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Mobile Healthcare
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 | Scoop.it

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.

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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 | Scoop.it
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.

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Which telemedicine model will triumph?

Which telemedicine model will triumph? | Mobile Healthcare | Scoop.it

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.

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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.

Read more: http://medcitynews.com/2014/08/telemedicine-model-will-triumph/#ixzz3A9ptqfmT

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Sensors And Sensitivity

Sensors And Sensitivity | Mobile Healthcare | Scoop.it

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
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Rowan Norrie's curator insight, August 5, 6:13 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 | Scoop.it

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


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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.

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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.

Read more: http://medcitynews.com/2014/06/12-digital-health-companies-get-huge-shout-apple-new-ad/#ixzz35XnIkdmi


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Andrew Spong's curator insight, June 23, 5:08 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 | Scoop.it

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.”

Off-the-Shelf

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,Ginger.io, 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 Ginger.io. “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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The Next Fitbits Uncovered: Heart-Rate Sensors, GPS Info, Atmospheric Tracking, And Smartphone Notifications | TechCrunch

The Next Fitbits Uncovered: Heart-Rate Sensors, GPS Info, Atmospheric Tracking, And Smartphone Notifications | TechCrunch | Mobile Healthcare | Scoop.it
The Fitbit product line is looking a little stale especially after the recall of the Fitbit Force. But that's seemingly about to change with the addition of..

Via Tictrac, Lionel Reichardt / le Pharmageek
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Lilly launches depression information app - PMLiVE

Lilly launches depression information app - PMLiVE | Mobile Healthcare | Scoop.it

Lilly UK has launched a new mobile app to help patients with depression better manage their condition through improved communication with healthcare professionals.

The new Talking Progress iPhone and Android will also act as an interactive and informative tool for use between appointments that allows patients to record their moods and take notes in preparation for a visit to their doctor.

Alan Lenox Smith, a spokesperson for Lilly Medical, said: "Talking Progress was developed to address a need within the management of depression; communication. 

"By taking advantage of the growing demand for innovative channels, we were able to create an interactive tool which allows patients to be active participants in their recovery through understanding their symptoms and improving communication with their healthcare professional."

The number of people with depression is rising in the UK, and and each year one in four people will experience mental health problems. However, Lilly notes, only a quarter of those affected in the UK receive treatment.

The company said one of the main barriers to effective care is a lack of communication between a patient and their healthcare professional, which can lead to both poorer quality treatment and outcomes.

Lilly will support its new mobile app with a printed Talking Progress booklet for healthcare professionals and a workbook for patients, which can be ordered from the company on request.

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Apple unwraps 'Healthkit' to propel mobile-health ambitions

Apple unwraps 'Healthkit' to propel mobile-health ambitions | Mobile Healthcare | Scoop.it

(Reuters) - Apple Inc took the wraps off a mobile application that can collect and analyze users' health data, part of a suite of new features outlined for its computing and mobile software, at its annual developers' conference on Monday.

Called "Healthkit," it will pull together data such as blood pressure and weight, collected by a growing plethora of healthcare apps on the iPhone or iPad, Apple executives told developers.

The company will work in tandem with Nike Inc, a major player in fitness tracking, and the Mayo Clinic on the new feature, which will be included with the latest versions of Apple's mobile software.

"That information lives in silos," said Craig Federighi, Apple's senior vice president of software engineering. "You can't get a single comprehensive picture."

Apple, which will discuss new software features with the thousands of developers gathered in San Francisco this week, did not elaborate on Healthkit's features and capabilities.

The news follows arch-rival Samsung Electronics Co Ltd's announcement last week of a mobile health-data store called SAMI (Samsung Architecture Multimodal Interactions).

It is unclear how Apple will promote Healthkit. Samsung plans to market SAMI by hosting a developer challenge and setting aside a $50 million fund for early-stage digital health entrepreneurs.

 

COURTSHIP

Monday's event in downtown San Francisco, an annual pilgrimage of sorts for the large and growing Apple developer community, was short of major surprises.

Apple has one of the most dedicated software communities in the tech industry, with more than 9 million registered developers. Every year, the iPhone maker and rival Google Inc, whose Android mobile devices comprise an estimated four-fifths of all smartphones sold globally, show the latest software enhancements to thousands of prospective developers.

Chief Executive Tim Cook, opening Apple's conference on Monday, said the iPhone maker has sold more than 800 million mobile devices. Some 130 million customers bought their first Apple mobile device in the past 12 months, he added.

Apple described how its latest "Yosemite" Mac software, which comes on the heels of its well-reviewed "Mavericks" release, will come with a new Internet storage application, and allow users to pick up calls and see text messages relayed to iPhones.

Computer users would also be able to call up maps, search for information or look up documents by typing directly onto their home screens

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The importance of humanising healthcare Technology 

The importance of humanising healthcare Technology  | Mobile Healthcare | Scoop.it

"Technology has seriously upped the ante when it comes to enabling patients to be informed and educated about their health. There are more than70,000 websites that disseminate health information.

 

As exciting as this may sound, access to the general public is often hindered by design issues (poor navigation, writing at graduate level, and disorganization) and questionable quality and accuracy of information.

 

We can do better."


Via Andrew Spong, Philippe Marchal/Pharma Hub, Lionel Reichardt / le Pharmageek
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Wearable Tech and Health Insurance | HealthWorks Collective

Wearable Tech and Health Insurance | HealthWorks Collective | Mobile Healthcare | Scoop.it
From fitness bands to sensors that can be swallowed, wearable technology is expanding the possibilities of medicine. The evolution and expanding capabilities of wearables make them primed to transform healthcare and flip the health insurance industry on its head.

 

The Evolution of Wearable Technology 

Though technology has advanced by leaps in recent years, the wearable tech revolution is still only beginning. Nielsen’s Connected Life Report found that about 70 percent of consumers are aware of the wearable technology that is available, but only 15 percent of consumers report using a wearable device in their daily lives.

In the current market, wearable activity trackers are king. They come in all shapes and sizes and track and monitor everything from the number of steps you take in a day to the patterns of your sleep at night. They can even connect and transfer data to a variety of handheld devices. The success of these activity trackers is largely due to their target audience: young, physically active consumers who are more likely to have the disposable income to purchase new gadgets.

But wearable technology includes much more than pedometers and wrist-worn activity trackers. Science and medicine have been pushing the limits of wearable technology in recent years to include everything from full-sized robotic suits for paraplegics to tiny sensors that can be embedded in organs to track their functions. 

As the possibilities for wearables continue to expand — taking healthcare beyond fitness tracking to more precise, personalized therapies and treatments — the industry is primed to see an explosion of new consumers.

What’s Holding Wearables Back?

With research and development backing, investor enthusiasm, and the incredible potential to change the healthcare field, what’s keeping wearable tech from being “the big thing” instead of “the next big thing”?

There are two main factors limiting the widespread adoption of wearable gadgets. The first, and perhaps most significant, is the cost. Seventy-two percent of consumers surveyed said they wished wearable devices were less expensive. As more companies jump on the wearable tech bandwagon and more devices are released to the marketplace, competition will drive the cost down, but financial assistance from insurance companies would incentivize consumers who might be held back by cost or never even consider purchasing a wearable device otherwise. 

Second, the majority of devices on the market are fitness-related, and their marketing is geared toward health-conscious consumers. However, the consumers who would see the greatest impact on their health through the use of wearables are those at high risk, those with chronic illnesses, and those who lead a more sedentary life. Devices that can help these consumers are still relatively unknown to the general public, which slows their adoption. Older or less tech-savvy consumers are also more hesitant to dive into the wearable tech pool without a more direct and personalized explanation of the ways wearables will benefit them over time.

To many consumers, wearables are still a novelty. Many people don’t understand their value, especially when they see the price tag. But as more consumers are educated on the variety of devices and the specific ways these technologies will benefit their lives, the adoption rate will increase dramatically. And the best way to get consumers to see these devices in a new light is for insurance companies to begin integrating wearable technology into their business models. 

Why Wearables Are Good for Insurance Companies

Insurance companies stand to benefit greatly by integrating wearable technology into their policies and coverage. They can expect:

Healthier, more engaged customers: Wearable technologies educate patients on their own bodies, empowering them to make wiser decisions about their health. Healthier customers will require fewer appointments, tests, and hospital visits. Plus, wearable devices are constant reminders for patients to set and meet health goals and recognize their progress, keeping them on track for healthier living.

Better models of risk and care: As wearable technology collects more data about individual customers, insurance companies can adjust their risk models to more accurately fit each patient. That way, the insurer and the patient are only paying for the care that particular individual needs, rather than the indeterminate needs of a group.

Stronger collaboration with healthcare providers: Wearable devices allow patients to share and transfer information to physicians from any location at any time, which can be shared with insurance providers. Physicians and insurers will have the same patient information in front of them at the click of a button, allowing all parties to work as a team to make decisions about treatment and care centered around each individual. 

More specific, personalized treatments and diagnoses: Since wearable devices gather the health data of users around the clock, diagnoses and treatment plans can be fine-tuned for each patient, cutting down on the need (and cost) of labs, tests, and extended hospital stays. Patients with chronic conditions can be monitored closely from the comfort of their homes.

A lower bottom line: Overall, wearables can save insurance companies money. They could allow more patients — even those with chronic illnesses or post-operative needs — to be continually monitored outside the hospital. This will help dramatically reduce the rate of costly readmissions. The personalized and predictive data will make treatment and care more precise and less of a costly guessing game, especially after they step out of the hospital.

4 Ways Insurance Companies Can Make Wearables Work

For insurance companies to integrate wearable technology into their business models, they must find solutions that are easy to implement, add value to individual customers, and make the overall healthcare experience more pleasant. Ideas for such implementation include:

Creating tools that connect devices with insurance companies. Companies should create a platform for patients to engage with their insurer through their wearable device in an easy and purposeful way. Providers such as HumanaVitality and CarePass are already doing this by letting patients sync devices with their accounts. Insurance companies could also offer discounts or rewards to patients who connect, meet goals, and stay active and healthy.

Developing a simple consumer adoption process. Companies could offer wearable devices when consumers sign up for coverage. Have them choose a device, and ship it to their door upon checkout. The cost could even be subsidized as an additional incentive. Likewise, if a patient becomes ill or has surgery, companies can offer or suggest specific products to manage the illness or help with the recovery process.

Interpreting and using the data in meaningful ways. Insurance companies should help patients connect their devices with their doctors, provide them with insights on the product and how to get the most out of it, and offer suggestions for positive changes they can make. Helping patients feel more comfortable using their devices will ensure that their devices become a regular part of their daily life.

Serving as a tech navigator. There are so many choices out there — and even more set to hit the market in the coming years — that it can be an overwhelming experience to find the right wearable device. Health insurance companies are in the perfect position to be trusted intermediaries between manufacturers and patients. They can help patients identify the devices that are right for their specific needs, assist in curbing the cost, and provide assistance to customers as they begin integrating the devices into their daily lives.

3 Things Insurers Need to Reevaluate

The adoption of wearable technology will require some additional work from insurance providers to integrate wearables effectively. Here are three things insurance companies will need to reevaluate:

Business models: Insurance companies’ business models will need to include wearable technology. Companies can no longer sit back and estimate the risk of individuals and groups; they must become active participants in managing that risk if they want to stay relevant.

Programs: Providers will need to develop additional programs and provide an end-to-end service that can manage risk, provide insurance coverage, and use data between the systems for effective health management.

Transparency: The transparency surrounding prices and quality of medical services varies widely, even within the same network. Providers will need to be more open to build trust with their patients.

Wearable technology will be a major force in the future of medicine, yet the health insurance industry still needs to hop on board to increase adoption of these devices. Insurance providers must recognize that wearables offer a treasure trove of personalized health data that will not only revolutionize how insurance companies interact with customers, but will also help insurers, doctors, employers, and patients unite around a common goal.

 
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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 | Scoop.it

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.


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Report: Healthcare analytics market is still “finding its way” | HealthITAnalytics.com

Report: Healthcare analytics market is still “finding its way” | HealthITAnalytics.com | Mobile Healthcare | Scoop.it
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 | Scoop.it
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 | Scoop.it

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.

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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 | Scoop.it

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 | Scoop.it

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 | Scoop.it

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 | Scoop.it

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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Apple plans multiple designs for smartwatch, which will likely be launched in the fall

Apple plans multiple designs for smartwatch, which will likely be launched in the fall | Mobile Healthcare | Scoop.it

Apple is planning multiple versions of its smartwatch, likely to be launched in the fall, as the company tries to counter wearable devices from rivals

 

The new wrist device from Apple will include more than 10 sensors including ones to track health and fitness, these people said. Apple aims to address an overarching criticism of existing smartwatches that they fail to provide functions significantly different from that of a smartphone, said a person familiar with the matter.


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How mobile became mighty in healthcare

How mobile became mighty in healthcare | Mobile Healthcare | Scoop.it
Without a doubt, 2014 will be declared the year mobile became mighty in healthcare. No matter where in the world you live, whether you are talking about patients, consumers, or healthcare providers, mobile is revolutionising the future of healthcare – so much so, that it's worth taking a closer look at 10 powerful trends emerging throughout the mobile health space. We'll also be showcasing our findings on mobile health user experience at the Mighty Mobile seminar at the inauguralCannes Lions Health festival.

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UK and France join forces to drive telehealth deployment

UK and France join forces to drive telehealth deployment | Mobile Healthcare | Scoop.it

Telehealth supporters have announced a link-up between English and French technology experts in an effort to drive the growth of eHealth in Europe.  The MALCOLM project - Mapping Assisted Living Capability Over La Manche - brings together the South East Health Technologies Alliance (SEHTA), a health technologies cluster with expertise in care and assisted Living; and Pôle TES from Basse-Normandie in France, a cluster with expertise in the field of secure electronic transactions.  The project will research and map the needs and capabilities of the eHealth sector in Normandy and the South East of England in order to help organisations and companies involved in delivering care services to develop and implement innovative ICT-based home support systems. The subsequent needs analysis will focus on two target groups: people aged 60 to 75 years (65-75 in England); and those aged over 75 years. These target groups were chosen because the care issues are the same on both sides of the Channel: namely an ageing population with a longer life expectanc, and the isolation of some of the coastal populations.  The research conducted by the MALCOLM project will be of particular relevance to SMEs and other organisations involved in the assisted living supply chain; health and care providers such as hospitals, old people's homes, specialised clinics, etc; and third sector and charities working with older people.  The assisted living capability in both regions will be summarised in a report that will provide a sound analytical basis to support regional implementation plans, identify good practices, allow a direct comparison between the two regions, stimulate the cross-border development of new products and services, and stimulate the development of new clusters.  The results of the project will be disseminated at two events, the first on 16 October in Maidstone, Kent; and the second on 20 November  in Colombelles in Normandy. Both events will provide an opportunity to discuss the results of the comparative study and for networking between stakeholders involved in eHealth from both countries.  The initiative comes at an important time for both regions. In South East England care providers are working to provide more patient-centred, integrated health and social care and, following on from the Whole System Demonstrator (WSD), to implement more technologically-enabled care services. Basse-Normandie has recently been identified as a 'Silver Region' forging a link between eHealth and the Silver Economy. By becoming involved in the MALCOLM project companies and organizations working in the area of home support for the elderly will have the opportunity to share expertise, identify new opportunities and be involved in the development of a powerful new cluster.  The project was awarded an EU grant of €149,980.50 under the cross-border INTERREG IV A Channel Programme and started in

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Simon Stevens, the new chief executive of NHS England, says more patients should be treated in their own communitie

Simon Stevens, the new chief executive of NHS England, says more patients should be treated in their own communitie | Mobile Healthcare | Scoop.it

The NHS must stop closing cottage-style hospitals and return to treating more patients in their local communities, the new head of the health service has said in his first interview.

In a marked reversal of current policy, Simon Stevens said the NHS must expand its local services because too many patients are being robbed of “dignity and compassion”.

Mr Stevens warned that British hospitals have become among the worst in western Europe at caring for local populations, because too many services have been stripped out and centralised.

 

He said Britain must learn from countries such as Sweden, the Netherlands and the United States, which have pioneered ways of bolstering community care around small hospitals to meet the needs of their populations.

“A number of other countries have found it possible to run viable local hospitals serving smaller communities than sometimes we think are sustainable in the NHS,” Mr Stevens said in an interview with The Telegraph.

“Most of western Europe has hospitals which are able to serve their local communities, without everything having to be centralised,” he added.

Mr Stevens, a former health adviser to Tony Blair, said spiralling numbers of elderly patients are ending up in hospital unnecessarily, because they had not been given care which could have kept them at home.

In an interview ahead of a major speech next week, outlining his plans for the health service, he said:

Businesses should financially reward employees for losing weight and adopting healthy lifestyles;

The NHS needs to abandon a fixation with “mass centralisation” and instead invest in community services to care for the elderly;

The waiting targets which Labour introduced became “an impediment to care” in too many cases;

The European Working Time Directive damaged health care in the NHS, making it harder to keep small hospitals open;

Mr Stevens, took up the post last month, after 11 years working for private health care firms in Europe, the US and South America.

On Wednesday he will make a major speech to the NHS Confederation’s conference in Liverpool, outlining new models of care to build community services around small hospitals and meet the needs of an ageing population. He told The Telegraph: “The single most important question facing us is how do we best support older people? Two thirds of hospital patients are over retirement age.”

Too often such patients suffered failings in care, because systems were not designed around their needs, he said.

“You cannot have a modern health service that is not treating older patients with dignity and compassion, supporting them at home and ensuring targeted prevention [of ill health],” he said.

Vulnerable patients are frequently ending up in hospital because they had not received basic help when they needed it, resulting in falls and other avoidable incidents, he suggested. “I look at the fact there’s been a 124 per cent increase in the number of people admitted to hospital for less than two days over the last 14 years, and that tells me we haven’t got it right, supporting people at the time they need it,” he said.

The system of care outside hospitals is too complex, with too much duplication and too many gaps for patients to fall through, he suggests. “There is a big opportunity to reorganise that so it meets the needs of those at home. At the moment it is too complicated and too fragmented. If you were starting from scratch you would not design community services like that.”

Next week he will outline new models of healthcare which will be introduced to bolster small hospitals, which could see hospitals taking over the running of some GP services, and more close working between specialist and community care.

He said the NHS could learn a lot from some elderly care provided in the United States, where companies had taken steps to ensure community services and hospital specialists worked as one team.

Mr Stevens said that for more than a decade the NHS had fallen victim to a “steady push towards centralisation” resulting in fewer hospitals, largely as a result of the way the European Working Time Directive had been interpreted by the European Court of Justice. Other EU members had adapted far better to its rules limiting doctors’ working hours, particularly in rural settings, he said.

He said the NHS needed to learn from innovation around the world.

“Sweden for example has in some ways better working between health and social care than we have,” he said. “The Dutch have interesting ways of organising maternity services, with more choice and more midwife-led care.”

He also called on businesses in the UK to financially reward employees for losing weight and adopting healthy lifestyles. He spoke of how he put on weight while living in the US, but lost almost three stone after being spurred into action by a company scheme which offered financial rewards to staff who reduced their Body Mass Index. Mr Stevens said he intended to encourage employers in Britain to introduce similar perks to “nudge” staff towards a more healthy lifestyle.

He said the NHS could also learn from the way the US had introduced electronic hospital records, which had been a “huge misfire” in this country, with a £12bn central scheme eventually abandoned.

Mr Stevens was adviser to two health secretaries under Labour, Frank Dobson and Alan Milburn, from 1997 to 2001, before advising Tony Blair for three years. During that time they drew up Labour’s flagship health policies – waiting targets, foundation trusts, contracts with the private sector, many of which became controversial.

He defended the role played by targets in improving care for millions of patients but said that in a number of “important cases” including the Mid Staffs scandal, they became “an impediment, not a driver of high quality care.”

In 2004 he became President of UnitedHealth Europe, and become vice president of the group, based in the US.

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A telehealth robot used for dementia patients include wearable devices and sensors around the home to monitor the person’s health

A telehealth robot used for dementia patients include wearable devices and sensors around the home to monitor the person’s health | Mobile Healthcare | Scoop.it

A robot used for dementia patients being trialled by NHS Western Isles is set to go into commercial production across Europe next year.

The GiraffPlus project, funded by the European Union, uses a motorised Giraff robot with a built-in camera, speaker and microphone to connect elderly people to their family and friends and allow them to stay in touch from afar.

The system also includes wearable devices and sensors around the home to monitor the person’s health.

The sensors are designed to detect activities like cooking, sleeping and watching television, while monitoring the person’s health through their blood pressure and sugar levels among other measures.

EU Project coordinator Amy Loutfi said the GiraffPlus system is currently in six homes across Europe, and will be in 15 by the end of 2014.

Loutfi said the evaluation of the system is still in progress, but early feedback has emphasised the need to avoid a “one size fits all” approach and ensure the technology can be tailored to people’s needs.

The system is currently set to go into commercial production by the end of 2015, based on an upfront fee and monthly subscriptions to make it competitive with increasingly expensive full-time care.

European Commission vice-president Neelie Kroes said: "None of us is getting any younger. But we all want to know that we will not lose our dignity, respect and independence as we age.

“The EU is investing in new technology that can support the silver generation – adding not just years to our life, but also life to our years."

NHS Western Isles is currently trialling the Giraff robot, without the sensors, as part of the EU’s RemoDem project to improve access to healthcare for those living in remote areas.

Trust IT director Jon Harris told EHI last July (http://www.ehi.co.uk/news/EHI/8744/robot-to-help-dementia-patients) the Giraff was more than “Skype on a stick” and could be a valuable tool to assist with remote working.

“It’s a really interesting gadget and it has huge promise in terms of what it can do. You can also check on the state of the house and what it looks like, to see how the person is coping.”

EHI approached the trust for an update on the trial but was told the trust will not comment on any aspects of the project until it has been completed and evaluated.

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