Ambio raises $525K for home health monitoring

By: Jonah Comstock | Sep 10, 2013        

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ambioStamford, Connecticut-based Ambio Health, a company developing a low-cost platform for connecting home medical monitors, has raised a third angel round of $525,000. The money comes from mostly existing angels and one new investor, CEO Kevin Jones told MobiHealthNews. With its previous two raises, the company’s total funding comes to $2 million since the company was founded in 2011.

The Ambio Remote Health Monitoring system, which debuted at CES in January, received FDA 510(k) clearance in July. The system adds wireless capability to standard home health monitors and automates data collection. Jones told MobiHealthNews in July that the company’s wireless gateway system would sell for $19.99, as would each wireless connector, which plug into the USB ports of specific medical devices like Agamatrix’s Presto blood glucose monitor or Homedics’ BPA-060 blood pressure monitor.

Jones told MobiHealthNews that the funding, along with previous funding, will be used for product development, sales and marketing, and general operations.

When devices are connected to the Ambio system, they automatically log their readings and upload them to a secure, HIPAA-compliant web platform called the Ambio Care Portal. From there, readings can be viewed by family members, healthcare providers, and caregivers. In addition patients can set reminders for readings and medications, which can be delivered as phone calls, texts, or emails.

The platform is currently optimized for chronic disease patients, especially those with diabetes and hypertension, but upcoming products, including door and window sensors, will focus on supporting aging in place seniors.


Doro, Withings brings quantified self to seniors

By: Aditi Pai | Sep 10, 2013        

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Withings Smart Activity TrackerSweden-based Doro has announced a partnership with French device company Withings. Owners of Doro’s new smartphone, Liberto 810, will be able to get certain Withings products at a discount. The companies plan to bring a similar offering to the United States by as early as next year.

Doro, which specializes in making phones for seniors, aims to demonstrate that combined with an adapted smartphone, they will increase the acceptance and usage of Withings devices by seniors. The partnership currently includes two Withings devices, the Withings Smart Body Analyzer, a smart weight scale, and Withings Pulse Smart Activity Tracker.

According to Doro, the partnership with Withings is just beginning. Doro President and CEO Jérôme Arnaud told MobiHealthNews that he believes the company will build on their partnership and may create an app for the extended family. This app would help family members be aware of any irregularities in the user’s health.

“On the more private and particular level it is one of the most important preoccupations of the children to know how their parents’ health is, and ‘Is everything okay?'” Arnaud said.

He also acknowledged that there is a market for emergency response systems today and that using the Withings devices to keep track of the user’s heart rate and other vitals could eventually help “alert someone who is in a position to react in case something goes wrong”.

Doro already provides mPERS functionalities to some customers as part of its offerings.

Last November, Doro announced a partnership with Bosch Healthcare to expand Bosch’s European telehealth network to include a mobile phone-based component. Up until that point, Bosch’s telehealth offering in Europe had been in the home. Integration with Doro’s phones was done in order to allow seniors to be in touch with Bosche’s system even outside their homes. The mobile phones have an alarm button built in, which would contain GPS information, allowing Bosch to dispatch emergency response teams to the user’s location, even if they’re not able to speak or don’t know where they are.

WebMD’s revamped app is another step toward its longterm behavior change platform plans

By: Brian Dolan | Sep 10, 2013        

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WebMD iPhone appWith the launch of a revamped 4.0 version of its flagship app, WebMD has begun to execute on a strategy that Bill Pence, the company’s EVP and CTO, laid out for MobiHealthNews earlier this year. Based on my March discussion with Pence and a recent interview with Todd Zander, WebMD’s VP of Mobile and Emerging Media, the longterm vision for WebMD is to create an app and web experience that includes health trackers, educational materials, app prescription mechanisms for providers, a storefront that highlights and markets biometric devices, and a series of behavior change programs that support them.

This week’s relaunch of the WebMD app is but one baby step toward realizing that vision, but that step equips WebMD’s iPhone app with some important new features.

For one, the new WebMD app marks the first time the company has bridged its popular consumer-facing app with its also popular healthcare provider facing app, Medscape.

Physicians can now “prescribe” patient education materials to their patients by pushing that content to the patient’s phone. After getting their permission, the physician sends the patient a message with a link to a mobile-enabled website that features the educational material. Once loaded, that page invites visitors to download the WebMD app where they could also view (and save) the material for later viewing. Or, the patient can just view it on the mobile site and save the link for later viewing.

“This is going to be a long road,” Zander told MobiHealthNews. “We want to connect healthcare professional experiences on mobile with patient experiences on mobile and the first step is to allow doctors to prescribe educational materials to their patients from app to app. They will prescribe from their Medscape app patient education materials and the patient can access that from the WebMD web page or if they have the WebMD app then they can access it from the app.”

“Once we perfect that use case — and it is going to take some time — then you can start to think about all the other exciting things that doctors can prescribe patients,” he said. “You can also start to think about the kind of data that patients can send back to doctors in a very secure way.”

WebMD believes that because physicians are well known to be mobile savvy — they access health information from their phones all the time now — they are likely interested in giving that same experience to their patients.

“You can imagine all the future use cases of doctors prescribing devices, prescribing apps — there are all sorts of things that doctors could prescribe,” Zander said.

Zander also noted that the new WebMD app is more personalized for users. WebMD has launched chronic pain, pregnancy, and baby tracking apps over the course of the past year, and these apps have helped it understand how important personalization is. Apps that can be customized and tailored to the individual lead users to come back more, spend more time in the apps, and enter more information, Zander said. The new WebMD app asks users specific questions about themselves and their lifestyle goals, including Do you want to sleep more? Do you want reduced stress? Do you want to maintain a better work-life balance? The app also asks users which kinds of activities they are interested in pursuing to achieve some of these goals, including losing weight or exercising.

The app also refreshes daily so the content and healthy tips are updated, which Zander believes will help people open and use the app daily instead of just when they are sick or have a particular health-related question: “What we learned with our website and with the original WebMD app is that people look for healthy living information just as much as they look for condition specific information.”

Historically, WebMD’s business model has centered on advertising. That’s not likely to change any time soon, but the prospect of prescribing apps, devices, and offering behavior change programs in the future could open up new revenue streams for the company in the future.

“We generate revenue today predominantly on advertising,” Zander said. “There is a lot of opportunity to learn about our users on mobile. This is true for WebMD just as it is at other large publishers: We have been trying to learn about our users on mobile. What they are doing. Who they are. Prior to this launch we didn’t have a really robust, personalized experience. You could save drugs, save condition information, and other information like that, but we really didn’t know if you were trying to lose weight, trying to reduce stress, or what your goals were. What’s exciting now is we are starting to learn a lot about our users and what their goals are in life. I don’t have to know who that specific person is, of course, but I can know that I’ve got all these people who want to lose weight or these people who want to sleep better.”

The grouping is what’s important to the advertisers, not personally identifiable information, Zander explained.

“When you look at all these different audiences,” Zander said, “you are able to do some interesting things with advertising.”

ATA: Health systems discuss success with using telehealth to reduce admissions

By: Neil Versel | Sep 10, 2013        

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Erin Denholm

When applied to the right circumstances and with appropriate planning, remote monitoring can be highly effective at avoiding inpatient admissions and visits to the emergency room for patients with chronic diseases. As a bonus, investments in monitoring technologies and services often pay off quickly, attendees at the American Telemedicine Association’s Fall Forum heard Monday in Toronto.

If hospitals are losing money on readmissions due to Medicare’s two-year-old policy of not paying for certain preventable readmissions within 30 days of initial discharge, remote monitoring can produce a return on investment in the first year, said Erin Denholm, senior vice president for clinical transformation at Centura Health in Englewood, Colorado.

The 15-hospital system achieved its ROI from reducing the number of home visits by nurses and, as a bonus, has achieved greater patient satisfaction because patients with home monitoring technology feel like they have more “touches” with Centura than those not in the telehealth program, according to Denholm.

The results on the clinical side have been more impressive.

The Centura Health at Home network stems from a telehealth initiative begun in 2004 with one Colorado Springs hospital that was still on a capitated reimbursement model after HMOs fell out of favor, and long before “accountable care” entered the lexicon. The hospital wanted to cut ER visits and readmissions for congestive heart failure by 60 percent. By concentrating on Medicare Advantage enrollees who had had at least three ER visits in the prior six months, Centura saw a 90 percent drop-off in inpatient admissions. Nine years later, not one of the original monitoring group has ever come back to the ER for CHF-related symptoms, Denholm said.

Partners HealthCare in Boston has been running its Connected Cardiac Care program through the organization’s Center for Connected Health since 2003.

By monitoring the weight, blood pressure, oxygen saturation and symptoms of CHF patients with daily calls for two months at a time following hospital discharge, Partners has seen a two-thirds reduction in CHF readmissions and 58 percent reduction in all-cause readmissions in the year following program participation, according to Dr. Kamal Jethwani, corporate manager of research and innovation at the Center for Connected Health.

Now, home monitoring has become a standard of care for CHF, and Partners management is fully behind the program, Jethwani reported. Since Partners started requiring cardiologists to opt their patients out of the program within seven days of a discharge order, nonparticipation has fallen from 10 percent to 1 percent.

“Organizational commitment is very important,” Jethwani said via telepresence from Boston on an InTouch Health robot set up at the Sheraton Centre Toronto hotel. Otherwise, remote monitoring ends up being yet another silo, he explained.

Likewise, a remote monitoring program should concentrate on the right patients, added Doreen Salek, director of population management at Geisinger Health Plan, the Danville, Pa.-based managed care division of Geisinger Health System.

“You will get a return on investment if you are choosing the right patients,” Salek said, emphasizing that not every person with a given condition is worth supplying with technology and care management services. “It’s quality, not quantity.”

Geisinger has seen a 44 percent dip in CHF readmissions when high-risk patients have access to both case management and technology, either Bluetooth weight scales or interactive voice response to remind them to weigh themselves, Salek reported. The readmission rate is 20 percent lower with both components than with case management alone.

Eight ways the Microsoft Kinect will change healthcare

By: Jonah Comstock | Sep 10, 2013        

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Kinect_Report_cover_260We never really know where the next game-changing innovation will come from. The smartphone started out as just that — a smarter phone. But when Apple opened up its API to developers, that open source project started to unlock the true potential of a handheld, connected touchscreen computer. Nowadays, the ability to make a phone call might just be the least important thing your smartphone does for you.

In the next few years, we might be saying something similar about the Microsoft Kinect, which has a similarly open software development kit. What began as a video game controller is rapidly becoming much more, as developers turn the power of computerized gesture recognition onto a bevy of healthcare uses.

Today, MobiHealthNews launches “Kinect the Docs: How Microsoft’s video game technology is changing healthcare,” a 30-page report on the impact of the technology on the healthcare space. In it, we discuss eight different ways people are already looking into using the Kinect to help people lead healthier lives. Here they are in brief. To get the full report, check out MobiHealthNews’s research store.

1. Fitness and Exergaming

The hands-free, full body control scheme of the Kinect makes it ideal for creating video games that get people active and moving. In addition, the Kinect’s camera can watch you move and record your movements, so it can give feedback on how much you’re moving or whether you’re doing a particular exercise correctly. The gamification possibilities for that kind of instant feedback are extensive, and research work by groups like the Mayo Clinic has shown that exergaming works for seniors as well as younger people.

2. Physical Therapy

The same feedback functionality makes the Kinect an ideal tool for at-home and in-clinic physical therapy. MobiHealthNews wrote about seven startups working in Kinect-based physical therapy in May, including West Health spin-off Reflexion Health and former game developer Respondesign. Many of those startups are now in clinical trials or even launched and working with patients.

3. Surgery Support

One of the very first healthcare use cases attempted even before Microsoft opened up the Kinect SDK was to allow surgeons to access medical imagery like X-rays without scrubbing out or having to work through an assistant. With gesture-based controls, surgeons can not only interact with static medical imagery onscreen, but can even refer to a live-feed from a flouroscopy camera. A Canadian company called GestSure is already deploying the technology in a handful of hospitals.

4. Autism Screening and Therapy

MobiHealthNews recently wrote about a project in development from Kaiser Permanente, using a Kinect game to screen young children for autism spectrum disorders. A study at the University of Minnesota also used Kinect sensors, deployed passively in a nursery, to scope out telltale signs of the condition. And autism centers like the Lakeside Center for Autism in Issaquah, Washington have found the technology just as useful for working with children who are already diagnosed.

5. Virtual Visits and Virtual Nurses is using the Kinect as an advanced video camera for virtual consultations. The company hopes to reduce the resources hospitals need to commit to following up with chronic disease patients, while still reducing readmissions. The key to that cost saving is a virtual nurse, an avatar that uses Kinect gesture recognition and Nuance voice recognition to communicate with patients just like a human doctor.

6. Virtual Group Therapy

Group therapy can be helpful in the treatment of conditions like alcoholism and PTSD, but people sometimes have a hard time opening themselves up even to strangers. Using the Kinect, groups of patients could meet up virtually and truly anonymously, represented by avatars who would share their voice and body language but without an identifiable face. This technology hasn’t really been realized, but both Microsoft itself and the Pentagon have expressed interest in it.

7. Aging in Place and Fall Prevention

Could a passive Kinect sensor in an elderly person’s home analyze their gait and deliver an early warning about an increase risk of falling? That’s what one startup, Atlas5D is trying to find out. So is a team at the University of Missouri, with backing from the NIH and the NSF. Fall prevention is one of the most elusive goals in mobile health, but the Kinect has shown some promise in tackling it.

8. Helping the Blind to Navigate and the Deaf to Communicate

Researchers have demonstrated the potential of the Kinect to both guide a blind person through a building, and to translate from sign language to text and speech in near-real time. One uses the camera’s ability to detect 3D objects while the other uses the software’s ability to track human hand movements. Both are far from commercialization, but they demonstrate the extraordinary potential of the technology.

Head over to the MobiHealthNews research store to pick up your copy of “Kinect the Docs: How Microsoft’s video game technology is changing healthcare.”

Asthmapolis, now Propeller, moves beyond asthma

By: Jonah Comstock | Sep 10, 2013        

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Propeller_RespiratoryManagementPlatformAsthmapolis, the Madison-Wisconsin based smart inhaler company, is changing its name as it moves beyond both asthma treatment and GPS mapping. The company’s rebranding as Propeller Health will correspond with a broadening of its offerings to include chronic obstructive pulmonary disease, or COPD, a lung condition similar to asthma except more likely to afflict an older population.

“From a commercial standpoint, there’s just so much overlap between what we’re doing with asthma and what we need to be doing with COPD that it just has made sense in our customers’ eyes, so in part we’re reacting to that market demand,” David Van Sickle, CEO of Propeller Health, told MobiHealthNews.

The name change will coincide with a relaunch of the Asthmapolis app, now called Propeller Health, on the Google Play store and App Store (although only available to patients who are signed up via their health plan or care provider). The new version of the app will have a reworked interface allowing both COPD and asthma patients to make use of it, but will work with the company’s existing FDA-cleared sensor. The company will be launching COPD-specific inhaler sensors later on, pending regulatory clearance.

Van Sickle said the approach to COPD is less about geographic mapping, because environment is less of a factor in COPD exacerbations than in asthma attacks. Instead, the focus is on adherence and early warning.

“We know that by getting people more adherent to those we can reduce the rate of exacerbation by about 20 percent,” he said. “And then the second thing is monitoring the use of those inhaled drugs that are taken in response to a worsening. You can get four to five days of advance warning of someone who’s worsening and about to show up in the emergency room. There’s just a lot they can do in those four to five days to intervene medically, to hopefully avert the hospitalization or at the very least shorten the length of stay that might result.”

In addition, Van Sickle said the GPS functionality could be helpful psychologically, assuring COPD patients, via anonymized data, that they are not alone in their disease.

“People with chronic diseases can often feel isolated, especially in the case of older folks with COPD. So thinking about how we make people feel at least like they have peers that might be suffering similarly is also part of what we’re trying to accomplish,” he said.

Asthmapolis has been adopted by a number of providers since its 2010 launch, including Dignity Health in CaliforniaAmerigroup in Florida, and the City of Louisville. More recently, the platform has shown up at the Sharp Rees-Stealy Medical Centers in San Diego and as part of a trial with Qualcomm and Zephyr at Rady Children’s Hospital.

Alongside the rebranding announcement, Propeller Health reported that in these early trials, Asthmapolis has been shown to increase medication adherence by 80 percent.

“Early outcomes have been promising,” the company wrote in a press release. “In the last month, more than two-thirds of Propeller users with asthma were well-controlled or transitioned to well-controlled; by comparison, only 30-40 percent of the general population with asthma has their disease under control. In recent programs, up to 80 percent of patients with asthma remain engaged with Propeller three to six months after enrollment.”

The new name opens up Propeller to pursue a broad range of diseases, and Van Sickle says the company might move into other chronic respiratory diseases like cystic fibrosis as time goes on, and perhaps even move into other diseases.

“For the next year and even 2014, I see us focused on chronic respiratory disease. And we are thinking about that in a very broad sense, to potentially include cystic fibrosis, and we’re looking at the global opportunities and are pursuing international regulatory clearance for the system. So that’s a lot for us to take on in a year, but whether that ultimately plays out as the full breadth and mission of the company I can’t say at this point.”