Draft senate bill to ease telehealth licensure challenges

By: Brian Dolan | Feb 7, 2012        

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Brian Dolan, Editor, MobiHealthNewsAt some point this Spring, and perhaps as early as April, Senator Tom Udall, a Democrat from New Mexico, plans to introduce a bill that would help ease some of the biggest barriers currently facing telehealth. The expected bill, which is still being drafted, would streamline licensure portability for physicians and make it easier for them to practice telemedicine in more than one state.

Udall’s legislative assistant Fern Goodhart told Government Health IT that the bill would streamline licensure for physicians by creating a unified set of standardized data in a comprehensive, interoperable database of primary source verified credentials that might include claims history, hospital privileges, and criminal background check with one unified application. Goodhart also predicted that multi-state could just be the beginning and telemedicine could have nationwide licensure ultimately.

GlobalMed Blog adds some more details: “Senator Udall’s bill would set up a voluntary system in which doctors would be licensed by their state boards who would retain jurisdiction for disciplinary issues. At the same time, doctors could sign up for a national license that would [allow] them to practice any medicine – not just telemedicine – in any cooperating state. A Udall aide says that the bill may have to include some incentives to bring states along with the concept. (For medical board buy-in, especially those that will lose license fees from physicians who hold multiple state licenses, this may be a key component.)”

In an earlier post, GlobalMed Blog noted that the Federation of State Medical Boards (FSMB) believes Udall’s bill is on the wrong track: Lisa Robin, the FSMB’s Chief Advocacy Officer said that: “The FSMB and representatives of the New Mexico Medical Board have conveyed to the Senator (Udall) strong opposition to the draft legislation in its current form, arguing that the bill undermines state-based licensure and replaces it with a national licensure system that has potential to compromise state autonomy in the regulation and practice of medicine and the protection of the public,” according to the post. Robin told Udall FSMB would help Udall rework it.

The American Telemedicine Association (ATA), which organized the meeting during which Goodhart shared Udall’s plans for the bill, summed up the meeting like so: “It was pointed out that the issues went beyond telemedicine to include the millions of travelers, large employers and others. Concerns came from both rural and urban areas and included both Republican and Democratic Members of Congress. Legislation to address the issues is being drafted by Sen. Tom Udall (D-NM) and a variety of approaches to resolve the problems are under consideration by a number of parties.”

These are important developments for mobile health — here’s hoping they lead to real action.

If you missed the meeting but would like to tune in, the full 1.5 hour video of it is available over at Vimeo here.

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CardioComm enters mobile cardiac telemetry market

By: Brian Dolan | Feb 7, 2012        

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CardioComm ECG Monitor

CardioComm ECG Monitor

CardioComm Solutions and TZ Medical inked a device integration and distribution deal that brings the pair into the the mobile cardiac telemetry (MCT) electrocardiographic (ECG) and arrhythmia management market. CardioComm will integrate TZM’s Aera CT MCT monitor into its GEMS software to create a new offering called GEMS Aera CT. It will be an extension of CardioComm’s GEMS Air, a global ECG management offering.

Other companies already offering mobile cardiac telemetry services include Corventis, CardioNet, and LifeWatch.

“Few companies have been able to address the need for a more beneficial mobile arrhythmia monitoring tool. The majority are large IDTFs that produce their own proprietary MCT device which are restricted for use within their own customer base,” Etienne Grima, CEO of CardioComm Solutions stated. “TZM has engineered the first FDA cleared OEM MCT device which, with our GEMS software, will enable small and large IDTF and medical call centers to now enter the MCT market, a market which represents a significant revenue generating opportunity. The MCT market is USA specific where CMS approved reimbursement for this diagnostic test is particularly favorable at $754.” More here.

In semi-related news: One former cardiologist turned consultant recently argued in a column that patients should be given access to the data captured from their implantable heart devices. MCT monitoring does not generally leverage an implantable device, but the argument seems to hold for both:

“Furnishing of this data will benefit patients,” Dr. David Lee Scher wrote over at KevinMD.com. “Some patients will want to receive the entirety of the data, though they might not understand it all. However, most would do well with limited pertinent information which would serve them and their caregivers well. In either case, both population groups deserve it.”

Few SMS health applications have been evaluated

By: Brian Dolan | Feb 7, 2012        

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Text4babyPhoneThe Journal of Medical Internet Research recently published a research paper called, SMS Applications for Disease Prevention in Developing Countries, that found while there have been many text message-powered health initiatives, very few of them have been sufficiently evaluated.

“Those that did conduct evaluations reported process evaluation and uptake, providing limited data about behavior change. Moreover, with a low number of documents found in the peer-reviewed literature, it appears that, to date, little is being done to advance our understanding of what works and what outcomes could be achieved in using SMS for disease prevention in a developing country context. Major opportunities are perceived, evident by the number and wide variety of projects… However, the need remains for evidence-based dissemination of information about using mobile phones and SMS for improving health in the developing world. The limited evidence found in this systematic review highlights the need for research that assesses behavioral, social, economic, and health outcomes of mobile phone interventions aimed at promoting health in developing country contexts,” wrote the three Switzerland-based researchers: Dr. Dr. Carole Déglise, Suzanne Suggs, and Peter Odermatt.

The study reviewed 34 SMS applications (excluding those not launched in developing markets or that focused on disease prevention) but only five had made available evaluation study findings. The researchers stated that most of the applications they reviewed were pilot projects “in various levels of sophistication” with “modes of intervention varying between one-way or two-way communication, with or without incentives, and with educative games.” Of those five SMS applications that did have evaluation findings available, the researchers said that the “primary barriers identified were language, timing of messages, mobile network fluctuations, lack of financial incentives, data privacy, and mobile phone turnover.”

Efficacy studies for all mobile health services — not just those for developing markets — is shaping up to be one of the big trends of 2012.

Be sure to read the entire research paper over at JMIR here.

March launch for SkyLight’s smartphone-microscope adapter

By: Brian Dolan | Feb 6, 2012        

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SkyLight smartphone microscopeSkyLight, an adapter that claims to connect almost any smartphone to any microscope will go on sale in March. The device’s designers received funding to create the device via crowdsourcing funding site Kickstarter. The devicemakers designed the adapter so that it could upgrade older microscopes for the digital age with an eye on community healthcare workers in emerging markets as well as science classes. It fits any microscope eyepiece that has an outside diameter between one inch and 1.75 inches.

The device enables users to leverage their smartphone’s camera to capture photos and videos through the microscope’s eyepiece. Those images can then be uploaded, emailed, and shared. Users can also share the captured images in real-time as well as through collaborative video conferencing software.

The SkyLight adapter aims to be intuitive and easy to use. Here are the four steps given by the device’s makers: 1) Use one or more rubber inserts to size the SkyLight to the microscope eyepiece and tighten the thumbscrew so that the SkyLight fits snugly over the eyepiece of the microscope. 2) Place a smartphone on the stage between the two clips. 3) Slide the smartphone up and down and left to right until the image from the microscope is centered over the smartphone camera. 4) Slide the Skylight along the eyepiece to get a crisp image and tighten the thumbscrew to lock it in place.

“For the health worker in Malawai, Africa, the SkyLight will enable circa 1980 microscopes to send diagnostic images to the nearest doctor, who may be separated by hundreds of miles,” the team writes over at its Kickstarter page.

Visit the SkyLight site for more.

American Medical Association offers weight loss app

By: Brian Dolan | Feb 6, 2012        

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AMA Weight What Matters appAt the end of January the American Medical Association (AMA) offered up its second consumer facing smartphone app: Weigh What Matters. The free app, which is available for Apple iOS and Android devices, aims to help people work with their physicians to set up health goals and track their progress toward meeting them. The app includes weight, diet, and activity goals and tracking mechanisms.

According to the AMA: “Once goals are established, users can track their weight, physical activity and nutrition with daily entries. It also calculates a user’s Body Mass Index (BMI) and provides a mechanism to view progress reports and email them to the user’s physician.”

The most notable thing about the AMA’s app launch is that its existence may alert some physicians to the existence of mobile health apps. AMA President Dr. Peter Carmel stated in a press release that the app “encourages user to consult with their physicians” on establishing health goals.

The association could certainly help physicians find apps to use during patient visits, but it is a shame that the AMA is reinventing the wheel by developing their own one-note wellness tracking and medication adherence apps when there are already hundreds of such apps available and in use. The AMA could better use its influence to create it own certification program (like Happtique is doing) of health and medical apps that it suggests physicians use with patients and patients use in consultation with their doctors.

More on the AMA’s latest consumer app in the press release below: Keep reading>>

NASA developing noninvasive smartphone health sensor

By: Brian Dolan | Feb 6, 2012        

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NASA VariableTechFor a number of years now NASA Ames scientist Jing Li has been hard at work developing what Gizmodo recently called the “greatest phone accessory of all time.” The tech publication had an exclusive look Li’s gadget, a postage-sized chip with 32 nanosensor bars, each made up of a different nano-structure material that can respond to different chemicals in different ways. The chip requires about 5 milliwatts of power so it can run for 8 continuous hours on a single charge when connected to a smartphone. Gizmodo strongly suggests the device is designed to connect to Apple’s iPhone and may not be too far away from commercialization.

A Chattanooga, Tennessee-based startup called VariableTech seems to be helping Li develop the device. VariableTech appears to be set to launch a KickStarter campaign to help fund the development of the consumer-facing devices, too.

The device is chiefly designed to monitor carbon monoxide in the user’s home along with real-time tracking of levels of chlorine, ammonia and methane in the immediate environment. Gizmodo suggests that a companion app could send data back to the Department of Homeland Security, which is funding much of the research that will lead to a consumer version of the device.

A version of the device has been installed on the International Space Station for about three years now. It monitors fuel leaks in launch vehicles and also monitors air quality — especially formaldehyde — in the air inside the ISS.

Gizmodo suggests that people with diabetes could use a version of the device to detect their blood sugar level, which correlates with acetone in the breath. Another correlation exists between nitrous oxide in the breath and lung cancer. The device certainly has the potential to become a critical tool or a contender for the X Prize’s Qualcomm-sponsored Tricorder competition.

Read the Gizmodo article here.