Wearables blog – update

Since this editors’ piece on wearables four days ago there has been a stream of news about interoperability of various apps, resulting in frequent updates to the original blog, to the point where it was beginning no longer to resemble the original.

Chris Bergstrom of WellDoc has now kindly pointed me to the Mobihealthnews item on Samsung’s digital health partners announcement, and to his company’s specific interoperability announcement with Samsung, enabling activity and other data to be obtained from other Android apps to help those with diabetes to manage their condition better.

WellDoc of course developed the first prescription app – this item from mHealthWatch in turn based on a Telegraph article that suggests that GPs in the UK will shortly be prescribing apps for patients in large quantities. The source of the Telegraph’s intelligence is none other than Personalised Health and Care 2020, the recently published NHS document that we covered extensively yesterday, which was perhaps a tad less optimistic about medical app take-up.

Yesterday’s Apple intros and implications for health monitoring

A knockout or a catch up? Now that the Hype Dust is settling (along with Apple’s stock price), let’s take a look at what we know today about the new, larger iPhones and the Apple Watch regarding health monitoring.

Where it was a catch up:

  • Size and screen in phones. Apple got the message: squinting at tiny type and swiping to enlarge is rapidly becoming yesterday’s pain. As smartphones and larger screens knocked out the Blackberry, Samsung led the way in sizing up and higher resolution–and others followed suit. The awful fact is that the smartphone market is aging, both in users and who’s left in the market to grow it, and we want to see, not squint.
  • [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/09/apple-watch-beauty-shot.png” thumb_width=”150″ /]Finally (drum roll), a sleeker smartwatch with fitness tracking, out sometime next year–and not just a sports model. The basic model is a rubbery Sport watch, the mid-line has a sapphire crystal, stainless steel case and (proprietary) swappable bands. The beauty is the upmarket version in gold with a leather band (left, courtesy re/Code).
    • Here Apple is up against multiple in-market competition from Fitbit to Moto to Withings to Samsung Gear–whose pricing is well below the starter Apple Watch at $349 in the $200 and below range.
    • The Apple Watch looks seriously great, distinctively thinner and it’ll be a prestige item. But does it track more and better? No. According to reports (updated today) this is what it has: heart rate monitor, pulse, daily activity for which you need the phone. No sleep monitoring. It also has to be charged every night. There may be other features from developers, but they are under wraps for now and will likely require phone tethering. (re/Code) It’s not a comprehensive lifestyle watch–yet.

Where it could be a knockout in healthcare:

  • Finally, a compelling reason for health care providers to ditch the old iPhone and not go Android. Healthcare providers in the US are heavily wedded to iOS: (more…)

2015: mHealth’s breakout year–or more of the same sideways?

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/09/the-thinker-statue-flickr-satyakam-khadikar-480.jpg” thumb_width=”150″ /]Adopting or Ditching It? We’re barely into September, yet the first 2015 prediction-of-a-sort is on the record from Center for Connected Health‘s Dr. Joseph Kvedar in The eHealth Blog. Does Apple HealthKit+Samsung‘s SHealth’s iterations+Google Fit+smartwatches everywhere (including LG’s G Watch R) equal $7.2 billion in wearables alone by 2018 as part of a mHealthy $49 billion by 2020? He’s optimistic, yet he hedges his bets with the caveat

“The challenge in health care is that, though we know what patients/consumers need to do to improve their health, most of them don’t want to hear about it.”

Which indicates that Dr. Kvedar has joined our small group of Thinkers puzzling out why health apps haven’t taken off beyond their Quantified Selfer early adopters and what Parks Associates termed ‘Healthy and Engaged’ [TTA 11 Aug]. With 1/3 of the purchasers of activity trackers putting them in the drawer after six months and the unstickiness of apps (80 percent are abandoned after a shocking two weeks), the winning combination isn’t obvious. But is it ‘focus on engagement’ and ‘personal, motivational and ubiquitous’? Certainly key factors, but how do we get the ‘Challenged but Mindful’ with a chronic condition–or two or three–to track and reward their real progress, even on a bad day–which an activity tracker which constantly presses you to exceed your performance has trouble gauging. (more…)

Samsung vs Apple: Go big or go home

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/09/gear-s-hands-on.jpg” thumb_width=”150″ /]Implications for mobile health abound in the fight for the innovation throne. Kicking off the autumn intro season was Samsung’s big reveal Wednesday at IFA Berlin and NYC of their new phablets (Note 4, the oddly curved/fallaway screen Note Edge), the big ‘n’ curvy almost-phone Gear S smartwatch and the virtual reality headset Gear VR for the Note 4. Clearly Samsung is pushing the boundaries on size and innovation leadership–as well as the sheer number of phones/phablets/wearables in market with something for everyone. Its health developer platform SAMI and the Simband hardware [TTA 30 May] plus joint research with UCSF on ‘novel vital signs’ [TTA 2 June] positions it in the health tech area as the alternative to Apple. ZDNet, Gizmag (Gear S), CNet (Gear VR) which may have some health uses.

Next Tuesday is Apple’s premiere of two new iPhone 6 models with 4.7 inch and 5.5 inch screens to go on sale this month, plus an announcement for a yet-unnamed Apple wearable, but a rumored price of $400 for on-sale next year. Their developments with (more…)

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

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.)

Telecare helping Alzheimer’s patients live in the ‘connected home’

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/08/140825141047-lively-pillbox-sensor-story-top.jpg” thumb_width=”150″ /]There’s life in telecare–it’s (finally) morphing into ‘connected home’. Is this ‘slope of enlightenment’ and ‘plateau of productivity’ time?  We haven’t had a spotlight on the part of telecare which is sensor-based behavioral monitoring, but here’s one that shines on not just one but four systems which indicates a big change in focus, long developing: SmartThings, Lively, BeClose and certified Grizzled Pioneer GrandCare Systems. CNN.com crafted an article out of a fairly obvious placement by the Alzheimer’s Association, but all to a good end.

Notably SmartThings by Physical Graph (just purchased by Samsung for a reported $200 million after raising $15.5 million through Series A, undoubtedly for their algorithms and in its health reach strategy versus Apple Health) pitches itself on its website as simple home automation, yet this article is all about older adult safety. Lively, which is depicted with an interesting connected pill dispenser (above) and BeClose carve their approaches close to caregivers.  All three are DIY systems. GrandCare remains the anomaly, with the highest (custom) home install price ($699 and up) but with a home tablet that engages the older person with virtual visits, music, pictures, daily updates and family/clinician connectivity. They were also first to move in this direction; this Editor recalls their pioneering in the home automation area with CEDIA, the home electronic design association.

After years, are we finally seeing a shift in consumer perception?  (more…)

The smartphone as great healthcare leveler: Eric Topol

Eric Topol MD, cardiologist, Chief Medical Advisor for the rebooted (but so far quiet) AT&T ForHealth and Chief Academic Officer at Scripps Health, is no stranger to the ‘big statement’ and is well known as an advocate for all things mHealthy. For at least two years, he has been promoting the smartphone’s ‘equalizer’ capabilities in health not only via apps and ‘add ons’ but also as a storehouse or central repository for individual health information, including genetic screening, which can be transmitted onward to a practitioner, lab or PHR. Dr Topol’s ‘big statements’ were fully on display in his keynote at HealthLeaders’ CFO Exchange conference. A promoter of the ‘creative destruction of medicine’ (the title of his most recent book, WSJ article), he believes that everything from the office visit (virtualized) (more…)

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

[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…)

Tons of app health data, bound for…third parties?

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/04/obey_1984.jpg” thumb_width=”150″ /] The law of unintended consequences also applies to Quantified Selfers. Health apps seem to be reaching beyond the QS early adopters and becoming a commonplace, whether on your wrist or built into your smartphone. Apple, Google, IBM and Samsung are all in.The DH3 set (Digital Health Hypester Horde) could not be more pleased. But where is that data going? According to the US Federal Trade Commission (FTC), it’s ending up where your online data goes–profitably sold by developers large and small to your friendly data broker and onward to marketers. You may think it’s private, but it isn’t. There is the famous case of an Target (store) app used to determine whether female customers were pregnant (purchases such as pregnancy tests) and then market related and baby products to them. Commissioner Julie Brill doesn’t like the possibility that health data could be part of the Spooky Monster Mash that is Big Data. “We don’t know where that information ultimately goes,” Brill told a recent Association for Competitive Technology panel. “It makes consumers uncomfortable.” (Ahem!) From the consumer protection standpoint, the FTC would like to do something about it, and they happen to be very good at that type of regulation. Compliance will not only be an added cost of doing business, it will cut into that ol’ business plan. And you thought that the only problem around apps and the Feds was gauging risk to users. Do you have that creepy ‘Big Brother is Watching You’ feeling?  Health IT Outcomes, FierceMobileHealthcare, VentureBeat.

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!

More Samsung ‘we try harder’ telehealth moves

Is Samsung playing Avis “We try harder®” to Apple’s Hertz?

Samsung’s other, less noticed end-run in addition to the Simband reference hardware and SAMI ‘open ecosystem’  is an initiative creating a joint research center with the University of California, San Francisco (UCSF) called the Center for Digital Health Innovation (CDHI). It is being headed by Michael Blum, a medical doctor who is the UCSF assistant vice chancellor of informatics. From the statements made to The Atlantic, Dr Blum’s intent is to clinically validate the sensors and algorithms produced within the Samsung ecosystem. Already featured are four initial projects: CareWeb (a collaborative care platform built on Salesforce.com), Tidepool (infrastructure for diabetes apps), Health eHeart (clinical trial app on heart disease) and Trinity (‘precision team care’). On the frontier: ‘novel vital signs’ which he predicts will come out of the analysis of standard vital signs, “…new markers of health and wellness that come out of these large datasets.”  Is Samsung, rather than going head-to-head with Apple on Healthbook [TTA 22 Mar] is leapfrogging into something akin to Telehealth 2.0 or 3.0? Yet this Editor notes that we haven’t figured out, for the most part, the FBQs (Five Big Questions)* of 1.0….

* The Five Big Questions (FBQs)–who pays, how much, who’s looking at the data, who’s actioning it, how data is integrated into patient records.

Samsung’s ‘shot over bow’ in health

Watched closely as part of Samsung’s various moves in health (here in the US heavily promoting the S5’s heart monitoring capabilities) is their unveiling of a reference hardware called the Simband, a wristband designed for interchangeable body sensor modules yet in fact to be developed. Its platform is dubbed Samsung Architecture for Multimodal Interactions (SAMI) and is part of an open ecosystem which invites developers “to design and integrate their own sensor technology and, through the SAMI platform, develop applications and algorithms for wearables.” The design was in partnership with the biosensing institution Imec and will be available before end of 2014.(Gizmag) Coming before Apple’s Worldwide Developers Conference (WWDC) and the rumored announcement of the Healthbook iOS app [TTA 22 Mar]…the Samsung-Apple wars continue, and not in court. Also Gizmodo

Samsung’s mHealthy S5, Gear–and potential

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/02/gear-2-neo-620×554.jpg” thumb_width=”150″ /]Is there an untapped mHealth business model here?

Samsung’s dual announcements in New York and at Barcelona’s annual GSMA Mobile World Congress (MWC) of the Galaxy S5 smartphone and the latest iterations of their smartwatch (left), the Gear 2/Neo, confirm what this Editor believes will be a major 2014 trend: the matter-of-fact integration of vital signs sensors into easy-to-adopt form factors. Reported by ZDNet:

  • Galaxy S5:It’s so small and unnoticeable, you would be forgiven for not giving it a second thought. Next to the flash is a heart-rate sensor that can — prepare yourself for a hearty dose of real-life sci-fi — see the blood pumping through your finger. It works when you gently push your finger over the flash on the rear of the handset. This ties in with the smartphone’s pre-installed health apps, such as the S Health, which includes a fitness tracker and pedometer.” The phone also connects to the Gear 2 software. (This is in addition to the fingerprint scanner.) Article
  • Gear 2 and Gear 2 Neo specification: Bluetooth 4 low energy, Infrared, heart rate sensor, accelerometer, gyroscope  Article

Easy to use tools for health–and fall detection–baked into a mainstream phone and a fairly attractive smartwatch. There’s plenty of health and safety functionality for all ages built into both.  What’s the missing link? Here’s a thought. A manufacturer/wireless JV or subsidiary which targets the health monitoring potential of these devices to create a separate revenue stream. The ‘risk’ could be spread to resellers allowed to creatively adapt devices like the Gear for older adults in independent and assisted living environments, or for autistic/at-risk children. This is not an inconsistently supported AT&T ForHealth [TTA 5 Feb] or a failed Lifecomm [TTA 14 Oct 13], but an entirely different business model. Reader thoughts?  

More on MWC: Washington Post

Update 28 February: The Galaxy S5’s heart rate sensor may make it a medical device in the eyes of South Korea’s health agency, forcing the phone to be regulated and reviewed in the ROK before its 11 April worldwide release. FierceMedicalDevices. Hat tip to @DrDave01 (Dr. David Albert of AliveCor) and David Doherty of @mhealthinsight via Twitter.

South Korea to push Telehealth – good for Samsung

Returning from the World Economic Forum in Davos, Switzerland, where she met with several company CEOs, [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Park-Geun-hye.jpg” thumb_width=”150″ /]South Korean President Park Geun-hye has decided to promote telehealth as a new growth engine for South Korea according to the Shanghai Daily. The president wants to see the country become a global leader in telehealth with a strong domestic use of the technology.

This is particularly fortunate for Samsung, the country’s largest group of companies, which is also said to be planning biomedicine and medical equipment to be among its growth sectors with a reported 10-year total of $22 bn (US) of investment across all its growth sectors. Samsung already produces major hospital equipment such as ultrasound and digital radiography systems, currently operates a massive hospital and cancer center in Seoul and is, (more…)

The CES of Health preview

International CES in Las Vegas will be the annual ten-ring circus it always is, but this year even the tech watchers are concentrating on health. There appears to be no blockbuster consumer electronics debuts this year, so what you will see in the rinse-and-repeat cycle are the connected categories of Wearables and The Internet of Things. Basically everything will be connected, automated…and gathering lots of data on you (what ZDNet’s Jason Hiner in his CES preview article has dubbed Contextual Computing, and he likes it). Lisa Suennen of Psilos Group, writing in MedCityNews, coins her own slightly dismissive term, ‘The Internet of Wearable Things’, and makes the entirely sensible point that sensing your fitness is one thing, doing something about it another. But the critical health app that soars over her goal posts is the Surf Life Saving WA Twitter account. If you’re in Western Australia and hitting the water, you want to know where the sharks are. This gives it to you. This Editor also sees that Samsung received FDA 510(k) approval for their heavily hyped S Health app built into the US-released Galaxy S4 smartphone. While the UK enjoyed third party device connectivity back to the S3, the US version of S Health, according to Mobihealthnews, only connected to three unreleased Samsung peripherals and relied on manual entries. This undoubtedly will change–expect there to be buzz about where Samsung will now take this at CES. And there’s always hay to be made with sleep analysis tracking–high-end multi-sensor fitness watch Basis Science has now added advanced sleep tracking to its BodyIQ analysis of running, walking and biking, as well as upgrading its looks (VentureBeat).

Certainly more to come out of CES and conferences within CES this coming week!

Around the mHealth Summit in 70 pictures

Courtesy of mHealth Insight/3G Doctor, David Doherty takes the LIFE magazine approach and delightfully, you feel like you are there. He hosted a get-together at his booth on Monday (many pics), stops by AliveCor, Alere Connect (hello Kent Dicks), the Venture+ Forum (see Lois Drapin’s earlier article; hello Richard Scarfo, director of the Summit and Pat Salber of HealthTechHatch crowdfunder and the DoctorWeighsIn), VNA Health Group, investor in many things Esther Dyson, Google Glass Explorers, Samsung’s Galaxy Gear smartwatch and the ‘panini generation’ courtesy of AT&T ForHealth. But you’ll have to page all the way down to see the last shot of an ‘wild, wooly and yo-ho-ho’ AliveCor demo in My thoughts on the 2013 mHealth Summit as it happens…