Halamka: Time is right for patient-generated data, care traffic controllers needed

By: Jonah Comstock | Jul 31, 2014        

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John HalamkaBoston’s Beth Israel Deaconess Medical Center is gearing up to get data from patients’ consumer devices like Fitbit, Jawbone UP, or Withings weight scale into their EHR, according to CIO and emergency room physician Dr. John Halamka. Halamka says a number of factors make now the time for patient-generated data: devices have reached the maturity and ease of use needed to be a part of people’s care regimen; changing payment models are incentivizing the shift; and the emergence of middleware like Apple’s HealthKit will present hospitals with the piece that’s hitherto been missing in the patient generated data puzzle.

“In Massachusetts, it turns out fee for service is dying fast and being replaced with alternative quality contracts,” Halamka told MobiHealthNews. “Blue Cross pays you for wellness, not sickness. The idea of ordering five MRIs doesn’t get reimbursed; it’s ‘Here’s a fixed dollar amount to keep you healthy.’ And so hospitals and ACOs are now looking at continuous wellness, as opposed to more procedures, more hospitalizations, and more ED visits. It’s great that Withings or Jawbone or whatever is collecting this data on their website, but what I, as a CIO, need to do is gather the data on your medical record, inpatient, outpatient, devices in your home, and understand what I can do to keep you well.”

Halamka offered up his own Withings Pulse O2 tracker and weight scale as an example of what’s possible now from low-cost consumer trackers.

“You can look at my iPhone and say, ‘Oh, over the last week I walked 80,000 steps, my weight’s 170, my percentage of body fat is 8 percent. I’m sleeping 4 hours a night which is deep sleep followed by punctuated light sleep, followed by getting up once,’” he said. “I now have from a $100 device a complete understanding of activity of daily living and my basic functions as a human. That’s a maturity of technology and consumerization and ease of use that just didn’t exist until recent history.”  Keep reading>>


2018: 75 million wireless-connected health and fitness devices predicted to ship

By: Brian Dolan | Jul 31, 2014        

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Basis Band Carbon SteelBy 2018 an estimated 75.7 million consumer health and fitness devices with integrated wireless connectivity will ship, up from 23 million such devices in 2011, according to a recent report from IHS Technology. The research firms points out that Bluetooth Smart-connected devices are the most popular, but devices that make use of the fitness and health-focused ANT standard also have a foothold.

The firm also expects that the semiconductors that provide the wireless connectivity for health and fitness devices will have “solid double-digit growth” this year and over the course of the next few.

“Shipments this year for wireless semiconductors in health and fitness will reach a projected 61.2 million units, up 11 percent from 55.0 million in 2013. The expected strong expansion for this year continues the robust growth of 2012 and 2013. And the market shows little signs of slowing, with shipments in 2018 climbing to 95.78 million units,” the firm wrote in a recent press release.

IHS principal analyst Lee Ratliff noted in a written statement that mobility and power consumption are key for health devices.

“Because most health and fitness devices are mobile, wireless connectivity is important,” Ratliff said in a statement. “And because these wireless mobile devices are in most cases also wearable and thus require a small form-factor, they cannot be power hogs and must support low-energy consumption to have the best chance of succeeding in the consumer market.”

Stanford University trains surgical residents with Google Glass

By: Aditi Pai | Jul 31, 2014        

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google glassStanford University Medical Center’s Department of Cardiothoracic Surgery has started using Google Glass in its resident training program. Stanford will use software from Glass app maker CrowdOptic to help train residents on performing cardiothoracic surgery.

While a resident is operating on a patient, surgeons can use the CrowdOptic software to watch the resident’s progress and send visual feedback to the resident on technique. Before using Google Glass, the company explains, because views are restricted, it was difficult for surgeons to fully understand how the procedure was going from the resident’s perspective.

This is CrowdOptic’s second major partnership with a hospital.

In June, CrowdOptic partnered with the University of California San Francisco, to test how the software could help faculty in the Department of Orthopaedic Surgery. During the trial period, surgeons at UCSF used the app to communicate with remote physicians and also train residents. The broadcasts of these surgeries were sent to remote and local televisions so that any number of hospital faculty members could watch.

“We see strong potential for technology to enhance the training of physicians who will benefit from live perspectives of views that have been to date restricted by the realities of modern day orthopedic surgery,” UCSF Chair of Orthopaedic Surgery Dr. Thomas Vail said in a statement at the time. “These include physicians developing new clinical procedures and techniques to more fundamental training principles such as understanding the 3-dimensionality of anatomy required in modern orthopedics.”

CrowdOptic was also included in a list of five Glass Certified Partners that Google announced earlier this summer. Two other healthcare-related startups on the list included Augmedix, which developed a clinical documentation offering for physicians, and Wearable Intelligence, which offers hospital faculty a series of workflow systems to help make communication and file transfers more efficient.

iDoc24 study finds smartphone-enabled dermatology screening more efficient for referrals

By: Aditi Pai | Jul 31, 2014        

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handyscopeTeledermatology referrals that use a smartphone with an attached dermoscope allowed dermatologists to manage their patients faster and more efficiently than by traditional paper referrals, according to a paper published in medical journal Acta Dermato-Venereologica.

The study was conducted by Alexander Borve, the CEO of iDoc24, which has offices in Stolkholm, Sweden and San Francisco.

All participants in the trial were seen by a primary care doctor for a “suspicious skin lesion”. The 122 doctors in the study referred 746 patients through the traditional paper-based system and 816 patients via iDoc’s software with the help of an iPhone-connected dermoscope, called Handyscope. The dermoscope is iDoc24-branded but was made by a Germany-based medical imaging company, called FotoFinder, which is an investor in iDoc24.

iDoc24 found that when physicians referred patients via dermoscope, patients who needed surgery had shorter wait times, triage decisions were more reliable, the time needed to diagnose and treat skin cancer was reduced, and more patients from this group were treated on their first visit to the dermatologist. Four of the teledermoscopy referrals were excluded from the trial because of poor image quality.

The dermatologist responded to the primary care doctor teledermoscopy referral in less than two days on average, while the dermatologist responded to the primary care doctor who referred the patient via traditional means in five days on average. The doctors who triaged patients using teledermoscopy marked 19 patients as high priority malignant melanoma patients. These doctors were accurate in rating the priority of the visit. Using the paper-based system, 75 percent of malignant melanoma referrals that were rated at medium or low priority were incorrect. In 98 percent of the cases, when a primary care doctor used teledermoscopy, they referred the patient, analyzed the images and came up with a treatment plan within 24 hours.

This study was a followup to the company’s preliminary trial conducted last year. In this first trial, the company found that teledermatology, conducted using an iPhone, a dedicated app, and a connected dermascope, can be roughly as effective as a face-to-face dermatology consultation.

In May iDoc24 ran a skin cancer public awareness campaign in San Francisco with a sunscreen company. The company provided cancer screenings for people who were passing through a park using iDoc24′s other app, FirstDerm, a consumer facing question and answer app that launched in early 2014. iDoc24 employees performed 99 screenings in the park and found 10 possible cancerous legions, two possible cases of melanoma, and one possible case of basal cell carcinoma.

Runtastic launches Orbit, a wearable to tie its apps together

By: Jonah Comstock | Jul 31, 2014        

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Runtastic OrbitTwo years after its first foray into the hardware space, Austrian fitness company Runtastic is launching a new $119.99 wearable activity tracker, the Runtastic Orbit. The company aims to differentiate itself from the crowded activity tracker market by closely integrating the device with Runtastic’s existing ecosystem of fitness apps, and also by targeting the European market, which is not yet as engaged with activity trackers as United States consumers are.

“There’s Fitbit in the US, there’s Jawbone in US, they do have big pockets and a lot of VC money, sure,” Runtastic CEO Florian Gschwandtner told MobiHealthNews. “But here in Europe … nobody has a clue about wearables. Whereas Runtastic, we have a really strong brand here in Europe, I would say we’re the known brand either in the running apps or the whole mobile health fitness, we’re the number one company here and we have a really good track record. And we think with our 85 million downloads, with our newsletter of 20 million people, we don’t start from scratch. We have finished distribution here in Europe, so we’re already on the shelves.”

The Orbit will track steps, calories burned, active minutes, and sleep at launch. Additional tracking parameters related to swimming and cycling will become available via firmware updates, and the device has an ambient light sensor that will be usable in an update as well. Double tapping the single button on the device also allows the users to track their mood in a limited way — they can denote happy moments that will then appear as a smiley face on their activity graph in the app.  Keep reading>>

How young French oncologists are using medical apps

By: Jonah Comstock | Jul 30, 2014        

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Smartphone and tablet use by level of experience.

Smartphone and tablet use by level of experience.

A new study in the Journal of Radiation Oncology looked at self-reported smartphone and tablet ownership and usage statistics in young, French, radiation oncologists. While the sample is quite specific and not necessarily generalizable, it does present an interesting look at the up-and-coming generation of physicians (most of the subjects had five years of experience or less).

The survey, conducted online among 131 members of a summer educational session for radiation oncologists, showed that 93 percent of the specialists owned a smartphone and 32.8 percent owned a tablet. The smartphone users were more likely to use their device at work than the tablet users: 78.6 percent of the residents owning a smartphone used it at work, while just 29.4 percent of tablet owners did so.

More than half of the residents (57 percent) used their smartphone more than five times a day, with another quarter reporting that they used it exactly five times a day. Most smartphone owners (91 percent) had at least one medical app on their phone, and 33 percent had more than five. Asked whether they had verified the validity of the apps on their phones, only 60 percent said they had. The survey also asked the oncologists which apps they used specifically.  Keep reading>>