Boston Scientific offers CardioTeach iPad app

By: Brian Dolan | Oct 31, 2011        

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Boston Scientific CardioTeachLast week Boston Scientific launched an iPad app for physicians called CardioTeach, which medical professionals can use with their patients to discuss cardiovascular diseases. The app covers a number of diseases including atrial and ventricular arrhythmias, coronary artery disease, heart failure, heart rhythm disorders and peripheral vascular disease.

The app helps physicians to customize and annotate anatomical illustrations; overlay cardiac devices, such as pacemakers and lead wires, onto anatomical illustrations; add notes for emphasis, clarification or personalization; email completed graphics and information to patients, caregivers or other healthcare professionals.

The app’s release includes a testimonial quote from Dr Leslie Saxon, Chief of Cardiovascular Medicine at University of Southern California: “Most medical device apps are designed to educate physicians on a specific product or therapy. CardioTeach is unique because it lets clinicians better educate patients about their overall heart and vascular health and available treatment options. I like CardioTeach because it allows patients to have something they can reference after they leave my office and when thinking about or explaining what went on during the office visit. It also allows my patients and families to educate themselves prior to and between visits.”

Saxon worked with Boston Scientific on the concept version of its Latitude app about two years ago. At the 2009 Body Computing Conference in Los Angeles, Boston Scientific showed off a concept iPhone app, called Latitude Connected, that is currently focused on cardiac rhythm care management, but its full range of functions enable physicians to access patient records, monitor implanted devices, tap into patient support networks and schedule follow-up care. The prototype application was developed and conceived by Dr Saxon in conjunction with an iPhone development team in USC’s Viterbi Engineering School.

Boston Scientific is also a founding member of the USC Body Computing Center, which officially announced its founding members earlier this year.

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For more on Boston Scientific’s new app, read the press release below:

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How should we evaluate a health app’s efficacy?

By: Brian Dolan | Oct 27, 2011        

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Brian Dolan, Editor, MobiHealthNewsWithout actually trying it out, an early critic may have faulted the first automobile for not having a horse to pull it. After all, how else would a vehicle of the day transport a person from one location to another? Horses were a necessary part of the equation back then; the rubric of the day made their participation mandatory.

Such may be the state of mobile health efficacy studies.

Before we go any further, it’s worth noting that I applaud the research discussed below for tackling the efficacy of health apps, especially since this study began at a time when mobile health was a largely unknown field discussed as a fringe topic in some healthcare circles. To be sure, the efficacy of mobile health services needs more attention, but I believe it requires a deeper study than the one discussed below.

A recent paper published in the international, peer-reviewed Translational Behavioral Medicine journal found that of the 204 “weight loss” apps available from Apple’s AppStore as of September 25, 2009, not a single one adhered to all 13 of the evidence-informed practices for weight loss programs suggested by government agencies at the time. The 13 practices researchers looked for among the apps were at the time common to all of the following governmental agencies: the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), the Food and Drug Administration (FDA), and the US Department of Agriculture (USDA).

The study checked whether the apps adhered to these 13 evidenced-based practices: (1) Provide BMI assessment and explanation. (2) Recommends a diet rich in fruits and vegetables. (3) Recommends certain amount of physical activity each day. (4) Recommends certain amount of water consumption. (5) Encourages user to keep a food diary. (6) Tracks calorie balance of calories in vs. calories out. (7) Recommends a weight loss goal of 1 to 2 pounds a week. (8) Recommends portion size control. (9) Recommends users to read nutrition labels. (10) Provides a means to track weight. (11) Keeps a physical activity journal. (12) Provides a way to plan meals. (13) Provides a way to seek social support.

This study, which was conducted by researchers at Duke University and George Washington University, found that only one app adhered to 12 of these evidence-based practices and 50 apps adhered to exactly none of them. These evidence-based practices, of course, were developed before the creation of smartphone medical apps. They are not best practices for smartphone-based weight loss apps, but rather best practices for weight loss programs in general. Might they still apply to smartphone apps? Sure. Are they the be-all-end-all litmus test for weight loss apps? Of course not.

It’s important to note that the researchers never tested these weight loss smartphone apps. They never downloaded them. (We have seen this head-scratching method of study before.) The analysis of the weight loss apps’ adherence to these 13 evidence-based practices was based solely on the apps’ descriptions in the iTunes AppStore. The researchers acknowledge in their paper that the apps may adhere to more or less of them than their descriptions let on.

If you’re going to make a claim that an app is ineffective, at least test it with a patient population first.

It is also frustrating that this study only saw publication last month, yet the research includes apps published more than two years ago. It is frustrating that the researchers do not take into account how efficacy may be affected by the unique qualities the smartphone platform provides — qualities that are impossibly represented in a evidence-based guideline list conceived before smartphone apps existed.

Should the efficacy of mHealth rest on the shoulders of researchers that never take the time to download the apps they critique? Should the efficacy of apps be subject solely to a study of whether they adhere to evidence-based practices conceived prior to their platform existed?

Do cars need horses to pull them?

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Intel’s Dishman touts “virtual” care coordination

By: Neil Versel | Oct 27, 2011        

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ericdishmanWhen it comes to mobile health, Eric Dishman, director of health innovation and policy at Intel, for Intel’s Healthcare Innovation Group, is a realist.

“On one hand, Intel is really excited about the future of m-health and mobile health. On the other hand, we’re a little worried that there’s a lot of hype around it right now,” Dishman told MobiHealthNews in an interview at the just-concluded Medical Group Management Association (MGMA) annual conference in Las Vegas, where he delivered a keynote address.

Dishman also will be speaking at the mHealth Summit near Washington, D.C., in December. “One of my messages is going to be, look, just because there’s 33,000 smartphone apps around about health and wellness and diabetes management, doesn’t mean people are using them,” he said. “If you actually look at the data, not that many people are downloading them. Not that many people, even if they’ve downloaded them, are using them more than once to be a part of their everyday care.”

“Over time, it’s certainly true that mobile devices, whether they’re implantable devices or cell phones, are going to be used to collect data and coach us, but it’s not taking off nearly as quickly as we want. That’s because there’s got to be someone on the other end—a clinician, a nurse or someone that’s trained to intervene.”

And that is why Intel is interested in what Dishman calls “virtual care coordination” and “real-time care coordination” as part of a changing, more connected healthcare environment that promotes wellness, prevention and independent living.

“In a world in which there’s not going to be enough doctors and nurses and hospital beds to take care of an increasingly older and sicker population, Intel’s really focused on how do we use disruptive technologies to enable care of people in the home and in the community,” Dishman explained. “And how do we enable self-care technologies for patients themselves and how do we make family members and neighbors who are already doing $275 billion worth of care a year, according to AARP, how do we use IT to enable them to make sure that they’re delivering high-quality care?”

During his MGMA keynote, Dishman showed images of a research prototype home-based assessment device to measure symptoms of Parkinson’s disease, a rather important subject at Intel because company co-founder and former CEO Andy Grove suffers from the progressive neurological disorder. There is no cure for Parkinson’s, and treatments tend to be hit-or-miss. Grove and his foundation contributed to the project to help measure disease progression at home. Keep reading>>

Health startups wanted at SXSW 2012

By: Brian Dolan | Oct 27, 2011        

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acceleratorI am excited and honored to be an adviser to SXSW’s Accelerator program for its 2012 event, which will be the first year that the event includes a category for health technology startups. SXSW is taking submissions for its pitch event between now and mid-November and it’s still looking for health startups. Here’s the description for the health category:

“Health Technologies – This category is about patient-centric health applications and technologies that connect patients, families, physicians, pharmacists, care providers (hospital, clinics) and benefit providers — to share timely, relevant health data and drive better outcomes at affordable and sustainable cost levels.” Sounds like your startup?

Next year marks this event’s fourth go around. Prior years included big name judges like Tim Draper of DFJ, Chris Hughes of Facebook, Paul Graham of Y Combinator, Craig Newmark of Craiglist, Robert Scoble of Scobleizer, Jeff Pulver of 140 Conference, Chris Shipley of Demo, and Tom Conrad of Pandora. Next year will include some as yet unnamed judges from the world of healthcare.

Let me know if you apply to be featured at the event (I’ll do what I can to help mobile health startups get a seat at the table) and let me know if the $175 entrance fee is a hardship — I might be able to work something out. The application deadline is Friday, November 18, and the event itself will be March 12-14, 2012 in Austin, TX. Additional application details after the jump: Keep reading>>

Singapore company testing Bluetooth monitoring system in US

By: Neil Versel | Oct 27, 2011        

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Entra Health Systems MyGlucoHealth Wireless meter Nokia

ConnectedHealth device partner: Entra Health Systems

There’s another new player in the burgeoning world of home-based connected health, and it’s called, well, ConnectedHealth. The Singapore-based company is slowly entering the US market with a wireless platform for connecting customized, Continua-certified home monitoring devices.

ConnectedHealth and partner Sovran, an Oakland, Calif., company that offers medical transcription and custom software development services, showed their system at this week’s Medical Group Management Association (MGMA) annual conference in Las Vegas.

Sovran wrote the firmware for a series of Bluetooth-enabled home medical devices, including a weight scale, blood-pressure cuff, glucometer and pulse oximeter. “We’ve built our own Bluetooth stack,” Sovran principal Patrick Liu said at MGMA.

Each device transmits real-time data to a dedicated Android smartphone, which uploads readings to a Web portal that each patient’s physicians and other caregivers can access. (The Android app and Web portal also are Sovran creations, and that company also is providing transcription services for ConnectedHealth.) “Data can also be piped to an EMR,” Lui said, though that hasn’t been done yet.

He said that one multispecialty practice in Southern California is testing the ConnectedHealth products with elderly and other patients with high-risk chronic diseases such as diabetes, congestive heart failure and chronic obstructive pulmonary disease.

“The devices are meant to be easy to use,” Liu said. Since the products have been designed for seniors, patients don’t have to do anything they wouldn’t do with traditional scales, glucose meters, oximeters or BP cuffs, but the computer-savvy have the option of logging onto the Web portal to monitor their own values. There is a one-click interface in the portal for patients or caregivers to order supplies such as glucose test strips, Liu added.

Offering the technology to physician practices is one strategy ConnectedHealth is pursuing in the U.S., a market that Liu admitted is “cloudy” right now. Other potential sales avenues include health insurers, large employers, hospitals and integrated delivery networks. The plan is to charge an unspecified monthly fee per user, according to Liu.

Health systems in particular should take an interested, according to Liu, with the advent of Accountable Care Organizations, the growth of bundled payments and Medicare’s new policy that refuses to reimburse for certain preventable readmissions within 30 days of hospital discharge. “If you aren’t being reimbursed, this is the perfect solution,” Liu said.

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Click here for a video demo of ConnectedHealth’s Home Diabetes Kit.

Swiss school builds smartphone ECG monitor

By: Chris Gullo | Oct 26, 2011        

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EPFLResearchers at the Swiss university Ecole Polytechnique Federale de Lausanne (EPFL)’s Embedded Systems and Telecommunications Circuits lab have developed a non-invasive wireless cardiac monitor powered by a smartphone. The prototype is intended to alert potential patients and their doctors to cardiac anomalies.

The wireless body sensor network (WBSN) uses four sensors applied to the skin, as well as a radio module that attaches to the user’s waist, to transmit ECG data to a smartphone app.

“This system collects very reliable and precise data, it’s equipped with a very effective noise filtering system, and it has batteries that can last for 3-4 weeks at a time,” stated EPFL professor David Atienza, head of EPFL’s Embedded Systems Lab, in an article on the EPFL website. “Above all it provides an automatic analysis and immediate transmission of data in compressed format to the doctor, preventing him or her from having to work through hours of recorded data.” In a video on the site, Atienza offered up an additional use case: The sensor can detect when a driver is falling asleep at the wheel and alert them to wake up.

“Its size, its lightness, its ease of use, the fact that it measures continuously and remotely, which allows analysis to take place anywhere, makes this device very attractive to doctors,” stated Etienne Pruvot, a cardiologist in the Lausanne University Hospitals (CHUV) Cardiology Service.

While Pruvot believes its ease of use is attractive to physicians, will consumers really be interested in spending the entire day with four leads attached to their chests? Many heart monitoring offerings that have bubbled up in the past year have avoided going down the path of requiring users to attach multiple leads to their bodies. iPhoneECG is one such case in point.

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Check out the CNN story here