12 trends for mobile health in 2012

By: Brian Dolan | Feb 14, 2012        

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Brian Dolan, Editor, MobiHealthNewsLast week MobiHealthNews hosted its first webinar of 2012. During my presentation I shared my 12 trends for 2012. Our co-presenter, Aaron Kaufman from Kony Healthcare Solutions also shared his take on the year ahead. Check out the complimentary, hour-long webinar on demand right here.

1.) The Adoption of Smartphones and Tablets. This is by far the most obvious trend because it has been so steady for the past few years. It is still an important one to consider. By the end of 2011, Nielsen expected half of the US population to own a smartphone. At the end of 2011 62 percent of 25 to 34 year olds had smartphones. About 53 percent of 35 to 44 year olds did. The fastest growing age group for smartphone adoption in the past year was the 55 to 64 year old age group. Adoption among this group went from 17 percent to 30 percent a year later. Similarly the iPad has had the fastest adoption rate of any consumer electronics device in history. We know that now more than 80 percent of physicians in the US have smartphones. Between 30 percent and 50 percent have tablets now depending on who you ask.

2.) Increased FDA Clarity. This was the big trend of 2011: The FDA proposed guidelines for how it translates existing medical device regulations into the world of apps, smartphones, and tablets. For the most part these guidelines were well-received, but a number of questions remained over where exactly the FDA would draw its lines. The mHealth Regulatory Coalition recently asked the FDA to re-publish an updated set of proposals that take into account changes it should make based on comments from the industry. While it is unclear whether the FDA will publish new guidelines for a new commenting period, it is expected that the FDA will publish either the final guidelines or a new draft set by year-end. While the regulatory discussion will continue to be an important one — there are still a number of loose ends including how the FDA views clinical decision support, for example — this won’t be the primary focus of mobile health discussions in 2012.

3.) Consumer Devices in the Healthcare Enterprise. This is the trend that is really at the heart of the mobile health IT discussion for healthcare providers. While a good number of healthcare facilities are deploying consumer devices like the Apple iPhone, iPad, or iPod touch, and in rarer cases Android devices, for the most part these devices are being brought into work by healthcare workers. BYOD is the name of the trend and its a big one for everyone working in all areas of IT today. The big issues stemming from this trend include security concerns, HIPAA compliance, and user experience. Security solutions and broader mobile device management solutions will find a lot of customers in healthcare this year. The other issue brought about by BYOD is accessing enterprise apps. As the Seattle Hospital’s iPad debacle last year showed, these devices aren’t enough — they require well-designed native apps to ensure that providers will use them for accessing EHRs and other HIS apps. I expect design and usability concerns vs. security concerns to be a huge headache for providers this year. Finally, these consumer devices provide access to distracting consumer apps. Healthcare providers are being distracted by these devices while on the job. While this might be controversial, I think this is a rather absurd concern. We trust them to do so much, we should trust them to know when not to be surfing Facebook. Keep reading>>


Bosch sues three competitors over Health Buddy patents

By: Neil Versel | Feb 14, 2012        

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Health Buddy now BoschRobert Bosch Healthcare Systems has sued three makers of remote home health monitoring technology, claiming that the competitors infringed on patents for Bosch’s Health Buddy system.

The telehealth business of German industrial conglomerate Robert Bosch GmbH filed three separate lawsuits last month in federal court in California against: mobile health monitoring technology vendor MedApps, of Scottsdale, Ariz.; Austin, Texas-based startup Waldo Networks; and telehealth vendor Express MD Solutions, Berkeley Heights, N.J. At press time, MobiHealthNews was awaiting copies of the lawsuits, but spokeswoman Cheryl Kilborn of Robert Bosch LLC, the U.S. affiliate of Robert Bosch GmbH and parent of Bosch Healthcare said the three cases relate to intellectual property.

“We feel it is important to demonstrate that IP is important, and not just to our company,” Kilborn told MobiHealthNews. “Bosch Healthcare Systems, like most high-tech companies, values its intellectual property as an essential asset of its business,” she added in an e-mailed statement.”Bosch is open to working with those companies that are interested in securing this technology through a licensing agreement, and we are in discussion with numerous companies in this regard.”

Bosch is seeking to have the court order the three defendants to stop marketing their products, plus unspecified punitive damages.

The three companies do, like Bosch, market products for home-based health monitoring. MedApps makes connectivity software and devices for home health, including the HealthPAL data-transmission unit. Express MD Solutions offers the Electronic House Call vitals monitor and various Web-based telehealth services. Keep reading>>

Study: Mobile phone-based heart failure monitoring convenient, easy to use

By: Brian Dolan | Feb 13, 2012        

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LifeWatch's CardGuard PMP4 Suite of Devices

LifeWatch's CardGuard PMP4 Suite of Devices

A recently published study in the Journal of Medical Internet Research found that mobile phone-based heart failure telemonitoring was an easy to use solution that offered immediate feedback to both patients and clinicians. The small study — just 22 heart failure patients used the mobile phone-based monitoring system for six months — required patients to take daily weight and blood pressure readings along with weekly single-lead ECGs and daily symptom questionnaires.

Five participating cardiologists also received alerts to their mobile phones.

Of the 22 participating patients, 17 did not have an implantable cardioverter-defibrillator (ICD) so they were provided with an ECG recorder and asked to take weekly recordings. Weight and blood pressure were recorded by a weight scale and blood pressure monitor developed by A&D Medical. ECG recordings were taken by SelfCheck ECG PMP4, developed by LifeWatch’s CardGuard. These were automatically sent wirelessly via Bluetooth to a BlackBerry Pearl 8130 smartphone developed by Research in Motion. The data was then sent to a software application on the BlackBerry device where it was displayed and stored before being transmitted to a data repository accessed by the hospital.

The patients found the mobile phone-based telemonitoring system to be easy to use, even very elderly patients — one was 88 years old — as well as those with no prior mobile phone experience were able to successfully use the telemonitoring system, according to the researchers. The researchers noted that some patients took about a week to get comfortable using the system and many patients had family members who helped them when necessary.

Did the fact that it was mobile make a difference? The researchers noted that patients said the portability of the mobile phone-based telemonitoring system was useful, because it could be taken on vacation. Also, researchers noted that the website for the study “was seldom used by patients” and that only 13 patients ever logged onto the website.

The clinicians also liked the portability of the mobile phone-based telemonitoring system, because they could monitor their patients from anywhere: “One of the cardiologists’ main concerns was the potential lack of time to respond to alerts, due to their busy schedules, if the telemonitoring system was permanently integrated into the clinic. They suggested a nurse practitioner manage the alerts, instead of a cardiologist,” the researchers noted.

Check out the full report over at JMIR here.

AT&T helps developers connect apps to health systems

By: Brian Dolan | Feb 13, 2012        

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To date, WellDoc's DiabetesManager is one of the few mobile health apps to have gone through an RCT.

In the fall of 2010, AT&T announced a partnership with WellDoc to bring the mobile health startup’s DiabetesManager app and service offering to its enterprise customers. Ever since then the mobile operator has been searching for other “best of breed” vendors to help bring to market. During that “exhaustive search” AT&T realized that both its customers and the developers it had met with were in need of access to better tools to improve mobile health applications, Eleanor Chye, Executive Director, Mobility Healthcare and Pharma, Mobility Product Management, for AT&T Business Solutions told MobiHealthNews in a recent interview.

Most apps are disconnected from healthcare systems. Most apps aren’t able to share data with hospital information systems. Most apps don’t even talk with each other.

That’s why this week AT&T launched a beta version of its AT&T Developer Center ForHealth, which aims to help mobile health app developers to build apps that are connected to the healthcare system and that make use of publicly available data sets. AT&T expects the developer platform to “streamline, accelerate and lower costs in the development, deployment and management of enterprise-grade mHealth applications,” according to its press release.

There is a real need from both sides — mHealth developers and our customers want to unleash the siloes in which data resides in,” Chye said. “This will enable developers to create mashup applications and umbrella applications. Up until now, each time an app developer or someone with a device peripheral wants to upload or connect that data to a legacy health IT system — whether it’s a health insurer or hospital — that is extremely expensive. There are huge barriers to that. So, [at AT&T] we said why don’t we create that connection and bring to bare our knowledge on how to create that infrastructure.”

The beta version of the the new developer platform includes cloud-based developer tools, an ability to aggregate clinical and wellness data from apps and devices, HIPAA-compliant data storage, and an API gateway and mobile client that can be embedded into any third party app to enable apps to link together. AT&T is funding five health startups to go through StartUp Health’s academy, Chye said. AT&T is also working with Health 2.0 on its developer challenges to make AT&T’s developer platform the “platform of choice” for developers participating in the challenges, she said.

AT&T said a number of additional features are in the works, including a data integration engine that will link apps to enterprise data systems in hospitals, practices, health insurers and other healthcare institutions; an API gateway that enables developers to leverage AT&T services and other third party services like texting or location-based services on a pay per use basis; and, finally, enterprise billing and customer care tools.

Cloud based services. Innovations in database management. Innovations in API gateways. Identity management. Application to application sharing of data. We built all that with healthcare in mind. That’s the genesis of this open developer suite of tools with common infrastructure to bring these faster and cheaper while linked. Now end customers can get access to all of these applications. Can get applications that are linked together and to their backend systems.

Chye told MobiHealthNews that the platform will be free to use for developers. AT&T is “not going to touch” developers’ intellectual property. The operator plans to generate some revenues from the platform for its paid services, including the HIPAA-complient storage service, texting services, location-based services, and for providing the secure connections to healthcare institutions’ systems.

“That’s going to be a much lower cost to go through us then have the developer pay to [connect to each healthcare system] one-by-one,” Chye said.

AT&T is already working with a number of groups who put on healthcare hackathons and developer challenges, including Health 2.0, StartUp Health, HIMSS, and Rock Health, to seed the platform with developers. Chye says more than 100 developers have already signed on to — in the very least — “take a look under the covers.” The platform will have connections to some of the device makers and app developers who already make APIs available, including Withings, Fitbit and others. It will also launch with connectivity to some of  the applications AT&T has built itself.

“That includes an app AT&T built called MyHealthFamily,” Chye said. “With it, a parent can look at the healthcare across their entire family. We have built the integrator on the database so it can connect [to healthcare IT systems] using the HL7 protocol. We could go through a hospital and connect through HL7. We can also connect through [continuing care document] data. We are building over time our repertoire of connectivity points.”

AT&T, however, hasn’t yet begun discussions with healthcare providers and HIS vendors. Chye expects to begin those discussions next week at HIMSS. “It’s really early days,” she said.

For more on the new AT&T developer platform, read the press release below: Keep reading>>

CardioNet buys cardiac monitoring provider for $5.8 million

By: Brian Dolan | Feb 13, 2012        

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CardioNet patient monitorMobile cardiac outpatient telemetry services provider CardioNet announced last week the acquisition of ECG Scanning & Medical Services, a cardiac monitoring provider, for $5.8 million in cash. The deal price could include an additional $600,000 cash earn out if certain performance milestones are met.

“We are excited to join forces with ECG Scanning. ECG Scanning is a respected cardiac monitoring provider that affords CardioNet access to established relationships with healthcare providers and payors in the mid-west,” stated Joseph Capper, President and Chief Executive Officer of CardioNet. “This acquisition demonstrates our commitment to augment the growth of our core business through strategic transactions. The combined strength of the two companies further cements CardioNet’s position as the leading provider of wireless cardiac monitoring services.”

The company’s last acquisition was announced in November 2010: At that time CardioNet announced plans to acquire Biotel in a definitive merger agreement for $11 million in cash. That deal was a long time coming: CardioNet had previously announced plans to acquire Biotel but cancelled the plans three days after the CMS contractor that reimbursed for CardioNet’s services cut the reimbursement rate by almost one third. The Biotel acquisition brought its Braemar subsidiary’s wireless event monitor under the CardioNet umbrella and also set CardioNet up to enter the clinical services market through Biotel’s Agility Centralized Research Services. Those include event, Holter and twelve-lead ECG monitoring services for medical device, pharmaceutical, contract research, and academic research organizations.

When it announced its Biotel acquisition, CardioNet also disclosed plans to partner with another wireless-enabled health company, MedApps, to form a “strategic alliance” to “deploy new and innovative wireless monitoring solutions that benefit patients in a cost-effective, meaningful manner.” In 2009 CardioNet pointed to chronic condition management as a potential market opportunity, but beyond the planned MedApps partnership has not moved into the space.

Press release announcing the ECG Scanning & Medical Services acquisition below: Keep reading>>

Cellnovo launches cellular-enabled insulin pump, usability trial

By: Brian Dolan | Feb 10, 2012        

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CellnovoLondon-based Cellnovo commercially launched its cellular-enabled diabetes management system and insulin pump this week in the UK. The company also launched a usability trial of its offering with 100 patients who have type 1 diabetes. The study will take place at “ten of the leading diabetes centers across the UK” according to the company and it and will include patients who are both adults and children. The device already has a CE Mark but has not yet secured FDA 510(k) clearance.

Cellnovo’s diabetes management system, also called Cellnovo, includes an insulin pump that wirelessly connects to a touchscreen, cellular-enabled handheld glucose monitoring device. Last April DiabetesMine reported that “Cellnovo has actually been prepping and manufacturing for a couple years now, so they are ready to meet the demand” now that they have launched.

“The Cellnovo system provides us immediate access to the clinical status of all our patients on a single screen,” stated Professor Stephen Greene of the University of Dundee, who is one of the people running the trial. “With accurate and current information we can identify and address problems immediately that, otherwise, might go unnoticed for months, contributing to excess cost and potentially tragic patient complications. In this clinical trial we will be the first to explore these new opportunities in diabetes patient management and hope to uncover new ways to improve and extend care, optimise workflow and drive cost efficiencies.”

About a year ago Cellnovo announced a whopping $48 million second round of funding from Edmond de Rothschild Investment Partners (EdRIP), Forbion Capital Partners; Auriga Partners, NBGI Ventures, and Credit Agricole Private Equity. Return backers from the company’s first round of funding included Advent Venture Partners, HealthCare Ventures, and NESTA. Last September Cellnovo inked a deal with Johnson & Johnson company LifeScan that sees the startup embedding LifeScan glucometer technology into its mobile health offering. LifeScan made headlines in early 2009 when it appeared on-stage at the Apple Word Wide Developers Conference and showed off a prototype for a blood glucose meter that synched up to the then new iPhone 3G.

In a 2010 interview with the publication Invivo, Cellnovo’s CEO Bill Mckeon explained that: “If people understand Cellnovo as a device that sends data to a website, they are missing the point. If you had asked Steve Jobs at Apple about his new MP3 player called the iPod, and how it compares to other MP3 players, he might have said, ‘I am not making an MP3 player. I’m bringing entertainment into your life in a number of ways.’”

Here’s how Cellnovo describes its opportunity: “Type 1 diabetes is routinely managed with pump technology throughout much of Europe and North America where 20-25 percent of patients gain benefit from therapy that mimics the body’s normal production of insulin. Yet the UK lags behind, with 96 percent of patients having to rely on multiple daily injections. By introducing a unique system that uses cellular data and touch screen technology, Cellnovo aims to eliminate the barriers to adoption of insulin pump therapy; simplifying and reducing the workload for doctors and nurses, while also improving the quality of insight and diabetes management achieved by patients.”

Some great details about the system in this DiabetesMine article from last April.
More about the commercial launch and planned trial in the press release below: Keep reading>>