Instabeat builds heads up heart rate tracker for swimmers

By: Jonah Comstock | Apr 24, 2013        

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InstabeatMonitoring heart rate and calorie burn is helpful for any kind of athlete, but for one sport in particular, traditional wearable trackers won’t cut it: swimming. A Beirut, Lebanon-based startup called Instabeat is looking to fill that gap. Instabeat has been in development for two years, appearing at events like TED and CES in the meantime. The company has received seed funding and built a prototype, and is now launching a crowdfunding campaign on Indiegogo to go into production mode.

“Runners and bikers have all these cool devices to monitor their workout, but these simply won’t work for swimming,” Founder (and former professional swimmer) Hind Hobeika says in the company’s Indiegogo video. “This is why we created Instabeat.”

Rather than a wristband, chest strap, or belt clip, Instabeat is an eyepiece that clips on to a pair of swimming goggles. This allows it to measure heart rate from the temporal artery on the side of the face, using an optical sensor. Motion sensors in the device also track calories burned, laps, breathing pattern, flip turns, all read from motion sensors that are built into the device alongside the optical heart rate sensor.

But it also allows the technology to incorporate a heads up display (HUD), so swimmers can actually assess whether their heart rate is in their target range while in the water. The heads-up display is pretty basic — it displays one of three colors that correspond to target zones: blue for fat burning, green for fitness, and red for “maximum performance”. To see the rest of their data, users can connect the device via USB to a computer and see a more informationally rich dashboard. If the company hits $100,000 in funding (its goal is $35,000) the team says it will add Bluetooth syncing for iPhone and Android phones.

“We wanted a device that would appeal to all swimmers, fit well on different head shapes and sizes, and be compatible with different goggle brands. The design had to be completely waterproof, unobtrusive, durable, lightweight, and hydrodynamic,” designer Marylise Andreos says in the video.

Of the activity trackers on the market, only Misfit Shine and Amiigo really market themselves to swimmers, both in a wrist-worn form factor. Other trackers claim to be waterproof when worn in the shower or caught in the rain, but makers don’t recommend that users swim in them.

Wearable heads up displays are still virtually nonexistent in the fitness tracking world, perhaps because it’s easy enough for a runner or biker to glance at a wristworn device mid-workout. A swimmer, on the other hand, doesn’t have that option. Even so, by providing realtime biofeedback, heads up displays have a lot of potential to optimize workouts in any sport, and will be an obvious use case for Google Glass. Now that its developer API is released, it’s hard to imagine that device makers like Fitbit and app-makers like Runkeeper won’t jump at the chance to build a Glass-based HUD. Another Indiegogo project, the SMART cycling helmet, which has now surpassed its funding goals, wants to include a HUD in future iterations.

Instabeat expects to sell the devices for $149, a little steeper than most trackers for runners or cyclists, but not by much. At five days in, the campaign has raised just over $12,000.

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Managing business risk in mobile health: Part 1

By: admin | Apr 24, 2013        

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Bradley Merrill ThompsonBy Bradley Merrill Thompson

Some technology companies are sitting on the sidelines, or just dipping their toes in the mHealth waters, out of fear of the unknown. Will FDA regulate this space? If we get into healthcare, will we get sued if someone breaks a finger nail using our app? Will the FTC come after us if we don’t have a bunch of clinical trials to support every claim we make? Will a patient come after us if personal health information somehow gets into the wrong hands? What about the company’s reputation if something goes wrong? And don’t get me started if your product triggers Medicare reimbursement. In many ways, the healthcare field seems scary at first, just based on the headlines we all read concerning regulatory and legal landmines.

Equally troubling, some technology companies are diving in without understanding the risks or having a plan to mitigate them. Indeed some just seem to be in a state of denial, as if not thinking about these issues makes them go away. Something akin to don’t ask, don’t tell. Others figure that as long as they don’t intend any harm, nothing bad can happen to them.

Both approaches are equally misguided. Instead of those approaches, I suggest you deal with the risk–understand and address it. This isn’t rocket science. I promise you can handle this, and make money doing so if your idea is good.

I am not going to do a treatise and describe all of the obscure legal and regulatory risks. If you like reading statutes and regulations, you’re in the wrong place. I’m not even going to paraphrase the law most of the time. My goal is simply to give you practical guidelines for how to navigate these uncertain waters.

I’m also not going to cover the myriad of legal and regulatory risks including product liability, HIPAA compliance, fraud and abuse, and the FTC. Instead I’m going to focus on FDA, partly because it’s representative of the other risks, and partly because it’s the area I know best. If your product doesn’t work well and someone gets hurt, you will have to both deal with FDA and face product liability.

A technology company new to the potentially regulated mHealth space needs to start by understanding: (1) the regulatory risk– its sources, nature, magnitude and likelihood and then (2) more importantly, the primary risk mitigation strategies– how to avoid getting in trouble with FDA. I’m calling the second topic risk mitigation probably just because I’m a lawyer; most people would refer to it as best business practices. It also has elements of strategic planning, in that you can think of it as considering all of the possible threats, and also looking at the possible opportunities.

At its heart, FDA regulatory risk is fairly intuitive because you only need to remember one thing: it’s all about putting the patient first. Every FDA requirement can be explained by reference to what’s necessary to protect the patient. And that includes protecting the patient from misleading information, not just physical harm.

To make this more manageable, I thought in part one I would address the regulatory risk, and save the mitigation strategies for part two to be published soon.

Root Cause of Regulatory Risk

I’ve been doing this stuff nearly 30 years, and it’s been my observation that companies get in trouble for one of three reasons: Keep reading>>

CrowdMed gets $1.1M to crowdsource diagnosis

By: Jonah Comstock | Apr 23, 2013        

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Prediction markets have been used to predict everything from Oscar winning films and box office trends to the outcome of presidential elections, often with impressive accuracy. Now a new startup called CrowdMed aims to use a prediction market in healthcare. The Y Combinator-backed startup just raised $1.1 million in seed funding to use “the wisdom of crowds” to give diagnostic suggestions to patients with obscure or baffling medical conditions.

The theory of a prediction market is that when a large enough population bets real or fake money on predictions in a system similar to a stock exchange, their bets will reflect their confidence and, in aggregate, will create a robust predictive model. CrowdMed founder Jared Heyman worked with predictive markets in his last job at market research firm Infosurv. He also watched his sister live for three years with a potentially fatal disease that her doctors couldn’t figure out. Putting those two experiences together, he decided to build CrowdMed.

“Prediction markets are very good at extracting the right knowledge from the right people,” Heyman told MobiHealthNews. “There’s lots of reasons for this. You can look as prediction markets as a simple voting system. If you feel very confident, you will express that confidence to us by how much you’re willing to bet. They have something to lose by getting it wrong and something to gain by getting it right. By asking people to put their money where their mouth is, we’re really getting a sense of peoples’ confidence.”

CrowdMedLike many predictive markets in the United States, CrowdMed uses a virtual currency. However, according to Heyman, users will be able to trade in their points for real-money donations to charities. On the CrowdMed platform, which has recently moved from a private to a public beta, users can sign up to be either a patient or a medical detective (or “MD” on the site.) Patients give CrowdMed all the information they have about their medical quandary: symptoms, family history, and test results. Those cases are de-identified and presented to the MDs, who can suggest a diagnosis or bet on the diagnoses that have already been suggested. If their diagnosis proves correct, they make as much as they bet in the site’s virtual currency.

“We’re not assuming that you as a random person would be well-equipped to solve a particular case,” Heyman said. “But if we have a lot of people and a lot of cases, it’s not unlikely that someone in the crowd has a particular knowledge. Even though I’m not a doctor, if I was sitting next to someone on an airplane who had a very similar symptom set to my sister’s, I would say ‘I’m not a doctor, but you should look into what my sister had.’ So we’re trying to take that same phenomenon and add a lot more structure to it.”

Of course, CrowdMed doesn’t purport to replace doctors or offer diagnoses, only “diagnostic suggestions”.

“When I talk in terms of CrowdMed producing diagnoses, I’m talking about diagnostic suggestions for you to discuss with your doctor,” Heyman said. “We are simply trying to produce a short list of highly likely diagnostic possibilities. It’s up to your doctor to confirm the diganosis and prescribe treatment. Our job is to narrow the field from 8,000 possibilities down to the two or three that are the most likely.”

CrowdMed’s seed investors include NEA, Andreessen Horowitz, Greylock Partners, SV Angel (Ron Conway’s fund), and Y Combinator. Heyman said he decided to participate in Y-Combinator rather than in a health-specific incubator because he considers CrowdMed to be as much a consumer web company as a healthcare company.

Following some press attention from their launch at TEDMED, the company is doing a second speed round to secure additional seed funding on top of the $1.1 million. The startup plans to use the money for continued product development and marketing. But Heyman said the platform has already worked to identify 20 different real-life conditions that were previously solved and confirmed, though often only after many years and dozens of doctors. Heyman says the biggest challenge right now is recruiting medical detectives to participate in large enough numbers to make the platform truly and reliably effective.

Sense4Baby raises $4M, hires new CEO

By: Jonah Comstock | Apr 23, 2013        

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image002Sense4Baby, the fetal monitoring system that was the first startup to spin off from the West Health Institute, has raised $4 million from the West Health Investment Fund. The startup also appointed Dr. Jessica Grossman, an obstetrician/gynecologist who has been serving as medical director of Ethicon Endo-Surgery, a Johnson and Johnson medical device company, as president and CEO.

Some or all of the funding was likely raised when Sense4Baby spun off from West Health in September of 2012. At the time, the company received an undisclosed investment from its progenitor, described as a “significant funding commitment,” and became the first company in West Health’s incubator.

Sense4Baby markets a wireless fetal monitor that straps onto a pregnant woman’s belly and transmits data about both maternal and fetal heart rates as well as monitoring contractions. It sends the information via Bluetooth to a smartphone or tablet which can then upload it to a secure cloud. It’s been developed for use in high-risk pregnancies.

West first announced the Sense4Baby technology as a prototype in November 2010. In January 2012, West partnered with the Carlos Slim Health Institute to study the impact of the technology in the state of Yucatan in Mexico.

Grossman has worked with several startup medical device companies in the past 10 years. She served as founder, president and member of the board of directors at Gynesonics, an early stage medical device company focused on minimally invasive solutions for women’s health. Gynesonics raised more than $20 million in venture capital financing and invented and helped develop the first intrauterine, ultrasound-guided radiofrequency ablation device for fibroid tumors. She has also been an investor herself, investing in Hygeia Personal Care Products, according to AngelList.

Grossman trained as an OB-GYN at Pennsylvania hospital and has her MD from Thomas Jefferson University. She did research at Beth Israel Deaconess Medical Center in Boston. She is also a board member for two nonprofits: the American United Nations Population Fund and Medicines 360.

“Dr. Grossman’s medical and professional experience will help guide Sense4Baby’s clinical and commercial success,” Nicholas Valeriani, chairman of the board of Sense4Baby and chief executive officer of the West Health Institute, said in a statement. “Sense4Baby demonstrates how West Health’s family of entities can work together to help lower the cost of health care. The company licensed a technology invented at the Institute for the public good, is housed at the West Health Incubator and received capital from the Investment Fund with the ultimate goal of bringing a new, cost-lowering and patient-centered technology to market.”

Sense4Baby’s wireless monitoring technology is still pending FDA clearance.

Cigna taps MDLive for remote patient consults

By: Brian Dolan | Apr 23, 2013        

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MDLive CignaCigna announced a deal with telehealth provider MDLive to offer some of its health plan members access to online video, telephone or email consultations with physicians. The plan members would have access to the 2,200 internal medicine, family practice and pediatric physicians that MDLive has on-call in states around the country.

MDLive CEO Randy Parker told MobiHealthNews that the focus of the deal with Cigna is on the health insurance company’s self-insured employers customer group. Cigna members’ whose employer opts to offer MDLive’s services to their employees will have access to the services beginning in 2014. Cigna plans to begin marketing the offering to that group this June.

The eligible Cigna health plan members can use MDLive either by scheduling an appointment or requesting a consultation right away. MDLive says the average wait time is about 11 minutes and the user is notified that the doctor is ready to connect by both text message and email notifications.

Of course, these remote consultations are only for non-emergency medical issues, including colds, the flu, rashes, sinus issues or headaches for children and adults. The video demo of the Cigna-MDLive service also showed an option for scheduling an appointment with a “Therapist”, so mental health services may be included or just around the corner.

While the consultations can be simple phone conversations or email exchanges, Parker said that the video consultations through MDLive work on computers as well as through iPhones, iPads, and Android devices — all via a secure, HIPAA-compliant connection. Parker said his company has noticed a recent uptick in usage among both MDLive physicians and patients using iPads to conduct remote consultations.

Parker also stressed that while MDLive is an alternative for late night emergency room visits when the issue is not an emergency, MDLive aims to make the consultation that takes place between its physicians and patients easily transferrable to that patient’s primary care provider to ensure continuity of care. Parker said that continuity of care is often not maintained when patients go to the ER.

“Whatever takes place during an MDLive visit is captured and transferred securely to the patient’s primary care provider,” Parker said. “It’s all worth noting that we are the 411 not the 911 and MDLive does not replace the need to go the doctor, but we find that more than 70 percent of the patients who go to the ER could have avoided that visit or at least resolved their problems through a solution and a platform like MDLive.”

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

By: Brian Dolan | Apr 23, 2013        

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Google’s former Chief Health Strategist Roni Zeiger MD and Gilles Frydman, founder of the Association of Cancer Online Resources (ACOR), announced the launch of Smart Patients, a new online community for cancer patients and caregivers, at the TEDMED event in Washington DC last week.

“What we are primarily trying to do is help cancer patients and caregivers learn more effectively from each other,” Zeiger told MobiHealthNews in an interview before his talk at TEDMED. “It turns out when people get sick or their loved ones do, within a couple of months they become quite expert in their illness and they are really motivated to help each other. That is a part of healthcare that we haven’t really tapped into. We want that to happen more and we want the rest of the healthcare system to learn more from patients so that they can do a better job — whether that’s healthcare providers or pharma companies. There is an opportunity for us to learn more from and with patients.”

Smart Patients

Screenshot of Smart Patients' "Conversation Feed"

Smart Patients has been operating in closed beta for a few months with a group of invitation-only members. As of last week it is now open to all cancer patients and caregivers who can join the free site to search for clinical trials, discuss clinical trials, and start and follow conversations related to their disease. The site has re-architected the clinicaltrials.gov database to make it easier to search for and find relevant trials for cancer patients.

“We use clinicaltrials.gov everyday and appreciate it, but it is not very good.” Zeiger said. “This is not something we planned to do initially but… we ended up building a next generation search engine for clinical trials with intuitive design and organized with filter option — just like the kind of search you find at Kayak.com or Yelp.”

As part of Zeiger’s job at Google he, of course, spent a lot of time considering how Google might improve search results for health-related queries.

“When I was focusing on search at Google it became clear that for the more severe and rare side of medicine, which most cancers fall into, the static web pages that you can find through search often aren’t enough,” Zeiger said. “They are good for the initial one or two pager but when you need more information, specifically how this applies to my particular context, that’s when learning from others who have particular expertise becomes really important.”

Apart from finding clinical trials, Smart Patients community members can start conversations on any topic of interest and tag those threads with keywords that others can then follow. Since patients will be able to follow both specific conversations they find interesting and keyword tags, which could be commonly used by people with different types of cancer, Zeiger believes one benefit of the platform will be knowledge sharing and community building between patients who have different types of cancer. One feature that early users have requested but is not yet implemented is the ability to follow other people on Smart Patients.

Zeiger said the business model of Smart Patients is to work with partners, including pharma companies, and share with them anonymous insights and data from the communities. It has no plans to add advertising or marketing.

“For example, we might share a report about what issue lung cancer patients are most interested in over the last quarter,” Zeiger said. “We also do voluntary surveys. One example is to give feedback about a draft design of a clinical trial that might be presented to patients as a summary of the trial or maybe share specific aspects of a trial that a client might want feedback on.”

At launch, Smart Patients announced partnerships with The Bonnie J. Addario Lung Cancer Foundation, Cancer Commons, and WorldOne Interactive (which owns physician social network Sermo now). The company also announced that it is working with Oncosec Medical, which will look to include patient feedback from the Smart Patients community on the design of upcoming clinical trials for its skin cancer treatments.

“One of the lessons that personal health records [taught us] is that the question should not be ‘What should a PHR look like?'” Zeiger said. “The question should be what do real patients actually need?  I’m not sure what the PHR term means, I think it means different things to different people. One thing I think we need to do as an industry is get better at healthcare products. We need to get better at user-centered design and begin with users’ needs and build from there and not necessarily build what the industry thinks patients need.”