Shouldn’t we be concentrating on digital therapeutics rather than ‘health apps’?

Where the money and attention are going. The first generation of Quantified Self apps was all about viewing your data and storing it online in a vault or graphs…somewhere, usually proprietary. Your Pebble, Fitbit, or Jawbone tracked, you crunched the numbers and found the meaning. At the same time, there are wellness companies like Welltok, ShapeUp, Keas, Virgin HealthMiles, and RedBrick Health, usually working with companies or insurers, that use various methods (money, gamification, other rewards) to influence lifestyle and improve a person’s health in a quantified, verifiable, but general way. What’s happened? There are now apps that combine both data and behavior change, focusing on a specific but important (again) condition, coach to change behavior and verify results rigorously through clinical trials. Some, like Omada Health, prove through those clinical trials that their program successfully changes pre-diabetic indicators, such as weight loss, decrease cholesterol and improved glucose control–without medication. This results in big savings for insurance companies, one reason why a $50 million Series C was led by Cigna. Another model is to work with pharmaceutical companies to better guide treatment. Propeller Health with its asthma/COPD inhaler tracker is partnering with pharma GlaxoSmithKline on a digital platform to better manage lung patient usage, and surely this will go through a clinical trial. We will be seeing more of this type of convergence in medical apps. (The rebooted Jawbone Health Hub is moving in this exact direction.) The Forbes article, while short, is written by someone who knows the business of apps– the co-founder of the AppNext distribution/monetization platform. He does achieve his aim in making us think differently about the potential of ‘health apps’. 

Breathe, exhale: a future bracelet that may predict asthma attacks through breath

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/05/micronano201722-f1.jpg” thumb_width=”175″ /]A sensor developed by a research team from Rutgers University may in future lead to wearables that predict asthma attacks. The team developed a reduced graphene oxide sensor to detect telltale biomarkers–elevated nitrite levels in exhaled breath condensate (EBC)–that mark the increased airway inflammation present in a developing asthma attack. Currently, breath has to be condensed before being sampled by the nanoelectric sensor, but the team’s goal is “to develop a device that someone with asthma or another respiratory disease can wear around their neck or on their wrist and blow into it periodically to predict the onset of an asthma attack or other problems,” according to researcher Mehdi Javanmard. This concept is far more convenient than a bulky spirometer. Beyond warning the person of an asthma attack, the technology could also be used for other obstructive lung diseases and for tracking treatment/drug effectiveness. Hat tip to Toni Bunting of TASK Ltd. FuturityMicrosystems & Nanoengineering (journal, full text)

It is good to see credible academic R&D in this area of wearables, since there have been others claiming measurement of calories, blood glucose, and hydration, that have been, or been close to, scams. We suspected the Healbe GoBe couldn’t do what it claimed in calorie and BG measurement in 2014 [TTA 26 June 14 and 24 Feb 15] after raising $1 million (more…)

Peak flow in your pocket: Smart Peak Flow meter/app gets Kickstarted (UK)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/12/smartflow-meter.png” thumb_width=”150″ /]A UK-based startup, Smart Respiratory Products, has successfully Kickstarted its smartphone/tablet-based peak flow meter and app with a total pledge to date of £11,322 (just over $14,000). Targeted to asthmatics, the meter plugs into the 3.5 mm audio jack (left). Like a standard peak flow meter, the user blows into the Smart Peak Flow meter, and the measurement is sent to the app, available through the Apple Store and Google Play. The measurement must be taken in a well-lit area, as the ambient light is chopped up by a photo sensor at the bottom as the patient’s forceful breath passes through a fan. The flashing signal goes into the microphone as a sound file.

The app measures the force of breath and charts it. It also engages the user through challenges, “personal bests” and winning streaks. There are also virtual badges awarded and snappy ‘earned quotes’. Those who take the ’90 Day Challenge’ of daily use receive an inhaler monitor, a cap that transmits to the phone when the inhaler is used.

Smart does not mention other respiratory uses for the peak flow meter, such as COPD.

According to MedCityNews, the company plans to complete its 510(k) and CE Mark applications by mid-2017. They will ship IFU prototypes to its Kickstarter supporters in February. The pricing on Kickstarter for the device is £10 with deluxe versions starting at £16. MedCityNews also noted that Sparo Labs’ Wing, which we profiled in November 2015, gained its FDA clearance in June but is at a $129 price. Founder Thomas Antalffy of Smart:  “I have spoken to pharmaceutical companies, and the dream for me would be to include Smart Peak Flow or the smart inhaler with every box of inhalers people buy.” At his prices, it might be possible.

Opportunity for developers – can you help asthma sufferers?

Asthma UK today unveils a key report that tells developers how mHealth could help asthma sufferers better. Entitled “Connected asthma: how technology will transform care”, whilst picking out a few excellent exemplars, it describes how poor the average asthma app currently is – for example only 6% of such apps provide pollution status, and only 8% cover inhaler technique.

Historically CHF, COPD & diabetes have been regarded as the key long term conditions to manage using telehealth. When, as this editor did a few years back, a suggestion was made to try it on asthma, clinicians tended to look askance. Yet as this report shows, mHealth can do a huge amount to improve the management of asthma especially now many people have smartphones. And, bluntly, asthma kills (more…)

Wing: a device that warns prior to asthma attacks

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/11/wing-device-964×644.jpg” thumb_width=”150″ /]A St Louis, Missouri startup, Sparo Labs, has developed what they term an ‘early warning device’ for asthma attacks. The Wing pocket-size sensor which connects to a smartphone app (iPhone 5 and later, Android soon) measure both peak flow (how fast you can blow out air) and FEV1 (how much air you blow out in 1 second). The app measures it against personal levels (80-100 percent of best is fine, 50-80 percent is caution and below 50 percent is red zone) so that a person (or caregiver) receives an accurate reading of their breathing level; if something is wrong, the person can take their medication and/or seek assistance. For the 10 percent of Americans who have difficulty breathing, not just from asthma but living with COPD, cystic and pulmonary fibrosis, bronchitis and other respiratory conditions, the Wing’s compact design and under-$200 price point won’t leave them breathless. Wing is financing/testing on Indiegogo with a 20 Nov goal of $50,000 ($32,000 to date), awaiting 510(k) FDA clearance with an in-market date of August 2016. PSFK blog, Gizmag,Hat tip to Toni Bunting, our former N. Ireland Editor. 

COPD Navigator app in pilot with Mount Sinai Hospital (NYC)

An app to help make life easier for a reported 24 million COPD patients in the US has been developed jointly by Mount Sinai Hospital, the affiliated National Jewish Health Respiratory Institute in New York and LifeMap Solutions. The COPD Navigator app encourages patient self-management through visualizing patient data and patterns, including symptoms, medication, treatment adherence, and quality of life, coupled with alerts about local air quality and weather which can dramatically influence risk. Patient data is transmitted to their physician, with an emphasis on fitting into office workflows. LifeMap is also tracking when the patient uses an inhaler through their self-designed Bluetooth LE device, though it uses any Apple HealthKit enabled inhaler. (more…)

The hypealicious, hyperluxus Apple Watch debut–what the healtherati are interested in

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]L’œil de Gimlet eyes the Apple Watch. What’s down the road is more important than Monday’s unveil. Certainly The Eye, an adorer of all things over-the-top, would love to have the $10,000-and-up 18 karat, Daddy Warbucks, Solid Gold Cadillac edition of the Apple Watch. It is the sheer hyperluxus, Mercedes-Maybach S600-ness of it all that races my pulse. Stop at $4,000? Nein! $10,000 and up lends a golden glow to all those ordinary, plastic-banded, Mickey Mouse-faced $349 and up versions for the Applepolloi that take that pulse, burp your wrist when you’re not moving enough, open the garage door, play tunes and let you draw little thingies on the face that you can send to your friends. (Urp) What’s even better than a Merc-Maybach in Conspicuous Consumption-Ville? That it will be out of date in a year, unless Apple has a trade-in policy.

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/03/Tim-Cook-previews-the-App-008.jpg” thumb_width=”200″ /] Cue Tim Cook and the Happy Dance of the Watches. (Photo: Zuma/Rex via Guardian)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/03/Apple-Goldfinger.jpg” thumb_width=”200″ /]Cue Shirley Bassey. (Gigaom via Twitter)

Ah, but let us get down to business and cut our swathe through the fog d’hype. (Editor Donna just walked in the door…)

As predicted and projected, the Apple Watch in stores 24 April in Australia, Canada, China, France, Germany, Hong Kong, Japan, UK and US goes light and standard on health measurement features: accelerometer, heart rate sensors, running and weekly activity reports. What’s different? Wrist burps you if you’re a lazy, sitting sod. (Not a great feature for deep meditators or napsters.) The leak from two weeks ago feinted health through downplaying the functionality of the Watch. Back in September, claims included blood pressure and stress monitoring. [TTA 18 Feb]

Now for the right cross. It’s not the Watch, it’s the ResearchKit. Apple gets serious in health apps beyond HealthKit, partnering with the stars in the medical research firmament. As reported: (more…)