Mango Health users most adherent on Wednesdays

By: Jonah Comstock | Jul 11, 2013        

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Mango Health, the Rock Health startup behind a gamified medication adherence app that launched in April after 16 weeks of beta testing, released aggregated data about adherence habits of its user base.

“Our belief is that understanding how consumers interact with medications and supplements each day is an important part of the quantified self movement that is often overlooked, and an important first step in solving the huge problem of medication non-adherence in the US,” CEO Jason Oberfest told MobiHealthNews in an email.

Mango Health

The company released data about its users in a blog post this morning. While Oberfest wouldn’t disclose the company’s user base because of ongoing discussions with a potential partner, he did tell MobiHealthNews that users have viewed over 1 million medication reminders in the 14 weeks since the app launched. MobiHealthNews’s very rough estimate from that data would put Mango’s likely user base in the thousands.

According to Mango, 64 percent of all the medications added to the app are prescription drugs and 36 percent are over-the-counter medications or supplements. The number one prescription drug is Lisinopril, which is prescribed for hypertension and congestive heart failure and the number one over-the-counter medication or supplement was fish oil. In general, Oberfest said, statins (a class of drugs taken to lower cholesterol that does not include Lisinopril) were the most common medication entered.

The company also looked at adherence by day of the week and found that, in general, its user base is most adherent on Wednesdays and least adherent on Saturdays. In general, the weekends, including Fridays, fare worst than weekdays for adherence.

Mango Health also tracked adherence by drug. The findings seem to indicate, unsurprisingly, that drugs for mental health conditions have lower adherence than other medications. The drugs Mango users take most consistently include Tamoxifen Citrate (a breast cancer drug), Loestrin (a birth control pill), and Glucophage (a medication for people with diabetes, also known as Metformin). Those most often missed are evening primrose oil (a natural supplement for menstrual cramps), Seroquel (an antipsychotic), Adderall (an ADHD medication), Bupropion (an antidepressant), and Lorazepam (a sedative prescribed for anxiety disorders.)

Some specific insights that Oberfest suggests might help improve adherence also came out of the data. For instance, statins were the most common drugs combined with other drugs, and for at least one drug (Metformin), adherence when taken with a particular statin was as high as 91 percent.


Philips teams with Indiegogo for health innovation contest

By: Jonah Comstock | Jul 10, 2013        

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Slava Rubin, CEO of Indiegogo, and Greg Sebasky, Chairman of Philips North America.

Slava Rubin, CEO of Indiegogo, and Greg Sebasky, Chairman of Philips North America.

Philips has announced an innovation contest to give a total of $100,000 out to five startups creating technology to improve health and wellness. But companies that compete stand to get a lot more than the $60,000 grand prize: the Innovation Fellows Competition is being conducted in partnership with Indiegogo, and companies entering will be expected to crowdfund their projects as well.

“It was important to us to include a crowdfunding element to the competition to help bring more support for these big ideas,” Greg Sebasky, Chairman of Philips North America, told MobiHealthNews in an email. “Now, innovators will not only gain access to the financial resources they need to bring their products to market, but everyone around the world can vote with their dollars on those innovations that they believe are the most meaningful.”

Sebasky said Philips chose Indiegogo over other crowdfunding sites because of the site’s “global reach and breadth of campaign topics.”

“Indiegogo offers the best platform to align with our competition focus on healthy living and has the potential to support what we hope grows into a global program,” he wrote.

Philips is looking for innovations in three categories: “Living Well”, which includes addressing problems like restful sleep and home security, “Enjoying Life”, which includes products to increase happiness as well as technology for aging independently, and, finally, “Being Healthy”, which includes “new products or services that enable people to better monitor their family’s health, seek medical treatment, prevent illness and live a healthy lifestyle.”

Registration for the competition opened June 18 and the contest will run until October. Three of the judges’ announced criteria — innovativeness, feasibility, and impact — deal with the idea itself, but the other two are related to the crowdfunding campaigns. To be considered, projects will have to have at least 100 backers and have raised 50 percent of their funding goal in a special crowdfunding campaign run concurrently with the contest. Judges will also look at transparency, or how specifically the entrant has explained how the funds will be used to support the project.

The top company will get a $60,000 cash prize and a chance to meet with Sebasky and his team at Philips to help develop their idea. Four other companies will get $10,000 each.

According to Sebasky, Philips was inspired to launch the contest by the results of a survey the company conducted called the Meaningful Innovation Index, in which 1,000 people in each of five countries (China, The Netherlands, the US, the Kingdom of Saudi Arabia and Russia) were asked questions about their level of satisfaction with technological innovation.

The survey showed that Americans especially rank their health as an important area in their lives. Asked to list important areas, 75 percent listed preventative health, 74 percent listed healthy lifestyle, 70 percent listed eating healthily, and 68 percent listed staying fit and active. Finally, 77 percent listed “living independently as I age”. However, asked if they were satisfied with the products currently available in these areas, only 28 percent were satisfied with preventative care, 31 with healthy lifestyle, 30 percent with eating healthily and staying fit and active, and 32 percent with independent living.

“According to our research, there is an appetite for future innovations to go beyond creating technology for technology’s sake, instead aiming to make a difference in people’s everyday lives, specifically in living well, being healthy and enjoying life,” Sebasky said.

Multi-state anesthesia group adopting Shareable Ink module for Meaningful Use

By: Neil Versel | Jul 10, 2013        

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shareableinkA large, multi-state anesthesia group will use the iPad version of Shareable Ink’s Anesthesia Cloud EHR module to help clinicians document patient encounters at all 25 of its practice locations, Nashville, Tenn.-based Shareable Ink announced Tuesday.

The group, Resolute Anesthesia and Pain Solutions, has been piloting the system at its flagship Boca Raton, Fla., location as physicians there work to achieve Stage 1 Meaningful Use, and will be introducing Anesthesia Cloud at all of its other sites in Florida, Missouri and Illinois this summer. “We’ve had a very wide acceptance by our clinicians,” says Resolute’s human resources director, Wendy Pizzo, largely because the technology does not force them to change their practice style.

Physicians and nurse anesthetists opted for the Shareable Ink iPad app, launched at HIMSS13, rather than the version of Anesthesia Cloud that uses Anoto digital pens to capture data from plain paper because it the Apple tablet allows those who serve patients at multiple hospitals and ambulatory surgery centers to take patient records with them. (Pizzo says none of the ASCs Resolute physicians practice at currently has an EHR.)

“It’s exactly like the piece of paper they’re used to,” according to Pizzo, who had been administrator of predecessor company Broad Anesthesia Associates. Broad merged with the former Mid-Florida Anesthesia Associates, and the combined company changed its name to Resolute in May.

The app will connect through Shareable Ink’s cloud to an ambulatory EHR, though users never need to see the interface. “All my anesthesia records are on the Shareable,” Pizzo says.

The Boca Raton location has begun its 90-day attestation period for Stage 1 Meaningful Use, and others are starting to adopt the technology now. “Our goal is to have all of our providers online by September so they can have their 90-day attestation period this year,” Pizzo says. Physicians and other eligible providers that reach Stage 1 before the end of 2013 are eligible for as much as $39,000 in Medicare bonus payments through 2016; the maximum drops to $24,000 next year.

Meantime, Shareable Ink is helping Resolute select an EHR, a decision that Shareable Ink founder and CTO Stephen Hau tells MobiHealthNews will be made in the next few weeks. “We will likely be inputting the data into an EHR which we will integrate on behalf of Resolute,” Hau says.

Healthbox launches accelerator class in Nashville

By: Aditi Pai | Jul 10, 2013        

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healthbox_CEO_Nina_NashifThis week, Healthbox launched a new accelerator program in partnership with BlueCross BlueShield in Nashville, Tennessee. Other Healthbox locations include Chicago, Boston, London and most recently, Jacksonville, Florida. Healthbox typically partners with the local Blue health plan in each of its locations.

Nashville, home to 31 hospitals and more than 250 healthcare companies is “the Silicon Valley of healthcare,” according to Healthbox Founder and CEO Nina Nashif. In 2011, Nashville’s venture capital community invested $104 million in healthcare services and HIT startups. The accelerator also partnered with the Nashville Healthcare Council, an initiative of the Nashville Area Chamber of Commerce to establish Nashville’s position as the nation’s healthcare industry capital. According to the Nashville Healthcare Council, in 2008, one in eight Nashville workers were employed by a healthcare provider.

In April, Healthbox announced a program in Jacksonville, Florida, sponsored by Florida Blue that will begin July 24.

Regardless of location, every Healthbox startup in the class participates in a 16-week program and receives $50,000 to fund development over the course of the program.

Nashif told MobiHealthNews in April that Healthbox has a strong focus on supporting its companies by building relationships with local industry players.

A few months ago, an additional two accelerators launched on the east coast, The Iron Yard in upstate South Carolina and Tigerlabs Health in Princeton, New Jersey. Like Healthbox’s targeted locations, Tigerlabs Health used their location to their advantage, touting New Jersey’s proximity to major pharmaceutical companies.

The application process for Nashville will continue until August 4th, and the program will start September 9th.


Azumio integrates its apps into Argus, an all-day tracker

By: Jonah Comstock | Jul 10, 2013        

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MobiHealthNewsPalo Alto-based Azumio, makers of the popular Instant Heart Rate app and a number of other mobile health apps, launched a new free app called Argus, which aggregates readings from many of Azumio’s other apps as well as including built-in tracking for food, sleep, and activity. Unlike most of Azumio’s apps, which are available for Apple and Android, Argus is currently available on iPhone only.

“We experimented with a lot of things in the last few years,” Peter Kuhar, the CTO and co-founder of Azumio, told MobiHealthNews. “We reached a lot of different user segments that didn’t, in a lot of cases, overlap a lot. So this is sort of a framework to guide users to what they want. It’s not just another app, it’s a whole service, a smart engine we’re building in the background. In the future, it’ll be the only health app you need.”

The interface of the app, which runs continuously in the background of an iPhone, is a honeycomb-like timeline. The user can pull in modules when they exercise, eat something, sleep, or even drink a cup of coffee. Certain things are recorded automatically, like movement and use of other Azumio apps, but most currently have to be entered manually. Users can enter goals about food, sleep, and exercise as well.

The most robust buit-in tracker in Argos is the activity tracker, which uses the phone’s GPS and accelerometer, to do all-day tracking without the need for a connected hardware device, much like ProtoGeo’s Moves app. To save power, the app uses the phone’s accelerometer to track movement most of the time. When it detects the user is traveling a certain speed, it registers a run on the timeline and switches to the GPS to track the run more accurately. If the GPS says that the user is staying in place while the accelerometer says they’re running, the app will conclude that the user is on a treadmill and deactivate the GPS again.

“This was developed for quite some time, frankly, and we have compared it to everything that’s out in the market,” Kuhar told MobiHealthNews. “The accuracy, I can say, is in most cases better than all the other devices out there. You have your phone always with you and it’s not something you forget.”

Argus also connects with a few devices at present: wristworn heart rate and step trackers LifeTrak and New Balance LifeTRNR, as well as Withings connected weight scale. Kuhar said the company is looking into integrating with other trackers like Jawbone UP, Fitbit, and Nike+ FuelBand.

The tracking for food is more rudimentary — the user can take a picture of their food with the phone’s camera and select the food group that it’s in.

“It helps for people who just want to think twice before they eat,” said Kuhar. “Some users want to add more information and track exact calories, so we might add that in. But we also don’t want it to be too automatic. We want users to be in the app.”

Similarly, the app can track sleep on its own or through Azumio’s Sleep Time app, but if the user doesn’t have Sleep Time, they must manually enter when they go to sleep and and when they wake up.

Kuhar said that many of Azumio’s apps, like HealthyCloud, which had some similar functionality to Argus, are gradually being phased out. Their most popular apps — Instant Fitness, Instant Fitness Family, Sleep Time, Fitness Buddy and Instant Heart Rate — will remain available and most are already incorporated into Argus. The exception is Glucose Buddy, a workout app which the company acquired along with developer SkyHealth last year. Kuhar said that because Glucose Buddy has its own database and servers it will take a longer time to incorporate into Argus. Correction: An earlier version of this article suggested that Fitness Buddy was not integrated with Argus. It is.

When Azumio acquired SkyHealth, the company spoke about developing a mobile health and fitness platform. Argus looks to be the culmination of that plan and an apparent move away from more medical-related apps like HealthyCloud and Glucose Buddy, into a fitness and wellness focus.

“The future of bringing mobile health applications to a wider audience is here, and starts by creating a single source for the best mobile health and fitness solutions,” SkyHealth CEO Tom Xu said at the time. “Now, with Azumio, we have the resources and experience to create a mobile health and fitness platform that will impact hundreds of millions of consumers.”

San Francisco hospice launches app to educate, assist doctors

By: Jonah Comstock | Jul 9, 2013        

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Hospice by the BaySan Francisco-based Hospice by the Bay, the second oldest hospice care facility in the nation, has introduced an app to help physicians refer patients to end of life care.

“If you look at the overall population, the eligible population of Medicare patients, only about 50 percent of those eligible ever get hospice care for a lot of reasons,” David Zwicky, director of business strategy at Hospice by the Bay, told MobiHealthNews. “So there’s a lot of education that needs to happen for both the general public and the ‘medical public,’ if you will. Anything we can do to get the information out there is a good thing.”

The app, which is available for free from the Apple AppStore and the Google Play store, provides doctors with several different tools to help them treat patients who may be reaching the end of their life. Hospice by the Bay developed the app in partnership with iReferDR, a developer that’s created similar apps for other hospices in the past.

The Centers for Medicare and Medicaid Services (CMS) will reimburse patients for six months of hospice care. Because of this, CMS has released guidelines, called “local coverage determinations”, to help doctors determine when patients are in their last six months of life based on the patient’s symptoms. The app organizes all those guidelines by condition so doctors can easily access them.

Physicians can also see the hospice’s drug formulary, which might not be familiar to them because hospice facilities use much larger dosages of certain medications like morphine and opiates than most care providers.

The app also includes educational materials to help physicians feel more comfortable with hospice care, including a video about how to have the hospice care conversation with a patient or family, bios of Hospice by the Bay’s medical directors, and links out to articles about the benefits of hospice and palliative care.

“That’s often a barrier, because it’s a very difficult conversation to have,” Zwicky said. “Our medical directors do this day in and day out, and we thought it would be good to give that advice to a clinician.”

Finally, the app allows doctors to hit the “Refer Now” button and either call the hospice on the phone or fill out a form on the app to submit a written referral. Physicians can lock in information about themselves that they might enter over and over again, or they can use the phone number for a consultation, Zwicky said.

Zwicky said it was too early to share download numbers, since they only released the app last week. The facility intends to reach out to physicians via direct mail and advertising to encourage them to download and use the app. He said Hospice by the Bay is also considering taking the app beyond the hospital.

“One of the things we’ve talked about is whether or not we need to do something similar for the general public,” he said. “It would be a little different in nature, more educational. And I’m not sure how we would get people to download it. But we’re talking about it.”

Zwicky said the current app could help people get into hospice sooner, which could improve the end of their life. Despite that Medicare will cover six months of hospice care, Zwicky said, “the average length of stay is about 60 days, and the median is down around 20. So there’s a huge gap in terms of benefit coverage between what’s out there and what people are taking advantage of.”