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A collection of latest innovations in healthcare, in the space of mobile health, telemedicine and remote patient monitoring
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E-Health Tracking Increasingly Common; 21% of people who track their health use some form of technology

E-Health Tracking Increasingly Common;  21% of people who track their health use some form of technology | Mobile Healthcare |

Whether they have chronic ailments like diabetes or just want to watch their weight, Americans are increasingly tracking their health using smartphone applications and other devices that collect personal data automatically, according to health industry researchers.

“The explosion of mobile devices means that more Americans have an opportunity to start tracking health data in an organized way,” said Susannah Fox, an associate director of the Pew Research Center’s Internet and American Life Project, which was to release the national study on Monday. Many of the people surveyed said the experience had changed their overall approach to health.

More than 500 companies were making or developing self-management tools by last fall, up 35 percent from January 2012, said Matthew Holt, co-chairman of Health 2.0, a market intelligence project that keeps a database of health technology companies. Nearly 13,000 health and fitness apps are now available, he said.

The Pew study said 21 percent of people who track their health use some form of technology.

They are people like Steven Jonas of Portland, Ore., who uses an electronic monitor to check his heart rate when he feels stressed. Then he breathes deeply for a few minutes and watches the monitor on his laptop as his heart slows down.

“It’s incredibly effective in a weird way,” he said.

Mr. Jonas said he also used electronic means to track his mood, weight, mental sharpness, sleep and memory.

Dr. Peter A. Margolis is a principal investigator at the Collaborative Chronic Care Network Project, which tests new ways to diagnose and treat diseases. He has connected 20 young patients who have Crohn’s disease with tracking software developed by a team led by Ian Eslick, a doctoral candidate at the Media Lab at the Massachusetts Institute of Technology.

Data from their phones is reported to a Web site that charts the patients’ behavior patterns, said Dr. Margolis, a professor of pediatrics at Cincinnati Children’s Hospital. Some phones have software that automatically reports the data.

Patients and their parents and doctors watch the charts for early warning signs of flare-up symptoms, like abdominal pain, nausea and vomiting, before the flare-ups occur. The physicians then adjust the children’s treatment to minimize the symptoms.

“One of the main findings was that many patients were unaware of the amount of variation in their symptoms that they were having every day,” Dr. Margolis said.

The Pew survey found most people with several chronic conditions said that tracking had led them to ask a doctor new questions, led them to seek a second opinion or influenced their treatment decisions.

Mr. Holt said self-tracking products and services companies formed the fastest growing category among the 2,100 health technology companies in his database. He said venture capital financing in the sector rose 20 percent from January through September 2012, with $539 million allotted to new products and services for consumers by Sept. 30.

He attributed the rise to a “perceived increase in consumer interest in wellness and tracking in general, and the expectation that at-home monitoring of all types of patients will be a bigger deal under the new accountable care organizations,” as President Obama’s health care law takes effect.

But even an enthusiast like Mr. Jonas said he saw “a dark side to tracking.”

“People who are feeling down may not want a tracking device to keep reminding them of their mood,” he said.

Laurent FLOURET's curator insight, October 31, 2014 9:24 AM

"The Pew survey found most people with several chronic conditions said that tracking had led them to ask a doctor new questions, led them to seek a second opinion or influenced their treatment decisions."

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Tablet app reduces CHF patient readmissions by 53 percent

Tablet app reduces CHF patient readmissions by 53 percent | Mobile Healthcare |

New York City-based Health Recovery Solutions announced that its tablet-based program reduced the 30-day readmission rate for 130 congestive heart failure (CHF) patients at Penn Medicine’s Penn Care at Home program by 53 percent.


Health Recovery Solutions looked at Penn Care at Home’s data between July 2014 and February 2015. During this time, the readmission rate fell from 8 percent to 3.8 percent.


Via Alex Butler
Havas Lynx Medical's curator insight, May 28, 6:58 AM

Used correctly, digital can aid patients to achieve goals

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FDA makes official its hands-off approach to regulating health apps and medical software

FDA makes official its hands-off approach to regulating health apps and medical software | Mobile Healthcare |

The Food and Drug Administration today issued its final guidance on the regulation of health apps and other software, and health tech developers should be breathing a sigh of relief.

The FDA confirmed that it’ll take a hands-off approach to most medical device data systems (MDDS), or software that conveys data to and from a medical device (like a glucose meter, for example).

“This guidance confirms our intention to not enforce regulations for technologies that receive, transmit, store, or display data from medical devices,” the FDA statement reads. “We hope that finalization of this policy will create an impetus for the development of new technologies to better use and display this data.”

The agency updated its Mobile Medical Apps guidance to be consistent with the MDDS final guidance. In general, the FDA will not regulate apps that don’t pose a real health threat to the user if they malfunction. And most of the apps that fit that bill are ones that turn a mobile device into a serious diagnostic or treatment platform. That is, they “transform a mobile platform into a regulated medical device by using attachments, display screens, sensors, or other such methods,” in the FDA’s words.

Other apps will be left alone, such as ones that just help users document or track basic health metrics, or self-manage a disease or condition without providing specific treatment advice.

“FDA is certainly sticking to its word, working to down-classify or altogether exempt low-risk software-based technologies,” said our go-to FDA regulation specialist, attorney Brad Thompson, who works with medical devices makers to navigate the sometimes tricky FDA regulatory waters.

Thompson said today’s news is big for the health tech industry. “The implications are profound, both for MDDS-type software, but also for what it suggests about the future for health information technology generally,” he said. “FDA is quite earnestly working to ensure that it uses the lightest regulatory touch appropriate for software.”

He continues:

“It’s exciting, because it means that innovation in this space can truly flourish. This is a very natural extension from the recent FDA guidance on accessories where FDA acknowledges that the risk associated with an accessory is not necessarily the same as the risk of the parent medical device.”

The news comes just weeks after the FDA issued two draft guidances that explain how it intends to regulate low-risk hardware and software products focused on general wellness and medical device accessories. It’ll take a similar light regulatory approach to these product classes

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An Epilepsy Tracker So Beautiful, It Could Be Sold In An Apple Store

An Epilepsy Tracker So Beautiful, It Could Be Sold In An Apple Store | Mobile Healthcare |
Wearables are getting smarter. Once considered little more than glorified pedometers, the wearables coming out of 2015 are going to be considerably more powerful. So powerful, in fact, that they might save lives. That's what the Embrace aims to do. A wearable created by the computing company Empatica, the Embrace isn't just an attractive looking smartwatch that can do all the usual fitness-tracker tricks. It's designed to help epileptics track and manage their seizures without feeling stigmatized. "With the Embrace, we didn't want to design a medical device someone living with epilepsy would be ashamed of," explains Mladen Barbaric, a designer at Pearl Studios, which helped make the Embrace a reality. According to Barbaric, the Embrace was the result of a question: can you make a device that everyone would want to wear, even if you literally have to? In appearance, the Embrace is about as minimalist as you can get. A thin square of metal held on your wrist with an understated magnetically clasped band, the Embrace can be used as an understated watch, telling time according to the position of two small LEDs in the central ring. Like other wearables, it connects to a smartphone app, giving you metrics on your fitness, your sleep patterns, and more. WHY DO PEOPLE WHO ARE SICK, HAVE TO HAVE UGLY DEVICES, WHILE THE PEOPLE WHO ARE HEALTHY GET BEAUTIFUL DEVICES THAT AREN’T VERY USEFUL? But where the Embrace differentiates itself from the competition is as an epilepsy tracker. According to statistics released in 2012 by the Institute of Medicine, one out of every 26 people in the United States will suffer an epileptic seizure in his or her lifetime. And seizures are dangerous: more people die from epileptic seizures every year than in a house fire. Yet even though there's no shame to owning a smoke detector, many epileptics feel stigmatized by wearing epilepsy trackers. "I became really obsessed with this question: Why do people who are sick have to have ugly devices, while the people who are healthy get beautiful devices that aren’t very useful?" Empatica founder Matteo Lai tells me. "Are people living with a chronic condition not worthy of the same design, quality and sophistication that we’re all used to? We wanted to have a device that could be sold at the Apple Store, but that was designed to save lives." o measure epilepsy, the Embrace uses clinical-grade sensors to detect a user's electrodermal activity, or the way electrical signals spike through their skin. These signals can be used to determine a number of factors, like whether we are stressed or scared, but can also be used to detect unexpected events, like convulsive seizures. When the Embrace detects such a seizure, it automatically sends an alert to a friend, partner, or caretaker, along with the wearer's location. The Embrace is the result of more than seven years of research and development from medical designers who originally came out of MIT. The Embrace, which costs $189, recently concluded a successful Indiegogo campaign., but you can still preorder one. You can do so here.
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Glow raises $17 to develop digital health tools for women | mobihealthnews

Glow raises $17 to develop digital health tools for women | mobihealthnews | Mobile Healthcare |

San Francisco-based Glow raised $17 million in a round led by Formation 8 with participation from existing investors Founder’s Fund and Andreessen Horowitz. This brings Glow’s total funding to $23 million.

“If you look at the evolution of our products — of what we’ve done — we have gone from fertile health and started evolving and moving towards general women’s health,” Glow CEO Mike Huang told MobiHealthNews. “A lot of the investment will definitely go into, not only product development, but also opportunities for research that can further help us expand in that direction. The ultimate vision is that we are able to provide the best and most engaging experience for users out there [and] hopefully through our experience they can stay engaged and improve their health.”

Glow also plans to use the funds to continue expanding its data science, product, and design teams. When the company raised its first round of funding last year, Glow had 10 employees. Now it has closer to 20.

Additionally, Glow wants to hire operations staff to continue to scale one of its newer products, Glow Enterprise.

“We are in discussion with a lot of companies in terms of rolling [Glow Enterprise] out,” Huang said. “The problem is it’s a really progressive benefits program, if you will. For those people who truly value women’s health in a company… [well,] we saw the diversity studies.”

Given that there are still comparatively few women in senior positions at companies as compared to men, Huang said this is an area Glow believes to be “truly underserved”.

“The awareness is not at the level we’d like to see,” he said. “We want to change that.”

Glow released the program in February 2014 for employers as an extension of its not for profit offering, called Glow First, which helps women who are having trouble conceiving. Women pay into a fund — $50 per month for 10 months and if at any point during those 10 months a woman gets pregnant, she stops contributing to the fund. And when the 10 months are over, women who did not get pregnant receive funds to pay for services at an infertility clinic.

The first cohort of users enrolled in the Glow First program finished the 10-month program this month. Huang said 50 users who were enrolled in Glow First received 4 times the amount they put in — $2,000.

Huang also said he’s interested in conducting research on new products including a pregnancy test device and a basal body thermometer. He added that if the company pursues pregnancy tests, they would have to get FDA approval, which would take a long time.

In July, Glow announced a new app for pregnant women, called Glow Nurture. The new app offers users a very similar experience to Glow. The main screen shows women a picture of a baby and the picture changes as weeks and month pass to represent the baby’s growth. Women can also run through a list of survey questions about how they feel physically and emotionally, if they’ve exercised, how much weight they’ve gained, how much water they’ve had, and if they’ve done their kegel exercises. The app is only available on iOS, but Huang said that an Android version will be out sometime this year.

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How Google Fit and Apple Healthkit integrate patient data from health apps

How Google Fit and Apple Healthkit integrate patient data from health apps | Mobile Healthcare |

Google launched a preview software developers kit (SDK) for the Google Fit fitness app platform at Google I/O earlier this year. Similarly, Apple launched their new Healthkit API at Apple’s WWDC 14 — and clearly healthcare will be a big focus for Apple with their Apple Watch. Developers are now able to create and test health and fitness apps for Android and iOS 8.

Via Alex Butler
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Report: Healthcare analytics market is still “finding its way” |

Report: Healthcare analytics market is still “finding its way” | | Mobile Healthcare |
The healthcare industry might finally be waking up to the possibilities of big data and clinical analytics, but the marketplace for analytics solutions is still finding its feet, says a new report from Chillmark Research.  While the shift to pay-for-performance reimbursement models is driving interest and investment in population health management tools and tighter management of the revenue cycle, a fragmented market and provider confusion over the most effective analytics strategies may be keeping the vendor community treading water. While EHRs are firmly entrenched in the provider consciousness, and most healthcare organizations have figured out how to leverage the technology to improve care, they are less certain about the right path to take when it comes to supplemental software such as clinical decision support, analytics dashboards, and patient management suites.  While the report found more than a hundred vendors offering solutions for these problems – a dizzying array of choice for cost-sensitive customers – few of those vendors are successfully addressing the long-term needs of healthcare providers.“Vendors can be roughly divided into two categories: best-of-breed and platform-play vendors depending on their particular products and marketing strategies,” writes analyst Cora Sharma in the report. “It is currently a best-of-breed market, with providers adapting vendor solutions to meet a particular need created by a specific payment contract. Vendors aspiring to be become enterprise-wide platforms find ‘enterprise-thinking’ healthcare organizations in short supply.”Some EHR vendors are finding opportunities to sell more technology to existing customers by developing integrated population health management and patient engagement products that are already interoperable with the existing EHR, the report adds.  Other surveys and studies have found that providers are generally eager to embrace these fully integrated offerings that allow for clinical documentation, risk identification, and patient management all in one place.But EHR vendors with viable analytics packages form only a small piece of the healthcare analytics marketplace, Sharma points out.  Best-of-breed vendors are taking the lead, but healthcare organizations don’t have to fall into the trap of spending exorbitant amounts of money cobbling together specialized solutions.  By examining the scope and quality of their data before investing in technology, healthcare organizations can devise far-seeing strategies that encourage accountable care while choosing health IT that meets long-term goals across the continuum of care.
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An interesting perspective of how Sweden care for the elderly population.

An interesting perspective of how Sweden care for the elderly population. | Mobile Healthcare |
The system for looking after older people in England is "horribly fragmented", Care Minister Norman Lamb has said during a visit Sweden to see how the elderly are cared for there.
Chaturika Jayadewa's insight:

A Great example which demostrate the value of flexible holistic care that integrates primary secondary and social care.

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#Telehealth only lead to modest improvement of #Diabetes management in this trial over 12 months.

#Telehealth only lead to modest improvement of #Diabetes management in this trial over 12 months. | Mobile Healthcare |

The Whole Systems Demonstrator was a large, pragmatic, cluster randomised trial that compared telehealth with usual care among 3,230 patients with long-term conditions in three areas of England. Telehealth involved the regular transmission of physiological information such as blood glucose to health professionals working remotely. We examined whether telehealth led to changes in glycosylated haemoglobin (HbA1c) among the subset of patients with type 2 diabetes.

Kel Mohror's comment, August 7, 2014 2:51 PM
The technology is new and patients need more than 12 months to make life-style behavior changes that lead to better, more effective management of the condition and reducing its effects.
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MIT finger device reads to the blind in real time

MIT finger device reads to the blind in real time | Mobile Healthcare |

Scientists at the Massachusetts Institute of Technology are developing an audio reading device to be worn on the index finger of people whose vision is impaired, giving them affordable and immediate access to printed words.

The so-called FingerReader, a prototype produced by a 3-D printer, fits like a ring on the user’s finger, equipped with a small camera that scans text. A synthesized voice reads words aloud, quickly translating books, restaurant menus and other needed materials for daily living, especially away from home or office.

Reading is as easy as pointing the finger at text. Special software tracks the finger movement, identifies words and processes the information. The device has vibration motors that alert readers when they stray from the script, said Roy Shilkrot, who is developing the device at the MIT Media Lab.

For Jerry Berrier, 62, who was born blind, the promise of the FingerReader is its portability and offer of real-time functionality at school, a doctor’s office and restaurants.

‘‘When I go to the doctor’s office, there may be forms that I wanna read before I sign them,’’ Berrier said.

He said there are other optical character recognition devices on the market for those with vision impairments, but none that he knows of that will read in real time.

Berrier manages training and evaluation for a federal program that distributes technology to low-income people in Massachusetts and Rhode Island who have lost their sight and hearing. He works from the Perkins School for the Blind in Watertown, Massachusetts.

‘‘Everywhere we go, for folks who are sighted, there are things that inform us about the products that we are about to interact with. I wanna be able to interact with those same products, regardless of how I have to do it,’’ Berrier said.

Pattie Maes, an MIT professor who founded and leads the Fluid Interfaces research group developing the prototype, says the FingerReader is like ‘‘reading with the tip of your finger and it’s a lot more flexible, a lot more immediate than any solution that they have right now.’’

Developing the gizmo has taken three years of software coding, experimenting with various designs and working on feedback from a test group of visually impaired people. Much work remains before it is ready for the market, Shilkrot said, including making it work on cellphones.

Shilkrot said developers believe they will be able to affordably market the FingerReader but he could not yet estimate a price. The potential market includes some of the 11.2 million people in the United States with vision impairment, according to U.S. Census Bureau estimates.

Current technology used in homes and offices offers cumbersome scanners that must process the desired script before it can be read aloud by character-recognition software installed on a computer or smartphone, Shilkrot said. The FingerReader would not replace Braille — the system of raised dots that form words, interpreted by touch. Instead, Shilkrot said, the new device would enable users to access a vast number of books and other materials that are not currently available in Braille.

Developers had to overcome unusual challenges to help people with visual impairments move their reading fingers along a straight line of printed text that they could not see. Users also had to be alerted at the beginning and end of the reading material.

Their solutions? Audio cues in the software that processes information from the FingerReader and vibration motors in the ring.

The FingerReader can read papers, books, magazines, newspapers, computer screens and other devices, but it has problems with text on a touch screen, said Shilkrot.

That’s because touching the screen with the tip of the finger would move text around, producing unintended results. Disabling the touch-screen function eliminates the problem, he said.

Berrier said affordable pricing could make the FingerReader a key tool to help people with vision impairment integrate into the modern information economy.

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Apple iWatch Set to Launch This Fall Pending FDA Approval

Apple iWatch Set to Launch This Fall Pending FDA Approval | Mobile Healthcare |

The highly anticipated Apple iWatch is reportedly ready for launch; however, it is still awaiting approval from the U.S. Food and Drug Administration (FDA),  according to Chinese Media reports. Currently, the device is rumored to be shelved pending approval from the FDA certifying the iWatch as medical equipment due to its biometric sensors for heart rate, blood pressure and glucose level tracking features. While the FDA is ensuring the iWatch meets the FDA requirements, Apple is seeking patents for the product in other countries such as Mexico, Taiwan, Russa, and Japan (Miller/Inferse/6/23). 

Back in 2013, Apple hired former Nike consultant Jay Blalnik to gear up for the smartwatch and later meet with the FDA to discuss the product in December 2013. Over the weekend, 9to5Mac reported that Apple is partnering with professional athletes such as LA Lakers basketball player Kobe Bryant and Boston Red Sox baseball player Dustin Brown to test the iWatch. The athletes have reportedly signed non-disclosure agreements with Apple. 

The iWatch is slated for commercial launch this fall in October.  Quanta Computer, a Taiwan brand, has already announced that it will start making the iWatch next month and is expected to produce an estimated 50 million shipments within the first year in the market. If the iWatch does not get FDA approval in time, it is possible that the blood glucose level tracker may not be included in the first iteration. 

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The Race to Dominate Digital Health Heats Up

The Race to Dominate Digital Health Heats Up | Mobile Healthcare |

The battle to own digital health will escalate this week with Google expected to introduce a new service to collect data from fitness trackers and apps.

The tech giant’s addition to its mobile operating system, likely to be described in greater detail at the I/O conference in San Francisco, follows Apple’s unveiling of HealthKit,Samsung’s S.A.M.I. announcement and WebMD’s launch of Healthy Target.

Each is a play to become the consumer platform for health, a one-stop hub for a person’s own biometric data as well as personalized insights and health content. It’s the latest in a long line of fierce wars for the mobile customer, which have ranged across phone specs, developer loyalty, navigation services, music, media and more.

No one is quite sure how it will play out – but they all know for sure that they don’t want to miss out. Health offers the next opening to differentiate operating systems, the next opportunity to tie consumers into ecosystems and the next source of information that can be tapped for consumer insights.

But that will only happen on the margins until businesses convince mainstream consumers that fitness devices, apps and services should matter to them. And at this point, with today’s offerings, it’s far from clear the public is sold.

“Right now, they’re boring, underwhelming and inaccurate,” said Esther Dyson, chair of EDventure Holdings. “But they’ll make the data much more interesting and meaningful, and the wearables themselves will become better.”

They certainly should. Because despite feeble early efforts in the space, including the shuttering of Google Health in 2012 and stumbles in hardware, the broad potential here is shifting the premise of healthcare from treating disease to preventing it. And perhaps, with enough data from enough people, to help discover long-sought cures for deadly illnesses.

No Magic Bullet

An online survey by Endeavour Partners found that half of people who own a fitness tracker no longer use it, with about a third dropping off within the first six months.

Venture fund Rock Health, which has invested in the wearables space, suggested in arefreshingly clear-eyed report on the state of the devices that those numbers were likely too conservative. In its survey of 10 staff members – who, recall, work in digital health – usage plummeted below 25 percent within half a year.

To date, the sense is that most demand for health trackers and the data they provide comes from the barbell market of the ultra fit and the unhealthy: Those who want to scrupulously monitor their activities and progress, and those in real need of insight and motivation. Medical-grade devices for mobile phones like glucose meters and blood pressure cuffs are generally designed for those already dealing with signs of disease.

The rest of us only tend to think about health when we’re unhealthy, venturing off to WebMD when we’ve got that weird growth and forcing the subject into the back of our minds the rest of the time.

“How do you get those people motivated?” said Malay Gandhi, managing partner at Rock Health. “It’s one of the largest fundamental challenges in health care. I don’t think there’s a magic bullet.”

Indeed, the base assumption of fitness trackers and services is actually a fairly audacious one: that mainstream consumers will want to strap themselves to sensors 24 hours a day and adjust habits in hopes of avoiding diseases that might be decades away.

The sector’s stunning success in getting us all to text, tweet and slingshot disgruntled birds on our phones won’t automatically translate into getting us all to eat our vegetables in the real world.

But it is the right vision, especially in a nation dealing with epidemic levels of obesity anddiabetes: To the degree that U.S. consumers start to think about their health in a farsighted way, it’s a win for patients, physicians, employers and the healthcare system.

Smarter Sensors

To succeed, companies will have to figure out how to deliver something of real, perceivable value (which would seem like an obvious statement but for the litany of copycat devices cluttering the market today).

Fitness trackers that measure steps, sleep and calories are thoroughly commoditized at this point – and the data is a backwards look at activity, not a measure of one’s actual state of health.

No one is quite sure what the “killer app” of the space looks like yet, but most observers believe it starts with better sensors.

“It won’t be one thing that measures all of your health,” Dr. Krishna Yeshwant, a general partner at Google Ventures and a physician. “It’s something that will be narrow but that closes the loop in a real-time way and gets people to change their behavior.”

Companies are experimenting broadly – or, less generously, throwing everything they’ve got against the wall to see what sticks.

In May, Samsung showed off its concept for the Simband tracker, saying it could integrate third party sensors that would monitor heart rate, hydration, blood pressure, respiration and glucose concentrations, among other things.

Apple, which plans to unveil a smart watch later in October, appears to be working on an array of novel sensors, based on media reports and hiring patterns. Google X revealed it’s developing a smart contact lens that can measure glucose levels through tears.

Integrity Applications of Israel has already earned limited approval to sell a bloodless glucose monitor in certain parts of Europe that uses a clip-on earlobe sensor.

Others are working on wearables that monitor respiration, body position, brain activityand more.

Some of these sensors are further along than others, some will require the Food and Drug Administration’s sign off, and some can’t be packed into a device on the wrist.

But many point to a convenient and accurate bloodless glucose sensor as a breakthrough for healthcare and a critical entry point for the wearables space.

“It’s been a holy grail for a long time,” Yeshwant said.

The most obvious advantage is that it would allow diabetics to monitor their blood sugar levels, adjusting their diets or medications accordingly, without painful skin pricks. But it would also offer everyday consumers a way to understand how diet affects health in real time.

Yeshwant compares it to people driving in more fuel-efficient ways when dashboards show plummeting levels with every gunning of the gas pedal.

If consumers see that devouring a piece of cake immediately spikes their blood sugar, it makes them more cognizant of the effects of their actions, he said. They’ll start to think twice before indulging – especially people already at risk for developing diabetes.

Better Data

A major motivation for the platform plays described above is surely the rich data provided by devices that people wear around all day, every day.

Internet and mobile companies already have increasingly complete consumer profiles, packed with location, shopping patterns, search history, social graphs and more.

“You layer on top of that biometric data and it gets a lot more interesting,” said Sonny Yu of Misfit Wearables, makers of the Shine activity monitor.

But, again, consumers won’t use these devices and hand over this data until they see how the information helps them.

So how might that happen?

The platforms themselves may help make the data more relevant, to the degree that they collect information from multiple sources and try to deliver unified insights from it, Dyson said.

Those better sensors should also mean more useful data. That becomes particularly true as more devices earn FDA approval, enabling them to move from making ill-defined “wellness” promises to delivering information with clinical validity that doctors and researchers can put to use.

Perhaps the most interesting detail in Apple’s unveiling of HealthKit – which aggregates data from fitness trackers, medical devices, apps and the phone’s own sensors — was the partnership with Mayo Health Clinic and Epic Systems, a major provider of digital health records. That suggests the data can feed into the official records for patients at clinics using Epic.

As digital wellness platforms merge with electronic medical records, through acquisitions, partnerships or otherwise, the digital picture of one’s health becomes increasingly detailed.

“Candidly, it’s the easy stuff that they’re doing right now,” said Ryan Howard, CEO of Practice Fusion, one of the largest providers of online electronic health records. “But if I had, ‘James is a 30-year-old male in San Francisco,’ your past medical history and steps and blood sugar, all together, that becomes really, really interesting.”

The Big Promise

Interesting in several ways.

For one, a real-time feed of medical data into clinics and hospitals means doctors can be alerted and respond in the event of alarming divergences. This model has already emerged with companies like Medtronic, which develops a heart monitor that can inform doctors in the case of a cardiac event.

Devices that can collect increasingly reliable data at home, including glucose levels, could also be a significant boost for telemedicine, saving people the cost and hassle of going into the physician’s office.

“That could really change the way people think about how care is delivered,” Yeshwant said.

Now throw in genomic data, thanks to plummeting prices of DNA sequencing. And maybe we all start to regularly test our pH levels and gut microbiome from home, a possibilityraised by Larry Smarr, founding director of the California Institute for Telecommunications and Information Technology and perhaps the ultimate “Measured Man.”

At a minimum, what we could start to get is a detailed guide of how our activity and diet effect health, a clearer sense of our specific medical risks and earlier indictions when things start to go awry.

“Healthcare today is about: You get sick, and then you get health care,” Smarr said. “Instead, we’re going to keep you healthy so you don’t need healthcare.”

The even bigger promise here is that collecting increasingly complete medical profiles from millions and millions of people, healthy and sick and somewhere in between, will offer fresh insights into the causes and cures for devastating diseases.

Everyone will effectively be enrolled in a medical study on a length and scale that we’ve never seen.

Things that look like anomalies could reveal themselves as patterns. Genomic differences that make people more or less susceptible to diseases may light the path to better diagnoses and treatments.

Big data approaches are already being leveraged in research for cancer, Parkinson’s,Alzheimer’s and many other diseases. And most researchers I’ve spoken to believe it’s only a matter of time until the tools lead to medical breakthroughs.

So while there’s a long list of business, cultural, regulatory, liability and privacy challenges standing in the way of this long-term vision — there are even more reasons to tackle them all.

As Bill Maris of Google Ventures put it: “Medicine needs to come out of the Dark Ages now.”

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Smartphone App Measures Respiratory Rate to Help Detect Pneumonia in Children

Smartphone App Measures Respiratory Rate to Help Detect Pneumonia in Children | Mobile Healthcare |

Monitoring children’s breathing rate is commonly done simply by using a stopwatch, but it turns out that just about any smartphone can be a perfect respiratory monitor. Researchers from BC Children’s Hospital and the University of British Columbia have developed an app that simply asks the user to tap the touchscreen every time the patient breathes in. The app in turn calculates the breathing rate and displays it on the screen along with an animation of a breathing child, to help make sure the calculated breathing rate matches what the person is seeing.

In a study of children’s breathing, the app provided accurate results after roughly ten seconds of counting, while the manual stopwatch method requires a full minute to perform. The researchers plan to combine the app with the Phone Oximeter pulse oximeter they developed a few years ago to create a cheap and mobile tool for pneumonia detection.

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Beyond the pill trend marks milestone with Proteus-Otsuka digital medicine-NDA application - MedCity News

Beyond the pill trend marks milestone with Proteus-Otsuka digital medicine-NDA application - MedCity News | Mobile Healthcare |
The “Beyond the Pill” movement marked a major milestone with the FDA’s acceptance of the first digital medicine-New Drug Application. It will pair Proteus Digital Health’s ingestible sensor platform with Otsuka Pharmaceuticals’ FDA-approved Abilify drug to treat people with schizophrenia, bipolar disorder and in some cases for major depressive disorder to monitor adherence.

The Abilify tablet contains an ingestible sensor that communicates with a wearable sensor patch and medical software application. The idea is to measure adherence.

Otsuka CEO for development and commercialization Dr. William Carson said in a statement that patients suffering from severe mental illnesses struggle with adhering to or communicating with their healthcare teams about their medication regimen, which can greatly impact outcomes and disease progression.

The technology behind the embedded sensor is pretty cool. Stomach juices activate an energy source — similar to a potato starch battery. The embedded sensor sends signals to a skin patch electrode, which wirelessly transmits information such as vital signs, body position and verification of medication ingestion.

The sensor would be embedded during the drug manufacturing process as a combination drug-device, communicating with the Proteus patch and relevant medical software.  If approved, the combination drug-device could be used to tailor medicines more closely to reflect each of our medication-taking patterns and lifestyle choices, Andrew Thompson, Proteus Digital Health CEO said in a statement.

The complexities behind poor adherence loom large in the face of attempts to improve it. But with schizophrenia the consequences of non adherence include relapse, hospitalization and attempted suicide, depending on the severity of the condition.

Last year Proteus Digital Health raised $120 million to commercialize its digital medicines.

The FDA’s move follows its clearance of Propeller Health’s remote monitoring platforms for GSK and Boehringer Ingelheim to better track how people with asthma and COPD use their inhalers between appointments. The idea is that by tracking how patients use the devices Propeller’s platform can provide useful information to physicians to help alert them to potential problems with patients’ medication or the inhaler, before the problems worsen.

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Elite Concierge Healthcare Practices: Making Telemedicine Work For Everyone

Elite Concierge Healthcare Practices: Making Telemedicine Work For Everyone | Mobile Healthcare |

There are individuals, family offices, and private equity funds that are heavily investing in telemedicine devices – hardware and software – that will enable physicians to diagnose, monitor, and even treat patients in distant locations. For a multitude of excellent reasons, they see the future of telemedicine to be foundational to the future of healthcare delivery.

A major complication to the effectiveness of telemedicine is weaknesses in the human side of the process. It’s the functioning systems and processes – the “peopleware” – that will enable physicians to use the technology to expertly meet the needs of their patients.

There are two components to “peopleware.” On one side is motivating patients to diligently use the mobile technology to monitor themselves and take corrective actions when directed by their physicians. Many physicians will attest that getting patients to listen and be responsive – to follow directions – can periodically be a very trying exercise in futility. The evolution of the technology will make some – but not all – of this conundrum vanish.

The other “peopleware” component is the physicians’ learning curve in how to provide their expertise as a core part of a telemedicine ecosystem. This includes detailing the workflows essential for a smooth running, long distance physician/patient relationship.

With a tremendous amount of attention being paid to developing amazing devices, “peopleware” in this environment is being addressed by a growing number of concierge healthcare practices as well as various medical institutions. According to Daniel Carlin, M.D., president of WorldClinic and a leader in the industry, “The point of failure for most device based solutions is usually over reliance on technology. The key to success is to lead with the doctor/patient relationship; it must be enduring, caring and based in trust and compassion. The devices, when tied to a physician, provide ongoing, useful data for diagnosis and treatment, resulting in better care.”

Wellframe CEO Jacob Sattelmair spoke at the Digital Healthcare Summit in Boston and said, “When we think about digital medicine, it’s not about replacing human care, it’s about amplifying and extending human care and helping patients feel more connected and more cared for especially during periods of need.”

The world of elite concierge medicine is an excellent environment for the refinement of devices but, more critically, to the development of the “peopleware.” The lessons learned here would be able to be leveraged as the benefits of telemedicine are rolled out to everyone.

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14 Major U.S. Hospitals Now Using HealthKit as Apple Adds Health Industry Advisors

14 Major U.S. Hospitals Now Using HealthKit as Apple Adds Health Industry Advisors | Mobile Healthcare |

Fourteen major U.S. hospitals have rolled out their own trials of Apple's HealthKit tool, with the pilot program earning praise among doctors for its ease of use and advanced tracking of various health metrics, reports Reuters. 

According to the news agency, eight hospitals trying out HealthKit are on the U.S. News & World Report's Honor Roll which ranks the best hospitals, with the program seeing more of a positive reaction versus health tracking programs by Google and Samsung.

Ochsner Medical Center in New Orleans has been working with Apple and Epic Systems, Ochsner's medical records vendor, to roll out a pilot program for high-risk patients. The team is already tracking several hundred patients who are struggling to control their blood pressure. The devices measure blood pressure and other statistics and send it to Apple phones and tablets. 

"If we had more data, like daily weights, we could give the patient a call before they need to be hospitalized," said Chief Clinical Transformation Officer Dr. Richard Milani.

Via Alex Butler
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Analytics in the era of value-based care

Analytics in the era of value-based care | Mobile Healthcare |

The power of revenue cycle and population health analytics multiplies when you manage them together


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Apple's HealthKit Now Sends Medical Data Right to Your Health Record

Apple's HealthKit Now Sends Medical Data Right to Your Health Record | Mobile Healthcare |
iHealth was the first company to sell a medical device through Apple, so it's only natural it's also the first to fully integrate its products with Apple's HealthKit. That means all the data iHealth's connected monitors and trackers collect not only gets sent straight to the app, it's also automagically logged in your electronic health record.

Via Alex Butler
Sandy Spencer's curator insight, September 30, 2014 10:53 AM

This could be so important during a medical event.

Olivia Klenda's curator insight, September 30, 2014 6:50 PM

The new HealthKit is a great way to keep track of your personal health records, exercise, and eating habits. 

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How wearable tech will change your life—like it or not

The Silicon Valley giant has redrawn the line that separates our technology and ourselves. That may not be a good thing

With the unveiling of the Apple Watch Tuesday in Cupertino, California, Apple is attempting to put technology somewhere where it’s never been particularly welcome. Like a pushy date, the Apple Watch wants to get intimate with us in a way we’re not entirely used to or prepared for. This isn’t just a new product, this is technology attempting to colonize our bodies.

The Apple Watch is very personal—“personal” and “intimate” were words that Apple CEO Tim Cook and his colleagues used over and over again when presenting it to the public for the first time. That’s where the watch is likely to change things, because it does something computers aren’t generally supposed to: it lives on your body. It perches on your wrist, like one of Cinderella’s helpful bluebirds. It gets closer than we’re used technology getting. It gets inside your personal bubble. We’re used to technology being safely Other, but the Apple Watch wants to snuggle up and become part of your Self.

This is new, and slightly unnerving. When technologies get adopted as fast as we tend to adopt Apple’s products, there are always unintended consequences. When the iPhone came out it was praised to the skies as a design and engineering marvel, because it is one, but no one really understood what it would be like to have it in our lives. Nobody anticipated the way iPhones exert a constant gravitational tug on our attention. Do I have e-mail? What’s happening on Twitter? Could I get away with playing Tiny Wings at this meeting? When you’re carrying a smartphone, your attention is never entirely undivided.

The reality of living with an iPhone, or any smart, connected device, is that it makes reality feel just that little bit less real. One gets over-connected, to the point where the thoughts and opinions of distant anonymous strangers start to feel more urgent than those of your loved ones who are in the same room as you. One forgets how to be alone and undistracted. Ironically enough experiences don’t feel fully real till you’ve used your phone to make them virtual—tweeted them or tumbled them or Instagrammed them or YouTubed them, and the world has congratulated you for doing so. Smartphones create needs we never had before, and were probably better off without.

The great thing about the Apple Watch is that it’s always there—you don’t even have to take it out of your bag to look at it, the way you would with an iPhone. But unlike an iPhone you can’t put the Apple Watch away either. It’s always with you. During the company’s press event the artist Banksy posted a drawing to his Twitter feed of an iPhone growing roots that strangle and sink into the wrist of the hand holding it. You can see where he was coming from. This is technology establishing a new beachhead. To wear a device as powerful as the Apple Watch makes you ever so slightly post-human.

What might post-humanity be like? The paradox of a wearable device is that it both gives you control and takes it away at the same time. Consider the watch’s fitness applications. They capture all data that your body generates, your heart and activity and so on, gathers it up and stores and returns it to you in a form you can use. Once the development community gets through apping it, there’s no telling what else it might gather. This will change your experience of your body. The wristwatch made the idea of not knowing what time it was seem bizarre; in five years it might seem bizarre not to know how many calories you’ve eaten today, or what your resting heart rate is.

But wearables also ask you to give up control. Your phone will start telling you what you should and shouldn’t eat and how far you should run. It’s going to get in between you and your body and mediate that relationship. Wearables will make your physical self visible to the virtual world in the form of information, an indelible digital body-print, and that information is going to behave like any other information behaves these days. It will be copied and circulated. It will go places you don’t expect. People will use that information to track you and market to you. It will be bought and sold and leaked—imagine a data-spill comparable to the recent iCloud leak, only with Apple Watch data instead of naked selfies.

The Apple Watch represents a redrawing of the map that locates technology in one place and our bodies in another. The line between the two will never be as easy to find again. Once you’re OK with wearing technology, the only way forward is inward: the next product launch after the Apple Watch would logically be the iMplant. If Apple succeeds in legitimizing wearables as a category, it will have successfully established the founding node in a network that could spread throughout our bodies, with Apple setting the standards. Then we’ll really have to decide how much control we want—and what we’re prepared to give up for it.

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Apple's iWatch & iPhone 6 event from physician perspective

Apple's iWatch & iPhone 6 event from physician perspective | Mobile Healthcare |
Apple's iPhone 6 and iWatch event could have a significant impact on health tracking depending on the integration of the iWatch with Apple's Health app.

Via Alex Butler
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Which telemedicine model will triumph?

Which telemedicine model will triumph? | Mobile Healthcare |

With news that Richard  Branson sees telemedicine as a decent investment opportunity, it raises the  question of whether a dominant telemedicine model will emerge. That was one of  the observations shared by Katerina Fialkovskaya, co-founder and managing partner at  Boston-based OKM Capital.

She welcomed Branson’s entrance into the market last week and noted:

“The flow of investment into the space will certainly accelerate the process  and help to figure out the winning model. Whoever is the winner, the benefits  for the society, that mobile technology is to bring by disrupting the health  care, are incomparable to the social network revolution.”

It’s too early to say which model will win, since familiarity with  telemedicine will take some time before it works its way into the mainstream  awareness. But here’s a sense of how some companies are approaching telemedicine  models.


Web-based and mobile companies like Doctor on Demand, in  which Branson invested, provide feedback to patients based on the symptoms they  give. They tend to generate revenue from employers interested in whittling down  healthcare expenses and whose employees tend to have high out-of-pocket costs.  Users tend to get whoever is qualified to provide medical advice in their  community. Some also offer the services to consumers for a flat fee, such as  $50-$60.

What’s interesting is the scope for specialty medicine in this area such as  dermatology. Dermatologist on  Call is a direct to consumer mobile platform that lets users take a  picture of a rash or mole and send it to the company and receive a response from  a dermatologist in three business days. Second opinions are also another part of  the model. MDLive  recently partnered with Children’s Hospital of Pittsburgh to offer second  opinions in pediatric cases. For $3,000 2ndMD  customers can speak with two to five specialists, depending on their condition,  after providing lab, test results and a physician’s assessment or recommendation  for treatment a few days before.

The healthcare kiosk has the feel of stepping into some  futuristic pod. HealthSpot and SoloHealth  are the dominant companies in this space. HealthSpot users connect with a  physician online and tend to play an active role in the exam by using one of a  handful of electronic medical devices such as a thermometer, stethoscope, an  otoscope to get a better view of an ear and a dermascope to get a better view of  a rash or skin problem. Non emergency medicine tends to dominate in telemedicine  and kiosks are no exception. Each of the devices transmits an image or reading  to the physician on the other side of the screen. It’s formed a joint venture  with Cleveland Clinic after doing a pilot of the service for one year which  raises some interesting questions about which directions it could go in. It’s  also providing it kiosk service through an employer wellness plan by Kaiser  Permanente to one of its company clients.

With healthcare kiosks and many of the online models, the physician tends to  be someone the patient hasn’t previously met. But the founders of these  businesses take the view that access triumphs familiarity. SoloHealth has kiosks  in retail sites and lets consumers in high-traffic retail locations monitor  their blood pressure, central vision and weight, as well as get a health-risk  assessment. Users can identify and contact local physicians. WellPoint  and Coinstar are among its investors.

The highest profile national drugstores are still experimenting with how they  approach telemedicine through in-store clinics. The furthest  along appears to be Rite Aid. It embraces  both telemedicine through the in-store clinic and the online experience. Its NowClinic is available at 58 of  its stores through  a collaboration with UnitedHealthcare’s Optum Health Solutions. It started  with nine stores in Detroit in 2011, but now has a presence in stores around  Baltimore, Philadelphia and Pittsburgh. In some states providers — doctors or  nurse practitioners can prescribe medication based on their diagnosis. But it  also offers 24/7 access to providers online. Users log in and complete their  contact details and health history. They can also get a copy of the physician’s  summary sent to their primary care provider and integrated into their health  record.

CVS uses nurse practitioners to provide telemedicine services to patients in  the presence of a nurse. Although its initial focus has been rural communities  where Medicare tends to reimburse for telehealth care, an increasing number of  states require private insurers to cover telemedicine, including California.  That’s where CVS is piloting telehealth in 28 states. Walmart  is collaborating with Humana to provide telemedicine access in a handful of  stores at Humana Health and Well Being Centers.

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Sensors And Sensitivity

Sensors And Sensitivity | Mobile Healthcare |

This is the sensible trajectory of connected sensor technology. The world around us gains the ability to perceive us, rather than wearable sensors trying to figure out what’s going on in our environment by taking a continuous measure of us.

Via Alex Butler
Rowan Norrie's curator insight, August 5, 2014 9:13 AM

A useful lesson - wearables should not just be about harvesting data for the sake of it. By incorporating into objects we are in contact with, e.g. seat belts, we can make it a seamless part of our everyday life to gather information when it really matters.

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Smartphone coaching can boost diabetic management and help reduce disease risks

Smartphone coaching can boost diabetic management and help reduce disease risks | Mobile Healthcare |

Diabetics living in low to modest socioeconomic communities can benefit from patient coaching via smartphone when it comes to managing their disease and improving their health, according to a new study from the School of Kinesiology & Health Science at York University in Canada. Researchers conducted a six-month pilot study, involving 21 participants, in which a smartphone application intervention program using provided to patients as well as device coaching. The focus was to improve behavioral management of type 2 diabetes in ethnically-diverse populations. Of the 21 participants 12 saw their sugar levels drop with minimal changes in medication. The smartphone not only helped reduce diseasee complications but helped patients hurdle obstacles such as miscommunication and issues with attending medical care tied to travel difficulties. Study

Via Alex Butler, Bart Collet
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From beyond the pill to beyond the pixel: twelve digital health companies championed by Apple

As I watched the new “Strength” ad for the iPhone 5s, all the devices looked  like Apple accessories. Then I wondered how much the digital health companies  had to pay for such high-profile product placement. Finally I realized that  Apple would anticipate the “What app is that?” questions and have a list  somewhere.

Just as the company did with the April ad for the iPhone 5s – “Powerful,” Apple has a a  gorgeous “Explore More Apps from the Film” page listing all the apps  and linking to the App store. I have read press releases from many of these 12  companies. I have to say, it’s wonderful to see them get such a loud shout-out  from Apple.


Here are the companies whose products are shown in action in the ad.

Argus – Pedometer and calorie, nutrition and  activity tracker

Health Mate – Step tracker and life coach from  Withings miCoach smartball – Companion app for the $300  miCoach Smart Ball to improve soccer skills

Misfit Shine – Waterproof tracker made from  airplane metal and able to track running, walking, biking and swimming Nike+ Running – App to track your runs and help you  reach your goals

7 Minute Workout – A scientific, personalized  fitness workout in 7-minute intervals from Johnson & Johnson

Sprint Timer – Sports timer and photo finish app  that displays a finish line on the phone screen so you can see who crosses it  first

StrongLifts 5×5 Workout – Weightlifting app that  features three exercises, three times a week at 45 minutes per workout

TRX Force – Digital version of the 12-week  conditioning program used by the military

Wahoo Fitness – Running, cycling and fitness app  (in the ad it is shown timing a bike race) WeMo – App controls the WeMo Switch and WeMo  Motion, home automation devices (apparently this is what you need to start your  fitness routine in the morning) Zepp Golf – companion app for Zepp multi-sport  motion sensor, focused on analyzing a golf swing

Conveniently, the tagline from the “Powerful” ad fits this new ad as  well: “You have the power to create, shape and share your life. It’s right  there in your hand. Or bag. Or pocket. It’s your iPhone 5s.”

There was one digital health company in the “Powerful” ad, the Heart Rate Monitor by Azumio.

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Via Andrew Spong
Andrew Spong's curator insight, June 23, 2014 8:08 AM

There have been many ongoing conversations about threats to pharma's visibility in digital environments emerging from outside the industry.


As hardware manufacturers align themselves with companies responsible for apps and peripherals compatible with their devices, another challenge to pharma's visibility and relevance in digital spaces has emerged.



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In Ten Years, You Won’t Even Know You’re Wearing Them

In Ten Years, You Won’t Even Know You’re Wearing Them | Mobile Healthcare |

Roozbeh Ghaffari won’t let me take a picture of the thin, rectangular piece of silicone he just handed me. It’s about the size of two postage stamps, and, as you’d expect, it feels rubbery and folds freely. Shiny thin wires show through their transparent packaging. They slither through the silicone like a exuberant dragon dancers in a Chinese New Year parade. As I thumb the device, I worry I’m going to kink one of the delicate-looking metallic threads. Don’t worry, Ghaffari assures me. “You can bend it in half.”

The device is a sensor, and it represents some of the core technology of MC10, a startup that makes flexible electronics. Ghaffari, cofounder and director of advanced technology at the company, isn’t at liberty to tell me what, exactly, it senses. It could be temperature, muscle activity, or heart rate.

A prototype of MC10's BioStamp senses temperature, heart rate, and other vital signs.

The sensor’s counterpart is another rectangle of silicone. This one encases more traditional semiconductor chips, each about half the size of your pinky nail. Rather than being soldered to a brittle green board that’s etched with interconnects, the chips are linked by what appear to be the same wavy, bendable wires. It’s not as flexible as the passive sensor because of the chips, but it’s still supple enough to bend around my finger. It’s the brains of the system, Ghaffari tells me. It receives data from the sensor and then processes, stores, and passes on that information.

Ghaffari and I are sitting inside a brick-walled, light-filled conference room at MC10’s headquarters in Cambridge, Massachusetts. A pleasant breeze whispers through the open windows, which look down on the packed parking lot one story below. Outside the conference room, the open office is similarly stuffed. People are buzzing about, stepping over and past other researchers and programmers hunched over their crowded desks. MC10 only makes one product that you can buy right now—a thin cap worn by football players under their helmets to alert them to potentially dangerous blows—but you get the sense that’s about to change.

Wearable sensors, like the kind that MC10 and other companies make, will take computing to its next frontier—our bodies. Until recently, big-name technology companies were content to fight for space on our desks, our laps, or in our pockets. But as each of those becomes increasingly saturated, they’ve started to turn their attention to our wrists, fingers, and faces. The technology is ripe and some of the apps have already been written. All that’s needed is a reason to buy.

Companies like Apple, Samsung, and Google are clearly hoping that health monitoring is what turns the wearable market into the next billion-dollar opportunity. It’s a road that’s been partially paved by Fitbit and Jawbone, two companies that make simple fitness trackers. They hang off our wrists or around our necks, recording things like footsteps and heart rate. The big players in mobile are muscling in on the market, having recently announced apps, prototypes, or both.

But each of those forays is a tentative toe in the water. The devices available now, and to be announced in the coming months, are just the tip of the iceberg. They’re simple and unsophisticated, like early cell phones. In the coming years, wearable health sensors will grow more capable, and they’ll likely become integrated into our daily lives. Yet the challenges they face are far more complex than those required by other revolutionary devices like smartphones, and the regulatory hurdles are far higher. That means the golden age of wearable health sensors isn’t upon us, but it will be soon. Here’s a look at how we got here—and where we’re going.

No Longer a Novelty

In the late-1990s, John Rogers, now a materials scientist at the University of Illinois, was playing around with new ways of making electronics from unusual materials at Bell Labs. He and his colleagues were working on circuits made from organic materials printed on bendable sheets of plastic. One of their projects involved making flexible displays that could curl like paper. While the work was “exploratory” with no defined product, Rogers says, “we thought that was a cool vision for a class of consumer electronics device.”

Flexible displays didn’t move much beyond concept phones and prototypes, but Rogers remained captivated by the idea of flexible electronics. In 2003, he left Bell Labs for Illinois and started his own research lab. “When I finished up in Bell Labs and made the transition back to academics, I decided that kind of form factor was interesting, but maybe something beyond flexible would be even more compelling,” Rogers says. What really interested him, he adds, was “going from flexible—things that bend like paper or plastic—to something that could not only bend but also stretch like a rubber band.”

A flexible display concept

Rogers also wanted to ditch the polymer semiconductors that drove the backplane of Bell Labs’ bendable displays. Their performance was lackluster. Instead, he wanted to make flexible materials that “could potentially support very sophisticated function in electronics—not just an active-matrix backplane, but maybe a real radio or microprocessor,” he recalls.

What, exactly, they would use them for, no one really knew at first.

Rogers’s lab zeroed in on silicon, a well-understood semiconductor that he knew would offer the performance he desired. But traditional silicon doesn’t bend easily. So Rogers’s lab layered single-crystal silicon just a few hundred nanometers thick onto a rubbery substrate. It was thin enough that it wouldn’t break when bent. The next step—stretchability—required some more clever engineering. Rather than alter the silicon substantially, they pulled the rubbery substrate taut before affixing the silicon; releasing the tension caused the silicon to collapse like an accordion, but not break. The result was a device that was both flexible and stretchable, yet it still had retained silicon’s computational potential. But what, exactly, they would use them for, no one really knew at first.

“What I think qualitatively changed for us is that, as we began to give seminars on our work at various universities, various conferences, I began to notice a lot of interest from the medical community,” Roger says. Rather than just building supple gadgets, he and his lab started to think about how computers could interface with the human body. “From that point, the research took on a different tone.”

After that, things started to fall in place quickly, and within five years of moving to the University of Illinois, Rogers was ready to test some of his discoveries in the real world. He asked George Whitesides, his postdoc advisor at Harvard with experience founding companies, for some introductions. Shortly thereafter, MC10 was born.

Quick to Market

The path MC10 has taken is emblematic of the industry as a whole. Their first product is a device called the Checklight. It’s a skull-cap worn under the helmet of athletes in contact sports such as football. There’s a light that sits on the nape of the neck that glows red when a potentially harmful blow strikes the player’s head. It’s relatively simple, and, more important, it’s not regulated by the FDA. That means MC10 could get it to the market quickly while they were getting their other devices approved.

MC10's technology is behind Reebok's Checklight, which alerts athletes to when they've received a potentially dangerous blow to the head.

Many of the other devices sold today are also unregulated by the FDA. That means they can’t make any specific claims related to the device’s function. For example, the red light on the Checklight doesn’t necessarily mean a player has a concussion, just that they should probably take it easy and maybe see a doctor. Other sensors like the Fitbit or older devices like Polar heart monitors also operate in this unregulated space. They give people raw numbers like heart rate, blood oxygen level, or steps taken and leave the medical conclusions to the user.

“Without concrete conclusions, eventually people will get tired of these.”

“That’s a limited set of data,” says Ida Sim, a professor of medicine at the University of California, San Francisco. “That data is really being used for wellness and fitness, which really doesn’t address the bulk of the market, the bulk of people. The value of that data for clinical care is not that high.”

Many companies remain hesitant to draw medical conclusions, though, because it means going through the FDA approval process, just like any other new medical device. Depending on the claims being made, that process can be take anywhere from two to ten years or more.

Given the potential in healthcare, though, companies making wearable sensors will probably be pushed in that direction, says Daniel Oliver, a Blavatnik Fellow at Harvard University who is also working on wearable technology to monitor head impacts. “Eventually people will get tired of these if there’s not concrete conclusions being drawn from whatever sensor you’re wearing.”


Sophisticated sensors like the type I saw at MC10 may be several years from the market, but many scientists are already using off-the-shelf components to monitor our bodies. Harrison Hall is one of them. A PhD student at Dartmouth College, he’s working on a body-scale sensor network to detect and measure epileptic seizures. With enough data, he hopes that we’ll be able to better understand the different types of seizures, maybe even to the point of predict an impending episode.

Decades of research have shown that certain kinds of seizures cause a drop in blood oxygen levels, and Hall hopes to build on that work by taking more continuous measurements across a broader population. Typically, he says, blood oxygen levels are spot checked. “There’s no continuity, and they don’t really take into account what was immediately happening before or post. You lose a lot of information there.” Currently, Hall is testing various sensors, including accelerometers and pulse oximeters, both of which are inexpensive and readily available. Accelerometers would help detect the onset of a seizure, and the pulse oximeters would measurehow the person’s oxygen levels change before, during, and after the event.

A basic pulse oximeter

As his data set grows, Hall hopes to apply machine learning algorithms that will train themselves to pick up on differences between seizures. They could help make some useful generalizations about epilepsy in general. But even if that’s not possible—there are many different forms of the neurological disorder—the algorithms can still draw conclusions about an individual. It could allow for treatments that are tailored more carefully to a person’s specific form of epilepsy.

Hall’s monitor is still years away from widespread availability, but others are already making use of sensors that most of us carry every day. Anmol Madan became interested in what our smartphones can say about ourselves when he was a graduate student at MIT’s Media Lab. “There’s about 5 billion phones on the planet,” Madan says. “It turns out your phone is the ultimate wearable because people are always carrying them, charging them, uploading the data, and all the other things we expect people to do with wearable devices and sensors.”

That got Madan thinking. For many of us, phones are a portal into our world. They see who we interact with and how. They know when we wake up in the morning and when we go to bed at night. And because they’re in our pockets or purses for so much of the day, they can tell how often we move and where we go. That data can paint an incredibly intimate portrait of our lives and, by extension, our well-being.

Madan began playing with different models of human interaction, and he soon realized that with the right observations, he could tell if a person with a history of depression was suffering from an episode. They tended not to communicate with friends and family as frequently, nor did they leave the house as often or move about their home as much.

So Madan devised software that gathers messages, phone records, GPS locations—even accelerometer data—and runs it through a machine-learning model to determine when a person is symptomatic. The software runs in the background on someone’s phone and sends data off to a server where the algorithms reside. If the algorithms suspect a person is suffering a depressive episode, his company,, fires off a notification to a specified person, whether that be a nurse, friend, or family member. The hope is that if those people can intervene at the right time, Madan says, it could prevent the episode from worsening.

Up in the Air

Wearable sensors and the services they power are arriving at a critical time in healthcare, especially in the United States, where the Affordable Care Act is changing how doctors are being reimbursed. The idea is that doctors shouldn’t get paid based on how many visits they squeeze in or how many tests they run, but how well their patients do. “Part of the reason why mobile is interesting is because it intersects the healthcare system at a time of rapid changes and fundamental changes in reimbursements,” says Sim, the UCSF doctor. “Everything is up in the air right now.”

Wearable technology could facilitate that transition, allowing patient outcomes to be tracked over time, efficiently and without frequent, costly follow-up visits with a doctor or nurse. That could help reign in healthcare costs, or at least blunt its seemingly inexorable rise.

Others are hoping that wearables could help us manage chronic illnesses that are prevalent in an aging population. “Patients are spending less and less time with doctors. Diseases that we cannot manage are usually diseases that are chronic and slowly or rapidly degenerative, but diseases that are changing. They’re not static,” says Vicki Sato, a professor at the Harvard Business School and advisor to “As the medical need continues to increase in areas like that, but our patient-physician interface time decreases—we’re going to have to fill that gap somehow or quality of care will certainly diminish.”

Wearable health sensors could provide unobtrusive, continuous monitoring and alert doctors to when a patient's vital signs change.

Whether wearables succeed in making us healthier—and keeping us that way—could depend on how the data is used. Today, information generated by wearable sensors is treated as a competitive advantage by companies. “I really think data is the valuable commodity for a company like Fitbit,” says Oliver, the Blavatnik Fellow. Sensor companies retain massive data sets so they can refine their product and algorithms. Sharing that data with other companies could cost them their competitive advantage. “I can’t ever really imagine them just opening their data up,” Oliver says.

“Mobile is new. There’s no legacy systems, no dominant players.”

But such proprietary approaches could limit how extensively wearables impact healthcare, Sim says. Just look at electronic health records. “In electronic health records, it’s very siloed,” she says. Dominant players hold data very close to their chests. “You can’t share data. We spend billions of dollars trying to get data and share data. It’s just the wrong approach. And yet mobile is new. There’s no legacy systems, no dominant players, even now.”

That’s why Sim helped found Open mHealth, a set of open standards that allows any doctor, patient, or researcher to read data from any device. The goal, she says, is to “break down silos so that data can flow much more freely across different apps and differently solutions.” (Patients, she emphasizes, still have ultimate control over which data is shared with whom.) Sim likens it to TCP/IP, the standards that govern how data flows across the internet and that have enabled its exponential growth over the last several decades.

Market forces outside companies’ control may force some degree of standardization between devices and services. Early health and wellness programs used to issue specific fitness trackers to participants to ensure consistent data, says Greg Norman, a senior research scientist at American Specialty Health, a wellness program company. “Now there’s this whole movement called ‘bring your own device,’ ” he says, which greatly complicates matters. Not only is the data not shareable, it’s not always consistent from one device to another. “You hope that eventually there will be some standards and metrics.”

The tension between proprietary control and open sharing may ultimately dictate the role wearables play in our health and well-being. Closed systems may help drive development early on, but once the market matures, flexibility may win out. “The healthcare industry can’t ignore it, this idea of owning your data, having access to your data, determining who sees your data,” Norman says. “At some point, there has to be consolidation and agreement.” By then, wearables may be so pervasive and inconspicuous that we may not even notice we’re wearing them.

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