Two new reports from mHealth Alliance highlight research gaps, misdirection: While not related to the recent PLOS Medicine meta-analyses, both mHA reports criticize the lack of rigor and quality study designs. The first critiques current mHealth efforts in the maternal, newborn and child health (MNCH) area; the second surveys the global mHealth ecosystem, with the preponderance of projects in sub-Saharan Africa versus Asia and Latin America. FierceMobileHealthcare (links to both reports)… PROST8CARE text service supporting prostate cancer patients: Messages from side effects to food and diet tips will be timed with treatments to help advanced cancer patients as they undergo chemotherapy. Developed by Mobile Commons with sponsorship by Sanofi US and the Prostate Cancer Foundation….Your smartphone may help manage chronic pain: A Norwegian study of smartphone-enabled interventions of 112 subjects during chronic pain rehabilitation, using written daily diaries for four weeks with therapist review and one in-person session, indicated improved and sustained self-management. FierceMobileHealthcare, Journal of Medical Internet Research full text article... iMPak Health adopting HealthSaaS Connected Outcomes Platform: This will link the Kraken medication management system to mobile apps. HealthSaaS will also work with this JV between the Meridian Health System of central New Jersey and Sweden’s Cypak on mobile apps that forward patient biometric data to the iMPak Connect Portal currently in development. Release….Update on Philips’ next-gen PERS, Philips GoSafe: Premiered at CES 2013 [TA 11 Jan], this cellular/GPS/fall detector (AutoAlert) model will now hit the US market in late March. As previously reported, Philips will be selling the system direct to consumer outright for about $150 with $50/monthly for service. It’s an upper-end product meant for a younger, more active market. LeadingAge.

Here on the US side of all things teleHealthy, mHealthy, dHealthy or just plain Health Techy, a Silicon Valley company called Jawbone, best known for its Bluetooth phone accessories and a single foray into tracking with UP, has acquired, at a price no one seems to agree on, the breezily and Big Data-ly named Massive Health. Massive’s one, heavily huzzahed contribution to the Healthy World was an app called Eatery, which would somehow decipher from snaps of your eats your habits and where you could change ’em. Jawbone, Massive–all Silicon Valley rock-star led, with veritable brass bands of hype marching behind (see GigaOM’s report). There’s a ton of press and interpretation of this acquisition being hotly debated in various forums, notably:

• Neil Versel’s take in Mobihealthnews with his proposition that direct to consumer (DTC) beyond fitness and the ‘worried well’ is not where the money is, and that most of these heavily hyped companies would not know healthcare from their cocktail quiche. Economics and human behavior rules; he pits Massive vs. TV reward program Viggle.
• David Doherty at the 3G Doctor Blog analyzes Neil V. point-by-point and counterpoint (in defense of Neil, to my knowledge he does not edit Mobihealthnews, and his views are often at variance with many companies covered more glowingly by other contributors)
• David Shaywitz, MD over in Forbes puts the SV Hype Machine on the dissection table, noting the well known tendency of VCs to celebrate their exits (no matter how much cash went circling down the drain) and presents a little hope for DTC at the end.

Editor Donna (@deetelecare) is on the side of the wary and the plain ol’ weary: of the endless hype; of ‘better mousetraps’ beating paths to someone’s door; of VCs with their ‘plays on health’ (hat tip to Neil); of those who willfully ignore that the customer has ‘Who Cares’ stamped on their forehead and jolly well insists on doing things for their reasons, not yours; of developers not bringing skeptics (marketers, clinicians, your neighbor, Aunt Sadie) in at the start and frequently therein to kick holes in the proposition. It’s detrimental to real implementation whether B2B or B2 the end user. Thus it remains the decidedly unglamorous Same Old Struggle to make it work, get the direction right, get it funded, help a few people along the way and especially, not believe your own press releases. Also see initial (and revised) reporting in TechCrunch.

EHRs, a/k/a the Rodney Dangerfield of eHealth, may be hedging their bets by placing their chips on mHealth. eClinicalWorks, one of the estimated 600+ EHRs in the US market, but one of the few with any real market share due to its preference by many state regional extension centers (RECs), announced yesterday that they are developing a from-scratch 100-person division called ‘healow’ (Health & Online Wellness) to develop systems that drive online consumer engagement–according to the article, “to make appointments, check test results, or ask their doctor a question on the go”. CEO Girish Navani claims that they have already been approached by telehealth providers to platform their data into practices. Of course, practices will be able to easily incorporate all this into workflow, and there are no existing systems out there that already do this. Warning: the CEO has pronounced that they are “creating an ecosystem around patient engagement.” Westborough-based eClinicalWorks commits $25M to launch mobile health business (Boston Business Journal)

Healthcare accelerators (Blueprint Health, StartUp Health, RockHealth) have lately gained most of the buzz, but incubators and ‘labs’ have been where many companies have gained their start. Phoenix, Arizona has entered the fray with SEED SPOT, featuring three healthcare-related startups among 16. While they may be able to serve up their companies ‘piping hot’ into a lower cost, supportive environment, chilly New York City has the opposite situation. Even with the advantages of world-class academic and healthcare resources, it’s been a forbidding setting for startups for years with money and attention going to e-commerce and financial businesses. The Bio & Health Tech Entrepreneurship Lab, backed by the New York Economic Development Corporation (NYCEDC), intends to change this with a first class of 20 startups. Their technologies are along a broad spectrum including wound healing, genetic testing, imaging, diabetes treatment, big data for genomics and mHealth for high-risk patients. SEED SPOT incubates health startups in Phoenix (Forbes) NYC-backed health startup lab wants to turn academics into entrepreneurs (GigaOM) Bio & Health Tech website

For the past few years, mHealth has been advocated, quite plausibly, as a key part of improved public health in low to middle-income countries. Cell phones are ubiquitous in African countries, and in the West there’s news of potentially revolutionary apps and clinical device attachments at least every month. Now here is another one of those pesky review studies, published in the Journal of Medical Internet Research. While not dumping a cold bucket of water on these high hopes, the review certainly points out the need for more rigor. Studies to date are heavy on process documentation, few demonstrate impact on outcomes, and lack scale. Most programs involved text/SMS messaging or support tools for community health workers. The review was authored by a team from the Malaria Consortium (UK, Uganda), the Institute of Global Health, University College London, and the London School of Hygiene and Tropical Medicine. Mobile Health (mHealth) Approaches and Lessons for Increased Performance and Retention of Community Health Workers in Low- and Middle-Income Countries: A Review (JMIR) Also iHealthBeat and FierceMobileHealthcare

Not just one, but two major analyses of mHealth studies to date. Published in PLOS Medicine with the 42-study review of mHealth as used by health professionals [TA 18 Jan] is a separate review, by the same team, of 75 studies evaluating disease management outcomes and behavior change in health care consumers. Like the review of professional studies, the outcomes are inconclusive and inconsistent due to study quality. What was promising was perhaps the simplest: “Text messaging interventions increased adherence to ART (antiretroviral therapy) and smoking cessation and should be considered for inclusion in services.” The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review (PLOS Medicine) The much-discussed Scientific American article, App’d to Fail: Mobile Health Treatments Fall Short in First Full Checkup

We had earlier this month reported on Rock Health’s digital health estimate of $1.4 billion, up 45% vs. 2011 with 20% going towards the five biggest deals of the year [TA 8 Jan]. Now Austin, Texas-based Mercom Capital Group does its own slightly lower count of $1.2 billion in VC investment in what’s termed HIT, but this is 200% higher than their prior year total of $480 million. There’s overlap but difference in their five big companies: Castlight Health (provider comparison), 23andMe (personal genetics), GoHealth (health insurance comparison), Kinnser Software (home health clinical support) and the Practice Fusion EHR. Mercom also details the M&A activity topping $7 billion with McKesson being the most active acquirer. Finally, Mobile Health Market News did its own analysis and came up with $907 million, led by ‘health care IT service’, monitoring and consumer apps (although skewed wildly from Castlight Health in this category). What is also clear is that the pace slowed in 3rd and 4th quarters–and that the pace of 2013 investment very much depends on the US economic climate and the effects of government healthcare policy. Mercom: iHealthBeat (summary), MedCityNews, Healthcare IT News. Mobile Health Market News, mHealthWatch

Out now, the January edition of the Telecare LIN newsletter. It contains “news of a new telehealth and telecare strategy from Scotland and aspirations of a paperless NHS from English Health Secretary, Jeremy Hunt. There are new grant announcements as well as adult social care and public health funding programmes for local authorities…[changes to the NHS]…predictions about telehealth and mhealth for 2013 including some links to the recent Consumer Electronics Show which featured digital health.” There is also a comprehensive list of news links in the separate supplement. PDF download.

For your weekend reading, this overview of 42 mHealth studies monitoring use by health professionals is accessible not only in full text, but also has multiple (downloadable) comparison charts and plenty of related reading. The findings will come as no surprise: current studies are limited, show only modest benefits, diagnosis based on mobile photos showed a reduction in diagnosis accuracy, SMS (text) appointment reminders show some benefit. High-quality trials measuring clinical outcomes are needed. The Effectiveness of Mobile-Health Technologies to Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis (PLOS Medicine) Hat tip to reader David Lee Scher, MD.

Normally Editor Donna would append this HIStalk Connect article [WARNING 31 Aug 2014: linked page may now be infected with malware] to our earlier one [TA 8 Jan] but it’s an extremely thorough external analysis of why Epocrates‘ core product–a mobile drug reference–would be worth nearly $300 million (a 22% premium to share value) to Athenahealth. While most have pointed out the mHealth aspects in improving the latter’s mobile offerings, the real reason, according to writer Travis Good, MD, is for Athenahealth to gain exposure to a hard-to-reach group via Epocrates’ ubiquity, and gain more physician users of its core services, practice management and EHR.