iPhone 3.0 all about mHealth

By: Brian Dolan | Mar 17, 2009        

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iPhone 3.0As I predicted last week, Apple announced this afternoon new features of the iPhone OS 3.0 platform that will enable a new host of mobile health applications, devices and services. Today’s event at Apple’s headquarters included speakers from LifeScan, a Johnson&Johnson company, as well as advanced functionality for connecting accessories like medical devices via USB and Bluetooth (Continua, are you reading this?). As I mentioned last week, the expected “push technology” update did, in fact, come to fruition as app developers can now send notifications to iPhone users even when their apps are not running live on the iPhone. This means medication adherence apps or other medical reminders applications are now more effective, because the user no longer has to remember to click on the app to get the reminders. Reminders can now be “pushed” to the phone like a text message.

LifeScan MeterBefore showing off a blood pressure monitor, Scott Forstall, SVP of iPhone Software at Apple gushed: “Now here’s a class [of services] that we think will be really interesting: medical devices.” Forstall explained that the new iPhone OS will allow application developers to sync medical devices like BP monitors via both Bluetooth and USB. 

“So imagine the possibilities,” Forstall continued. “We think this is profound.”

Forstall then brought up Anita Mathew from Lifescan, a Johnson&Johnson company, to demo an iPhone application that lets users upload glucose readings from their connected blood glucose monitors to their iPhone. The app then lets users send their readings and a message about how they’re feeling to caregivers like their parents, children or physician. The glucose reader app also includes a meal builder and insulin schedule for easy tracking by tagging readings as pre- or post-meals. The iPhone app can even estimate, based on diet, how much insulin is needed after each meal. The app also shows glucose levels in a chart form and lists each previous reading.

We wrote about LifeScan previously for their role as an investor along with Sprint in WellDoc’s ongoing pilot of a mobile phone-based diabetes monitoring system, that has resulted in an average of 2 percent drop in the users’ A1c level.

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  • http://ceuq.com DNhop

    Touting the Apple iPhone as a miracle medical advice only benefits Apple.

    There is no benefit whatsoever to an iPhone only app. The iPhone occupies less than 20% of the smartphone market. So who has the other 80% covered?

    mobiHealthNews seems to think that the iPhone is going to change the Health Care system and all of its ills.

    What does someone have to do to have these thrills?

    First, you have to buy an iPhone – about 400 bucks each
    Then you have to subscribe to their carrier – 200 a month
    Then you have to join Apple iTunes – No fee to join, some apps are free.
    Then you have to download any app you want – Again, some free.

    To outfit a consumer with this item you are looking in excess of $2,800.00 per year.

    The same is true if Apple or anyone else wants to push their products to a healthcare worker.

    You have great products and apps that come with a hefty price and most work only on the iPhone.

    I do not know of anyone developing programs for the iPhone only.

    Why?

    Remember that other 80%?

    There are ways and methods of creating apps and widgets that are free to use and work flawlessly on ALL smartphones or web enabled devices, including the PC.

    The value of any healthcare model is that it has no cost to the user.

    There are 4.5 Billion mobile phones in use.

    Take a look at some of these sites:

    iCPR.mobi
    iHosp.mobi
    EmergencyGuide.mobi

    dot Mobi is not technology. It is a standard that works on all platforms and browsers.

    Most of all, it is easily adapted to any environment – the mobile device and the PC.

    One of the biggest issues I see in healthcare and mobile technology is that healthcare does not even use the tools in place to their best potential.

    The cost of revamping what is allready in place and using that hardware and technology to its greatest potential is minimal compared to upgrading.

    But many will try to sell the healthcare industry new hardware, PC’s, monitors in an attempt to convince the industry that they need these upgrades when the plain simple answer is no – No, you do not need to upgrade your equipement. And the reason no one needs to upgrade is because you already have what you need. You just are not using it properly.

    I doubt that there will be one person in the healthcare industry utter those words. There is not enough money to be made by simply training and re-training employees to use what they are currently using.

    Lets outfit each station with the latest $500 monitor, the latest $400 wireless printer, the last spectrum phone at $500 a pop and the lastest PC PCU at $1200. So each nurse’s module or work space is going to run say Thirty Five Hundred Bucks but we’ll also need to sell some softway with our name at it at say $75,000.00.

    So in the hospital I work at, given an estimated 1500 workstations modules for the docs, nurse, etc on a 9 floor acute care hospital we are going to give them a $5.2 million upgrade that they do not need, courtesy of our taxpayer dollars.

    The healthcare IT sector needs a giant enema to get with the program. All that is new is not needed. All that is needed is someone to show them how to maximize the efficiency of the tools in place and that alternatives exist.

    I would hate to think that I needed to carry around a $500 iPhone that I will ultimately lose or get stolen all because I needed an app or two that unquestionably is available to all smartphones for free.

    Sure, that makes sense to me.

    Its not my money anyways.

    Its yours.

  • http://mobihealthnews.com Brian Dolan

    Thanks for the comment, DNhop. I’ve noted your enthusiasm for .mobi before and certainly invite you to expound on how it can help move mobile technologies in mHealth forward. You have yet to make that case.

    If you have an idea for a way to incentivize developers and the industry to make compelling mHealth apps that work on all devices (including PCs) but–at the same time–have no cost to the end user–since “the value of any healthcare model is that it has no cost to the user”–I’m all ears.

    Finally, we do not believe the iPhone is going to cure all the ills in the healthcare industry, but we believe the marketing power behind the iPhone–all the hype and pomp you take umbrage at–is doing much to push the industry along. Today’s announcement, including the work iPhone did with LifeScan to hook blood glucose monitors up to the iPhone, demonstrates to the mass market that these solutions are not just possible today but commercially viable. Millions of people will read or hear about today’s announcement and realize that mHealth is here and now.

  • http://dnhop.com Gerry

    Enthusiasm for .mobi – yes.

    “You have yet to make that case.”

    This is my first knowledge of such a call to action.

    I have no doubt that mhealth is here. It has been here. Before the iPhone. I do not take “umbrage at” the iPhone. I am a little miffed why you and your publication are not picking up on the fact these are Apple iPhone only apps.

    Honestly, if Apple owns but 17% of the smartphone market, we is anyone discounting the other 83%?

    It makes no sense to me.

    As a marketer and as a publication for mobile health, why are you not raising these questions to Apple? Why are you not asking, “How is this going to benefit the hundreds of millions of diabetics who do not have an iPhone, do not want an iPhone, and can not afford an iPhone?”

    This is what I am in a tizzy about. It is like no mobile or mobility existed before the iPhone and nothing can beat the iPhone.

    What on earth did you report about before the iPhone as being useful to all and not only to those who could afford it?

    Gerry

  • http://mobihealthnews.com Brian Dolan

    Thanks, Gerry. It’s true the iPhone isn’t the cheapest phone on the market and as a result will not benefit all of the hundreds of millions of diabetics who do not have/want or cannot afford an iPhone. Apple seems to be focused on enabling apps for their own devices since that is how they make money. Regardless, their efforts have driven a lot of innovation–hard to argue with that.

    As you noted, I also hope other device makers and app stores will follow their lead and make or enable similar apps for other and cheaper phones. (There are many, many app stores about to launch and a few already out there like Handango, for example.)

    Finally, we make every effort to follow each and every mHealth story so let us know if there’s more to the .mobi and mHealth trend.

  • http://dnhop.com Gerry

    I appreciate this publication like you wouldn’t believe and never knew you existed until recently.

    In regards to innovations, certainly. While their devices are not new in Asia (touch screen phones have been out for about 2 years in Japan) it is a phenomenal tool. And as a tool, one would hope that the tools be used for the greater good.

    With that said, anticipation is also growing with the Android and gPhone release. This also seems promising. Being that the Android project and the gPhone is open source, this will allow accessabilty by nearly any device.

    If a non-tech type like me can produce a mobile site with simple basic tools and skills then anyone can. And perhaps they are.

    We don’t enjoy a budget of Apple’s size to launch and promote. However, many are seeing the benefit from being small and cutting out the middle man.

    While I might be partial to .mobi, I am more partial to getting all these tools to the hands of the healthcare workers.

    And for the record, I want to point out that iCPR.mobi, iHosp.mobi, and EmergencyGuide.mobi are totally ad free. I have no desire to monitize these sites. It is more important that any one learn or have at their disposal CPR instructions, or find a Doc, Hospital, or clinic when they need it, or have one site (EmergencyGuide.mobi) that contains all of that plus CDC updates and Poison Control.

    I may push these but it is for no personal benefit or gain.

  • http://mobienthusiast.mobi Holly

    I celebrate the fact that the iPhone is being used for more than listening to music, playing games, and watching movies. Anything to help the public health is a win in my book.

    It can’t stop there, though, and I agree with Gerry that for the rest of the world that surfs the internet on Windows Mobile Devices, Treos, Blackberries and every other smartphone or feature phone with a wap browser, there needs to be a similar service. The advantage of the iphone app is that it can ping the user to download updates or, if the application is integrated with iCal, it can add the medication schedule to the end user’s calendar. Typical smartphones and feature phones can’t do that.

    This type of service could probably be handled by an sms messaging system, but sms and shortcodes aren’t free. There are plenty of companies that will sell you an unlimited sms plan, or free sms plan, but in reality many of them are fakes that use smtp instead, and mobile carriers can refuse to deliver the messages.

    The cost of development and the monthly sms/fees need to be paid for by somebody – either a not-for-profit, or a brand sponsor. But yes, I think a .mobi site where there is nothing to download would be beneficial to the majority of non-iPhone users.

  • Phil K

    @ DNHop / @ Gerry :
    …”First, you have to buy an iPhone – about 400 bucks each
    Then you have to subscribe to their carrier – 200 a month
    Then you have to join Apple iTunes – No fee to join, some apps are free.
    Then you have to download any app you want – Again, some free.

    To outfit a consumer with this item you are looking in excess of $2,800.00 per year.”…

    I’m curious what country you’re in, or if you’re talking about USD. I say this because your cost estimates are completely different from actual reasonable costs in USD. Here the US we pay about $400 for the phone, then about $80 per month for a reasonable number of minutes plus unlimited 3G data. That’s all in about 50% less than what you estimate. Your assertions about joining iTunes and having to download apps are also beside the point – neither are compulsory, though available for free if desired. Some applications cost money, but that’s the case with computers (and practically everything else), too.

    The meat of what you’re talking about makes good sense – developing applications for specific platforms has inherent pros and cons. Developers who make software for windows mobile, android, or iPhone exclusively miss out on other platforms. None of that is new; in fact, its common and has been for as long as software has been around. Moving towards web standards is a reasonable approach, but then you’re optimizing for mobile experiences and not optimizing for desktop users. Lets also not forget that some “smart” phones use the Symbian browser, which requires a fundamentally different codebase (and a much degraded experience). I fail to see what’s wrong (or even different) with a company building an application for the iPhone, though. The iPhone OS is clearly ahead of its competition when it comes to native mobile applications, especially in terms of the development kit and user interface options. New development kits are becoming available that will allow applications to be compiled for multiple mobile OS’s with the same code base, which will be a great step for native mobile apps.

    While mobile web applications are flexible and portable, native mobile apps also have benefits — they can certainly be faster than web applications because of local processing, and they also remain useful even when a network connection is not available. They are likely to have more integration with native UI controls and better consistency with user expectations. Not a slam dunk, but not wasted effort as you seem to claim.

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  • http://ceuq.com DNhop

    @Phil K – I am in the US and I was basing my figures on the All included unlimited AT&T plans. The basic rate does not include many of the Apple iPhone features. Not to mention iTunes prices.

    For heavy uses, such as for the medical practices, anything less would be costly to the extreme by having to pay for additional time.

    Personally, I have the Apple iPod touch. Actually, this is a better fit for the healthcare workers. There is simply the process of getting a pass word to log onto the intranet or the servers of a hospital.

    Yes, there is Symbian and numerous OS’s. This I am well aware of.

    The point is right now, this very minute we are speaking of, no-one needs to wait for anything new because this process of rendering sites across all platforms already exists.

    That is THE primary issue facing hospital staff and workers. You have to be in these environments to truly understand the frustration. My wife and I both are. And we are both aware of how time consuming having to enter the same data, or same therapy, visit, treatment, medications, events, progress notes, into 5 – 7 different systems because no one is talking to each other, computer wise.

    There are software and licenses that need to be purchased for everything you can possibly imagine for every single thing because all that is available right now is proprietary software. Unfortunately, the ones making the decision of which one to use over the other is not in a clinical role. Most often, it is not the best choice.

    Sure, we can say that is an internal problem. But it is not. It is a Universal Healthcare problem. One that all emphasis on MIT and HIT should be focusing on.

    That is why I say “Phooey” on the iPhone and iPhone apps. They are so limited in scope and usage to a specific product. And there is no integration whatsoever with what currently exists.

    The one who can figure this out will be the savior and hero of the American Healthcare Model (if you want to call it that).

    Okay, I mention dot mobi sites. Doesn’t matter what it is. It could be dot com, dot net….it really does not matter what extension is used. The point is someone made these sites to work flawlessly across all platforms, all devices, all mobile phones, all PC’s and all laptops. No upgrade to pay for, no licensing fees, no software upgrades. Use what you have right now to access this information and it is free, free, free.

    It works on 100% of the web enabled devices 100% of the time. It is fast to load, fast to use, and works flawlessly. Again, all PC’s, all laptops, all web enabled devices.

    What if I took a .com and made this? Would that make people want to use it? Perhaps.

    But that is off track and off my points of not setting limits of accessability.

    Seriously, try any of the sites listed. Most of them are geared towards the consumer but medical related none the less.

    RxD.mobi – Prescription Drug Directory. Incredible site. Generic and Brand drug directory as well as a Pharmacy Locator
    iCPR.mobi – New American Heart Association’s “Hands Only” CPR technique for Adult, Child, and Infant.
    iHosp.mobi – Locate Hospital, Doctors, Clinics, ER and more with local search capability.
    EmercencyGuide.mobi – 4 apps in one; iCPR, iHosp, CDC, and Poison Control
    Type1.mobi – Juvenile Diabetes site
    EarlySigns.mobi – Pregnancy site and advice
    BabyCenter.mobi – the mobile counter part of BabyCenter.com
    GlutenFreeDiets.mobi
    narcotics.mobi

    This is just a sampling of some sites I have been made aware of. All of these sites have the capability of working seamlessly with exisiting technology and devices. All are free to use and there are no downloads.

    As I mentioned, these could easily have been any extension currently in circulation made to dot mobi compliance standards.

    As for one device only apps, when you have the time listen to (or watch) the round table discussion “Mobile Web Wars” presented last year. These are the industry leaders on Mobile techonology. Pick up on the question “how many of you are designing iPhone only apps?”. None. The same is true for Android.

    http://tinyurl.com/5dvyrd

    Please scroll down to the 4th presentation. Even non techheads like me enjoyed this discussion and learned so much.

    There is a reason why Blackberry users are called “crackBerries”. They are addicted to the Blackberry.

    Me, I have the Helio Ocean.

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  • newton

    Regarding DNHops posts…They have numerous factual errors regarding the iPhone costs, and to me, seem to be misleading about the general applicability of the mobile OSX platform. I find the points DNHops makes confusing, and he appears to have an inherent bias against the platform.

    The iPhone costs $199 with a 2-year agreement of $69/ month for UNLIMITED data and 450 min./month. Alternatively, you can buy an iPod Touch for $229 one-time fee and avoid the monthly fees. The Touch runs the same mobile OSX platform. I predict that next year, the cost for a Touch will go to around $200.

    iTunes is free and runs on both Mac and PC platforms. Thus, the medical information collected on your iPhone or iPod Touch can be synced to your computer. There is nothing preventing the medical device company from writing their App so that the information collected via the iPhone/Touch can be later saved/transferred to an open standard, cross-platform format onto your computer. That choice has nothing to do with Apple. Apple is merely providing these medical companies a Tool. This Tool is not free because Apple, as a public company, has a fiduciary duty to try to make money.

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  • TDOG

    I have yet to find a company that manufacturers blood glucose monitors who makes software that is compatible with Apple computers. I have been asking for this for years and the response I get is that it’s not worth their investment. This goes for LifeScan and One Touch. I am a user of the One Touch meter. I have been using their meter ever since they have been producing them. They give the meters away for free because they make their money on the strips, 1.00 each. How hard or expensive is it really to create software that will work with Apple’s software? It seems to me that the meter companies are not only lazy, behind in times but also greedy.

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  • http://www.macadamian.com/insight/healthcare Didier Thizy

    Mobile apps in healthcare – will we ever see real “mHealth” in hospitals, or will apps always be limited to fitness tracking and education/reference?

    My colleague wrote a piece on this topic ( http://tinyurl.com/2ejrhs5 ) in which he observes that for all the news about mHealth, iPhone, etc. apps today are basically limited to 4 categories: reference, education, personal health or fitness tracking, and miscellaneous utility.

    What will it take to get to the next level, the promise of mHealth within hospitals to enable workers to be more efficient and provide a higher degree of care?

  • http://mobihealthnews.com Brian Dolan

    Hi Didier,

    I just happened to read your colleague’s article. While I agree there is still plenty of opportunity for better apps for use in hospitals, the post you linked to is very limited. We did our own study of health-related apps available for iPhone, Android, BlackBerry and others — we found many, many more apps than the dozen or so your group points to…

    I’d suggest you take another look.

    Thanks for the comment,
    Brian

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