients healthy. In December America’s health department chose Montefiore for a pilot to improve care and lower costs for the old.
All this should be cause for excitement. Resources are slowly being reallocated. Nurses and other health workers will put their training to better use. Devices will bolster care in ways previously unthinkable. Doctors, meanwhile, will devote their skill to the complex tasks worthy of their highly trained abilities. Doctors may thus lose some of their old standing. But patients will clearly win.
In order to help immobilized and mute people converse with each other, Josep William Widjaja and Ridwan Djuhari dedicated their lives to develop abilities augmentation products.
Inspired by Kwa Geok Choo, the wife of Singapore first Prime Minister, Lee Kuan Yew and the story of how the couple still communicated with each after Kwa’s severe stroke in 2008, the duo decided to help the handicapped and vulnerable gain back control, independence, and improve their lives with physical computing technologies.
Aibilities is one such instance. DokterKita (DoKita in short; “Our Doctor” in English) is their second product, which targets the general market. It is a telemedicine app where one can receive consultation and healthcare services from respective doctors. The beta app is currently looking for more doctors – maternity, infant health and nutrition specialist to join their network.
Also known as “ANDTechnology”, the duo, who knew each other ever since their university days, initially focused on assembling hardware to solve this problem. However, they later realized that implementing hardware-based solution was not practical since consumers would be unwilling to buy a hardware, which is priced higher than merely acquiring a mobile application.
They then turned into developing an eye-tracking Android app in order to provide a communication platform for those experiencing movement disabilities.
The team then went onto to win the Android Samsung Mobile Apps at SparxUp Awards last year and have devoted the Eye Control app in Samsung Market exclusively for six months. Even before its official approval, the app has already been garnering several positive response and heavy users. The Lite version is completed and available for download without any charge.
Strategic partnerships with Ikatan Dokter Indonesia (IDI) Jakarta Barat have also been established. ANDTechnology received certain amounts of commission resulting from the managment of doctors’ database and developing of their membership portal. Another tie-up is with Lab Wira, where they help the health lab in moving various medical tests and results to the cloud database and providing the users with web and mobile access.
“Realistically speaking, we plan to hit around 1000 users for Eye Control and 5000 users for Dokita this year. If the user responds positively, new features such as remote control for television or air-con and SMS with the ability in sending fixed-sentence messages will be launched soon afterward,” Widjaja adds.
Unlike tyical startups in Indonesia, this duo does not ascribe titles such as CEO or CTO to themselves. They believe that the appropriate time comes when “product revenue grows till a point where the management level calls for a proper organizational structre.”
Currently, Widjaja is heading the technical strategical direction whereas Dhujari is in charge of product development. They both work together on the company vision, goal, milestones, market research, analysis, and the execution plan.
CHICAGO — As Dr. Danielle McCarthy listens to a man beg for a prescription for painkillers, she weighs her possible responses.
¶ A 31-year-old emergency room physician, she listens patiently as the man tells her that “every morning I wake up in pain,” describing the agony he continues to endure, three years after being injured in a car wreck.
¶ He has tried physical therapy, acupuncture and chiropractic treatment, he says. Nothing works except pills, he insists, as his voice grows louder and more demanding.
¶ Their exchange is similar to conversations that take place on almost every shift at Northwestern Memorial Hospital here, Dr. McCarthy said. But it is fiction — part of an interactive video game designed to train doctors to identify deceptive behavior by people likely to abuse prescription painkillers. The patient is an actor whose statements and responses are generated by the program.
¶ The video game was designed based on research by Dr. Michael F. Fleming at the Northwestern University Feinberg School of Medicine and draws on technology used by the F.B.I. to train agents in interrogation tactics. It teaches doctors to look for warning signs of drug abuse, like a history of family problems, and to observe nonverbal signs of nervousness, like breaking eye contact, fidgeting and finger-tapping.
¶ The game, which is in its final phase of testing, is aimed at primary care and family doctors, who often feel uncomfortable and unqualified assessing their patients in this regard.
¶ “This isn’t something medical students have traditionally been trained for,” Dr. Fleming said. “These are hard conversations to have.”
¶ It can be a thorny matter, Dr. McCarthy said, because physicians are trained to help patients, but they do not want to enable drug abuse. “You don’t want people to be in pain,” she said. “And you’re put on the spot. I’ve had patients yell at me. I’ve never been hit, but once or twice I’ve felt physically threatened.”
¶ In 2009, for the first time, the number of deaths from drug overdoses surpassed those from highway traffic accidents, according to Gail Hayes, a spokeswoman for the Centers for Disease Control and Prevention. She said misuse of prescription medication has been largely the cause. About 75 percent of overdoses involved prescription drugs, she added.
¶ So health care professionals are searching for better ways to distinguish patients who can be trusted to use prescription pain medications properly from those out to abuse them. According to the C.D.C., prescription drug abuse is the fastest growing drug problem in the United States, fueled by the use of highly addictive opioid analgesics like OxyContin.
¶ The Web-based interactive video game, which will soon be available online for a fee to medical schools and health care providers, includes about 2,000 statements by the patient, ranging in tone from charming to irate. A doctor can choose from 1,500 questions and responses, selecting one from five to seven options that appear on the screen when it is time to speak to the patient.
¶ The dialogue is drawn from research by Dr. Fleming, based on interviews with more than 1,000 patients who were receiving opioids for pain. “We have 95 percent of what a patient and doctor would say or do,” he said.
¶ Sharp skills are needed to assess a patient’s motives, he said, because an objective measurement, like from a blood test or an X-ray, is not available to gauge pain, and the opioids can be highly addictive.
¶ The game’s software was developed by Dale E. Olsen, a former professor of engineering at Johns Hopkins University. He is the founder and president of Simmersion, a company that has created simulation training programs for the F.B.I. The game’s development was financed by a $1 million grant from the Small Business Administration and the National Institute on Drug Abuse. Dr. Olsen, who has a Ph.D. in statistics, said the game would cost users about $50 an hour. It is designed to be used for 10 sessions of 15 to 20 minutes each. He said customers would most likely include medical schools, as well as private and government health care providers.
¶ The game encourages doctors to adopt a more collaborative and less accusatory approach with patients, Dr. Olsen said. “The goal is to build rapport,” he said.
¶ Dr. McCarthy, wearing headphones and blue scrubs, faces the computer screen, where the patient, named Tom, a trim man with a neatly cropped beard, is asking for pain medication.
¶ The physician asks Tom to describe his pain. Tom points vaguely to his lower back. She asks about whether he has ever had any problems with pills. He acknowledges that he once accidentally took too many pills, but that it was “no big deal.”
¶ When she asks him to submit to a drug screening, he is testy, but agrees to do so if she insists — “and then I want my pills.”
¶ At the end of the interactive portion, the game awarded Dr. McCarthy high marks for communication skills, for asking for a drug test and for declining the request for a prescription. She lost points for not asking enough questions.
¶ Dr. McCarthy nodded at the screen in acknowledgment of her score. She explained that there are time constraints in her work.
¶ “We move pretty quickly in the emergency room,” she said. “We’re not usually going to have time for 60 questions.”
Medical device inventor, investor, and electronics engineer Mir Imran once told me “problems don’t care about technology.” As it turns out, many innovators and entrepreneurs tend to be so enamored by technology that they neglect to spend sufficient time understanding the market needs that their products are meant to address.
This tendency is rather widespread in the domain of mobile health (or insert "digital health," "connected health" or any other nomenclature you prefer), which, if you listen to some accounts, is a field set to explode in importance. I agree that the time is ripe for transformation in medicine, which hasn't been revolutionized by electronics nearly as dramatically as many consumer industries. But the pace of change might be disappointing to those who are most enthusiastic about the prospects of a short-term mobile revolution. And not just because of expense of investing in it and the fact that regulation tends to slow down the introduction of new technology...
For a product to find success in the marketplace, not only does it need to be easy enough to use that it is unobtrusive, but the user must be inspired enough to use it to fix their problem.
On a related note, a recent piece by device designer Stuart Karten explains that “technology must come together with meaning to be successful.” Only products that “connect with people’s values and mindsets—their ceremonies, behaviors, rituals, motivations, and preferences” are truly successful, he explains.
A new app from ViroPharma seeks to both raise awareness of a rare disease and provide a social forum with the same tool: Facebook. The HAE Family Tree Facebook App works like every other Facebook app, but with an added twist.
As is the case with most apps, users who sign up for it can invite fellow Facebook members to join. But amateur genealogists can also manually enter in the names of family members who don't have Facebook accounts. That's an important note, because this is more than just another family network.
Other interactive tools aim to help patients understand how hereditary angioedema presents in families, but the HAE Family Tree Facebook App looks to go a step further. By helping families trace the familial progress of the disease—which is marked by uncontrolled and potentially dangerous swelling—the app is designed to encourage relatives to get tested and get treated.
HAE affects approximately 6,000 to 6,500 adults in the US, and patient advocates estimate that it takes about 10 years for patients to get the right diagnosis. HAE is caused by deficient or ineffective levels of a C1 inhibitor protein, which triggers swelling in the abdomen, face, arms and legs, and can interfere with a patient's breathing. It also has a high probability of transmission—the US Hereditary Angioedema Association says parents have a 50% chance of passing the disease onto their children.
This is not the first time ViroPharma has tried to connect HAE patients. The company's Ryze Above patient support program, launched in 2010, provides emotional and other kinds of support for patients taking ViroPharma's HAE drug Cinryze. The program had lacked a social media component. The new app links to the older program's treatment trackers and resources, including patient stories and information about Cinryze.
The app also allows for a bit of customization—the HAE genealogist can choose from three designs that range from island-inspired with coconuts, tropical with a floral motif and woodland with pinecone decorations.
Patients helped the company choose this platform. “Many people in the HAE community are already gathering and connecting on Facebook, and ViroPharma developed the Family Tree app to provide our patients and their families with a tool that supports their desire to build connections with others in the HAE community,” said Bianca Jay, senior product manager for HAE at ViroPharma, in a statement.
Put all this data in the cloud, (privacy not included) and personal medicine becomes a reality, tracking our mood, skin temperatures and the analysis of correlated data becomes a new picture we have of ourselves, and a new image we can project unto the world.
“They’re really external extensions of our mind,” said Joseph Tranquillo, associate professor of biomedical and electrical engineering at Bucknell University. (referring to all our networked devices- CNN)
So, vast amounts of data, self-tracking, personal information stock exchange, our own memories in the cloud, implants under our skins transmitting the data continuously.
Via Peter Vander Auwera, ddrrnt, Bart Collet
A study of nurses relying upon handheld devices found that 16 percent said the mobile equipment had helped them avoid at least one error in clinical treatment while another six percent indicated it had enabled them to avoid errors on multiple occasions.
Via Andrew Spong
Pfizer is hoping a mobile app is the missing ingredient in its bid to slow the rate at which its blockbuster cholesterol drug Lipitor haemorrhages sales.
The drug went off-patent in the US in November and revenues have subsequently, as expected, experienced a steep fall.
The pharma company has already put a series of measures in place to trade on the product’s brand equity, from pharmacy discounting deals to setting up its own mail-order service, and these are now joined by a new app.
The Recipes 2 Go app can be used with iPhone, iPad and Android mobile devices and offers a series of healthy recipes, a shopping list feature and tips on portion sizes and exercise.
It also joins up with the company’s co-payment card for Liptior, allowing users to input their ID number from the programme and have their card details easily available when refilling their prescription for the drug.
The pharma company teamed up with EatingWell, a healthy-eating consumer magazine, to develop the free app and an accompanying website - lipitorsmartliving.com.
Greg Reeder, senior director, team leader, US Brands, Established Products Business Unit at Pfizer, said: "Taking a cholesterol-lowering medication like Lipitor is just part of the equation for maintaining a healthy lifestyle.
"The healthy recipes from our partnership with EatingWell gives Pfizer another innovative way to educate patients on the importance of managing cholesterol."
The Recipes 2 Go app also marks the first time Pfizer has supported a prescription product in the US with a consumer mobile app, where its efforts to date have covered smoking cessation, cold and flu information and entertaining babies and young children.
However, Lipitor may not remain a prescription-only product for long. In November Pfizer’s CEO Ian Read told a conference call: “There is an intent at some point to have an OTC version of Lipitor in the marketplace.”
At its peak the cholesterol drug was the world’s biggest selling-medicine, and responsible for a quarter of Pfizer’s sales, but cheaper generic versions of Lipitor have already taken their toll on revenues.
This year the product’s Q1 sales, the first full quarter since Lipitor lost US patent protection, fell to $383m, down a huge 71 per cent from the $1.3bn the brand brought in for the first quarter of 2011.
Like how Netflix recommends movies and TV shows or how Amazon.com suggests products to buy, the algorithm makes predictions based on what a patient has already experienced as well as the experiences of other patients showing a similar medical history.
“This provides physicians with insights on what might be coming next for a patient, based on experiences of other patients. It also gives a predication that is interpretable by patients,” said Tyler McCormick, an assistant professor of statistics and sociology at the University of Washington.
Via Bart Collet
Feeling under the weather? In the future, you'll take out your smartphone--not to call your doctor, but to check your own vitals.
What if monitoring your heart rate and blood pressure was as easy (and addictive) as checking Facebook updates? That’s the future Dr. Leslie Saxon is working toward at USC’s Keck School of Medicine. As Executive Director of the university's Center for Body Computing, Saxon develops health care apps that provide personalized medical data to her patients in real-time. One app takes an EKG reading from an iPhone case, which reads the data from a patient’s fingertips.
"I imagine this medical iTunes," Dr. Saxon says, emphasizing that there’s no reason medical data shouldn’t appear on your smartphone right alongside sports scores and Words with Friends. "The sooner in medicine we let (patients) learn themselves and start to look at their data and understand it, the more sophisticated our own dialogue will be."
Her latest venture is everyheartbeat, a website that will aggregate heartbeat data from around the globe to search for patterns while also warning individuals of potential health issues.
Tuesday, June 5, 2012 1:00 PM - 2:00 PM EDT
Here's more information:
As a follow up to the recently released iHT2 Population Health Management Report, “A Roadmap for Provider-Based Automation in a New Era of Healthcare,” we invite you to attend this complimentary webinar focused on reviewing the reports findings as well as giving an outlook into the future of Population Health Management.
Join many of the reports contributors as they answer your questions, as well as expand on their thoughts related to exploring Population Health Management and the key role that finding automation plays in PHM.
All webinar registrants will also receive the iHT2 Population Health Management Summary Report which outlines specifically the six major stages within population health management and how automation can be used to make population health management more “feasible, scalable, and sustainable.
"It may be time to sack your therapist. The researchers conducting the world’s first clinical study on the use of smartphone apps to treat depression have given VentureBeat a preview of the results. 73.5 percent of depressed participants who used an application called Viary, were no longer considered to be depressed by the end of the study.
"81 people participated in the study over 8 weeks. Participants had to be at least mildly depressed, meaning they scored 0-13 on the Beck Depression Inventory or BDI-II scale, one of the most widely accepted measurements of depression, to qualify for the study. Most of the participants were at least moderately depressed (20–28 BDI-II), with a mean score of 25 BDI-II.
Participants were split into 2 groups. The first group used the behavior-change application Viary while the second group used a mindfulness app not specifically designed to treat depression. Each weekend participants wrote about the highs and lows of their week and the only contact with a mental health professional was a short response written by a psychology student. Treatment therefore mainly involved usage of the assigned applications.
The Viary application prompted users to engage in approximately 100 behaviors known to help relieve depression and tracked their progress. These behaviors were designed to help the depressed person add structure to his everyday life by doing simple tasks like getting out of bed in the morning when the alarm rings or cooking a meal, and to increase social contact and participation in novel activities. The mean value for the group using Viary was 25 on BDI-II before the treatment started and 13 when the treatment concluded." (...)
"Viary is aimed at coaches, therapists, HR managers and others involved in personal development to help them to track progress between appointments. Clients like it too. “People like to gather data which makes their own development concrete,” Hoa explains."
CE: Typical. Article starts claiming that an app/technology will replace therapists, only to express a couple of paragraphs later how it is better when used with the aid of professionals.
Via Alex Butler, Mariano Fernandez S., Camilo Erazo
As a healthcare organization there are a few risks you need to consider before entering the world of social media. Do you want to open up the door for negative comments? Can you risk exposing your organization to privacy, security and ethics breaches? What happens if your staff inappropriately shares confidential information about patients and how will you handle ethical questions about patient/provider relationships?
These are all relevant and important issues that needs to be addressed separately in a social media policy. However, they should not stop you from being present and engaging in social media. Recent reports are showing that 40% of consumers have sought out reviews of treatments, physicians and other patient experiences using social media*. The conversations, check-ins, reviews, referrals, discussions and sharing will go on whether your organization are aware of them or not.
Think of your social media efforts as a way to support your business strategy and integrated marketing in order to take a more active and engaging role. With the right leadership and resources, social media can evolve into social business.
Here are a few areas where social media and new technology can benefit a healthcare organization.
Customer Service/Reputation Management
Consumer/Patient and Professional Education
Patient Monitoring/Care Coordination
*Source: PwC "Social Media "Likes" Healthcare, from Marketing to Social Business"
Patients who received text message reminders to take their medicine significantly improved their medication adherence, according to a new study.
Published in Clinical Therapeutics, the report involved 580 people and found 85 per cent of those receiving the alerts followed their oral medicine regimen, while among those that didn’t receive the reminders, 77 per cent took their treatment as prescribed.
The findings were particularly striking among patients who were prescribed an oral anti-diabetic drug (91 per cent Vs 82 per cent) or a beta-blocker (88 per cent to 71 per cent).
The study saw a control group of 290 people and another group of the same size that opted-in to receive text message medication-specific dosage-specific reminders for a chronic oral medication, matching the reminders to pharmacy claims for the same medication.
“Findings suggest that members opting into a text message reminder programme have significantly higher chronic oral medication adherence compared with members not opting to receive medication-specific text message reminders, and that the use of a text message reminder programme assists in preserving higher rates of adherence over time,” the researchers concluded.
Earlier this year an SMS text dose reminder service promoting patient adherence was a key part of a Janssen’s MyIncivio hepatitis C patient programme.
Texting was also highlighted in a report last year by mobile operators’ assocation GSM World, which praised SMS reminders for medical and vaccination appointments from Mobiltel Bulgaria.
Social media's potential to influence health policy showed up early in the debate over PSA measurement as a screening test for prostate cancer, according to study reported here.
Within 2 hours after the first news media report last fall about the U.S. Preventive Services Task Force draft recommendation against PSA testing, the first related post appeared on the social website Twitter.
Over the next hour, Tweets related to prostate cancer increased by 50% as compared with the 4 hours prior to the USPSTF announcement, and 60% of the increased Tweet volume related to the task force recommendation.
Most Twitter users did not express an opinion about the recommendation, but among those who did, the pro-PSA screening contingent outnumbered the anti-screening (pro-USPSTF) posters by more than 3 to 1, Vinay Prabhu, said at the American Urological Association meeting.
"Social media, such as Twitter, are a useful way to gauge public sentiment," said Prabhu, a medical student at New York University in New York City. "Social media may also have a role in influencing public sentiment and altering policy."
Via nrip, dbtmobile
Renowned physician-researcher told medical school graduates that they will witness a health-care world transformed by genetic sequencing, wireless biosensors, cloud computing and online social networks as their new careers unfold
(...) "“You are the next generation of leading physicians and scientists in a new era of medicine, and you are all digital natives,” Dr. Topol told the 206 graduates who gathered for the Tuesday evening ceremony in the Jesse H. Jones Hall for Performing Arts in downtown Houston.
“Your role will be progressively morphed into providing guidance, wisdom and experience on how to transform data and information to knowledge and judgment,” he said. “A new emerging partnership in medicine without the historic information asymmetry. Without the high priest’s, paternalism and doctor-knows-best attitude.” (...)
CE: The good thing about this prophecy is that we'll get to see if it becomes true...
Via Camilo Erazo
To supplement its 2011 Survey of Health Care Consumers, Deloitte offers a library of fact sheets on topics including insurance, wellness, primary care, tra (Deloitte #2011 Survey of Health Care Consumers | Fact Sheet Library
Via Lionel Reichardt / le Pharmageek
TEDxMaastricht is the European stage for bright ideas, bold thinkers and innovators in medicine and healthcare.
In her blog Renske Visscher mentions how e-health can make clients less dependent. After a thought experiment with friends she concludes a side effect of the use of e-health makes clients more dependent on technology (anotherstriking example of the innovation paradox).For Renske, working daily on the development of e-health, it’s obvious that e-health can make people less dependent on healthcare professionals. I share her thoughts and in addition I think a paradigm shift is needed before we really are making clients less dependent. Inspired by her blog I’d like to make a start by elaborating on one of my current projects. By doing so I hope to start a debate about the fundamental use of e-health.
Together with several organizations that provide social healthcare for people with a mental disability I’m currently developing a project called JouwOmgeving.nl (Dutch for Your Space). JouwOmgeving.nl is an online private platform for clients which provides the opportunity to work on your goals and therapy independent from time, people and space. You can use tools which can give you insights in for example how to deal with your emotions, monitor your progress and work on your goals regarding behavioral change based on movies, exercises, reliable and uncomplicated information.
The platform offers the possibility to share your progress with you social network like your parents. By offering an account parents can get an update on what their child’s current goals are, how he or she works on it and what progress he or she makes. Parents can also get their own platform which can learn them how to deal with raising their disabled child. This way parents are empowered to take care of their child and makes their child even less dependent on healthcare. The intention is to offer the client the full ownership over the platform. After the professional care has stopped the clients remain access to their online platform and all of the information, exercises, tips and tricks.
In this way the platform forms an important addition to the regular face to face treatment. Every time I’m working on this platform I get more convinced that the use of some sort of JouwOmgeving should be standard practice within any behavioral treatment. This not meant to push the use of e-health but to promote and encourage independence and self-reliance. A responsibility we as healthcare professionals and innovators have to clients, their parents, the tax payer and the Minister who assigned us to provide the care that someone needs to be as independent as possible.