Unbelievable new products from RunKeeper, Epic, Google

By: Neil Versel | Apr 1, 2013        

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RunKeeper for iPadEarly Monday morning, RunKeeper, maker of the popular fitness tracker app of the same name, tweeted, “We’re revealing a real treat today: RunKeeper for iPad! Check it out!” and included links to both a blog post and a dedicated page on the company website.

“We’re always trying to do more to make running and getting in shape easier and more intuitive,” the post says. “In the process, we’ve discovered that for many of our users, the phone screen is just too small to get all that important real-time fitness information into one convenient place.”

The landing page is more direct. “RunKeeper for iPad: BIGGER is better,” reads the message there, which is accompanied by a video of a runner sporting an iPad strapped to his chest. The iPad screen even converts to a “digital running bib” with race numbers, a weight scale when stood on and a calorie-counting food tray for “building a perfectly nutritious meal on the go.”

Viewers can click on “get the app” to see a special message from RunKeeper: they have been had. It’s April Fool’s Day.

RunKeeper was not the only company having a little fun with digital health and health IT on this first day of April.

Epic Systems, the EHR vendor which never issues press releases, won’t negotiate on price and even decides which healthcare providers are worthy of being its customers, does loosen up at least once a year, changing its home page each April 1.

This year, Epic pokes fun at all of its perceived inflexibility, including the fact that the Verona, Wis.-based company wants to sell end-to-end systems across entire enterprises, not break up its technology into pieces and interface with core technology from other vendors. “Long Rumored Epic Kool-Aid Recipe Finally Released; Closely-guarded recipe the subject of ONC inquiry,” reads the lead headline.

“Now that the Epic Kool-Aid recipe is public, other healthcare software vendors report that they’re working on their own variations of the drink, predicting that their flavors will be ‘tastier, lower in calories, and more interoperable,'” the story says. “Epic is not releasing its ‘secret sauce’ recipe, since it is mostly just mushroom soup.”

Later, Epic takes a dig at national health IT coordinator Dr. Farzad Mostashari’s wardrobe with a story headlined, “MU3 requires Eligible Providers to wear bowties.” (For the record, Farzad’s Bowtie has had its own Twitter account since February.) Keep reading>>

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Survey: Employee wellness still seems ripe for digital health

By: Brian Dolan | Apr 1, 2013        

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iHealth Blood PressureA recent survey of almost 800 large and mid-size employers in the US, representing more than 7 million employees, found that a majority offer incentives to employees for agreeing to take health risk questionnaires (HRQ), biometrics screenings, or similar health-related programs. The survey, conducted by global HR firm Aon Hewitt, found that 83 percent of employers offer such incentives.

Within that group, 79 percent incentivize employees via rewards, while just 5 percent use negative consequences to encourage participation. About 16 percent use both. The survey found that 64 percent use monetary incentives between $50 and $500, and about 18 percent offer incentives of more than $500.

A different study, conducted by Aon Hewitt survey conducted and the National Business Group on Health and The Futures Company, found that of those workers who participated in a HRQ and received some kind of suggested next step for leading a healthier life about 86 percent took some kind of action. About 65 percent said it led to at least one lifestyle improvement.

About half of the employers who offer incentives said they led to improved health behaviors, increased employee engagement, and better employee morale.

Aon Hewitt noted that linking incentives to results and actions instead of just rewarding employees for participating in a wellness program is a new trend. That trend plays well with the rise of quantified self devices and apps that make it easier to track progress.

For the group of employers that offer incentives, 56 percent require employees to actively participate in health programs, comply with medications or participate in activities like health coaching. About 24 percent of employers who offer incentives encourage employees to get their BMI, blood pressure, blood sugar, or cholesterol into acceptable ranges. A majority of employers plan to go down that road in the next two to three years. About 22 percent of employers said they are interested in leveraging games to improve their existing programs.

While a number of health startups are targeting employers with platforms that aim to encourage healthier behaviors among employees — typically by leveraging competitions and games — over the years at least one investor has discouraged health startups from focusing on employers.

“Many startup founders still believe that large corporations can be a great customer or channel for health and wellness products. The idea is that this will help keep employees healthy and reduce absenteeism and insurance premiums. Well, I still haven’t heard which specific organization at IBM, United Airlines, or P&G has budget to buy this stuff and I find it hard to believe the ROI will be quantifiable.” Skip Fleshman, a Managing Partner at Asset Management Ventures, wrote about a year ago. “If you want to build a real company, then solve a real medical problem and start, from day one, with a plan that works alongside the payers, providers, and physicians.”

California offers health plan ratings iPhone app

By: Jonah Comstock | Apr 1, 2013        

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California OPA appThe state of California’s Office of the Patient Advocate (OPA) released its 2013 quality report cards for health plans. This time, though, they released the information via a newly redesigned website and, for the first time, as an app for iPhone and iPad.

The report cards allow patients to compare 10 Health Maintenance Organizations (HMOs), six Preferred Provider Organizations (PPOs), and 209 medical groups on overall quality of care, and also on quality of care for 40 different specific conditions. OPA director Amy Krause told California Healthline that California is the first state to release a health plan report card in app form.

The app, which is free in the AppStore, allows users to view all the ratings of a single plan, or view how all the plans rate on a particular condition, such as asthma, heart disease, or diabetes. They can also see how other patients rate plans on non-care quality metrics like doctor communication, ease of setting up appointments, and customer service. In addition, the app provides contact information for health plans and general information for patients like how to make the most of a doctor visit.

The ratings come from data collected by the California Department of Insurance. Quality of care ratings are based on de-identified data from a random sample of patients using the health plan, drawn directly from the organization’s records. Patient experience ratings are based on surveys conducted annually by the Department of Insurance, which reaches out to a sample of health plan members by phone or mail. A third metric tracks the ratio of health plan enrollees to customer complaints.

DrChrono adds Mayo Clinic content to iPad EHR for patient education

By: Brian Dolan | Mar 28, 2013        

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DrChrono Mayo ClinicY-Combinator incubated company DrChrono, the EHR company currently focused exclusively on iPad- and iPhone-toting providers, has added digitized patient education content in an exclusive licensing deal with the Mayo Clinic to help its DrChrono customers fulfill the patient education component of meaningful use.

DrChrono CEO and Co-Founder Michael Nusimow told MobiHealthNews during a recent interview that the content from Mayo Clinic will be presented to patients as they sign in via iPads in their physicians’ waiting rooms. While the deal brings more than 2,600 pieces of content and more than 300 educational videos from the Mayo Clinic to DrChrono’s platform, physicians will be able to curate that content and tailor it to each patient. The EHR vendor can also automatically include different types of content based on what’s in that particular patient’s medical record.

Nusimow also sees opportunities to let physicians know when patients view certain videos, which can help trigger conversations in the exam room about the content the patient just viewed or read.

The Mayo Clinic content is also going to be made available to patients through DrChrono’s patient facing portal, iPhone app, iPad app, and Android app, so that patients can access that content any time the choose. Nusimow sees future opportunities to help physicians better understand which content their patients are viewing through the apps and portal between visits, too.

“I’m pleased that Mayo Clinic’s patient education materials, which are normally only available to Mayo patients, now will be available via the internet to all patients in the United States,” Dr. Steven A. Smith, medical director for Patient Education at Mayo Clinic’s Rochester, Minnesota campus, said in a statement. “Doctors distributing these educational documents and videos to their patients can be confident they contain content that will assist them in their delivery of clinical care.”

Nusimow told MobiHealthNews that by including content from a trusted healthcare provider like the Mayo Clinic, DrChrono’s provider customers probably don’t have to take the time to review patient education materials for accuracy. Nusimow says that some EHR vendors that offer patient education materials scrape it from the web, which can make for content of “varying quality”, he said.

DrChrono currently serves small practices and ambulatory healthcare practices — everything from single doctor practices up to 70 physicians in the practice, Nusimow said. The company currently has about 40,000 providers using its EHR.

DrChrono has also been progressive on the patient generated data front. It was one of the first EHR companies to integrate data from consumer health devices offered by iHealth.

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Medical society endorsement of apps can’t be a good idea

By: Neil Versel | Mar 28, 2013        

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Neil_Versel_LargeIn the run-up to and in the wake of last week’s congressional hearings on potential Food and Drug Adminstration regulation of mobile health and medical apps, we have heard numerous alternatives to the existing FDA regulatory framework proposed.

Congress should give the Office of the National Coordinator for Health Information Technology (ONC) the power to regulate not only apps, but also electronic health records, some have suggested. Others would like to see self-policing by the private sector, akin to the initial role of the Certification Commission for Healthcare Information Technology (CCHIT), which started as the EHR vendors’ answer to the prospect of regulation. Happtique may seem to be heading down this path, but CEO Benjamin Chodor shot that notion down during the hearings.

A third approach might be along the lines of what CCHIT has become today, a participant in a privately run but federally monitored certification program to test products against government standards.

And then there is the interesting idea proffered by Dr. Thomas Santo on the popular KevinMD blog last week: Get physician organizations involved.

“If you visit the websites of some of the major medical organizations in the country, the American Medical Association, the American College of Physicians, the American Academy of Pediatrics, among many others, not one of them has a link to ‘endorsed apps,’ ‘mobile health’ or any other reference to digital health tools,” Santo wrote. I don’t know who the “many others” are, so I can’t check this claim, but the point is taken.

“Without providing some guidance as to what works and doesn’t work, physicians miss the opportunity to maximize the benefits of this technology in terms of quality of care, access to care and cost, those things that occupy much of the discussion on health care today,” Santo continues.

This I know to be true. Without professional guidance, health and medical apps risk falling into the “for amusement purposes only” category, and if physicians aren’t willing to help their patients understand how certain apps fit into the overall picture of health, then we are just building another silo in an oversiloed industry. It is good for patients to be engaged, but professionals still have to help consumers interpret the information digital tools produce or uncover.

“One hurdle to capitalizing on this new wave of patient engagement is the fact that the market is full of products that are unlikely to produce any long-term health benefits, with more beneficial, substantive tools interspersed in between,” Santo adds. This is also true.

The Federal Trade Commission has forced at least two acne-related apps of dubious benefit off the market. Threat of legal action over a copyright issue caused another app developer to pull a mobile psychiatric reference guide. Again, though, these appear to be isolated incidents, a combination of a federal agency acting once and the owner of intellectual property engaging in some self-policing.

I like the idea of professional organizations reviewing apps for accuracy and medical usefulness, but I shudder when I think about medical societies “endorsing” products. As I read Santo’s commentary, the first thing that came to mind was the endorsement the AMA effectively gave Sunbeam products in 1997 when the two entities inked a marketing deal.

After a public backlash against the AMA’s credibility, the medical society terminated the agreement, and ended up paying Sunbeam $9.9 million to settle a lawsuit. Fallout from that incident later led the AMA’s chief executive to sue the organization.

Ever since then, the AMA has been rightfully wary of lending its seal of approval to commercial products that were not its own. I hardly think the organization – or any other medical society – would be eager to endorse mobile apps.