E-HEALTH - E-SANTE - PHARMAGEEK

Use of eHealth technologies is common in the multiple sclerosis (MS) population and facilitates the exchange of health care information with providers, according to a recent study.

However, use of eHealth and mHealth technologies varies substantially with sociodemographic factors, and health care providers need to be aware of these disparities as these technologies are increasingly leveraged in health care settings.

Researchers surveyed participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry in 2017 about their use of eHealth technologies using questions adapted from the Health Information National Trends (HINTS) 4 Cycle 4 survey. They found:

• Of 6,423 participants included in the analysis, most participants were female, and white, with a mean (SD) age of 59.7 (10.1) years.
• Overall, 5,408 (84.2%) had exchanged medical information with a health professional most often using a secure online portal (1,839, 28.6%), followed by email (1,327, 20.7%).
• Of the 5,529 smartphone and tablet users, 2,556 (46.2%) used an mHealth app.

read original at https://www.mdedge.com/clinicalneurologynews/clinical-edge/summary/multiple-sclerosis/use-ehealth-technologies-common-ms

The objective of this study was to investigate how users experience the implementation of self-regulation techniques
in a Web-based intervention targeting physical activity and sedentary behavior in the general population.

Background: eHealth interventions show stronger effects when informed by solid behavioral change theories; for example,
self-regulation models supporting people in translating vague intentions to specific actions have shown to be effective in altering
health behaviors. Although these theories inform developers about which behavioral change techniques should be included, they
provide limited information about how these techniques can be engagingly implemented in Web-based interventions. Considering
the high levels of attrition in eHealth, investigating users’ experience about the implementation of behavior change techniques might be a fruitful avenue.

Results:

The techniques “providing feedback on performance,” “action planning,” and “prompting review of behavioral goals”
were appreciated by users.

However, the implementation of “barrier identification/problem solving” appeared to frustrate users; this was also reflected by the users’ website data—many coping plans were of poor quality.

Most users were well aware of the benefits of adopting a more active way of living and stated not to have learned novel information. However, they appreciated the provided information because it reminded them about the importance of having an active lifestyle. Furthermore, prompting users to self-monitor their behavioral change was not sufficiently stimulating to make users actually monitor their behavior.

Conclusions: Iteratively involving potential end users offers guidance to optimally adapt the implementation of various

Digital health is rapidly changing our lives. Almost every day, new developments using data, artificial intelligence and smartphones to improve health, on individual and population levels, are entering the market. In 2015, there were more than 40,000 healthcare apps on Apple's U.S. App Store alone. And the number has kept growing.

But in the process of delivering the next revolutionary technology, health-tech innovators have often neglected to include usability in their apps so that they may also benefit people with disabilities, research suggests 


“People with disabilities have a particularly hard time, as they are often overlooked in the design of new technology, both regarding tools and content,” noted a report titled, “Health Inequalities in eHealth Context,” by the European Commission.

“Due to their impairment, the notion of them being proficient (information and communications technology) users is often sidelined.”

So, what does this issue look like in the real world?

In August, the U.S. Food and Drug Administration approved the marketing of the first mobile health (mHealth) app for contraception: Natural Cycles. The app allows women to avoid pregnancy by monitoring their resting body temperature — known as the basal body temperature — and recording their data so that an algorithm can determine their daily fertility.

With “perfect use,” the app’s creators say the failure rate is 1.8 percent, which means that 1.8 in 100 women annually will become pregnant despite using the technology.

But although the app meets the FDA’s guidelines governing mHealth apps, Natural Cycles poses problems for some nontraditional eHealth users, including women who have disabilities or irregular periods.

read the whole story at https://www.hcanews.com/news/natural-cycles-is-the-first-fdaapproved-contraception-app-but-its-not-for-all-women

The future of medicine starts here.

Seniors used digital health at low rates with only modest increases from 2011 through 2014. To our knowledge, this is the first nationally representative study to examine trends in seniors’ digital health use, although a study in Northern California found higher patient portal use than the clinician contact rate in this study.3

Seniors’ use of everyday technology was below that of the general population (approximately 90% use the internet and own cell phones; 60% search for health information),4 but similar to other studies of older adults, except for the finding of racial and socioeconomic differences.4,5 Relying on everyday technology or generic internet use rates to estimate digital health use may be misleading. For example, although 63% used a computer and 43% used the internet, only 10% filled prescriptions online.

Limitations include that NHATS is a closed cohort with inception in 2011; more recent cohorts may be different. Many survey participants were lost to follow-up or died, although there were not large changes in sample characteristics. Data were only available over 4 years.

Digital health is not reaching most seniors and is associated with socioeconomic disparities, raising concern about its ability to improve quality, cost, and safety of their health care. Future innovations should focus on usability, adherence, and scalability to improve the reach and effectiveness of digital health for seniors.

In case you haven’t heard: Samsung is now a pharmaceutical company, or at least on the point of becoming one. Subsequent to its having invested at least $2b in biopharmaceuticals, the South Korean giant will be bringing a biosimilar version of Amgen’s Enbrel to market in 2016.

That’s right.

In 2016, a company best known for its consumer electronics and heavily invested in mobile health is going to start producing pharmaceuticals, and will apparently begin by bringing a treatment to market which will presumably make it a dominant force overnight in the two disease areas in which Enbrel has indications, namely moderate to severe rheumatoid arthritis, and psoriatic arthritis.

The implications of this for legacy pharmaceutical companies are wide-reaching and significant. Let’s consider a few of them (I anticipate updating this post over the next few months):

- Samsung now has more touch points across the health ecosystem than any other pharmaceutical company. ...

- Samsung’s total focus on customer experience and design makes it a credible champion of the participatory patient’s interests. ...

- Hundreds of millions of people carry this pharmaceutical company’s brand with them day and night. ...

- Consumers will think of Samsung as a consumer electronics company that makes pharmaceuticals. ...

- Samsung will be the first consumer technology company to enter the pharmaceutical marketplace, but it will not be the last.

If this thought doesn’t focus legacy pharmaceutical companies into throwing everything they have into reforming themselves as social business, nothing will. The survival of even the largest companies is far from certain when giants such as Samsung have set their sights upon entering the industry.

Samsung doesn’t think like a pharmaceutical company.

Pharmaceutical companies better start thinking like Samsung.

This report examines 13 trends that fit within four larger themes highlighting how consumer technologies, data analytics and information systems are changing the way healthcare is delivered both from a patient and physician...

This year, when patients throughout the United States begin downloading the world’s first doctor-prescribed smartphone app, mobile health care will finally get what big-time medicine most requires: a way to get insurance companies to pay for it.

The app, called BlueStar, helps people with Type 2 diabetes (the most common kind) by suggesting, in real time, when to test their blood sugar and how to control it by varying medication, food, and exercise. That it requires a physician’s prescription is actually an advantage, because it means insurance companies will reimburse BlueStar’s fee.

Happtique is on a mission to build a professional app store for health care. But independent developers spotted security flaws just days after the company authorized its first set of medical apps.

The company has responded to these concerns by suspending its certification registry until further notice.

The flaws were initially spotted by Harold Smith III, chief executive of Monkton Health, who published his findings in a blog post. Smith wrote that he typically reaches out to express his concerns in a private forum. But in this particular case, he felt that Happtique had been slow to respond. “I chose to publicly disclose after waiting eight days in one instance and three in another,” he wrote.

Smith explained that he randomly picked two apps from the 16 apps that Happtique had certified and found that both had issues storing sensitive information as plain text files and one of them wasn’t using HTTPS.

Happtique is attempting to do something very bold in a sector that is riddled with regulation.

The company is taking data security seriously, as its potential customers (primarily hospitals) are concerned that new mobile health apps will put sensitive patient information at risk. 

In an interview, Corey Ackerman, Happtique’s president and chief executive, said the program will remain suspended into the company determines a “responsible course of action.” According to Ackerman, Happtique is currently working with Smith to resolve the flaws. He said that “participating appdevelopers [like Smith] deserve a lot of credit throughout this process.”

“Certification is not a product; it’s an iterative process,” he added. Ackerman believes that feedback from third parties will help the company keep pace with the complexities and rapid advancements of mobile health technology.

We most recently covered Happtique back in September, when the company’s former chief executive Ben Chodor, was called in to Congress to testify about how the Food and Drug Administration (FDA) should regulate health-related applications. In recent months, Happtique has seen some turnover, as it focuses its attention on hospital customers, according to a report in MobiHealthNews.

Read more: http://venturebeat.com/2013/12/13/first-health-app-store-runs-into-first-major-hurdle-security-flaws/

Quelles que soient leurs formes, les principaux actes de télémédecine (téléconsultation, télé-expertise, télésurveillance) ne sont pas remboursés et les praticiens qui participent aux nombreuses expérimentations en la matière, médecins ou pharmaciens, ne sont pas rémunérés pour le service médical rendu. Si le PLFSS 2014 prévoit le financement d’actes ciblés, ils ne seront pilotés et évalués qu’au décours des trois prochaines années. Nous sommes donc loin d’un modèle économiquement viable et reproductible au niveau national, à la différence de nos voisins européens (Italie, Allemagne ou Espagne) qui ont profité d’une autonomie de gestion et de fonctionnement au niveau régional pour définir des protocoles de prise en charge.

Pour autant, la France fourmille d’initiatives portées par les professionnels, certaines en toute indépendance. Toutes visent un bénéfice immédiat pour les patients montrant que les outils sont bien au service des usages et non l’inverse, comme le rappelle Pierre Traineau, Directeur général du CATEL. Les patients eux-mêmes se mobilisent et tirent profit des nouvelles solutions technologiques mises à leur disposition pour prévenir, suivre ou mieux accompagner leurs symptômes et leurs maladies. Preuve en est la consommation croissante des applications mobiles de Santé et l’explosion du « Quantified self ». Ces deux tendances pourraient inciter les différents acteurs de la chaîne de Santé à basculer définitivement vers une économie de services.

Mobile medical apps need to be regulated because patient safety is at risk when they are used to diagnose or treat a disease, said Jeffrey Shuren, director of the Food and Drug Administration's Center for Devices and Radiological Health at a Nov. 19 House Energy and Commerce Committee subcommittee on health hearing.

The FDA's regulation of software as a medical device is based on risk and function, Shuren told the panel, and the FDA treats devices that perform the same function the same way regardless of the platform on which it is used.

"It's not about the platform. It's about the function," said Shuren.

Software becomes a medical device through intended use and diagnosis of disease and conditions or treatment cure mitigation of disease, he said.

"All we are saying is, the functions, when they stay the same, treat them the same, because the impact and the risk to patients is the same," Shuren said. "Simply because they got smaller and I can pick it up and walk out of the room with it, doesn't change the risk to the patients. Why for that reason alone would we treat it differently?"

The FDA issued nonbinding guidance Sept. 25 with their plan of how to regulate mobile apps as medical devices.

If, for instance, an app illuminates an LED light, like prevalent flashlight apps do, the FDA wouldn't consider it a medical device. But if the developer labels and markets it as a light source for doctors to examine patients, the FDA would approach it as it would an ophthalmoscope, the guidance says.

But the FDA might not need that guidance if Congress passes a bill that's currently sitting in the House Energy and Commerce Committee.

The bill (H.R.3303) would amend the Food, Drug and Cosmetic Act to regulate medical software. It would establish three categories of software--clinical, health and medical--with the two former software types not subject to FDA regulation.

But Shuren told the subcommittee that the bill undermines the FDA's authority to assure the safety and effectiveness of high risk medical devices.

The FDA would no longer be able to regulate blood glucose meters and software that is used to analyze pap smear slides, Shuren said.

"It's very confusing to us what this actually accomplishes," he said.

Read more: http://www.fiercemobilegovernment.com/story/mobile-medical-apps-need-be-regulated-patient-safety-fda-official-tells-hou/2013-11-27

This quote of Nick Mason (the Pink Floyd Drummer) on trends within the music industry got me thinking about some unthinkable things we'll see materialise as a result of the rapid convergence of mob...

“A Series of Forbes Insights Profiles of Thought Leaders changing the Business Landscape: Ron Gutman, Founder and CEO, Healthtap... “My vision is to give peop (#tech #app #news Ron Gutman's HealthTap Seeks to Be the First Global Mobile...”

“CDW Healthcare's healthcare mobility trends infographic explores the adoption of tablets by doctors, the impact on hospitals and potential savings.”

An IMS Health report on consumer facing mobile health apps offers an outlook on the future of mobile health technology and has a breakdown of mhealth apps.

A study found just five apps account for 15 per cent of all downloads in the healthcare category, an example say the authors of a significant skew in how the market works.

To move beyond the hype of mobile health, the industry needs clinical trial data that shows its benefits in acute care, chronic care and physician efficiency.

Melissa Thompson takes an interesting look at mobile healthcare in her Huff Post article about Frictionless Health. First I love the concept of frictionless healthcare. There is almost nothing about healthcare today that’s frictionless.

Analysis of the influence of technology and smartphones in the field of medicine and how it they can be used to look after our health. @MWCBarcelona

New York, NY-based non-profit Stupid Cancer, one of the largest pediatric cancer non-profits in the country, launches a crowdfuding campaign to raise funds

White paper identifies barriers of mHealth adoption and addresses the ways mHealth can empower older people to take a more proactive role in their own care.

A majority of web users still don’t use health apps, but there is a growing contingent (26.4%) that does—at least sometimes. Fitness and general health lead the pack.