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When tech improves the personal touch
 Doctors “know instinctively that the human side of medicine — the attentive listening, the visual cues, the continued eye contact, and the careful history and physical exam — is critical…” Dr. Val Jones, CEO of Better Health, wrote in a commentary piece last week. “The problem we have with EMRs is that they often interrupt the sensitive and intuitive parts of what we do. EMRs and other digital ‘tools’ designed to make our work more efficient, may do so at the expense of the human connectedness our patients deserve and need.”
Jones’ commentary is a must-read for anyone interested in new technology’s impact on the patient-doctor relationship. As she notes, a more efficient practice is not necessarily a more effective one.
“Digital tools designed to make work more efficient” certainly would include the many wireless-enabled point-of-care services coming to market, but first a quick note on EMRs: The notion that EMRs will boost a practice’s efficiency has not yet been proven, according to one industry thought leader: Continue>>
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| Mobile application for sharing genetic data
At the Consumer Genetics Show in Boston today, genome sequencing company Illumina’s President and CEO Jay Flatley announced that Illumina had partnered with four major direct-to-consumer genomics companies and demonstrated a very rough concept for a mobile application that leveraged a consumer’s genomic profile.
Illumina inked partnerships with consumer-facing genome analysis services 23andme, Navigenics, deCODE and Knome to present the raw data that Illumina sequences to the consumer. Illumina sequences a customers entire genome, which is why the price tag is $48,000, compared to the couple hundred dollars companies like 23andme charge to sequence portions of a customer’s genome.
Flatley admitted that the pricepoint was still much too high for mass consumer adoption, but he explained that Illumina wanted to get in the market now to tap into that very thin slice of the market that would be willing to spend $48,000 for the information.
“We realize at $48,000 that is still [for] a thin slice[of the market], but we think it is time to begin,” Flatley told the audience at the Consumer Genetics Show. “We also want to perfect this process before it becomes routinely used and to begin building the ecosystem for data analysis now.”
Despite the high pricepoint, Flatley argued that now was the time to engage regulators, to work through clinical validation issues and work through the remaining privacy and ethical concerns that still linger in the industry. During the next five years, perhaps markedly sooner, the pricepoint for whole genome sequencing will fall from Illumina’s $48,000 to under $1,000, Flatley said.
“Ultimately, we think this data needs to be mobile-connected and probably in the cloud,” Flatley said as he cued a series of slides that showed a concept for an Illumina iPhone application branded MyGenome. “We think an iPhone type device is where this data will end up living, but clearly we can’t fit an entire sequence on the iPhone of today.” Continue >>
Slideshow: Illumina’s (concept) MyGenome iPhone app
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Apple: FDA clearance up to iPhone developers
The U.S. Food and Drug Administration has indicated in the past that under certain circumstances the iPhone may be considered a medical device and therefore regulated as one, however, as of February the FDA still hadn’t figured out exactly which circumstances those might be.
Turns out Apple isn’t waiting around for the FDA. iPhone application developer and GraniteKey COO Mike Ahmadi wrote in to point out that Apple’s iPhone developer agreement includes a special section that puts the regulatory onus, in particular the duty of ensuring FDA compliance, on the developers themselves.
Obviously this section of the agreement has become increasingly important since Apple began promoting connected peripheral devices and medical apps like LifeScan’s glucometer and AirStrip’s cardiac monitoring application at the company’s iPhone 3.0 and World Wide Developer Conference events.
Under the developer agreement section labeled “Regulatory Compliance for Health, Medical and Related Apps,” Apple writes: “You agree that You will not seek any regulatory marketing permissions or make any determinations that may result in any Apple products being deemed regulated or that may impose any obligations or limitations on Apple. By submitting Your Application to Apple for selection for distribution via the App Store, You represent and warrant that You are in full compliance with any applicable laws, regulations, and policies, including but not limited to all FDA laws, regulations and policies….”
Read on for the entire section related to regulatory compliance for health and medical apps. Continue >>
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Interoperability for mHealth devices has a pulse
What’s old is new again? Continua Health Alliance certified Nonin’s Bluetooth-enabled fingertip pulse oximeter as the first, interoperable wireless health device. Nonin’s USB-enabled pulse oximeter was the very first (and only other) Continua-certified device.
The news runs counter to claims made by the Continua Health Alliance’s Rick Cnossen, who chairs the alliance’s technical working groups: At the American Telemedicine Association event in April, Cnossen announced that the first Bluetooth-enabled Continua-certified device would be announced in early May. What’s more, Cnossen indicated to an audience member during the question and answer period that the first Bluetooth-enabled Continua device would not be made by Nonin.
While delays for certification announcements are common and understandable, the move to promote Nonin’s wireless pulse oximeter as the very first Continua-certified wireless health device is somewhat puzzling. Continua is an alliance of some 190 companies, many of which make health devices that are assumedly gunning for interoperability certification. Cnossen’s comments at ATA indicated he understood that promoting another Nonin device would do a disservice to the marketing effect of announcing a different company’s product — if only to make clear that Nonin isn’t the only company with market-ready, interoperable devices.
Instead it appears that — at least for now — Continua is a one trick pony.
Related:
Continua announces Bluetooth Low Energy, ZigBee for Version 2
Which technology should Continua pick?
Continua: TV set-top box could be home health hub T
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| Reactions: Smartphones to replace pagers
Last week we wrote about the growing popularity of smartphones among doctors and their growing use at hospitals. We wondered what it would take for smartphones to displace legacy pagers.
After posting our article with the question: “What’s it going to take for smartphones to replace pagers in hospitals?” we received a number of comments. We reprinted a few of them below with the authors’ permission:
What’s it going to take for smartphones to replace pagers in hospitals?
“Extinction of Homo Sapiens-Pager. They will go the way of the Neanderthal and be killed off by Homo Sapiens-Smartphone.”
-Mark Moffitt MBA, BSEE
“Regarding pagers and smartphones: To replace pagers the mobile network would need to improve markedly. [It would need to improve] mostly in-building, but that is where the majority of house staff pages are sent. Depending on the geography, outdoor reception can be an issue, too.” -Dr. Joseph Kvedar, Founder & Director, Center for Connected Health, Partners Healthcare
“There are a couple of financial factors: 1) Cost. Pagers are significantly cheaper so giving 3,000 nurses and physicians pagers at $5/month is significantly cheaper than giving them smartphones. 2) Work vs. Home. Does work pay for the smartphone? If so, how to you stop employees from using it (a “company asset”) for personal stuff? Is it a personal smartphone? If so, why should the employee allow their employer to use it for work related business? This is a messy issue and you see a lot of people who are carrying multiple mobile devices (pager, work smartphone, personal cell phone) as a result.
The ‘I didn’t get the page’ comment is one you get a lot. With cell phones, you get more two-way communication that gets around the one-way pager excuse that some use to avoid people.” -George Brenckle, SVP & CIO, UMass Memorial Healthcare
“Along with the financial factors there is also the issue of coverage both inside and outside of buildings. Getting coverage for pagers in building is still easier and less expensive than for cell phones. Getting cell signal in remote areas is extremely difficult, and while not easy with paging, it is easier.” -Phil Clough, CTO at Berkshire Health Systems
“What are pagers? ;-)” -Dr. Ahmad Risk, Alif Healthcare
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| Mobile: Wild frontier of unclaimed health space
“Pioneers get the arrows,” as the saying goes. I much prefer: “Pioneers get arrows in their back.” Being early in a market is great — if the market is ready for you.
I have been in and around Internet and healthcare for nearly 15 years. I almost regret to say that that for many reasons, but mostly because I have been waiting that long for technology to revolutionize healthcare. That is a decade long trend in the making. I don’t think there has been much transformation other than a lot of VC money has been burned and consumers and HCPs are now both online. If you go back to the start of the millennium when the “Year 2000″ was the issue du jour, consumers and “silver surfers” were online then too and health information was at the top of the list for why they came online. The same is true today except the “silver surfers” are now the fastest growing segment on Facebook.
We have seen the DVR (digital video recorder) disrupt television viewing and single handily ruin Thursday’s “Must See TV.” We’ve seen the notion of watching a full-length movie on your phone become a reality and being able to watch your favorite TV shows remotely on your PC come and take hold in a shorter timeframe.
It’s interesting to watch mobile health take off and the AppStore on iTunes fill up with apps. Mobile is now the wild frontier of unclaimed health space. I truthfully think everyone is, to use the expression, “building the airplane while flying it” and not entirely sure where things will end up. Continue >>
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| Timeline: The iPhone as medical tool
Ever since Apple’s AppStore created a dedicated category for medical applications for the iPhone and iTouch, it seems that — as Apple’s Mark Wilson put it today at the World Wide Developers Conference — “The medical community is flocking to the iPhone.”
To put today’s launch of the iPhone 3.0 in perspective, we’ve assembled a list of just some of the health-related milestones that the iPhone has experienced during the past eight months. While it’s not the only mobile platform out there, it’s hard to argue with the fact that the iPhone has attracted more developers and therefore more applications and services for the medical community than any other on the market today.
Here’s a look back on the events that led to the iPhone’s growing importance for the medical field: Continue>>
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| Continua picks ZigBee, Bluetooth LE for V.2
In what looks to be a coup for the ZigBee Alliance, the Continua Health Alliance has picked Bluetooth Low Energy and ZigBee for inclusion in its next set of guidelines for interoperability between health devices and systems. The two low power standards will become the technology that Continua promotes for devices used in health and fitness and aging independently.
The two technologies beat out rival low power technologies Sensium, ANT+, BodyLAN (used in Nike+) and Z-Wave, which all pitched Continua for the coveted spot in the guidelines. (Are we likely to see less of these technologies in fitness and health services moving forward?)
Continua picked Bluetooth low energy, which is still awaiting finalization of its specification, for future low power mobile devices, including activity monitors and heart rate sensors. The alliance also tapped ZigBee Health Care technology for sensors that could be used as motion detectors or bed pressure sensors and other use cases that would “enhance the daily living of those who require assistance aging independently,” according to the Continua press release.
“Version two of our guidelines is well on its way,” Continua Health Alliance President David Whitlinger told mobihealthnews a few months ago and just before the alliance began discussion on picking the new technologies. The first “radio selection will be predominantly geared toward the health and fitness devices that are typically body worn… The other use cases being addressed via low power radio are the sensors that might be distributed throughout the home of an elder individual, for example,” Whitlinger explained. “It’s possible they could both be the same technology, but because the use cases are different there is an option that there could be two separate radio technologies.”
Whitlinger’s comment that one technology could handle both use cases prompted many to speculate the Bluetooth LE would be picked for both uses, which makes the ZigBee pick a coup for the technology.
“The exciting aspect of Bluetooth low energy is its ability to enable low cost devices to be made that can send their data all of the way to the web. It’s based on over ten years of experience and promises to have the fastest growing ecosystem of any wireless standard. Today’s meeting sent a clear message to developers that they need to start designing now to be ready for the first generation of Bluetooth low energy handsets,” Nick Hunn, an analyst over at Creative Connectivity, wrote in a recent report.
Related:
Which technology should Continua pick?
Continua: TV set-top box could become the home health hub
First Continua-certified Bluetooth device forthcomingT
Full press release from Continua Continue >>
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| Palm Pre launches with no medical apps
Despite its long history in the medical industry, Palm has launched its latest device with no medical applications. We have written about Palm’s legacy as a platform of choice for doctors and other health workers who have depended on the company’s PDA for the last decade, but with the company’s new smartphone, the Pre, it seems Palm did not have them in mind.
Well, Palm CEO Ed Colligan did have the medical community in mind in February when he told listeners on an investors’ call that there were only a few apps that Palm felt it needed to have at launch. The only one he specifically mentioned at the time? Epocrates.
Most of the lists of apps expected to hit the Palm Pre at or near launch included Epocrates and WebMD, but neither seemed to make the cut. For those looking to port legacy Palm OS apps onto their new Palm Pre, you are in luck. The one app that will surely be helpful to the medical community is a simulator called MotionApps Classic app which allows old Palm apps to run on the new Pre.
We expect to see Epocrates and WebMD for the new Palm Pre in the coming days or weeks, but until then Palm Pre users can experience the old as new again by navigating through the legacy versions of these and thousands of other apps. Continue reading for a video showing how MotionApps looks on the Palm Pre. Continue >>
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| FDA approves MedApps telemonitor
The FDA announced today that wireless remote monitoring system HealthPAL, which MedApss developed, has received 510(k) clearance, according to an email from the company.
HealthPAL is the small, portable dedicated device that MedApps uses to collect data from connected glucose meters, blood pressure monitors, pulse oximeters and weight scales. The data is then sent over a secure server to an online portal like Microsoft’s HealthVault or Google Health for caregivers, physicians or the patient themselves to view.
MedApps has conducted pilots at Cleveland Clinic and Baptist Home Health Network to test the system.
The HealthPAL device is “about the size of a cell-phone” and “its low cost enables remote monitoring to be available to large patient populations.” MedApps explains that while it has some buttons for special features and set-up, the reading and data transmissions are automated: “The patient does not push any buttons, navigate any screen commands or touch the HealthPAL in any fashion.”
Continue >>
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| Microsoft: 10% US wants texts from insurers
Ten percent of Americans believe text messaging is the best way for them to communicate with health insurers, according to the Microsoft Health Engagement Survey 2009, which Kelton Research conducted. The survey concluded that consumers want coaching via email and phones from their healthcare providers to help them improve their own health.
66 percent: Interested in emails from providers for encouragement
52 percent: Want emails from providers that include feedback on their health progress
62 percent: PHRs (like Microsoft’s HealthVault or Google Health) are valuable
55 percent: Healthcare system is fragmented for helping people proactively manage their health
49 percent: Health plans only support them once they need to visit a doctor, not for wellness
77 percent: Find technology “inviting” instead of “intimidating” when it comes to helping them manage their healthh
While the survey found that only 10 percent of Americans believe text messaging is the best channel for communications from health insurers, if the survey’s sample size (1,002 Americans 18-years-old and up) is to be believed: That’s equivalent to 30.4 million people in the U.S. Read more for other stats from Microsoft’s survey.
Continue >>
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| Voxiva, CDC, WH to launch Text4Baby
At last week’s inaugural HealthCampNash in Nashville, TN, Paul Meyer, co-founder, president and chairman of Voxiva, led with a keynote presentation, called “Mobile Health – Lessons from Around the World,” which included a number of case studies from developing markets as well as a sneak peak of Voxiva’s plans in the U.S. Since 2001, Voxiva has been building mobile health applications that address two key questions few traditional healthcare IT vendors consider, namely: 1) Where are the people? and 2) Where is the health?
Voxiva began by creating mobile health services in developing countries (First launch: Peru), so they aimed to leverage the technology people were already using. Meyer offered a number of case studies from countries like Mexico, Kenya and Rwanda where mobile health applications engage patients and change behavior. The services include risk assessment, appointment reminders, adverse event tracking, and satisfaction surveys.
In Mexico, people are tracking their diabetes, getting tips, and interacting with their providers. In Kenya, they receive medication reminders, and in Peru rural health workers can input a text code for a disease found, such as cholera, where it is updated to their national health system in real time.
In Rwanda, the Ministry of Health implemented a system that uses mobile phones to register patients, order supplies, and access lab results. Meyer states there are 184 studies happening globally that show results for smoking cessation, improvement in diabetics, and even birth outcomes when programs were combined with mobile interaction. For example, in one study 28 percent of smokers receiving quit messages via SMS actually quit, versus 19 percent who do did not. In another study, SMS reminders improved primary care attendance from 48 percent to 59 percent. Continue >>
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| LifeWatch posts up against CardioNet
Remote cardiac monitoring company LifeWatch has inked an exclusive carrier agreement with Verizon Wireless for its mobile phone-based service for cardiac patients. LifeWatch’s LifeStar Ambulatory Cardiac Telemetry (ACT) service is a direct competitor to CardioNet’s MCOT service, but unlike CardioNet, the company uses the patient’s mobile phone to transmit the monitoring data. CardioNet uses a dedicated “pager-sized” device to collect and transmit its data.
LifeWatch has served some 60,000 patients with its ACT solution since its launch in the beginning of 2007, while CardioNet has served close to 250,000 patients to date. CardioNet also has deals in place with payers that cover about 200 million lives.
“New avenues of development for both [Verizon Wireless and LifeWatch] will open as LifeWatch expands our innovation pipeline to remotely monitor patients for additional disease states and wellness conditions from virtually any location,” said Dr. Yacov Geva, Chairman and CEO of LifeWatch’s parent company Card Guard.
In May, CardioNet announced its new avenue for development: Monitoring patients for sleep apnea. Continue >>
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June 16-17, Ft. Lauderdale:
8th CCS Summit
Transforming Healthcare through Health Information Technology
Designed to help top-level executives, legislators, physicians, regulators and technologists come to grips with the swirling forces of health information technology change, policy development and changing business models, the CCS HIT provides an intimate, high-level forum that facilitates open avenues of communication amongst executives and stakeholders in healthcare.
Register
June 22-23, Seattle, WA:
Sixth Annual Healthcare Unbound Conference & Exhibition
Healthcare Unbound will have a strong focus on use of remote monitoring / home telehealth technologies for wellness promotion and disease management, with a special emphasis on Baby Boomers and the elderly population. The agenda will also cover topics such as the emerging role of mobile/wireless technologies, legal/regulatory developments and reimbursement issues, strategies for success for Healthcare Unbound vendors and much more.
Register
July 27-28, Boston, MA:
The World Health Care Congress Leadership Summit on Wireless Health
This two-day Summit convenes policy-makers, payers, providers and medical group practices from across the nation to discuss business and clinical opportunities for integrating mHealth, Remote Monitoring and Telehealth solutions into existing care systems. Real-life, case studies and the results to-date from pilots at several leading provider organizations will be shared.
Register
October 6-9, San Diego, CA:
CTIA WIRELESS I.T. & Entertainment
No matter what your business is – healthcare, entertainment, fleet management or financial planning – wireless can transform how you do business. International CTIA WIRELESS I.T. & Entertainment brings this possibility to life. With a focus on applications, network architecture and technologies such as LBS, machine-to-machine and WiMAX (just to name a few), this international event brings a community of users, carriers, developers and manufacturers together to generate dialogue, share ideas and debate the economics of MOBILE BUSINESS.
Register
October 27-30, San Diego:
TEDMED 2009
The fifth in a series created by Marc Hodosh and Richard Saul Wurman, TEDMED celebrates conversations that demonstrate the intersection and connections between all things medical and healthcare related: from personal health to public health, devices to design and Hollywood to the hospital. Together, this encompasses more than twenty percent of our GNP in America while touching everyone’s life around the globe.
Register
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