Healthcare, keep kicking the tires on wellness

By: Brian Dolan | Feb 2, 2012        

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Brian Dolan, Editor, MobiHealthNewsThis week results from a study conducted in 2008 found their way into a medical journal: Virtual coaches work. According to the study, conducted by researchers at the Center for Connected Health, Northeastern University, and Massachusetts General Hospital overweight people wearing wireless pedometers upped their average activity levels by a significant amount if they checked in with a virtual coach a few times a week.

The researchers contend that virtual coaches will help people adhere to other care regimens, too.

In other news, the Wall Street Journal’s AllThingsD publication interviewed Andy Smith, CEO of fitness app developer DailyBurn, who argued the growing crop of connected fitness devices are just “glorified accelerometers” and only helpful to a small subset of “Type A” personalities. Smith points out that most smartphones today already come equipped with accelerometers embedded, which makes asking people to pay an additional $100 or $150 for a dedicated fitness device that does little more than a smartphone fitness app “not quite a gimmick, but close to it.”

DailyBurn started out creating data-centric smartphone fitness apps, but since it got acquired by IAC in 2010 it began to pivot its strategy. Smith says it has moved away from data and is now offering an app that provides video clips that aim to encourage users to exercise four to six times per week.

Perhaps it’s not surprising to hear that a fitness app developer is skeptical about dedicated fitness devices, but it seems that if done correctly — virtual coaches — which should be at the heart of any of these fitness offerings whether app or dedicated device, can significantly increase a user’s activity levels.

As we learned in our research report, mObesity, nearly all of those companies offering dedicated fitness devices and weight loss apps today believe their wares have a mass market appeal. They don’t believe these are tools for a data-obsessed subgroup. They believe these apps and gadgets could find adoption but any type of user — if they are designed to be easy enough to use, inexpensive, and fun.

The virtual coach researchers used some of the simplest wireless fitness devices available today — Fitlinxx wireless pedometers coupled with an avatar-based virtual coach program that participants accessed via their home computers. When compared to the control group, those meeting with the virtual coach increased activity levels equivalent to a half mile of steps taken.

It may be true that today healthcare and wellness are two separate markets, as one MobiHealthNews reader pointed out last week in a comment:

“Finally recognition that fitness and healthcare are two very distinct and separate fields. It astonishes me that healthcare execs are lulled into kicking the tires on a B2C solution, drawn by their consumer interest. Almost all B2C solutions have been devised by young, healthy and spirited entrepreneurs for that narrow slice of young, healthy, avid fitness enthusiasts. The solution has no place in the life of a 52 yr old Type II Diabetic with a BMI of 36 and uncontrolled BP dangerously averaging 148/96. They don’t need to know the times of their splits. They barely even walk.”

The average age of participants in the virtual coach study was 42. They were all overweight or obese. They benefited from a virtual coach. Would they have benefited more from a Nike+ Fuel Band? Maybe, but probably not given the way its sports-focused platform is designed today.

Consumerization of health is one of the key trends mobile health is driving. In order for today’s sick care system to transition to one more focused on prevention, healthcare industry incumbents need to continue to be lulled into kicking the tires on consumer health startups. And when consumer health startups develop virtual coach companions for their fitness devices and apps, they should consider how many Baby Boomers might use it.


You say mobile, I say wireless, but it doesn’t really matter

By: Neil Versel | Feb 2, 2012        

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Neil_Versel_LargeIt’s come up again.

“I am studying the wireless healthcare market and wanted to understand if there is any difference between wireless healthcare and mobile healthcare (m-health) market,” reads the question on the popular LinkedIn Wireless Health group‘s message board.

Some of the responses are expected, others are, shall we say, interesting:

  • “Generally, m-health uses mobile cellular technology, typically in an outpatient setting. Wireless healthcare can include both ambulatory (outpatient, home care, etc.) using mobile cellular technology as well as RF and Wi-Fi in hospital settings.”
  • “I expect that most m-health market research looks [at] mobile phones and smartphones using cellular, or cellular-like technologies… but that last bit can get tricky. Even if a mobile phone device and mobile phone app is connected to remote services over Wi-Fi at Starbucks or at home through a picocell due to poor cellular coverage, I would think the device and app would be counted under ‘mHealth.’
    But what if it’s a tablet or ultrabook connected over a cellular network (or Wi-Fi at home or in a hotspot)?  And what if the apps are optimized for a PC or tablet and not a phone? Isn’t the device still mobile? But does that mean it’s counted by market researchers as m-health? I think opinions may differ.
    Next, consider wireless connections between sensor devices using short-distance and low-power wireless technologies like ANT+, Bluetooth, ZigBee or Z-Wave. Does that wireless connected blood pressure cuff, arm band or body monitor patch count as m-health? I think market researchers would instead categorize those as ‘wireless health’ products.”
  • “M-health is a expertise domain definition. While wireless healthcare represetns a medium for sending and receiving data, wireless technology basically uses radio (and sometimes light – infrared) spectrum to move data. In designing a specific mHealth system, various wireless technologies should be considered to fit the purpose. Each technology provides a different set of capabilities, the single common feature being the ability to share data wirelessly.”
  • “Telehealth is often not mobile but Internet-based (connecting a patient with a physician using technology). I would go with the following: Wireless health — any situation where a patient connects with their health management using wireless technology (phone, Internet, etc.). M-health — any situation where a patient connects with their health management using a mobile device such as a tablet or mobile phone.
  • “Wireless is trending towards shorter distances, which decreases transmit power, increases battery life, improves security, and increases bandwidth performance, often dramatically.

Confused? Yeah, so am I. For the record, I use the following definition when I make public presentations about mobile healthcare, as I will Thursday at the Telehealth Alliance of Oregon’s annual meeting in Portland: Mobile health is an enabling technology that’s part of a personalized, wireless future. Keep reading>>

Study: Virtual coach improves activity levels for overweight, obese

By: Brian Dolan | Feb 1, 2012        

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Virtual CoachA study published in the Journal of Medical Internet Research found that using a “virtual coach” helped overweight or obese people increase their activity levels. Researchers at Boston-based Center for Connected Health, a division of Partners HealthCare, and Massachusetts General Hospital found that virtual coaches increased step counts by a significant amount. Participants in the study wore wireless, Fitlinxx pedometers.

While JMIR just published the study, the data was collected and analyzed in 2008.

“New technologies are showing great promise as effective, accessible and inexpensive solutions to a number of chronic health conditions and Internet-based interventions are demonstrating reductions in weight using a combination of self-monitoring, education and motivational messaging,” stated Dr. Joseph Kvedar, Founder and Director, Center for Connected Health, and study co-author. “We believe these results may be further enhanced with the addition of automated coaching, to promote accountability and adherence.”

Another co-author of the study, Timothy Bickmore, Associate Professor of computer science at Northeastern University, developed the Virtual Coach technology used in the study.

Seventy obese or overweight patients participated in the study. The average age was 42 years old. About 84 percent were females and 97 percent of those participating were college educated. Study participants were asked to wear a wireless pedometer and were given access to a website where they could view their step counts. Half of the group also met with a Virtual Coach, which is an automated and animated computer agent, on their computers at home. This application helped the intervention group set goals and also provided personalized feedback based on how well they were doing. Those with access to the virtual coaches were told to meet with them three times a week for about five to ten minutes.

During the 12-week study those with access to the virtual coach showed significant improvement when compared to those without access to the coach. The average step count in the control group fell from 7,174 steps to 6,149 steps. The average step count for those with access to the coach went from 6,943 to 7,024 steps.

By the end of the study, in other words, the control group walked half a mile less.

Read the full study over at JMIR’s site.
Or read more about the study in the press release below:

Keep reading>>

IBM acquires mobile enterprise developer Worklight

By: Brian Dolan | Feb 1, 2012        

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IBM WorklightIBM has acquired Israel-based mobile platform developer Worklight for an undisclosed sum. Worklight offers mobile application management to companies in a number of sectors, including healthcare. According to the acquisition announcement, Worklight is set to become a key component of IBM’s mobility strategy. IBM will leverage Worklight to help enterprise clients “speed the delivery of existing and new mobile applications to multiple devices” while ensuring “secure connections between smartphone and tablet applications with enterprise IT systems,” the announcement stated.

With the Worklight acquisition IBM certainly has mobility solutions for the healthcare enterprise in mind:

“For example, a bank can create a single application that offers features to enable its customers to securely connect to their account, pay bills and manage their investments, regardless of the device they are using. Similarly, a hospital could use Worklight technology to extend its existing IT system to allow direct input of health history, allergies, and prescriptions by a patient using a tablet,” according to the announcement.

IBM also noted the growing importance of mobile in the overall enterprise: A recent IBM survey of more than 3,000 global CIOs found that 75 percent pointed to mobility solutions as one of their top spending priorities. IBM also pointed out that last year, for the first time, shipments of smartphones exceeded total PC shipments.

IBM also claims that “every day more than one billion mobile phone subscribers are touched by IBM software.”

More on Worklight and its acquisition by IBM in the press release below: Keep reading>>

For iPad to succeed in medicine, significant software innovation needed

By: Brian Dolan | Feb 1, 2012        

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iPad medical appsA recent survey of more than 100 physicians conducted by Spyglass Consulting Group concluded that 80 percent of physicians believe the iPad has a “promising future in healthcare,” but they remain skeptical that the device is ready to transform patient care delivery. Gregg Malkary, Managing Director of Spyglass Consulting Group, noted that the iPad is just one component of the overall end-to-end clinical solution and that “significant software innovation” is needed to help the iPad and other tablets to realize their potential in healthcare.

Of the more than 100 physicians interviewed, 98 percent said that they had adopted mobile computing devices to support their personal and professional workflows. The physicians cited a number of reasons for mobile device adoption: ease of use, low costs, lightweight, widespread cellular connectivity, cloud-based Internet-connected apps, and location-based services.

Of the more than 100 physicians surveyed, 75 percent said that their hospital IT staff was hesitant or unwilling to support personal mobile devices on the corporate network because of security, reliability, and cost and maintenance concerns.

Interestingly, about 83 percent of the physicians said their desktop computers were still the primary devices that they used for accessing patient data when at home, in their office, or at the hospital. Physicians said they used mobiles to access clinical information when they were outside of these normal working environments.

In mid-2010, Spyglass published results from a similar survey that found of the (more than) 100 physicians surveyed, 94 percent said they were using smartphones to communicate, manage personal and business workflows, and access medical information. Spyglass conducted a similar study back in 2006 — back then only 59 percent of the physicians surveyed were using smartphones.

More details about the study in the press release below: Keep reading>>

Text4Baby helps employers promote maternal health tips

By: Brian Dolan | Feb 1, 2012        

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Text4babyPhoneText4Baby has partnered with Benz Communications to develop a maternal health “toolkit” for employers that aims to help them promote the Text4Baby service and other maternity benefits to employees.

Text4Baby is a free, SMS-based health information service for new and expectant mothers. It is available in both English and Spanish.

Here’s how the (former) White House CTO Aneesh Chopra described the Text4Baby service when he officially launched it two years ago: “The US government is formally announcing the launch of Text4Baby, [a free health service] designed to take advantage of the capabilities of cell phones, which have 90 percent penetration in the US. Starting today, women can text the word BABY or in spanish BEBE to 511411 and be automatically enrolled at no charge. The service provides at least three free text messages each week and [lasts during and shortly after the pregnancy]. The messages explain some of the experiences they may be going through and suggests ways for them to” keep themselves and their baby healthy.

Text4Baby launched in February of 2010, but we first mentioned it in a report back in 2009. Voxiva, which powers the Text4Baby service, recently launched Text2Quit, a similar service for smoking cessation. Alere is offering the smoking cessation service thanks to a licensing agreement with Voxiva.

A number of efficacy studies on the Text4Baby program are in the works, including one recently announced by HHS that will look at health outcomes from EHR data.

The Text4baby Toolkit offered by Benz and Text4Baby is free for employers to download and includes “ready-to-use templates that can be customized and integrated into existing benefits communication programs and channels,” according to the companies. The kits include program information sheets, benefits guide content, newsletter article template, wallet card, and even suggestions for messages employers can send out on Twitter to promote the service.

More in the press release below: Keep reading>>