For your weekend reading, this overview of 42 mHealth studies monitoring use by health professionals is accessible not only in full text, but also has multiple (downloadable) comparison charts and plenty of related reading. The findings will come as no surprise: current studies are limited, show only modest benefits, diagnosis based on mobile photos showed a reduction in diagnosis accuracy, SMS (text) appointment reminders show some benefit. High-quality trials measuring clinical outcomes are needed. The Effectiveness of Mobile-Health Technologies to Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis (PLOS Medicine) Hat tip to reader David Lee Scher, MD.
What type of system in the US (and elsewhere) provides the best quality of care based on metrics such as care levels, medication usage and services? This article, while written with its conclusion in mind (the US consumes too many dollars in health care, yet has too many for-profit facilities that stint on care to maximize profit, thus everything in healthcare should be non-profit), does bring up interesting data as to the differences in quality of care between non-profit and for-profit hospitals and post-acute facilities, plus the broad failure of health maintenance organization (HMO) insurance plans to deliver savings as promised. Low-profit but needed areas such as psychiatric emergency care (!) and home health care tend to get shorted at for-profit hospitals and (not mentioned) insurance plans. The writer also does not mention that non-profit facilities can offset many costs through a lower tax burden and endowments. And as one of the commenters points out, according to his research, developed Asian countries have even higher levels of privatization than the US, yet take only 5% of GDP and boast better health outcomes. Health care and profits, a poor mix (New York Times)
A group at the University of Washington, in collaboration with Seattle Children’s Hospital, is measuring your heavy breathing on the phone–for health reasons. For people who are asthmatics, have chronic bronchitis or cystic fibrosis, breathing measurement is critical. Spirometers measure the power (or weakness) of their lungs. The Washington researchers first developed the SpiroSmart app to estimate the volume of air exhaled by the sound waves recorded as you breathe out. In early experiments, results were roughly comparable to a home spirometer. The next iteration, SpiroCall, is a dial-in that records that long breath of air–and early tests indicate that it preserved enough audio quality for the recorded exhalation to be used as a spirometric substitute. This indicates that any phone, even basic cellphones that older people and those in developing countries use, can remotely measure lung health or detect signs of lung disease. Tracking Lung Health With a Cell Phone (MIT Technology Review) Hat tip to Toni Bunting of TANN Ireland.
The Central Standard Timing ‘e-ink’ watch will, when it goes into production, be the world’s thinnest watch at 0.80mm and wholly assembled in USA (take that, Switzerland). Its high visibility, basic colors and stainless steel band (in three preliminary sizes) makes it cool–and ‘Mick and Tina’ cool (when costs go down from the current projected $170) for the older adult or vision impaired market. It’s always on and charged/adjusted at the base station. What would be interesting if this technology, or the watch itself, eventually incorporates things like fall detection or pulse monitoring. PSFK article. CST Kickstarter page (where it is oversubscribed at nearly $450K). Another hat tip to Toni Bunting of TANN Ireland.
Investment bankers TripleTree and the Wireless-Life Sciences Association (WLSA) are opening nominations for the 5th Annual iAwards (my, has time flown!). Nominees will be judged this year on “uniqueness of their solution; marketplace traction; clinical, operational or consumer relevance; size of addressable market and international presence across three categories” (operational effectiveness, clinical application and consumer engagement). Get in your applications and $250 fee by 29 March; twelve finalists will be announced 19 April with three winners feted at the WLSA Convergence Summit, San Diego, 28-30 May. Overview
Some encouraging and unusual developments with Aetna and Cigna around weight loss and wellness. In December, Aetna unveiled Passage, a fitness app it developed with Microsoft, which takes the user on virtual tours of running or biking in Barcelona, New York or Rome, with real-time photos of those locations, restaurant recommendations and historical facts along the route. Cigna has bundled four apps for nutrition, exercise, and mind and body relaxation free to the first 20,000 downloaders. For instance, the most popular, Fooducate, helps users grade the nutrition in their groceries and offers more healthy alternatives. The sudden interest in consumer engagement, after languishing for the past year or so, is due to the imminency of the ACA (Accountable Care Act a/k/a ‘ObamaCare’). Prevention increasingly equals savings and is easier to achieve with apps being further along the curve than even last year. Apps latest bid by health insurers to manage wellness (American Medical News)
Health 2.0 and the New York eHealth Collaborative invite designers and developers to submit prototypes for a secure portal that will present 19.5 million New Yorkers with their individual PHR while educating them about health data privacy rights. Developers have a chance to win up to $15,000 (first place). Submission deadline is 11 April; New Yorkers will vote on the best prototypes through 21 April. Overview and registration form
EHRs are rapidly becoming the Rodney Dangerfield of eHealth (‘I don’t get no respect’). No surprise to any doctor or clinical staff who uses them–but the realization has dawned that it has actually made charts more labor intensive. “I think we’ve sort of made the paper chart electronic, but what we’ve done almost nothing of is automation.” has to be one of the drollest quotes of the past few years (Dr. Donald Rucker, VP and chief medical officer of Siemens Healthcare USA). Instead of using computers to automate, EHRs make records even ‘stickier’. Hospitals like it because it helps capture billing more accurately. MDs aren’t technophobes (a common accusation) but “they’re not going to embrace any technology that makes them less efficient”. Neil Versel takes a ‘gimlety’ look at the subject in his comments on this TEDMED webcast (1 hour recast here) in InformationWeek Healthcare.
And the think tank RAND Corporation adds to the pile-on, with RAND rethinking its optimistic 2005 analysis of $81 million in HIT savings that fed the proliferation of EHR companies and Federal subsidies. Expected savings haven’t materialized, and productivity, interoperability plus quality benefits haven’t been achieved by existing systems, according to Dr. Arthur L. Kellermann, one of the authors of the analysis published in this month’s Health Affairs (abstract only). A list of shortcomings as long as the East River are discussed far more critically in commentary featured in the NY Times, Charles Webster, MD’s EHR blog on how you get to the ‘iron triangle’ of unstable software (hat tip to Vince Kuraitis), and Brian Ahier’s commentary on (this is a first) Google+.
Health 2.0 has now released their January hour-long podcast which previews their 2013 US 7th Annual conference 29 September-3 October which will be at the Santa Clara Convention Center (California), a look forward to Health 2.0 Dubai in two weeks and India in February. It will take you a while to get past the ‘adverts’ to how telehealth and health tech can better work with hospitals to improve care and care transitions (Marco Smit at about 11:00). (Warning, it is also a little kludgy in loading.)
More CES articles and roundups:
Some ways to put digital health in action at CES: turn the techies into health tech ambassadors by giving them devices to wear during CES and doing a competitive tally of their results, with an award from a prestige panel; test a smoking cessation program (and similar); include in CES the culture change partners such as health systems and data analysts who can actually make that flood of device data into something useful. Interesting POV. How entrepreneurs, execs can take advantage of the techies at CES (MedCityNews)
UnitedHealthGroup is looking to connect its beneficiaries to healthy lifestyles, through tools such as adapting ‘DanceDanceRevolution’ to a classroom setting, mobile apps, cost estimators and rewards programs. Unfortunately, it will need to be more exciting to consumers than as presented at the Digital Health Summit, if this article is to be an indicator. UnitedHealth Group makes waves at CES (mHIMSS) The Forbes article (next) goes into more detail on their 4,000 square foot and more importantly, the global $60,000 Breakthrough Health Tech Challenge prize to help people more effectively manage chronic health conditions.
And finally, the fork making all the news. After you’ve traipsed hundreds of miles of aisles, sat in on your 75th presentation, and have sensory overload to the nth degree, Editor Donna can understand those covering CES for falling all over the HAPIfork from HAPILABS rather than, say, a massage table (legitimate, readers!!) Yes, it was a CES finalist. Yes, it’s a great ‘little engine that could’ story involving a young entrepreneur with a charming French accent. Yes, it’s buzzy because it’s buzzes (literally) if you are eating too fast and uploads your consumption metrics to your smartphone. But it’s a gadget….which still needs funding, which undoubtedly it will get. Launching February on Kickstarter with a Q2 to-market projected (in time for Valentine’s Day?) The Fork That Buzzed CES 2013 (Forbes)
Writer and Singularity University VP Vivek Wadhwa opines in Venture Beat on the defining technologies we’ll see in 2013. (He was spot on with the cool down of social media, the rising tide of security breaches and cloud-computing failures). All these, but especially the second, are important to healthcare tech. Editor Donna’s comments and opinion follow:
- Tablet explosion to computing revolution: cheaper, more powerful, but don’t agree that anything decent will ever be given away. And no, tablets will not kill PCs because they are one-way communication tools–great for internet surfing, books, presentations and video, bad for responding to your email, documents or structured creative work. Perhaps the two forms will morph together…..
- The ‘quantified self’ goes mainstream and creates a new regulatory battlefield: some progress into the educated next segment of early adopters, fitness buffs and the slightly hypochondriac, prices will decline, but the people who could really use the monitoring will continue to be uninterested or not smartphoned. Watch to see adoption trends by young diabetics and asthmatics.
- Manufacturing jobs continue to return to the US: maybe in tech. And robots are being developed everywhere other than the US.
- From big baloney to big opportunity in big data: companies will continue to wrestle with this, and the analysis tools keep changing….
- New user interface paradigms: Leap Motion will be the biggest product of the year and may supplant the mouse and the kludgy touchpad, but don’t dig any graves for keyboards yet. QWERTY keyboards revolutionized mechanical writing starting in 1872 and have carried through to the smartphone; somehow no one has yet found a faster, easier way to communicate the written word. I bet on the 141 year old tech sticking around for awhile.
The Microsoft Kinect is proving to be a versatile platform for physical therapy and more. Microsoft’s public sector solutions area has been busily developing relationships to pair up off-the-shelf software with Kinect so that injured soldiers, sailors, airmen and Marines can perform their physical therapy effectively at home. The latest is with the US Air Force to define requirements for a Kinect therapy system and with the Army’s Communications-Electronics Research, Development, and Engineering Center (CERDEC). DARPA, the Joint Improvised Explosive Device Defeat Organization, Army Medicine, the Navy’s Bureau of Medicine and contractors Lockheed Martin, SAIC and CACI have all expressed interest in the Kinect. Beyond PT, the Army is seeking proposals for adapting Kinect for pilot training and simulation. Microsoft is also exploring how Kinect could be used in PTSD treatment. This is in addition to West Health Institute’s partnering with the Naval Medical Center of San Diego to conduct clinical trials of the West Health-developed Reflexion Rehabilitation Measurement Tool (RMT) using Kinect [TA 23 Oct]. This is cheering news as Kinect is inexpensive and PC-based, using equipment many soldiers and reservists already have at home. At least there is no FDA to come down on Microsoft for ‘off-label use’ of its electronics. Microsoft Wants to Kinect with Pentagon (Defense News) Can the Kinect Help Heal Wounded Veterans? (MIT Technology News) Hat tip to Toni Bunting of TANN Ireland.
UPDATE 16 Jan: Germany’s Fraunhofer Institute for Open Communication Systems (FOKUS) is also testing a Kinect-based rehabilitation program. This adds a smartphone-lined mobile sensor unit to measures vital signs such as pulse, oxygen saturation levels, and (where applicable) ECG/EKG readings. The physiotherapist sees this data in addition to the Kinect-based information and can tailor therapy to avoid dangerous levels of stress. Gizmag.
January 27-28 2013, Jumeirah Beach Hotel Conference Center
One of a series of global health innovation conferences delivering live demos of the latest health technologies and apps for health care consumers, caregivers, patients, health professionals and biomedical researchers. This is a first of its kind for Dubai and a step towards setting up a regional ‘platform’ for health innovation. Website for more info.
Excellent news from TANN Ireland – in response to a public outcry over the weekend, the Irish Government has reversed its decision to halve the budget for personal alarms/telecare this year. Irish Government reverses elderly personal alarm decision. Previous item about the proposed cuts.
Hughes Network Systems will provide broadband satellite services to the New England Telehealth Consortium under a four-year contract. It will enable services to three truck-based, one boat-based and one fixed-location units, providing medical care to migrant farm workers in Maine, New Hampshire and Vermont. They are also in discussion with the VA. [See also Hughes Telematics item 14 June 2012, third bullet down.] Spaceway is “a router in the sky,” explained Tony Bardo at Hughes. “This is a routable, private network for the New England Telehealth Consortium, and we can offer them considerably higher speeds than with our traditional Ku satellites.” Until now, Hughes’ satellite-based private network services have been used primarily by government agencies involved in public safety applications. They hope that the New England Telehealth Consortium deal will open up a new market for telemedicine. More detail: Hughes wins its first satellite-based telemedicine deal NetworkedWorld. Heads-up thanks to Peter Range.
Independa, our first funded health tech company of 2013, saved some news for CES. Not only is partner/investor LG Electronics expanding the use of the Angela telehealth/socialization suite in its commercial market Pro:Centric TVs, but also Samsung Mobile is loading its Galaxy Tab 2 with Angela, available through designated distributors. This combination of TV and tablet technology is a first for the telehealth area, giving care providers in both community and home settings. Independa releases: LG, Samsung. mHIMSS article
The RP-VITA robot developed by iRobot/InTouch is first to gain FDA approval for active patient monitoring in high-acuity environments where immediate clinical actions may be needed (such as ER/ED, pre/post-operative). Available on lease for $6,000 monthly. HealthWorks Collective article
Philips introduced another iteration to Lifeline, called GoSafe. This version is the first Lifeline product that goes outside the home through cellular connectivity provided by AT&T. It features GPS detection on the Skyhook network, AutoAlert fall detection and alarming–but still is a kludgy device which has to be worn around the neck. Its in-home base connector is either connected to POTS or cellular for a better signal. Also different from traditional Lifeline, the device itself will need to be purchased (@ $150) with a $50/monthly monitoring fee. It is targeted for a less frail, more active older adult. Available in March. For those liking metrics, Philips revealed to Mobihealthnews that Lifeline has helped over 7 million people live independently in their own homes–a huge base–and the AutoAlert version has gained 100,000 users. Also Medgadget Whither the overlap with Lifecomm (the Philips/Qualcomm/Hughes Telematics-Verizon JV)? Also will be out early this year, after its beta, according to Mobihealthnews.
Videos Galore. The Digital Health Summit just uploaded multiple interview videos on YouTube, a pick-n-mix as most (as of Friday afternoon NYC time) are not fully labeled. No panel/presentation/keynote interviews yet but here’s another brace of DHS videos. The Wall Street Journal in its CES 2013 ‘Gadgets to look for’ has a video on Scanadu (at 0:37) and in its Thursday highlights, Samsung’s flexible phone/tablet screen (at 1:02)–the WOW of the day.
The HealthSpot Station telemedicine/telehealth walk-in kiosk, which we previewed at CES New York, officially debuted (release) with a kiosk display on the floor, and also announced its partnership with Miami Children’s Hospital on a proposed multi-part project (release). The telemedicine consult portion will be provided by Teladoc (Teladoc release).
ADT Pulse, the home automation division of security giant ADT, and Ideal Life announced a strategic partnership to integrate Ideal Life’s telehealth into the ADT home management system. (release)
Our recently profiled [TA 4 Jan] iPhone/Android med reminder app, MediSafe Project from Israel, claims that its users since November (two months!) have an 81% med adherence rate, versus the WHO 50% average in developing countries. For those on cholesterol statins, the percentage is 84%. Impressive, though early days. MedCityNews
A Series C funding to note is PatientSafe Solutions, a patient workflow and documentation mobile platform. Investors are the Merck Global Health Innovation (GHI) fund and with participation from Camden Partners, TPG Capital, and Psilos Group. Release
What happened to Google Glasses? The Vuzik M100 Smart Glasses only will distract you in one eye. It has built-in Wi-FI, Bluetooth, the ability to record HD video (720p), a compass, an accelerometer and a 16:9, WQVGA, full color display. Perhaps the future for hospital and assisted living care staff? Gizmag
Another recap courtesy of HISTalk Connect [WARNING 31 Aug 2014: linked page may now be infected with malware] (scroll down to CES Week in Review)
And stick-in-the-eye advice from a long-time observer of CES, from the IT perspective but equally applicable to bright eHealth developers: avoid spending time and treasure on ‘solutions in search of problems’ like refrigerators with embedded tablets. The CES cesspool is all our own fault (ZDNet)