2015: mHealth’s breakout year–or more of the same sideways?

click to enlargeAdopting or Ditching It? We’re barely into September, yet the first 2015 prediction-of-a-sort is on the record from Center for Connected Health‘s Dr. Joseph Kvedar in The eHealth Blog. Does Apple HealthKit+Samsung‘s SHealth’s iterations+Google Fit+smartwatches everywhere (including LG’s G Watch R) equal $7.2 billion in wearables alone by 2018 as part of a mHealthy $49 billion by 2020? He’s optimistic, yet he hedges his bets with the caveat

“The challenge in health care is that, though we know what patients/consumers need to do to improve their health, most of them don’t want to hear about it.”

Which indicates that Dr. Kvedar has joined our small group of Thinkers puzzling out why health apps haven’t taken off beyond their Quantified Selfer early adopters and what Parks Associates termed ‘Healthy and Engaged’ [TTA 11 Aug]. With 1/3 of the purchasers of activity trackers putting them in the drawer after six months and the unstickiness of apps (80 percent are abandoned after a shocking two weeks), the winning combination isn’t obvious. But is it ‘focus on engagement’ and ‘personal, motivational and ubiquitous’? Certainly key factors, but how do we get the ‘Challenged but Mindful’ with a chronic condition–or two or three–to track and reward their real progress, even on a bad day–which an activity tracker which constantly presses you to exceed your performance has trouble gauging. (more…)

All that Quantified Self data? Drowning doctors don’t want to see it.

click to enlargeOur long-time readers will remember Questions # 3, 4 and 5 of The Five Big Questions (FBQ*). They have not lost their salience as doctors are rejecting the not-terribly-accurate ‘telehealth’ data [TTA 10 May] generated by popular fitness trackers such as Fitbit, Misfit Shine and Jawbone. We do note that Apple’s Health/HealthKit has trotted out alliances with Mayo Clinic and Epic Systems (EHR) on apps and integrating data into an PHR [TTA 3 June], as well as Samsung’s SAMI [2 June] funding a University of California (UCSF) research center and (of course) Google. But this article confirms (more…)

Text messaging for health: simple and it works

This Editor often casts a skeptical eye on short (2.5 month) studies and those sponsored by companies with a vested interest in the patient engagement technology being successful. In this case, the study reinforces earlier findings by the Center for Connected Health and other providers. Sending text messages to Medicaid (low income state-based health insurance program) recipients, even for a short time, proved to be effective. The targeted group was pregnant women plus families with children and teenagers in New York’s Healthfirst Medicaid managed care program. HealthCrowd, the developer, sent this group messages about prenatal care; wellness visits for children; and/or vaccinations. (more…)

State policies, size influence hospital telehealth adoption

A study published this month in Health Affairs examines the factors influencing adoption of telehealth (likely telemedicine/remote consults, though it’s difficult to tell from context). While 42 percent of US hospitals have telehealth capabilities, positive influences are inclusion in a hospital system, teaching hospital status, non-profit status and importantly, whether state regulations promote private payer reimbursement. Another apparent positive in adoption is small population and few hospitals: Alaska (71 percent), Arkansas (71 percent), South Dakota (70 percent), and Maine (69 percent). A major negative factor: restrictive licensure of out-of-state providers that prevent multi-state practice.  Authored by the busy Dr. Joseph Kvedar of the Center for Connected Health, Julia Adler-Milstein of the University of Michigan and David W. Bates of Brigham and Women’s Hospital, Boston. HA abstract (full text is paywalled), FierceHealthIT  Earlier this week in TTA: Ohio telehealth bill passed in Senate

Health Affairs review of telehealth/telemedicine studies

Just published in Health Affairs is Connected Health: A Review Of Technologies And Strategies To Improve Patient Care With Telemedicine And Telehealth, an overview of several studies on telehealth and telemedicine in use for congestive heart failure (Center for Connected Health), care coordination (VA), ‘store and forward’ imaging, remote ICU, medication adherence (CCH with Vitality GlowCaps) and e-referrals. The article closes with a (too-short) discussion of the three criteria that telemedicine must meet to demonstrate effectiveness: assurance of quality (met), aligning financial incentives in using telehealth to provide desired outcomes (in progress) and more research on quality and cost impact (ditto). Authored by Dr. Joseph Kvedar of CCH, Molly Joel Coye of UCLA and Wendy Everett of NEHI. Full text in PDF, HTML. Hat tip to Editor Chrys.

The CES of Health: post-scripts

It’s Everywhere, Everyday, Disruptive, Not Impressive and Still ‘Bicycles for Fish’.

Neil Versel’s first major article recaps the Digital Health Summit ‘Point of Care Everywhere’ panel with Dr. Joseph Kvedar of Partners HealthCare/Center for Connected Health, Walter De Brouwer, founder and CEO of Scanadu (the tri-corder everyone’s waiting for) and Laura Mitchell, VP of business development at ‘grizzled pioneer’ in telecare and telehealth GrandCare Systems. The key is integration–for Dr. Kvedar, making it ‘about life, personal and social’; for Mr. DeBrower, bringing digital health into the home; for Ms. Mitchell, persuading long-term-care providers that technology provides useful, actionable information. Some surprises here: Scanadu will be shipping 8,800 units in March to its Indiegogo supporters and is going into a Scripps Health clinical trial; Dr. Kvedar admitted that the latest CCH startup, social wellness site Wellocracy [TTA 30 Oct] is “still searching for its audience.” The headline is “Mobile health has a lot of power, but it’s raw and new”–but is that helpful in positioning it to the Big Users–payers, pharma, providers–who are not all that daring? Mobihealthnews 

Everyday Health with the Digital Health Summit announced on Thursday their 2014 awards for innovation to five US companies for ‘achievement in technology innovation aimed at improving health outcomes.’ They include Scanadu but also four less heralded companies: (more…)

Fast takes for Friday

Changes at Center for Connected Health, DecaWave’s chip, Happy Hackers  Healthcare.gov

Center for Connected Health executives to head Portuguese ‘body dynamics’ company in US. Associate Director Joseph Ternullo, who over the years was one of the key organizers of the Connected Health Symposium, is leaving Partners HealthCare/CCH after 17 years to lead the US subsidiary of Kinematix (formerly Tomorrow Options) located in Boston. This was announced by email to CCH contacts today. Kinematix in October raised $2.6 million in Series B funding from Portugal Ventures. Heading the US board is another Partners HealthCare alumnus, Jay Pieper, formerly CEO of Partners International Medical Services. Kinematix’s two products focus on sensor-based monitoring for foot health assessment and to prevent pressure sores and falls.  Release. Boston Business Journal….ScenSor senses you to 10 centimeters. A 6 x 6 mm chip (more…)

Cancer patient app grant to Partners HealthCare

This may be the first app to assist with patient cancer management of symptoms, medication and side effects. The Center for Connected Health division of Partners HealthCare in Boston is developing an app targeted to oral chemotherapy patients to better monitor their symptoms, adverse treatment effects and improve medication adherence. The research is being funded by a grant from the McKesson Foundation’s Mobilizing for Health initiative. The smartphone app will be tested for three months with a group of 104 patients at Dana-Farber Cancer Institute. Features include self-care strategies for symptom management, a medication tracking device which also provides feedback on symptoms, strategies to prevent side effects, patient education and psychosocial support.  CCH release, iHealthBeat

Health tech enthusiasm ≠ implementation and scale

Laurie Orlov’s impressions of this year’s Connected Health Symposium, hosted as usual by Partners HealthCare in Boston, presents the conundrum that telehealth and health tech faces beyond the consumer segment, booming fitness trackers and the apps bought one day, discarded the next. How do you get telehealth beyond the pilot to a permanent program in a health system? Do these systems really want to move healthcare to the home? According to Ms. Orlov, there’s amazingly no change from last year on these questions. They are still testing, not broadly deploying (how do companies like Ideal Life and Care Innovations [ever-funded? really?] which aren’t near substantial adoption continue?); and health systems are moving care from brick-and-mortar to the home but slowly, still. Continuing too is the lack of focus on how technology can work best with older adults.  (more…)

Wellocracy launched to explain fitness tracking, apps

Partners HealthCare’s Center for Connected Health has launched Wellocracy, to explain to consumers how you can get the most out of their fitness trackers, health apps and related devices. It won’t be a ‘Consumer Reports’ of devices or apps (though provides a comparison chart), ‘curate’ them as the now seemingly dormant Happtique once intended to do or screech at you on your ‘issues’ as Cigna’s Go You does, but offers sensible advice on how to get the most out of the kit you just bought and the information it provides. Also it addresses the ‘stickiness factor’–staying with a regimen–connects to outside news and adds a large dollop of social engagement with sharing ‘The New Fit Revolution.’ Coincidentally, The Center’s Joseph Kvedar, M.D. just co-authored a book, Wellocracy: Move to a Great Body, with Carol Colman and Justin Mager, MD. Release includes a useful Harris Interactive survey that indicates that fitness and sleep tracking are seen favorably and perceived as valuable but is still large on potential, short on customers.

Addicted to mobile health? Telepsychiatry to the rescue!

Dr. Joseph Kvedar of Boston’s Center for Connected Health counted himself in this Editor’s camp as annoyed by the mHealth hype (inflicted by those we’ve dubbed the D3HDigital Health Hypester Horde), and far more of a believer in SMS for health programs. His blog post is a ‘kind of edge’ towards thinking that mHealth can be habit-forming. In the CCH’s own clinical trials, more participants have smartphones (tracking the general population’s adoption) even with the lag among those with chronic disease (maybe a question of affordability?) and want apps. And then he sees the pattern of people checking their smartphone obsessively, like budgies with bells and mirrors….along with a study that indicates that patients with a passive sensor to upload blood glucose measurement, rather than pushing a button, were “significantly more adherent to their plan and had better health outcomes.” Not having to do something in the Diabetic’s Perpetual Battle of Stalingrad is addictive? Well, this is edging towards a nomination for ‘What in the Blue Blazes?” Could mobile health become addictive? (CHealth Blog) Hat tip to reader Bob Pyke via Twitter

Well, we can send Dr. K to a connected psychiatrist for a session of e-therapy.  (more…)

In changing behavior, ‘wanna’ works better than ‘hafta’

click to enlargeThe proliferation of apps, tracking programs and devices that promise to change your life through Quantifying Yourself and lead you to the New Jerusalem of fitness and health is fascinating in number and variety. Yet why do some apps and programs do their job of changing behavior–and others, equally well-intentioned, do not? It’s all about ‘wanna’ vs. ‘hafta.’  Tracking your caloric consumption quickly turns into a ‘hafta’ drag for most (MyFitnessPal), but if you plug into a lively online community (Fitocracy), make the app easy to use and the changes gradual, plus forgive a few lapses, the same activity can start feeling rewarding and ‘wanna’. It’s all about personal autonomy, reward and control. It may be carrots rather than carrot cake, but you’re doing the choosing. Must reading for those working to develop corporate wellness programs, sticky apps and engage users. Why Behavior Change Apps Fail To Change Behavior (TechCrunch) Hat tip to reader Sandeep Pulim, MD via LinkedIn.

Related: Our April discussion of employee wellness programs, Employee wellness: Carrot? Stick? Or something else?

An example of simplification helping to increase positive behavior–and perhaps outcomes–is the recent study of the Center for Connected Health’s BP Connect program. Mobile users took their blood pressure more often than the telephone hub/device users; these older users (median age 61!) found the mobile version both easier and more convenient in portability. Overall BP scores went down moderately. Connected Health Study Finds Mobile Health Improves Patient Engagement (HIT Consultant)