Results from a study of smartphones' use in juvenile diabetes conducted by Joseph Cafazzo PhD to see there would be an improvement in health...
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From the FaceTalk homepage:
'For a growing number of patients it has become increasingly challenging to have their doctor or health professional on location due to reduced mobility or lack of time. The solution to this challenge is FaceTalk.
With just a few clicks you can open your own virtual doctor's office and create your virtual clinic. It's an ideal solution where both the healthcare professional and the patient wins'.
Via Andrew Spong
Researchers from North Carolina State University’s Gains Through Gaminglaboratory have found that playing the massive multiplayer online video game World of Warcraft (WoW) appeared to boost cognitive functioning in older adults. The researchers hypothesized that playing a cognitively complex game such as WoW, which requires multitasking and extensive use of a number of cognitive skills such as map reading, planning and tracking of multiple status indicators, could boost the cognitive performance of the elderly.The study, which is available on-line as a corrected proof at the journal Computers in Human Behaviour, initially examined the spatial ability, memory and focus of adults aged 60 to 77, to set a baseline. An intervention group of 20 adults then played WoW for roughly 14 hours over the course of two weeks, while a control group of 19 adults played no WoW over the two weeks. At the end of the 2 weeks both groups were re-tested for cognitive functioning. Ultimately the researchers observed a greater cognitive improvement in intervention group when compared with controls.
According to the press release:
Among participants who scored well on baseline cognitive functioning tests, there was no significant improvement after playing WoW – they were already doing great, McLaughlin says [Dr. Anne McLaughlin, an investigator involved in the study] . But we saw significant improvement in both spatial ability and focus for participants who scored low on the initial baseline tests. Pre- and post-game testing showed no change for participants on memory.
It is certainly an interesting finding, but hopefully not one that will have psychology students downing books for joypads. On the upside, it looks like World of Warcraft just creeped to the top of our “Things to do when we retire” list.
Via Chaturika Jayadewa, Bart Collet
The Bluetooth low energy (BLE) standard promises long term connectivity of digital devices minus the short battery life that traditional Bluetooth has often been responsible for in the past. Health monitoring technologies may turn out to be the biggest beneficiaries of BLE, since size and power consumption are usually critical when devices have to be worn by patients over extended periods of time.
Via Substance Active
According to the survey, just over a quarter of all doctors in the EU — primary care and specialist — use an iPad for professional purposes. That’s a big number for a device primarily aimed at content consumption and not hardened against a hospital environment.
Via Substance Active
The worldwide mHealth market will grow to a revenue opportunity worth $23 billion by 2017, according to a new report conducted by PricewaterhouseCoopers (PwC) and funded by the GSM Association. PwC notes that while advancements in medical technology and a general worldwide increase in income levels would suggest progress for healthcare, issues of affordability, complexity and access are still big problems for the industry. Given the near ubiquity of mobile networks as well as the rise of smartphones and other connected devices, PwC believes mobile will play an increasingly important role in developed and developing countries to help healthcare stakeholders overcome these challenges.
PwC estimates that mobile-enabled monitoring services, like those offered for chronic disease management, will make up 65 per cent of the worldwide mHealth market and account for $15 billion in revenues by 2017. The second largest segment will be diagnostic services, which will generate $3.4 billion in revenues worldwide, and make up 15 per cent of the global mHealth market. (PwC notes that mobile telemedicine and health call centers are included in that segment.) The third largest market opportunity is in what PwC calls “treatment services,” which include medication and treatment adherence devices (like Vitality’s GlowCap) and services. These will make up 10 percent of the overall market or about $2.3 billion.
According to the PwC report, mobile operators stand to capitalize on mHealth-related revenues of about $11.5 billion by 2017. Device makers have an mHealth market opportunity of $6.6 billion, while content and application developers have an mHealth market opportunity of $2.6 billion. Finally, healthcare providers stand to generate $2.4 billion in mHealth revenues by 2017, according to the researchers.
According to PwC and the GSMA, Europe will be the biggest mHealth market in 2017. The region has a $6.9 billion mHealth market opportunity, while North America’s mHealth market opp is $6.5 billion. Here’s a quick list of other regions and countries mentioned: Latin America, $1.6 billion; Africa, $1.2 billion; United States, $5.9 billion; China, $2.5 billion; Japan, $1.4 billion.
Health IT developers are producing medical applications for mobile users rapidly for both Android and iPhone, and soon for Window Phones. Most of these are educational or for reference. There are some software applications for remote monitoring which are presently in the FDA approval process.
While pundits proclaim that patients clamor for direct “physician-patient” telemedicine” Few if any real studies have been done to demonstrate this demand.
Until now there were few if any teleconference software that was affordable for medical practices and patients. In fact a teleconference room and/or facility costs in the range of five figures. Skype has been available however it presents some limitations in regard to the number of participants unless users are subscribed to the paying service.
Health Train Express will be sponsoring a “Demonstration Project” on Physician-Patient Telemedicine.
I know, I know many will tell me I should not do this due to regulations and all, however progress is made by those willing to risk something in the name of REAL PROGRESS instead of a bunch of committee meetings. Lett MDs be the arbiters of what works and doesn’t work. Once we demonstrate the need and demand for these services some innovator and entrepreneur will find a way to host medical teleconferences for an acceptable stipend.
The following caveats and disclaimers will be posted for each telemedicine conference to be held on Google + Hangouts.
[This is a “Demonstration Project in telemedicine. The project will attempt to determine what the demand is from patients for Primary Care and/or Specialty Care using Telemedicine Because the Google + Hangouts are not encrypted we will only answer non specific general questions To be in compliance with HIPAA privacy and confidentiality laws DO NOT identify a problem or question with yourself. Please ask your questions in the third person (he, she, we, it)
We appreciate your interest in this telemedicine demonstration project. At the end of thirty (30) days the results will be published here in Health Train Express. The announcement will be posted on Twitter @glevin1 Facebook/gmlevin and Google +.
“During the Google + Telemedicine Hangout you will be asked if you agree to having your interview recorded. If you decline it will not be recorded. The recordings will be available to a closed panel of physicians and well known patient advocate and will not be released to the general public. The review committee will comply with HIPAA regulations to protect your identity. Your waiver of HIPAA regulations will only apply to the G+ interview.
AGAIN, DO NOT IDENTIFY YOURSELF IN THE INTERVIEW ]
Health Bloggers, #hcsm, #healthit #mapp # healthreform and #telemedicine readers, if you wish to join a telemedicine hangout contact me via email at firstname.lastname@example.org. You will receive an invite for each conference.
I invite other physicians to join as part of this ‘ground breaking use of affordable and existing platforms. The platform will allow multiple consultations for an individual or group of patients.
Google has “mothballed” the Google Health personal health record for the time being. The statistical results of the study will be shared with Google in the interest of a professional encrypted platform in the future.
Providers, I hope to see many of you in this hangout. Please use twitter, FB, and/or email to communicate with other physicians and providers regarding the demonstration project.
Stephen A. Schuster of Westboro has always been quick to adopt new technology.
An email user since 1982, the 51-year-old CEO of Rainier Communications, a technology public-relations firm in Westboro, started using email 10 years ago to communicate with his physician, Dr. Bruce R. Weinstein at UMass Memorial Medical Center — University Campus in Worcester.
“At one point I had a really simple question to ask him,” Mr. Schuster said. So he looked up his doctor's email address online. “I just shot him an email. To try to get a doctor on a phone is really hard.”
Mr. Schuster's ease with sharing health information over email — he once sent a photo of a mole — is still not the norm, both locally and nationally. Concerns about privacy, timeliness of information, liability and clinical appropriateness have hampered use of electronic communication. But medical practices are now finding ways to adapt to communication technologies and even move beyond traditional email to Web-based shared medical records.
A national survey in 2009 by the California HealthCare Foundation found that only 8 percent of adults had communicated with their doctor via email.
Physicians are one of the last professions to embrace email for communicating with patients. Overall, 6.7 percent of all office-based physicians nationally emailed their patients routinely in 2008, according to the Center for Studying Health Systems Change. Even in highly integrated group — staff-model HMOs — only half the physicians regularly used email.
UMass Memorial Health Care physicians aren't fully on board the email train, but clinical communication technology is being looked at closely by the approximately 400 physicians who practice in the system.
“The reason medicine is one of the last professions (to adopt email) is we do our best work in person,” said Dr. Sarika Aggarwal, an internal medicine physician in Shrewsbury, who serves as the medical director of the Office of Clinical Integration at UMass Memorial Health Care.
Dr. Aggarwal said that while email is convenient, the biggest issue is privacy, which doctors are strictly regulated by federal law to protect.
Some doctors are also concerned about getting overwhelmed with lengthy emails from patients, or missing an email among the hundreds that can pile up in a doctor's inbox.
Beyond the privacy and management issues, Dr. Aggarwal was concerned about not having the face-to-face interaction that's an important part of medical treatment.
“I almost know from how they (patients) look when they come in, how they're dressed, how they are and the seriousness of their condition,” she said.
The UMass Memorial physicians are looking at Skype for video-conferencing with patients, and a secure patient email portal, connected to the electronic medical record, will be set up in the next year.
Tri-River Family Health Center in Uxbridge uses a secure Web-based patient portal called RelayHealth for patients to email their doctor.
“I use it a lot with patients who are diabetic. They can email me their blood sugar (levels) and I can be their cheerleader-coach,” said Nurse Manager Michelle Drew, who monitors the emails.
At Tri-River, as with all physician practices that use email, patients are told it is strictly for non-urgent issues that can wait up to two business days to be answered.
Only 600 or so patients among the 20,000 patients seen at Tri-River have signed up for RelayHealth, according to Ms. Drew.
Despite the relatively small volume, she said, “It does help us with access on the phone. It helps us decrease the volume of non-urgent phone calls.”
Richard J. DeSimone, Tri-River Family Health Center director, said that although some insurance companies reimburse for email consultation, the health center doesn't bill for it.
“You have to turn that to dictation, get it to the billing department and maybe get paid $25,” he said. “If it gets that far, you've got to come in (for a visit) anyway.”
Worcester-based Reliant Medical Group, formerly the Fallon Clinic, has for three years used a “tethered personal health record” called MyChart, as described by Dr. Lawrence D. Garber, an internal medicine physician and medical director for informatics. The patient logs in to a secure server and sees the actual electronic health record.
MyChart can be accessed from an iPhone or Android smartphone app, as well as through the Internet.
“This isn't just communication. It's also a safety thing,” Dr. Garber said, explaining that patients can double-check the information in their record, as well as use it to send a message to their physician or request an appointment.
He said that 20 percent of Reliant's patients use MyChart, most commonly to check lab test results and order prescription renewals.
Dr. Garber said that initially there were fears that patients would use it inappropriately for emergency symptoms like emailing about chest pain or for flooding doctors with messages.
“That hasn't happened,” he said. “They've been very reasonable in what they asked. They've been sending us concise, organized emails telling us what's going on.”
Reliant pediatrician Dr. Lloyd D. Fisher, who chairs the Communications Committee of the Massachusetts Medical Society, said that pediatricians needed to work out some additional legal issues surrounding confidentiality. A parent or legal guardian has unlimited access to the child's chart until age 13. After that, federal and state laws protect the adolescent's confidentiality on mental health, substance abuse and reproductive health, among other issues.
Dr. Fisher said that teens, who can get their own account at age 13, like emailing their doctor for questions they might be embarrassed to ask directly. He said, “They don't like picking up the phone. They're more comfortable with electronic forms of communicating.”
MyChart is also helpful for college students to stay in contact with their primary care physician when they're away at school, Dr. Fisher said.
Dr. Garber said that the 250-physician group is working with Worcester Polytechnic Institute to evaluate patient utilization with MyChart.
“Patients do love it,” he said. “We have looked at that.”
For 59-year-old Richard T. Kneeland of Pomfret Center, Conn., a lawyer for Allegro Microsystems in Worcester and a patient of Dr. Garber's, MyChart “helps to break down that wall that has been created by managed health care.”
He logs in from anywhere in the world and has instant access to his prescriptions, lab tests and medical history. He said he likes being able to click on a lab test and find out what the test is for and why it was ordered.
Mobile devices in healthcare organizations are no longer a rare sight – some reports suggest that as many as 80% of physicians use mobile devices at work. Yet despite this rapid adoption, a survey from SpyGlass Consulting indicates that physicians believe that mobile devices currently fill a limited number of uses and fall short of their potential.
Spyglass Consulting, a market intelligence firm focused on mobile computing and wireless technologies within the healthcare industry, surveyed 100 physicians via phone interviews.
One note, though, is that these interviews were done in the spring of 2010, so the findings may not be entirely applicable to the current landscape.
The report, Point of Care Computing for Physicians 2012 indicates that while 98 percent of physicians interviewed are using mobile devices to support both personal and professional workflows, 83 percent of them are still using desktop computers as their primary source for accessing patient data when at the hospital, clinic or home.
Gregg Malkary, managing director of Spyglass Consulting, explains that one of the critical barriers to making mobile devices more useful is that the pace of device adoption is much faster than appropriate software development,
“Part of the problem lies in the pace of development. While the devices are being adopted ‘at a phenomenally rapid pace,’ they’re not being redesigned to fit the clinical needs of the physicians. For example, the study indicates 80 percent of physicians surveyed believe the iPad shows promise for healthcare, but at present it can only be used as a communications platform.”
The key component, Malkary contends, is the lack of native apps for healthcare professionals.
“The iPad represents only one component of an overall end-to-end clinical solution. Significant software innovation will be required to realize the vision for anytime, anywhere clinical computing. Clinical applications must be rewritten and optimized to take advantage of the native capabilities of the Apple iPad and other mobile devices including gesture-based computing, natural language speech recognition, unified communications and video conferencing.”
This contention is something that intuitively makes sense – we’ve previously discussed how accessing desktop environments with VMWare and Citrix, while enabling mobile access, fall far short on realizing the potential of the device to improve efficiency. There are however, many apps–particularly clinical reference apps–that take advantage of the capabilities of mobile devices to make it easier to access information at the point of care. Some EMR vendors, both traditional platforms like Epic and cloud-based platforms like Epocrates or Practice Fusion, are even moving towards native apps that do the same.
Another finding of the survey is that communication remains an enormously inefficient process in healthcare. Physicians reported difficulty in communicating with their colleagues, patients, and office staff. And when it comes to coordinating patient care, particularly transitions of care, this can be dangerous; 56% of patients survey reported that transitions of care were something they were particularly concerned about.
This, again, is another area in which mobile devices can help. Software that can consolidate the many different streams of information coming in to the physician and enable the ability to easily and quickly respond would make an enormous impact on physician efficiency. For example, the Allscripts mobile app enables physicians to receive messages regarding patients, refill prescriptions easily, call their patients, and even enter a phone note into the EHR.
The report, however, additionally cites resistance among health IT due to concerns over security, system stability, cost, and so on. Despite the fact that this report was compiled nearly two years ago, its clear that the challenges they found remain today.
In 2001, the technology magazine Wired coined the phrase "geek syndrome" to describe the threefold increase in autism diagnoses in California's Silicon Valley over the space of a decade.
The rumour that Bill Gates himself, founder of Microsoft and figurehead of the world IT industry, displays the traits of Asperger's syndrome, the high-functioning form of autism, spread like wildfire, across – appropriately – the internet.
Via Alex Butler
At the beginning of the month DocBookMD announced a $2.2 million seed round of funding from a handful of private investors from the healthcare industry. DocBookMD offers a HIPAA-compliant platform for doctors to exchange texts, photos, charts, x-rays and similar information.About 6,500 physicians now use the app, according to a report over at MedCityNews.
While the company did not specifically list out its investors, Dr. Matt Rogers, a cardiologist based in Austin and DocBookMD board member, was noted as one. The company’s advisory board also includes business school professor James Nolen from The University of Texas, Mike Betzer, the CEO of Social Dynamx, and RJ Brideau, the SVP of Sales at ReachForce.
DocBookMD was founded by husband and wife practicing physicians: Dr. Tim Gueramy, an orthopedic surgeon, and Dr. Trace Haas, a family physician. Gueramy is CEO of the company while Haas serves as the Chief Medical Officer.
DocBookMD makes its app available to more than 80 different physicians association groups. The app was available to about 100,000 physicians as of December 2011, according to the company. At the beginning of February 2012, DocBookMD claimed that its app has experienced 20 percent growth in users month over month. The app is available for iPhone, iPad, iPod touch, and Android phones.
DocBookMD expects to connect the app to electronic medical records (EMRs) in the near future, according to MedCityNews. The company’s current business model is to work with medical liability companies as sponsors, according to the report.
More in DocBookMD’s press release below:
Austin, Texas February 01, 2012 – DocBookMD today announced the company has raised $2.2 million in seed round funding from private investors involved in the healthcare industry. The new funding will allow the company to accelerate adoption of its rapidly growing mHealth application, DocBookMD. Currently used by physicians in more than 20 states, DocBookMD allows doctors to rapidly exchange text, photos, charts, X-rays and other information to speed patient care and save valuable time.
“DocBookMD is transforming the way I work by helping me communicate in real-time with my team and the ER, as well as make quick consultations and referrals,” said Dr. Matt Rogers, an Austin cardiologist and a company investor. “It’s allowed me to make better decisions on which patients need care immediately as the ER sends me electrocardiograms which I can evaluate on the spot wherever I am.”
Unique to DocBookMD is the management team’s expertise in medicine. Co-founders are husband and wife, as well as practicing physicians: Dr. Tim Gueramy, an orthopedic surgeon, serves as CEO; and Dr. Tracey Haas, a family physician, is the company’s Chief Medical Officer. Ray Wolf, who serves as DocBookMD’s Chief Operating Officer, has a technology background which includes United Technologies, Dell, and Brocade. The company’s advisory Boards include numerous physicians such as Dr. Rogers, as well as business luminaries who include James Nolen, Distinguished Senior Lecturer in the Department of Finance at The University of Texas at Austin McCombs School of Business; Mike Betzer, CEO of Social Dynamx; and R.J. Brideau, SVP Sales and Customer Success at ReachForce.
“We’re proud to have financial backing from investors who have a deep understanding of the day-to-day communication challenges and subtleties of how physicians work,” said Dr. Gueramy.
DocBookMD is growing rapidly with 20 percent more users signing on month over month. The mobile application is available free to physicians who are members of a medical society who has signed up for the service. DocBookMD is available for iPhone, iPad, iPod touch and Android phones. To download the application, visit the App store or Market on your smartphone.
In addition to text messages and photos, DocBookMD also allows physicians to:
assign an urgency setting to outgoing text messages and confirm receipt
search a local pharmacy directory, and
search a local medical society directory to locate other doctors by name or by specialty.
As a HIPPA-compliant messaging application, DocBookMD also solves the ban on texting patient information recently imposed by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Since July 2011, physicians who sent individually identifiable health information via a text were in violation of HIPAA regulations, a felony offense. Penalties include hefty fines of up to $50,000 or up to one year in jail or both.
Recently, the Community Preventive Services Task Force made a positive recommendation for using mobile phone-based tobacco cessation interventions. This recommendation is significant because it was based on existing research, as opposed to some other approaches used to recommend apps (such as crowdsourcing).
The committee indicated that there was sufficient evidence for effectiveness of these interventions in increasing tobacco abstinence among people interested in quitting smoking. It made its determination based on findings from “six studies in which mobile phone-based interventions were implemented alone or in combination with Internet-based interventions.”
What is the Community Preventive Services Task Force?
The Community Preventive Services Task Force is an “independent, non-federal, uncompensated body of public health and prevention experts.” All of the members are appointed by the Director of the Center for Disease Control and Prevention (CDC). It is not the same as the United States Preventive Services Task Force, which conducts reviews of existing literature to make recommendations for preventive health services in primary health care.
The goals of the Task Force include the following:
Oversee the prioritization process for which systematic reviews to conductParticipate in development and refinement of review methodsConsider the findings of all reviews and issue recommendations and findings to help inform decision making about policy, practice, research, and research funding in a wide range of U.S. settings
The Task Force produces summaries of evidence for different public health interventions. These are placed on a website called The Community Guide which is a resource for anyone interested in using an evidence-based approach to improve community health.
The services reviewed by the US Preventive Services Task Force are usually prescribed by a physician or other health care professional. The Affordable Care Act gives this Task Force a great deal of power by stating that none of the services receiving a high level recommendation are subject to cost sharing by insurers, essentially making these services free.
The recommendation of the Community Preventive Services Task Force was based on a systematic review approach. This procedure consisted of three major steps: identifying all relevant studies, assessing their quality, and summarizing the evidence. For mobile phone based smoking cessation interventions, the Task Force reviewed an existing systematic review conducted in December of 2008 along with subsequent studies up until August of 2011. The evidence for the recommendation came from six studies which evaluated the effectiveness of interventions that used automated text messaging for previously recruited participants who were willing to make an attempt to quit smoking.
All the studies were randomized controlled trials and assessed either self-reported or biochemically verified cessation outcomes at 6 or 12 months. Among these studies, three used mobile phone text interventions as the primary cessation support and three used mobile phone text interventions as a complement to an Internet based approach. At 6 months, both approaches demonstrated cessation rates better than control groups with more improvement in the studies with an Internet based approach and mobile phone texting as a complement.
Problems with the recommendation
One problem with the recommendation is that it is not specific to a particular age group. This intervention may work best for younger people because recruitment rates for older tobacco users were low in the studies. In addition, the studies were all conducted in other countries (Norway, New Zealand, and the United Kingdom), so their applicability to the US, especially populations experiencing smoking health disparities (mainly poorer Americans), is not clear and requires more research. None of the studies provide any information on the economic costs and benefits of mobile phone based interventions for tobacco cessation. Such information will be useful in the future as clinicians seek reimbursement from insurers for prescribing these kind of programs.
In addition, companies administering these cessation support programs will likely seek reimbursement for this procedure. Another problem the Task Force points out is that although mobile phone based interventions can be tailored to specific populations, they require on-going advertising and service promotion to ensure that people use them.
Thus, they require evidence based approaches to disseminate and/or implement them. For some populations, the evidence for health promotion may not be that strong which provides weaker infrastructure for implementing mobile interventions. There may be a role for the private sector here because of their ongoing efforts to advertise a variety of products to different populations (such as certain ethnic or gender populations). There are also concerns about the technological complications that arise for some users of these interventions as well as confidential and privacy concerns.
Future Research Needed
As with any recommendations of this nature, the recommendations are only as good as the existing evidence. Some of the key research questions raised by the Task Force are:
What are the economic costs and benefits of mobile phone based texting interventions for smoking cessation? In particular, what are the costs and benefits of interventions that are sustained over one yearCan these interventions work in US populations suffering from smoking disparities?Are there certain age groups that are more receptive to these interventions? If so, which ones and why?How do these interventions work in combination with other types of smoking cessation interventions?
The systematic review approach will help guide future research into interventions to help adults and teens quit smoking.
Efforts to create a medical imaging mega-cloud are in the works, according to an article published this week in The Register. Researchers at Peake Healthcare Innovations (a collaborative venture between Johns Hopkins University and Harris Corp.), VMware, and Intel are teaming up on the project, which ultimately could become a nationwide central warehouse.
The Johns Hopkins hospital system essentially will serve as a testing ground for project prior to a nationwide rollout, according to The Register. A full private cloud version of PeakeSecure--Peake's medical records cloud--will be rolled out at Johns Hopkins next month, with a public version set for completion by in the next several months, according to Jim Philbin, Peake's chief technology officer. Philbin also serves as co-director of the Johns Hopkins Center for Biomedical and Imaging Informatics.
Intel technology will enable the visualization of medical imaging, according to a statement from Intel Worldwide Director of Health IT Rick Cnossen in a joint announcement from Peake and VMware. The technology, Cnossen said, allows for "cloud-computing usage models that synergize compute power, performance and protection," which ultimately helps with cost control and security efforts.
Initially, three managed data centers will serve the East coast, according to The Register, with three more data centers to follow to serve the remainder of the nation.
In similar news, Siemens Healthcare and Dell are planning to collaborate on their own medical image archiving and sharing service, according to AuntMinnie.com. Siemens will use Dell's Unified Clinical Archive software on a cloud-based platform to be called Siemens Image Sharing and Archiving.
"We see changes in the market occurring for a need for imaging data that are different from what a classic radiology or cardiology [picture archiving and communication systems] can offer," Siemens Vice President of Business Management Kurt Reiff told AuntMinnie.com. "With the proliferation of mobile access to data through smartphones and tablet PCs, and with the steady explosion of digital data stimulated by electronic health record adoption initiatives, the market is changing."
Read more: Medical imaging 'mega-cloud' in the works - FierceHealthIT http://www.fiercehealthit.com/story/medical-imaging-mega-cloud-works/2012-02-17#ixzz1mvUaPloM
Last week MobiHealthNews hosted its first webinar of 2012. During my presentation I shared my 12 trends for 2012. Our co-presenter, Aaron Kaufman from Kony Healthcare Solutions also shared his take on the year ahead. Check out the complimentary, hour-long webinar on demand right here.1.) The Adoption of Smartphones and Tablets. This is by far the most obvious trend because it has been so steady for the past few years. It is still an important one to consider. By the end of 2011, Nielsen expected half of the US population to own a smartphone. At the end of 2011 62 percent of 25 to 34 year olds had smartphones. About 53 percent of 35 to 44 year olds did. The fastest growing age group for smartphone adoption in the past year was the 55 to 64 year old age group. Adoption among this group went from 17 percent to 30 percent a year later. Similarly the iPad has had the fastest adoption rate of any consumer electronics device in history. We know that now more than 80 percent of physicians in the US have smartphones. Between 30 percent and 50 percent have tablets now depending on who you ask.
2.) Increased FDA Clarity. This was the big trend of 2011: The FDA proposed guidelines for how it translates existing medical device regulations into the world of apps, smartphones, and tablets. For the most part these guidelines were well-received, but a number of questions remained over where exactly the FDA would draw its lines. The mHealth Regulatory Coalition recently asked the FDA to re-publish an updated set of proposals that take into account changes it should make based on comments from the industry. While it is unclear whether the FDA will publish new guidelines for a new commenting period, it is expected that the FDA will publish either the final guidelines or a new draft set by year-end. While the regulatory discussion will continue to be an important one — there are still a number of loose ends including how the FDA views clinical decision support, for example — this won’t be the primary focus of mobile health discussions in 2012.
3.) Consumer Devices in the Healthcare Enterprise. This is the trend that is really at the heart of the mobile health IT discussion for healthcare providers. While a good number of healthcare facilities are deploying consumer devices like the Apple iPhone, iPad, or iPod touch, and in rarer cases Android devices, for the most part these devices are being brought into work by healthcare workers. BYOD is the name of the trend and its a big one for everyone working in all areas of IT today. The big issues stemming from this trend include security concerns, HIPAA compliance, and user experience. Security solutions and broader mobile device management solutions will find a lot of customers in healthcare this year. The other issue brought about by BYOD is accessing enterprise apps. As the Seattle Hospital’s iPad debacle last year showed, these devices aren’t enough — they require well-designed native apps to ensure that providers will use them for accessing EHRs and other HIS apps. I expect design and usability concerns vs. security concerns to be a huge headache for providers this year. Finally, these consumer devices provide access to distracting consumer apps. Healthcare providers are being distracted by these devices while on the job. While this might be controversial, I think this is a rather absurd concern. We trust them to do so much, we should trust them to know when not to be surfing Facebook.
4.) More Efficacy Studies. This is the big trend for 2012 in my opinion. I think many others agree, too. This year, 2012 will be the year that the serious mobile health service providers step up and prove that their services work. Efficacy studies will lead to greater awareness and investment in mobile health by the provider and payor communities. Recent systematic reviews of medical literature suggests that few studies have been done to prove mobile health efficacy. I think that will be a different story come 2013. WellDoc is once again ahead of the curve here. WellDoc was out in front with FDA clearance and they are ahead of the pack since they have more than one RCT published now. Other companies working in mHealth will follow suit.
5.) Certification of Health and Medical Apps. We need more groups willing to take on this task. It’s a huge opportunity and one that is unique to health apps in my opinion. Happtique, a subsidiary of the for-profit arm of the Greater New York Hospital Association (GNYHA Ventures), is the first organization to take it on. Happtique recently put together a blue ribbon panel that includes ePatient Dave, a couple of doctors and a PhD. This panel is constructing a certification process that Happtique will use to decide which consumer health apps and professional medical apps it will promote. I think any medical association can be doing the same. The American Medical Association should stop developing their own apps and start picking winners from the almost 20,000 health apps that are already in the market. This is an opportunity for every patient-centered organization — the American Diabetes Association, for example — and every medical professional association, not just the AMA — to step up and help us sort through the opaque world of health and medical apps. I think that more groups will step up in 2012.
6.) Focus on Behavior Change. This one might be a parallel to efficacy studies, but it deserves its own mention. There are nearly 13,000 consumer health apps available today. Some of them are substantial — not many — but there are some. The problem with a lot of apps today is they have a built-in expectation that you will use them. Using health apps requires behavior change but few mobile health app developers seem to realize that. Behavior change will be a top trend in 2012.
7.) Many more app developer Challenges. The Health 2.0 events group received a $6 million dollar grant from the federal government to create these health app challenges. Many other companies have created their own. What makes this trend so important is that these challenges actually focus developer energy on problems that currently exist in healthcare today. These challenges are focusing on creating apps for people with cancer or for reporting adverse effects of medical devices. Few developers have tackled issues like that on their own accord. These challenges are an important force guiding health app developers today and hopefully throughout 2012.
8.) Investment Dollars Hold Steady. The total investment in mobile health-related companies in 2011 was more than twice as much as total investment in 2010. We counted more than half a billion dollars flowing into mobile health companies last year. As we reported about a year ago, the total investment in mHealth companies in 2010 was $233 million. There were also only a little more than a dozen announced investment rounds in 2010. In 2011 there were about four times that many. I think we can expect to hear about at least as many deals and at least as much money in 2012, but I think a lot of bets were placed last year and I would be surprised if 2012 outpaces 2011. Curious to hear others reactions to the investment climate for digital health.
9.) Silicon Valley Gets Serious About Healthcare. Silicon Valley companies became very interested in fitness and wellness last year thanks in part to the Quantified Self Movement. This year thanks to groups like Rock Health, which help startups meet mentors with deep healthcare experience, more of these companies are going to shift away from fitness and wellness to focus on other pressing issues facing healthcare. That’s not to say less companies will try to capitalize on the burgeoning connected fitness market — many more will enter that space, too. But Silicon Valley will begin to better understand healthcare in 2012.
10.) Payors offer More Substantial Mobile Services. Late last year Aetna announced that it had acquired Healthagen, maker of the iTriage app. Aetna said the app would be a key component of its consumer engagement strategy moving forward. It would also be a core consumer-facing feature of the health plan’s accountable care organization (ACO) solution. Other health plans are beginning to realize that mobile apps can help people navigate the complexities of the healthcare system and health insurance. More health plans will offer substantial apps and not just wellness apps and games with tenuous ties to wellness. Thanks to this trend, by next year there will be many more consumer-facing utility apps for healthcare.
11.) Three Big Mobile Opportunities for Pharma: Marketing, Clinical Trials, Adherence. I covered this in a column earlier this year. I think pharma companies are finally stepping up their mobile games. Proteus Biomedical launched a system called Helius that will be available at Lloyd’s Pharmacies in the UK sometime this year. Helius includes a smartphone app, a peel and stick sensor patch, and an ingestible tablet that has a microchip built into it. Helius users swallow the tablet when they take their medication. Once the tablet hits their stomach and breaks down, it sends a signal to the patch on their skin, which tells the app on their phone. Clinical trials is another big area. Pfizer’s mobile-enabled clinical trial which it is conducting with Exco InTouch is promising. Finally, pharma companies are going to get more serious about advertising on mobile platforms in the year ahead. The first healthcare-focused mobile ad network launched last year, Tomorrow Networks.
12.) A Home Health Shakeout. This one is a bit of a teaser. Bigger companies are entering the connected home health space and some of the startups working in this space for the past few years are starting to fall apart. By the end of the year, we will see at least a few companies quietly fade away. It’s still one of the core markets for mobile health, lots of opportunity, but some of the weaker companies’ time has run out.
Tune into the whole webinar right here (registration required).
Sense A/S out of Taastrup, Denmark is developing a continuous blood pressure monitor that doesn’t rely on a typical pressure cuff, but rather on a patch that has electrodes that sense the changing impedance of tissue around a vessel and convert it into a BP reading. Measuring other characteristics in electrical signal can also identify vascular stiffness and pulse velocity. The company just raised € 4.5 million in a third investment round and believes that a 510(k) approval from the FDA is likely sufficient to get the device to market.
The Danish company Sense A/S develops ContiPress™, which continuously measures the patient’s blood pressure 24 hours a day, down to every 10 second day and night, without the user noticing. ContiPress™ consists of an intelligent patch, which the doctor or nurse places on the patient’s upper arm. From there, the unit monitors the patient’s blood pressure over 24 hours and stores the data for subsequent analysis via an enclosed piece of software. The result is comprehensive data about the patient’s blood pressure over 24 hours and thus an optimal basis for making the correct diagnosis.
Sense has raised € 4.5 million in an investment round with venture fund SEED Capital and Vækstfonden. It is the company third round, since it was founded in 2006 in connection with an investment from SEED Capital. Second round of investment came from SEED Capital and Vækstfonden in 2010. ContiPress™ is currently a prototype that has been clinically tested on people with very large differences in both blood pressure, BMI (body mass index) and age with promising results that verify the measurement principle. The investment round will be used to refine the device and try ContiPress™ in a more extensive clinical testing within the expected commercial launch.
The "quantified self": It's a lifestyle philosophy that says tracking one's own personal data -- calories burned, hours slept, miles run -- is the path to self-realization. All this data-tracking requires gadgets, and many innovative specimens were on display at CES 2012 last month.
When it comes to your health, correcting bad behavior after periodic visits to the doctor is a step in the right direction. And it's even more likely that you'll make positive lifestyle adjustments based on, say, weekly visits to a personal trainer or daily weigh-ins on your bathroom scale. But turn yourself into a platform of analysis in the Internet of Things, and you’ve got real-time feedback loops to help keep you on target and alert you to problems. Your body is an API that developers are just beginning to figure out.
Basis B1 Band
Launching this spring, the Basis B1 Band is a wrist-mounted body monitor with five built-in sensors, the most intriguing of which is an optical heart-rate monitor. The device shines light through your skin and reads your pulse by measuring blood flow, eliminating the need for an annoying chest strap.
The B1 also includes thermometers for measuring both skin and ambient temperatures, a standard accelerometer for recording movement, and galvanic skin response sensors for detecting sweat levels (and, thereby, reporting physical exertion).
The data is uploadable via USB or Bluetooth. Basis algorithms then crunch the data and display it graphically in a browser-based Dashboard. The default presentation is exceedingly simple, but you can parse the data for a more granular snapshot. There are also gaming and social aspects for added stickiness.
The B1 is set to launch this spring for $199.
Photo: Jim Merithew/Wired.com
Par l'intermédiaire d'une plateforme web, Les Entreprises du Médicament (Leem) interpelle les candidats à la Présidentielle au sujet de l'industrie du médicament.
Cette plateforme propose de découvrir à l’aide d’un outil dynamique les principales propositions du Leem autour des thèmes du dynamisme économique, du progrès thérapeutique, de l’emploi, de la cohérence stratégique ou de la confiance partagée.
Ces propositions ainsi que les chiffres clés du Leem sont disponibles en téléchargement.
Un fil santé vrai/faux sur les idées reçues concernant l’industrie du médicament, nommé “2012 Factchecking“, est également mis à disposition.
Outre cette plateforme, le Leem organise des débats en région sur les enjeux liés au médicament (à Toulouse le 8 février, Strasbourg le 22 février, Lyon le 29 février, Agen le 9 mars et Clermont-Ferrand le 14 mars), et un grand meeting parisien pour clôturer ces débats le 21 mars à 19H00, à la Mutualité.