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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Steve Jobs: iCloud may even store medical data

By: Brian Dolan | Nov 3, 2011        

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MIM VueMe AppAs has been well documented here and elsewhere, Apple’s devices have seen impressive adoption among healthcare professionals. iPhones, iPods, and iPads have — along with other mobile devices — served as useful mobile platforms for health-related apps and services for general consumers, too.

Recently, in the days following the memorial service for Apple founder Steve Jobs and the publication of his biography, a handful of fleeting references to Jobs’ views on the future of medicine have emerged along with a glimpse if his vision for Apple’s role in it.

One of the passages in Walter Isaacson’s recently published biography of Steve Jobs quotes the former CEO as envisioning Apple’s iCloud as a place where people might store their medical data:

“We need to be the company that manages your relationship with the cloud—streams your music and videos from the cloud, stores your pictures and information, and maybe even your medical data,” Jobs told Isaacson. “Apple was the first to have the insight about your computer becoming a digital hub. So we wrote all of these apps—iPhoto, iMovie, iTunes—and tied in our devices, like the iPod and iPhone and iPad, and it’s worked brilliantly. But over the next few years, the hub is going to move from your computer into the cloud. So it’s the same digital hub strategy, but the hub’s in a different place. It means you will always have access to your content and you won’t have to sync.”

Jobs’ sister, the exceptionally eloquent author Mona Simpson, said in her eulogy for her brother that Jobs sketched re-designs for various things found in his room at the ICU.

“Intubated, when he couldn’t talk, he asked for a notepad,” Simpson said. “He sketched devices to hold an iPad in a hospital bed. He designed new fluid monitors and x-ray equipment. He redrew that not-quite-special-enough hospital unit. And every time his wife walked into the room, I watched his smile remake itself on his face.”

Isaacson quotes Jobs comparing the current opportunity for new innovations in medicine to the time period back when he first began working in personal computers. Jobs said his son had taken an interest in medical research:

“One of the very few silver linings about me getting sick is that Reed’s gotten to spend a lot of time studying with some very good doctors,” Jobs said. “His enthusiasm for it is exactly how I felt about computers when I was his age. I think the biggest innovations of the twenty-first century will be the intersection of biology and technology. A new era is beginning, just like the digital one was when I was his age.”

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Pew: Health app adoption same as last year

By: Brian Dolan | Nov 3, 2011        

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Pew Health Apps AdoptionFor more than a year now the Pew Research Centers’s Internet & American Life Project has been tracking the adoption of health apps by adults in the US. In September 2010 Pew found that about 9 percent of all adult mobile phone users in the US had downloaded an app that “helped them track or manage their health.” In its most recent survey in August 2011 Pew found that about 11 percent of all adult cell phone users having downloaded an app that helps them manage their health. While that is a slight increase over last year’s number, Pew characterized it as “a statistically insignificant difference.” App adoption, therefore, has been largely stagnant over the past 12 months.

Pew writes that “health apps” include those that capture “a wide range of software applications, from those that count calories and help manage an exercise routine, to more advanced apps that monitor vital signs and help individuals manage serious health conditions.”

The survey conducted this past August, however, was conducted a bit differently: “In August 2011, the question was asked of adults who have downloaded an app to a cell phone or tablet computer, rather than all cell phone users. More than a quarter of this population (29 percent) report downloading a health app. Looking just at adults who download apps to a cell phone, this translates to 11 percent of all adult cell phone users having downloaded an app that helps them manage their health, a statistically insignificant difference from the 9 percent of adult cell users who reported having a mobile health app in September 2010,” Pew writes.

Pew also found that the new survey results show little change among health app adoption rates among different racial/ethnic groups.

Be sure to check out Pew’s entire report, which focuses on overall cell phone and apps adoption — not just for health. Full report freely available here.
If you’d like to learn more about health apps, be sure to register for MobiHealthNews’ webinar: What Makes A Health App Effective? (Complimentary Registration Here)

New iPhone medical apps: Telethrive Ringadoc, JASN

By: Chris Gullo | Nov 3, 2011        

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eat chew restEvery day dozens of new health-related apps make their way into the AppStore. This week we noticed about a half dozen health apps that we felt were worth highlighting, including the quiet launch of a video consultation app that has made a lot of noise pre-launch (more on that below).

MobiHealthNews continues to track the growing number of apps available to both medical professionals and consumers. As we predicted in our recent Professional Apps Report, by next summer we expect the number of iOS apps intended for use by medical professionals and medical students to top 9,000 apps. The number of health-related iOS apps intended for use by consumers will grow to more than 13,000 by next summer, according to MobiHealthNews’ Consumer Health Apps Report.

Read on to learn about the newest health apps that joined the AppStore during the past week — the ones worth knowing about, anyway.

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ONC to gauge consumer opinions on mobile health privacy, security

By: Neil Versel | Nov 2, 2011        

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ONC's Dr. Farzad Mostashari

ONC National Health IT Coordinator Dr. Farzad Mostashari

The Office of the National Coordinator for Health Information Technology is conducting a series of focus groups to gauge consumer opinion on privacy and security of mobile health technologies.

ONC’s Office of the Chief Privacy Officer, which is running the focus groups, is looking to “explore the attitudes and preferences of a diverse sample of consumers with respect to the communication of health related information on mobile phones and devices, including text messaging,” according to a brief listing on a page of HHS “Text4Health” projects. The plan is part of the Obama administration’s “open government initiative.”

In a widely distributed email sent out this week, ONC said it would employ a “a qualitative data collection approach to obtain in-depth information from mHealth users regarding privacy and security concerns with this technology and perspectives on potential safeguards.” The office specifically mentioned Skype as an example of mobile communication of health information in a list that also included text messaging, on-the-go email access and downloaded apps.

Research will span multiple populations across the country, according to the email. ONC provided few additional details other than saying it would make results of its research available sometime next year.

The public contact for the project is ONC Chief Privacy Officer Joy Pritts. She can be reached at

Epocrates adds personalized app recommendations

By: Chris Gullo | Nov 2, 2011        

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epocratesEpocrates announced a major update to their chart topping drug reference app this week, including a customizable app directory and faster access to medical content.

The updated app includes a customizable home screen for faster access to frequently used features, a new notification system, and, most notably, an App Directory. The App Directory allows users to download medical apps from within Epocrates, with recommendations provided  based on the user’s provided areas of interest.

The App Directory includes both paid and free apps, and currently features Epocrates EHR, Netter’s Anatomy Flash Cards, Growth Evaluation Tool, BMI Tool, Pregnancy and Infant Care MRC and Epocrates CME. Epocrates said that clinicians are “overwhelmed” by the thousands of clinical apps available today, and the new App Directory within the Epocrates app hopes to address that.

MobiHealthNews’ contributing editor Neil Versel recently shared this thoughts on why private app stores could be the ‘Next Big Thing’. What sets Epocrates’ list of curated apps apart from other curated app store offerings is that Epocrates suggests particular apps for individual users based on that user’s profile. Apple recently put together a new, curated section of its AppStore that presents medical and health apps intended for use by professionals. The curated, medical app store under development by Happtique helps healthcare organizations create their own appstores to better enable enterprise-wide distribution. Unlike Epocrates and Apple’s curated lists, however, Happtique said it would not be in the business of deciding which apps were “good” or “bad”.

“Mobile apps are only as valuable as they are useful,” stated Rose Crane, president and chief executive officer of Epocrates, in a press release. “We’ve advanced the user experience of our world-class drug reference app and added a singular channel to discover, store and access reliable tools. Furthermore, this is a fresh foundation for new partner engagements and opportunities to deliver even more value-add resources to our network.”

Epocrates consistently remains a top free download in iTunes medical category. Leading up to the recent relaunch of their mobile app, the company named Facebook’s mobile chief, Erick Tseng, to its board of directors this summer.

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Read the press release below. Keep reading>>