Apple puts onus of FDA clearance on iPhone developers

By: Brian Dolan | Jun 9, 2009        

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FDAThe U.S. Food and Drug Administration has indicated in the past that under certain circumstances the iPhone may be considered a medical device and therefore regulated as one, however, as of February the FDA still hadn’t figured out exactly which circumstances those might be.

Turns out Apple isn’t waiting around for the FDA. iPhone application developer and GraniteKey COO Mike Ahmadi wrote in to point out that Apple’s iPhone developer agreement includes a special section that puts the regulatory onus, in particular the duty of ensuring FDA compliance, on the developers themselves. 

Obviously this section of the agreement has become increasingly important since Apple began promoting connected peripheral devices and medical apps like LifeScan’s glucometer and AirStrip’s cardiac monitoring application at the company’s iPhone 3.0 and World Wide Developer Conference events.

Under the developer agreement section labeled “Regulatory Compliance for Health, Medical and Related Apps,” Apple writes: “You agree that You will not seek any regulatory marketing permissions or make any determinations that may result in any Apple products being deemed regulated or that may impose any obligations or limitations on Apple. By submitting Your Application to Apple for selection for distribution via the App Store, You represent and warrant that You are in full compliance with any applicable laws, regulations, and policies, including but not limited to all FDA laws, regulations and policies….”

Read on for the entire section related to regulatory compliance for health and medical apps. Keep reading>>

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Interoperability for wireless health devices has a pulse, at least

By: Brian Dolan | Jun 9, 2009        

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Continua Health AllianceWhat’s old is new again? Continua Health Alliance certified Nonin’s Bluetooth-enabled fingertip pulse oximeter as the first, interoperable wireless health device. Nonin’s USB-enabled pulse oximeter was the very first (and only other) Continua-certified device. 

The news runs counter to claims made by the Continua Health Alliance’s Rick Cnossen, who chairs the alliance’s technical working groups: At the American Telemedicine Association event in April, Cnossen announced that the first Bluetooth-enabled Continua-certified device would be announced in early May. What’s more, Cnossen indicated to an audience member during the question and answer period that the first Bluetooth-enabled Continua device would not be made by Nonin. 

While delays for certification announcements are common and understandable, the move to promote Nonin’s wireless pulse oximeter as the very first Continua-certified wireless health device is somewhat puzzling. Continua is an alliance of some 190 companies, many of which make health devices that are assumedly gunning for interoperability certification. Cnossen’s comments at ATA indicated he understood that promoting another Nonin device would do a disservice to the marketing effect of announcing a different company’s product — if only to make clear that Nonin isn’t the only company with market-ready, interoperable devices.

Instead it appears that — at least for now — Continua is a one trick pony.

Related:
Continua announces Bluetooth Low Energy, ZigBee for Version 2
Which technology should Continua pick?
Continua: TV set-top box could be home health hub 

Read on for the press release from Continua. Keep reading>>

How, when and why smartphones will replace pagers

By: Brian Dolan | Jun 9, 2009        

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Last week we wrote about the growing popularity of smartphones among doctors and their growing use at hospitals. We wondered what it would take for smartphones to displace legacy pagers.

After posting our article with the question: “What’s it going to take for smartphones to replace pagers in hospitals?” we received a number of comments. We reprinted a few of them below with the authors’ permission:

What’s it going to take for smartphones to replace pagers in hospitals?

“Extinction of Homo Sapiens-Pager. They will go the way of the Neanderthal and be killed off by Homo Sapiens-Smartphone.” -Mark Moffitt MBA, BSEE

“Regarding pagers and smartphones: To replace pagers the mobile network would need to improve markedly. [It would need to improve] mostly in-building, but that is where the majority of house staff pages are sent. Depending on the geography, outdoor reception can be an issue, too.” -Dr. Joseph Kvedar, Founder & Director, Center for Connected Health, Partners Healthcare

“There are a couple of financial factors: 1) Cost. Pagers are significantly cheaper so giving 3,000 nurses and physicians pagers at $5/month is significantly cheaper than giving them smartphones. 2) Work vs. Home. Does work pay for the smartphone? If so, how to you stop employees from using it (a “company asset”) for personal stuff? Is it a personal smartphone? If so, why should the employee allow their employer to use it for work related business? This is a messy issue and you see a lot of people who are carrying multiple mobile devices (pager, work smartphone, personal cell phone) as a result.

The ‘I didn’t get the page’ comment is one you get a lot. With cell phones, you get more two-way communication that gets around the one-way pager excuse that some use to avoid people.” -George Brenckle, SVP & CIO, UMass Memorial Healthcare

“Along with the financial factors there is also the issue of coverage both inside and outside of buildings. Getting coverage for pagers in building is still easier and less expensive than for cell phones. Getting cell signal in remote areas is extremely difficult, and while not easy with paging, it is easier.” -Phil Clough, CTO at Berkshire Health Systems

“What are pagers? ;-)” -Dr. Ahmad Risk, Alif Healthcare

Mobile: The wild frontier of unclaimed health space

By: Brian Dolan | Jun 9, 2009        

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By Jim Lefevere

Jim Lefevere“Pioneers get the arrows,” as the saying goes. I much prefer: “Pioneers get arrows in their back.” Being early in a market is great — if the market is ready for you.

I have been in and around Internet and healthcare for nearly 15 years. I almost regret to say that that for many reasons, but mostly because I have been waiting that long for technology to revolutionize healthcare. That is a decade long trend in the making. I don’t think there has been much transformation other than a lot of VC money has been burned and consumers and HCPs are now both online. If you go back to the start of the millennium when the “Year 2000″ was the issue du jour, consumers and “silver surfers” were online then too and health information was at the top of the list for why they came online. The same is true today except the “silver surfers” are now the fastest growing segment on Facebook.

We have seen the DVR (digital video recorder) disrupt television viewing and single handily ruin Thursday’s “Must See TV.” We’ve seen the notion of watching a full-length movie on your phone become a reality and being able to watch your favorite TV shows remotely on your PC come and take hold in a shorter timeframe.

It’s interesting to watch mobile health take off and the AppStore on iTunes fill up with apps. Mobile is now the wild frontier of unclaimed health space. I truthfully think everyone is, to use the expression, “building the airplane while flying it” and not entirely sure where things will end up. Keep reading>>

Doctors: When tech improves the personal touch

By: Brian Dolan | Jun 8, 2009        

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Brian DolanDoctors “know instinctively that the human side of medicine — the attentive listening, the visual cues, the continued eye contact, and the careful history and physical exam — is critical…” Dr. Val Jones, CEO of Better Health, wrote in a commentary piece last week. “The problem we have with EMRs is that they often interrupt the sensitive and intuitive parts of what we do. EMRs and other digital ‘tools’ designed to make our work more efficient, may do so at the expense of the human connectedness our patients deserve and need.”

Jones’ commentary is a must-read for anyone interested in new technology’s impact on the patient-doctor relationship. As she notes, a more efficient practice is not necessarily a more effective one.

“Digital tools designed to make work more efficient” certainly would include the many wireless-enabled point-of-care services coming to market, but first a quick note on EMRs: The notion that EMRs will boost a practice’s efficiency has not yet been proven, according to one industry thought leader: Keep reading>>

Continua picks ZigBee, Bluetooth LE for health devices, sensors

By: Brian Dolan | Jun 8, 2009        

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Continua Health AllianceIn what looks to be a coup for the ZigBee Alliance, the Continua Health Alliance has picked Bluetooth Low Energy and ZigBee for inclusion in its next set of guidelines for interoperability between health devices and systems. The two low power standards will become the technology that Continua promotes for devices used in health and fitness and aging independently. 

The two technologies beat out rival low power technologies Sensium, ANT+, BodyLAN (used in Nike+) and Z-Wave, which all pitched Continua for the coveted spot in the guidelines. (Are we likely to see less of these technologies in fitness and health services moving forward?)

Continua picked Bluetooth low energy, which is still awaiting finalization of its specification, for future low power mobile devices, including activity monitors and heart rate sensors. The alliance also tapped ZigBee Health Care technology for sensors that could be used as motion detectors or bed pressure sensors and other use cases that would “enhance the daily living of those who require assistance aging independently,” according to the Continua press release.

“Version two of our guidelines is well on its way,” Continua Health Alliance President David Whitlinger told mobihealthnews a few months ago and just before the alliance began discussion on picking the new technologies. The first “radio selection will be predominantly geared toward the health and fitness devices that are typically body worn… The other use cases being addressed via low power radio are the sensors that might be distributed throughout the home of an elder individual, for example,” Whitlinger explained. “It’s possible they could both be the same technology, but because the use cases are different there is an option that there could be two separate radio technologies.”

Whitlinger’s comment that one technology could handle both use cases prompted many to speculate the Bluetooth LE would be picked for both uses, which makes the ZigBee pick a coup for the technology.

“The exciting aspect of Bluetooth low energy is its ability to enable low cost devices to be made that can send their data all of the way to the web. It’s based on over ten years of experience and promises to have the fastest growing ecosystem of any wireless standard. Today’s meeting sent a clear message to developers that they need to start designing now to be ready for the first generation of Bluetooth low energy handsets,” Nick Hunn, an analyst over at Creative Connectivity, wrote in a recent report.

Related:
Which technology should Continua pick?
Continua: TV set-top box could become the home health hub
First Continua-certified Bluetooth device forthcoming

Continue reading for the full press release from Continua Keep reading>>