FDA small survey: Hospitals eye patient tracking

By: Chris Gullo | Nov 7, 2011        

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Awarepoint real-time dashboardA small FDA survey of nine hospitals found that the most popular use cases for RFID (radio frequency identification) technology are infusion pumps, portable monitors, wheelchairs, beds, and ventilators. Eight of the nine hospitals surveyed use RFID or RTLS (real time location services) technologies. These hospitals are part of the FDA’s Center for Devices and Radiological Health (CDRH) MedSun network, which aims to identify and solve problems in primary care hospitals and healthcare facilities related to medical device use.

According to the survey summary, the FDA wanted to learn how RFID and RTLS systems operated in a hospital with various medical devices, including their usage, planning and deployment, location within the hospital, and whether there was interference between the systems and other medical devices.

Interestingly, “several” of the respondents expressed interest in patient tracking services: “Some reasons include tracking patients who may be confused or have a brain injury and also for tracking patients in the Emergency Department to avoid delays with x-rays and lab testing,” the press release stated. “Two facilities are using RFID/RTLS technology to protect infants from abduction with a system that alarms when infants are taken outside of certain locations. In contrast, some respondents know that management and employee unions have concerns with implementing these types of systems. Additional comments relate to hospital cultures that are not ready to implement ‘tagging patients’ at this time.”

Other insights from the survey include:

  • Most of the hospitals use RFID technology throughout the entire facility.
  • Most do not use RFID devices to track medications or other pharmacy products. (One respondent’s facility uses bar codes for medication administration, and another expressed interest in using RFID to track expiration dates of medications.)
  • Times for transmitting information from the readers range from every millisecond to once every 10 minutes.
  • Minimal interference issues were reported using the devices.

Overall reaction to using RFID or RTLS was positive, and some respondents reported improved patient care.

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Read the FDA summary here.

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Pages, text messages both fall short for medical alerts

By: Chris Gullo | Nov 5, 2011        

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amcomPagers for healthcare are going the way of the dodo, according to middleware healthcare device maker Amcom. MobiHealthNews recently spoke to Amcom president Chris Heim and mobile product manager Brian Edds about their company’s place in the evolving mHealth industry.

“When it comes to medical devices, input devices [oximeters, blood pressure monitors, glucometers, etc.] and output devices [smartphones, tablets] are getting more complex,” said Heim.”There’s a divergent universe of options. Housekeeping still might have a pager, nurses carry WiFi phones, doctors have smartphones… and you have to find a way to communicate between them all.”

Once doctors began adopting smartphones (now adoption has reached some 80 percent of MDs in the US), they quickly started using SMS as a way of communicating with other doctors and staff because of its speed and ease of use compared to older methods.

TigerText president and co-founder Brad Brooks recently stated that more than 70 percent of US physicians use text messages to discuss cases and exchange patient information with other physicians. Brooks made the comments during an online presentation last month.

“SMS is quick and simple, but not secure,” Heim said. “It might not necessarily get to the correct doctor or the correct device… and it offers no accountability.”

To combat that, Amcom’s Mobile Connect logs every message sent and delivered. Doctors receiving urgent messages get notifications on platforms like Android, BlackBerry, and iOS. With this month’s release of iOS5, Heim says alerts are even more efficient.

“With iOS5 [the notifications] are better now,” he said. “You can see them organized by app, so users will see [the app name] AMC (Amcom Mobile Connect). It’s much easier to differentiate.” The Amcom app notifies users with a loud ringtone, and continues to alert every 30 seconds the doctor doesn’t respond, for up to 5 minutes.

“There’s a shift now from messaging to communications — physicians want conversations, not pages,” Heim said. With so many physicians caring for the same patient — the average is about nine doctors contributing to the care of the average patient — “patients want their doctors to to be able to talk to each other, not a chart.”

In September, Amcom’s Commtech messenger middleware received FDA clearance as a Class II medical device. Following the MDDS rule clarifications, it was clear to Amcom that its middleware now required clearance, based on the revised medical device regulations that published last February.

Paging giant USA Mobility acquired Amcom back in March for $163 million. The company said the acquisition would help “modernize” USA Mobility’s messaging offerings, which are mostly paging systems. Despite the move by USA Mobility, not everyone believes that paging needs any more “modernization”. Some in the pager industry don’t feel that smartphones will ever fully replace pagers: Ted McNaught, president of paging carrier Critical Alert Systems, wrote an op-ed piece for MobiHealthNews in August that argued the cellular networks that smartphones run on and the devices themselves were not reliable enough to handle important healthcare messages and alerts.

Edds says that smartphone and tablets can be just as reliable as pagers, but there will be a long transition period.

“There’s going to be [pagers] for a long, long, time… but they are declining in healthcare. When it was introduced, paging was simple. Everything came from a single source: one company offered both the hardware and network via a pager tower placed on top of a hospital building. But there are downsides,” said Edds. “There is limited functionality, and you can’t really respond to people.”

Edds contends that though cellular signals have problems, like dead spots, the use of multiple networks, cellular in a combination with WiFi, helps protect against those dropout issues by providing redundancy.

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Jawbone launches Fitbit-like UP wristband

By: Chris Gullo | Nov 4, 2011        

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jawbone-up-lowres-001Bluetooth headset maker Jawbone released Jawbone UP this week, a continuously-worn wristband sensor that tracks daily activity and sleep patterns. The device retails for $99.99 and is available starting November 6 at retailers including Target, Apple Stores, and Best Buy.

The UP band’s sensors track steps walked, pace, calories burned, and active versus inactive time. Its sleep sensor tracks phases of sleep, hours slept, overall sleep quality, and includes a smart alarm, which are most but not all of the metrics tracked by the best known sleep management device, Zeo.

“As the global health crisis mounted, we felt a strong sense of responsibility to see if we could leverage our resources, talents, and ecosystem to try and help make a difference,” stated Hosain Rahman, Jawbone founder and CEO, in a press release. “UP is Jawbone’s first step in giving people tools to become engaged as consumers of their own health. It’s a complete system designed to integrate seamlessly into one’s total lifestyle, 24 hours a day, not just the few times a week people may work out.”

The collected data integrates with the UP App, a free download for iOS devices, which shows the user’s daily sleep and activity data, and includes a “Lifeline” that maps the data across a timeline. The app’s “food activity” metric is based on photos the user snaps of their meals. The app also locates where the user is eating and asks how the food affected them to tracks patterns in eating habits over time. The food feature sounds vaguely similar to Massive Health’s The Eatery app, which launched at the beginning of this week.

When the UP band was announced this summer, Rahman said that “it seems like a big departure [for the company], but once we start talking about the things it takes to make this whole category work, we get into things like making it tiny, having a long battery life, making it fashionable, making it waterproof, working with smart phones, having a rich, visual experience on your smart phone and making it social.”

Those social aspects include a team community feature, where members join teams of friends to motivate or compete against other teams, seeing their activity in a ‘news feed’ within the app, and health challenges. Health challenges can be competitive or collaborative and can be created by users or taken from health professionals and organizations, including DailyFeats, Healthier Generation, 24 Hour Fitness, and GE Healthyimagination.

“We think the magnitude of this health epidemic requires an entire community to affect real change and we are delighted to partner with leading innovators. There are so many great folks working on so many great ideas that we created our system as an open platform enabling health experts to connect with individuals in fun, engaging ways that have never been possible before,” continued Rahman. “We want users to find programs and challenges created by experts that are just right for them.”

Jawbone’s UP has a number of competitors, including BodyMedia, Basis, Nike+, and DirectLife. Based on the details provided in the launch release, it seems it’s most similar competitor is Fitbit, which offers much of the same functionality and tracks similar metrics.

The UP band is available November 6th for $99.99 in seven colors (Dark Black, Dark Brown, Dark Red, Bright White, Bright Silver, Bright Red, Bright Blue) and in small, medium, and large sizes.

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Read the press release below. Keep reading>>

Lessons learned about effective health apps

By: Brian Dolan | Nov 3, 2011        

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iPad medicalWhat makes a health app effective? How should we determine an app’s efficacy or effectiveness? While these have long been questions put forth in mobile health discussions, answers have finally become more substantial.

Join MobiHealthNews and two other healthcare industry thought leaders for a complimentary webinar focused on the world of health and medical apps. We will present exclusive findings from our recent apps reports, which include an analysis of health and fitness apps published during the past three years.

What does the world of health-related apps look like today? How do the most effective health apps engaging users? Which apps have failed to get traction? Why? We’ll explore these questions and many more.

We’ll also hear from one leading health application developer who believes that health apps must be tethered to the healthcare system to be effective. Mobile communication platforms and the apps that run on them now enable an entirely new approach to reaching patients beyond the walls of a hospital or clinic. These emerging apps connect with legacy networks and systems to provide entirely new approaches to keeping people well at very low costs.

Bring your questions for a lively Q&A period to follow the presentations. Tune in Thursday, November 17th at 2PM EDT. Complimentary Registration Here!

No, health sensing clothes aren’t heading to AT&T stores

By: Brian Dolan | Nov 3, 2011        

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Brian Dolan, Editor, MobiHealthNewsLast Friday Forbes wrote that AT&T Stores plan to start selling “clothes that track the wearer’s heart rate, body temperature and other vital signs” similar to the health monitoring clothing that the NFL used to evaluate potential players earlier this year. While it may be true that AT&T may have plans to — some day — add cellular connectivity to clothes for health tracking clothing, the mobile operator told MobiHealthNews that it has no plans to sell them in its stores.

In June AT&T announced that it was working to embed cellular connectivity in Zephyr Technology’s physiological Bioharness monitor device, which currently offers Bluetooth connectivity, but as of today a cellular-enabled version of the monitor is not yet available. Zephyr worked with Under Armour to create the E39 health sensing shirts that the Forbes article refers to, but those aren’t cellular enabled yet either — also Bluetooth.

The Forbes article was based on an interview with Glenn Lurie, who is president of AT&T’s Emerging Devices division. Lurie seemed to be speculating about future devices the carrier may support — perhaps some were in the near term — and  Forbes characterized health sensing clothes as the devices that were “next up” for AT&T sales channels.

“I can see where the Forbes piece is a bit confusing,” an AT&T spokesperson told MobiHealthNews in an email. “Glenn’s point was that we are looking at all kinds of opportunities, including clothing that offers trackable technology. We are not saying we’ll be selling this in our stores (though that’s easy to infer from [Forbes writer Elizabeth] Woyke’s language), rather, we will be looking to sell connections for these devices.”

Unfortunately, the story that spread from the Forbes article was just the opposite. Headlines from other publications that picked up the story: “AT&T plans to sell clothes that track your vital signs wirelessly.” “AT&T to sell connected clothing.” “AT&T to Begin Selling Clothing with Embedded Wireless Health Sensors.” “AT&T diversifies portfolio with E39 shirt.” There’s more and they are all untrue.

My favorite reference to this story came from a post over at the New York Times blog this morning. In a story called “Could ‘Smart’ Textiles Prove Toxic?” the NYTimes wrote: “Asked about the potential recycling of AT&T’s ‘bio-tracking clothes,’ a company spokeswoman, Dawn Benton, wrote, ‘At this point in time we don’t have a comment or insight on this topic.’”

That’s probably because no such clothes exist yet.

Might AT&T stores one day sell cellular-enabled clothing? Perhaps. It’s definitely not the type of device that’s “next up” for AT&T Store shelves though.

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CHIME focus group shows fine line between security and usability

By: Neil Versel | Nov 3, 2011        

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Neil VerselYou know something has caught on in health IT when healthcare CIOs start talking about it. And when vendors are willing to shell out big bucks to hear hospital-based IT administrators share their opinions on it. By that measure, mobile access to hospital networks is very much a mainstream idea now.

I come to this conclusion after sitting in on a Compuware focus group with a baker’s dozen of CIOs at last week’s College of Healthcare Information Management Executives (CHIME) Fall CIO Forum.

Compuware executives convened the panel to help them make R&D investment decisions in healthcare, based on three areas of discussion: how CIOs are addressing the mobile user experience; what poor user experience costs health systems in terms of lost productivity and low adoption rates; and what CIOs consider important elements of user “dashboards” on both fixed and mobile devices.

This was just the second year CHIME allowed media to observe the previously off-limits focus groups, and not all vendors consented. Journalists like myself were bound by strict rules. We could report on the general concepts discussed, but specifics about technology and the CIOs’ opinions were strictly off the record. Nor were we allowed to identify or directly quote individual participants unless they were willing to talk one-on-one after the session.

The idea is that vendors spend a lot of money for 90-minute blocks of time with health IT leaders so they can have frank discussions about strategic concepts, many of which are still be considered confidential. Having reporters around kind of defeats that purpose, unless we’re given a gag order in advance. (If you want something to be off the record, tell me up front. Otherwise, it’s fair game.)

So, what did I find? CIOs are having a lot of growing pains with mobility. No surprise there. Unlike pretty much every other form of technology in a hospital, lots of mobile devices network administrators are being asked to support actually belong to the users. Employees and medical staff are bringing in their own smartphones and tablets, then demanding on-the-go access to institutional systems.

As the Compuware discussion noted, clinicians expect a “Google experience” out of EHRs, meaning a fast response. But network capacity, particularly of the wireless variety, is being stretched, lessening the user experience. This leads to reduced clinician productivity, lower satisfaction and, ultimately, resistance to EHR adoption and lower “meaningful use” bonus payments.

“We’re hearing that there’s a gap in service because [smartphones and tablets] are personal devices,” Michael Wilson, senior IT director for clinical services at Compuware, told me at the end of the session. And Detroit-based Compuware is sharpening its healthcare focus around application performance, or what the company calls “end-user experience management.”

The general consensus in the focus group was that mobile devices don’t quite deliver the optimal user experience. For example, physicians are often inconvenienced by the iTunes App store. Last month, millions of iPhone and iPad owners had to reinstall all of their apps after downloading the new Apple iOS version 5. In healthcare settings, guess who all the docs turned to for tech support?

(The desire among CIOs to get a better handle on app management has been driving the nascent trend of private healthcare app stores.)

Some CIOs also complained that health IT vendors might be working a bit too hard to produce software in native mobile format that they neglect security. With tighter HIPAA restrictions and increased penalties for breaches since the HITECH Act in 2009, this could be a fatal flaw. But it’s vital information for companies to have as they walk the delicate line between security and usability. Those who strike the right balance will be richly rewarded.

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