12 mobile health stories from HIMSS

By: Brian Dolan | Feb 24, 2011        

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Brian Dolan, Editor, MobiHealthNewsA number of longtime HIMSS attendees, including my colleague Neil Versel, pointed out that this year’s event in Orlando, Fla. had renewed energy. The past two years’ events were more staid on account of the down economy. The magicians at vendor booths had less flourish, anyway.

Whether you are of the opinion that HIMSS has its mojo back, is tapping into a hype cycle or neither — what is undoubtedly true is that HIMSS has discovered mobile in a big way. As predicted by many, countless vendors demonstrated how potential customers could use tablets (overwhelmingly Apple’s iPad) and smartphones (still a good mix, but mostly iPhone and Android) to run new apps or legacy software.

I had the chance to sit down and discuss mobility in healthcare with a number of care providers, payors, vendors and even a handful of investors (yes, there’s more of them at HIMSS now, too).

Here’s a quick round-up of 12 mobile health-related news bulletins to come out of HIMSS this week. We’ll have more on some of these and other HIMSS stories in the coming days. A sampling of the mobile highlights at HIMSS: Keep reading>>

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WWHI forms group to standardize in-hospital wireless

By: Brian Dolan | Feb 24, 2011        

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Nox Medical“Assurance is the number one fear for new wireless sensor companies looking to work in the hospital environment,” Ed Cantwell, a new Senior Vice President at the West Wireless Health Institute, told MobiHealthNews in an interview on-site at the HIMSS event in Orlando, Fla. Cantwell said that the four principles of assurance are coverage, signal strength, capacity, and certainty.

“We continue to be focused aggressively on the question: How do we lower healthcare costs?” WWHI CEO Don Casey told MobiHealthNews. “One of the best ways a not-for-profit medical research organization can do that is to help create standards and protocols that can facilitate adoption of different parts of the mHealth ecosystem. We believe that once those are set up, established, and adopted, it will set off a flurry of innovation. With the virtual explosion of wireless medical devices used in hospitals, coupled with consumer oriented communications devices that have come into the hospital environment, we think we can play a role in creating a reliable utility-like resource. In order to do that we went out to find someone with the entrepreneurial zeal, expertise and practical bent of having actually executed these type projects to lead our initiaitive in this space.” That’s where Cantwell comes in.

Does the wireless network blanket the facility? Is the signal strength strong enough? Is there enough capacity? Will another wireless or connected device interfere with the new one?

“We believe that creating some standards and architectures that guarantee those four things would allow anyone — from GE Healthcare to Carefusion to Sotera Wireless — to develop with confidence that there will be an environment that will guarantee their devices and applications will work,” Casey said.

Cantwell is leading the not-for-profit institute’s initiative to help create these standard by forming a steering committee made up of hospital CIOs who have had success with wireless networking in their facilities as well as CIOs who haven’t yet along with CTOs, CMOs, wireless operator executives and regulators from the FCC and FDA.

“The platform of wireless health is the wild wild west right now,” Canwell said. “We need to turn it into a reliable, medical-grade wireless utility.”

Cantwell said the plan is to work with the steering committee, which is just being formed now, to formulate a reference architecture that is executable right away.

“Our objective is that by mid-year we will have a first version of the architecture,” he said.

Agile health app developers bring the heat in “Iron Programmer” challenge

By: Neil Versel | Feb 24, 2011        

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Everyone’s got a smartphone app, or so it seems, but sometimes the most useful mobile technology doesn’t come in app form.

That’s one of the key takeaways from a live demonstration of “agile programming” between two development teams at the first-ever HIT X.0: Beyond the Edge subconference Wednesday at the annual HIMSS conference in Orlando, Fla.

In the inaugural Iron Programmer Challenge — HIMSS’s answer to Iron Chef, complete with the theme music from the cooking show — the young duo from start-up mobile app developer HealthFinch threw down with HTML5 rather than an application programmer interface because it works on most any device with a Web browser. Their competitors, San Francisco online media professional Hunter Whitney and Washington, D.C., technology marketing specialist Douglas Naegele, went with a rudimentary but useful iPhone app.

The exercise was intended to demonstrate that programming doesn’t have to flow through a large, enterprise-wide system, according to session moderator Dr. Lyle Berkowitz, medical director of clinical information systems at Northwestern Memorial Physicians Group in Chicago and Director, Szollosi Healthcare Innovation Program (SHIP). Such a strategy can help vendors “build a recipe” for serving small but important needs of providers, Berkowitz said.

Both approaches were meant to save time and money in meeting the challenge, based on the “secret ingredient,” a form to allow physicians to send electronic “expect” notices to hospital emergency departments. This being programming and not cooking, the two teams learned that secret 2½ weeks ago, rather than at the start of the hour, à la Kitchen Stadium.

The common theme between the TV show and the HIMSS event is that the competitors had to move quickly and adjust to the twist thrown in by the “chairman.” Berkowitz asked the programmers to make modifications on the fly, with the audience voting on whether each should repurpose the form or change how messages are sent.

(Unfortunately, due to the smaller-than-expected turnout for the closing session of HIT X.0, Berkowitz didn’t ask attendees to choose a winner, as had been planned. Update: Berkowitz told MobiHealthNews in an email: “There was never any intention to name a winner on this one… the intent of the session was to explain what agile programming meant and to show some varying styles.”)

Naegele and Whitney quickly repurposed their form to make it suitable for a school infirmary, for example, to report sports injuries. HealthFinch co-founders Jonathan Baran and Ash Gupta tweaked their “ExpectER” program to output SMS text messages rather than make automated phone calls in a computerized voice.

Though Naegele and Whitney were slowed by Internet connectivity problems on the stage, both teams got the job done in a matter of minutes.

“The beauty of the agile approach is flexibility,” Gupta said.

“We love working in an agile environment. Organizations don’t,” added Baran.

Of course, getting organizational buy-in is a challenge in itself. One reason is that an agile strategy calls for users to accept an app early in the development process — the “first inning,” as Naegele described it — while typical software doesn’t make it to beta testers until more like the “seventh inning.” Seeing something so early could make it seem like the programmers don’t know what they’re doing, Naegele said.

Indeed, the apps on display were pretty simple, but that was as much because of the intended purpose as it was the agile strategy. According to Whitney, the ED is a hectic, distracting environment, so he and Naegele wanted to provide a minimum level of information to support better care for when an on-call doctor gets paged in the middle of the night.

Their app included just the patient’s name, date of birth, medication and allergy lists, past medical history, a clinical summary, the hospital name, the form of transportation and the method of notifying the ED. With the basic app in place, users later can opt for extra features, such as the ability to attach a digital photo to the “expect” notice, Whitney explained.

In agile programming, there’s a mantra: “Release early, iterate often and keep pace with reality,” Whitney said.

Egyptian mobile operators pilot Mobile Baby

By: Brian Dolan | Feb 23, 2011        

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GreatConnectionTwo mobile operators in Egypt, Orascom Telecom and Mobinil announced  a partnership with Great Connection to pilot the startup’s Mobile Baby service, which enables healthcare providers to send ultrasound images right to patients’ smartphones. Mobile Baby competes with paper print outs and DVDs and claims to cut down on the time and costs associated with providing expectant parents with a copy of their ultrasound images. The service also lets the patients share these images immediately with friends and family.

Great Connection explains the service in its recent press release: “Mobile Baby enables medical practitioners to send ultrasound images, video clips and 3D scans to and from referring physicians for remote medical diagnostics. The application works directly from ultrasound machines, with images delivered to any mobile phone via SMS, MMS and email.”

“Currently, the patient to doctor ratio in Egypt is 1 to 1,900,” Khaled Bichara, Group Chief Executive Officer, Orascom Telecom stated in the recent press release. ”This disparity makes it challenging for healthcare providers to meet the healthcare needs in Egypt’s rural regions, particularly pregnant women requiring pre-natal care. Mobile Baby is the first such service to be deployed in Egypt…” Bichara noted that Qualcomm is a partner in the pilot also. Qualcomm has helped introduce Great Connection to mobile operators around the world since the Swedish startup moved to San Diego early last year.

Great Connection noted in the press release that it plans to leverage its DICOM image transfer services in other areas beyond Mobile Baby.

More from the press release below. Keep reading>>

Healthcare to spend $4.5B on wireless data by 2014

By: Brian Dolan | Feb 23, 2011        

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Mobile Health Industry Revenues Predictions

(Click for more on which segments of mobile health these figures include.)

According to a report from In-Stat released this month, the healthcare industry in the United States will spend more than $4.5 billion on wireless data spending by 2014.

In-Stat lists a number of wireless health use cases as drivers of the increasing spend on wireless data: caregivers’ interest in access to patient data, coordinating care; validating patient identity; billing for services and preventing medical errors.

“Growing federal initiatives have increased the emphasis on digitizing records nationwide,” Greg Potter, a research analyst at In-Stat stated in a press release. “At the same time, disaster response and disease control increasingly require integration with governmental authorities. Add in an aging population, complex insurance company billing, patient identity protection, and drug theft and you have the perfect storm in the pursuit of a digital means to rein in personnel and asset management costs with a highly mobile medical workforce.”

In early 2010 CSMG made a similar prediction for wireless health revenues in the US market. However, CSMG’s market prediction included a wide range of services: monitoring, personal emergency response services (PERS), telemedicine, mobile medical equipment, mobile health information, RFID tracking and health/fitness software. CSMG predicted that revenues for those services to top $4.6 billion in the U.S. by 2014.

Another similar dollar amount appeared in a 2009 Parks Associates report. That firm predicted that the wireless home health market would be worth $4.4 billion by 2013. It’s a slightly different lens to view the industry through but it’s remarkable how similar the time frames and dollar amounts among these three reports.

More from In-Stat’s short press release below: Keep reading>>

McKesson Foundation awards $1.3M in mHealth research grants

By: Brian Dolan | Feb 22, 2011        

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Neal Sikka, GWU, Emergency Room Physician

Dr Neal Sikka, GWU

The McKesson Foundation announced the winners of six research grants it has awarded as part of its Mobilizing for Health initiative. The grants include $1.3 million in funds in total and each of the awardees will receive grants of around $250,000 for their mobile phone-enabled research project centered on diabetes management. The projects that the Foundation awarded make use of a range of mobile technologies and services, from text messaging (SMS) to “comprehensive” software programs.

Last year we interviewed Carrie Varoquiers, president of the McKesson Foundation, to learn more about the Mobilizing for Health grants program:

“[The McKesson Foundation] had been funding diabetes management programs at these clinics, and we continue to do that, but we realized that with our limited budget we were only touching 150 or 200 people at each clinic,” Varoquiers said. “If we were to invest in research in mHealth that helps to answer some of the unanswered questions around mHealth, we could potentially affect millions of patients. We realized that there was a great opportunity for us to help build the evidence base for positive health outcomes. I think there is a lot of potential in mHealth to positively affect patients’ lives, in particular low income patients’ lives.”

The six recipients of the grants include:

Drs Joshua Cohen and Neal Sikka of George Washington University received one of the grants to study the use of SMS messaging to reduce emergency department visits for people with diabetes. We mentioned Sikka last year for his innovative use of mobile phone cameras in emergency rooms.

Another physician at George Washington University, Dr Samir Patel received a $250,000 grant from the foundation for a study called “Enhancing diabetes and hypertension self-management: A randomized trial of a mobile phone strategy.”

Dr Lawrence Cheskin of Johns Hopkins Bloomberg School of Health will use the funds to conduct a weight control-centered study called “Tailored Rapid Interactive Mobile Messaging (TRIMM) for weight control among the underserved.”

Kevin Clauson, Pharm.D., of Nova Southeastern University will use the research grant to conduct a pilot study that assesses the impact of SMS (text messages) on medication adherence for Type 2 diabetes patients.

David Lindeman, MSW, Ph.D., of the Public Health Institute will conduct a study called “Patient-centered mHealth: New horizons in diabetes care at Family Health Centers of San Diego.

Finally, Drs Sanjay Arora, Michael Menchine, and Anne Peters, at the University of Southern California will use the funds to conduct a study called “Improving diabetes care for low-income Latino patients in the Los Angeles County healthcare system.”

Update: The Foundation has $1.5 million set aside for these grants, but award a little more than $1.3 million for these six projects.

For more on the grants, read the press release after the jump. Keep reading>>