Startup converts massive medical text to interactive iPad form

By: Neil Versel | Jan 31, 2012        

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Harrisons iPad App TourSan Francisco-based startup Inkling has introduced an interactive, custom-built iPad version of a popular medical school textbook that could not be properly rendered on a typical e-reader.

Harrison’s Principles of Internal Medicine, published by McGraw-Hill, is a 4,400-page title in print. The iPad version adds interactive animations and other multimedia elements – enough digital content to fill 57 additional chapters – including more than five hours of instructional video.

Inkling CEO Matt MacInnis tells MobiHealthNews that Amazon.com’s Kindle, Barnes and Noble’s Kobo and other popular e-readers really have no facility for handling tables and multimedia. For that matter, many e-reader apps are not well-suited for interactive medical content because the information has to be verified for accuracy.

Typically when a publisher prepares a novel for an e-reader, a computer merely dumps the text and formatting into a template, the process that takes a matter of seconds. But with medical texts, someone needs to curate the content to assure everything is correct. “If the dosage is wrong, I can’t blame it on Kindle,” MacInnis says.

Inkling has built a digital publishing platform for what MacInnis calls “difficult” topics, such as science and medicine, just for this purpose. “People on our team had to sit there and curate all of the content from the ground up,” MacInnis says.

But the payoff is rich content and fast information retrieval. “[People] can search all 4,400 pages in a second,” MacInnis says. Users can even search inside of video content and inside of animated guided tours, he adds.

Inkling also offers digital content for preclinical medical education, but MacInnis says that Harrison’s Principles of Internal Medicine is by far the largest project the company, which is a little more than two years old, has done to date.

Right now, the platform is only available for Apple’s iPad, though MacInnis says Inkling plans to expand to other operating systems.

View a demo of the iPad version of Harrison’s Principles of Internal Medicine here.

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Study: Diagnostic imaging on iPads twice as slow

By: Brian Dolan | Jan 31, 2012        

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OsiriX HD iOS

OsiriX HD App for iOS

A study from the University of Maryland found that radiologists using iPad 2s to evaluate patients for tuberculosis (TB) took twice as long to make a diagnosis as they did when using a 27-inch LCD monitor. Still, the study of 200 negative and 40 positive TB cases that included five radiologists, found the two displays to yield no significant differences when it came to diagnostic decisions.

Those diagnostic imaging applications that have secured FDA clearance, like Mobile MIM or Calgary Scientific’s ResolutionMD, are cleared to be used when a traditional, larger display is not immediately available.

This study used OsiriX HD viewing software for the iPad 2s and OsiriX viewing software on a 27-inch iMac monitor. Medical student Samir Abboud presented the research at the RSNA meeting in Chicago last year, according to the report in AuntMinnie.com.

The researchers randomly selected the 200 negative cases and 40 positive cases from a database of more than 500, which had been originally interpreted by a chest fellowship-trained attending radiologist. The DICOM images were loaded into a viewer in random order and two chest fellowship-trained attending physicians, two chest fellows, and on fourth year resident characterized the images as positive or negative.

Regardless of the display, the study found agreement among the five readers was statistically equal. Only two cases did not have agreement: One was called positive on iPad but negative on the larger display, and the second disagreement had it the other way around.

Be sure to read all the details in the AuntMinnie.com report here (registration required)

Aetna’s dentists get iPads to help patients stop smoking

By: Brian Dolan | Jan 31, 2012        

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iPad 2Aetna is set to begin a trial program that equips New York City-area dentists with iPads to help them better educate their patients about tobacco use in an effort to curb smoking. The trial program includes a clinical decision support system (CDSS) that is built on a medical knowledge base, patient data, and decision support technology that provides dentists with personally targeted advice for each patient.

The trial is still in its earliest stages: Aetna is working with Columbia University to design and implement the program.

Dr. David Albert DDS, Director of the Division of Community Health at the Columbia University College of Dental Medicine in New York City, is the principal investigator for the study, which aims to determine how impactful such a CDSS system is on the patient population.

The study is called, “The Dental Tobacco Cessation iPad” and it still has undergo testing and modifications before it rolls out formally at five NYC dental offices.

“The program is designed as an innovative interface between patients and dentists and we anticipate that devices like the iPad can be used to break down barriers between clinicians’ and their patients,” said Dr. Albert. “We will evaluate if we are able to encourage and assist dentists to provide tobacco cessation advice and assistance for their patients who use tobacco products. Tobacco use poorly affects the mouth and teeth and the patient’s overall health. Helping patients to quit tobacco use is a goal that the US Public Health Service encourages all dentists to adopt.”

For more on Aetna’s iPad trial, read the press release below: Keep reading>>

Does Goldman Sachs think ZocDoc will IPO?

By: Brian Dolan | Jan 30, 2012        

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ZocDocThis week’s talk of the planned Facebook initial public offering got me thinking about a story from late last year: Which mobile health company is likely to IPO first? Some investors have already placed their bets.

At the end of November last year, investment bank and securities firm Goldman Sachs held a quiet, stealthy event that included presentations from about two dozen startups that the financial firm reportedly believes are likely IPO candidates in the future. The event is intended to help Goldman cozy up with these promising startups early on.

According to the list pieced together by TechCrunch, among those early-stage companies that received an invitation to the event there was only one health-focused company: ZocDoc, a physician and dentist appointment scheduling site and app.

Jawbone, which offered up the Jawbone UP fitness device last year (and promptly offered full refunds to early buyers because of bugs), also presented at the conference, but its core business is Bluetooth earpieces and speakers — not health devices.

ZocDoc allows patients to find nearby doctors who accept their insurance, then book appointments, via Android and iOS apps, as well as a web-based interface. The service is free for patients, while doctors pay a $250 monthly fee to fill open appointments.

Last year ZocDoc pulled in about $75 million from investors. In August DST Global injected $50 million into the company. A short month later Goldman Sachs itself made a $25 million strategic investment in ZocDoc, which boosted the company’s overall investment total to close to $100 million.

Given its $25 million investment, it’s no surprise Goldman picked ZocDoc to present in November.

For more on the Goldman Sachs event, read this TechCrunch post.

ONC: Health apps among big trends of 2012

By: Brian Dolan | Jan 30, 2012        

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ONC's Dr. Farzad MostashariLast week Dr. Farzad Mostashari, the National Coordinator for Health Information Technology at the US Department of Health and Human Services, penned a column on his top five health IT predictions for the year ahead. Not surprisingly, Mostashari expects consumers to use eHealth to get more involved in managing their own health.

“I believe this year we will see consumers and patients use information technology to become better informed about their health and more engaged with their own care than ever before,” Mostashari writes. “In large part, this will happen because it’s becoming easier for consumers to electronically access their own information. Personal health records are becoming easier to use as more data holders make it possible to download information through tools like Blue Button. Many health care providers are setting up patient portals which are directly connected to their EHRs. The Medicare and Medicaid EHR Incentive Programs already require providers to give patients access to their electronic health information, and I anticipate future stages will build on that notion. And the work that is being done on standards and interoperability will help make consumer access to their health information more seamless and more useful.”

Mostashari also noted his office’s push to encourage developers to create more meaningful health apps through its series of app challenges that it puts on through Health 2.0, which received a $6 million grant to conduct the challenges.

“In addition, developers are coming out with more apps for mobile devices that make it easier for consumers and patients to get information about different diseases and track their own health over time. Along those lines, several Beacon Communities have launched txt4health, a consumer engagement campaign that uses cell phone text messaging to deliver information about diabetes care and management,” Mostashari writes. “ONC will diligently keep encouraging the marketplace to develop mobile apps and other consumer-friendly platforms that get patients engaged by sponsoring challenges like the Healthy Apps Challenge. Once consumers start to see their own information, they will be more empowered to be partners in their own care and come to expect that providers will use health IT as a tool to help deliver high-quality care.”

Late last year the ONC’s Office of the Chief Privacy Officer announced that it was looking to “explore the attitudes and preferences of a diverse sample of consumers with respect to the communication of health related information on mobile phones and devices, including text messaging.”

Read Mostashari’s predictions in-full over at the government’s Health IT Buzz blog.

Glooko raises $3.5M to connect meters to phones

By: Brian Dolan | Jan 30, 2012        

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glookoGlooko, which offers a simple glucose monitoring logbook app and a cable that connects meters to iPhones, recently raised $3.5 million in its first round of funding, which was led by The Social+Capital Partnership, and included return backers Bill Campbell, Vint Cerf, Judy Estrin and Andy Hertzfeld, Venky Harinarayan, Russell Hirsch and Xtreme Labs, according to various reports. The Social+Capital Partnership’s founder and managing partner, Chamath Palihapitiya, has joined Glooko’s board of directors, too.

The startup was co-founded by the head of a similar project at Johnson & Johnson’s Lifescan division, which demonstrated an iPhone hooked up to a glucose meter via a cable way back in 2009. The prototype demonstrated on-stage at Apple’s World Wide Developers Conference that year never actually launched commercially.

Currently, Glooko offers just two simple products: A cable that connects seven of the more popular blood glucose meters to the iPhone and a free, simple companion iPhone logbook app that stores readings. Glooko has solved a simple connectivity problem but is moving slowly toward more regulated products: Developing apps that offered trend analysis or coaching would require FDA clearance and requisite quality assurance work. The company’s cable costs about $40 and is available on Amazon.

“Yes, our current paradigm is just a logbook,” Glooko Co-founder Anita Mathew told MobiHealthNews last year. “One differentiated piece is that we don’t have manual entry of blood glucose numbers. Those numbers are sucked out of the meter into [the app] via the cable,” she said. “Why do that and not just do what Glucose Buddy does? It’s a point of difference, for one, but also, if you talk to enough physicians out there, there is some skepticism among that group when a patient brings a hand written log book to them. They wonder, is it accurate enough? Did they forget to write down numbers? Or write 58 instead of 85? Or is it inaccurate because they could potentially make up numbers because they are afraid that their doctor is going to get upset with them?”

Glooko has 1,000 users now, according to statements made by Glooko executives to TechCrunch. Android versions of the app are in the works. The new funds will be used to develop apps and cords for other smartphone platforms. The money will also help the company market its wares to potential users.

Timed with the fundraising news, Glooko published a new version of its logbook app to the AppStore. The new version also includes support for Bayer’s glucose meter, the Breeze 2. The app also now includes a food database, a 30-day logbook, and availability in Canada.

FDA-cleared Telcare, a cellular-enabled meter, recently went on sale and Sanofi’s iPhone-enabled glucose meter, the iBGStar, which AgaMatrix developed, also recently received FDA clearance.