Early studies show mobiles can encourage exercise

By: Jonah Comstock | Nov 27, 2012        

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Fitbit Zip Fitbit OneA new meta-analysis of 11 studies shows that mobile device-enabled interventions can help increase people’s physical activity. The study, published in the Journal of Medical Internet Research, is the first meta-analysis of its kind, according to the authors.

The 11 studies looked at a broad range of mobile interventions, a few of which seem out of date in the current market. Eight of the 11 used text messaging to offer motivation and report activity. Four used smartphone apps, and two used Personal Digital Assistants, or PDAs.

“You go to conferences and there’s a lot of talk about mobile health interventions,” said Jason Fanning of the University of Illinois at Champagne-Urbana, one of the authors on the study, “but we didn’t have a concrete or objective way of looking at this.” Fanning says this foundational data will give a comparison point for future studies, possibly involving newer technologies.

A total of 1,351 individuals participated in the 11 studies. Three studies reported no effect, but the others all showed a positive effect. It was difficult to pull together aggregate data, Fanning said, because the studies used different metrics for success when it came to increasing physical activity: different studies used self-reported activity, pedometer data, accelerometer data, and metabolic equivalents.

Though there wasn’t enough data to draw statistically significant conclusions, Fanning said the effectiveness of the studies suggested a few trends. He said interventions that involved goal setting seemed to do better, and that frequent engagement predicted success.

“Those interventions that were interacted with most frequently were more effective, especially with an SMS-based intervention,” Fanning said.

Activity trackers and companion apps are already available in the market, of course, such as the Fitbit One, Misfit’s Shine, Jawbone’s UP bracelet and BodyMedia’s FIT armband. Fanning says he’s looking forward to efficacy data on those products.

“In the near future there will be a small number of validation papers coming out on some of those devices, and that will be interesting,” he said. “If those are more valid, you’ll see a much higher saturation of those devices in a research context.”


Apple’s top 80 apps for doctors, nurses, patients

By: Brian Dolan | Nov 27, 2012        

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iPhone Apps

Based on the more rigorous surveys and reports, it’s still true that clinicians are generally more eager adopters of both mobile devices and the medical apps that run on them. The persistent challenge for many iPad-toting physicians, however, is where to turn for medical app recommendations. In its efforts to be at least somewhat helpful on that front, Apple has slightly reworked and beefed up its now more visible section of “Apps For Healthcare Professionals”, which appears to be consistently featured in the AppStore’s medical section now.

We’ll be discussing mobile health tools used by clinicians with HCA and AirStrip Technologies this Thursday afternoon — be sure to register for our free webinar here, if you have not done so already.

In May 2012 Manhattan Research published its latest data on physician smartphone, tablet, and app adoption, which in most ways outpaces the average consumer. In May the research firm found that already 62 percent of US doctors already had some kind of tablet device — twice as many as in 2011 — and even many of those with devices planned to buy an additional one within a few months.

The iPad continues to dominate as the physician’s tablet of choice. Only the Kindle Fire had made some inroads beyond single percentage points of adoption, which is where all other comers stood.

Manhattan’s VP of Research Monique Levy noted in May that while tablet adoption has soared, doctors aren’t finding the devices to be replacements for their smartphones. One of the biggest strikes against tablets, according to those physicians surveyed, were that tablets are too big for their lab coat pockets. Levy said that while new coats with larger pockets are available they “don’t cut it,” according to the thousands of physicians surveyed.

The new iPad mini certainly solves that problem, which may mean smartphone cannibalization is possible in the years ahead after all.

As app users, physicians typically download fewer apps than the average consumer but they use a higher share of those apps that they do download, according to Manhattan. They also use their apps on a more frequent basis than the average consumer. Between patient consultations, physicians are likely to use their tablet or a desktop/laptop if they are looking to read a full journal abstract, watch a video, or fully access an EHR. During patient consultations the range of activities physicians are likely to do on smartphones is a little bit narrower, and often include “simple tasks that have one or two steps,” Levy said. About 18 percent of physicians use some aspects of EHRs on their mobile devices — even on their smartphones. The biggest surprise Manhattan Research encountered during its survey was a lack of mobile offerings that help enable the “swivel effect” where the physician flips the screen around to explain something to their patients.

In September 2011, Apple added a new section to its AppStore for healthcare professionals that included about 50 apps designed for iPad and iPhone users. A little more than a year later the section has been slightly reworked: Apple added a new subsection for nurses, changed the name of its “point of care” section to “patient education” and added a few new apps to most of the existing subsections, too. Apple now recommends some 80 apps to healthcare professionals and it makes for an interesting list of top medical apps.

Finding worthwhile medical apps has been a longstanding issue for physicians, nurses, and other clinicians. Wading through the now tens of thousands of health-related apps to find useful ones to use in care settings is a generally cumbersome chore unless you know what you are looking for. Over the years a handful of blogs have sprung up to offer recommendations and reviews from individual medical students or physicians. Happtique has quickly built a following as it develops its own filtered medical app store of sorts that intends to make it easier for healthcare facilities to discover and distribute apps. And Apple appears to be slowly doing its part to highlight apps it deems to be of a certain quality, but its reasons for choosing the 80 apps below — like many things the company does — remains unclear.

Given the thousands of tweets and shares our first review of Apple’s Apps for Healthcare Professionals received, we have taken another look to update and compile a slideshow of the apps currently featured in the section and broken them into the categories that Apple uses. Read on for a brief description of each and some screenshots: Keep reading>>

Qualcomm contributes to ClearCare’s $4.6 million round

By: Jonah Comstock | Nov 27, 2012        

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ClearCare OnlineQualcomm Ventures is one of several investors in the first round of funding for ClearCare, a San Francisco-based company that provides a front- and back-end online software platform for the home care industry. ClearCare raised $4.6 million in combined seed and first round funds from Qualcomm and venture firms Voyager Capital and Harbor Pacific Capital. Voyager led the round. The 2-year-old company plans to use the funds to continue to develop the product and to grow sales.

ClearCare’s software platform enables the families of aging in place seniors to have real-time access to caregiver records, which the caregiver can update online, by text messaging, or by phone. In addition, it includes back-end services like accounting and HR. According to the company, they have more than 250 home care businesses using their service across the country and in Canada.

Right now there’s no relationship between Qualcomm and ClearCare beyond the investment, but both companies see potential collaboration in the future with Qualcomm Life’s home monitoring and alert systems.

“We see natural synergy with ClearCare’s platform,” Jack Young, Director of Qualcomm Ventures, said in a statement. “Qualcomm offers a growing variety of in-home wireless health solutions, and data from these technologies ultimately has to be delivered and leveraged by all the constituencies in the care ecosystem. ClearCare’s platform is well-positioned to get in-home data to the parties that need it and make it actionable.”

Young told MobiHealthNews Qualcomm has been watching the home care space for some time, citing the statistic that 10,000 baby boomers turn 65 each day. He said that new solutions for senior care will be important as the number of people needing care grows.

ClearCare Chief Operations Officer Jacqueline Kung told MobiHealthNews that the home care space is badly in need of online innovation. When caregivers keep only paper records it can be hard for families, especially far away families, to know how their loved one is doing.

Partners was “mystery” Healthrageous investor

By: Jonah Comstock | Nov 26, 2012        

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HealthrageousMobiHealthNews covered health coaching platform company Healthrageous’s $6.5 million second round funding last month, but the company just announced that the final investor in that round was the Partners Innovation Fund, a division of Partners HealthCare. Partners is the parent company of the Center for Connected Health, the group Healthrageous spun off from when it was founded.

Healthrageous CEO Rick Lee said that Partners Innovation Fund was in discussions about investing when the company was founded, but a change in their conflict of interest policy prompted them to alter the relationship. Partners holds a royalty license for the Healthrageous technology developed at the Center for Connected Health. Lee sees the benefit in having Partners as a full-fledged investor.

“It has a lot of gravitas in the world of medical science,” said Lee, “and if you’re pitching your commercial application to a chief medical officer who was trained at Mass Gen or Brigham and Women’s it’s something they relish and regard with a good deal of recognition and support. So it is an excellent marketing angle for us.”

The same Center for Connected Health study that led to Healthrageous’s founding was finally published in the October 2012 issue of the American Heart Journal. In a randomized clinical trial of 404 employees with pre-hypertension or hypertension who worked at EMC, those who used a web-based self-management program showed a 95 percent sustained engagement rate and were more likely to have lowered their blood pressure.

People in the intervention group used an online program and a provided blood pressure cuff to track their readings and share them with their care providers securely. At the end of the study, 22 percent experienced a greater than 10 mmHg drop in systolic blood pressure and 29 percent had a greater than 5 mmHg drop in diastolic blood pressure. Overall, the intervention group had a statistically significant drop in average diastolic, but not systolic pressure. In addition, participants were more likely to report starting a new medication or communicating better with their doctor.

Healthrageous says the data from its ongoing hypertension self management offering suggests the outcome continues beyond six months. The company reported a 70 percent sustained engagement rate for participants in its program.

Today, Healthrageous offers monitoring and biofeedback solutions through mobile devices as well as the web, and has expanded its area of operations beyond hypertension, launching a recent pilot for diabetes management. It’s all based on the same philosophy of using constant monitoring, game and social dynamics, and biofeedback to motivate behavior change. But Lee says a lot has changed in the three years since the initial trial was conducted. The move from a connected to a wireless blood pressure cuff increases ease of use, as does the early move from PC-based web connectivity to mobile use.

“The big improvement in the business model, … that, for obvious reasons, wasn’t tried in the initial trial, was investing in machine learning and building a machine learning platform that could personalize messages to the end user. It collects demographic and preference data about each user and then uses it to better inform about what questions to ask and how to ask them,” Lee said.

He also said current hypertension interventions through Healthrageous include an accelerometer, since increasing activity is the best way, apart from medication, to combat hypertension. Users see graphs of their activity rates displayed alongside blood pressure, so they can see the effect movement has.

The interface and the machine learning platform are both likely to improve soon. Those are two areas the company said it would improve with the money from last month’s funding round.

iRhythm scores $1.5M, study support from California HealthCare Foundation

By: Neil Versel | Nov 26, 2012        

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iRhythm Zio PatchThe California HealthCare Foundation (CHCF) has invested $1.5 million in iRhythm Technologies, maker of Zio Patch, an FDA-cleared ambulatory cardiac rhythm monitor. The Oakland, Calif.-based foundation also says it will sponsor studies of the technology at two safety-net health systems in the state.

Zio Patch differs from many other wearable monitors in that it does not have built-in wireless connectivity to a base station, smartphone or central server. Instead, the single-use product stores up to 14 days of data locally. After the monitoring period, users mail in the Zio Patch for analysis.

The trial will help clinicians at public hospitals, outpatient facilities and rural clinics detect and treat heart arrhythmia in patients who might not otherwise get the necessary care, according to CHCF and San Francisco-based iRhythm.

“iRhythm’s Zio Patch technology has the potential to increase access to timely diagnosis and care for patients in both rural and urban environments,” Margaret Laws, manager of the CHCF Health Innovation Fund, which is making the actual investment, says in a statement released just before Thanksgiving. “The simplicity of their approach to ambulatory cardiac monitoring minimizes logistical difficulties, promotes increased patient compliance and streamlines the process for patients and clinicians, making this a solution that can bring great value to underserved Californians,” says Laws, who also directs the foundation’s Innovations for the Underserved program.

“The Zio Patch also has the potential to reduce the cost of cardiac rhythm testing by reducing the number of times monitoring must be done before a diagnosis is obtained, which could result in overall reduction of costs to the healthcare system,” Laws adds in an iRhythm press release.

The CHCF investment is small compared to earlier venture capital iRhythm secured from other investors. Notably, medical device manufacturer St. Jude Medical led a $10 million round of financing in 2010, along with Mohr Davidow Ventures and Synergy Life Science Partners. Last year, Kaiser Permanente Ventures offered up $7 million and New Leaf Venture Partners provided $15 million. All told, iRhythm has raised about $52 million in private equity.

Zio Patch received 510(k) regulatory clearance from the Food and Drug Administration in July, though it has been on the market since 2011. More than 85,000 patients have used the device, according to iRhythm.

First responder startup secures six-figure funding

By: Jonah Comstock | Nov 23, 2012        

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MEDIVIEWBeyond Lucid Technologies, a 3-year-old startup that offers a mobile platform for first responders, called Mediview, announced a new investor this week. Dalmore Investments LLC, an angel fund based in Minneapolis, gave the company a six-figure convertible note, according to their website. This appears to be the company’s first major raise. It will be added to $420,000 in previously announced seed funding, including grants from the National Institutes of Health and Carnegie Mellon.

The company’s CEO Jonathon Feit told MobiHealthNews that because of the nature of the angel group they wanted to keep the exact funding number quiet. But he said the company will be using the money to build up a marketing department around what he believes is already a very functional product.

“We’ve been operating very much in a bootstrap fashion, since we started,” he said. “And we’ve been living the Silicon Valley dream, working out of a garage and virtually. That’s gonna change and the efficiency we’re going to get out of that is pretty significant.” He also said the company plans to hire more sales and marketing staff.

Beyond Lucid Technologies (BLT) has been a company to watch this fall. In September it was selected as one of the 12 companies to join incubator StartUp Health’s second class. In October BLT won the Series A category of the DC to VC: HIT Startup Showcase, sponsored by Morganthaler Ventures and Health 2.0. Feit and co-founder Christian Witt met Dr. John Blank, who leads Dalmore Investments, at DC to VC, according to the announcement.

Blank said in the press release, “We know that each year, emergency responders lose roughly $3 billion in unbilled and uncollected revenue because existing methods are ineffective to document care while traveling in a vehicle alongside a sick patient. Generating reliable health records in the EMS context — and unlocking the data they hold — has been a problem in search of a solution for years. We are working with Beyond Lucid Technologies because we think Mediview provides this necessary solution.”

At the DC to VC competition, Beyond Lucid impressed judges by having a comprehensive system and identifying a real problem space in healthcare: They estimate 50 percent of ambulances use paper records which are then handed off to the hospital ER staff, a system that doesn’t get crucial health information to doctors as quickly or efficiently as it could. Mediview is a cloud-based mobile platform which connects to hospital EHRs, handling the information hand-off digitally. Despite a relatively small amount of funding, BLT has managed to sign on a number of clients, Feit said.

The company has been getting a lot more interest since DC to VC, Feit said.

“We hadn’t been courting VC investments; we’d been building quietly,” he said. “It’s kind of a Catch-22. You need some truth points in order to generate money and vice versa. But when it comes to certain healthcare services, you simply can’t deploy a beta. You have to have a version that works. If something goes wrong, people die.”