Off-the-shelf smartphones meet few HIPAA, MU security requirements

By: Neil Versel | Jun 15, 2012        

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ONC's Dr. Farzad Mostashari

ONC's Dr. Farzad Mostashari

Most mobile phones on the market today meet no more than 40 percent of security requirements — such as those called for by HIPAA or proposed “meaningful use” Stage 2 standards — in the out-of-the-box configurations, according to the Office of the National Coordinator for Health Information Technology.

And even after being manually configured, only iPhone and BlackBerry smartphones typically achieve about 60 percent of standards. Other brands do not fare as well, Will Phelps, an IT security specialist in ONC’s Office of the Chief Privacy Officer, said, according to a report in Government Health IT.

Phelps spoke last week at the Government Health IT conference in Washington. The publication is a wholly owned subsidiary of the Healthcare Information and Management Systems Society (HIMSS), which sponsored the event.

ONC is conducting research as it prepares guidance to help small and medium-sized provider organizations secure the growing number of mobile devices that process health data. “They may not have an IT staff or third-party vendor to manage their devices for them. So we want to get them to a point where their devices are operating as securely as possible,” Phelps told the gathering, according to Government Health IT.

“You have to make sure that the devices are able to apply the appropriate security controls to make sure that the patient records are protected,” he advised.

For the guidance, which ONC will publish online later this year in the form of a series of best practices, the office will describe how to handle security in various use cases, according to ONC Office of the Chief Privacy Officer attorney Kathryn Marchesini. Scenarios will include logging in from a coffee shop, sending e-mail from a mobile device and responding to the “bring-your-own-device” phenomenon, she reportedly said.

The office also will disseminate its best practices through the national network of federally funded regional extension centers set up to help smaller providers adopt and use health IT.

In developing guidance, ONC plans on testing security software from various vendors for compliance with security standards, according to the Government Health IT report. Expect to see future outreach to vendors and patients as well.


AirStrip acquires Palomar tech to enable mobile EHR access

By: Brian Dolan | Jun 14, 2012        

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Simulated screenshots of AirStrip's expanded iPad app

Simulated screenshots of AirStrip's expanded iPad app

This week San Antonio-based AirStrip Technologies announced that it was expanding its suite of mobile patient monitoring applications to enable physicians to more easily access information housed in various electronic health record systems (EHRs) via their mobile devices. The expanded offering leverages a recent acquisition by AirStrip. The company bought the worldwide, exclusive rights to market and develop San Diego-based healthcare system Palomar Health’s EHR-agnostic and mobile-enabled MIAA (Medical Information Anytime Anywhere) platform.

While the companies aren’t calling it an acquisition officially, that is what it is in effect, they told MobiHealthNews.

AirStrip’s expanded offering will make available real-time access to medical device data as it always has but it will also now include all other current and historical patient information that is relevant to clinical decision-making. AirStrip’s CEO Alan Portela stressed to MobiHealthNews in an interview that the key is that the augmented mobile application will allow physicians to access information stored in EHRs developed by different EHR and EMR vendors. Because of increasing consolidation between organizations that own healthcare facilities and the fact that it is not unusual for the same healthcare system to have different EHR systems installed in its various facilities, the need for a mobile app that can access data from multiple records systems is crucial.

AirStrip specifically pointed to Cerner and the VA’s VistA EHR system as two examples of the EHRs it currently can help physicians access through the app.

AirStrip’s Portela has long-argued that EHRs are important but mostly as platforms, like the operating system on a computer. Their true value and benefits are unlocked by connecting mobile apps and other technologies built on top of them.

More details on the expanded feature set of AirStrip’s mobile offerings in the press release below: Keep reading>>

Axial acquires Mayo Clinic mobile health startup mRemedy

By: Brian Dolan | Jun 14, 2012        

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mRemedyCare transitions technology provider Axial Exchange has acquired mRemedy, a mobile health app company formed by the Mayo Clinic and DoApp in late 2009. While the companies did not disclose specific financial details about the acquisition, Mayo Clinic and Axial’s existing investor Canaan Partners both invested in Axial Exchange to help it complete the acquisition. The resulting company now counts those two investors as well as Mayo Clinic’s Dr. Paul Y. Takahashi and Dr. Nathan Jacobson as investors and board members.

As part of the agreement Axial Exchange also gains access to content from that it will incorporate into its patient-facing wares.

While mRemedy initially launched a handful of consumer health apps, its core product was myTality, a patient-facing mobile health app that aims to help users better navigate a future hospital visit and helps hospital market their services. Axial’s software as a service platform includes two key offerings: Axial Patient and Axial Provider. myTality will help Axial scale up its mobile offerings, the company wrote in a statement.

Notably, Axial’s products took the top prize in a recent HHS Partnership for Patients Initiative innovation competition, run by ONC called, “Ensuring Safe Transitions From Hospital to Home.”

When mRemedy launched almost two years ago the company planned to develop apps based on Mayo Clinic’s research and services. The first mRemedy app, Mayo Clinic Meditation, launched in the final days of 2009 in Apple’s AppStore for iPhone and iPod touch users. That first app, which teaches users relaxation and breathing techniques costs $4.95 and is based on a program created by Mayo professor Dr. Amit Sood.

After a few consumer health app launches throughout 2010, mRemedy pivoted and launched myTality. When it launched, myTality was described as a suite of custom apps built for “clinics and hospitals and their patients” and includes medical trackers, medical directories, medical reference guides and more. At the time of this acquisition, mRemedy’s suite of mobile app trackers include myWeight, mPressure, and myGlucose. In mid-2011 mRemedy announced that Lexington, Kentucky-based Central Baptist Hospital had signed on as the first hospital to offer the suite of apps to its patients.

That pivot is what led mRemedy to its buyer this week.

iPad helps IT consultant-turned-cancer patient seize control of her care

By: Neil Versel | Jun 14, 2012        

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Carrie HandleyCarrie Handley, a mobile health and health IT consultant in Waterloo, Ontario, knew that healthcare was an inefficient industry with plenty of communications shortfalls. But she didn’t realize how pervasive and frustrating the problem was until she was diagnosed with breast cancer two years ago.

In fact, Handley, a former marketing executive with several medical imaging companies, was initially misdiagnosed in April 2010 because of an error in communicating the results of the mammogram.

“The nurse who read [the results] over the phone to me didn’t read the entire report and said that it was negative, and so I went on my merry way,” Handley tells MobiHealthNews. Several weeks later, the hospital that did the exam called, wondering why she hadn’t returned for a follow-up appointment. “It was indeed not negative, it was positive,” Handley recalls.

After getting a late start on the treatment, Handley needed three successive surgeries.

“I got angry. I wasn’t going to become a victim or a helpless patient,” she says. But she channeled the anger into something positive. I thought, ‘You know what, I’m going to get all of my images and all of my reports because I want to understand what’s going on. I don’t want to have this to happen to me again through this process.'” Handley went to all of the facilities she had received care at and got copies of all her records – a few CDs with images, but mostly paper documents.

“Originally it started off in a binder, which, as you can imagine, became very heavy and cumbersome and awkward to carry around,” Handley says. After months of dragging the binder from appointment to appointment, she went mobile, digitizing all the information and storing it on a USB drive.

“That seemed to be a really smart thing to do because it was tiny. Well, that proved to be illogical because it was easy to lose and nobody really knew what to do with it once they had it in their hands,” Handley says, echoing the experience of many who have tried USB-based personal health records.

At one point, a physician put the USB drive in his lab coat, which then probably wound up in a laundry bin. “As I was being wheeled into surgery, I thought, well, that was really dumb of me,” Handley recalls. After she got home, she first put the records on a laptop, then her son came over with an iPad. She found the right container, one that was both portable and made the information easy to share with her doctors and nurses.

“By having all of that information, you become so informed and you can have a better relationship with your clinician. Yes, at first, it’s a bit difficult. They are very wary of how much information you have and if it’s even correct,” Handley says. Keep reading>>

Medical app revenues to steadily grow 25 percent annually

By: Brian Dolan | Jun 14, 2012        

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Kalorama Information Medical Apps ResearchAccording to a recent report by Kalorama Information, the market for mobile healthcare software apps was worth about $150 million in 2011. Previous studies from the research firm in years past have pegged the market at $41 million in 2009 and $84.1 million in 2010. As we wrote in 2010, the year-over-year growth in professional medical app revenues at that time more than doubled. As the $150 million estimate for 2011 shows, revenues for medical apps has still grown year-over-year but instead of doubling revenues, medical apps for healthcare professionals brought in just under 80 percent more revenues in 2011 than they did in 2010.

Kalorama has previously stated that in 2009 the $41 million market for medical apps made up just about 1.5 percent of the total mobile app market. In its most recent report, Kalorama makes a similar statement. According to a written statement the firm issued about its newest apps report, medical apps still make up just 1 to 2 percent of the overall app market:

“While the overall mobile app market is expected to continue to display strong double-digit growth through 2016, the medical app market will also continue to grow — at a faster rate,” the research firm stated. “Although they make up just 1-2 percent of the entire market for mobile apps, Kalorama finds that healthcare apps will grow 25 percent annually over the next five years, compared to still-impressive 23 percent growth estimated for the standard apps market.”

Judging by the more than 100 percent annual growth rate for medical app revenues between 2009 and 2010 and the almost 80 percent growth between 2010 and 2011, an expected 25 percent annual growth over the next five year certainly indicates a deceleration from the initial boom. Still, that is solid growth for years to come. Kalorama Information’s Publisher Bruce Carlson told MobiHealthNews that every new technology finds an initial spike in year-over-year percentage growth before settling into a more steady growth rate. Carlson characterized Kalorama’s 25 percent year-over-year growth rate for this market as “conservative”, like most of Kalorama’s work. He also said, as expected, that the firm is usually right.

Kalorama also found that the average price of medical apps has not changed in the past three years: According to the research firm it still hovers at around $15, just as they found them to be priced in 2009. MobiHealthNews’ own data on average prices for professional medical apps indicated a different trend: The price of professional medical apps is slowly but steadily dropping. In our research the average medical app intended for use by healthcare professionals cost about $9 in mid-2010 and it dropped to just under $8 in mid-2011.

More details about the report here.

Smartphone app for AFib detection awaits FDA clearance

By: Neil Versel | Jun 13, 2012        

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AFib Smartphone AppWe are getting closer to the day when a smartphone app can detect atrial fibrillation in patients at high risk of a stroke or heart failure.

Researchers at Worcester Polytechnic Institute in Worcester, Mass., have submitted an application to the Food and Drug Administration for 510(k) approval of an Android app that can pick up subtle changes in skin color by scanning blood vessels, thanks to an algorithm developed at the school.

The yet-unnamed app measures heart rate, heart rhythm, respiration rate and, with the help of an external pulse oximeter, blood oxygen saturation, by scanning the patient’s index finger for about a minute in front of the phone’s video camera. A color bar on the screen turns red if the heartbeat is irregular, indicating possible atrial fibrillation.

“AFib is so common, but many people have no symptoms, or subtle symptoms like getting winded. This tool will be very helpful because AFib is so hard and expensive to diagnose,” cardiologist Dr. David D. McManus of UMass Memorial Medical Center tells the Worcester Telegram & Gazette.

UMass Memorial clinicians tested the app on about 60 AFib patients, using Motorola Droid phones. Readings on the phone were just as accurate as those taken with traditional electrocardiograms. The WPI researchers published some of their findings last year in the journal IEEE Transactions on Biomedical Engineering. That article discussed some of the limitations of using a smartphone in place of an ECG, but also listed many of the positives.

“One of the advantages of mobile phone monitoring is that it allows patients to make baseline measurements at any time, building a database of normal cardiac function that could allow for improved detection of disease states,” the WPI team wrote. “Current mobile phone technology extends beyond simply monitoring and measuring with ease for a patient; it could also be used to relay the information to medical professionals. This gives a patient the ability to carry an accurate physiological monitor anywhere, without additional hardware beyond what’s already included in many consumer mobile phones.”

However, McManus is not sure if the app would be sold directly to the public. He tells the Telegram & Gazette that there may be a market it among payer-supported preventive health and wellness programs. “It’s not intended to replace EKGs or doctor visits, but it’s a valuable piece of information,” McManus adds.

The app should be available for Android and Apple’s iPhone in three to six months, depending on FDA review, of course. While WPI engineers are said to be working on an iPad version, the iPad camera has a different kind of light source that it not compatible with the current smartphone software, according to the Worcester newspaper.