Qualcomm Life launches 2net in Europe

By: Jonah Comstock | Nov 12, 2012        

Tags: | | | | | | |  |

Qualcomm InfographicJust under a year after it’s US launch, Qualcomm Life announced the expansion of its 2net wireless health platform in the European market.

Laurent Vandebrouk, managing director of Qualcomm Life Europe, told MobiHealthNews that some of Qualcomm Life’s medical device partners are already in the European market, and some partners in the US would like to expand into Europe.

Qualcomm’s 2net is a cloud-based telehealth system that connects a variety of third-party home health monitors to make biometric data easily available to doctors and care providers at a distance. There are four different ways to get data into the 2net platform, including the 2net Hub, an external device that receives and passes on data to doctors via Bluetooth, WiFi, or ANT+ radio. Since last year, the Qualcomm Life “ecosystem” in the U.S. has expanded to include more than 120 partners, customers, and collaborators at different stages of integration with the system.

Qualcomm officials said they have been envisioning a European launch for some time, with some U.S.-based users asking for the system to be internationally supported. On Thursday, Qualcomm Life Vice President Don Jones wrote a blog post about Europe’s ripeness for mobile health expansion, citing data that predicts the European mobile health market will be worth €5.3 billion in 2017.

Jones pointed to the 3 Million Lives project, a UK government initiative that implemented remote patient monitoring on a wide scale in England. Projects like that demonstrate a receptiveness to telehealth on the part of European governments, which will be exceptionally relevant to Qualcomm Life in light of the many government-based single-payer healthcare systems in Europe. That could make a big difference in how quickly next-generation remote monitoring technologies can get off the ground in Europe, since developers don’t have to sell providers on them one at a time. Jones told MobiHealthNews he expects larger deployments of remote monitoring in Europe, as opposed to the pattern of many smaller ones that’s been seen in the US.

Additionally, in Europe the regulatory process for medical devices is primarily focused on safety, Jones said; whereas FDA regulations are geared towards both safety and efficacy. Because of that, some devices hit the market in Europe before they’re cleared in the US.

“From that perspective, we may see some devices [connecting to Qualcomm Life’s platform in Europe] that are headed to the US, but aren’t here yet,” he said.

When Qualcomm announced the launch today at the International Telehealth and Telecare Conference, they also shared that two European companies have already signed on as new 2net partners. Telbios provides remote monitoring and chronic disease care in Italy. Cystelcom, a software development company, runs a service called mHealthAlert, which uses remote monitoring to reduce readmission rates for chronic disease patients. Cystelcom will also be partnered with Qualcomm, distributing 2net in the autonomous governments of Spain.

This summer, MobiHealthNews reported on the 2net SDK development challenge. While they were preparing to role out in Europe, Qualcomm Life was also announcing the winners of that contest last week. The company challenged software developers to create the next “killer health app” that would integrate a patient’s 2net data.

The $20,000 winner, Telsano, developed an online dashboard for tracking patient health. The second and third places went to MyHealthPoint and HealthHub, both patient interfaces that leverage 2net data.


Study: Virtual avatars improve fitness motivation

By: Jonah Comstock | Nov 8, 2012        

Tags: | | | | | | |  |

Screen Shot 2012-11-08 at 5.45.46 PMA common media narrative has it that screen time in front of TV and video games is a big contributor to inaction and obesity. But people following mobile health know that video games have the potential to impact fitness in a positive direction as well. In 2010, MobiHealthNews wrote about the potential for virtual avatars to improve fitness feedback. Now, a recent study from the University of Missouri shows support for these ideas, suggesting that social engagement with avatars can improve self-image and engagement in a health context.

Elizabeth Behm-Morawitz, study author and Assistant Professor of Communication at U of M, looked at self-reported data from 279 users of the game Second Life, where players create virtual avatars and interact in an online, social context with other players. She had participants report on how fit or idealized their avatar was and report their own height and weight.

“Taking on a different persona online can have real effects on your offline health when you’re embodying this avatar that you’ve created,” Behm-Morawitz told MobiHealthNews. “Oftentimes that physical or virtual embodiment is idealized in nature. And rather than having a negative impact on self-esteem, this was motivating.”

Behm-Morawitz found that in general, Second Life players used their avatars to test out new looks or styles in a low risk environment. She also believes the social nature of Second Life enhances the sense of identification users have with their avatar. Because it’s a medium through which they interact with others, she suggests, people are more prone to identify strongly with their avatar.

“For health-related behaviors (i.e. diet and exercise), the avatar may serve as a source of motivation or inspiration to take better care of the body offline,” Behm-Morawitz writes in the study. “Indeed, virtual world users who perceived their avatar to be more attractive than their offline self and representative of their ideal appearance were more likely to report avatar effects on offline appearance and health behaviors. Health and fitness providers may consider having clients use virtual worlds in conjunction with specific health-related education and wellness programs.”

Despite the press garnered by products like WiiFit, Behm-Morawitz suggests the potential for harnessing virtual play to improve health is largely unrealized.

“When your looking at something like WiiFit,” Behm-Morawitz told MobiHealthNews, “the avatar selection is rudimentary compared to something like Second Life.” She suggested that a successful pro-fitness game would need to incorporate a social element as well. For an avatar to be a really successful feedback mechanism, this study suggests it needs to be visible to others.

But the real market here might be expanding beyond the fitness buffs who already use health apps. This technology has the potential to engage a group of people, gamers, who often aren’t already invested in fitness.

“Even with the absence of a directed [health-related] presence online, the participants were still realizing a positive effect on their offline health,” Behm-Morawitz said. “And that’s sort of a different take.”

HealthCrowd promotes patient engagement through messaging

By: Jonah Comstock | Nov 8, 2012        

Tags: | | | |  |

Screen Shot 2012-11-08 at 11.17.27. AMThe recent Pew Internet Project study reported that only 9 percent of American adults use texting to get health updates, although 80 percent use text messaging. As app adoption stagnates, some start-ups, like California-based HealthCrowd, are hitching their wagon to mobile messaging, including text messaging, rather than apps, as the future of patient engagement.

“There are too many apps out there, and you don’t know which ones are any good,” HealthCrowd co-founder and CEO Neng Bing Doh told MobiHealthNews in a recent interview. “It’s too much work to find one, and then it’s more work to download it, and it’s more work to use it.”

HealthCrowd sells health-related messaging systems to health plans and care providers, which can use them for communications & outreach, chronic disease management, discharge follow-up, and behavioral health support. For instance, one HealthCrowd intervention for recovering alcoholics involved texting a person’s friends to remind them to congratulate him on a “sobriety birthday.”

The company’s team comes from a mix of health and engineering backgrounds; Bing spent five years in online advertising. She says the practices in that field inspired her to do health-related messaging in a new way: targeting and tailoring messages the way Google targets ads.

“What everybody else does today is they send text messages. They have a doctor or clinician write the text messages, and then they farm out these messages to the entire world and they expect people to respond to them,” Doh said. “For each action that we study, we’ve got thousands of different variations of the same message. … If you don’t find a way to touch someone, make them laugh, whatever it is, you won’t get them to respond.”

Bing says the demographic that engages the most with the messages isn’t quite who you’d expect.

“When people first hear about our solution they say it’s perfect for teenagers,” she said. “That’s not true and I’ll tell you why. They grew up on texting. It’s not novel, it’s not interesting. It’s how they communicate. You have to take it up a notch. You have to find a better way to reach out to them. But the older folks, text messaging is novel, they don’t get many texts.”

HealthCrowd’s approach seems to get results. For instance, Bing says preliminary results from a pilot study with a University of Iowa Hospitals and Clinics cardiac rehab program were promising. Compared to non-text message enrolled participants, four times as many HealthCrowd users showed up at a 3-month follow-up appointment and twice as many completed the 6-month program. The patients texted back to 30 to 40 percent of the messages they received.

According to Doh, the company’s business model, charging health care organizations per member per month, has worked well for the company so far, particularly working with Medicaid populations. There’s one other advantage to engagement via messaging –- it skirts the need for FDA clearance.

“We don’t diagnose, we don’t practice,” said Doh, noting that right now the service is opt-in for the customer, which alleviates some potential privacy concerns. “We use the power of messaging to reach people, to get them to do things.”

Doh compared HealthCrowd’s program to Bosch Healthcare’s Health Buddy product, which uses a specially-made device to deliver health messages. Doh says they do “exactly the same thing” — but cheaper, and without the need for a dedicated device.

Three years of stagnant health app adoption

By: Brian Dolan | Nov 8, 2012        

Tags: | | | | | | | |  |

Brian Dolan, Editor, MobiHealthNewsAs has been tradition for some time now, every year around this time the digital health community gets a wake up call. The Pew Internet & American Life Project published its latest report on mobile health this morning and while it is filled to the brim with helpful, encouraging statistics related to mobile health adoptions, buried deep within is an outright discouraging one. Health app adoption has remained flat.

Since 2010 about 10 percent of American adults with mobile phones have had some kind of app on their phone that helps them track or manage their health, according to Pew’s survey. While the figure presented in Pew’s reports has ticked up or down one percentage point this year and last year, it’s within the survey’s margin of error.

Pew’s Associate Director Susannah Fox told MobiHealthNews that this year’s survey has a bit more of a focus on smartphone users, which have about twice the adoption rate for health apps when compared to the general population. About 19 percent of smartphone users have some kind of health app that helps them track or manage their health.

Of course, not all of the consumer health-related apps available today explicitly help people to “track” or “manage” their health, some simply provide helpful tips or reference materials. Pew’s question seems to hit on more interactive apps. Fox said that’s for a reason.

“When we wrote that survey question back in 2010 it was about wanting to find out about people’s engagement,” Fox said. “The Pew Internet Research Project studies the social impact of the internet and back in the year 2000 it was very much about people’s changing relationship with information. As the Internet evolved our project evolved to study not only how people access information but how they engage with information as well as with each other and instutions. That was the context of writing that question. This comes to the point again where we can examine what a survey question is good for and what it is not good for. We write a survey question in the hopes that just the general population can understand what we are talking about.”

The question also specifically asks about a “health app” and does not explicitly include fitness as part of the question. Even Apple makes a distinction between the two as demonstrated by the name of its AppStore category Health & Fitness. Still, of the survey respondents who said they used a health app to track or manage their health, the largest cohort said they used a fitness tracking app. Did other fitness app users say “no” because they didn’t consider their running app a “health” app?

Pew’s surveys are the gold standard for mobile and digital health metrics. Few would disagree with that sentiment. That said, Fox is open to improving this survey if possible. Any helpful suggestions for rewording or similar surveys that might inspire new questions are welcome, she said.

Assuming Pew’s survey results are correct and there still is a large portion of the population that would benefit from health apps, what might drive adoption moving forward? There has been a significant proliferation in the number of health apps available, but seemingly no increase in adoption.

“What is going to be the trigger for health app adoption given the fact that for three years running we have not seen significant growth?” Fox asked. “The trends that I am watching — I don’t make predictions — but [there are three] trends that I am watching. [The first is] smartphone adoption. If smartphone adoption continues increasing and we see continued engagement with smartphones users getting health apps, then looking for increased health app adoption among smartphone users seems to make sense.”

While there is something intuitive about the growing adoption of smartphones leading to a larger base for health apps, if you examine Pew’s data on overall health app adoption among all mobile phone users — not just smartphone users — you find flat adoption for three years, despite the significant gains in smartphone adoption that occurred between 2010 and 2012. Fox didn’t disagree with this but made clear that this isn’t the only trend worth watching, other factors are important, too.

“The other aspect is media portrayal of apps,” Fox said. “I perceive that there has been an increase in mainstream media coverage of health apps.”

This is without a doubt true. Big name newspapers and blogs of all stripes have been promoting suggested health app lists throughout 2012.

“The third aspect of this that I am watching for is clinical integration,” Fox said. “That is when your doctor prescribes an app. That is going to have a different effect on your interest in trying it, over you just downloading it, or it coming pre-installed on your phone. Those are the trends I’m watching — again, they are not predictions, just some of the trends I am keeping an eye on.”

Read the full Pew report here.

AMIA studies show iPad remains popular with docs but imperfect

By: Neil Versel | Nov 8, 2012        

Tags: | | | | | | | | | |  |

Allscripts Wand iPad EHRThe iPad continues to be a hugely popular but imperfect tool for physicians, as suggested by two papers presented Monday at the American Medical Informatics Association (AMIA) annual symposium in Chicago.

In two Fairview Health Services emergency departments in the Minneapolis-St. Paul area, physicians actually told IT leadership prior to the December 2010 go-live of an electronic medical record that they would not use the EMR unless they could access the new system on iPads. This “unique and interesting phenomenon,” as one of the newly published papers put it, prompted University of Minnesota researchers to explore why.

“Any physician will swear by the fact that EMRs slow them down,” said lead author Akhil Rao, a former Minnesota graduate student who now is a clinical analyst at HealthEast Care System in St. Paul. The doctors put a premium on workflow efficiency, and were convinced that iPads would make their jobs easier, he explained. In fact, 85 percent of the 14 emergency physicians Rao and his research partners interviewed – out of 22 total in the two EDs – already owned an iPad. Keep reading>>

Pew: 19 percent of smartphone users have health apps

By: Jonah Comstock | Nov 8, 2012        

Tags: | | | | | | | |  |
Pew Mobile Health 2012

Source: Pew Internet/CHCF Health Surveys: August 9 ‐ September 13, 2010 , N=3,001 adults; August 7 ‐ September 6, 2012, N=3,014 adults ages 18+. Margin of error for both surveys is +/‐ 3 percentage points for results based on cell phone owners.

About 11 percent of all mobile phone users and 19 percent of smartphone users have at least one health app on their device, according to Pew Internet & American Life Project’s Mobile Health 2012 survey, which the group published this morning. The percentage of mobile phone users who have downloaded a health app has remained unchanged since 2010.

Forty-five percent of the 3,014 adults surveyed said they used a smartphone. Pew’s Associate Director Susannah Fox, who wrote the report, likened this smartphone tipping point to the adoption of broadband Internet back in 2003. In both cases, adoption happened quickly and fundamentally changed the way users engaged with the online world.

“Mobile seems to increase people’s likelihood to participate,” Fox told MobiHealthNews. “It’s the smartphone owners that I ended up really focusing on in the analysis, because they’re so much more likely to use [their devices] to access health information.”

This is the first year that Pew has identified smartphone users with a single question, rather than a complicated series. The term “smartphone” has only recently become widely understood enough for that approach to return meaningful results, Fox said.

The study looked at who was most likely to use health apps within the group of smartphone users. While 19 percent of smartphone users have health apps, that number changes to 22 percent for caregivers, 21 percent for those with chronic conditions, and 22 percent for those who had faced significant medical crises in the last 12 months.

Pew also asked about positive health events. Specifically, one question referred to “significant change … such as gaining or losing a lot of weight, becoming pregnant, or quitting smoking.” A full 29 percent of respondents who reported that kind of change were health app adopters.

Of the 254 health app-users in the survey, fitness and wellness apps dominated among respondents. Thirty-eight percent used apps to track exercise, fitness, or heart rate, 31 percent tracked diet or food and 12 percent tracked weight. The next largest categories were menstrual cycle trackers at 7 percent and blood pressure trackers at 5 percent. Fox said it was no surprise that the top three categories were wellness-related.

“But that’s where the fun really starts,” she said. “After the obvious findings.”

The report lists a number of other health app categories cited by less than 1 percent of respondents, including “Hypnosis” and “First Aid.” Fox said the “Long Tail” of the app market likely contains niche markets that could be successful for app-makers, but she did not specifically point to any of these niche categories as winning ones.

Predictably, app adoption broke down along age lines, with 24 percent of health app users between ages 18 and 29 and another 19 percent between 30 and 49. Fox said the middle age group’s interest in health is typical – that’s the group that has their own personal health issues, as well as often caring for their children and parents. By 65 most people are seeing a doctor regularly and are happy with their offline care.

Fox says that data shows the youngest group, digital natives, are more intimate with their smartphones, and therefore they might be more comfortable casually corresponding with them on health-related questions. Because these young adopters see the smartphone as a go-to for all information, that includes health information also.

Outside of apps specifically, the survey showed that 31 percent of mobile phone owners have used their phones to look up health information, up from 17 percent in a comparable 2010 survey. When you look at just smartphone owners, that number goes up to 52 percent. The report showed that Latinos, African Americans, those between the ages of 18 to 49, and those with college degrees are more likely than others to use their phones to look for health information.

The increased health engagement of Latino and African American users can be partly explained by the diversification of the country, Fox said. Younger people are statistically more likely to be minorities than older people are. Additionally, though, there is a perception that Latinos and African Americans are more likely to be mobile-only and early smartphone adopters.

Only 9 percent of the 2,581 mobile phone users surveyed used text messaging to receive health or medical information, with women, African Americans, and those between the ages of 30 and 49 the most likely to receive health information by text.