Generational hesitation holds back patient engagement on both sides

By: Aditi Pai | Dec 3, 2014        

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Massachusetts General Hospital Director of Healthcare Transformation Lab Eric Isselbacher

Massachusetts General Hospital Director of Healthcare Transformation Lab Eric Isselbacher

The key to patient engagement is educating the patient so that the doctor-patient relationship resembles a partnership, according to Massachusetts General Hospital’s Dr. Eric Isselbacher.  But, he added, there are still many other challenges to engaging patients with digital tools.

Isselbacher and Blue Cross Blue Shield’s Jason Robart discussed some of these challenges at MassTLC’s Healthcare Conference in Boston.

One barrier to patient engagement that Isselbacher, the director of Mass General’s Healthcare Transformation Lab, identified is the generational divide.

“Some of the older physicians have been practicing in a very traditional environment for a long time,” he said. “And an EHR is difficult to grapple with, having everything typed, not handwritten is difficult to grapple with, having people monitor your performance as a physician is difficult, and certainly the digital age communicating with patients in ways other than sitting in the office face-to-face is difficult. I think that for some people that may be too big of a transition, it’s too late in their careers and I don’t think it’s realistic to expect that they are going to embrace it.”

The way to fix this, Isselbacher said, may be to just let this generation of doctors practice medicine the way they always have and then retire out of the system. On the other hand, Isselbacher said that the younger generation of doctors is much more comfortable with electronic devices and social media, and therefore they see patient engagement tools as an opportunity.

“I think they realize that the traditional system of interacting with the patients face-to-face in the office is very limiting,” he said. “And to be able to engage face-to-face with patients at home in real time rather than scheduled visits in the office is a real paradigm shift for them. They think it’s exciting.”

Another concern he had is that patients are resistant to change for the similar reasons.

“Generally speaking, younger patients embrace this totally, older patients often are a bit resistant,” Isselbacher said. “I had a patient just last week who lives in western Massachusetts and I offered him the opportunity to have a telemedicine visit with me because I already had his test results. It would be a great opportunity just to do a televisit. He had a computer with a camera on it, we could just meet virtually. He didn’t want to. I repeated myself, I said ‘You don’t have to drive into Boston, I will see you, I will see you on the computer screen’. Nope, he wanted to drive into Boston.”

Isselbacher pointed out that to this patient, the face to face interaction is the doctor-patient relationship.

“I certainly don’t want to rob him of that, but it just goes to show that patients can be as wedded to their culture and tradition as doctors are,” he said. “So I think that patients are self-selecting. Some jump at the chance to do televisits and communicate via email and others want to have traditional visits. For better or for worse, this will be a gradual process.”

For Jason Robart — who is not only is the Chief Human Resources Officer at Blue Cross Blue Shield of Massachusetts, but also the head of the payor’s investment arm — one of the major challenges is how Blue Cross Blue Shield can support their members differently than they have in the past.

“Internally, and I only learned this about six months ago, you may have been a Blue Cross Member your entire life — we don’t know that,” Robart said. “Because most health insurance is still provided through the employer account, our entire system is based at the account level. So you had coverage from Blue Cross as child through your parents, you then had coverage perhaps when you went to college and had a student package, you then had coverage at your first employer, second employer, etc. In each of those cases you changed your identity. So there is no way for us to connect Nancy today to Nancy who first started.”

He added that as Blue Cross Blue Shield thinks about care and the progression of illness, the company will focus on learning what happened to members 20 years ago and what a member’s health status is now.

“We are reorienting our entire organization around the consumer,” Robart said. “And what do we need to do to be able to capture that information and make that information accessible to you as you make your healthcare choices.”

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Kinsa’s FDA-cleared, smartphone-connected thermometer now at CVS, Apple stores

By: Aditi Pai | Dec 3, 2014        

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Kinsa ThermometerNew York City-based Kinsa Health has announced that its FDA-cleared smartphone-connected thermometer is now available at CVS and Apple Stores across the US as well as online at Amazon, Apple.com, and Kinsa’s website.

Kinsa’s thermometer, which was cleared in January, connects to a smartphone via the headphone jack. The thermometer can be used orally, under-arm, or rectally. Data from the device is sent to a companion app, which records the user’s temperature, when the temperature was taken, and other data about how the user is feeling. For children, the app also uses the smartphone’s display screen to offer animated visuals throughout a temperature reading in order to calm, distract, and engage kids.  Keep reading>>

Through partnership, Mount Sinai looks to promote internal innovation

By: Jonah Comstock | Dec 2, 2014        

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Mount Sinai- Patient iPads - Home Screen

Mount Sinai’s patient stay app.

New York-based Mount Sinai Health System is expanding its internal innovation and collaboration group by partnering with Edison Nation Medical, a Charlotte, North Carolina-based “healthcare innovation marketplace”.

Mount Sinai Health System already has a technology innovation group: Mount Sinai Innovation Partners (MSIP), which is based at the Icahn School of Medicine at Mount Sinai. But up until now, that program has focused on therapies and life sciences innovations, generated by designated research faculty. Edison, on the other hand, focuses on medical devices and consumer products, and will seek them out among practicing primary care physicians and specialists.

“MSIP is excited to introduce Edison Nation Medical to our institution,” Erik Lium, the executive director of MSIP, said in a statement. “It is a great opportunity to engage with additional stakeholders outside of the traditional research environment who contribute to our innovative culture and have a positive impact on the future of healthcare.”

Edison Nation Medical connects inventors with medical-related ideas to manufacturing partners that can quickly bring those ideas to scale and to market. As part of the partnership, Edison will shepherd ideas from Mount Sinai physicians and employees through that same pipeline.

“Leading research institutions like Mount Sinai generate a significant volume of high-quality innovation,” Robert Grajewski, president of Edison Nation Medical, said in a statement. “At Edison Nation Medical, we have the infrastructure and expertise to handle innovation at scale, and we’re thrilled to work with MSIP to help them efficiently translate devices and consumer related healthcare products from concept to marketplace.”

There’s been an ongoing trend in tech savvy hospitals of bringing in partners to promote, encourage, and manage internal innovation. Boston Children’s Hospital has been incubating apps in-house since 2010 in its Fast Track Innovation in Technology award program, and recently supplemented that with its “Innovation Tank” competition sponsored by Philips. And Utah’s Intermountain Healthcare recently partnered with Healthbox to create the Intermountain Foundry for incubating internal innovators.

Of course, Mount Sinai hospitals have already made news a number of times over the years for consumer-facing and medical device-related pilots. Mount Sinai Hospital has offered visit-tracking iPads to both those in its geriatric emergency room in 2012 and the general patient population this past July. It also launched a pilot of CoheroHealth’s inhaler sensor in October.

Ginger.io launches mental health initiative for low-income Utah populations

By: Aditi Pai | Dec 2, 2014        

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ginger.ioGinger.io, a health startup focused on passive data collection through smartphones, has partnered with the Association for Utah Community Health (AUCH) to launch Utah SmartCare, a care management program that aims to improve patient engagement and health outcomes in low-income Utah populations. Cambia Health Foundation awarded Ginger.io and AUCH a grant for the project.

Utah SmartCare will initially target 500 patients with co-morbid conditions or patients with a mental illness as well as a physical health condition, like hypertension. The program will focus on low-income patients living at or below 200 percent of federal poverty guidelines who are either Medicaid beneficiaries or uninsured.

“Up until this point, we haven’t had the technology to effectively measure how patients are feeling outside of a care setting,” Cofounder and CEO of Ginger.io Dr. Anmol Madan said in a statement. “Now that this remote data is more readily available, we are integrating it with the existing healthcare system and using it to deliver the sort of personalized outreach that improves care for patients and drives down costs, both of which substantially benefit the entire system.”

The program will help patients stay in contact with doctors between office visits. Doctors will use a smartphone app to gather data on patients through survey questions and insights into the patients’ daily activity and socialization. Ginger.io’s analytics engine will then take this data, analyze it, and display results on the patient dashboard, which is monitored by clinic staff. If the clinic staff notice any deviation from the patient’s normal data, they then notify the doctor. Keep reading>>

Misfit raises $40M from Xiaomi, JD.com to better serve Chinese wearables market

By: Brian Dolan | Dec 2, 2014        

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MisfitFlashMisfit, maker of the activity tracking devices Shine and Flash, has raised $40 million from China-based strategic investors ecommerce giant JD.com and smartphone maker Xiaomi. Other new investors in the round include GGV Capital, which led the round, and Shunwei. Misift’s existing investors Founders Fund, Khosla Ventures, Horizons Ventures, and Norwest Venture Partners also participated. The company has raised a total of $63.6 million to date.

Misfit co-founder and CEO Sonny Vu told MobiHealthNews in an interview that the company is at breakeven and still has its last $15 million round of funding in the bank. Xiaomi, the third largest smartphone maker in the world, and JD.com, which Vu compared to Amazon, will help Misfit better understand the Chinese market and help it to develop and launch products more quickly. Vu said that while Misfit’s activity trackers are probably in third place in the US behind Fitbit and Jawbone, in China it is the most popular of those major brands.

Misfit, which informally dropped the “Wearables” from its name since it began offering smart home products in addition to bodyworn ones, has always been more globally focused than other activity tracking companies, and it has always had close ties to Asia. Its Shine device first launched at Apple stores in Hong Kong and Japan. The vast majority of its workforce – 95 out of 135 – works in either Vietnam, Hong Kong, or Korea, Vu said.

Keep reading>>

Still facing FDA opposition in the US, 23andMe heads across the pond

By: Jonah Comstock | Dec 2, 2014        

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23andMeGoogle-backed 23andMe is finally relaunching its mail-order personal genome service — just not in the United States. Instead, the company is launching in England, which has a different regulatory framework than the United States.

“These products are considered to be in the lowest risk category and so there is no requirement for any premarket assessment,” a spokesperson for the Medications and Healthcare products Regulatory Agency (MHRA) told MobiHealthNews in an email. “23andMe have included warnings not to change drug therapy or take medically significant action without medical advice.”

With its $99 genome tests, 23andMe was one of the rising stars of digital health until about a year ago — when the FDA sent the company a sternly worded public letter, instructing them to shut down their personal genome service pending regulatory approval. The company complied, but continued to operate its ancestry-based business. Keep reading>>