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Highlights abound at Healthcare Unbound
 Not unlike the mHealth industry, the city of Seattle began with a number of false starts: The first European settlers in the city named their original village “New York,” but perhaps because of the anticipated confusion changed it to “Alki,” which meant “by and by” or “someday” in Chinook. A few years later Alki’s settlers found it rough goings so they moved a short distance across the bay in an area that later grew into the city of Seattle we know today.
There were far fewer “somedays” or “by and bys” and more lessons learned and real-world launches according to many presenters at The Sixth Annual Healthcare Unbound Conference and Expo that took place in Seattle this past week. While I still heard a good number of “somedays,” it doesn’t sound like anyone’s abandoning the mHealth settlement.
For posterity’s sake, here are the highlights and memorable moments from Seattle. (Excluding, of course, the delicious sandwiches from Armandino Batale’s Salumi sandwich shop downtown and the tasty Yirgacheffe at Trabant Coffee & Chai.)
Diversinet’s Jay Couse let it slip that partner company AllOne Mobile had just completed a pilot with Wal-Mart for mobile phone-based personal health records. Couse also noted that AllOne Mobile runs on 286 devices.
Qualcomm’s Clint McClellan revealed that the long-awaited Lifecomm, which has been discussed since 2005, will offer two wireless health devices shortly after launching: A mobile phone with a glucometer built-in and a wireless medallion that will be life “Lifeline-on-steroids.”
Kaiser Permanente’s Kendra Markle pointed to a website that sends users text messages at random points throughout the day and simply asks what they are doing and how happy they are. The site, HappyFactor.com, then enables users to log on and determine trends between moods and activities.
Noted industry thought leader Dr. David Kibbe asked attendees during his keynote: Why is it that physicians have shown little reluctance to adopt iPhones, while only 15 percent of physicians in this country are currently using some form of EHR?
Critical Mass’ Michael Barrett suggested that the healthcare industry needs to start listening more to behavioralists to determine how best to “nudge” the general public into making healthier choices. An example: While driving on the highway, what if instead of a “Your speed is X MPH” sign, a sign informed passersby on the number of “Calories consumed today”? Barrett said these real-time cues for making healthier decisions could be key.
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| West Wireless Health to conduct Corventis trial
According to a report from the Wall Street Journal, the West Wireless Health Institute will soon announce plans to conduct a clinical trial with Corventis, a remote heart monitoring company. Corventis makes use of a Band Aid-like wireless sensor-enabled patch that sends heart readings through Bluetooth to a patients’ iPhone or BlackBerry. The data is then transmitted to a physician’s office and the physician is alerted if any irregularities appear in the readings.
The West Wireless Health Institute told the Wall Street Journal that other device makers are looking to team up with the Institute to conduct trials of their own. For now, though, the focus will be on Corventis.
“The goal is to get it used in medicine, to get reimbursement, to shake up how medicine is practiced,” Dr. Eric Topol, the West Wireless Health Institute’s chief medical officer told the WSJ.
Topol is down in Washington D.C. for the wireless health event that CTIA organized. In a recent interview, Topol explained why the federal government should be focusing on wireless health instead of just EMR for its health reform plans: Continue >>
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Continua: Enough pilots, time for deployments
The Continua Health Alliance, a consortium of wireless and medical companies, which aim to create an interoperable ecosystem of medical devices and systems, has been busy this year. After announcing its first two Continua-certified products, the Alliance also announced two new wireless technologies for its Version 2 guidelines: ZigBee and Bluetooth Low Energy. Most of the devices under Continua’s purview are in the wheelhouse of wireless remote monitoring.
Chuck Parker, Executive Director of Continua Health Alliance, told attendees at Healthcare Unbound in Seattle, Washington that the Alliance’s membership has swelled to 207 members, which marks a 17+ companies jump in just the past two months. Parker also revealed that two different companies had already had their hardware cleared by Continua’s certification process and should be announced soon.
“We’re just waiting on the paper work,” Parker said.
Parker said that remote patient monitoring doesn’t need to do anymore trials or pilots. The Veterans Health Administration (VA) has done remote patient monitoring pilots with about 30,000 patients over the past four years, Parker said. That’s enough pilots, Parker said, we don’t need to do any more pilots for remote patient monitoring; we need to move to deployments, and look to the VA for their pilots’ findings.
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| Kibbe: Successful EMRs like iPhone platform
Why does it seem like so many physicians have embraced the iPhone, but only 15 percent of them are using some form of electronic health record EHR technology? That’s one of the questions that Dr. David Kibbe posed to the audience at Healthcare Unbound here in Seattle, Washington.
Kibbe suggested a number of reasons for why physicians are adopting smartphones like the iPhone while shirking EHRs, but the most striking reason was accompanied by a drawing of Apple’s basic UI: A screen with a button that said Push. On the following slide Kibbe showed what he called the typical EHR user interface design: A big mess of buttons and blinking boxes, including a blinking box that lights up when there’s an error. Design and ease of use are crucial barriers to any new technology’s adoption and Kibbe is wise to point out this simple but important point.
Once EMR vendors begin to open up their APIs, the industry will begin to see thousands of new applications built on the EHR platform just like Apple’s AppStore, Kibbe predicted. Those apps would include remote monitoring apps, he said. Kibbe also predicted that in the beginning a number of EMR platforms will emerge and some of them will come from outside of traditional healthcare incumbents, but the ones to succeed will be the ones that create clinical groupware that is interoperable, substitutable, low-cost and low risk.
The fact that 15 percent of physicians are using some form of EHR indicates that the other 85 percent don’t want them.
This situation is ripe for disruptive innovation, a term often misused and misunderstood, Kibbe explained. Clayton Christensen’s theory of Disruptive Innovation actually begins with disruptive innovations or technologies that are actually “crummy” in the beginning. The key is that they are good enough, open enough and substitutable to the point where they overtake the incumbents’ offerings, despite the obvious gap in quality.
We recently reported that Boston’s Children’s Hospital’s Informatics Program published a group of principles to guide the creation of a new health information infrastructure for the U.S. The piece was a follow-up on an article published in The New England Journal of Medicine in March. The latest article argued for the development of a platform model, very much like Apple iPhone’s setup, to encourage the development of “substitutable” healthcare applications.
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| Aetna: Ultimate goal is health info on-the-go
Aetna’s Head of Digital Engagement Strategy and Innovation Robert Heyl gave attendees at this week’s Healthcare Unbound conference in Seattle a sneak peak at the company’s mobile plans as well as an update on how well Aetna’s customers have been engaged with its health information portal SmartSource.
Heyl said SmartSource aims to bring resources together that enable Aetna members to go to one reliable online location to find the information they need to make informed health decisions. The site aims to be personalized and relevant to the user — so the content is shaped by the user’s health profile on file with Aetna. If a user has diabetes, for example, SmartSource might suggest new diabetes management tools to user upon logging in.
Of Aetna’s 6 million members about 13 percent or about 780,000 members have visited the SmartSource online portal.
About 53 percent of those visitors were female, while 47 percent were male.
Aetna found that 64 percent of all traffic was from members between the ages of 40 and 64-years-old.
The women users searched for personal health information about 41 percent of the time, while the men users were looking for health information for themselves 73 percent of the time.
Most popular searches were for diabetes, pregnancy/infertility, obesity/weight loss/fitness, high blood pressure/cholesterol, depression/mental health and pain management.
Heyl said that Aetna understood that health decisions mostly occur while people are going about their daily lives, so the ultimate goal is to take the information in SmartSource and bring it to the mobile platform. While Heyl didn’t give a time frame for a mobile application launch, he did include a mock-up for what a mobile app for SmartSource might look like someday (pictured here.)
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| Kaiser Permanente touts SMS mood tracker
Kaiser Permanente’s Director of Internet Services, Kendra Markle told attendees at the Healthcare Unbound event here in Seattle that “wireless technology is revolutionizing health behavior change tools.” These tools can now reach people anytime, including during those moments directly before we make health-related decisions, she said.
These tools can now reach people right when they sit down in front of their food, Markle said. Once location-based services are added into that picture, real-time monitoring of eating habits can take on a whole new (and creepy?) context as caregivers or friends can keep tabs on where we eat. Mobile social networks are already leveraging location-based services like “friend finders” so it’s not a stretch to see these services applied to changing health behaviors, too.
Markle offered up a great example for mood tracking via mobiles: HappyFactor.com, which enables users to track their moods through text message responses. At random times throughout the day, HappyFactor asks its users how happy they are and also what they are doing. The service then compiles the responses and maps them against the activities reported to determine which activities make the user happiest and which tend to bring them down. Users can then visit the site to review the trends and use that data to make better decisions in the future. (To be clear, Happy Factor was not developed by Kaiser Permanente.)
HappyFactor offers a similar service to the text message-based mood tracking service Living Profiles, which debuted at the Health 2.0 conference in Boston in April. Living Profiles plans to mine teenagers’ text messages for key words that are indicative of moods. The group tracks and categorizes words the teens use and then gives them updates that help the teens understand changes month-over-month.
For more on HappyFactor, check out the site here
For more on Living Profiles, check out this post from Health 2.0
Related:
Kaiser has plans beyond text message appointment reminders
Kaiser Permanente to rollout nationwide text message reminders
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| Lifecomm to offer glucometer phone
At the Healthcare Unbound conference here in Seattle, Qualcomm’s Clint McClellan revealed that Lifecomm, a Qualcomm start-up that has been in the works for a number of years, will sell a mobile phone with an embedded glucometer as one of its first offerings. Lifecomm was first announced by Qualcomm in 2005, but has yet to launch. The company will reportedly manage the wireless connectivity services for health devices and health-management tools equipped mobile phones.
McClellan said that Lifecomm will also offer a medallion like those worn by seniors in case they fall down and can’t get up, except the Lifecomm medallion will have an accelerometer embedded that can detect a fall. It will also include the technology of a “full mobile phone,” McClellan said. Think “Lifeline-on-steroids.”
Lifecomm isn’t the only iron that Qualcomm has in the fire, of course, McClellan mentioned other Qualcomm-related start-ups like Proteus Biomedical, MicroCHIPS, Triage Wireless, Chealcomm and Isis.
The real key to the future of this mHealth industry is low cost, disposable (maybe after one week) wireless sensor patches, McClellan said. Isis makes transdermal drug delivery patches that aim to deliver exact drug doses at the exact time. The sensors use ZigBee radio technology and automatically deliver the drugs, which may be best delivered in the middle of the night.
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| Epocrates: One third of US physicians use us
Epocrates prevents about one adverse drug event (ADE) per week for most physicians who use its mobile clinical software, according to a poll that the company recently conducted. Epocrates surveyed more than 2,000 physicians that use its mobile clinical reference app and 60 percent reported avoiding about one ADE a week and found the app more helpful than EMRs for actionable reference information.
Epocrates claims that more than 33 percent of US physicians use Epocrates, which means it prevents more than 100,000 ADEs each week, according to the company.
“Having an EMR system is certainly helpful and key to modernizing our healthcare system, but Epocrates is my go-to source during patient visits,” Dr. Ronald Hirsch, Illinois-based internist, said in an Epocrates release. “It’s always within reach and the up-to-date content includes drugs, diseases and diagnostics.”
Some other metrics from the Epocrates survey: Continue >>
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| AAHSA: Transformation comes from small tech
The American Association of Homes and Services for the Aging (AAHSA) may be a national nonprofit organization that represents 5,000 not-for-profit nursing homes, retirement communities, assisted living residences and senior housing communities, but it’s President and CEO said he still knows a thing or two about Twitter. AAHSA’s Larry Minnix told attendees at the Healthcare Unbound event here in Seattle, Washington that anyone who doesn’t believe that “small technologies” don’t have the power to change things needs to pay attention to what Twitter has done to provide a media outlet for coverage of the Iran elections and related protests.
Transformation comes from small things, Minnix said.
Those could include technologies that help seniors live more independently, while maintaining their mobility thanks to wireless sensors and remote monitors around the house, like the ones the Continua Health Alliance recently selected ZigBee technology to support.
Small things like wireless sensors could transform the lives of seniors and their caretakers alike.
Minnix noted that about 70 percent of people in the US “will face the opportunity of becoming a long-term caregiver for a loved one,” which costs about $5,500 a year to take care of an elderly person at home. If you are a remote long-term caregiver it typically costs closer to $9,000. Currently, 34 million people in the US provide care to someone who is over the age of 50, but that number is expected to balloon soon as Baby Boomers age.
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| Roadside signs: Models for health nudges?
You know those “Your Speed Limit Is…” signs on the side of the road? Turns out they are very effective. Michael Barrett, managing partner at Critical Mass Consulting, wondered whether the healthcare industry could learn a thing or two from those simple, roadside sentinels. Barrett made the case this morning during a presentation at the Healthcare Unbound conference here in Seattle, Washington.
Barrett noted that the importance of triggering behavioral changes has not been lost on the current administration – President Obama has at least three trained behaviorists as advisers to the health policy group. What if instead of showing your current speed juxtaposed with the speed limit, the sign on the side of the highway showed your current caloric intake for the day next to the daily recommended number of calories, Barrett asked the audience.
These real-time cues for eating habits or other health decisions “nudge” us into making behavioral changes, and even though it’s a top-down approach, Barrett called it Libertarian paternalism. They are nudges not mandates, he argued, and they need to be easily avoided and ignored if a person so desires.
Of course, we don’t need a roadside sign for real-time cues for behavioral health changes — we almost all have mobile phones in our pockets for that.
Read on for the healthcare industry timeline that Barrett presented at a different conference earlier this year. The presentation aimed to contextualize the wireless healthcare “revolution.” Continue >>
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| Slideshow: BlackBerry health & fitness apps
Shortly after BlackBerry’s App World launched we noted that it had 34 applications in its Health & Fitness category. Since our last article two months ago, BlackBerry’s App World has added four more health and fitness related applications, while Apple’s iPhone App Store has added 96 health-related apps… just this past week.
Since the iPhone’s App Store is hosted online and is accessible from any desktop (BB App World is viewable by BB users only), it’s spawned a number of lists for health-related applications many of which are outdated as soon as they publish because of the growing number of applications hosted by the store.
Meanwhile, if the last two months are any indication, a snapshot of the applications available in BlackBerry’s App World should stand the test of time at least for a while. In order to illustrate the types of apps currently available on App World, mobihealthnews compiled a slideshow of 14 of the 38 health and fitness related applications currently available from the App World online store.
The apps enable users to track anything from caloric intake to time in the gym, while fitness professionals as well as doctors, nurses and other caregivers can use some of these apps to track their clients’ or patients’ progress. Continue >>
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| $1M NIH grant to nudge obese teens off couch
Thanks to a $1 million grant from the National Institutes of Health, University of Southern California researchers have developed a wireless body area network (BAN) that they plan to leverage to help overweight and obese teenagers adhere to their daily fitness regimens.
The USC team’s BAN consists of an accelerometer, heart rate monitor, GPS device and a sensor that measures electrical conductivity of the skin. The data is then routed wirelessly to a Nokia phone, which can then transmit it to a secure server for later viewing. USC calls the project the KNOWME Networks study because the goal is to train the sensors so well that they know what the wearer is doing.
“We’d like to be able to ping you and say, ‘You’ve been inactive for six hours, and your friend Courtney is three miles away and running — there’s an activity possibility for you,’” Donna Spruijt-Metz of the Keck School of Medicine, an associate professor in preventive medicine, told the LA Times in a recent interview. Continue >>
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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.
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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.
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October 6-7, San Francisco:
Health 2.0
With nearly a hundred speakers and plenty of new healthcare demos and technologies on display on stage and in the exhibit hall, you’ll get a sweeping overview of the ways that information technology and the web are changing healthcare. We’ll be looking at the “traditional” Health 2.0 areas like vertical search, online social networks and tools for consumers. But the conference will also be focusing on how new technologies are connecting patients and clinicians, and examining the impact of Health 2.0 technologies on patients lives.
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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.
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