23andme and FDA: making nice?

In a reversal from the ‘¡No pasarán!’ (‘They shall not pass!’) position 23andme and its QS fans famously took back in the winter and spring [TTA 2 Apr, with prior links] vis-a-vis FDA on interpretation of genetic tests, this report from VentureBeat indicates that 23andme is holding out an olive branch. It’s not your usual cutting. It’s an application for Bloom’s Syndrome, a rare inherited genetic disorder, which FDA just accepted. Adding to it is that CEO Anne Wojcicki is a carrier of this disorder. VentureBeat’s speculation is that if successful, the Bloom’s Syndrome application would be the template for future test applications. The tone on both sides has grown conciliatory. For example: sitting on the same Congressional panel on healthcare last Tuesday was an FDA physician directly involved in the approval situation and Ms Wojcicki. There was a well-timed, quite emollient interview with Ms Wojcicki in the Wall Street Journal this past weekend. Certainly a factor is that 23andme is still growing, but less quickly–up 150,000 from its pre-FDA contretemps level of 550,000. And its funders, even though closely related to Ms Wojcicki, hate to wait on numbers which are certainly below projections.

Is consumer digital device engagement sticky? Or just the hype?

A wonderfully cranky essay by Laurie Orlov on her new blog Boomer Health Tech Watch might make you think The Gimlet Eye was her guest writer (see below). Ms Orlov observes the ratched-up noise level around wearables, fitness bands, smartwatches (in which your Editor will be drenched quadrophonically next Wednesday at CEWeek NYC, glutton for punishment as she is). Yes, we’re swooning around Apple Health [TTA 3 June] and having a minor swivet around Samsung’s Simband and SAMI [TTA 2 June]. The bucket of cold water in Ms Orlov’s grip is the high dropout rate among fitness band users (33-50 percent, cited from Endeavour Partners and NPD Group); this Editor will also add the devices’ relative inaccuracy, fragility and glitches [TTA 10 May]. But ‘the investor community (via the media) clearly IS being transformed, at least temporarily’ as well as outside the health industry, by a belief that these devices will push the world into Quantified Selfing for the Masses. Will wearables herald our arrival at the New Jerusalem of Health? Certainly it’s been trumpeted and tromboned by the D3H (Digital Health Hypester Horde) badly needing a fresh fave rave. But can digital health survive another Hype Curve dive? Can weThe Consumerization of Health Care — is it working?

Further in this jugular vein, Business Investor, in a superficial swipe, dubs smartwatches uncool just because they trail fitness bands by six points. They did a better job in March delving into the real challenges that wearables face: smartwatches look and feel like a brick on your wrist (Ed. D’s term), Google Glass is socially unacceptable in many quarters (banned in Silicon Valley!) and wearables are still in Early Adopter-Ville.

Update: Ms Orlov just sent to this Editor a brief comment with a link to a thoughtful NY Times article not only on The Trouble with Apple’s Health App, but also how the barriers are more subtle–and more common-sensical–than the hype around how consumers are eager to register every burp on a PHR (they’re not), they don’t want to be nagged by technology (easier than your mom to be rid of) and the group that needs it most (the old, poor) has the least, for now, access to it. But largely ignored by the D3H.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”75″ /]On assignment off Cape May, New Jersey inventorying readiness of coastal defense fortifications. Just between us. Shhhh!

Monday’s ‘in the news’ briefs

Proteus raises $120 million from “major new institutional investors based in the United States, Europe and Asia” for further development of its ‘smart pills’. Mobihealthnews. Previously in TTA here (starting in 2009!) It’s a long way from ‘tattletale pills’…..InTouch Health now has an FDA-cleared iPad app, CS for iPad, to support a digital stethoscope component on the mobile devices. The app is designed to assess heart and lung sounds in real time in acute-care settings particularly tele-ICU. MedCityNews…..In the mood to read your brainwaves? The Muse is here to help with neurofeedback. MedCityNews takes it on a test drive and if you don’t mind wiping your head down to get a good connection, it definitely points to the future of controlling computers with brain waves and in the meantime, pairing up health apps to get a correlation with those waves….And finally a ‘think piece’ in HeartSisters by Carolyn Thomas“To just be a person, and not a patient anymore” is largely an impossible dream for those with chronic disease. It’s part of the basis behind non-compliance and other patient behavior that doctors have difficulty understanding. The experience of the patient–the frustration (the ‘perpetual battle of Stalingrad’) and the burden that person carries is the argument behind ‘Minimally Disruptive Medicine’. Must reading as those same patients will be pressed now even more to Quantify Themselves and also to keep track of every fluctuation in vital signs on their iPhone.

More telehealth for the bassinet set

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/12/3019806-poster-1280-sprouting.jpg” thumb_width=”160″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/product_sock-Owlet.png” thumb_width=”160″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/0ca96884.MimoKimono.png” thumb_width=”160″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Sensible-baby.jpg” thumb_width=”160″ /]Industry talk is that wearables are no longer the hottest things on the hype curve because of smartwatches and smartphones getting even smarter, but one area is the exception: baby wearables. MedCityNews has an overview of four, three of which we’ve noted since late 2012: Sproutling, Owlet, Rest Devices’ Mimo Turtle (which fastens into Kimono, a/k/a the ‘onesie’) and (new to us) Sensible Baby SmartOne. All have some combination of heart rate, skin temperature, movement/sleep position monitoring from sensors into a smartphone app. Form factors: Sproutling and Owlet are anklets, Mimo Turtle’s monitor fits into a designated secure pocket in the lower (baby’s) left of the onesie, Sensible Baby goes into a pocket or attaches to clothing so it’s likely more suitable up to toddler age. Last December’s FastCompanyDesign article on Sproutling targeted its debut for this summer [TTA 10 Dec 13], but there’s no trace of a website so it’s still in development. Owlet’s been in market since fall 2013 [TTA 27 Aug 13] as has Mimo Turtle which is now sold through major retailer Babies ‘R’ Us.  Sensible Baby is still inviting beta testers and pre-orders at $99, projecting $149 when on sale later this year. There’s also no reassurance on the site that the SmartOne can be safely chewed — and of greater concern, its size appears to be small enough to swallow. With pricing between $150 and $300, they are at the Velocity of Cute as ‘ooh-ahh’ gifts for those baby showers which are coming up on many calendars and for your favorite Quantified Self Moms. (Just hold the obsessive smartphone checking.)

Also: Investor/engineering lab Lemnos Labs’ blog posting on Sproutling’s development from application/prototype to a scalable production model will be interesting especially if you are being challenged in the hardware development process.

Previously in TTA: Wearables on the hype cycle: a ‘Fitbit for babies’Owlet baby monitor sock exceeds funding goal (But Huggies Tweet Pee seems to have stayed in Brasil…), Owlet baby monitor sock moving to marketCute sensor fashions now for baby

Smartwatches, fitness trackers: overload in several ways

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/acitivity-trackers_wellocracy_chealth-blog-kvedar.jpg” thumb_width=”150″ /]Dedicated Quantified Selfers, who have more than one device strapped to their arm and wrist, know that when like measurements are compared from two different devices (e.g. step counts, weight, activity, blood pressure), like stock or mutual funds, their performance will vary. Sleep trackers are among the worst offenders. But newbies just ‘into’ this may be confused. Not to worry! The prescription from Dr Kvedar is: “Expecting these consumer devices to have scientific accuracy is unrealistic. Expecting them to help you keep your activity level top of mind and measured in context from day to day is realistic and in most cases helpful.” They set a tone and help motivation, with other tools such as social groups and coaching. Reassuring words, especially as Dr Kvedar has launched Wellocracy to help individuals to understand that.

There’s of course pressure from clinicians to upgrade fitness monitor readings to clinical quality so they can use it…but absolutely no clarity on exactly how they would use it, a seemingly contradictory statement which centers on the quality of analysis and what alerts would be pushed to the clinician, who memorably has his or her ‘hair on fire trying to do what they do right now.’   (more…)

UK-centered review of mobile health tech

Perhaps it’s the focus of this US-based Editor, but other than the occasional feature in the Guardian, Times or Telegraph, there are few articles on digital health written as general audience overviews of problems to be solved and relative capabilities of devices, rather than whiz-bang gadget fests. Thus this Editor’s attention to one just published in TechAdvisor/PC Advisor. Springing off of Quantified Selfer Dr Larry Smarr’s early diagnosis of Crohn’s disease, and based on his principle of ‘devices can help us notice trends before they become serious’, the writer reviews enabling tech such as mobile ECG AliveCor; Azoi’s Wello iPhone case/Android peripheral measuring heart rate, blood pressure, temperature and lung capacity; the overabundance of unproven health apps leading to the NHS’ Choices HealthApps library [TTA 9 May 13, RSM meeting summary 22 Apr] and web-based Vitrucare from Dynamic Health Systems for long-term chronic condition management. Oddly the article mentions Qualcomm and the Tricorder X Prize without in the same (heavy) breath, Scanadu. (Ed. Note–a check of their blog indicates no update on their delayed shipments due to production problems, TTA 5 Apr) Medical apps and devices are placing the future of healthcare in the palm of our hands

The ‘grey’ market is where it’s at for ‘quantified selfing’

Surprisingly in the tech-addicted (and young-skewing, based on subject matter) Gigaom is this short piece on how health tech companies are missing the boat by targeting the young, healthy fitness addict or plain addicted-to-the-data Quantified Self (QS) market, rather than those over 50 and their families. ‘Simple’ and unobtrusive are the keywords, especially for what the late and much missed MetLife Mature Market Institute termed the ‘old-old’–those over 80. Mentioned are home activity monitoring systems such as Lively, BeClose and GrandCare Systems supplanting the PERS pendant (Lifeline) and the additional alert capabilities offered by GreatCall/Jitterbug. (This Editor will also mention a new telecare system entering the European and Americas markets, Essence Care@Home, which premiered at Mobile World Congress 2014. More on this in the next few days.) What’s notable about the article is the emphasis on the market size (via expert Laurie Orlov): $2 billion now, ten times that in 2020. What’s incomplete about the article is no ‘look-ahead’ to how devices like smartwatches (and watch-like forms such as AFrame), sensor-based wearables which connect to smartphones–and sensor-equipped smartphones, tablets and even Glass-type devices with simple apps which can help with self-or group-monitoring, prompts for those with cognitive difficulties, and more. Worldwide, we are also running out of carers [TTA 24 April]. Who will crack the code on tech for seniors?

Pacifying baby, taking temperature

UK developer BlueMaestro has announced a temperature-sensing baby pacifier with the somewhat obvious name Pacifi. According to Mobihealthnews (but frustratingly not on their website), the pacifier sends temperature data via Bluetooth Smart to an iPhone or Android app. Parents can record medication dosing and reminders, track temperature and medication over time, and set up an alarm when baby runs a high predetermined temperature. It’s also dishwasher safe. Pacifi joins Raiing Wireless‘ body thermometer FDA cleared in 2012 (now iThermometer) and Kinsa’s plug-in smart thermometer which took a crowdsourcing approach to local public health. It is not cleared for sale yet in the UK or US, but was shown at last month’s Mobile World Congress Barcelona and the Smart UK Project in London. Unfortunately, it may be a while before Quantified Self Moms can put it on the list for their baby showers, along with the Owlet monitoring sock, Mimo onesie and iTeddy [TTA 10 Sept]. Related: MedCityNews compares Mimo to adult sleep monitor Lark, awarding the matchup to Mimo. The real matchup is Owlet versus Mimo (see this Editor’s comment). (Also see our comments here discussing the safety of RF monitoring around babies.)

Apple patents health monitoring headphones with ‘head gesture’ control

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/02/apple-patent-earphones.jpg” thumb_width=”150″ /]Another reminder of Apple’s growing interest in the health monitoring and fitness space is the news that the company has just been granted a patent for a “Sports monitoring system for headphones, earbuds and/or headsets” (U.S. Patent No. 8,655,004). The biometric headphone system can sense a number of metrics including temperature, heart rate and perspiration levels. It also contains ‘head gesture’ control which could allow users to change music tracks and adjust volume by tilting or rotating their head. Read more in Apple Insider.

Related TTA posts: Sensor-based monitoring coming to an iPhone near you? /  Wearable technology – so much choice, so much data to sell? / Turn up, tune in but don’t drop out with health monitoring earphones

 

The Quantified Selfer’s Christmas form letter

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]  APPROVED by The Gimlet Eye, on assignment directing Air Traffic Control for Mr. Claus.

Dear ______,

I can see from my ______ wrist device that it’s once again time for my annual Christmas letter to update you on a number of personal facts about the past year! Lucky for you, I’ve been able to view my daily data on a variety of self-tracking devices using interactive graphs to spot trends and patterns so far.  The year raced off to a great start because I got a new ______ from Santa last Christmas. (Continued…)

Our final pre-Christmas post is from the ‘♥ Sister’ herself, Carolyn Thomas, who has written this most witty communication that you may well receive from your favorite (?) Quantified Selfer. If not, reading this you will be forearmed at holiday tables and gatherings. You will view your QS nephew or friend in a new, more tolerant light. Wearing their Google Glass, tracking the cookies and egg nog on their Fitbit or Jawbone UP, passing around the Misfit Shine, obsessing on what workout will most efficiently balance the caloric intake…. To the rescue? Spot the Dog. Fitbit, Jawbone and Shine make great chew toys, and Glass…will Spot get to it before the video hits the cloud?

We wish all of our readers a marvelous Christmas Holiday, Festive Season and Happy New Year! (and thank Carolyn for the reference!–Ed. Donna)

150 Health 2.0 presentations online

Last month’s Health 2.0 three-day conference in San Francisco appears to be almost totally on video, with presentations ranging from 5 minutes to over 1/2 hour. The 15 pages include demos, keynotes and interviews. Warning–don’t use the categories at the upper right hand corner or the sidebar to try to sort through them, because these group together multiple meetings by topic. Everything you wanted to know about Quantified Selfing, patient communities (PatientsLikeMe, Medivizor), HIT, EMRs, employer wellness programs (Keas), discussing end of life care (Blaine Warkentine’s Vimty) as well as other ‘unmentionables’ like vulnerability, caregiving, social support, death, sex, taxes. Quite a few on the US health insurance exchange which was going to lead Americans to The New Healthcare Jerusalem in a few days. Somehow GetInsured.com manages to calculate possible individual insurance savings in two-three screens, though you have to call about insurance. Tim Kelsey, the NHS National Director for Patients and Information, announces £1 billion in a technology fund hereHealth 2.0 San Francisco 2013.

Turn up, tune in but don’t drop out with health monitoring earphones

microsoft_septimu_earphonesAs part of a recent research project, Microsoft has incorporated health and fitness monitoring into a pair of earphones.

One application being developed for the hardware platform named Septimu, is a smartphone app called Musical Heart. The app enables Septimu to generate tunes based on a person’s mood or activity. So for example, fitness enthusiasts who want to keep the heart rate high can use Musical Heart to automatically up the tempo, helping them keep up the pace. Or for those feeling stressed or angry, Musical Heart could select something more soothing to help bring the heart rate and breathing down to a more relaxed level. Reported in PSFK

A timely study published online last week in Proceedings of the National Academy of Sciences, demonstrated that ‘musical agency’ (i.e. music chosen by the study participants) greatly decreased perceived exertion during strenuous activity. (more…)

Don’t worry, there’s a wristband for that…

tactiluNot one for my Christmas list, but check out this TechCrunch review if you want to find out more about the Tikker wristwatch (which is currently doing well on Kickstarter). Tikker will calculate when you’re likely to bite the dust, based on factors like age, activity level, BMI and location.

If you’re hesitating as to how you might feel about wearing such a thing, just place a mood wristband on your other arm. (more…)

Body computing, sensors and all that data

This past week’s Body Computing Conference at University of Southern California (USC) had three sessions focusing on wearable sensors and the big names such as the well-financed Fitbit, Jawbone, BodyMedia, the ingestible sensor Proteus and Zephyr. The panels were split between the medical-grade and the consumer oriented with this report indicating some friction between the two. The notion of the Quantified Self died hard, even with Basis Science’s Marco Della Torre noting that 80% of health app users abandon them within two weeks, so the discussion moved to form factor and the ‘holy grail’ of getting the 90% of never-ever QSers to pay some attention. Of course, it’s the flood of data that has to somehow be processed (one of the FBQs) even though the doctors appear to be unconvinced of the evidence…but the ‘big data’ may be proving it after the fact. The future of wearable sensors in healthcare (iMedicalApps)

Relax, it’s (not) just a breathing monitor headset

breath monitor treadmillA headset which monitors the quality of your breathing is being developed by BreathResearch, a San Francisco Bay area start-up.

Combined with a mobile app, the ‘Breath Acoustics’ headset listens to your breathing and analyzes the patterns. Sensor-based breath monitoring may be a less commonly monitored biometric pattern but recent studies suggest it could be used to detect stress levels, bacterial infections and other conditions. The headset also presents other biometric data, including heart rate, pulse oximetry, and respiration.  (more…)

Quantified selfing: elitist and privacy invading

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The last place you’d expect to see a populist view of Quantified Selfing, outside of the retrograde publications perused by The Gimlet Eye, is Wired. All these Fitbits, Jawbone UPs, Misfit Shines, baby monitors and of course Google Glass cost, cost, cost–upfront and especially for the ongoing subscription services. Even wearables, at this point, are nowhere near cheap and cheerful nor will be for some time. Is QS a luxury of the residents of Elysium? Wired’s Quantified Man, Chris Dancy, toting up his five-sensor/system cost, pays $400-$1,000 per month. The Eye tears up at the effect on the exchequer. But the most painful point for the article’s writer is less elitism than privacy: all the data churned out, existing somewhere to be mined, and all those ad messages waiting to be served up on Glass. PPG–pay per gaze–indeed. Your ‘Quantified-Self’: Are Wearable Technologies Just a Luxury for the Upper-Class?