The Supreme Court’s hypothetical mobile phone mandate

By: Brian Dolan | Mar 29, 2012        

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Brian Dolan, Editor, MobiHealthNewsQuick note: Be sure to tune in to today’s complimentary MobiHealthNews webinar, Meaningful Uses for Mobile, for a discussion on how two of the biggest topics in healthcare today intersect: Meaningful Use and mobile health. We’ll kick things off at 2PM ET. Complimentary Registration right here.

While the Supreme Court has been hearing the case for and against the individual mandate for health insurance this week, we had no plans to cover the arguments since they had little to do with this publication’s mandate. That changed on Tuesday when Chief Justice John Roberts suggested that if the government can require individuals to buy health insurance, it could use similar reasoning to require individuals to buy a mobile phone.

Here’s how the Chief Justice made his case, according to the transcript from Tuesday’s proceedings:

CHIEF JUSTICE ROBERTS: Well, the same, it seems to me, would be true say for the market in emergency services: police, fire, ambulance, roadside assistance, whatever. You don’t know when you’re going to need it; you’re not sure that you will. But the same is true for health care. You don’t know if you’re going to need a heart transplant or if you ever will. So there is a market there. To — in some extent, we all participate in it. So can the government require you to buy a cell phone because that would facilitate responding when you need emergency services? You can just dial 911 no matter where you are?

GENERAL VERRILLI: No, Mr. Chief Justice. think that’s different. It’s — We — I don’t think we think of that as a market. This is a market. This is market regulation. And in addition, you have a situation in this market not only where people enter involuntarily as to when they enter and won’t be able to control what they need when they enter but when they –

CHIEF JUSTICE ROBERTS: It seems to me that’s the same as in my hypothetical. You don’t know when you’re going to need police assistance. You can’t predict the extent to emergency response that you’ll need. But when you do, and the government provides it.

Whether or not this hypothetical sways you or seems irrelevant to the federal health insurance mandate, by making this argument the Supreme Court Justice called attention to the essence of mobile health. Immediate access to emergency services is the tip of the ice berg for mobile health services, which are increasingly expanding to include anytime, anywhere access to a variety of necessary health information and services.

While the suggestion of a mobile phone mandate was certainly intended to be provocative, it’s worth pointing out that the government already provides mobile phones to people in need. Far from a mandate, but recognition of the device’s importance. The Lifeline program now benefits millions of people who must meet federal low-income guidelines or qualify social service programs like food stamps or Medicaid. A 2009 report in the New York Times referred to it as “a form of wireless welfare that puts a societal stamp on the central role played by the mobile device.”

Roberts obviously understands that central role.

Perhaps the outcome of the Supreme Court case will be that the federal government cannot mandate the purchase of health insurance. Perhaps not. But it is telling that — for the Supreme Court Chief Justice, anyway — the short list of necessary health-related services today includes a mobile phone subscription.

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Castlight Health takes cost, quality measures mobile

By: Brian Dolan | Mar 29, 2012        

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Castlight Mobile AppsThis week Castlight Health, which offers a personalized health care shopping platform that helps employees better understand the price of medical services and the quality of certain providers, has launched its first mobile app: Castlight Mobile is currently available as a native app for Apple iOS and Google Android devices users, but the company suggests BlackBerry users and others can access the platform through an optimized mobile site, too. The free apps are only available to employees at companies that already use Castlight’s healthcare costs platform.

While Castlight’s list of customers includes various self-insured employers, like financial services firms and biotech companies, the Castlight customers most excited about the app’s launch are those with employees who don’t tend to spend their day behind a computer screen, Ethan Prater, vice president of products at Castlight Health told MobiHealthNews in a recent interview. Retail store chains, grocery store chains, and mining companies are among the Castlight customers that have looked forward to Castlight Mobile, Prater said.

“These types of employees tend to over index as smartphone users than even some of the white collar workers that we serve,” Prater said. “While retail employees and grocery store employees may not sit behind a computer all day, they tend to spend most of their time in the break room on their smartphones.”

Prater noted that the app will make it easier for Castlight users to engage their primary care providers in discussions about costs and quality measures for specialists the PCP refers them to.

“We call this feature ‘check your referral’,” Prater said. “People don’t generally want to change their primary care physician since that is someone they trust. It’s not where the cost is, anyway. The cost is in downstream referrals like specialists. So we created this feature that enables users at the point of care… to very quickly look up and locate the specialist [the PCP recommends] using the app. Then, [the patient] can view that specialist’s cost and quality metrics and ask [their] provider: Is this the specialist we are talking about?”

Prater said the conversation can then turn to other option that the app calls the patient’s attention to and help start a conversation about higher quality and lower cost options for referrals.

“This is a very mobile-specific use case,” Prater said. “You’ll find that we designed this so it is extremely fast for someone to do that at the point of care.”

Castlight sources its quality metrics from a combination of public and private sources, including the HHS Health Data Initiative, Leapfrog, NCQA, and more recently state quality collaboratives like an organization called Minnesota Community Measurement. Castlight also leverages patient satisfaction data from companies like Vitals and Citysearch, which Prater said are important, complementary data sources for decision-making, but different from true quality measures.

The app also includes GPS-enabled provider look-up that flows into turn-by-turn directions to the facility. The app also offers a graphical explanation of the user’s personal plan status that helps user’s understand their deductibles since plans can be complex.

Almost all of the features offered on the desktop, online version of Castlight are present in the app except for one: Castlight found that beta users of the app didn’t see a need to be able to access past care claims to see how much an employer paid or the user paid for past care. Prater said that Castlight may add this feature in the future, but for now it’s one of the few features stripped out for those using the app.

Castlight was founded four years ago by Todd Park, Giovanni Colella, and Bryan Roberts. Park is now the US Federal CTO and former CTO of HHS. Colella previously co-founded Relay Health but is the current CEO of Castlight. Roberts is a partner at venture capital firm Venrock.

More on Castlight’s mobile app in the press release below: Keep reading>>

iSonea begins recruiting for pediatric asthma trial

By: Brian Dolan | Mar 28, 2012        

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iSonea Booth

iSonea showed off its wares at HIMSS in the Qualcomm Life booth. The Asthma Sense iPhone app pictured is not yet available in the AppStore.

iSonea, makers of the WheezoMeter, has begun recruiting for a post-market study of its asthma monitoring device for children under the age of 12 years old. The company aims to determine the device’s ability to accurately assess wheeze rate in a group of pediatric patients. The study is expected to include about 95 participants and will be based in Folsom, California, according to the clinical trial’s listing on clinicaltrials.gov.

iSonea’s core offering today is a medical device called the WheezoMeter, a point of care, handheld device that “analyzes 30 seconds of breath sounds using advanced signal processing algorithms to detect, quantify and objectively document the presence of wheeze and its extent,” according to iSonea’s website. The company is currently seeking an over-the-counter (OTC) status for the WheezoMeter from the FDA. Last month iSonea announced plans to leverage Qualcomm’s 2net platform for home health devices.

“Asthma impacts more than 7 million children in the United States, and the number of children expected to be diagnosed with this chronic condition continues to climb at alarming rates,” Dr. Jonathan Freudman, medical director for iSonea, stated in a company release. “This study is an important milestone for iSonea. In the pediatric asthma population, it is challenging to accurately monitor and manage asthma symptoms in patients using conventional techniques. The WheezoMeter has the potential to meet a critical unmet need for better, easy to use monitoring tools for young asthma patients.”

At the HIMSS event in February, iSonea demonstrated its device as part of the Qualcomm Life booth. While the company’s setup included an image of an iPhone app called Asthma Sense (pictured), the app is not yet available for download from Apple’s AppStore.

In the future, iSonea hopes to become hardware agnostic and create smartphone peripherals that work like its WheezoMeter today. Assuming the FDA grants the Wheezometer OTC status based on the bench validation study the company currently has underway, iSonea CEO Michael Thomas said the company plans to create smartphone-based versions of the medical device for iPhone, Android, and BlackBerry devices. Thomas told a journalist in Australia last year that since there were about half a billion smartphones sold the world over in the past year, and there are expected to be about 1 billion smartphones sold in 2015, the smartphone has become the most efficient way for iSonea to get its technology to the 300 million people worldwide who have asthma.

More on the clinical trial in the press release below: Keep reading>>

Rite Aid plays catch up with Rx refill app

By: Brian Dolan | Mar 28, 2012        

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Rite Aid iPhone appThis week Rite Aid launched smartphone apps for iPhone and Android device users that lets customers refill their prescriptions by scanning the medication bottle with their device’s camera. Walgreens launched a similar app in November 2010. CVS launched its first prescription refill app in July 2010, but it didn’t have the refill by scan feature. Walgreens just added medication adherence reminders and Rx transfer features this month.

Rite Aid’s prescription refill app also lets users refill prescriptions by entering the prescription number by keypad, transfer prescriptions from competing pharmacies (where allowed), and it also lets them sign up for text, email and phone alerts for its Rx Reminders service.

“We’ve seen traffic to our mobile-optimized website grow steadily as proof positive that our customers’ communication preferences are evolving,” John Learish, senior vice president, marketing at Rite Aid stated in a press release. “With this new app for Android and iPhone-powered devices, Rite Aid is ready to further engage customers when and how they choose to communicate, adding relevant services inside the app that increase the convenience and value we can offer.”

The app also includes a store locator that leverages the smartphone’s GPS to find nearby Rite Aid stores. Like similar apps from competitors, it also lets users filter by which locations have in-store clinics or other services.

Rite Aid has been more pioneering than its competition when it comes to telehealth: Last year the retail pharmacy chain announced a deal with Optum to connect its customers with Optum nurses and other providers via Optum’s videochat-enabled NowClinic service. The service is currently available in select parts of Pennsylvania and Michigan, according to Optum’s site.

For more on mobile health at retail clinics and other clinics, check out MobiHealthNews’ complimentary report: Mobile Health at the Clinic.

More on the new app in the press release below: Keep reading>>

US patient monitoring market worth $3.1B in 2011

By: Brian Dolan | Mar 28, 2012        

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Withings Blood PressureAccording to a new report from iData Research, the US patient monitoring market was worth more than $3.1 billion in 2011 and it is expected to approach $4.2 billion by 2018. The research firm points to a few key drivers of this growth: the rapid adoption of wireless ambulatory telemetry monitors, low acuity vital signs monitors, telehealth services for chronic condition management, and monitoring of cardiovascular implantable electronic devices. The firm also expects traditional monitoring products like multi-parameter vital signs monitoring, telemetry, fetal and neonatal monitoring, to continue to grow as they replace outdated systems.

The report comes just a few days after a similar report from GBI hit the wires: Earlier this week GBI predicted that the global patient monitoring devices market will hit $8 billion in 2017, up from $6.1 billion in 2010. The firm estimated the device market’s CAGR at about 4 percent for the next five years. Like iData, GBI pointed to advancements in wireless and sensor technologies as a key driver of the patient monitoring devices market.

iData also reported that physicians and clinicians are becoming more aware of remote monitoring of patients after discharge from the hospital. The firm also said that smartphone compatible monitoring products will drive sales for some corners of the market, including pulse oximetry and blood pressure monitoring. The benefits of a smartphone compatible monitoring device are: “convenience of monitoring, ease of use, familiar platform for smartphone users, new and exciting method for measuring blood pressure, and the ability to share and analyze results,” according to iData.

“The growing awareness of the benefits of remote monitoring, in addition to large purchases by the Department of Veterans Affairs has helped drive growth in the telehealth for the chronic conditions segment,” Dr. Kamran Zamanian, CEO of iData stated in a release. “By 2018, the US telehealth market is expected to more than double in value, with companies such as Honeywell, Bosch Healthcare and Cardiocom battling for market share.”

More in the release below: Keep reading>>

In mobile health, follow the money, not the hype

By: Neil Versel | Mar 28, 2012        

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Neil_Versel_LargeA recent article in the Baltimore Sun about a series of mobile health studies underway at Johns Hopkins University referenced a person familiar to many a MobiHealthNews reader: Susannah Fox, the healthcare research guru at the Pew Internet & American Life Project.

According to Fox, about 10 percent of U.S. adults who have cell phones – and nearly every adult in the country has one these days – had registered to use a mobile health app, a number nearly unchanged from a year ago. Many, Fox told the Sun, used the app only once, if they even tried it at all.

Granted, not every mobile phone user has a smartphone that can run third-party apps, but smartphone adoption continues to grow, so it might seem surprising that interest in health apps has reached a plateau at least for now. I, for one, was not surprised.

I’ve been saying for quite some time that direct-to-consumer health apps have limited appeal as long as they’re made for the same young, techie types who design them. And apparently I am not alone.

Earlier this month, The Atlantic ran a provocative story about why Silicon Valley has yet to design a good health app. “Homogenous teams of innovators make products for people just like them. And that’s a problem,” reads the subhead.

“Many great innovators build what they know, for whom they know,” the story says, noting that Mark Zuckerberg – or at least the Zuck depicted by Jesse Eisenberg in “The Social Network” – built the framework for Facebook because it helped him meet new people and “access the lives of the elite.” Obviously, there is a huge market for that sort of thing, and the scale of Facebook reflects that.

This model does not necessarily translate to healthcare, though. “[The] demographics of an audience of Lululemon wearers, yoga-practitioners, and vegans is a very different market segment than the obese, the chronically ill, and those with limited access to health education resources,” South Africa native Kanyi Maqubela writes in his Atlantic commentary. Keep reading>>