KLAS survey confirms BYOD security concerns

By: Jonah Comstock | Nov 5, 2012        

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Methods to Protect Data on Mobile Devices

Source: KLAS

No surprise here: A new report from KLAS Research suggests that health care providers are concerned about security in the increasingly BYOD mobile healthcare environment.

Of the 105 CIOs, IT specialists, and physicians surveyed, 70 percent used mobile devices to access their electronic health records, including customers of nearly every major EHR (Epic, Cerner, GE, Allscripts, Siemens, MEDITECH, and McKesson). The vast majority of organizations, 94 percent, were supporting Apple, with 49 percent and 44 percent supporting Android and Microsoft, respectively.

The supremacy of Apple is reflective of the trend toward BYOD strategies, where physicians use their own devices and IT departments support them. KLAS analyst Erik Westerlind told MobiHealthNews that 86 percent of respondents had some kind BYOD policy, and 31 percent had full BYOD. This is also the source for many of the security concerns, which are more often held by CIOs.

“With the increased use of personal mobile devices in healthcare becoming more prevalent, providers are very concerned about controlling what data is accessed, where it is stored, and how the data can be protected,” Westerlind said in a statement. “In addition, providers say that virtualization, encryption, and mobile device management applications are among the main solutions to combat some of these security concerns.”

Virtualization refers to software that lets doctors access and view patient information on their mobile devices, but keeps data from actually being stored there. Encryption locks patient data so it can’t be viewed or accessed without a password, and MDM software are usually system-level solutions that increase the security of communication between devices. For instance, if a device is lost or stolen, an MDM can remotely wipe it of sensitive data. The report showed 52 percent of providers using virtualization, 46 percent using encryption, and 35 percent using mobile device management.

Physicians interviewed also had some functionality concerns about their mobile devices, which they said worked well for data display but generally had problems supporting data input. Some were also concerned that their devices’ small screens were keeping crucial information from being displayed. On a 1-5 scale for usability, no respondent gave their mobile devices higher than a four.

Westerlind predicts that as mobile adoption increases, companies will move from virtualization, which can be limiting, to MDM and cloud-based solutions, allowing physicians to take full advantage of their devices’ capabilities.

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Pew: 70 percent of Americans are self-trackers

By: Jonah Comstock | Nov 2, 2012        

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Susannah FoxAccording to a forthcoming survey from Pew Internet Project, 7 in 10 American adults are self-trackers of some kind.

Sixty percent of Americans are tracking weight, diet, or exercise, said Associate Director of Digital Strategy Susannah Fox, who previewed some results from the survey at the Connected Health Symposium in Boston last week. One third track health indicators or symptoms, and one third are tracking a health indicator for a loved one they care for. Altogether that adds up to 7 out of 10 doing some kind of self-tracking, but only about a fifth are using technology like mobile devices, and half of self-trackers are only tracking “in their heads.” Fox illustrated this with the idea of the “skinny jeans tracker” — someone who is tracking their weight only by noticing when they can’t fit into a certain pair of pants. The numbers for health app adoption are expected when the full survey is published next week, but last year’s report showed no growth.

Smartphones are becoming ubiquitous in the lives of the people who use them, so they offer the potential to turn head-trackers into real trackers, recording more complete data that can help them better manage their health. The goal guiding app developers, Fox says, should be to make tracking health on your phone as easy as tracking it in your head.

Tracking is useful for anyone managing their fitness, weight or sleep patterns. For people with chronic diseases like diabetes, though, it can be essential, and having those records can drastically improve care. Right now, according to the study 62 percent of adults living with two or more chronic conditions is self-tracking.

The survey showed that of those who track their health, two-thirds don’t share that data with anyone. (Of the other third, half share with a clinician and the other half with family or friends.) This could help inform app design, Fox suggested. Just as people will ask Google embarrassing questions they’d never ask their doctor, she pointed out, apps have the potential to offer confidentiality and intimacy that even a doctor can’t.

Finally, Fox shared some numbers that demonstrate the impact self-tracking is having on people’s health care. The survey showed that among self trackers, 34 percent say the practice affected a health decision, 40 percent say it led them to ask their doctor a new question or seek a second opinion, and 46 percent said it changed their overall approach to health.

You can read Fox’s whole speech here.

Health to drive wearables market to $1.5B by 2014

By: Jonah Comstock | Nov 2, 2012        

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Fitbit Zip Fitbit OneA new report from Juniper is the latest in a flurry of forecasts about the role that smart wearable devices, or wearables, are going to play in the mobile technology market over the next few years. Juniper says wearables will be a $1.5 billion market by 2014, up from just $800 million this year.

Some of that drive is from “multifunction” devices like Google’s Project Glass and a similar product rumored to be in development by Apple. And those forthcoming devices, due out in 2014, are part of why Juniper has singled that out as a “watershed year” for the industry – Google Glass is slated for release in late 2013 or early 2014, and patent filings suggest a 2012 timeline for similar products from Apple.

But Juniper analyst Nitin Bhas says mobile health is leading the trend in driving those numbers, especially because many mobile health wearables are already on the market. In particular, fitness technology like Nike+ and Fitbit tracker is growing rapidly. The Juniper report predicts fitness and sports devices will outsell health devices, but the health sector will have slightly higher retail value.

Other reports that have been released this year tell a similar story. ABI predicted in February 2012 that there will be 90 million wearable fitness devices by 2017, and another 80 million health-related ones.

In August, an IMS report predicted that the wearable device market would be worth a minimum of $6 billion by 2016, another two years after Juniper’s estimate. IMS pointed to continuous glucose monitors as the dominant health care category and predicted they would continue to dominate that market.

Overall, the IMS report seems a bit more optimistic than Juniper’s, but a lot will depend on whether multi-function wearables like Google Glass take off or whether they flop.

“There are, of course, inherent challenges in forecasting a market which is early in its life-cycle,” Bhas said in an email. “While Juniper Research has questioned key players on their expectations of the market for both their own projects and the market as a whole, we believe that only when several commercial roll-outs are underway can adoption rates be ascertained with a high degree of certainty.”

Forrester and GigaOm have both also released reports earlier this year that looked at some of the many possible facets of wearable computing, which go beyond monitors and headsets and into the realm of smart clothing. Forrester mentioned clothing that reacts to emotions and vibrating tattoos, while the GigaOm report highlighted haptic scarves for therapeutic purposes, and mobile phone controls that could be built directly into clothing.

The Juniper report also looked at military wearables, such as dual-focus contact lenses that could incorporate heads-up displays in combat situations. Due to the sensitive nature of military technology, those numbers aren’t included in the forecast, but military technologies often trickle down into the civilian sector.

Will wearable tech like Google Glass completely replace handheld mobile technology? Bhas says that due to the rise in cloud-based computing, it’s possible that wearable interfaces will be all you need.

“Wearable devices such as smart glasses will indeed integrate cloud computing with a content provider’s servers, resulting in enhanced consumer content and activities.” Bhas said. “We expect this device category to follow the trend displayed by the convergence of smartphones, music players and digital cameras.”

HealthTap adds two-pronged physician rating system

By: Neil Versel | Nov 2, 2012        

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HealthTapHealthTap, the online and mobile service that lets users ask health questions to physicians covering more than 100 medical specialties, is adding a two-faceted doctor rating system to help consumers make more informed choices.

HealthTap has introduced a “competition” to bring more transparency to the process of selecting a physician. The company is taking votes from users about each physician they have experienced, on non-medical factors including bedside manner, empathy and personality, according to the Palo Alto, Calif.-based company. At the same time, physicians can rate their peers in terms of medical knowledge.

As votes come in, the more than 16,000 physcians HealthTap says are now in its network will rise and fall in the rankings, based on medical speciality, procedure or specific health issue. Also factoring into the tally is the quality of information each doctor shares on HealthTap.

“If you want to choose a movie or a pizza shop, there’s a world of sites and reviews to help. But there’s nowhere trustworthy to go with a vital concern like your health,” HealthTap CEO Ron Gutman says in a company statement. “This is a transparent and meritocratic alternative to all the doctor reviews out there that are based on non-qualitative factors,” he adds.

There are plenty of physician and hospital rating sites online, including Vitals.com (which Inc. magazine named one of America’s 50 fastest-growing private companies this year), the long-established Healthgrades, RateMDs.com and, on a smaller scale, the esteemed, fiercely independent Consumer Reports. Consumer opinion forums like Yelp do rate doctors, though that site seems to be purely subjective.

What still eludes the healthcare industry is an objective rating system based on patient outcomes and other safety factors, however.

HealthTap has been a darling of the investment community, racking up sizeable cash infusions of $11.5 million from a group including ex-Google CEO Eric Schmidt and $2.5 million from angel investors led by Mohr Davidow Ventures. It also has seen its physician community soar from 6,000 last December to more than 16,000 today.

However, it has been controversial among some in the patient-safety community, who have questioned whether it is risky to get specific medical advice from physicians who patients do not have a pre-existing relationship with.

Mobile will be essential to meeting MU Stage 2, improving care coordination

By: Neil Versel | Nov 1, 2012        

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Neil_Versel_LargeWe’ve heard talk for years about patient engagement, but not a whole lot of real progress. Mobile technologies are about to change that, with a substantial boost from Stage 2 of the “meaningful use” EHR incentive program.

To meet Stage 2 requirements, starting in 2014 (or the second year after initially getting to Stage 1),  providers must share patient records with affiliated hospitals and physicians for 65 percent of patient transitions and referrals they handle. This must include 10 percent of transitions outside their organizations to providers using an EHR system from a different vendor.

Also, hospitals and physician practices alike must give 50 percent of their patients the ability to view and download their own medical records through online portals, up from 10 percent in Stage 1. And, perhaps most significantly, 5 percent of patients actually have to log in to those portals for doctors and healthcare organizations to achieve meaningful use.

The 5 percent threshold doesn’t sound like much, but I’ve recently concluded that it truly is a Big Deal. For the first time, EHR adoption isn’t completely in the hands of the provider, and that was on the minds of a lot of IT people at the recent College of Healthcare Information Management Executives Fall CIO Forum.

“We have to be very creative in doing this,” Pam McNutt, senior vice president and CIO of Methodist Health System in Dallas said at the meeting.

“We’re trying to figure out what our strategy is,” added Gary Paxson, CIO of White River Health System in rural Batesville, Ark.

Meanwhile, a potentially groundbreaking report from the esteemed Lucian Leape Institute of the National Patient Safety Foundation is calling for healthcare organizations to pick up the pace when it comes to coordinating and integrating patient care.

“Most failures of coordination occur during care transitions, when there is a failure to transfer key pieces of information during handover and to ensure the completion of essential tasks of care,” the report said. “Examples include failure to transfer the results of medical tests and even the medical record as a whole, specialists receiving little or no information from referring primary care providers, and inadequate or missing discharge summaries.”

The paper didn’t explicitly say so, but read between the lines and know that technology is going to have to support  care integration. In fact, that’s exactly what one of the authors, former Kaiser Permanente CEO Dr. David Lawrence, told me last week. “You almost cannot do complex medical care without that kind of connectivity” called for in Stage 2, Lawrence said.

And it looks like vendors are taking notice.

Just this week, Buffalo, N.Y.-based Smart Sign Out released an updated version of its iPad app that automates patient handoffs to ensure that essential data gets transferred between all members of each patient’s care team. It also lets clinicians enter orders and instructions and share with colleagues.

At CHIME, Albert Oriol, VP and CIO of Rady Children’s Hospital in San Diego, showed me how physicians use the Epic Haiku iPhone app to access the hospital’s EHR remotely to view clinical summaries, test results and communicate with patients and other clinicians. Oriol said Rady has even connected the mobile system to San Diego County’s immunization registry, an important feature for any pediatric hospital.

Just a few weeks earlier, former federal CTO Aneesh Chopra gave a shout-out to Humetrix’s iBlueButton, a suite of consumer iPhone and iPad apps that allows doctors and patients to “push” health data securely between their mobile devices during office visits.

I’m still not completely sold on the idea of patient-controlled personal health records doing a lot for interoperability, but, as McNutt said, meeting the Stage 2 standards is going to take some creativity. You have to give iBlueButton and some of these other app developers points for being creative.

Zephyr, MGH to trial wireless monitoring in childbirth

By: Neil Versel | Nov 1, 2012        

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ZephyrLife Android App

ZephyrLife's Android App

Massachusetts General Hospital in Boston will conduct a clinical trial of wearable health monitoring devices from Zephyr Technology to monitor pregnant women as they give birth, then quickly roll the system out to a hospital in Uganda in an effort to stem high infant mortality.

Mass General’s Center for Global Health is testing Annapolis, Md.-based Zephyr’s BioHarness wireless vitals sensor and ZephyrLife monitoring system in Boston for 30 to 60 days before deploying the technology abroad, according to Paul Costello, Zephyr’s VP of sales. ZephryLife measures movement, respiratory rate, heart rhythm and other vital signs to help health workers identify conditions such as arrhythmia, pressure ulcers and potential falls early.

The company previewed ZephyrLife  at  the Partners HealthCare Connected Health Symposium in Boston last week. Mass General is part of Harvard-affiliated Partners. “Small devices the size of a silver dollar will communicate to a central system,” Costello explained to MobiHealthNews this week.

Zephyr and the Center for Global Health are moving to get the system over to Uganda as quickly as possible because of the dire conditions associated with childbirth there, according to Costello. He says that maternity wards and other birthing centers typically have just one caregiver — rarely a physician or even a nurse — for 50 to 60 women at a time, and 14 babies and one mother die every day. “I mean, the numbers are appalling,” Costello says.

The BioHarness and ZephryLife combination will help the overwhelmed caregivers better prioritize their patients and allocate their scarce resources more efficiently. During both the trial in Boston and the implementation in Uganda, Mass General researchers will work with Zephyr to design computer algorithms to detect and manage patient risk.

Eventually, clinicians in Boston will be able to provide remote care by telemedicine, Costello adds. “This could be a continuous monitoring program,” he says.

Zephyr, in partnership with Under Armour and the University of Southern California’s Center for Body Computing, provides wearable BioHarness monitors to measure vitals of draft prospects at the NFL Scouting Combine each spring. The same technology measures stress and other physiological conditions in firefighters, soldiers and NASA astronauts.

The company also has been working with Flagstaff Medical Center in Arizona to help the hospital reduce readmissions for patients with congestive heart failure.

BioHarness won FDA 510(k) clearance in 2010.