California offers health plan ratings iPhone app

By: Jonah Comstock | Apr 1, 2013        

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California OPA appThe state of California’s Office of the Patient Advocate (OPA) released its 2013 quality report cards for health plans. This time, though, they released the information via a newly redesigned website and, for the first time, as an app for iPhone and iPad.

The report cards allow patients to compare 10 Health Maintenance Organizations (HMOs), six Preferred Provider Organizations (PPOs), and 209 medical groups on overall quality of care, and also on quality of care for 40 different specific conditions. OPA director Amy Krause told California Healthline that California is the first state to release a health plan report card in app form.

The app, which is free in the AppStore, allows users to view all the ratings of a single plan, or view how all the plans rate on a particular condition, such as asthma, heart disease, or diabetes. They can also see how other patients rate plans on non-care quality metrics like doctor communication, ease of setting up appointments, and customer service. In addition, the app provides contact information for health plans and general information for patients like how to make the most of a doctor visit.

The ratings come from data collected by the California Department of Insurance. Quality of care ratings are based on de-identified data from a random sample of patients using the health plan, drawn directly from the organization’s records. Patient experience ratings are based on surveys conducted annually by the Department of Insurance, which reaches out to a sample of health plan members by phone or mail. A third metric tracks the ratio of health plan enrollees to customer complaints.


DrChrono adds Mayo Clinic content to iPad EHR for patient education

By: Brian Dolan | Mar 28, 2013        

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DrChrono Mayo ClinicY-Combinator incubated company DrChrono, the EHR company currently focused exclusively on iPad- and iPhone-toting providers, has added digitized patient education content in an exclusive licensing deal with the Mayo Clinic to help its DrChrono customers fulfill the patient education component of meaningful use.

DrChrono CEO and Co-Founder Michael Nusimow told MobiHealthNews during a recent interview that the content from Mayo Clinic will be presented to patients as they sign in via iPads in their physicians’ waiting rooms. While the deal brings more than 2,600 pieces of content and more than 300 educational videos from the Mayo Clinic to DrChrono’s platform, physicians will be able to curate that content and tailor it to each patient. The EHR vendor can also automatically include different types of content based on what’s in that particular patient’s medical record.

Nusimow also sees opportunities to let physicians know when patients view certain videos, which can help trigger conversations in the exam room about the content the patient just viewed or read.

The Mayo Clinic content is also going to be made available to patients through DrChrono’s patient facing portal, iPhone app, iPad app, and Android app, so that patients can access that content any time the choose. Nusimow sees future opportunities to help physicians better understand which content their patients are viewing through the apps and portal between visits, too.

“I’m pleased that Mayo Clinic’s patient education materials, which are normally only available to Mayo patients, now will be available via the internet to all patients in the United States,” Dr. Steven A. Smith, medical director for Patient Education at Mayo Clinic’s Rochester, Minnesota campus, said in a statement. “Doctors distributing these educational documents and videos to their patients can be confident they contain content that will assist them in their delivery of clinical care.”

Nusimow told MobiHealthNews that by including content from a trusted healthcare provider like the Mayo Clinic, DrChrono’s provider customers probably don’t have to take the time to review patient education materials for accuracy. Nusimow says that some EHR vendors that offer patient education materials scrape it from the web, which can make for content of “varying quality”, he said.

DrChrono currently serves small practices and ambulatory healthcare practices — everything from single doctor practices up to 70 physicians in the practice, Nusimow said. The company currently has about 40,000 providers using its EHR.

DrChrono has also been progressive on the patient generated data front. It was one of the first EHR companies to integrate data from consumer health devices offered by iHealth.

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The IT Series will:

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Medical society endorsement of apps can’t be a good idea

By: Neil Versel | Mar 28, 2013        

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Neil_Versel_LargeIn the run-up to and in the wake of last week’s congressional hearings on potential Food and Drug Adminstration regulation of mobile health and medical apps, we have heard numerous alternatives to the existing FDA regulatory framework proposed.

Congress should give the Office of the National Coordinator for Health Information Technology (ONC) the power to regulate not only apps, but also electronic health records, some have suggested. Others would like to see self-policing by the private sector, akin to the initial role of the Certification Commission for Healthcare Information Technology (CCHIT), which started as the EHR vendors’ answer to the prospect of regulation. Happtique may seem to be heading down this path, but CEO Benjamin Chodor shot that notion down during the hearings.

A third approach might be along the lines of what CCHIT has become today, a participant in a privately run but federally monitored certification program to test products against government standards.

And then there is the interesting idea proffered by Dr. Thomas Santo on the popular KevinMD blog last week: Get physician organizations involved.

“If you visit the websites of some of the major medical organizations in the country, the American Medical Association, the American College of Physicians, the American Academy of Pediatrics, among many others, not one of them has a link to ‘endorsed apps,’ ‘mobile health’ or any other reference to digital health tools,” Santo wrote. I don’t know who the “many others” are, so I can’t check this claim, but the point is taken.

“Without providing some guidance as to what works and doesn’t work, physicians miss the opportunity to maximize the benefits of this technology in terms of quality of care, access to care and cost, those things that occupy much of the discussion on health care today,” Santo continues.

This I know to be true. Without professional guidance, health and medical apps risk falling into the “for amusement purposes only” category, and if physicians aren’t willing to help their patients understand how certain apps fit into the overall picture of health, then we are just building another silo in an oversiloed industry. It is good for patients to be engaged, but professionals still have to help consumers interpret the information digital tools produce or uncover.

“One hurdle to capitalizing on this new wave of patient engagement is the fact that the market is full of products that are unlikely to produce any long-term health benefits, with more beneficial, substantive tools interspersed in between,” Santo adds. This is also true.

The Federal Trade Commission has forced at least two acne-related apps of dubious benefit off the market. Threat of legal action over a copyright issue caused another app developer to pull a mobile psychiatric reference guide. Again, though, these appear to be isolated incidents, a combination of a federal agency acting once and the owner of intellectual property engaging in some self-policing.

I like the idea of professional organizations reviewing apps for accuracy and medical usefulness, but I shudder when I think about medical societies “endorsing” products. As I read Santo’s commentary, the first thing that came to mind was the endorsement the AMA effectively gave Sunbeam products in 1997 when the two entities inked a marketing deal.

After a public backlash against the AMA’s credibility, the medical society terminated the agreement, and ended up paying Sunbeam $9.9 million to settle a lawsuit. Fallout from that incident later led the AMA’s chief executive to sue the organization.

Ever since then, the AMA has been rightfully wary of lending its seal of approval to commercial products that were not its own. I hardly think the organization – or any other medical society – would be eager to endorse mobile apps.

McKesson offers practice management, pharmacy management apps

By: Brian Dolan | Mar 28, 2013        

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Medisoft Mobile McKessonCoinciding with the second day of congressional hearings on FDA regulation of mobile medical apps last week, McKesson announced the launch of a new app, Medisoft Mobile, for doctors and their staff that aims to make it easier to manage their practice through iPhones or iPads. Between the Medisoft Mobile app and the newest version of Medisoft software, care providers can now use their mobile devices to view schedules as well as to transmit charges, diagnosis codes and notes to the front desk.

One week later, McKesson’s pharmacy systems and automation division announced a deal with mscripts to bring to market a mobile pharmacy offering that works with McKesson’s EnterpriseRx pharmacy management system. The updated mobile practice management system enables pharmacies to talk to patients via two-way SMS text messaging and other mobile apps that run on iOS, Android, and Windows Phone operating systems. The system enables patients to refill prescriptions, receive pickup and dosage reminders, and more. It also enables pharmacies to send patients surveys or information about their clinics, drug recalls, or coupons.

During the second day of hearings last week, McKesson’s Senior Vice President of Clinical Development and Strategy, Dr. Jaqueline Mitus, said in her opening remarks: “The current regulatory approach for medical devices, however, is not well-suited for health IT. For example, does an iPad that reminds a patient to refill a prescription make it a medical device? What about an application that allows a clinician to access a medical journal or review an x-ray online? Should these applications and the iPad each be subject to FDA regulation?”

On the third day of hearings last week, Rep. Henry Waxman (D-CA) asked the FDA’s Christy Foreman whether the FDA would regulate a series of apps and devices, including: Mobile devices in general like the iPhone, iPad, BlackBerry, PDA, all health IT, an app to remind you to refill a prescription, and an app to help a doctor search a medical textbook. In all those cases Foreman said “no”. The FDA has cleared a couple of apps that aim to help physicians make diagnostic decisions based on x-rays and other images displayed on a mobile medical app, but non-diagnostic imaging apps have been available for years.

Sensiotec raises $1M for contactless patient monitoring

By: Jonah Comstock | Mar 27, 2013        

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SensiotecSensiotec, an Atlanta-based startup that’s developing contactless remote patient monitoring technology, raised $1 million from investor George Harris. Harris, a former leveraged buyout specialist introduced to the company by chief medical officer Dr. Neal Templeton, will also join the company’s board, CEO Robert Arkin told MobiHealthNews in an email.

The round brings Sensiotec’s total funding to $7 million, according to the company. The money will go toward developing clinical trials of its contactless monitoring technology at Atlanta Medical Center and Children’s Health of Atlanta.

“We’re hard at work on improving our algorithms, improving the device significantly to pick up more heart rate and more respiratory rate information,” Arkin told MobiHealthNews.

Sensiotec’s Virtual Medical Assistant technology, which is not yet commercially available, uses ultra-wide band (UWB), a high-frequency, low power radar technology that monitors heart and respiration rates without the need to touch the patient at all, and transmits the data to a variety of recipients — the technology has an open API and the company stresses interoperability. The company says it can integrate data from other third-party monitoring devices, such as Bluetooth-enabled pulse oximeters, blood pressure monitors, and weight scales.

“The VMA measures heart and respiration rates and movement, providing critical ‘spot’ and ‘trend’ data to a nurse’s station, tablet, cell phone or pager, without the need for electrodes that touch the patient directly or indirectly or pads that require contact with a mattress or other surface,” Arkin said in an email.

Sensiotec’s UWB monitoring technology, which was developed by Canadian company Wireless 2000, received FDA 510(k) clearance as a Class 2 device in 2009.

The company is one of many that compares its technology, with its noninvasive, no contact scanning, to Star Trek’s fictional tricorder. Arkin said the company has not yet decided whether to enter the competition for the Tricorder X Prize. Sensiotec may have more claim to Star Trek cred than others however, since the company has an actual astronaut, Dr. Bernard Harris, as chairman of its advisory board.