When is an app not an app? (When it’s a conundrum)

It all started so simply. In DHACA under the leadership of Rob Turpin (BSI) we produced the definitive guide to app regulation in the UK. Sure it was 44 pages long (and will shortly need updating) however we all knew that an app was standalone software and that none other than MEDDEV 2.1/6, the ultimate definitive guide to when an app is a medical device defined software as:

…a set of instructions that processes input data and creates output data.

However doubts began to creep into this editor’s mind when he heard that app developers in the US were avoiding (US/FDA) medical device classification as that would rule them out as service providers, which can reduce future  reimbursement benefits – as we quoted Ralph-Gordon Jahns of research2guidance in 2014 “profitable developers… rely on service sales as their primary source of revenue.”

Things got more complicated when it emerged at the UK Health Show this autumn that PHE was considering listing digital GP services as (more…)

The difficulty in differentiating telemedicine and telehealth

Our Editors have always tried to cleanly define the differences between telemedicine, telehealth and telecare, even as they blur in industry use. (See our Definitions sidebar for the latter two.) But telemedicine, at least on this side of the Atlantic, has lost linguistic ground to telehealth, which has become the umbrella term that eHealth wanted to be only two or three years ago. Similarly, digital health, connected health and mHealth have lost ground to health tech, since most devices now connect and incorporate mobility. And there are sub-genres, such as wearables, fitness trackers and aging tech.

Poor telehealth grows ever fuzzier emanations and penumbra! Now bearing the burden of virtual visits between doctor and patient, doctor-to-doctor professional consults, video conferencing (synchronous and asynchronous), remote patient monitoring of vital signs and qualitative information (ditto), and distance health monitoring to treat patients, it also begins to embrace its data: outcome-based analytics, population health and care modeling. Eric Wicklund accumulates a pile of studies from initial-heavy organizations: WHO, HIMSS, HHS, Center for Connected Health Policy (CCHP), ATA, TRC Network. All of which shows, perhaps contrary to Mr Wicklund’s intentions, how confusing simple concepts have become. mHealth Intelligence

6th Global mHealth App Developer Economics Study–closing soon!

click to enlargeresearch2guidance’s 6th Global mHealth App Developer Economics Study is still open (closing end of May) and interested in the opinions of those in the health tech field. Take 15 minutes or so and take the survey (link here). You’ll also receive a free copy of the survey once completed, and a chance to win either an Apple Watch or a Samsung Gear. Last year, over 5,000 industry experts did, including our TTA readers. Our article on the survey’s preliminary results in April. TTA and DHACA (Editor Charles, Managing Director) are media partners for this study. Hat tip to r2g’s Ralf Jahns.

6th Global mHealth App Developer Economics Study–early results in

click to enlargeresearch2guidance has shared with the Editors some of the preliminary results of the 6th Global mHealth App Developer Economics Study. Currently at 2,000 participants and open till the end of May (click here to take the 15 minute survey), it has grown to be the largest global market study of the sector. (Last year’s study topped out at more than 5,000 industry respondents and is available as a free download here.) For their time, respondents can view initial results upon completion of the survey, after publication in 2nd Quarter receive a copy of the report and be automatically entered into their prize draw of an Apple Watch or Samsung Gear.

Many of the results to date are neatly summarized in the infographic at left and below:

  • 61 percent believe mHealth solutions can cut costs through therapy adherence
  • 65 percent believe mHealth adoption could save costs by shortening or avoiding hospital visits
  • Market potential as a distributor: app stores still lead (61 percent) but half believe health insurers are now second. Doctors and hospitals trail at 42 percent and 38 percent respectively.
  • Most positive impact: following up and monitoring of conditions; information provision; diagnosis and treatment
  • But goals are still distant: 53 percent of respondents revealed they had only “partly achieved their goals”. 4 percent claimed their mHealth “dreams came true”. (Perhaps those who had their companies acquired? — Ed.)

r2g release.

TTA and DHACA (Editor Charles, Managing Director) are media partners for this study. Hat tip to Sean Phillips of r2g. Previously in TTA, Charles’ original article.

Abstracts for Med-e-Tel now online

click to enlargeMed-e-Tel Luxembourg, one of the longest continuously running health tech conferences in Europe (from 2004, certainly enough to qualify it as a Grizzled Pioneer), will be on this week from Wednesday to Friday, but if like this Editor you’ll be unfortunately far, far away, Prof. Maurice Mars, Richard E. Scott and Malina Jordanova of the organizing International Society for Telemedicine & eHealth (ISfTeH), have published the speaker abstracts online and free (requiring only registration.) See them here.

The abstract researchers span the globe–Nigeria, Greece, Sweden, Czech Republic, Brazil, New Jersey (!)…plus several from UK (including Malcolm Fisk), Portugal, France, Spain, Italy, South Africa and Bulgaria. Orange Labs will present the data of their diabetic bike riders from the 2015 mHealth Grand Tour (MHT)–this was a high point of last November’s mHealth Summit/HIMSS Connected Health [TTA 13 Nov 15]. There’s also research on topics you don’t hear about in most conferences: smart cities, mHealth’s environmental impact, telenursing, adapting eHealth to serve those of differing abilities, even substituting smart technologies for physical restraints. So many unusual views are represented here. Also in this issue, Vol 4 (2016), is a wealth of research from Brazil.

More in the Med-e-Tel update press release.

Seeking input from mHealth stakeholders: 6th Global mHealth App Developer Economics Study

click to enlargeResearch2guidance is inviting stakeholders from across the industry to share their experiences of working with and in mHealth to find out what is proving successful today and what might prove successful in the near future. Last year, over 5,000 industry experts participated in this study for the largest study on the global mHealth market. (TTA was a media partner for last year’s study.)

For the 6th edition of the Global mHealth App Developer Economics study, they are keen to find out:

  • Which business models are most effective to succeed in mHealth today?
  • Which app categories are most successful in meeting the demands of both patients and investors?
  • What does the relationship between Health Insurers and mHealth look like in 2016?

In return they are offering participants:

  • The chance to view initial results immediately after completing the survey
  • A free copy of the mHealth App Developer Economics 2016 report

Take the survey here

For anyone who has not read it yet, the excellent 2015 survey is here. (Their key findings from last November are here.) R2G press release 

165,000 apps, 3 bn downloads and counting: global mHealth apps study

click to enlargeThe results of the fifth annual mHealth App Economics survey are out. Our Readers were invited to participate back in March when it was sponsored by German research firm research2guidance in collaboration with mHealth Summit Europe and HIMSS and kicked off at the Riga meeting in May.

Major apps stores reported more than 165,000 mHealth apps published by 45,000 companies, and projected 3 billion downloads by close of 2015.  Some other key findings from R2G do surprise:

  • The target for apps is DTC–chronically ill patients–with their hospitals as #2. Physicians are important, but less so than last year’s survey.
  • App publishers aims appear altruistic. 53 percent of mHealth publishers claim that their main motivation is to help people improve their medical conditions. However, 60 percent aren’t reaching their goals yet mainly due to low reach. The vast majority of apps (62 percent) mark up less than 5,000 annual downloads. (See the chart below for some possible reasons why)
  • Diagnostic apps lead in anticipated business potential until 2020. And app publishers have added medical professionals to their team.
  • What app publishers find works to change behavior is not gamification. What does: integration of provider feedback or dialogue.
  • Yet providers, such as doctors and nurses, are seen as the most threatened group by mHealth solutions.
  • A scant 3 percent of mHealth publishers generate more than $1 million–and they are far more focused on sales and brand awareness than their brethren which make little. (chart)

(more…)

HIMSS Connected Health Conference/mHealth Summit starts Sunday–save $100

Time is short! This Editor will be attending the HIMSS Connected Health Conference this November 8-11 in Washington, DC (actually outside The Puzzle Palace in National Harbor, Maryland). Telehealth & Telecare Aware has been a media partner (disclosure) since the 2009 mHealth Summit. Changes this year include that it is three conferences in one: the original mHealth Summit with the Global mHealth Forum, the new PopHealth Summit (concentrating on health improvement on the community, regional and national level) and the much needed new CyberSecurity Summit.

Attend all three for one registration, including a large Exposition floor and three pavilions for Population Health, Cybersecurity and Games for Health. Also, there are extra co-located and add on events, mainly on Sunday the 8th. The Global mHealth Forum focuses on mobile and connected health in low and middle income countries (LMICs) and is on Wednesday.

The Summit organizers have been kind enough to offer an excellent discount to our readers of $100. When registering, click on the advert (above, right hand side) and use the promotional code TELEHEALTH100 to receive it. (more…)

Scottish Digital Health and Care Week

7-11 December, Strathclyde University’s Technology & Innovation Centre, Glasgow

click to enlargeThis year’s conference theme is “Using innovative technology to enable more integrated, sustainable & person-centered health and care”. It offers the opportunity to learn from across Scotland, the UK and beyond, with a mix of workshops and plenary sessions. Topics include the critical lessons learned when deploying technology enabled services at scale, drawing experiences from telecare, telehealth and eHealth; learning crucial lessons from the experience implementing the UK wide DALLAS programme. Delegates are encouraged to discuss current knowledge base on a range of topics; network with colleagues from across the relevant sectors; and actively consider application to their own practice. There are also multiple events during the week; more information at SCTT’s website. Registration. Hat tip to Mike Clark via Twitter

Two US events: Health Wildcatters Pitch Day (Texas), mHealth Deep Dive (California)

Health Wildcatters Pitch Day: 12 November, Majestic Theatre, Dallas Texas

This Texas accelerator will be presenting its 2015 class of 10 early stage companies in 10 days. Doors open at 2:30pm and the presentations are 3-5 pm. All attendees are cordially invited to the Pitch Day After Party which is a short two-block walk from the theatre at the Health Wildcatters office, 211 N. Ervay Street, 2nd floor. The $10 ticket cost is primarily to defray Eventbrite (having worked with them before!) as it is well-sponsored indeed. More information and registration hereHat tip to Fiona Schlachter.

Deep Dive: Health/mHealth/eHealth: 8 December, 2825 Lafayette Street, Building 34 (EBC entrance), Santa Clara, California

Shrinking smart devices, sensors, cloud services, connectivity, and an aging population have all created tremendous changes in healthcare and fitness. This half-day deep dive meeting will discuss wireless and mobility solutions, as well as the fixed and fiber side that enables remote radiology and VR tele-surgery through robotic arms. If you are interested in the marriage of startup tech with the health and fitness industries, join in this discussion and networking. It probably pays to be a member as the non-member fee is steep. There are also ‘spotlight tables’ that are discounted 50 percent for pre-revenue startups. Sponsored by the Telecom Council of Silicon Valley. Information and registration. Hat tip to Editor Charles and Mike Clark.

No future for mHealth as m-health

There is, but not what was envisioned five to six years ago. If you still think of mHealth as a subset of ‘health’ and defined by its devices as a separate strategy or ‘revolution’, it’s time to check your glasses’ prescription. Thus an article like this published in HIMSS Media’s mHealthNews that focuses on mobile devices starts off feeling antique (as in 2008-9) in its emphasis on video and direct to consumer apps and problems thereof–then fast forwards to This Modern World: the Graettinger-esque dissonance of data insecurity, the entry into the City of Glass of integration–multiple platforms, data sets and apps/tools into personalized, proactive care and clinical decision support.

At MedCity News, the snark prevails in coverage of a World Congress Boston mHealth + Telehealth World conference where participants seemed to treat mHealth as m-health–chattering on about smartphones and tablets as devices not delivery vehicles, (more…)

Women and eHealth on the international scale: JISfTeH explores

JISfTeH–the Journal of the International Society for Telemedicine and eHealth–published by the University of KwaZulu-Natal in South Africa, has an intriguing issue this quarter that focuses on the international role of women and eHealth, not only as recipients but also as developers, designers and integrators of what they term Information and Communication Technologies (ICTs). Encouraging a greater role for women in what we more commonly call HIT is the subject of various UN, academic and rural efforts. The articles here are about   programs designed by, implemented and largely for women: the ‘Zero Mothers Die’ global initiative using mHealth to reduce infant and maternal mortality, using video games in structured exercise to prevent depression and anxiety among new mothers in the rural Philippines, telehealth in the monitoring of gestational diabetes (more…)

A brief collation of important stuff

This editor has been so time starved of late that blogging has proved impossible. However the information has continued to come in so here is a selection of the most important:

CUHTec – effective Wednesday 1 April 2015, CUHTec is now being hosted by Coventry University Health Design & Technology Institute (HDTI). A new website is up and running where you can book courses online.

Telehealth Quality Group – the website for the International Code of Practice for Telehealth service, previously known as TeleSCoPE,  should go live on 22 April at midday, in synchrony with Malcolm Fisk starting his presentation on same at MedeTel.

Testbeds – there’s a most interesting NHS England initiative, whereby NHS units are being asked to put themselves up as trial sites for entrepreneurs to use as testbeds for innovative ways of providing care. The AHSNs will play a key role in brokering testbed and innovator.

Growth spaces for life sciences – an organisation calling itself (more…)

New alliance for m-health in Europe

Swedish telecommunications company Tele2, with operations in nine European countries, has announced that it is to partner with HCL Technologies to develop Machine to Machine (M2M) click to enlargeand Internet of Things (IoT) solutions, particularly those within the m-health click to enlargemarket. In an announcement on their website, HCL Technologies, which employs over 100,000 people worldwide, said “by focusing on the Healthcare segment in Europe, the two companies will jointly address one of the fastest growing areas of the M2M/IoT market. For example, in healthcare the two companies are planning to develop remote patient monitoring systems that are enabled through smartphones. HCL and Tele2 will work together in an effort to reduce transactional and operational costs for their partners, whilst tapping into the lucrative revenue opportunities that exist within the European IoT/M2M market.”

The news article continues “HCL will be responsible for the implementation, integration, roll-out and ongoing support of M2M/IoT solutions, in addition to device connectivity through its flagship Device Gateway product – Aegis. This becomes feasible through Tele2’s Control Center, which is the market leading M2M/IoT connectivity platform in the world.”

Moving past the hype on mobile, wearables for consumer health

click to enlargeDirectionally positive, but still quite developmental in reality. The gold rush not quite begun.

In the past week or two, this Editor has been working her way through a stack of surveys and journal-published research, all heavily promoting the greater interest in and usage of consumer mobile health. Here we have Monique Levy of the well-regarded Manhattan Research finding in their surveys (via Mobihealthnews):

  • 86 percent of the general population is online for health
    • Half of those use mobile
    • Two-thirds use social media to seek health information
    • One-third communicate digitally with doctors
    • Three-quarters interact with online pharma resources
    • About 20 percent of patients say that mobile is essential for managing their care–increasing to 32 percent of people with diabetes, 39 percent for people with MS

Before the D3H (Digital Health Hypester Horde) crowd vaults over the moon, however, Ms Levy states that “What people mostly do on their smartphone is look for information.” She recommends optimizing websites (in this context, primarily pharma) for mobile search, and apps should address “real customer pain points or niche needs”, not just a cool tracking app.

Yes, but the D3H point out the fifth annual ‘Pulse of Online Health’ by Makovsky Health (healthcare PR agency) and Kelton (research), a survey of over 1,000 adults, headlining that almost two-thirds (66 percent)of Americans would use a mobile app to manage health-related issues, (more…)

Data breach fail at AnthemHealth: an inadvertent ‘inside job’ (updated)

US health insurance giant AnthemHealth, which had a data breach of reportedly up to 80 million beneficiaries [TTA 6 Feb], was an inadvertent ‘inside job’. The Associated Press reported that the credentials of at least five employees were used to access information, at least one of whom was an administrator who viewed his credentials being used to query the data warehouse. It’s easier than you think to get them. In an analysis published by security firm Tripwire and also in MIT Technology Review, the writer Ken Westin outlines how easy it is to find that the Anthem warehouse is TeraData, and to match up employees engaged with it, through using public employee profiles on places like LinkedIn and job postings. Then it’s deductive to find exact email addresses (find the pattern–lead generation companies building business contact lists do this all the time) and send these key employees phishing emails  (more…)