Doctors launch new Dallas-based health accelerator

By: Jonah Comstock | Apr 26, 2013        

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Hubert Zajicek Portrait 2011 smallOne of the findings of a recent California Health Care Foundation whitepaper about health-specific accelerators was the importance of involving healthcare experts such as doctors in the organization.

Dr. Hubert Zajicek took that to heart in starting his new health tech accelerator, Health Wildcatters, in Dallas, Texas. Zajicek is a physician who specialized in nephrology, or kidney research. After a number of years of working with med-tech accelerator NTEC (North Texas Enterprise Center), Zajicek is teaming up with Dallas-based general tech accelerator Tech Wildcatters and investor partners Green Park & Golf Ventures, who he says are the most prolific digital health investors in the region, to start the new accelerator.

Zajicek says the focus of Health Wildcatters will be to acquaint health entrepreneurs with the realities of the healthcare space.

“You can have a really cool tech idea, but unless you know how you can sell this, you know you’re safe on HIPAA, you have a clear regulatory pathway and you have a way of selling your gadget to hospitals and providers, you can have a rude awakening,” he told MobiHealthNews, noting that tech entrepreneurs are used to a quicker sales cycle than is manageable in healthcare.

Health Wildcatters has opened applications and will take in 15 companies, to be chosen by mid-July. Companies in the accelerator will receive up to $35,000 in seed funding in exchange for 8 percent equity and the program will last 12 weeks. A strong focus of the program will be on mentorship. The accelerator has raised $1 million from 30 investors, most of whom Zajicek describes as mentor-investors.

“The poster child of the mentor-investors is a healthcare startup investor who has ‘been there, done that’, built a startup, executed, and now has war stories to tell,” he said. “We have a lot of those. We have a lot of entrepreneurial physicians who have started companies and have made angel investments.”

Mike Bartlett, founder of vision test app makers Vital Art and Science is one mentor-investor. Another is Michael Gorton, founder of Teladoc, which offers phone and online video consults with physicians. All are local to Dallas or the surrounding area, which Zajicek says has a wealth of mobile health movers and shakers and not much of a network to bring them all together.

“The healthcare IT startup scene in Dallas is not as well-known, but it’s actually quite robust,” he said. “That includes all the physicians that are starting clinics, centers, participating in hospitals. Dallas is not just a random needle on the map, it is a fast growing city in a prosperous state that has a lot of influx right now, but it’s got an extremely competitive healthcare ecosystem. There’s seven hospital groups that are basically expanding in a city that’s expanding rapidly.”

Not only are Zajicek and partner Dr. Clay Heighten physicians themselves, but many of their mentor-investors are as well. The increased involvement of doctors in the health tech startup scene is something of a trend. Blueprint Health is also physician-founded, and Rock Health has recently begun seeking more physicians on the investment side through its Rock Health Angel Group.

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Dr. House would approve of crowdsourcing diagnoses, but I sure don’t

By: Neil Versel | Apr 25, 2013        

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Neil_Versel_LargeUpon reading the story in MobiHealthNews this week about CrowdMed, the startup that relies on crowdsourcing to suggest possible diagnoses to patients with rare or mysterious conditions, I had two thoughts: clinical decision support and Dr. Gregory House.

Dr. House, the fictional diagnostic genius from the dearly departed Fox show, “House M.D.,” crowdsourced medical decision-making to his team of interns, underlings and foils for his practical jokes, ostensibly to teach them to be better diagnosticians. It made for great television for most of its eight years on the air, but it’s really a terrible way to practice medicine, essentially making educated guesses to develop differential diagnoses.

Though I loved the show for its humor, drama and complex characters – not to mention House’s obvious parallels to Sherlock Holmes – as a health IT reporter, I knew there was an Achilles’ heel. Give House a clinical decision support system and he solves his cases in a matter of minutes. No more guessing, no more unnecessary testing, no more questionable treatments that cause adverse reactions and make ailing patients even sicker. And you would have a boring show.

Unfortunately, the guesswork and overtreatment are all too common not only in a TV medical drama, but in real hospitals all across the industrialized world. I fear CrowdMed is just going to perpetuate the problem, the financial backing by Y Combinator and presence at TEDMED notwithstanding. The same goes for Grand Roundtable, a crowdsourcing platform for medical treatment ideas, part of the inaugural class of health incubator DreamIt Health.

The “wisdom of crowds,” as CrowdMed describes it, might work when searching for doctors, as Blueprint Health-supported MyNewMD offers, or for analyzing lots of data, but if I’m the one on the exam table, I don’t want a bunch of docs guessing over the internet. I want the right answer.

Clinical decision support systems sift through massive medical databases to suggest courses of treatment. Some focus specifically on diagnostic decision support, helping physicians match symptoms to create differential diagnoses. Isabel Healthcare comes to mind here, as does Dr. Larry Weed, who has spent the last six decades or so advocating computer-aided matching of patient problems to medical knowledge that isn’t always apparent to a physician used to seeing a small set of common diseases.

Sure, CDS has its drawbacks. Systems don’t always fit physician workflows. Doctors get overwhelmed with “alert fatigue” if the computer keeps sending repetitive warnings, and they start tuning the alerts out. And CDS, particularly for diagnostic purposes, needs a thorough patient history to be effective.

If I am the one being diagnosed, I’d rather spend the time filling out a complete history than having a bunch of doctors play guessing games. It doesn’t matter if it’s at House’s Princeton-Plainsboro Teaching Hospital or over the internet.

Philips Respironics offers SleepMapper app to motivate, inform sleep apnea patients

By: Brian Dolan | Apr 25, 2013        

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Respironics SleepMapperPhilips Respironics has included wireless connectivity in its CPAP (continuous positive airway pressure) machines for people with obstructive sleep apnea for going on four years now. The machines have transmitted data to healthcare providers who could remotely check-in on their patients and make adjustments to their machines and therapy as needed. With the launch of a new app, called SleepMapper, Philips Respironics is making some of the data that the CPAP machines track available directly to patients for the first time.

“Adherence rates for all sorts of medical recommendations are suboptimal, generally,” Mark Aloia, PhD, Senior Director, Global Clinical Research, Office of Medical and Health Affairs at Philips Healthcare told MobiHealthNews in an interview. “Adherence to CPAP [therapy] is typically poorer than others. Asking people to change how they are going to sleep is challenging.”

Untreated obstructive sleep apnea can cause excessive daytime sleepiness, mood changes, and impaired concentration and memory. It can also lead to hypertension, cerebrovascular disease and cardiovascular disease. CPAP therapy is delivered via a face mask that delivers positive air pressure to the upper airway — basically, blowing air into the person’s nose — in an attempt to prevent the upper airway from collapsing during sleep, which is what causes the obstruction.

Fewer than half of those patients prescribed CPAP continue to use it after the first year and an oft-cited study from 1993 found that the majority of CPAP users don’t use it as prescribed. Still, symptoms can improve if patients use CPAP for about 4.5 hours a night.

One of the core aims of the new, free SleepMapper app, available for both Apple iOS and Android devices, is to help patients to use their CPAP machines as recommended. Aloia said the app’s behavior change methods are based on an established protocol called Motivational Enhancement Therapy.

“Briefly, patients are approached in a non-directive manner with knowledge and acceptance that they might be ambivalent about making a commitment to the treatment,” according to a 2010 report from Respironics. “The goal is to promote patient thought about the treatment ambivalence the patient might be feeling and sway the decisional balance toward the benefits of using the treatment. Enhancing self-confidence about therapy use is a strong predictor of long-term adherence. Studies corroborate that MET can be an effective method to improve PAP adherence, especially in patients who do not have a profound negative response to PAP.”

The SleepMapper app aims to help answer questions new CPAP patients might have about their machines early on and help them get more confident about how to use their device each night. Aloia said confidence is one of the largest predictors for adherence. SleepMapper also helps patients set reachable goals to help them do the best they can each night, Aloia said. These goals are suggested by Respironics automatically through the app based on the patient’s past adherence rates.

The CPAP machine can inform patients on how many hours they managed to use it the night before, how many episodes of obstructed breathing they had during the night, and whether their mask might be leaking and, therefore, not affectively delivering enough air to keep their air passageway open.

“Most importantly, this is not just about having the data, but getting the right data back to the right patient at the right time,” Aloia said. “What I see happening in the field of health and technology is that many startups offering wearable remote monitoring devices are feeding data back to people ad nauseum.”

Aloia said that Respironic’s approach with SleepMapper is different because it aims to provide feedback at the teachable moments when the patient might be most willing to receive information that could lead to behavior change. For example, when patients are being adherent SleepMapper asks them to explain in their own words what is motivating them. When Respironics finds that the patient is no longer using their device as recommended, the app can send them an alert to remind them what had motivated them previously — in their own words.We give them access to show them how they are using. They do it to try to change behavior. We give them access to their data but what the app speaks to them about depends on how they behave.

Aloia also said that while an app like this can only help improve adherence and isn’t going to hurt anyone, Respironics is taking the extra step to conduct a clinical trial to determine its efficacy anyway. That trial is just getting underway now, he said.

“The intention here is to help patients help themselves through this complex therapy,” he said, “and give them the tools that they need to make decisions on their own based on their actual capabilities.”

Readers react to Smart Patients, Better startup launches

By: Aditi Pai | Apr 24, 2013        

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Better's health app

Better's health app

Over the past week, the launch of two startups — Smart Patients and Better — with high-profile founders (Roni Zeiger MD and Geoffrey Clapp, respectively) sparked a couple of interesting comments from MobiHealthNews readers. The Smart Patients launch encouraged readers to ask questions about how to manage the information shared in the community, while the Better launch initiated a conversation on the app’s usability and value.

Respond to the comments below by clicking to the link directly following each one. As always, to interact with MobiHealthNews staff directly, tweet @MobiHealthNews or like us on Facebook.

Google’s ex-Chief Health Strategist launches startup, Smart Patients

Hunter Hawkins: It’s refreshing to see more discussion and movement towards a patient-centric model of healthcare. Question, how is incorrect or non-accurate information filtered out? Link

Roni Zeiger: In communities that are working well, other members of the community challenge questionable information by asking for evidence or pointing out evidence that that they are aware of. We’ve found that cancer patients and caregivers become very knowledgeable and can work well together — as a network — to quickly uncover high quality info as well as point out less good info. Link

davidprior: Isn’t this just another Patients Like Me? Link

Roni Zeiger: I think what makes us potentially different from other community platforms:
– Focus on oncology
– Facilitate conversations not just within a cancer group but across groups, e.g., patients with bone mets can learn useful things from each other regardless of the location of their primary tumor
– Built-in clinical trial search that makes it easy to find trials AND have conversations about them; especially in oncology, many of the discussions are about trials, and our initial users asked for this feature Link

Bonnie Feldman: Giving patients in need more information is a powerful tool! Will they be able to connect to other networks, such as the Cancer Knowledge Action Network? Link

Mayo Clinic, Geoff Clapp launch mobile health startup, Better

Maria Dorfner: Gimmick. Anyone wanting to stay healthy or prevent illness is better off spending that $150/month elsewhere. I know a top lifestyle coach in #1 market that charges $10/month. For $150. that lifestyle coach should toss in doing your laundry, housecleaning and picking up your groceries. If they’re not, their lifestyle is the one getting better. Better for who is the question. This app serves the hospital. I wouldn’t be impressed by the “Black Seal” option. That service has always been available to anyone who pays for it. I’m a fan of the Mayo Clinic, but this app gets a thumbs down. Link

Geoffrey Clapp: Hi Maria, We’re still figuring out pricing, and no doubt, we will learn a lot in the market. I’d love to hear more from you about the $10 option, and what they do. While we certainly don’t do laundry – and trust me, I can barley handle my own – we do a lot of things outside the “norm” of health care, based on a lot of market research on what people wished they had. I don’t pretend it’s perfect or fully baked – such is life at a start-up. On the pricing, one comparison I would use is retrofit, which is right in the same area at $149/month – http://www.retrofitme.com/plan… at this is for weight loss only. There is no doubt we have a lot to figure out and certainly have a lot to learn by listening to the market and people like you – so to that end, I would like to hear more, please do reach out… Thank you. Link (with contact info, too)

Matt M: I work for a company called cloud2health doing something similar for a year now. The mobile app is releasing next month after user experience testing for the last 3 months. We’re running freemium, free for most users, $9.99 a month for those that want higher features/no-ads. Also, from the presentation I saw, I think much of this is too dense for a mobile experience. This is something we learned quickly, a mobile experience doesn’t lend itself to dense content overload. You have to walk to the line between app and medical device, too many people are stuck on the medical device model and end up making devices with terrible mobile UI. Mobile apps should be “medical light” for the average user, let power users access via tablet and web. The mass of people will fall in the medical light user model, only 15 percent or so of the population wants the information overload, the rest just want the one line summary. Link

Geoffrey Clapp: Hi Matt, I’d whole-heartedly agree on market feedback and mobile experiences. I get the sense you’ve learned a lot in your user trials, which is is great for our market. There is so much to learn from user trials and feedback loops, and there’s a real need for very quick, consumable, mobile content. Obviously, a big part of that model is to get from content to care (through a credentialed professional, where needed) as quick as possible when it’s needed – even in our free versions, this is a big goal of ours. I don’t agree that Medical Devices are a good example of overload/dense. FWIW, I’d actually argue (After far too long in this space) that most medical devices provide no useful, actionable, content to their users, and that’s a big problem. That said, you’re points on dense + mobility are spot on and important. Our entire market throws numbers and graphs at people and expects change, and that’s not okay. That said, very best to you and cloud2health. I’m glad you are focused on user feedback, it’s so critical. Link

Pharma data miner Treato scores $14.5M

By: Neil Versel | Apr 24, 2013        

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Treato PharmaTreato, an Israeli company that scours thousands of social media sites to glean patient insights about pharmaceuticals and treatments, has landed $14.5 million in new capital. OrbiMed Israel Partners and New Leaf Venture Partners led the round of funding, which also included previous investors Reed Elsevier Ventures and Western Technology Investments, the company says.

Treato, of Yehud, Israel, will use the money to set up a US office in New York and to expand its product offering, according to CEO Ido Hadari. “We really want to expand our presence in the US,” Hadari told MobiHealthNews. The company currently has one stateside sales representative, he added.

The new investment also will help the company build out its product, perhaps around therapeutic areas rather than just specific drugs, and to expand its reach globally, Hadari said.

Launched about a year and a half ago, Treato has developed an algorithm to search across social media sites large and small, from Facebook on down to local online communities for patients with specific medical conditions, to ascertain what people are saying about medications. Treato looks for patterns that could signify adverse reactions to drugs, off-label uses, reasons why people switch from one medication to another and other bits of intelligence.

The algorithm matches patient discussions to clinically validated information sources to help people understand how drugs actually work and serve as an early warning to many constituencies about potentially harmful side effects.

“It’s kind of the next generation of patient intelligence,” Hadari told MobiHealthNews. “It’s about applying advanced analytics to understanding what patients are really saying.”

To date, the Treato platform has analyzed 1.3 billion posts from 23 million people, covering 11,000 drugs and 13,000 conditions, according to the company. The free, advertising-free treato.com site gets more than 100,000 hits a day from patients, healthcare professionals, payers and pharma representatives.

Treato makes its money from a professional version, Treato Pharma, which has been live since October, providing in-depth and specialized metrics – such as what people eat when taking certain medications – for pharmaceutical marketing and safety teams. “Pharma companies have the opportunity to identify problems and threats and risks,” Hadari said.

Mobile health sensor market to hit $5.6B by 2017

By: Brian Dolan | Apr 24, 2013        

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Last month Germany-based research firm Research2Guidance predicted that the overall, worldwide mobile health market would generate about $26 billion in revenues by 2017, but this month it broke out a 2017 revenue prediction for mobile health sensors that connect to a mobile health app: $5.6 billion. The firm believes that this segment of the market will grow at a compound annual growth rate of 69 percent and 61 million health sensors will ship in 2017. According to the company, health sensors generated about $407 million in revenue in 2012.

Research2Guidance Sensors

Research2Guidance estimates that there are currently about 200 external health-related sensors that can connect to smartphones, and most are priced between $20 and $200. Most of the 61 million sensors that Research2Guidance expects will ship in 2017 will help users track health parameters for sports and fitness activities.

Research2Guidance argues that the market today is dominated by smaller sensor companies that first launched in 2009 or 2010, but larger sports and technology companies like Nike and Samsung are ramping up their health-related offerings now, too. The firm also believes that health sensor companies will increasingly shift their business models from proprietary data silos to sensors that feed into multiple apps from third parties.

In March the firm projected that by 2017 more than 3.4 billion people will have smartphones or tablets with access to mobile health apps, and 50 percent of them will have downloaded health apps.