Salute 2.0

HealthTap University allows medical students to help answer real patient questions, interact with, and learn from established physicians.

Via Michelle Petersen

"Medicine X" è il Congresso dell'Università di Stanford, in programma il prossimo autunno, per indagare come le nuove tecnologie faranno progredire la pratica medica, miglioreranno la salute e afideranno crescenti responsabilità ai pazienti. Gli organizzatori hanno annunciato borse di studio offerte da Alliance Health Networks per pazienti 2.0 che desiderino prendere parte ai lavori.

Via Anna Picchio

Smartphones and tablets are transforming healthcare by shifting control to patients, but the evolution is not without its challenges.

 

The Future of mHealth is our series that explores opportunities and challenges of mHealth, which aims to put widespread access to healthcare within the reach of those who need it most.

 

Healthcare challenges are on the rise worldwide. Chronic conditions take an ever-greater toll, and costs are on the rise. But health insurance no longer bridges the gap for many, and healthcare systems struggle to balance the need for top-notch care and innovation against shrinking budgets.

 

Answering the challenge, many parties in the medical industry are ramping up development of apps and software for mobile devices, which may increase speed and ease the delivery of healthcare to patients who need it most, especially in areas like preventing diseases, managing chronic conditions, and navigating the complexities of the hospital and insurance systems. The payoff could be great, but the incorporation of mobile technology into the complicated healthcare system is not without its perils.

 

Motivation, Education, and Prevention on the Go

 

According to the Centers for Disease Control and prevention, conditions such as heart disease, stroke, diabetes, arthritis and cancer are the most common and costly health problems in the U.S.

 

Habits like smoking, a sedentary lifestyle, poor diet, high stress, or excess body weight increase risks for conditions like heart disease that threaten life and health. These diseases represent the largest concentration of healthcare spending, taking a huge toll on both well-being and wallets.

 

People can largely prevent or control these conditions, however, by instigating healthy changes and staying motivated to stick with them. Mobile health solutions can help consumers achieve this goal, bringing them a step closer to better health through education and motivation, and ultimately streamlining use of the healthcare system.

 

Apps such as MealSnap provide an instant calorie count when a user snaps a picture of their plate with a smartphone, encouraging healthy eating.

 

Other apps, such as FitBit and Fooducate, track exercise and calorie intake to help people stay on course with weight loss, while the government-sponsored Text4Health program is proven to help people stay tobacco-free through use of motivating and informational text messages.

 

Other apps help people track exercise intensity and time, use the GPS in their phones to map running and walking routes, compete against themselves and others to take more steps or perform more activity minutes, and keep a daily diary to identify and avoid triggers for conditions such as migraines and asthma.

 

Managing Conditions Gets Easier...

Via Thibaud Guymard

'Quintiles has solidified its commitment to the digital space as a channel for patient engagement and recruitment to clinical trials by pooling its online communities and digital expertise in a Digital Patient business unit.

 

Headed by David Coman, formerly senior vice president, communications and patient recruitment at Quintiles, the new unit will sell its patient-engagement services directly to biopharmaceutical customers while working internally with other business units to develop and deliver innovative recruitment and engagement programmes, the US-based biopharmaceutical services provider explained.'

 

[AS: My POV - the expectation that patients will willingly participate in 'engagement services' sold to biopharmaceutical customers is a clear indiication that there is something wrong here with regard to the way the dynamics of social health are understood within the context of this proposition.]

Via Andrew Spong

E' il debutto su larga scala della cosiddetta medicina personalizzata o un "mettere il carro davanti ai buoi"?

You're taking a new medication and have dry mouth and feel dizzy.

Want to know how many other people have reported those side effects—and how your drug compares with similar drugs?

The U.S. Food and Drug Administration has millions of such "adverse event" reports, ranging from fatigue to fatal heart attacks, for thousands of prescription drugs dating back to 1969. But the information hasn't been readily accessible—until now.

A start-up company, AdverseEvents Inc., has streamlined the FDA's often impenetrable database and made it easy to search the adverse-event reports for more than 4,500 drugs, free and online. Another start-up, Clarimed LLC, has done the same for reports filed with the FDA on 130,000 medical devices, a far more complex group that runs the gamut from syringes to stents to tanning beds and diagnostic machines that could impact tens of thousands of lives.

Both companies, which launched in September, see their services as empowering patients, many of whom now comb Internet discussion boards for medical information. "If your doctor tells you to take a drug and it's three times more likely to give you a heart attack than another drug, not having that information seems foolish," says AdverseEvents President and co-founder Brian Overstreet.

While basic searches will remain free, AdverseEvents plans to charge consumers $10 a month for access to full drug reports starting Wednesday, and will offer health-care professionals and businesses more detailed information for additional fees. Clarimed may follow suit. Both websites offer a way to file reports to the FDA, but few visitors have done so.

Nora Iluri, CEO and founder of Clarimed, likens these efforts to the advent of J.D. Power and Associates safety ratings for cars. "Suddenly, manufacturers started competing on quality," she says. "The best way to drive quality improvements is to make things crystal clear and transparent as possible."

The adverse-event reporting system for drugs (known as AERS) helps the FDA monitor side effects that crop up after a medication is approved and used in the real world. (The system for devices, called Maude, for Manufacturer and User Facility Device Experience, started in the 1990s.) AERS has received 6.4 million reports, and the volume has risen steadily. There were 759,000 for drugs and 238,000 for devices in 2010. But reporting is voluntary, and represents only a fraction of all the side effects and malfunctions, the FDA says.

Agency analysts mine the data for worrisome trends that prompt further investigation and sometimes stronger warning labels or even removal from the market. The cholesterol-lowering drug Baycol, for example, was withdrawn in 2001 after 52 deaths from rhabdomyolysis, a muscle and kidney disorder, turned up in the adverse-event files. People seeking AERS information can download raw quarterly data from the FDA's website, but it isn't cumulative and requires technical expertise to use. They can also file a Freedom of Information Act request for more specific data, but what they get back may be voluminous and impenetrable. That's what Mr. Overstreet, a data-marketing entrepreneur, found when a friend's wife suffered a severe drug reaction and he went looking for information. He and his fellow data experts found the FDA's AER files indecipherable. "That's when we said, 'Let's fix this,' " he says.

One problem is that the data are sometimes jumbled. Most reports come through drug and device manufacturers, but patients, physicians, family members—even lawyers—can send reports to the FDA, and they often contain errors and inconsistencies. "There are at least 440 different ways to spell Ambien and each has a separate file at the FDA," Mr. Overstreet says.

AdverseEvents Inc. developed an algorithm that filters out duplicates and combines spelling variations, reducing over 200,000 drug names to about 4,500. It also made the data easily searchable and comparable for thousands of conditions and side effects back to 2004.

Still, the FDA's data have other limitations that some critics say make it potentially misleading. For one, there is no way to determine whether a side effect is due to a drug or a coincidence. (Device malfunctions are even trickier, since operator error or surgical skill can affect how they perform.) For another, the reporting doesn't necessarily mirror the true incidence of problems. New drugs tend to generate more reports than older ones, and a negative news story about a drug or device can prompt a sudden spike in reported problems. Expectations matter, too. Chemotherapy drugs that cause severe side effects get far fewer reports than drugs for, say, heartburn. What's more, the FDA files don't indicate how widely a drug or device is being used, so there is no perspective. For example, Lipitor tops all statins for side effects, with 76,535 adverse-events reported from 2004 to 2011 (most often muscle pain, pain in extremities and muscle weakness), compared with 34,938 for rival Crestor, according to AdverseEvents.com. But users aren't told that Lipitor was prescribed far more frequently, so the proportion of problems was smaller. AdverseEvents plans to post prescription data for some drugs.

But sales information isn't available for many medical devices—even for costly implants like artificial joints, says Ms. Iluri. Without such numbers, she says, "Neither we nor the FDA can easily compare safety for devices across manufacturers."

Via Chaturika Jayadewa

Si chiama Cartella Paziente Integrata (CPI) e rappresenta il futuro per una nuova versione della cartella clinica la cui metodologia di sviluppo è basata sul coinvolgimento degli operatori e sull’usabilità.

Via Cooperativa Easy

Comparing yourself to others with the same health problem can influence your physical and emotional health, according to researchers who conducted a qualitative synthesis of over 30 studies focusing on the relationship between social comparisons and health.

Via Andrew Spong

Novanta giorni: questo il tempo entro il quale far pervenire alla Food and Drug Administration qualsiasi consiglio o richiesta di chiarimento riguardo le nuove Guidance for Industry responding to unsolicited requests for Off-Label Information About Prescription Drugs and Medical Devices.