Long gone are the days when the idea of "games for health" meant exergaming. The mobile and social world has virtually exploded with a wealth of productivity apps, interactive personal trainers and beyond -- to say nothing of the complex effect the gamification movement has had on the concept of digital games that can help people feel better and do things better. Portable phones now come equipped with GPS and accelerometers that can help people keep track of fitness goals, and reward-oriented game design shows promise in helping people engage with their health goals. But Ben Sawyer, founder of the games for health conference, says there are even more big things about to happen that can create opportunities for game developers. "You're seeing this whole cadre of people rethinking software-based health," Sawyer tells Gamasutra. "They're getting very interested in games, and you're seeing this gamut from apps and apps with gamification through things that are true games." A happy side effect of current venture capitalist interest in game mechanics has been a stronger, business-oriented push into the field. They may be coming from the busines world, "but they're bumping into people who have been working on games for a while," Sawyer explains. The upcoming Games for Health conference, set for June 12-14 in Boston, will convene health, gaming and business professionals looking to explore these synergies. Keynote speakers include Constance Steinkuehler Squire, senior policy analyst for the White House Office of Science and Technology Policy; Bill Crounse, MD, senior director of worldwide health for Microsoft, and SuperBetter Labs' Jane McGonigal. "You're seeing people who aren't grant-based, not research-based, but product people looking at this mass opportunity in health and wellness, and they know games are going to be part of it," Sawyer says. "That's why you see this quick glom-on to gamification... then they have to figure out how to go further." It's game developers that can take intrigued health and wellness companies beyond the sort of participation that comes from imitation or a sense of obligation and into meaningfully-fun experiences that can help people improve their health. A number of wellness and productivity apps -- take the popular Runkeeper for example -- are making APIs available for developers to use, too. In particular, Sawyer is interested in a future for biometric sensors: "I think it's going to be a significant opportunity. It's still one of those things where you can see the pieces of it, but you haven't had that kind of 'aha' moment." Right now, the tech -- sensors like Nike's Fuel band, which provide detailed feedback on fitness and body performance and interface with interactive software -- is a little too cost-prohibitive to create a ton of mass market opportunity, but "it's going to happen," Sawyer says. "If I were [a sensor company], I'd be talking to developers already, saying over and over, 'this is a big opportunity." When you get those costs down, what's going to happen is if we can show that people who wear these bands get healthier because they change their behavior ever so slightly... then the large health companies might step in and start saying, 'okay, we're going to subsidize this.'" Sawyer expects two distinct groups to emerge: Developers doing apps directly, and companies that focus on enabling app economies for game developers. From there, it could only be a matter of time before major healthcare providers look to buy in. The gamification movement is useful in that it offers a starting point for companies from well outside the world of games -- but it can only do that, Sawyer warns. Without a strong, engaging infrastructure, layering game-like qualities on top of things will provide health companies only a temporary blip -- with the downside being that the minimal response might put them off games altogether, or make them believe gaming is a "box" they've already checked. Goal-setting or reward apps are only the beginning, not the sum of the whole. "There's this real ability to present to people what those differences might be, so that's good; one doesnt exist without the other right now," Sawyer says. 
Abingdon, United Kingdom, May 21 2012 – Isansys Lifecare Limited, the provider of complete real-time physiological patient data services and systems, today announces the introduction of its Patient Status Engine™ – the first cloud-based patient digitization and analytic solution for monitoring and predicting the present and future clinical status of patients anytime, anywhere. The introduction of the Patient Status Engine provides the platform for Isansys’ “Vitals as a Service™” solution, which is now offered for priority beta deployments in hospitals and other healthcare facilities. The Patient Status Engine is a complete end-to-end system that integrates wireless body-worn sensors with a cloud-based HIPAA/HL7 compliant Electronic Health Record (EHR), to transform real-time and historical continuous vital sign data into clinical status indicators and prediction tools. With the availability of these new cloud-based indicators and tools, healthcare providers can be notified of any change in a patient’s health status as it happens or predict changes that may happen in the future. This can – more effectively and affordably than ever before – address issues of in-hospital patient safety and avoidable deteriorations and significantly reduce hospital admission times. The Patient Status Engine allows healthcare providers to continue 24/7 surveillance of patients even after they have been discharged from hospital. As a networked and cloud-based system, patients and clinicians may be located anywhere. A further benefit is that a quantified record of a patient’s physiological status is established that can be used for audit purposes or to determine the effectiveness and quality of care. Last month, Isansys announced CE certification for its LifeTouch Patient Surveillance System, comprising the LifeTouch HRV011 intelligent body-worn wireless sensor and associated Patient Gateway – the world’s first cloud-ready medical device of its kind, and the first to be certified as a Class IIa medical device under the European Medical Device Directive (MDD). Today’s Patient Status Engine launch is the extension of the LifeTouch System into the clinical healthcare cloud. The LifeTouch HRV011 sensor performs a key patient digitisation function within the Patient Status Engine, and together with other devices allows healthcare providers to collect five vital signs continuously, wirelessly and in real-time – Heart Rate (HR), Respiration Rate (RR), Blood Pressure (BP), Pulse Oximetry (SpO2), and Temperature (T). The system also analyses the ECG signals to provide the essential data for Heart Rate Variability (HRV) techniques and methods. Other sensors such as accelerometers, weight scales and blood glucose sensors can be easily added to the network. The data from the body worn sensors is transmitted via a patient gateway and LAN or WAN to the cloud-based EHR, which offers a powerful transactional interface to allow multiple and simple configurability and connectivity of incoming and outgoing data. The vital sign data continuously updates the EHR to provide dynamic charting, and is aggregated in the EHR where “apps” run to provide interpreted data and other information to nurses and clinicians (and, eventually, to patients and monitored individuals themselves). A typical “app” is a predictive early warning scores (EWS) algorithm that can be proprietary to the customer or licensed from a third party. The Patient Status Engine is completely scalable. It can either run in a closed cloud allowing a single hospital, regional healthcare organization or HMO to maintain control over patient data; or it can run in a secure large cloud, for instance as a managed service across a whole country. The aggregated and de-personalised data in the database quickly builds into highly valuable Big Data sets for metadata analytics. The EHR platform is being provided by Tolven Corp., developers of a unique open source solution for secure healthcare and life science information. By using an open source model, the Tolven platform provides a low cost and very robust approach that challenges many current paradigms in healthcare IT that rely on proprietary and expensive software. The network architecture, integration with the Tolven platform and the secure server hosting has been achieved in collaboration with Fujitsu. Fujitsu’s plans for a managed healthcare data service comprising secure servers, the Tolven platform and end-to-end connectivity provide global scalability and security for the Isansys Patient Status Engine. Commenting on the announcement, Isansys Lifecare CEO Keith Errey said: “This is a clear demonstration of the power of collaboration, the advantages of the open source approach, and the benefits that can now be realised for patients and healthcare providers around the world. We are very pleased to be working with such great teams at Tolven and Fujitsu. Together, we can really change the game and vastly reduce the costs for healthcare payers by combining the open source Tolven platform, Fujitsu’s open, but highly secure, managed service model and our own low cost, technology-agnostic systems and services. With such outstanding supporting platform technologies, we are delighted to offer Isansys’ Vitals as a Service solution for beta deployment to visionary healthcare providers worldwide.” Rebecca Weir, Isansys Director of Business Development added: “This is a great moment for us. The complete end-to-end system – our Patient Status Engine – demonstrates our commitment to providing the latest technologies and devices to our customers in ways that invert many of the current business models in healthcare, and allow us to offer the benefits of the Patient Status Engine – significantly improved outcomes for patients and cost reductions for healthcare providers – in a simple, affordable service model. We really believe that this will have a fundamental and permanent impact on the way healthcare is structured and practised in the future.” Members of the media interested in scheduling a briefing with Isansys Lifecare, or arranging a one-to-one media briefing with Isansys at the Wireless Life Sciences Alliance Convergence Summit (May 23rd – 24th, San Diego, California), can do so by contacting Nicky Denovan at nicky [at]evokedset[dot]com. About Isansys Lifecare Limited Isansys Lifecare is a new generation healthcare company that provides patient surveillance and monitoring services built on an innovative, low cost and scalable platform We work with leading healthcare professionals, institutes and policy organisations operating in a wide range of healthcare settings, who want to employ new patient monitoring technologies and methods to improve patient outcomes and reduce costs. Isansys’ ‘Vitals as a Service’TM clinical solution provides continuous real-time information for automated patient surveillance, for early warning scores and track and trigger indicators, and for predicting adverse events. Through its low cost and highly scalable architecture, the LifeTouch-based system offers the opportunity for continuous surveillance of all patients regardless of whether they are in hospital, other care facilities, or at home. For the first time, healthcare providers can not only cost-effectively improve patient safety and enhance clinical outcomes, but also massively reduce costs associated with avoidable patient deterioration, medical errors, readmissions to intensive care wards, and admissions (and readmissions) to hospital. About Continuous Patient Physiological Monitoring It is well documented that patients who deteriorate and require admission to critical care or who suffer cardiac arrest, or many other adverse conditions, have abnormalities that are detectable by physiological observations well in advance. Continuous (or nearly continuous) monitoring of multiple vital signs provides the fundamental input for improved patient outcomes and reduced overall costs. In the US alone, remote patient monitoring devices are forecast to reduce healthcare costs by nearly $200 billion during the next 25 years, if more widely used by patients with certain chronic diseases (Source: Center for Technology and Aging Report, May 2010). About Fujitsu Fujitsu is a leading provider of IT-based business solutions for the global marketplace. With approximately 175,000 employees supporting customers in 70 countries, Fujitsu combines a worldwide corps of systems and services experts with highly reliable computing and communications products and advanced microelectronics to deliver added value to customers. Headquartered in Tokyo, Fujitsu Limited (TSE:6702) reported consolidated revenues of 4.6 trillion yen (US$47 billion) for the fiscal year ended March 31, 2009. For more information, please see: About Tolven Tolven based applications are in use in multiple sites in Europe, North America and Asia. The applications incorporate workflow, healthcare information standards, rules, and terminology management, thereby driving the evolution of complete solutions for comprehensive healthcare data collection, secure data storage, and semantic re-use of that data. The Tolven Platform is able to enforce a spectrum of patient consent functionality that fulfills compliance with existing and evolving standards for security and privacy across the globe. The Tolven electronic health record application set has achieved “complete” certification, for both inpatient and physician office venues, from the Office of the National Coordinator for Health Information Technology of the United States Department of Health and Human Services Tolven’s architecture facilitates secure exchange of both identified and de-identified clinical information among all relevant stakeholders (patients, clinicians, providers, insurers, pharmacies and researchers). The incorporation of JBoss Rules allows clinical decision support and analytical activities such as quality assurance reporting, epidemiology and clinical research to occur with minimal effort. The adaptive nature of the Tolven Platform has proven to be essential for gaining acceptance in areas where information technology has traditionally been inflexible, expensive to customize and cumbersome. 
As a flurry of health- and weight loss-focused gadgets and mobile apps flood the market, I.B.M. (International Business Machines), is getting a slice of the pie – the diet pie, that is. After more than 10 years of refining their concept for a program that utilizes data and analytics to help people make better health choices, the company’s patent has finally been approved. The program is very customizable and caters to all diets and lifestyles, and is fashioned around the idea that users can track their food consumption and calories burned to better manage their weight. Once released, the program will be available in a variety of means, including computer, smart phone, and even watch. And it’s primary purpose is to help steer people toward better choices through awareness and incentives. The concept for the program came to be after I.B.M inventor Michael Paolini and a few fellow engineers were eating a greasy meal at Ruby Tuesday’s when they concluded it was their burger and fry diet that was leading to their fuller waistlines. And so, they decided it was time to drop a few pounds. But instead of going it the traditional route, they decided to make it fun – and technical, as engineers do. So, they got to work on a program that not only enabled people to make healthier choices, but also inspired them to do so. What they developed, says Paolini, is a program that was highly influenced by hybrid car technology, which shows drivers what their gas mileage is, and gives them a choice to drive in a way that’s either conducive or in-conducive to better mileage. “It’s that mechanism that empowers the driver to make choices,” he says. “He could still put on the gas and go, but he could also change this technique. That’s the same kind of thing we’re doing here.” In addition to showing users their calories in and calories out – or in a sense, their ‘gas mileage’ – the program also includes incentives if they make positive choices. These incentives or ‘prizes’ include movie tickets and Farmville points, just for using the mobile app. But if companies implement the program for their employees – as they’re expected to – prizes could mean cash or even lower insurance premiums, since healthier employees ultimately cost less. The idea is simple: Incentivizing people to make better choices works. At I.B.M., for instance, employees can sign up for a health program, such as walking, and receive a $200 cash reward if they complete it within a certain window of time. Paolini says this pushes a person to the next step; and once they follow it, it encourages them to take it a step further. In addition to mobile and online apps, I.B.M.’s program will also be available in device form. Paolini says it will be about the size of two watches put together, and users can wear the device on their arm to monitor their metabolism. They can also use it to also enter in the food they eat, and track how many calories they’re burning during exercise. Having the device constantly available allows users to track their calories in and out, giving them more control over their everyday choices, weight, and ultimately, their health. ”With this feedback, it’s easier to change your behavior,” says Paolini. “Because without it, you’re left guessing what your progress is.” Another benefit of the program is that it’s in near real time, which means information is almost up to the second and incredibly accurate. However, Paolini recognizes that, as with any other diet tracking program, there’s no guarantee that people will be honest about what they eat when using the I.B.M. program. It has to be built on trust, he says. Ultimately, it’s up to the individual utilizing the program. “You can strap an ankle bracelet on people if you really cared to, but I don’t think people would do that voluntarily.” Still, Paolini is hopeful that the program will help bring about positive changes, both individually and corporately when it comes to people’s daily choices. Paolini himself used the program to lose 18 pounds, so he’s incredibly confident in its potential. As of yet there’s no official launch date, but we can expect the new program and mobile app to be available in the near future. 
The United States Food and Drug Administration is considering approval of the first over-the-counter HIV test that would allow people to test for the virus at home, quickly and without medical supervision. FDA reviewers say the OraQuick In-Home HIV test could play a significant role in slowing the spread of HIV, according to briefing documents posted online. They have also raised concerns about the accuracy of the test, a mouth swab that returns results in about 20 minutes. The review comes one day after an FDA advisory panel endorsed the HIV pill Truvada for preventive use. If the FDA follows the panel's advice, the daily medication would become the first drug approved to prevent healthy people becoming infected with the virus that causes AIDS. Advertisement: Story continues below Public health experts estimate a fifth, or about 240,000, of the 1.2 million HIV carriers in the US are not aware they are infected. Testing is one of the chief means of slowing new infections. In a trial conducted by the company, OraSure Technologies Inc, the test correctly detected HIV in those carrying the virus 93 per cent of the time. The FDA recommend a 95 per cent threshold for accuracy. The FDA estimates the test would miss about 3800 HIV-positive people per year, if approved for US consumers. The test was more accurate at correctly clearing patients who do not have the disease. In company studies, OraQuick correctly identified HIV-negative users 99 per cent of the time. In their briefing documents, FDA scientists note both the benefits and risks of expanding HIV testing with the take-home diagnostic kit. ''There is considerable personal and public health value in informing infected, but otherwise untested, persons of their true positive HIV status,'' the reviewers stated on Friday. ''However, this benefit is offset in some measure by HIV-positive individuals who receive an incorrect message that they are not infected.'' On Tuesday, the FDA will ask a panel of outside experts whether the test should be approved for over-the-counter sales in the US. The agency is not required to follow the group's advice, although it usually does. Based in Bethlehem, Pennsylvania, OraSure has marketed a version of OraQuick to health care practitioners since 2004. The test sells for $US17.50, though OraSure declined to discuss the price of the consumer version. 
Background: The use of mHealth apps has shown improved health outcomes in adult populations with type 2 diabetes mellitus. However, this has not been shown in the adolescent type 1 population, despite their predisposition to the use of technology. We hypothesized that a more tailored approach and a strong adherence mechanism is needed for this group. A team of researchers from the University of Alberta in Canada has developed a new DNA analysis system capable of performing up to 20 simultaneous tests. The system, dubbed the Domino, uses polymerase chain reaction technology to amplify and identify specific DNA sequences. Like many point of care diagnostic technologies, the Domino consists of a bench top unit and a disposable microfluidic cartridge containing an array of twenty gel posts. Each of the posts acts as a separate interface to a single sample of blood allowing several genetic tests to be performed simultaneously. The Domino may be used to screen for specific diseases or to determine genetic resistance to particular medication. Prof. Linda Polarski, an experimental oncologist who has been leading the research team explains the advantages of the Domino System: “With most cancers you want to treat the patient with the most effective therapeutic as possible”. “That’s what this does: it really enables personalized medicine. It will be able to test every patient at the right time, right in their doctor’s office. That’s currently not feasible because it’s too expensive.” The Domino system has been licensed by Aquila Diagnostic Systems, a local nano-tech start-up company. The “toaster-sized” desktop unit is expected to cost in the order of $5,000 with the cartridge chips costing just a few dollars each. To date the Domino has been used in a number of published studies demonstrating the efficacy of the system.The Domino chip is capable of performing 20 genetic tests from a single drop of blood. Video courtesy of Alex Stickel.v Researchers from the University of Auckland in New Zealand just published promising results of a study comparing a video game they designed to help treat depression in teenage kids against traditional face-to-face counseling. Called SPARX, the game guides the players through a number of challenges that help practice handling various life situations and emotions that come with them.The study, published in the latest issue of BMJ, has shown that the game was at least as effective as counseling in helping treat depression and anxiety in a study group of kids averaging 15 years old. More about the game from the developers: It uses a 3D animated game environment and a custom-made soundtrack to engage young people and teach them skills to manage symptoms of depression, in a self-directed learning format. Users are able to customise their avatar and journey to seven Provinces, each with a unique set of challenges and puzzles. The Guide explains how the skills in the game relate to the challenges a young person may face in the real world. Young people learn cognitive behavioural therapy techniques for dealing with symptoms of depression (e.g. dealing with negative thoughts, problem-solving, activity scheduling, relaxation, etc). It can be used with minimal oversight. For people who are both deaf and blind, communicating with other people can pose an interesting challenge. Usually, this is done using tactile methods, such as signing onto the palm of another person’s hand. But what happens if a blind and deaf person needs to communicate with someone that’s not immediately next to them, or they want to utilize technologies such as text messaging and email?The Design Research Lab in Germany has developed the Mobile Lorm Glove, a special glove that will help facilitate high-tech communication for deaf-blind people. The concept is simple, yet effective: the palm of the glove is covered with tactile pressure sensors in which the user composes a message using the Lorm Deafblind Manual Alphabet, a universal language for the deaf-blind that involves touching and sweeping various parts of the hand to correspond with letters of the alphabet. As the message is composed, a built-in Bluetooth antenna sends the message to the user’s phone, from where it can be sent to a recipient in the usual ways. However, since communication should be a two-way street, the Mobile Lorm Glove can also receive messages via Bluetooth, which are sent to a number of vibration motors on the back of the glove for the user to decode using the Lorm alphabet. In this manner, users can communicate with other Mobile Lorm Glove users, as well as anyone else with a phone. Besides being a communication device, the Mobile Lorm Glove could also change the ways that deaf-blind people can learn, as any digital medium, such as e-books or audiobooks, can be “felt” by the user. Here’s a video explaining the concept: 
In the largest collaborative study of the brain to date, scientists using imaging technology at more than 100 centers worldwide have for the first time zeroed in on genes that they agree play a role in intelligence and memory. Scientists working to understand the biology of brain function — and especially those using brain imaging, a blunt tool — have been badly stalled. But the new work, involving more than 200 scientists, lays out a strategy for breaking the logjam. The findings appear in a series of papers published online Sunday in the journal Nature Genetics. “What’s really new here is this movement toward crowd-sourcing brain research,” said Paul Thompson, a professor of neurology at the University of California, Los Angeles, and senior author of one of the papers. “This is an example of social networking in science, and it gives us a power we have not had.” The genes, which influence elements of brain size, may have subtle effects on how people think and behave, though many other factors, including education and general health, play a role in intelligence and could easily offset the effect of any single gene. Still, size matters, in brain research at least as much as in brain function. “I like this work a lot, because these guys finally did what needed to be done to take a real stab at merging imaging and genomics,” said Dr. Matthew W. State, a professor of psychiatry at Yale, who was not one of the collaborators. Brain imaging studies are expensive and, as a result, far too small to reliably tease out the effects of common gene variations. These effects tend to be tiny, for one thing, and difficult to distinguish from the background “noise” of other influences. And brain imaging is notoriously noisy: not only does overall brain size vary from person to person, for instance, but so do the sizes of specialized brain regions like the hippocampus, which is critical for memory formation. To solve the numbers problem, Dr. Thompson and three geneticists — Nick Martin and Margaret Wright, both of the Queensland Institute of Medical Research in Australia, and Barbara Franke of the Radboud University Nijmegen Medical Center in the Netherlands — persuaded research centers around the world to pool their resources and create one large database. It included genetic and extensive brain imaging results from about 21,000 people. The team then analyzed the collective data to see whether any genes were linked to brain structure. As the study was being completed, the Thompson group learned that another consortium, led by Boston University researchers, was doing a similar analysis using its own large group. The two teams’ findings did not completely line up. One found size-related genes that the other did not. But they agreed on two findings: one gene that correlated strongly with overall brain size, and another that correlated with the rate at which the hippocampus atrophies, or shrinks, with age. People who carried one variant of the overall-size gene had brains that were about 1 percent larger than those of people who carried another variant. The two variants are equally distributed — about half of people have one and half have the other. In a separate analysis in Australia, Dr. Martin and Dr. Wright found that size correlated with I.Q. People with the larger brains scored slightly higher on a standardized test. The results are all averages, meaning that they hold for the group but say nothing about any individual. (Some very smart people have relatively small brains.) The collaborators also found that about 10 percent of people carried a gene variant that correlated with a slightly accelerated rate of atrophy in the hippocampus. The hippocampi — there are two, each deep in the brain, one in the right side and one in the left, about level with the ears — are needed to form new memories. People with dementia often show pronounced atrophy in this region. The study was not set up to find a link between the gene variant and dementia, but experts suspect a connection. The collaboration is not likely to lead to new treatments any time soon, the authors said, and, as always, the findings will need replication before they are conclusive. It is more a beginning than an end, and it illustrates how far the field has to go to get any real traction — and what it will take. “It means sharing your data, pooling everything,” Dr. Thompson said, “and this is not usually how scientists work.” Although health care organizations deal with many types of government and professional regulations, as adoption of electronic health records (EHRs) progresses, they also need to form policies of their own to secure patient data, according to an April 11 report from HIMSS Analytics and Kroll Advisory Solutions, a provider of IT security. HIMSS Analytics performs analysis of IT processes in health care and is a division of the nonprofit Healthcare Information and Management Systems Society (HIMSS). For the study, HIMSS interviewed 250 health care industry professionals, including senior IT executives as well as compliance and security officers. Kroll provided funding and expertise for the research, which was performed in December 2011. Health care organizations have turned to government guidelines on security, but they need their own security measures as well, Brian Lapidus, senior vice president for Kroll, said in a statement. These government security guidelines include the 1996 Health Insurance Portability and Accountability Act (HIPAA) and the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act, which made penalties for data breaches more severe. Lapidus said the combination of compliance and proper security measures are beneficial in the same way as nutrition and exercise. "The magic happens when the two overlap," said Lapidus. "Evolving threats will always outpace even the most thorough regulatory requirements," said Lapidus. "For that reason, organizations will need to constantly assess their security risk levels and evolve their policies and procedures to ensure that they are in the best possible position to protect their patients and their bottom lines." The HIMSS report follows news of a Medicaid data breach at the Utah Department of Technology Services (DTS). The March 30 incident involved potential exposure of data for about 780,000 citizens when a hacker in Eastern Europe broke into a server at DTS. "The Utah data breach is an example of human error, because as reported, the server did not have a secure password," Lisa Gallagher, senior director of privacy and security for HIMSS, wrote in an email to eWEEK. "Any server or other data warehouse with patient health information must be securely protected." Meanwhile, 31 percent of respondents in the HIMSS/Kroll study considered mobile devices to be a top threat for health care data breaches. "The expanded use of mobile devices offers new operational efficiencies and increased vulnerabilities," said Gallagher. "Security steps for mobile devices should be included in the action plans so that guidelines are set." A large number of health care breaches reported to the U.S. Department of Health and Human Services were also due to portable devices, Gallagher noted. Human error by employees was a major factor in health breaches, according to respondents. Of the respondents, 79 percent said security breaches were initiated by an employee, and 56 percent said breaches occurred because employees had unauthorized access to information. "Human error in health care delivery has impactful consequences when it comes to security," said Gallagher. "Training employees on security measures and implementing the proper security protocols are basic steps to take, but also, are often overlooked." Despite the policies that need to be implemented, 85 percent of respondents say their health care organizations update their security action plan regularly. Methods to secure patient data include hiring practices, background checks and minimizing data access, said Gallagher. 
Healthcare in the U.S. is largely a mess thanks to unfit citizens, underinformed doctors, and confounding and inefficient processes. Here's a slew of innovative companies working to change all that.
GAIN Fitness 
Sanofi has launched an iPhone-compatible device in the UK it hopes will give the pharma company an edge in the tough blood glucose monitoring market. The iBGStar is the first blood glucose monitor to sync with the iPhone and iPod touch, and the first that allows users to input their own data and notes via a specially designed app. It costs £48 (about €57) and will be available exclusively through the Boots chemist chain, while Sanofi’s separate, standalone BGStar device, which is also launched today, will be available for free from healthcare professionals. Jason Lovatt, Sanofi’s brand lead for BGStar and iBGStar, told PMLiVE: “BGStar is similar to other products on the market, in that it’s a standalone separate device to measure blood glucose levels and it has a very competitive feature set. “The BGStar is a key piece of kit, but where the real innovation comes in is with the iBGStar, which connects to an iPhone and allows you to do a lot more with your results.” Acting as an electronic log book, the iBGStar’s Diabetes Manager app allows users to input specific notes against the readings, such as recording carbohydrate intake, insulin use or other factors that may help them understand their results. Information also can be shared via email with healthcare professionals and family members, The iBGStar also comes with additional support services, including a 24-hour freephone diabetes care line, a comprehensive website, patient support materials, a lifetime meter replacement service and free control solution. “It’s about trying to provide more than just the meter, more than just an insulin, and complement them with things that help people manage and handle their diabetes," Lovatt said. The product has already been launched in a number of other European countries, including France and Germany, where it has been well received Lovatt said. “Blood glucose monitoring is quite a tough market. There are very good products and well established brands. So for Sanofi to have come into the market and have had some success is a big accomplishment for the company. “What differentiates Sanofi from other companies is the fact that we are an insulin manufacturer as well,” Lovatt said. “The combined approach of looking at someone’s treatment needs with regards to their insulin, and then looking at their monitoring needs and then packaging together some education, that synergy is one of the key things that will differentiate Sanofi from other companies in the market.” Sanofi will use the same salesforce that sells its insulin products to distribute its monitors and demonstrate them to healthcare professionals, in particular diabetes nurses. The iBGStar has a CE mark as a medical device, in which setting it is classified as an accessory, and Sanofi is considering the practicalities of producing an Android version of the device, where the challenge will be working with smartphones that lack Apple’s standard connection slot. 
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. |
Using mobile phones to report malaria outbreaks in Africa has been stunningly effective — reducing the government response time to an outbreak from four weeks to three minutes, according to a new report. HP, along with partners Positive Innovation for the Next Generation (PING) and Clinton Health Access Initiative (CHAI), and mobile network provider MASCOM, announced the results of the first year of a mobile disease response pilot program last week. “We see technology having a profound impact on disease surveillance, which has a highly antiquated process,” says Paul Ellingstad, HP’s director of global heath. According to Ellingstad, it can take three to four weeks to send a list of sick patients to a district health clinic and then to the Ministry of Health of a respective country. Electronically automating disease surveillance speeds up the communication time to three minutes, meaning the government can immediately send bed nets and and alert citizens to take precautions. Some 1,068 notifications were reported to Ministry of Health officials since the program first rolled out in June 2011 in Botswana’s Chobe region. Healthcare workers have been trained to use mobile devices to collect malaria data and report outbreaks to authorities. The collected data is then plotted on a geo-tagged map, providing health workers context for their responses. Using the program’s technology, 89 potential outbreaks were identified during the pilot year. Speed isn’t mobile’s only advantage to the dated paper process. Ellingstad says reporting potential cases of malaria has increased from about 20% to 93% compliance. “This is an example of the role technology can play in fundamentally transforming and improving existing programs within the public health sector,” Ellingstad says. “What’s critical in doing so is partnering with governments and other leading NGOs to appropriately implement technology, rather than providing technology and letting the process sort itself out.” HP and CHAI have also started working with Kenya’s Ministry of Health and are in talks with Mozambique’s government to continue their expansion. Kenya’s government is already using the platform to track the spread of 11 diseases, including malaria. Botswana’s government hopes to add another 16 diseases in the near future. HP and PING plan to open another 20 health facilities in Botswana by June 1 and an additional 80 by October 2012. In August, the program will begin tracking other diseases, starting with multi-drug resistant tuberculosis. PING, a Botswana-based NGO, plans to develop a game-like mobile phone tutorial, to ease the training of new health workers. When it comes to future uses of mobile phones in public health, Ellingstad says he feels like the sky’s the limit. “Mobile phones in the health space feels like the Internet and e-commerce in 1994 and 1995,” he says. “Right now, we know it’s a connection point, since 5.7 billion people have access to a mobile phone. With that sort of pervasiveness, you can provide health information, education and prevention to millions at risk of death.” 
Last week, the Bill and Melinda Gates Foundation announced its latest round of grant winners for its Grand Challenges Explorations initiative. Among the recipients is a team from the University of California, San Diego and University of Illinois at Urbana-Champaign that is developing a tiny, flexible fetal monitor. We wrote about the technology behind the device back in August and were able to hear from David Icke, CEO of MC10, the company helping to commercialize it, at both FutureMed in February and at last month’s TEDMED conference. Described as an electronic “tattoo”, the device is a wearable patch of circuits, sensors, and wireless transmitters that sticks to the skin like a temporary tattoo and is able to stretch and flex with the skin. The researchers hope that the final product will continuously measure and monitor uterine contractions, fetal heart rate and oxygen, and maternal heart rate and body temperature. According to Todd Coleman, professor of bioengineering and head of the project, the device is unique because of its ability to continuously check a number of different measurements in an unobtrusive manner. Moreover, the device will work well in developing countries that lack sufficient healthcare access, but have high mobile phone usage, as it will transmit data wirelessly to a cellphone and on to the cloud to be viewed by physicians far away. Be sure to read about some of the other grant winners here. There’s a lot of neat research being done in the areas of vaccines, synthetic biology, and global health. 
As AT&T continues to expand its services into the telehealth market, the company has signed an agreement with Valued Relationships Inc. (VRI) to deliver a remote patient monitoring service to more effectively manage chronic diseases and help reduce hospital readmissions. The end-to-end managed service is scheduled to launch in the third quarter of 2012.
Patients receiving telemonitoring along with high blood pressure management support from a pharmacist were more likely to lower their blood pressure than those not receiving extra support, according to research presented at the American Heart Association's Quality of Care and Outcomes Research Scientific Sessions 2012. "Patients with high blood pressure visit physicians an average of four times each year, yet blood pressure is controlled in only about half of U.S. patients," said Karen Margolis, M.D., M.P.H., the study's lead author and director of clinical research of HealthPartners Research Foundation in Bloomington, Minn. "We looked at how the addition of a pharmacist-led, at-home telemonitoring program might improve patients' blood pressure control." Margolis and colleagues studied 450 patients with uncontrolled high blood pressure. Approximately half (222) of the patients were assigned to traditional care through their primary care providers. The other half (228 in the intervention group) saw a primary care provider and received additional high blood pressure management and telemonitoring support from a pharmacist. The intervention patients measured their blood pressure at home and sent the readings electronically to a secure website. Participating pharmacists accessed the information and consulted the patients every two to four weeks by phone. All 450 patients came to a special research clinic to have their blood pressure measured at the beginning of the study, and 403 of them were seen again after six months, Margolis said. The researchers found:Six months into the study, 45.2 percent of participants in the traditional care group and 71.8 percent in the telemonitoring intervention had reduced their blood pressure to healthy levels under 140/90 millimeters of mercury (mm Hg) in most patients, and under 130/80 mm Hg in those with diabetes or kidney disease.Blood pressure decreased more in the telemonitoring group. At the start of the study, patients' blood pressures averaged 148/85 mm Hg. At six months, the average was 126/76 mm Hg in the telemonitoring intervention and 138/82 mm Hg in the traditional care group.Patients in the telemonitoring group received more high blood pressure medicines after six months than patients in the traditional care group.Patients in the telemonitoring group reported that they were better at remembering to take their medications consistently than those in the traditional care group. "These early results suggest that home blood pressure telemonitoring with extra telephone care by a pharmacist was very effective in improving blood pressure control," Margolis said. "If these early results can be sustained over the long run, it might decrease the number of patients who suffer heart attacks, strokes or other complication of high blood pressure." Margolis and colleagues are continuing to follow these patients to determine the effects of the intervention for the longer term. The study participants were health-conscious, so results might be different for a less motivated group, Margolis said. 
Giving cheap smartphones to patients living in remote and rural areas has been suggested as a way of providing faster and more cost effective care. App designer Geoff Wilcock told BBC Radio Scotland's Out of Doors programme it would give people access to software that could be created for the NHS. Mr Wilcox said apps could aid in consultations and cut waiting times. The Scottish Centre for Telehealth and Telecare said patients expected greater use of technology. Highlands and Islands Enterprise (HIE) held a workshop on mobile phone applications last month. The agency said that by 2014 it was expected that some 77 billion apps will have been downloaded from the Android and Apple phone markets. Mr Wilcock, who took part in the workshop, said the NHS could provide patients with low-cost smartphones. He said: "I am a diabetic and I quite easily sympathise with anyone who has to go on a two to three hour trip for a 20 minute meeting with a clinical nurse, or a doctor. "Very expensive or valuable clinicians are also driving out for long periods to spend equally short times with the patient." Mr Wilcock said some of the journeys could be avoided by conducting consultations using apps. "If someone provided me with an application to fill out with information that will mean you will get treated in three weeks, or you can do it the other way which is three months, I know which I would choose." Dwynwen Hopcroft, from Connecting Carers, said it was looking at a number of ideas for apps that would help carers better understand services available to them and the people they look after. Anne Reoch, of the Scottish Centre for Telehealth and Telecare, which is part of NHS 24, predicted the use of apps by the health service would become increasingly important. She said: "People expect it and want it. They go into banks, things are run very efficiently technically. You go into other services that the public use on a regular basis and things are run by technical means. We do expect it." 
Illumina has launched the MyGenome iPad app, an app which visualizes the human genome. It allows you to explore a real human genome and view reports about important genetic variations. In its current iteration it acts mainly as an educational tool, however in future version Illumina foresees it becoming a clinical tool for use by physicians with their patients to improve communication of genetic data. The MyGenome app features an actual genome, a genome Map, health cards and reports and a video journey into the genome. The included genome belongs to Illumina’s own CEO Jay Flatley. More interestingly however, in future versions it will be possible to explore your own genome after you have had your genome sequenced by Illumina’s Individual Genome Sequencing service. Illumina plans to deliver genetic data first to the ordering physician via the app, providing direct access to the consumer only after the doctor has discussed the result with the consumer. The app is available for $0.99 from the Apple app store. In other news, Illumina has also introduced BaseSpace Apps, a dedicated applications store for its BaseSpace genomics cloud computing platform. A publicly available API allows developers to create and deploy new applications for the analysis of genetic data generated on Illumina systems. With the application store, Illumina wants to provide users with an ecosystem of genome analysis tools from the world’s leading bioinformatics vendors to analyze, understand and make use of the massive amounts of genetic data they generate. 
The multinational medical device industry has a "good" or "excellent" corporate reputation, according to 52% of patient groups responding to a new survey. In comparison, just 40% hold this view about pharmaceutical companies. In fact, this level of endorsement of the device industry's reputation places it, in the eyes of patient and patient groups, above all other healthcare sectors apart from retail pharmacists, says the independent study, which was funded by PatientView. However, the report also reveals that only 33% of responding patient groups believe the reputation of the medical device industry has improved during the past five years, with 32% considering that its reputation has declined over the period. The study defines "corporate reputation" as the extent to which medical device companies are meeting the expectations of patients and patient groups. 64% of respondent patient groups said that the device industry is "good" or "excellent" at being innovative, and 57% held this view about how the industry ensures patient safety. On other measures of the industry's performance, the percentages of patient groups holding this positive view were: - practising ethical marketing, 32%; - being transparent with external healthcare stakeholders, 30%; and - adopting fair pricing practices, 22%. The survey also looks at which individual companies in the sector have the best corporate reputations from the patient perspective. The clear winner is Coloplast, which the groups judged to be best on all the following six indicators: - whether the company has an effective patient-centred strategy; - the quality of the information which the company provides to patients; - its record on patient safety; - the usefulness of the firm's products to patients; - its record of transparency with external healthcare stakeholders; and - whether the company acts with integrity. Medtronic takes second place for how it performs against the six indicators, and Smith & Nephew is third, with Roche Diagnostics fourth and Abbott and Johnson & Johnson in joint fifth place, according to the survey, which polled 300 patient groups drawn from 42 countries across the world. PatientView comments that some of the larger device companies did not score well with the patient groups, and also that the findings "make relevant reading in light of the European Commission's call on February 9 for immediate action by national governments to 'tighten controls, increase surveillance and restore confidence' in the distribution of medical devices."
As we reported in our Mobile Health: State of the Industry Q1 2012 report, the FDA cleared SHL Telemedicine’s Smartheart device, which is meant to be used by consumers to send their own 12 lead ECG data to a physician from the device. Smartheart transmits the ECG data to the user’s mobile phone via Bluetooth.According to the company, “the Smartheart is a personal, hand-held battery powered, 12 lead ECG and rhythm strip device with Bluetooth connection. The Smartheart acquires ECG data via attached electrodes. The Smartheart transmits the data in real-time to a suitable Bluetooth communication device for forwarding it to a remote location and a certified medical professional capable of interpreting the results.” Here’s how the FDA 510(k) summary describes the intended use cases for SHL’s device: “The Smartheart device is intended to condition an electrocardiographic signal so that it can be transmitted digitally via Bluetooth technology and cellphone or communication device to a remote location. The Smartheart device is designed to be used by a patient to transmit a 12 lead ECG and rhythm strip in real-time to enable review at a physician’s office, hospital or other medical receiving center.” SHL’s Smartheart device gained attention in the press after a demonstration at TechCrunch’s Disrupt event last year. At the time the company expected to sell the device for about $500 and an accompanying data analysis service that includes reports and medical advice would carry an additional subscription fee that the company said would cost “way” less than $20 each month. While SHL’s device does include a 12 lead ECG, it is much more expensive than the more widely known (single lead) AliveCor iPhoneECG, which is not yet FDA cleared. The AliveCor device is expected to retail for about $100. As we reported in February, AliveCor expects to secure its CE Mark soon.
By: Brian Dolan
Earlier this year Accenture published a report, Connected Health: The Drive to Integrated Care, that analyzed the results of a survey of 3,727 physicians in eight countries. Accenture interviewed 500 physicians from Australia, Canada, England, France, Germany, Spain and the US, and about 200 in Singapore. Within the report’s almost 300 pages are a number of findings, but most of the discussion around mobile health is focused on patient engagement.“In terms of technologies that directly engage patients, the US is relatively well progressed compared with the other countries surveyed,” Accenture wrote. The firm found that about 17 percent of US physicians said that their patients had electronic access to their medical information, while physicians in the other countries surveyed are “far behind in this area,” according to Accenture. About 25 percent of the US physicians said that their patients can see health-related information from their medical records during consultations and they can use online or mobile tools to communicate with them or refill prescriptions. About 17 percent of the US physicians also said their patients can electronically book, change, or cancel appointments. Some 19 percent said their patients receive electronic reminders for follow-up care. About 21 percent said their patients can access health information and education for chronic condition management. Overall, however, digital health tools for chronic condition management are lacking, Accenture found. “Progress toward remote monitoring of patients with chronic conditions is relatively limited in the US (and indeed across all countries), with only 8 percent of physicians stating that their patients can use telemonitoring devices to monitor and record their own health indicators and remotely inform physicians of their conditions,” the firm wrote. In February a small consumer survey conducted by HIMSS and sponsored by Qualcomm Life found that a majority of consumers in the US are familiar with the term remote monitoring device, but only a quarter of those surveyed reported using one before. What’s more: Only 16 percent had heard about such devices from their healthcare provider. Accenture does predict more sophisticated mobile health apps in the future: “Several developments already point the way. New, independently developed, mobile healthcare ‘apps’ are giving people the tools to eat well and live well, and to begin managing their own healthcare needs. Industry data suggests that this will be an area of huge expansion over the coming years, embracing the potential of more powerful smartphones, tablet PCs and cloud capability.” A report over at RCRWireless quotes Health 2.0 founder Matthew Holt who points out that Accenture did not survey physicians in some of the more advanced health IT markets: Denmark, New Zealand, Norway, and the Netherlands.
An initial study of the iPhone ECG – which we’ve covered since its popular YouTube video was released last year – was presented at this past week’s American College of Cardiology 61st Annual Scientific Sessions in Chicago. The highly anticipated device is pending FDA approval, though questions have abounded about how exactly it will be applied. For example, will it predominantly be used by patients, emergency responders, and/or clinicians, and what diagnostically useful information can be obtained from it? Entitled “iPhone Rhythm Strip: Clinical Implications of Wireless and Ubiquitous Heart Rate Monitoring,” the new 8-week study enrolled 54 participants and has begun to answer these and many other questions. According to the company: After using the device, 24 percent of subjects reached out to their private physicians for a consultation and 16 percent felt that they discovered a health condition previously unknown to them. Seventy five percent of participants requested continuation of the device usage after the eight week study period. Thirty-three percent felt that they were more health conscious after participating in the study and 88 percent thought that the device was transmitting accurate information. Participants indicated that they found the portability, ease of use, and the form factor to be key aspects of the device that were most conducive for use. “The study provided us with important information required to optimize the device for physician and patient application,” commented Dr. [Leslie] Saxon. “This device incorporated into smartphones and tablets provides physicians and their patients with a clinical-quality, low cost heart monitor that will increase the global availability of advanced cardiac monitoring.” We reached out again to the device’s inventor, Dr. David Albert, and he provided the following anecdotes of how the iPhone ECG has been used: “We have diagnosed ventricular tachycardia in a previously asymptomatic 35-year old man. We have diagnosed a new case of Wolff-Parkinson-White syndrome in a 41-year old man, who is now being ablated. We have diagnosed paroxysmal supraventricular tachycardia in a 20-year old college athlete who had been blown off by her coaches. We have diagnosed Atrioventricular Nodal Reentry Tachycardia in a 17-year old congenital heart patient who was not diagnosed after a 2-week Holter study. And we have diagnosed silent ischemia. Dr. Eric Topol has diagnosed an acute ST Elevation myocardial infarction on a plane, forcing it to land. Now you must understand that we have not used our device in more than a couple of hundred people so this diagnostic yield is incredible!” Dr. Albert also sent us the abstract of the study, which we’ve included below: Poster 1247-575 iPhone Rhythm Strip – the Implications of Wireless and Ubiquitous Heart Rate Monitoring Leslie A. Saxon, Alexandra Smith, Sona Doshi, Jessica Dinsdale, Dave Albert, University of Southern California, LOS ANGELES, CA, USA Background: Wireless technologies enable transmission of high quality ECG recordings without the need for leads. A device incorporating electrodes into an Apple iPhone case allows for wireless recording of 30-second rhythm strips (LEAD 1) to the cloud (AliveCor, Okla. City, OK). ECGs can be downloaded for immediate interpretation using any browser. Methods: iPhone-owning attendees of a Body Computing Conference at USC participated in an 8-week study to determine how they utilize the device. Results: A total of 54 participants (43+/- 11 yrs, 77% male, 15% physicians, 61% business, 13% media/entertainment, 11% engineers) transmitted 36+/-53 30-second recordings weekly (range 3-298) for 8 weeks. Without training, subjects used the case to record ECG’s on themselves and others (61%). Transmission interpretation was normal sinus rhythm (68%); sinus brady or tachy (16%), extra atrial or ventricular systoles (2%), QRS delay (1%); and noise (13%). Symptomatic ventricular tachycardia and asymptomatic ST segment depression were detected in 2 participants, the latter in Mumbai, India (Figure 1A, B). Conclusion: Anytime ECG monitoring, as an adjunct to a smartphone is intuitive and allows users to learn about and characterize their heart rates & rhythms. It provides global identification of arryhythmias at any time. The implications of this technology for improving public awareness of health metrics and for the early diagnosis of arryhthmias are enormous. ![Doctors Believe Using Health Apps Will Cut Down on Visits [INFOGRAPHIC] | Mobile Healthcare | Scoop.it](http://img.scoop.it/kNE_MnDkrJzyeZe6bgottzl72eJkfbmt4t8yenImKBVaiQDB_Rd1H6kmuBWtceBJ)
Many doctors believe that using apps that keep track of your health will help cut down on doctor visits, a new infographic suggests.According to data revealed by Float Mobile Learning, 40% of doctors believe that using mobile health technologies such as apps that monitor fitness and eating habits can reduce the number of office visits needed by patients. About 88% of doctors are in full support of patients monitoring their health at home, especially when it comes to watching weight, blood sugar and vital signs, and many believe consumers should take advantage of the apps currently on the market to help along the process. “With the forthcoming changes to the U.S. healthcare system, there will be an increased focus on wellness programs and preventative medicine,” Chad Udell, managing director of Float Mobile Learning, told Mashable. “Mobile health offers a tremendous opportunity for people to become more involved in their own health and wellness.” It’s no secret that the mobile health industry is growing. There are more than 10,000 medical and healthcare apps available for download in the Apple App Store, making it the third-fastest growing app category among iPhone and Android users. Doctors are also getting in on the trend, as 80% said they use smartphones and medical apps. Physicians are also 250% more likely to own a tablet than other consumers. Udell noted that doctors continue to buy tablet devices in droves largely because they offer an easy way to stay in touch with their co-workers and patients. The infographic also noted that 56% of doctors said they turn to mobile devices to make faster decisions, and 40% said it reduces time spent on administration work. SEE ALSO: iPad Credited With Saving Man’s Life “It will be interesting to see the impact of the new iPad on medical imaging professionals such as radiologists, who will be able to take advantage of its great graphic capabilities,” Udell said. Among some of the most popular apps are Nike Plus — which turns a smartphone into a personal trainer — and iStethoscope that allows iPhone users to record and play back a heartbeat. Meanwhile, Welldoc is a series of programs and apps that can reduce hospital and ER visits in half by having patients monitor and manage their own chronic diseases. Do you use any mobile health apps? Will apps play a big role in the future for the health industry? Let us know your thoughts in the comments. Studying math while blind is a difficult proposition because many concepts are visually represented using charts, graphs, and other methods. To help address this problem, Engineers at Vanderbilt University have developed an Android app for touchscreen tablets that essentially turns visual objects into tactile ones. When the user touches a line or other object on the screen, the program activates the built-in vibrator so that the object can be felt. |
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