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.”

Smart diapers alert parents, detect disease

By: Aditi Pai | Jul 9, 2013        

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SmartDiaperAs the market for quantified self continues to grow with wearables like smart watches and apps that track diet and exercise, new mobile health technologies are cropping up with embedded sensors that track a baby’s health condition.

New York-based Pixie Scientific developed urine-tracking Smart Diapers. The diapers have a code on the bottom that will change colors after the baby pees. From there, parents need to scan the diaper with a companion app to log the information. While Smart Diapers tests for urinary tract infection, prolonged dehydration and developing kidney problems, it will also look for health patterns that will be visible after a few months of tracking. The website emphasizes that the product “is not to create another quantified self gadget, but to create a product that is unobtrusive in your daily life and only speaks up when there is reason to see a pediatrician or a specialist.”

Pixie Scientific just launched an Indiegogo crowdfunding campaign in order to begin manufacturing its product, conducting its first performance study and securing the FDA registration process. The study is set to take place at University of California San Francisco Benioff Children’s Hospital and will study the performance of Smart Diapers for monitoring children in pediatric intensive care.

According to a New York Times blog, founder Yaroslav Faybishenko said the diapers will cost 30 percent more than regular diapers.

This isn’t the only smart diaper to make headlines this year. In May, Huggies in Brazil announced TweetPee, the diaper will send tweets from a clip-on monitor to the companion app when it senses humidity so that parents will know when to change their baby’s diaper. The app also helps reminds parents when to buy more diapers. The product is currently just being tested and is expected to launch sometime this month. At the same time of the launch, Huggies will highlight the experiences of 10 moms and dads who use the app.

A few days ago, Immediate Media Company released a baby weaning app from parenting website MadeForMums in association with Heinz Baby.  The app features a week-by-week nutrition guide paired with recipes filtered by the age of the child. When a parent chooses a recipe, the information is sent to a shopping list for the parent’s convenience.

Irish startup creates Bluetooth stress sensor for biofeedback games

By: Jonah Comstock | Jul 9, 2013        

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PIP sensorGalvanic, a Dublin-based startup, has created a Bluetooth-enabled galvanic skin response sensor that’s also a game controller. The product, called the PIP sensor, is designed to help users learn to reduce their own stress through gamified biofeedback. The company is currently crowdfunding the device through Kickstarter.

UPDATE: Galvanic made their $100,000 funding goal, with 15 hours left in their campaign.

The PIP sensor is a small, wireless, handheld device that measures galvanic skin response, or skin conductivity, through the users’ fingertips and transmits that data to a mobile device via Bluetooth. The PIP sensor charges with a USB cord and has a battery life of about 8 hours.

Galvanic will be producing a standalone free app for quantified self enthusiasts that simply records and tracks stress levels. However, the company’s main focus has been on developing several games for Apple and Android phones and tablets that use the PIP sensor as the sole controller.

One game, Relax & Race, is a two player racing game where the speed of each player’s character (in the released screenshots, a pair of dragons) is determined by how relaxed they are, according to the PIP sensor. The company acknowledges that this is a little incongruous for gamers who are used to doing better at games when their adrenaline is flowing, or becoming stressed when they start to lose.

“The counter-intuitive way the PIP works is a powerful learning mechanism,” reads Galvanic’s Kickstarter page. “One of the great strengths of video games is that they allow the player to have fun, while performing the same task over and over again. By using games as the context for biofeedback, the user learns how to relax quickly, while having fun at the same time.”

Relax&RaceGalvanic has also developed a single-player game called The Loom, where the user lowering their stress level turns a landscape scene from winter to summer, and a film noir-themed party game called Lie Detective, which uses the PIP sensor as a lie detector.

The company plans to develop additional games and open up an SDK so anyone can create apps that use the sensor. The Cornell University design lab has already connected the PIP sensor to “mood lights” — special lamps that will adjust the lighting level in the room based on a user’s stress level.

Galvanic is currently just over halfway to its $100,000 Kickstarter goal. Via the campaign, backers can preorder a device and one game for $99 or a device and all three games for $109. The company plans to ship in the first quarter of 2014.

Galvanic skin response sensors have hit the market with various use cases in the past. Cambridge, Mass.-based Affectiva recently halted the production of its Q-Sensor, a wristworn device that used skin conductivity to predict the onset of seizures. In addition, BodyMedia and Basis Science both include galvanic skin response in the suite of sensors on their respective wearable devices. The US Department of Defense has also been developing apps, such as BioZen, that use various third-party sensors to do biofeedback and reduce stress.

Kaiser talks up monkey game, talks down EMR integration

By: Jonah Comstock | Jul 9, 2013        

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Kaiser Monkey BusinessWhen Kaiser Permanente debuted its Interchange platform API initiative last month, the company made it clear that they would not be feeding patient health information into third party apps or devices via APIs. While the health system has done notable research into incorporating things like exercise data into its EMR, it isn’t interested in integrating just any data stream. Kaiser Permanente’s Lead Innovation Designer Christine Folck recently spoke at the Games For Health conference in Boston, telling a group of developers what Kaiser Permanente is and isn’t looking for in health games and apps. Correction: An earlier version of this article stated inaccurately that Kaiser Permanente wasn’t interested in incorporating any data from apps and devices into its EMR. 

“Don’t come to us telling us you can upload [data] into our electronic medical record,” Folck said. “We don’t necessarily want it there. We have too much information in our electronic medical record. Kaiser Permanente was one of the first to go nationwide with our electronic medical record, we are fully integrated, but the problem is now everybody wants to upload into it. Our physicians don’t want it all there. They really don’t need to know how much exercise each of their patients is getting on a daily basis; they just don’t have time to process all of that.”

Folck also counseled developers against focusing on the the wrong platform for a given audience.

“We need to meet patients where they are at, so designing a game for an elderly patient for their smartphone isn’t going to help us, because they don’t have smartphones right now,” she said. “At least the majority don’t.”

Folck said Kaiser is interested in games that focus on healthcare niches that aren’t currently being addressed. For instance, she said the company has found plenty of good exercise apps and plenty of good nutrition apps, but hasn’t yet found a good app that does both.

As another example, Folck shared a project KP has been working on with software developer Vectorform, called Monkey Business. Monkey Business is an autism assessment tool that uses a Microsoft Kinect and an animated avatar (a monkey, naturally) to engage kids. She said the feedback from preliminary tests with the software has been positive.

The standard tests for autism today are carried out by a therapist who has to ask the child to answer a number of questions and perform actions.

“We find that with the current method, children at that age will not engage because they’re bored, whether they’re autistic or not,” Folck said. However, the monkey, which is controlled by a therapist using a separate controller, made all the difference. It instructs kids to perform the same actions, but in a gamified context. For instance, while the therapist in the traditional test would tell a child to jump, the monkey guides them in a game jumping from lily pad to lily pad.

“Even those that were severely autistic still engaged with the monkey,” she said. “Some of the feedback we got from the parents was that they wished they had the monkey at home to help their child make their bed or do things like that.”

Monkey Business is set to begin large-scale pilots soon, Folck said. She said Monkey Business was a smart game for Kaiser Permanente because it didn’t already exist in the market and it addressed a major pain point for their caregivers — in this case pediatric therapists. Finally, she said, the company is looking for partners with some clinical validation.

“KP always stands by doing medicine that is evidence-based and it’s the same way with our technologies and our games. We want technology and games that are evidence-based,” she said.

CVS adds OTC drug interaction checker to mobile app

By: Neil Versel | Jul 9, 2013        

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CVS Pharmacy AppRetail pharmacy heavyweight CVS Caremark has added a drug interaction checker to its CVS Mobile app that cautions consumers when an over-the-counter medication might interact with other drugs they are taking. The Woonsocket, RI-based company says it is the first drugstore chain to include such a feature in a mobile app.

With the new interaction checker, users can scan the barcodes on OTC medication packages with their phones or enter the name of the drug or an active ingredient to bring up a list of potential interactions. For those with a myCVS online account, the app automatically checks the OTC drug against the patient’s pharmacy history, which can be imported directly from CVS or manually populated to include other OTC medications and prescriptions filled through other pharmacies.

“This added level of guidance empowers users to make informed decisions,” CVS Chief Digital Officer Brian Tilzer told MobiHealthNews in an e-mail. “It’s important to point out that while this informational tool offers guidance, it’s not a replacement for counsel from a doctor or pharmacist.”

Like major competitors Walgreens and Rite Aid, CVS through its mobile app lets customers order refills by scanning the barcode of current prescriptions, though Walgreens was first in that regard. The CVS app also features a pill identifier to help people remember the names of their medications, as well as the ability to schedule immunization appointments at CVS pharmacies and locate stores with walk-in Minute Clinic operations.

“The combination of all of these innovative features makes it easier for our customers to take care of themselves and get access to important resources, right at their fingertips, no matter where they are,” Tilzer adds.

CVS Mobile is available for Apple iOS and Android. A separate CVS app for the iPad app features a “virtual pharmacy” that the company sees as somewhat experimental. “It’s not a normal app, it’s not a list of products. What we have is a digital rendering of a store. It’s not that we know this is the best way to interact with customers. We want to find out,” Tilzer explained at Mad*Pow’s Healthcare Experience Design Conference in March.

CVS Caremark has an additional app for members of pharmacy benefits manager Caremark.