Mayo Clinic to study efficacy of Sessions’ inactivity program

By: Brian Dolan | Jun 13, 2013        

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sessionsFor the past few years San Francisco-based Sessions has been developing a direct-to-consumer, mobile-enabled program for inactivity and nutrition. Sessions, which was a member of digital health accelerator Rock Health’s second class in 2012, is currently enrolling about 80 people on a rolling basis for a randomized control trial of its coaching program at the Mayo Clinic. Sessions first did an internal pilot at Mayo last year, which apparently went well enough to lead to the RCT opportunity.

“We started Sessions because we wanted to develop these prescriptions for lifestyle diseases,” Sessions CEO Nick Crocker told MobiHealthNews in a recent interview. “We are also trying to deliver these programs with a level of confidence and proven efficacy that doctors will be comfortable with. So, while we are a consumer company, we are trying to validate the approach we are taking through our partnership with Mayo.”

Crocker says one of the the key challenges for companies like Sessions is whenever they talk to a provider or payer the first question they’re asked is: “Does this stuff work?” Crocker says the team is confident in their engagement levels since those are easy enough to track, but he also believes proving efficacy in an RCT that tracks (hopefully) positive changes in biometrics over a period of time will show that the program is not just sticky but that it also gets results.

Sessions offers a 16-week program for $79 a month that includes a real life coach who works with you to make a plan to get moving either by going to the gym, walking more, playing sports — whatever you and the coach can come up with that seems to be the most likely way to get you moving. The coach helps Sessions users to choose achievable goals and sends reminders and encouragement along the way through various channels, including phone calls, text messages, or emails.

“We are are going to track the biometric impact of our program over 12 weeks, six months, and 12 months,” Crocker said. The RCT will track biometrics like A1C, blood pressure, and quality of life — among others. Since the trial is just beginning the team can’t disclose too many of the details in case it might bias results.

“Lifestyle is the chronic disease epidemic of our time, we need solutions to address that,” Crocker said. “You see a lot of pharmaceutical products for these issues, but I think that will become the exception to the rule. Whether it is one, five, or ten years from now, doctors will start prescribing these programs to patients looking for a solution for weight management or inactivity,” he said. “No doctor is writing prescriptions for this kind of program tomorrow, but in the next one or two years I think they will. The programs that they will prescribe are the ones that have proven efficacy.”

Crocker notes that most of the direct to consumer digital health discussion has focused on wearable devices as of late, but those companies are mostly just solving issues surrounding the acquisition or capture of data.

“I think the next phase for people to ask ‘what is the most effective way to interpret and use this data?'” Crocker said. “It’s going to start to get really interesting when these tools will augment the next phase of the cycle, which I think is going to be all about effective interventions.”


Harvard Pilgrim: Voice calls weren’t enough for diabetes management, now trying texts, too

By: Jonah Comstock | Jun 13, 2013        

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Care4LifeHarvard Pilgrim is not new to using digital health technology to improve patient care and wellness at home — the health insurance company worked with health engagement platform Eliza back in 2006 and with smart pillbox maker MedMinder in 2009, before signing its recent deal with Voxiva’s Care4Life. But Harvard Pilgrim is careful about the partnerships they engage in, making sure they’re both accessible to their target population, and create independently proven improvements in outcomes.

Lydia Bernstein, the director of clinical programs at Harvard Pilgrim, said that the traditional ways of reaching out to patients aren’t cutting it anymore, and digital channels are just now getting to the right level of reliability.

“It’s a different world right now,” she told MobiHealthNews. “Largely, the medium we have been using has been mail. We did some interactive voice recognition technology [with Eliza], and that worked fairly well, but I think that more and more people are texting. It’s easy, it’s with them all the time. I think we looked at this several years ago and we kind of postponed it because people still didn’t have the unlimited texting and we were concerned about having to promote something where people might have to pay. But most people do have unlimited texting now as part of their services. I think this is another way to reach out to our members. Not the only way, but another way.”

Bernstein said the system cut ties with Eliza, with whom they had worked on both diabetes management and colorectal screenings outreach, when their research arm, the Department of Population Medicine, determined that they weren’t really getting value out of phone calls. (Eliza has only recently added mobile outreach to their offerings.)

“We found that it wasn’t any more effective than what we were currently doing in terms of outreach,” she said. “Once they reached the people, they were very satisfied, but it’s difficult to catch people at home and we don’t have cell phone numbers for most people, so we wound up leaving messages. That’s why we’re looking at more of the mobile technology.”

Bernstein is excited about Voxiva’s Care4Life. In fact, for some time Harvard Pilgrim has been recommending Voxiva’s Text4baby service to its pregnant patients. But, she said, it’s still important to subject the program to scrutiny.

“This is our first real use of texting that we’re sending to a targeted population,” she said. “So we are having discussions now with Voxiva about evaluating the program, in terms of member satisfaction with the program, engagement with texting, and then also how to better get members engaged in their own healthcare. Those are the sorts of things we’re looking at and trying to measure, so we’ve had some initial conversations with Voxiva about that and folks from our research arm. … [Voxiva] has done some focus groups which they’re going to send us. They’ve also looked at the data of people currently enrolled, and they’ve seen some improvement in [A1C] and medication adherence, but those are all self-reported.”

Like many health plans, Harvard Pilgrim is looking for low-cost, effective programs to improve wellness and self-care among members. Partially, this has to do with the changing payment models in healthcare.

“We have a number of different types of contracting mechanisms now,” said Harvard Pilgrim spokesperson Mary Wallan. “We have quality grants that are given to help [providers] get ready for what’s coming and we actually do have some bundled payment models and some shared savings models and an ACO. So yes, we’re working with many of our providers on that basis and Harvard Pilgrim is very much embracing the new world and trying to provide better value for our patients while keeping the quality and helping the nation as a whole reduce our cost of healthcare.”

Bernstein thinks that Care4Life has potential to engage more people with diabetes because the user has so much control over how much they want to engage with the platform: They can just sign up for generic tips and reminders, or they can use a web portal to set up tracking or targeted reminders via text messaging.

If Care4Life goes well, Harvard Pilgrim intends to introduce some additional Voxiva programs for wellness and smoking cessation. In addition, the payor is a few months away from announcing a deal with an undisclosed “wellness vendor.” All in all, Bernstein sees the provider’s role as curating all the mobile health apps out there that could help their members.

“I think the difficulty is really weeding through all of the different apps and making sure we’re promoting or telling our members about reputable apps,” she said. “We’re learning that we’re not going to build anything, but we have to figure out what the best way is to identify those that would be valuable to our members in terms of managing their own health and wellness.”

GE Healthcare to spend $2B on common software platform for its products

By: Jonah Comstock | Jun 13, 2013        

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GE HealthcareGE Healthcare has announced it will invest $2 billion in software over the next five years. Working with the GE Software Center of Excellence in San Ramon, California, the GE subsidiary will use the funds to improve its hospital operations management software and reducing waste and inefficiency in the hospital software status quo.

GE Healthcare Software Chief Technology Officer Evren Eryurek stated in comments posted on GE’s website that GE Healthcare is developing a single common software platform that will span all GE Healthcare products and services (which include software for medical imaging, IT services, patient monitoring, diagnosis, and biopharmaceutical manufacturing).

“Often, our healthcare customers are faced with disparate IT platforms, with a variety of servers and databases. In addition, their clinicians many times deal with broken workflows for healthcare data analysis, lack of interoperability between healthcare IT systems, and a less-than-desirable user experience as they work tirelessly to deliver care,” Eryurek stated. “Investments GE Healthcare is making will address those challenges and enable our customers to improve their operations, asset management, and workflow effectiveness as well as to deliver consistent care especially to large patient populations.”

Eryurek said healthcare inefficiency has a global cost of $731 billion per year, and just a 1 percent improvement in efficiency could lead to savings of $63 billion over 15 years.

GE Healthcare outlined several ways its new investment would help address inefficiencies in healthcare. Better software could speed up scheduling and data entry. Clinical decision support software could improve outcomes as well as save doctors time. Software can reduce costs by analyzing workflows and identifying areas where providers could get more out of staff utilization, payment cycles, or reimbursement rates. Finally, by promoting care coordination and collaboration, software could keep multiple care givers from having to do the same work.

Eryurek also stressed two big ideas that GE Healthcare will be focused on: the “industrial internet” and big data.

“The industrial internet represents an open, global ecosystem of highly intelligent machines that connect, communicate and cooperate with each other and people, leading to breakthrough levels of efficiency and productivity,” he said. “Just like the internet transformed communication years ago, the industrial internet is turning the lines of communication between the caregiver and the patient from a winding dirt road into an express highway.”

Big data refers to smartly using the massive amount of health data that’s produced and stored by GE Healthcare’s software, something that should be easier to do on a common platform.

“Think about all the X-rays, CT scans, MRIs and lab reports done every day, think about digital pathology and images of those samples, and now think about even genomics data that is becoming more mainstream for predictive analysis,” Eryurek said. “The insights that are yet to be unlocked within this data hold the answers to many unknowns that medicine has been dealing with for decades.”

Shareable Ink hires ex-Allscripts exec as CEO; founder Hau moves to CTO

By: Neil Versel | Jun 12, 2013        

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A digital pen from Anoto.

Serial entrepreneur and longtime mobile health developer Stephen Hau is stepping aside as CEO of his current venture, Shareable Ink, as the Nashville, Tennessee-based provider of digital pen-based healthcare data capture has brought in a veteran health IT executive to run the company.

Laurie McGraw, most recently chief client officer at EHR vendor Allscripts Healthcare Solutions, took over as CEO of Shareable Ink last week to help the 4-year-old vendor move into a growth phase. Hau will shift to chief technology officer, heading up product development and platform strategy.

The news comes on the heels of privately held Shareable Ink closing late last month on a $3 million round of equity funding, led by previous investor Lemhi Ventures. “Right now, the company has some really strong momentum,” says McGraw, who tells MobiHealthNews that she will not substantially alter Shareable Ink’s strategy.

Shareable Ink uses digital pens from Anoto to capture handwriting on laser-printed, plain-paper forms, then sends data over a Bluetooth connection to a smartphone or PC, which links to a Shareable Ink cloud server. Within seconds, the server converts the handwriting to computable text for export into EHRs and practice management systems.

The software also is capable of capturing and converting handwriting from iPads or scanned documents. Shareable Ink earned certification for Meaningful Use as a module able to meet 11 of the ambulatory EHR standards in Stage 1. “It’s a platform to make workflows actionable and efficient,” McGraw says.

Today, Shareable Ink reports that 85 clients are live on its system, automating patient encounters in specialties not always amenable to keyboard-based EHRs, particularly anesthesia and emergency medicine. “That’s strong for a company in early stage,” according to McGraw, who says she was drawn to Shareable Ink by Hau’s “brilliance.”

McGraw, who is based in Boulder, Colorado, but will spend much of her time on the road, worked for EHR pioneer IDX Systems — later bought by GE Healthcare — in the 1990s. She moved to Allscripts in 2000 when that company bought point-of-care software vendor ChannelHealth from IDX.

At the time, Allscripts had $30 million in annual revenues. When McGraw left the Chicago-based company during a management purge last December, Allscripts was a $1.5 billion company.

ChannelHealth was an early player in mobile health, allowing physicians to dictate notes, enter orders and capture charges on personal digital assistants. Similarly, Hau founded mobile health company PatientKeeper in the 1990s.

McGraw says she was aware of Hau’s reputation, although the two had never met before they started talking about Shareable Ink.

“As I got to know him, I got really excited about the company,” she says.

Melon: A wearable to track concentration, maybe sleep

By: Brian Dolan | Jun 12, 2013        

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MelonLast June an LA-based startup called Axio finished building prototypes of an EEG headband with built-in audio neurofeedback, Bluetooth connectivity, an analytic engine and companion smartphone app that aimed to help people find ways to better concentrate.

“We want to revolutionize how people interact with their brains,” Axio co-founder Arye Barnehama told MobiHealthNews in an email at the time.

The startup planned to launch a Kickstarter in mid-June 2012 as a way to crowdfund is first run on its wearable headband. At the time, Kickstarter was very picky about working with companies that had any kind of medical, health, or fitness-related angle, and Axio’s campaign didn’t come to be.

That is, of course, until a few weeks ago, when Arye and the team at Axio changed their name to Melon and launched on Kickstarter. In the intervening year Kickstarter must have loosened up its rules in the face of overwhelming success from other wearable devices launching on competitor site Indiegogo — like the Misfit Shine last year, and more recently, the Scanadu Scout.

The Melon campaign achieved its $100,000 goal within 60 hours and has since surpassed $268,000. As of Wednesday morning, it has one day left in its crowdfunding campaign.

Barnehama says at launch Melon will be a fairly open-ended “cognitive enhancement” platform. Users will put on the Melon headband and start a session of monitoring focus levels for a given activity. Once the device is on, the aim is to add tags into the app’s analytics engine about what activity you are doing and how you are feeling: “math homework, coffee shop, sad,” for example. During the session the Melon app tracks your focus level based on an analysis of your EEG and asks you do to quick things to see if they might help you maintain more consistent focus — like taking a quick walk or a five minute break. The device can then measure if that tip was effective for that particular user and become more personalized in its suggestions as time goes on.

Perhaps most exciting about the Melon launch is its willingness to work with developers from the get go. The Kickstarter campaign shows people using Melon for all kinds of activities and Barnehama noted the important of concentration in everything from studying to painting and sports to meditation. He believes there will be strong interest from the developer community to create apps for specific use cases.

“Sleep is one example,” he said. “Sleep is often measured using EEG and other companies have tried that — like Zeo which was not able to continue — so sleep is an area that developers are really excited to work on using the Melon platform.”

Barnehama says Melon is designed to be comfortable and “you definitely can sleep with it on”, but admits that sleep is “such a difficult thing to integrate a device into” and that might be why the company itself isn’t pursuing it. Still, the void left by Zeo’s departure could certainly drum up a good amount of interest as Barnehama noted.

“We wanted to build something broad and not go too specific in the beginning because this is such new technology,” he said. “We want to let the platform get more specific over time. Melon can help people that need a little bit of understanding around how to focus and how to understand their everyday life a little bit better using data about themselves.”

“There are many ways it could go later.”

Basis goes Android-first for delayed app launch

By: Jonah Comstock | Jun 11, 2013        

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Basis Band syncingBasis Science, makers of the Basis Band, finally launched their first mobile app, and, notably, it’s an Android app. The app currently works on five phones, all from Samsung, but the company promises more to come.

The $199 Basis Band launched last November with Bluetooth connectivity built into all devices, but no mobile app at all. That was something of a surprising move for an activity tracker, but the device had already been in development for nearly two years. Basis’ Healthy Habits behavior change software platform has hitherto been available only as a web portal. The company announced the Android app at CES in January, slating it for the first quarter of 2013.

On their blog, the company offered a rationale for the delay. “For those who are curious about why we’re slightly delayed: Our engineers wanted to ensure that Bluetooth syncing worked well across all our supported handsets,” the company writes. “Since connectivity varies by handset and manufacturer, it took us a little bit more time to ensure that this top-requested feature worked great.”

There hasn’t been much of a consensus lately on whether it’s more important to build for Android or Apple in the activity tracking space. Misfit Wearables recently killed plans to include an Android app at launch for its Shine device, following in the footsteps of Nike, which briefly avowed that it would never develop an Android app before reportedly backing away from that assertion. Meanwhile, both Fitbit and Jawbone have launched Android apps recently to join the iPhone apps they released at launch. However, for Basis to start with Android, a platform generally considered harder and more time-consuming to develop for, especially when Bluetooth is involved, is unprecedented for such a high profile Quantified Self company.

Basis’ support of five Android devices trumps Fitbit — which supported two when it launched its Android app and now supports four — but falls to Jawbone, which announced support for 12 devices in February and now supports 14. Basis-wearing Apple fans won’t have to wait too long, though: The company says its iPhone app is in internal testing and should be out soon.

Basis’ Android app just brings the core functionality of Basis’ Healthy Habits platform mobile, but mobility does enhance the platform in several ways. The app will run in the background of the phone and sync wirelessly and automatically with the user’s Basis Band. Users can check their progress on goals throughout the day and receive notifications from the app when they meet a goal, or reminders when they’re not working hard enough toward one. This feeds very naturally into the idea of Healthy Habits.

“We call it ‘habits’ very intentionally,” Basis CEO Jef Holove said in a recent interview with MobiHealthNews. “It’s meant to reflect that these are small routines, very acheivable routines that you can build in, really specific concrete things that you can do in your life, even a busy life like we all lead, and make it habitual. And I think that’s what leads to the behavior change, which drives long-lasting improvement.”

When Basis raised $11.5 million in March in a round led by the Mayfield Fund, Holove said in a statement that the money would be used to scale and meet demand for the product. Holove recently told MobiHealthNews that Basis has finally caught up to all the initial orders for the device and is now “inviting people on the waitlist on a first-come, first-serve basis.”