Fitbit as clinical assessment tool: Mayo Clinic

Not unexpected, but sooner than one would think given the relative newness of fitness trackers. A Mayo Clinic study published in the September issue of the Journal of Thoracic Surgery (abstract) monitored a group of elderly patients who had elective major surgery, were older than 50 (that’s elderly?) and were expected to be in the hospital from 5 – 7 days. The Fitbit was worn on a disposable ankle strap given their limited mobility. Data went first to the Fitbit website then over to a dashboard for clinical use. Patients were also tracked when they went home, home with home health assistance or to skilled nursing/rehab. Day 2 seemed to be a critical breaking point (more…)

Signs of a home monitoring bubble?

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/08/Ambio-health.jpg” thumb_width=”175″ /]Suddenly home-based remote monitoring is very warm, if not hot. The news of investments at all levels–from Medtronic’s purchase of Cardiocom [TTA 12 Aug] to a $525,000 third angel round investment in AmbioHealth (which this Editor doubts would have been on MedCityNews’ radar a year ago)–sounds like home telehealth is finally, finally gaining traction with investors, which have been more attracted to hospital-based and fitness monitoring. But is it the right type of traction based on reasonable expectations? We were among the first to point out in 2010 in positing the FBQs* that where the data goes, how it’s being used and who’s taking action on it was critical. Now Robert Pearl MD in Forbes is also examining the new song of home RPM and finding a few off notes (or to mix metaphors, finding a pan of fool’s gold):

That’s because some promoters of home monitoring technology believe doctors will carefully scrutinize each EKG or blood sugar reading and use the information to tailor perfect regimens for their patients. This is not how medicine works.

and

Looking at thousands of EKG tracings won’t add much value either. In fact, putting all that information into an electronic medical record (EMR) only makes it more difficult for doctors to identify other, more vital pieces of information. Instead, doctors need to understand which of a few possible patterns are happening to determine the appropriate course of action.

Dr. Pearl’s prescription is for smartphones to embed telehealth monitoring capabilities at a price point slightly above the current cost, but less expensive than stand-alone devices (more…)

Fast funding and sale roundup for Thursday/Friday

A quick summary of news on both recent funding, another recently released funding analysis to add to the pile and sales–one completed, one potential:

  • The StartUp Health accelerator is now producing its independent analysis of health tech funding deals, presumably to catch the fire of RockHealth’s recognized quarterly report [TTA 9 July]. The July 2013 Digital Health Insights Funding Report is available in Slideshare format on their website with the most reported news being the 47 percent year-over-year growth to date, contrasting to RockHealth’s 12 percent, though the difference in all three may be the sampling. Practice management, big data and body computing/sensors lead the trends, according to their summary.
  • What is intriguing in the July deals is the whopping $40 million Series A funding of Oscar, which will integrate telemedicine (presumably consults) and free generic medications to its members in New York State, where they’ve stated they will be integrated into the Health Exchange in NY State. One wonders how they plan to do so on insurance exchanges which haven’t even started yet and which will be having their own challenges being a retail platform for health plans. Not unexpectedly you’ll find Khosla Ventures and Thrive Capital on the roster. MedSynergies led with a $65 million Series A for their software which will facilitate hospital networks performance monitoring of practices and provider referrals/scheduling. Internationally, Withings raised a $30 million Series A in July. MedCityNews also delves deeper into what they see as trends.
  • Fitbit just raised an additional $43 million to add to their previous $23 million. While they are still lagging fitness monitoring rival Jawbone UP by $84 million, rumors abound on what Fitbit plans to do with it: a more fully featured smartwatch? Additional apps to keep their user base engaged?–at the risk of overcomplication?   Fortune, TechCrunch
  • Toronto-based Diversinet closed their sale to New Jersey-based IMS Health for what seems like a small amount: (US)$3.5 million. Its MobiSecure technology provides government-security level mobile app security to customers such as AirStrip and the US Army. However, they were embroiled in early days in a breakup with a mobile provider, AllOne Health, and despite all their high-level tech clearances, the income realized, according to Mobihealthnews, was only in the $1 million range per year and declining and losses increasing. IMS Health is best known for its healthcare informatics, but has been involved with Ford’s in-car SYNC in development of the Allergy Alert app [TTA 7 Aug 12].
  • The ‘For Sale’ sign is also up at BlackBerry, with a corporate committee now officially exploring alliances and a sale, in the usual depressing drill. In a company once ubiquitous enough for smartphone usage to be dubbed ‘Crackberry’, and which still enjoys major worldwide market share and enterprise favor, they cannot get traction with new models. This Editor never used or liked BB, but it’s still kind of sad. ZDNet.

Apple-ologists discern ‘new’ interest in health tech and telehealth

With the same obsession that Kremlinologists had during the Cold War, the Apple-ologists at 9to5Mac divine that Apple is now suddenly interested in the sensor-based fitness sector of telehealth. Recent remarks by their CEO have been examined like the mutterings of the Oracles at Delphi. Their SVP of Technologies has been spotted wearing a Nike FuelBand, just like the CEO–and by looking at his picture, he does need it! Apple Marketing folks have been examining wearables like the Jawbone UP! (naturally as competition, duh!) Far more indicative from their sources: An all-star team from semiconductors to batteries to sensors is working in secrecy on the long-awaited iWatch. Talent’s been snatched from telehealth sensor companies AccuVein (vein mapping), the recently defunct C8 MediSensors (blood monitoring), and Senseonics (embedded sensor for blood glucose).  And they are most interested in sleep tracking. iWatch’s novelty emerges as Apple taps sensor and fitness experts

Apple’s been interested all along in healthcare–and others have been interested in Apple

No surprise to TTA readers, as you’ve been tracking Apple’s and competition’s healthcare moves along with us from the start.

  • the iPad in hospitals and their preliminary tests starting in early 2011 when tablets were new and untried [TTA 8 Feb 2011]
  • Editor Steve on the Apple Smart Shoe US Patent application back in January
  • Samsung’s hype on healthcare devices and software on the new Galaxy S4–fitness tracking disruptor?
  • 5.5 million plus of health app downloads (US) from the App Store (May)
  • the development of many devices that are based on the iPhone (Misfit ShineAliveCor‘s ECG, the Ozcan microscope and food testers only a few)
  • …though Microsoft’s Surface for healthcare back in February is likely a dud–MS just wrote off $900 million with the Surface RT, lowered its price (though only a fool with money to burn would buy it) and the Pro continues to struggle (ZDNet)

Smartwatches as the 2013-2014 tablet…and will they knock out fitness bands?

But this press focus on ‘Apple for Health’ does disguise that Apple is behind the curve, not leading it, on the watch form factor. Just like the Soviets, Apple better get a move-on or lose the race that gets serious next year. Smartwatches are fast becoming the new tablet [TTA 2 July]. One rosy industry estimate has 5 million units sold by end of 2014 (Canalys Research in Gigaom). Sony’s been there for awhile. Pebble sold 275,000 pre-orders through Kickstarter, their web store and now retail through Best Buy. This week the rumor broke among the Microsoft-ologists that they are working on an aluminum smartwatch with a 1.5-inch screen and a band out of Star Trek IV. (The comments below the TechCrunch article on the very thought of smartwatches are a good chuckle!) And undoubtedly looking over their shoulder because they’re gaining on you, contrary to Satchel Paige’s advice, are Fitbit, Jawbone and Nike, wondering if they’ll be the next Zeo.

Misfit Shine debut delayed, minus Android

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/05/leather-band21-1024×682.jpg” thumb_width=”150″ /]Announced to Misfit Shiners on the Saturday of the Memorial Day holiday weekend, of all times, was the further delay of their wearable tracker-sensor to mid-July from early June. The five to six week delay due to waterproofing was less aggravating to many pledgers than the dropping of Android compatibility for iOS only.  To those early birds who enthusiastically pledged their money to buy 10,000 units as part of the $846,000 incredibly oversubscribed placement on Indiegogo, the squishily worded justification on their blog from founder Sonny Vu, ” iOS allows us to roll out the features we want and give you the best user experience out of the box” did not satisfy–and the date of Android’s debut was not addressed. Comments on Indiegogo are not complimentary. With not only the kickstarter funding but a healthy jolt of Series A funds ($7.6 million), it is a mystery to most why Android is not supported from the start. Refund requests are a-go-go. So Misfit is sleek, waterproof….and has to overcome bad word-of-mouth from its funders just before its official debut. And directly competitive Fitbit and Jawbone UP support Android.  Crowdfund Insider, Mobihealthnews

Samsung Galaxy S4’s S Health: fitness tracker disruptor?

The much-heralded second quarter intro of the Samsung Galaxy S4 mobile phone is, according to multiple reviewers, a sustaining innovation (improvement). But embedded in it is a disruptive innovation to the fitness app sector dominated by Fitbit, Jawbone Up, Nike FuelBand and a raft of low-cost/free tracking apps.  It’s S Health, which according to Gizmodo’s incredibly detailed review monitors key activities and sleep (Editor emphasis):

Holy crap, Samsung put a health tracker in its phone! Which is actually a great idea. S Health is an app that will track your steps, stairs climbed, and the ambient temperature and humidity, plus track your food intake and estimate calories consumed/burned. You can even track sleep with an optional accessory (see below). Fitbit and co. should be nervous, although I’m curious to see what kind of ding this puts on your battery life.

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There are also a bevy of accessories that complement the S Health app. There’s a wristband you can wear independently of the phone (in case you prefer running without it), which will track your steps and monitor the quality of your sleep. It will then sync wirelessly with the app. There’s also a connected scale and heart rate monitor. Again, this isn’t good news for smaller fitness tracking companies.

The Verge has the S Health slide (grainy photo) presumably from the Samsung debut presentation. (Better photos over at CNet; photo here is courtesy of 3G Doctor–see below)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/03/s-health-via-device-foused-message1.png” thumb_width=”250″ /]If the implementation is high quality (and some commenters have issues with Samsung), Fitbit et al. could themselves be disrupted straight out of their (current) business model and consumer market, just like they did to Zeo.  S Health integrates–it’s already on your phone, it largely does what they do and gets the fitness tracking job done (‘Total Reports’) for most who are interested for free, even without the few available accessories. No downloading and going to Amazon or Best Buy to buy a raft of expensive accessories to make it work with your phone. No annual $49 membership so you can access your data.  Worst of all for the current crop of fitness trackers, not one–not even Nike–can beat the Samsung international distribution network and only Nike beats Samsung on brand recognition. Is it a deal-maker for consumers? Probably not, but it gets much much closer to the customer. Also a few things that Samsung has introduced–the Air View/Air Gesture eye tracking and gesture control–have great potential for app designers in other aspects of fitness and health.

We’ll have to wait and see–not too long– if other smartphones (HTC, Apple, LG, even BlackBerry) add fitness tracking. If I were Fitbit or Nike, this Editor would be hopping like an Easter Bunny to cut a licensing/partnership deal with them. BlackBerry with Nike FuelBand….

Related articles: Dan Munro over at Forbes cheers Samsung on in Latest Samsung Smartphone Adds Health Functions, Sky News adds the international perspective. CNet reports accessory pricing: S Band and Body Scale at $99.99 each, Heart Rate Monitor at $69.99. Update 18 March: Lt. Dan opines at HISTalk on What it means for healthcare and mHealth [WARNING 31 Aug 2014: linked page may now be infected with malware] –the market pushing for bigger smartphones that blur the line between phones and tablets, the navigation capabilities of Air View for EMR. A cold-waterish review/comments at iMedicalApps doesn’t think much of the native temp/humidity feature (your Editor begs to disagree); again a commenter brings up Samsung’s track record of weak software, but agrees that Era of mobile health tracking definitively arrives. Hat tip on these two updates to the 3G Doctor, David Doherty, via LinkedIn’s mHealth group. ZDNet notes Samsung’s Knox software to separate personal and business use on one phone, along with SAFE for enterprises.

And do read David Doherty, the 3G Doctor for a further dissection and projection of the S4’s capabilities in features like its camera, the humidity/temperature sensor, the aforementioned Air View/Gesture, the dual video, Smart Scroll for eye testing and even the recharging pad as particularly friendly to healthcare use — and users. Samsung takes S Health centre stage at Galaxy S4 launch and Will Samsung’s Smart Scroll turn the world upside down for mHealth Regulators? (mHealth Insight)