Text4Baby to expand. But does it work?

By: Brian Dolan | Apr 7, 2011        

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Brian Dolan, Editor, MobiHealthNewsText4Baby, the high profile free SMS-based service for new and expectant mothers, is heading to Russia this fall. Voxiva and Johnson & Johnson have teamed up to support the service in Russia, where the content of the text messages will be shaped by the Kulakov Center for Obstetrics, Gynecology and Perinatology of the Russian Ministry of Health and Social Development, or MOHSD.

While a press release announcing Text4Baby Russia hit the wires today, the service was announced last month during US Vice President Joe Biden’s wife’s visit to Moscow’s Kulakov Center. Dr. Jill Biden even blogged about it in the White House blog:

“The Text4Baby Russia service is scheduled to start sending messages to moms later this year,” Dr. Biden wrote. “As a mother and a grandmother – I congratulate all of those working on maternal health issues, and look forward to celebrating the growth of the Text4Baby program.”

In the year since it launched in the US Text4Baby has enrolled some 135,000 157,000 people. The service’s most impressive feat, in my opinion, was its ability to gather together the more than 300 500 outreach partners that included national, state, business, academic, nonprofit and other groups to promote the service. (Update: Voxiva sent updated numbers for subscribers and partners — the State Department release apparently had dated numbers.)

But does Text4Baby work?

Last year HHS CTO Todd Park announced plans to have Health Resources and Services Administration (HRSA) evaluate the efficacy of Text4Baby, but in the same breath he announced the creation of a Text4Health initiative at HHS to create new programs around other health topics like obesity, smoking cessation and child health issues.

The move drew some criticism. Keep reading>>

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McGuire: The land grab is misguided

By: Brian Dolan | Apr 7, 2011        

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Bill McGuire

The former chairman and CEO of United Health Group Dr. Bill McGuire recently discussed the opportunity for wireless health (or technology enabled healthcare or whatever you want to call it), wasteful spending on EMRs, the need for interactivity among healthcare technology applications, opera, education and much much more. Dr. McGuire is the Vice Chairman of TripleTree Holding Company and is delivering one of the keynotes at the upcoming Wireless-Life Sciences Alliance Convergence Summit in San Diego next month. TripleTree is an investment bank and one of the founding members of the WLSA and the summit.

Read on for an edited version of our recent conversation with Dr. Bill McGuire.

How do you characterize the opportunity for wireless health? Could you also provide us with some sense of the current investment climate — a lot of activity? A lot of interest but not a lot of activity?

I like to position it as: How can we build products, services, and systems that facilitate the eventual appropriate health and wellbeing for the people in this country and elsewhere. In pursuit of that and in consideration of all that has been done — both good and bad — and all that is yet to be done, which is significant and formidable, I think the whole area of technology enabled healthcare or mHealth or any term you’d like to apply, offers significant opportunity to meet that end. It still remains to be seen obviously what the most appropriate areas and most beneficial areas will be to accomplishing that. When it comes to investments, of course, there will be a lot of investments in things that don’t make any difference or are not contributory to the kind of outcomes I am describing.

What kind of things?

If you look at what has happened in last several years particularly with reform: These huge expenditures that have been directed at technology applications in healthcare. I’m afraid we will see that we have spent an enormous amount of money for marginal or no gain. It’s very indiscriminate. That’s classic healthcare, though and classic investing: ‘Let’s just throw money at things.’

You have the whole idea of applications on cell phones for example. Embedded among [the thousands] of health apps out there are probably a few that will make a difference in the lives of some people. Those apps should theoretically lower costs and improve outcomes, but most of these apps exist because we happen to like apps, it’s a nice story, so we chase them. Discerning what is ultimately going to make a difference and result in the kind of outcomes we are looking for, which is differentiated from just investing money, is the critical issue. The smart investors, smart developers, smart policy makers and so on will benefit from that. The land grab that is going on right now — just throwing money at it — is a little bit misguided.

Another issue is the lack of interactivity among these technology applications. The fragmentation and silos continue. Rather than determining how to piece a number of necessary components together, we have a lot of independent efforts out there to chase after something. We ask for electronic medical records (EMRs) but we don’t necessarily put out standards of performance and interactivity between them. So when someone comes along and asks to gather data or information we know that we can’t get it from each and everyone of them. Keep reading>>

ACO rules bode well for mobile and telehealth

By: Neil Versel | Apr 7, 2011        

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ACO AcademyDidn’t bother to read the 428 pages of proposed rules for Accountable Care Organizations and the Medicare Shared Savings Program that HHS released last week? Neither did we. But Eric Dishman, director of health policy for Intel-GE Care Innovations, the telehealth joint venture launched early this year, did. And he is encouraged by what he saw.

While politicians, mainstream media and much of the general public continues to frame healthcare reform in terms of insurance rather than actual care (or, in some cases, socialism and Big Brother), actual, technology-enabled reform of the American healthcare sector continues. As proposed, the rules, authorized by the Patient Protection and Affordable Care Act, offer lucrative financial incentives for providers to employ mobile and wireless health in managing recently discharged Medicare patients and those with chronic diseases.

Writing on the Intel blog, Dishman says he is “particularly heartened” to see certain provisions dealing with telehealth and mobility in the early pages of the plan.

“The ACO shall define processes to promote evidence-based medicine and patient engagement, report on quality and cost measures, and coordinate care, such as through the use of telehealth, remote patient monitoring, and other such enabling technologies,” is one section Dishman likes.

“Because of its capabilities with respect to prevention and anticipation, especially for chronically ill people, an ACO will be able to continually reduce its dependence on inpatient care. Instead, its patients will more likely be able to be home, where they often want to be, and, during a hospital admission, they receive assurance that their discharges will be well coordinated, and that they will not return due to avoidable complications,” is another.

“The explicit references to the use of telehealth and remote patient monitoring and the calling out of the need to move care to the home shows that CMS ‘gets it’ in terms of the need to ‘place-shift’ … where care occurs away from more expensive settings like hospitals,” Dishman says.

The post echoes what Care Innovations CEO Louis Burns told MobiHealthNews in January. “Dealing with a patient in their home is going to be a critical part of ACOs being successful,” Burns said.

Dishman also likes that HHS promotes the “triple aim” of CMS Administrator Dr. Donald Berwick. In his previous, longtime position as president of the Institute for Healthcare Improvement, Berwick said that care should improve population health, provide better care for individuals and lower or at least restraing the growth of healthcare costs. “ACOs are one of many tools to achieve these three aims,” Dishman writes.

Specifically, the HHS proposal calls on ACOs to “draw upon the best, most advanced models of care, using modern technologies, including telehealth and electronic health records, and other tools to continually reinvent care in the modern age.”

AirStrip partners with GE Healthcare again

By: Brian Dolan | Apr 6, 2011        

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AirStrip CardiologyIn a move that echoes the launch strategy for its first mobile remote monitoring app AirStrip OB, AirStrip Technologies has inked a deal with GE Healthcare to bring to market its new AirStrip Cardiology app for the Apple iPhone and iPad.

The partnership enables data from the GE Healthcare MUSE Cardiology Information System to be viewable on iOS devices via the new AirStrip Cardiology app, which promises “a continuous flow of electrocardiograph (ECG) data and interactive historical data access, helping mobile clinicians make more informed care decisions,” according to the companies’ press release.

The new app will help on-call cardiologists move away from a reliance on static ECG images from faxes or cell phone pictures that are easily distorted to the higher resolution AirStrip Cardiology app that can help cardiologists see 0.5 millimeter differences that could lead to better diagnoses, according to the companies.

The FDA cleared the AirStrip Cardiology app as part of its 510(k) clearance of the AirStrip RPM platform last year: “With FDA clearance in place, AirStrip now extends its virtual real time remote patient monitoring technology to a broad array of acute patient clinical settings, which include the intensive care unit, the emergency department, the operating room, the neonatal ICU, and virtually any other care environment,” the company stated in a release at the time.

Previous to that 510(k), AirStrip’s only offering was AirStrip OB, a wireless fetal monitoring surveillance app designed to work on smartphones and PDAs. The OB app received FDA 510(k) clearance in 2004. AirStrip OB helps physicians to more rapidly and thoroughly respond to a nurse call regarding fetal heart tracings or maternal contraction patterns by viewing the real time waveforms remotely using a mobile device, according to its 510(k) document.

Shortly after AirStrip OB first launched it was exclusively sold through GE Healthcare. In fact, AirStrip OB made its debut at HIMSS 2006 as part of GE Healthcare’s booth. At that time eight hospitals were using AirStrip OB and GE had plans to market the app to the 1,500 hospitals around the country that already had GE labor and delivery monitoring equipment installed that was compatible with the app. Hospital system HCA also had approved the app for use at any of its 200 hospitals.

AirStrip’s original exclusive deal with GE made it the exclusive seller of the OB app until 2008. During that time the app’s customer base grew fivefold: By April 2008 AirStrip OB had been installed in 40 hospitals in the US. That’s when AirStrip announced a move to break away from its exclusive relationship with GE Healthcare and become “vendor neutral.”

“With vendor neutrality in place, we can expand our vision of improving patient safety, increasing communication among caregivers and mitigating risk across the country,” Cameron Powell, MD, President and CMO of AirStrip Technologies said at the time.

EpiSurveyor creator Selanikio shakes up international development

By: Neil Versel | Apr 6, 2011        

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Joel Selanikio, Co-Founder, DataDyne

Joel Selanikio, Co-Founder, DataDyne

“I think EpiSurveyor is the most widely deployed mHealth application in the world,” says Georgetown University pediatrician Dr. Joel Selanikio, creator of the open access software that aids in disease surveillance and collection of public health data in underserved regions.  He’s not so much boasting as marveling at the power of mobility and the Internet to break down barriers in the disjointed, occasionally frustrating realm of international development.

“The only thing that’s been amazing about EpiSurveyor is that it’s in international development,” Selanikio tells MobiHealthNews. “In Silicon Valley, there would be nothing amazing about it.”

Countless billions of dollars have been spent trying to improve living standards and health in developing countries, but much of the money falls into the hands of corrupt regimes, wasteful organizations and jet-setting diplomats who, according to Selanikio, “fly around the world first class and stay in 5-star hotels,” undercutting their mission.

Until perhaps a decade ago, Selanikio says, there was a thought that Africa was too hard a problem to tackle with technology since there had been just one example of technology taking hold globally in all of human history: Radio. But then cellular phones started showing up in some of the poorest corners of the globe.

“We’ve got this enormous, runaway success with the mobile phone being able to scale down to the village,” Selanikio says. “It’s the most successful tech product in the developing world since the radio.” Keep reading>>

JAMA: Time to take mobile health games seriously

By: Brian Dolan | Apr 6, 2011        

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ZamThe Journal of the American Medical Association (JAMA) recently published a paper that argued health-focused video games, including those for mobile platforms, now deserve “serious attention.”

The commentary by Dr. Leighton Read of Alloy Ventures and Seriosity, Inc. and Dr. Stephen M. Shortell from the School of Public Health at UC Berkeley chronicles the popularity of video games and the promise that the popular form of media holds for teaching the public to make healthier choices. While people doing jumping jacks in front of their Xbox may prove entertaining, the real news is how Read and Shortell see mobile devices playing a big role in the healthy gaming world.

The authors see promise in mobile gaming thanks in part to GPS, accelerometers, advanced wireless sensors and mobile hotspots, which could revolutionize healthy gaming through location-based activity tracking, movement monitoring and even vital sign recording. While Wii Fit and Dance Dance Revolution get kids moving in front of the TV, the authors point to a more mobile option:  Zamzee. This startup is using a unique approach to getting 11- to 14-year-olds to be more physically active with the combination of a mobile pocket activity monitor and an online reward system where healthy changes mean real life gift cards and virtual prizes. Another mobile game mentioned in the paper is “Lit to Quit.” Columbia University is trialling this mobile smoking cessation game where users blow into their iPhone microphones to reduce their cravings for cigarettes. Cornell University has teens sharing mobile phone photos of portion sizes and ingredients with their friends in the Mindless Eating Challenge. Indiana University has students participating in an “alternate reality” game promoting healthy eating and exercise. Health insurance provider Humana has also been playing along with their Games for Health initiative featuring a brain exercise game that has users searching out colors (and taking mobile phone photos) in their surroundings as well as a walking game that lets users power a virtual gold prospector with every real-life step they take throughout the day.

While health-based mobile games are still very much an emerging trend, opportunity is knocking for those getting into the game. The Robert Wood Johnson Foundation for whom Dr. Read has consulted, is promoting and evaluating games aimed at health through their Health Games Research Initiative. And, the authors noted that the $10 billion set aside in the Affordable Care Act for disease prevention and health promotion over the next 5 years could be directed at companies with proven successful mobile health games.

For more, read the commentary over at JAMA.