Apps and wearables – developments over the summer

August 26, 2015 | by

Trying at least temporarily to distract this editor’s attention from his recent unfortunate experience with Jawbone technology, here are some interesting app and wearables snippets received over the summer.

We begin with news of the first CE certified mole checking app, SkinVision which rates moles using a simple traffic light system (using a red, orange or green risk rating). The app lets users store photos in multiple folders so they can track different moles over time. It aims to detect changing moles (color, size, symmetry etc.) that are a clear sign that something is wrong and that the person should visit a doctor immediately.

This contrasts with the findings of a paper published in June examining 46 insulin calculator apps, 45 of which were found to contain material problems, resulting in the conclusion that :”The majority of insulin dose calculator apps provide no protection against, and may actively contribute to, incorrect or inappropriate dose recommendations that put current users at risk of both catastrophic overdose and more subtle harms resulting from suboptimal glucose control.”, which to say the least of matters is worrying. (more…)

Is wearable IoT really necessary–and dangerous to your privacy?

August 21, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/is-your-journey-neccessary_.jpg” thumb_width=”150″ /]But does the average person even care? This Editor senses a groundswell of concern among HIT and health tech regarding the highly touted Internet of Things (IoT) and the dangers it might present. Our previous article reviewed the possibilities of hacking, system vulnerabilities in IoT networks and software bugs ‘bricking’ everyday objects such as refrigerators and cars. But what about wearables and the unimaginable amount of data they generate? Is it as unidentifiable as wearables makers claim? Columbia University computer science student Matthew Piccolella focuses in his article on healthcare ‘things’, primarily fitness trackers like Editor Charles’ favorite, Jawbone, but also clothing and even headsets that measure brain waves (Imec). Their volumes of data are changing the definition of healthcare privacy, which in the US has been synonymous with HIPAA. The problem is that health metadata are increasingly identifiable in a ‘big data’ world. (more…)

My Jawbone saga just got much worse: UP3

August 19, 2015 | by | 1 Comment

Readers may recall this editor’s most recent blast against Jawbone in which I complained about being emailed by them about a product I couldn’t buy. Well in due course I got a nice email from Jawbone, explaining the error and extolling the UP3, that I could buy. So nice that I relented and bought one.

Big mistake: my three UP bracelets that failed have lasted an average of some seven months each. The UP3 lasted just eight days before it stopped recording sleep correctly (an even shorter time than the two weeks the preproduction UP3 took to stop working when on trial by re/code).

Initial problem handling by Jawbone support has always been good – I can only assume they get lots of practice – and indeed I got an email straight back telling me how to do a ‘soft reset’ (These have never worked for me for any of the problems I’ve had, with either UP type of bracelet; perhaps it gets some people to give up.). When I told them it hadn’t worked, this was followed quickly by an email 10 working days ago telling me that they were referring my problem to colleagues and to expect a response within 2-3 working days.

Since when nothing: my emails have gone unresponded to, and I have heard nothing further. If this poor quality is the experience of others too (certainly some), then it’s clearly no wonder why FierceMobileHealthcare refer to Jawbone as one of six companies collectively making up 15 percent of the market with Apple & Fitbit way ahead.

It’s such a shame too, because in spite of the problems, my Jawbones, when they have worked, have been great motivators that have helped me lose over 12 kilos now – unlike the suggestions in the recent Guardian artcle, I’m sold on being nudged. I just need something I can rely on to nudge me!

67% of 50+ users found activity trackers beneficial: AARP study

July 23, 2015 | by

The just-published AARP study of 50+ consumers and design of sleep and activity trackers has found that a near-or majority surveyed found activity and sleep trackers useful in maintaining health. 71 percent found they increased awareness of habits; 67 percent found them useful and beneficial. Four user personas emerged: sticklers, achievers, enthusiasts and the ‘why not’-ers. Yet these mostly enthusiastic users experienced difficulties. During the six-week trial, many discontinued use of the trackers due to data inaccuracy, finding and using instructions, perceived device malfunctions, difficulty in syncing, difficulty in putting on the device and comfort in wearing. The seven trackers used by the 92 participants were from Misfit, Spire, Jawbone, Lumo and Withings. Conducted by Georgia Tech Research Institute’s HomeLab with AARP’s Project Catalyst: The Power of We initiative which encourages good product and service design for the 50+ demographic. Coming up: med management tools. iHealthBeat. AARP release. AARP’s Building a Better Tracker research paper

I’m finally losing faith in Jawbone

July 10, 2015 | by

A couple of days ago this editor got yet another promotion for a Jawbone product – UP4 – that he cannot buy. This time however, things were different.

Not only were the links both to find out more about, and to buy, the product broken, the UP4 isn’t even in the UK Jawbone store. Thankfully “Caitlyn” from “Jawbone Customer Care” did reply to my email, to give me standard blurb on the product explaining that it is linked to an American Express account to offer contactless payment. She also commented that it “is currently available for purchase in the US” so why the email was sent to a European she did not bother to explain, or seemingly, even care (they should know my address as they’ve used it often – see below). If this experience is repeated by other wearable suppliers, no wonder there continues to be a high level of abandonment among purchasers.

Now this editor has been after a posher UP ever since the new tracker that captures heart rate etc – the UP3 – was announced, seemingly many months back now, and so any email like this gets me excited, encouraging me to click ‘customise’ in the Jawbone store, only then to be told when I click through that it’s ‘coming soon’. and indeed it still is, apparently (even though Amazon now says it’ll be in stock by (more…)

Rock Health’s mid-year report: 2015 investment leveling off

July 10, 2015 | by

Rock Health‘s 2015 report is revealing in one aspect–that the authors try to put a game face on what is a flat situation in digital health investment for first half. Not even the most optimistic of the digerati expected a lift of 16 percent as we saw in 2014 versus 2013 [TTA 2 July 14], but the 8.7 percent fall off from 2014’s blistering $2.3 billion to $2.1 billion in 2015 year-to-date was unexpected. StartUp Health’s report indicated a slower start to 2015, though slightly less, so the reports correspond. Digital health still is growing faster than software, biotech and medical device.

Other highlights:

* The top six categories accounted for 50 percent of investment funding: wearables, analytics, consumer engagement, telemedicine, enterprise wellness, EHR/clinical workflow

*  In M&A action, this year’s first half has almost matched 2014’s full year total, but with only 13 percent of the investment. Most are digital health companies acquiring others for small amounts. (more…)

Fitbit and Teladoc: big IPOs, big questions

June 19, 2015 | by

This week’s big news (so far) of Fitbit’s $732 million initial public offering–the largest consumer electronics IPO ever–comes despite the Jawbone IP lawsuits [TTA 11 June]. Count us among those who question this ‘vote of confidence’ as raising unrealistic expectations for health tech by a fitness tracker not truly part of real digital health. Telemedicine provider Teladoc appears headed on the same track with an IPO estimated to come in at $137 million, probably by next week. This generous pricing (~$20/share) comes despite never being profitable in 13 years. Like Fitbit, Teladoc is facing lawsuits from its major competitor American Well on IP [TTA 9 June], with Teladoc asking the US Patent and Trademark Office to review the validity of several American Well patents. Both IPOs are on the New York Stock Exchange (NYSE). MedCityNews examines Fitbit and Teladoc.

What’s news at the end of the week

June 11, 2015 | by

Care Innovations harmonizes seniors, Panasonic adds diabetes, Jawbone and Fitbit bite, the first EHR/PHR Hack and Concussion in Cleveland. Converging its interests in remote patient monitoring with its long-time footprint in senior housing resident monitoring (QuietCare), Intel-GE Care Innovations is testing its Health Harmony remote patient monitoring system, partnering with two California-located Front Porch communities and the Front Porch Center for Innovation and Wellbeing. The residents selected have poor chronic condition management or have returned after a discharge from a skilled nursing facility. No disclosure on projected number or duration–and it doesn’t appear that QuietCare is part of the monitoring. Release….Panasonic just bought Bayer Healthcare’s diabetes/blood glucose monitoring device unit for $1.13 billion as Bayer continues to shed non-life science businesses. While old-school prick-and-bleed monitors are being eclipsed by continuous glucose monitors (CGMs) and mobile-based devices such as Telcare in the US and in Europe, there’s plenty of market remaining in the West, and new ones in Asia and the Middle East for simple devices. It joins Panasonic’s existing blood pressure monitors. MedCityNews….Jawbone and Fitbit continue to snap at each other in court, with the former on Wednesday filing a second lawsuit on patent infringement, specifically “a wellness application using data from a data-capable band”, with the added fillip of going to the International Trade Commission, which could ban the import of Fitbit products or component parts. The 28 May lawsuit was about Fitbit’s hiring of five former Jawbone employees who allegedly stole IP. The companies between them have hundreds of patents, and as this Editor has noted in previous IP and patent troll articles, the US Patent and Trademark Office (USPTO) is not especially rigorous in ensuring that patents are not overbroad. Wonderful for the IP attorneys, but not exactly what Fitbit wants as a runup to their expected IPO next week. Wall Street Journal….Now an EHR and PHR join Hackermania Running Wild. Medical Informatics Engineering reported Tuesday that in May their server was cyberattacked, exposing PHI of patients in five clients and separately information contained in the NoMoreClipboard PHR subsidiary. POLITICO reports that this is the first recorded instance of an EHR compromise. MIE Release, POLITICO Morning eHealth….If you are in the Cleveland, Ohio area and have an interest, Concussion: A National Challenge is a free, two-day event on detection and diagnosis sponsored by the National Academy of Engineering, the Institute of Medicine, Case Western Reserve University, Metro Health and Taipei Medical University. Advance registration required.

2015: a few predictions (UK-biased)

January 3, 2015 | by

As intimated in our review of last year’s predictions, we feel little need to change course significantly, however some are now done & dusted, whereas others have a way to go. The latter include a concern about doctors, especially those in hospitals, continuing to use high-risk uncertified apps where the chance of injury or death of a patient is high if there is an error in them. Uncertified dosage calculators are considered particularly concerning.

Of necessity this is an area where clinicians are unwilling to be quoted, and meetings impose Chatham House rules. Suffice to say therefore that the point has now been well taken, and the MHRA are well aware of general concerns. Our first prediction therefore is that:

One or more Royal College/College will advise or instruct its members only to use CE-certified or otherwise risk-assessed medical apps.

The challenge here of course is that a restriction to CE-certified apps-only would be a disaster as many, if not most, apps used by clinicians do not meet the definition of a Medical Device and so could not justifiably be CE-certified. And apps are now a major source of efficiencies in hospitals – (more…)

Data streams of the future analyzed at NYeC Digital Health

December 5, 2014 | by

Guest columnist Sarianne Gruber (@subtleimpact) also attended the NYeC Digital Health Conference and reflects on what to do with all that data patients and devices are generating–a natural for her as she is a consultant in data analytics for Encore Health Resources. 

The New York eHealth Collaborative hosted its fourth annual Digital Health Conference at New York City’s Chelsea Piers on November 17 and 18. There I was joined by 850 health-related professionals to listen, engage and see how life science meets digital technology. No doubt we have become a digital culture. Even seated on an airplane, I noticed the gentleman next to me wearing a Fitbit, and we strike up a conversation on step and sleep data and our dislike of the new dashboard. At the conference, Keynote Speaker Dr. Eric Topol, a Cleveland Clinic cardiologist and a leading practitioner of digital medicine, shared with us his thoughts on what it means be a part of this digital revolution as a patient and a doctor. Technology changes the scope of individual care. Advances in genomics now gives us answers based on our DNA that will genetically determine the success of medications and treatments. Epigenomics, a molecular diagnostics company, can prescreen an unborn baby of a mother with cancer with a simple blood test, sequencing the DNA, to manage her therapy. I was fascinated to hear that a genomic signal sensor can detect heart attacks and warn you of this possibly fatal event, and that necklace for heart failure patients can monitor fluid status averting repeated readmissions for these patients. Dr. Topol believes that digitized 24/7 patient health data will shift the patient–doctor relationship. Bringing in your self-monitored data, eliminates “the how are you feeling questions” and instead the doctor can confirm diagnosis and start treating the patient. “Patient owning data is a foreign concept and the digital revolution ushered this in.“ (more…)

“Events, dear boy, events” (UK)

November 7, 2014 | by

Harold Macmillan probably never said that in response to the question “What is most likely to blow a government off course?”, however we thought we’d use the quote to highlight a few cracking events coming up.

The Wearable Technology event, is being hosted by the Digital Catapult Centre, on 18th November, in London. On the topic of wearables, the BBC’s “the Bottom Line” had a great programme on 30th October on the subject. In the UK (at least) you can download a podcast or listen on iPlayer. There’s also an update on new Jawbone releases which seem now to be going for different form factors to the original UP, whose unreliability resulted in this editor being on his fourth such device in some 15 months. Info on Microsoft’s Band is here. The recent PWC report on Wearables is here.

At the same place starting on Monday 8th December there is a whole week of incredibly valuable assistance in the Digital Health Pit Stop, which is free! Events include a design day (8th), a business day (9th), a health day (10th), a data day (11th) and on 12th December (more…)

Forced to wear a fitness tracker for insurance? (US)

August 28, 2014 | by

For those covered by corporate health policies, the day is not far away where employee health insurance programs will require wearing a fitness tracker and meeting certain metrics, such as walking a million steps or sleep quality. Already some programs have the employee log food, exercise, blood glucose, heart rate and other vital signs to qualify for a discount. The trajectory is much like BYOD–once unheard of, now it is expected to be the norm in 50 percent of US companies by 2017, with a concomitant loss of personal security and privacy. CVS Caremark and other companies have already made the stick, not the carrot, the norm of employee wellness programs [TTA 12 April 2013]. Writer Adrian Kingsley-Hughes asks: “How much access do we want our employers to have to our medical data? How much access to our daily activities do we want our employers and insurers having?” And what about spoofing those Fitbits and Jawbones? His ZDNet article notes the interest that Apple (plus Samsung and Google, despite Sergey’s and Larry’s vapors–Ed.) has in health, then takes it out a few more yards with Wearables and health insurance: A health bar over everyone’s head (and do check out the comments.)

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

August 18, 2014 | by | 3 Comments
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/08/reduce-documentation1.jpg” thumb_width=”150″ /]Our 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…)

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

June 20, 2014 | by

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 we? The 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!

Wearables – a neat graphic, some thoughts, and a question for readers

May 7, 2014 | by

Thanks to Prof Mike Short for drawing our attention to a neat infographic on wearables. It’s quite something to see an area of personal electronics that is currently so hot that doesn’t yet feature an Apple logo – it cannot be long.

One aspect of wearables that might also make an interesting (though challenging to get right) infographic would be information privacy. Counting apps that turn smartphones into activity trackers as virtual wearables, Jonah Cornstock has an excellent piece just published on how the acquisition by Facebook (more…)

Wearables and Simple Telehealth – another step forward?

May 2, 2014 | by

In addition to Managing Editor Donna’s items on the opening of the Amazon Wearables Store, and the use of wearables by older ‘quantified selfers’,  Prof Mike Short has kindly drawn our attention to the most recent BBC Click programme which features wearables. Of particular interest to me was the first item on how Formula 1 technology involving measuring drivers’ heart activity is now being developed for the mass market, at rather lower cost. That will overcome a serious limitation of existing activity trackers that rely on accelerometers – for example my Jawbone UP faithfully measures every step I take whether walking or on a cross-trainer. However sessions on the rowing machine – or indeed a recent row in the London Head of the River race (for me definitely the most physically exhausting event so far this year), record no activity.

Another intriguing way of measuring heart activity is (more…)