Lively, a new eldercare monitoring system focused on social connections, heads to Kickstarter

By: Neil Versel | Apr 16, 2013        

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Lively hub sensorsA startup company is touting its system for remotely monitoring elderly people with chronic illnesses as having three advantages over existing products: elegant design, a focus on social connection rather than “fear of death,” as the CEO puts it, and price.

Lively, a San Francisco-based startup, is launching its eponymous system Tuesday, combining a series of wireless sensors, a data-collection hub and biweekly printed mailers that serve as kind of an analog social network.

A basic setup, to measure medication compliance, food and drink intake and general activity outside the home, will cost $149 up front with a monthly service fee of $19.95, though the company is taking pre-orders on crowdfunding site Kickstarter beginning Tuesday for $99, including one month of free service. (Like stress sensor startup Zinc, Lively is also is participating in a business accelerator from PCH International, an Irish-Chinese firm specializing in the launch of consumer electronics accessories.)

The disclike sensors—perhaps evoking the Misfit Shine in terms of form—are passive sensors with embedded communications chips. The base station, which has no wires other than an electrical cord and no on-off switch, was designed by Fred Bould of Bould Design, who, among other things, styled the Nest smart home thermostat. An embedded cellular link sends data to Lively’s cloud server.

But unlike the Misfit Shine or other personal monitoring devices, the sensors go on objects, not people. Co-founder and CEO Iggy Fanlo says participants in a pilot test of Lively complained that products for the 75-plus set often are not nicely designed. “We want something that’s beautiful that doesn’t stigmatize you as old and frail,” he tells MobiHealthNews.

One type of sensor goes on pill boxes, while another measures whether people are eating and drinking on a regular schedule by indicating when refrigerator or pantry doors are opened, both using accelerometers. A third variety is a key fob with a Bluetooth Low Energy transmitter than lets the server know when the user is out of range, typically 125 meters (about 410 feet). This measure acts as a proxy for indicating when the person has left home.

Additional sensors can be placed elsewhere, such as inside a car door to show when someone who might not be a safe driver got in the car or on a telephone handset to suggest, for example, that the elderly person called to make a doctor’s appointment. Keep reading>>


Cleveland Clinic app helps connect patients, doctors, trials

By: Jonah Comstock | Apr 15, 2013        

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cleveland clinic clinical trials appCleveland Clinic has built an app to help both physicians and patients find cancer clinical trials. The app, available for free from the iOS AppStore and the Google Play store, allows users to search the Cleveland Clinic’s the 130 active clinical trials by disease, phase, hospital location, or doctor. Although the app has been available since the end of January, the Cleveland Clinic has just officially announced it.

“When patients come in we’re always seeing if they’re appropriate for our clinical trials,” Dr. Brian Rini, an oncologist at the Cleveland Clinic Taussig Cancer Center and the physician lead on the app, told MobiHealthNews. “The app puts it all into one nice tidy package. It also has general information about clinical trials, consent, process. And it lists all the trials open throughout our system.”

According to the National Cancer Institute, less than 5 percent of adult cancer patients sign up for a clinical trial. And NCI studies have shown most patients don’t know clinical trials are an option for their care. Connecting more patients to trials can help improve patient outcomes and also help to move cancer research forward.

“Anything we can do to get more people is good,” said Rini. “The only way we make research advances is by putting more patients on clinical trials.”

Rini envisions the app as a tool for several different groups. He said that a certain slice of engaged patients are already doing research, searching for clinical trials online and bringing printouts into appointments. Other, older patients might not look at the app themselves, but caregivers or family members might.

“A lot of our patients have daughters, sons, etc. The way they get info is not picking up the phone, it’s looking on the internet or on a smartphone app,” said Rini. “It’s also an easy tool for a referring physician to look at, even if they’re sitting with the patient.”

The app will tell users about the protocols of a trial, what stage it’s in, potential benefits and drawbacks, and basic eligibility criteria. From there, the user can call the Cleveland Clinic’s Cancer Answer Line and possibly schedule a visit to determine final eligibility or get signed up. The app can also help connect patients with patient resources, financial services information, support groups and treatment guides.

Last month Novartis released an app called Clinical Trial Seek, which searches all the clinical trials in the government’s database. The Orlando Business Journal reported yesterday that Florida Hospital just launched its own clinical trial app, called MD Trial, although that app appears to have been in the AppStore since December. Florida Hospital’s app searches as well, but users can limit their search to Florida Hospital trials. Rini said he expects most major cancer centers will have an app like this soon if they don’t already.

“It sort of seems obvious,” he said. “We probably should have done it years ago.”

Seven in ten doctors have a self-tracking patient

By: Jonah Comstock | Apr 15, 2013        

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Microsoft HealthVault is one way patients can track health data.

Seventy percent of doctors report that at least one patient is sharing some form of health measurement data with them, according to Manhattan Research’s annual “Taking the Pulse” online survey of 2,950 practicing physicians.

Self-tracking is a budding area of research for pollsters — it was the headliner metric for the Pew Internet and American Life Project’s last health-focused report in January. Pew spoke to patients, not doctors, and found that 69 percent of people said they tracked at least one health metric, although half of those people were just tracking in their heads. More to the point, Pew’s research found that about a third of trackers share their data with someone else, and of those who share, about half share with a clinician. So if all the numbers are accurate, about one sixth of Americans are sharing health data with clinicians, but seven out of ten physicians have at least one patient in that group.

Another finding from Manhattan that lines up with Pew’s conclusions is that digital tools are not driving the tracking trend. Pew found that only one in five trackers used digital tools, while Manhattan Research found that the most common ways of sharing data with a doctor, according to the physicians, were writing it out by hand or giving the doctor a paper printout.

“Self-tracking is already a part of the care paradigm and its prevalence is going to accelerate rapidly as digital connection, payment reform, and outcome-focused delivery make advances,” James Avallone, Director of Physician Research at Manhattan Research, said in a statement. “We are seeing physician attitudes toward self-tracking aligning with policy, which is encouraging for all stakeholders involved.”

Manhattan Research also asked doctors what they thought of self-tracking, a topic MobiHealthNews explored in our February podcast. The firm found that 75 percent of doctors believed that self-tracking leads to better patient outcomes.

Healthbox measures its startups’ success in pilots

By: Jonah Comstock | Apr 15, 2013        

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Healthbox CEO Nina Nashif

After bringing their incubator to Europe last year, Healthbox has announced that its next class will be based in Jacksonville, Florida, sponsored by Florida Blue. Like Healthbox’s previous locations in Chicago and Boston, companies will receive $50,000 in seed capital and participate in a 16-week program. Healthbox will receive 7 percent equity in the companies.

As health-based accelerators proliferate, location has emerged as a way to stand out from the crowd, while promoting mobile health entrepreneurship all over the country. But different regions still have different needs and advantages. When TigerLabs Health launched, for instance, they promoted their New Jersey location and their proximity to major pharmaceutical companies. Healthbox sees Florida as a ripe and supportive environment for health startups.

“As you might know, we’ve run three programs over the past year, and what we’ve figured out is it takes a really present ecosystem to allow companies to flourish and make the most progress,” Jill Seidman, director of the Florida program, told MobiHealthNews. She said the state is home to innovative hospitals, active payers, and large Fortune 500 companies with a lot of employees — all good opportunities to test new mobile health products and services. Both Scripps Health Center and Mayo Clinic have Florida campuses (Mayo’s is in Jacksonville), and Florida sports a number of University-based health centers like the University of Florida’s Shands Health Center.

“There are a lot of organizations already there and we can be complementary to their research and innovation efforts,” Seidman said.

Healthbox founder and CEO Nina Nashif told MobiHealthNews that Healthbox has a strong focus on supporting its companies by building relationships with local industry players. That emphasis encourages certain companies to apply.

“Our ability to create networks of organizations that are willing to pilot early solutions and become early customers is vital to companies success and to ours,” she said. “We tend to see, because of the organizations that partner with us, more B2B in general across all of our programs and that will probably be the case here as well.”

Florida has a large Medicare population, and its Medicaid population is likely to expand soon, in light of a recent policy shift from Governor Rick Scott. Seidman and Nashif both said they wouldn’t be surprised if a number of applicants focused on products and services for aging populations, but also services that increase hospital connectivity.

Nashif also talked to MobiHealthNews about some metrics from Healthbox’s existing programs. She said that one of the biggest things the accelerator has learned from past classes is how to best make use of strategic partners.

“When you look at the press around the broader accelerator model, the metric that is typically talked about is the number of companies funded post program,” she said. “That’s important for venture capitalists. But we also look at, immediately after the program, how many companies are able to get pilots going in the healthcare system. Healthcare organizations tend to be comfortable with what they’ve always done and who they’ve always worked with. So taking a risk and working with someone new is not always common.”

By that metric, Healthbox is doing pretty well, according to Nashif.

“Collectively, 27 of our companies [out of 37 total] secured more than 50 pilots,” she said. “It means that we’re actually penetrating the system in the right way.”

International regulators focus on medical software, including apps

By: admin | Apr 15, 2013        

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Bradley Merrill ThompsonBy Bradley Merrill Thompson, EpsteinBeckerGreen

I’ve always found the saying, “Be careful what you wish for; you might just get it” to be rather condescending. In a way it suggests that we are too stupid to manage our own affairs. But like any popular saying, it probably has a kernel of truth.

Frankly, I’m a little nervous about a request made by industry for international medical device regulators to focus on standalone software, including mobile medical apps. At the request of an international trade group, on March 21, 2013, the International Medical Device Regulators Forum (IMDRF) decided to pursue harmonization of the regulatory approach to standalone medical device software. Standalone software in healthcare, as most people use that term, would include mobile medical apps, clinical decision support software, electronic health records and any other software used in healthcare that does not drive a medical device (hence it stands alone.)

Many of the industrialized and developing nations around the world established IMDRF in 2011 to provide a forum to discuss future directions in medical device regulation, and harmonization at an international level. The IMDRF builds upon the work of the Global Harmonization Task Force.

IMDRF membership includes regulators from Australia, Brazil, Canada, China, European Union, Japan and the United States, as well as the World Health Organization (WHO). In the US, for example, FDA is the participant, and in the EU the representative is the European Commission Directorate — General Health and Consumers. The recent IMDRF meeting that examined software took place in Nice (France) from 19 to 21 March 2013. The next meeting will take place in Brussels on 12-14 November 2013.

The IMDRF manages its agenda by formally adopting so-called work items. These work items then become the focus of activities between the full, semi-annual gatherings of the Forum. In 2012, at the fall meeting in Sydney, the DITTA (Global Diagnostic Imaging, Healthcare IT and Radiation Therapy Trade Association) recommended the creation of a work item dedicated to medical software. In an October 29, 2012 letter to IMDRF, DITTA wrote:

DITTA greatly appreciates the Management Committee’s further consideration during their session on 27 September of our proposal for a possible future IMDRF work item on medical software. Reasons which justified our suggested work item to IMDRF are that medical software is playing an increasingly greater role in medical technology in product-embedded software applications or in stand-alone software solutions. This includes but is not limited to aspects of software vulnerability with potential impact on patient safety. Therefore global harmonization of regulations and standards governing medical software is critical for patient safety as well as to the future innovation and prosperity of our industry.

Selecting standalone software as a work item is a big step as the 2-year-old forum only maintains about a half-dozen work items. Indeed, the most recent meeting only produced two new ones.

This is either a tremendous opportunity or a tremendous threat depending on whether you are an optimist or pessimist. I frankly don’t know what it is. Subject to what region you’re from, international harmonization can either raise the tide or lower it. Some folks worry that when regulators get together to compare notes on an issue the hurdles typically go up, kind of a regulatory arms race, but the positive side is that harmonization can be very helpful to international businesses.

Certainly there is a lot going on in the US with regard to mHealth regulation, but most people in the space can’t afford to simply ignore the rest of the world. Indeed, even if you’re only involved in US, this Forum has the potential to influence US regulation. Industry needs to be actively involved in all of these discussions to ensure the resulting regulation is sensible, and accommodates the innovation which is the lifeblood of mHealth. I just hope we like what we asked for.

Cedars-Sinai enlists FaceTime for moms to see their babies in the NICU

By: Neil Versel | Apr 12, 2013        

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Cedars Sinai LA iPad maternity wardUnmodified iPads simply running Apple’s built-in FaceTime app are giving new mothers at Cedars-Sinai Medical Center in Los Angeles a chance to see their premature or sick babies in the neonatal intensive care unit (NICU) even if they are immobile while recovering from delivery or the infants are in isolation.

“When mom’s recovering, she can’t come up to the NICU and see her baby,” Yvonne Kidder, a clinical nurse in the NICU at the Cedars-Sinai Maxine Dunitz Children’s Health Center tells MobiHealthNews in an interview. Kidder created BabyTime, so named because it uses FaceTime to let mothers see and virtually interact with their newborns within hours of birth.

“Moms sometimes take 2-3 days before they can see the baby,” Kidder says. “We want to cut that down to 2-3 hours.”

The hospital’s pediatrics chair estimates that 20 percent to 30 percent of deliveries by Caesarean section leave the mother confined to a recovery room in labor and delivery a floor below the NICU for 24-48 hours after childbirth. Hospital guidelines call for mothers to have video time with their babies at least once per 12-hour nursing shift. They also can ask questions of clinicians in the NICU by mobile videoconference.

BabyTime started Feb. 11 for a small group of new mothers who had C-sections. Later it will expand to traditional deliveries if needed, according to Kidder. “It’s just awesome,” Kidder reports two months later. “We’ve been getting wonderful feedback from the moms and the families.”

Kidder says she first got the idea in August 2012, when she was working with a mother who was sick in a recovery ward while her baby was in the NICU, and the patient had no other family members around. Nurses and respiratory therapists at Cedars have iPhones running the Voalte communications system, but at the time, they only had iPhone 3 models, which did not support FaceTime.

Kidder says she presented the FaceTime idea to her nurse manager, who then brought the idea to the medical director for women’s and children’s services. The hospital had been looking at a NICU webcam service called NICView with cameras at each bedside. “It did not have the flexibility of the iPad,” Kidder says, since nurses can move iPads around to provide different views. Buying a handful of Apple tablets was a lot less expensive than installing a camera system, though she says an NICView is still on the table for the future.

The hospital’s informatics project team met in September and created guidelines and consent policies for BabyTime, then agreed to purchase one iPad for the NICU and one for the postpartum ward. Kidder says Cedars plans on getting another iPad for the NICU and one for labor and delivery that patients can carry with them if they are transferred. “Sometimes mom gets very sick and needs to get to the ICU herself,” Kidder explains.

She foresees expanding BabyTime with iPads or other videoconferencing links at home and for babies needing to be moved to other hospitals. “We haven’t established how we are going to do this yet,” Kidder says.