Mobile epilepsy sensors: student-led, stopped, or stalled

By: Jonah Comstock | May 17, 2013        

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The SMART belt (Photo by: Jeff Fitlow/Rice University)

Epilepsy is one medical condition where the constant monitoring capability of a wearable sensor could save lives, providing an early warning when a person with epilepsy has a seizure or even predicting seizures before they happen. Surprisingly, though, it hasn’t been an overly popular target for mobile health entrepreneurs. For developers working on this technology, getting to market has proved challenging for various reasons.

Affectiva’s Q-Sensor

Rosalind Picard, a professor at the MIT Media Lab, developed a wristworn sensor to provide an early warning system for children with epilepsy. The discovery was made by accident, when Picard and her team were using the wristbands to study emotional responses in children on the autism spectrum. They discovered that changes in galvanic skin response could predict the onset of seizures.

Picard co-founded sensor company Affectiva to commercialize some of her work with emotion sensing. The device Picard and her student Ming-Zher Poh developed was the basis for Affectiva’s Q-Sensor, a commercial device used in a number of epilepsy studies, including one at Boston Children’s Hospital.

As of last month, however, Affectiva stopped production of the Q-Sensor, saying they were now focusing on their Affdex facial expression analysis software “in response to strong and growing market demand.” Affdex is not a healthcare product, but instead targets its offering at advertisers, who could use expression analysis as part of next generation focus groups.

“Affectiva will discontinue the Q Sensor, as of April 30, 2013,” the company said in a press release. “The company will stop taking new device orders after this time, but is committed to supporting all existing customers until April 30, 2014.”

Picard is on a sabbatical from MIT and couldn’t be reached for comment, but based on her absence from the company’s team page, she appears to have split with the company she co-founded.

Rice University’s SMART Belt

A team of undergraduate students at Rice University in Texas has created a prototype belt that could potentially detect seizures in children with epilepsy. The belt detects changes in electrical conductivity in skin and respiration, both signs of an oncoming epileptic seizure, using electrodes that rest against the skin. A module on the belt can send a signal to a computer or smartphone via Bluetooth if it detects signs of a seizure.

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Affectiva's discontinued Q-sensor

The team, made up of Ethan Leng, Mihir Mongia, Charles Park, Tiffany Varughese and Andrew Wu, calls the system the SMART belt, for Seizure Monitoring and Response Transducer. The project was sponsored by Houston-based Cyberonics, which developed and markets an FDA-cleared therapy for refractory epilepsy.

The developers claim the device works better than a motion sensor, because they say it’s less likely to return false positives. It also works best at night, when there aren’t many external stimuli that can interfere with the sensor.

“Some of the existing things on the market are vibration monitors, microphones in beds that detect motion and sounds coming from people with epilepsy when they’re sleeping. But one flaw with this approach is that they weren’t able to detect non-convulsive seizures,” Wu told MobiHealthNews. “Using EEG, which is the clinical standard, is also very costly. We want to make ours slightly more affordable, so more people could have access to this sort of technology.”

Wu said the team has tested the prototype on healthy people mimicking seizure symptoms by being startled or hyperventilating, but the device still needs to be tested on people with epilepsy. Although the students who took on the project, all seniors, have just graduated, Cyberonics maintains the intellectual property for the belt and it’s likely that the recent graduates will continue to develop it with an eye toward commercialization. You can check out a video about the project here.

Wave Technology Group

Back in 2010, MobiHealthNews spoke with Wave Technology Group, a startup working on constant EEG monitoring via a smartphone for patients with epilepsy. In an interview this week, founder and CEO Sam Cinquegrani said the group has continued to work on the technology in the meantime, and the advancement of mobile devices has been very promising. Wave now has a working prototype, and he believes the technology could even be developed to the point where it could predict seizures before they happen.

Cinquegrani said the delay in getting to market is due to a lack of funding, which is in turn a consequence of regulatory and reimbursement uncertainty.

“Our biggest problem right now, and the reason things have slowed down tremendously, is the investment community is very scared of anything that looks like a medical device and anything that’s reliant on the current payment model,” he told MobiHealthNews. “Investors are saying ‘How are you going to get anyone to pay for it?’”

The company’s solution may be to move to a different regulatory and reimbursement environment entirely. They’re in discussions to take their monitoring product to New Zealand for pilot testing.

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Tigerlabs Health launches first class of six startups

By: Jonah Comstock | May 16, 2013        

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CLUENine months after its launch announcement, Tigerlabs Health accelerator in Princeton, NJ has finally debuted its first class at a demo day event on Wednesday. The accelerator launched with a strong focus on it’s ties to the pharmaceutical industry, but the six startups it has assembled don’t seem overwhelmingly pharma-centric. The companies, from around the country and the world, received $20,000 in seed funding, mentorship, software, professional seminars and access to a co-working space.

None of the companies showcased at the demo day are participants in Tigerlabs’ recently announced Innovation Track, a partnership with Merck and New York Presbyterian Hospital. Those applications are still being accepted through July 2nd.

Here are the six companies in Tigerlabs Health’s first class.

CareTree

CareTree is creating an online portal for record keeping in senior and home care. The software helps caregivers keep track of medication adherence and reconciliation, and centralizes and stores documents and calendars. CareTree’s offering is HIPAA-compliant and secure. On their website, the company also pitches its software as a way for hospitals to help achieve Meaningful Use Stage 2, because the software can interface with EHR patient portals.

Clue

Clue is building an app for women to track fertility. The interface allows women to log factors like mood, pain, and menstruation on a calendar. The app from the Berlin-based company is currently in beta.

The DentBoard

The mission of DentBoard is to build an improved cloud-based software for managing dental practices. The business-intelligence software automatically pulls data from existing dental office software.

LifeVest

A portmanteau of “life” and “invest,” LifeVest is a consumer and employee health plan that incentivizes people to get and stay healthy by collecting money from them and sponsors from their friends and families. The money works like a stock — if a person meets their health goal, their investment appreciates; if they don’t, it goes down. WelTok CEO Jeff Margolis is an investor in the company.

New York City Technology in Medicine

The team at NYCTM saw an opportunity in the rise of needlessly high megapixel cameras in each successive generation of smartphones. According to a video on their website, they saw that increasing resolution as an opportunity to use the smartphone camera along with an algorithm to minutely track eye movement and pupil behavior, data which could lead to diagnosis and monitoring of multiple medical conditions.

PLoM.io

Paris-based PLoM stands for “Public Library of Models.” The company aims to leverage crowdsourcing to help with scientific research, including health-related studies.

Report: 56M sports, fitness monitors to ship in 2017

By: Jonah Comstock | May 16, 2013        

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Fitbit Flex__ColorsSports and fitness monitors, including wearable sensors and running and cycling computers, will hit 56.2 million global shipments in 2017, up from 43.8 million this year, according to IMS Research. Over the five years, the research firm predicts 252 million units will ship.

IMS Research’s sports and fitness monitor category includes “fitness and heart-rate monitors, sports and running computers, outdoor pursuit computers, cycle computers, activity monitors and pedometers,” according to a release from the firm.

The largest single segment of the market in 2012 was fitness and heart rate monitors that include a chest strap, accounting for 23 percent of the market, IMS said. As more easily wearable activity monitors like the Fitbit or Nike+ FuelBand eclipse chest straps, IMS predicts that will drop to 19 percent by 2017. Meanwhile, wrist and finger-based heart monitors will grow at a 9.5 percent compound annual growth rate through 2017.

IMS researchThe firm said that pedometers are currently the largest segment of the market on a per unit, rather than monetary basis. However as pedometers evolve into more sophisticated activity monitors, and smartphones evolve into pedometers, the firm expects pedometers to decline. Meanwhile, activity trackers will increase threefold over the next five years.

Last summer, IMS conducted a survey of 400 UK and US consumers that found 63 percent of smartphone owners who exercise at least once a week and are interested in sports and fitness apps were also prepared to buy a sports or fitness sensor.

A report from ABI Research that came out last January predicted 160 million shipments of wireless, wearable health sensors. They predicted that 60 percent of those sensors — or 96 million devices — would be fitness trackers.

Ringadoc adds another $700,000 for after-hours patient calls

By: Brian Dolan | May 16, 2013        

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Ringadoc iPhone appThis week San Francisco-based Ringadoc announced an additional $700,000 in funding for its seed round, which combined with its previously raised $1.2 million, brings its total round of funding up to $1.9 million. While Founders Fund’s FF Angel led the round, the new $700,000 comes from Los Angeles-based Siemer VC, Telegraph Hill Group, and Dr. Lyle Dennis, who is the Chief of Neurology at Bon Secours Health System. Additional angel investors include: Practice Fusion Founder and CEO Ryan Howard and Sharon Knight, the former president of concierge medical practice company One Medical Group.

Ringadoc CEO and Founder Jordan Michaels told MobiHealthNews in an interview that the company plans to use the new funding to ramp up sales and marketing of its after-hours, practice management offering. Michaels said that Ringadoc has now helped facilitate north of 100,000 after hours calls to physicians for patients.

As we noted at the beginning of 2013 — when Ringadoc added $450,000 to its coffers – Ringadoc planned to use those funds to scale its new offering Ringadoc exchange, develop new patient-facing apps, and to develop a premium service offering that could add video conferencing capabilities to the current voice-only communications offering.

Years ago Ringadoc had plans for its first patient facing app, which enabled patients to record video messages ahead of a virtual visit with a new physician, but Michaels said it has dropped those plans for now and have re-focused on improving after hour phone consultations for patients and physicians.

Ringadoc helps patients have  better healthcare customer experience: Patients who already have a physician likely have to deal with an annoying 1970s call center system to get a hold of their doctor after hours, and patients who don’t have a physician might be able to use a service to help them decide whether they should go to the emergency room, the urgent care center, or whether the issue might be handled over the phone.

“Initially we developed a direct to consumer play where patients could go to a bank of doctors that we curated in California to pay for an on demand consultation with a doctor,” Michaels told MobiHealthNews in January. “That is still available and still being piloted in California, but we quickly learned from that those doctors that they wanted to use the same technology with their own patients for after hour calls — not just to attract new patients.”

While Ringadoc used to be based out of Practice Fusion’s offices in San Francisco and has that company’s CEO as an advisor and investor, it has no formal partnership with the company. (Update: Ringadoc moved out of PF’s offices earlier this year.)  Ringadoc, however, could find a lot of points of integration with EHR providers and others working in the practice management space. Michaels told MobiHealthNews this week that Ringadoc plans to partner with EHR and PM vendors for those types of integrations in the near future.

Exclusive: Happtique refocuses on hospitals, CEO Ben Chodor resigns

By: Brian Dolan | May 16, 2013        

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Brian Dolan, Editor, MobiHealthNewsHapptique, a high-profile subsidiary of the Greater New York Hospital Association’s for-profit arm GNYHA Ventures, has had a rocky few weeks.

The association recently made the decision to re-focus Happtique just on hospital customers and strip upwards of $1 million out of Happtique’s budget. The contentious decision led to the resignation of Happtique’s CEO Ben Chodor, MobiHealthNews has learned, as well as other key players exiting the company. Chodor is still listed as a co-founder of Happtique on the company’s website, but since at least last week GNYHA Venture’s top executive Lee Perlman has been listed as Happtique’s new CEO. Perlman previously held that title prior to Chodor’s appointment in early 2012.

UPDATE: Brian Conway, SVP of Communications, GNYHA sent MobiHealthNews a statement in response to this morning’s report: “Happtique has not had a $1 million budget reduction, nor anything close to it. We have instead repurposed our budget in the short term, and are in fact expanding in areas such as software engineering and clinical resources. Further, Ben Chodor is still deeply involved in the company and has transitioned to a role focused more on Happtique’s strategic growth and less on day-to-day management. As for Happtique’s focus, it has always been primarily on hospitals, but we continue to actively explore other key mHealth sectors. And as for certification and mRx, both are 100 percent on track.”

Originally, Happtique was conceived as a healthcare-focused appstore for professional medical apps that sought to help solve the enterprise app distribution problem for healthcare facilities. Namely, Apple has not historically made it easy for businesses to distribute an app to all of its employees — instead each user has had to download a given app individually. Next, the Happtique team said it received feedback from its customers that healthcare providers wanted guidance about which apps were worthy of distribution — the healthcare enterprise craved curation. Of course, health apps in general are in need of curation and the concept of physicians prescribing health apps to patients dovetailed nicely with Happtique’s hospital distribution and curation mandate. In January 2012 Happtique saw a wide open opportunity to create an app certification program that would help all healthcare providers better determine which apps were worth prescribing to patients and — more generally — which apps consumers should view as clinically appropriate and technically sound.

Given Happtique’s parent association’s focus, the subsidiary’s interest in serving hospital customers is core to its business moving forward. It is unclear, however, how dramatically Happtique’s strategy will change in the near term.

One of the other key executives who has left Happtique as part of the refocusing and budget cut is Lois Drapin, the company’s former Chief Verticals Officer. Drapin was tasked with leading business development for Happtique’s non-hospital sectors, including pharma companies, health plans, and other big technology companies, according to her bio.

Whether the for-profit arm of a hospital association was the right group to help consumers decide which health apps were worth downloading remains an open question. Assumedly Happtique’s focus on its hospital customers means it will continue to build out a library of health and medical apps intended for use by healthcare professionals. What about its certification program for apps that physicians might consider prescribing to patients? What about Happtique’s mRx app prescription platform?

I’ve reached out to the company and will follow-up with additional details as we learn more.

Update #1: MobiHealthNews has just confirmed that Happtique’s Chief Marketing & Strategy Officer Tammy Lewis, who previously served as CMO of Surescripts, left the company shortly after the launch of its final guidelines for its Health App Certification program. Chodor, Drapin, and Lewis led the company along with longtime GNYHA employee Corey Ackerman who continues to serve as Happtique’s President and COO.

Update #2: A few readers with ties to the company tell MobiHealthNews that Happtique was seeking outside investment from venture capital firms but after reviewing term sheets, GNYHA decided against giving up any ownership in the company.

Update #3: GNYHA sent MobiHealthNews a statement on today’s news — included up top.

Can personal health data motivate behavioral change? It depends.

By: admin | May 16, 2013        

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Dave Dickinson HeadshotBy Dave Dickinson, Former CEO, Zeo

After leading Zeo for the last 5 years, I’d like to share some of the key lessons we learned as an early pioneer within the digital healthcare movement. This post includes lessons learned for those who share our mission of improving the health and wellness of mankind by leveraging the awesome power of technology. Hopefully, some thoughts will engage new ways of thinking and serve to help guide other healthcare innovators to keep carrying the flag forward.

One of the critical questions within the connected healthcare movement is whether or not personal health data will actually catalyze and then incentivize lasting behavioral change and better wellness. Will any kind of data serve to motivate behavioral change? Does it matter if we see our data on a smartphone versus a laptop screen? Do all people respond in the same way? Early on, we realized that our ability to transcend our customer base, from highly-engaged, “quantified self” early adopters to the mainstream world of the “frustrated sleepers”, would require far more than just the raw data itself. It turns out that the gift wrapping matters as much as the present inside.

Moving from Quantified Self early adopters to the Mainstream Motivated Self will not be easy, but here are some clues that may help:

All data is not created equal. Some of the health data that various sensors are generating is simply not that provocative or intrinsically motivating. The more intuitively obvious the data is, the lower the consumer engagement will be. Within sleep, we realized that simplistic sleep/wake data is simply not very motivating and will relegate this health metric to the back seat of behavioral change. However, when you are able to help consumers discover a new health unknown, such as the amount and vital roles of their REM, Deep and Light sleep, this new level of shock and awe may provide a better catalyst to engage the mainstream. This is akin to a cholesterol test where the underlying HDL (“good”) and LDL (“bad”) data may be more motivating to encourage statin compliance than just the overall number alone (because I may be more scared). The level of data granularity, and then the scales that are used to convey what is high, low and average, are very important considerations to not only catalyze interest but then to also provide enough statistical significance for the critical positive reinforcement rewards that will be needed later to sustain the changed behavior. Scales of 1-10? Unlikely to motivate change. How about 1-100? Obvious, and better, but don’t assume that this should always be the default. It depends.

Relate the data to something else I care about NOW. Unfortunately, consumers are not motivated enough to take action when the resulting benefits are longer-term or too scary, like the prospect of getting a terrible illness one day in the future. This is one of the greatest challenges of preventative healthcare; however, other ideas may be able to help here. For example, we found that comparing your personal sleep data to others your own age was far more motivating. Most people do not want to age before their time and well understand what being older than your age may imply as it relates to their performance, sex appeal, career development, closeness to the prospect of dementia and more. The cosmetic industry is a very big business, and Real Age built a business model around this powerful consumer insight.

Make your advice as personalized as possible. Knowing about what is best for “people like me” is a good start, but the consumer now has far higher expectations of what is possible with technology. They want a personalized self-assessment that is quickly followed up with far more “prescriptive” advice. This is still relatively new ground for the connected healthcare movement, as the marriage of personal sensors and powerful mobile apps is still in its infancy. I think we ain’t seen nothing yet when it comes to personalization. When we get there, I think we should expect better outcomes than we have now.

The presentation of the data matters. Quantified Selfers revel in being able to demonstrate their data correlations, share their cause & effect discoveries and review new, insightful hypotheses. I know because I am one of them. We are anecdotally discovering some amazing things, but alas, this is not the average consumer. Over the last five years, I have attended many connected health conferences. Unfortunately, I rarely see presentations from behavioral psychologists or, as important, designers and artists who can fire our emotions with the power of their visuals. Some data charts and graphs simply have no chance to capture our fear or to engage our competitiveness. Some data, like trend analysis, is not best displayed on a small smartphone screen, yet another challenge within connected healthcare as we move faster toward mobile viewing versus watching our health wins and losses on bigger screens at home. GE seems to know a lot about data visualization, and there may be some more lessons from their work (read more about it here).

Motivating behavioral change through data visualization can be very powerful, but it is more of an art than a science. We will need far more artists, user interface experts and psychologists to help make our data work harder to motivate better health. Yes, it will take a village of talent, but I believe a far more creatively diverse one than most technology-based innovators may feel comfortable residing within.