Report: Fitbit raises $30 million at $300 million valuation

By: Brian Dolan | Mar 5, 2013        

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Fitbit Zip Fitbit OneSan Francisco-based Fitbit, which offers activity monitors and a connected weight scale, has raised an additional $30 million in its fourth round of funding at a valuation of $300 million or more, according to a report over at TechCrunch. While the investors announced for its $12 million third round of funding in January 2012 included Foundry Group, True Ventures, SoftTech VC and Felicis Ventures, the investors in this fourth round are still unknown. The recent funding makes Fitbit one the best funded activity and weight tracking companies in digital health.

At the Consumer Electronics Show (CES) this year, Fitbit unveiled a new Bluetooth Smart-enabled, wrist-worn activity tracker, called Fitbit Flex. Like most of its other trackers, the Flex also helps users track their sleep health if worn at night. What set it a part from previous offerings from the company was that all of Fitbit’s previous activity trackers were intended to be worn clipped on to clothing or tucked into users’ pockets. The Flex, which is priced at $99.95 for preorders, was the first wrist-worn device from the company.

fitbitariaIn September 2012 Fitbit launched its first Bluetooth-enabled activity trackers: Fitbit One and Fitbit Zip. Legacy Fitbit devices only uploaded information to the Fitbit portal and app when the wearer was nearby a wireless-enabled hub that plugged into the user’s computer via USB, and the new Fitbit devices offer this too for users that do not use Bluetooth 4 compatible devices.

At the beginning of 2012, Fitbit unveiled the Aria WiFi scale, its first product offering outside of wearable activity monitors. Similar to Withings’ WiFi scale, the Aria measures weight, body fat percentage, as well as BMI and uploads the data via the user’s home WiFi network to Fitbit’s online portal.

Fitbit sells its devices in various retail stores including Target, Best Buy, Brookstone, REI, RadioShack, and more. It also worth noting that former Allscripts CEO Glen Tullman has written about the possibility of including Fitbit data in EHRs in the future.

Fitbit Flex__ColorsIn October 2011 Fitbit launched the Ultra, the second generation of its original wearable fitness monitor. Like the original Fitbit device, the Ultra is a wireless-enabled, fitness and calorie tracking device small enough to clip on to the user’s clothing. Fitbit leverages an internal motion detector to track the wearer’s movement, sleep, and calorie burn during both the day and night. Fitbit provides users with metrics like: steps taken, miles traveled, calories burned, calories consumed, bedtime, time to fall asleep, number of times awoken, total time in bed, and actual time sleeping.

Last month Fitbit announced an upgrade that enabled its devices wirelessly sync to Android phones and tablets via Bluetooth 4.0. Initially, syncing is enabled for the Samsung Galaxy S3 and the Samsung Galaxy Note II, with more promised to come.


Mobile might hold key to patient engagement in MU Stage 2

By: Neil Versel | Mar 5, 2013        

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Mayo Clinic's app: Patient

Mayo Clinic's app: Patient

When Stage 2 of the federal electronic health records (EHR) incentive program known as meaningful use begins in October (for hospitals) and in January 2014 (for physicians), compliance for the first time will not be completely in the hands of providers.

Stage 2 rules require participants to give at least half of their patients the ability to view and download their own medical records through online portals or personal health records, up from 10 percent in Stage 1. But more significantly, 5 percent of patients actually have to log in to those portals or healthcare providers will lose out on Medicare and Medicaid bonus payments.

The 5 percent figure may not sound like much, particularly because an earlier proposal called for the threshold to be 10 percent, but it has a lot of providers scrambling. The new requirement, for the first time, makes hospitals, health systems and medical practices to engage patients in their own care or risk losing extra revenue.

“They don’t like that it puts the onus on the institution to get patients to use portals,” Dr. Bruce Darrow, CMIO at Mount Sinai Hospital in New York City, told MobiHealthNews at this week’s Health Information and Management Systems Society (HIMSS) annual conference in New Orleans.

Darrow, a cardiologist, said that his patients are not exactly clamoring for access to their records at the moment. “I am more interested in getting my patient interested in a portal than my patient is in using it,” he said. And the interest level dips the lower you go on the socioeconomic scale. “I think it’s a much harder conversation to have if you’re in East Harlem,” Darrow said.

Mobile technology may very well be what breaks down the barriers. “That’s going to be where it goes,” Darrow predicted. After all, mobile phones – even non-smartphones – often are the only means people have of getting on the Internet.

“Mobile can give access to portals,” agreed Kenneth Kleinberg, managing director for healthcare at the Advisory Board Co.

Dr. Kate Christensen, medical director of Kaiser Permanente’s Internet Services Group, noted that 4 million Kaiser members have registered to use personal health records through an online portal. In 2012, patients sent 13 million secure e-mails to their doctors’ offices, viewed 33 million test results through the portal, booked 3 million appointments and requested 12 million prescription refills.

A year and a half after the organization released its first mobile app, 22 percent of portal traffic comes from mobile devices, Christensen said Sunday during the HIMSS pre-conference physician symposium. And the fastest-growing groups of users are seniors and people with chronic diseases. “The use of smartphones is also skyrocketing among older people,” Christensen said, “and I don’t really think it’s a barrier until about [age] 85.”

According to Dr. Geeta Nayyar, AT&T’s CMIO, mobile means “going home with our patients.” Obviously, AT&T has a vested interest in continued expansion of mobile communications, but tests have shown that patients like the flexibility.

Last year, AT&T and health insurer Health Care Service Corp. found some success in engaging patients with WellDoc’s DiabetesManager. In a pilot among 156 HCSC employees, 88 percent called the system “highly useful” for self-management of diabetes.

“We did the study for six months and found that patients were engaged,” Nayyar said at HIMSS.

MobiHealthNews coverage of the HIMSS13 event in New Orleans is sponsored by AirStrip Technologies.

Microsoft turns to partners to eschew “one size fits all” mentality

By: Jonah Comstock | Mar 5, 2013        

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Microsoft Windows 8 Surface Pro tabletThe inescapable question for Microsoft at HIMSS 2013 is this: How does the company maintain relevance in a mobile ecosystem increasingly dominated by Apple iPhones and iPads? With its Surface Pro tablet, Windows 8 operating system, and Office 365 HIPAA-compliant cloud platform, not to mention a bevy of new app partners, Apple’s longtime rival is doing its best to step up to the plate. The company recognizes that healthcare is one of the biggest battlefields.

“We focus on tech as an enabler, and how Microsoft plays a role,” Michael Robinson, head of health and life sciences for Microsoft in the US, told MobiHealthNews. “It’s a multibillion dollar business for us; it’s about working with our partners. [Healthcare] is the fastest growing vertical within Microsoft.”

Although some CIOs have purchased iPads for clinical use, a lot of iOS devices find their way into hospitals through BYOD channels — physicians bring in their home devices and hospital IT teams have to find a way to make them work in the hospital workflow. Because Apple builds its devices for consumers, not for enterprise, this can be a vexing situation for CIOs, said Microsoft Worldwide Senior Director of Health Dr. Bill Crounse in an interview last week.

“I think in the next purchasing cycle, what we are going to see is that as the message starts getting out, coming from health IT there’s gonna be this dynamic tension,” Crounse said. “No physician wants to put their patient at risk by using a device that’s putting information at risk. So I think the next time around, when the physician says ‘It’s time for me to get a new device, what should I be thinking about?’ I think IT is going to be pushing them toward this new generation of devices on Windows 8.”

The Surface tablet in particular offers some competitive features, including a larger range of ways to input data into the device.

“[Doctors] are really excited about using all the input modalities they want — touch, pen, keyboard, voice,” Microsoft Chief Health Strategist Dennis Schmuland told MobiHealthNews. “So because these devices are integrated with keyboards and microphones and all these inputs, it leads to better productivity.” Schmuland said the pop-up keyboard on Apple devices, which can pose a safety risk by blocking important medical information, is a good example of a way that a consumer device isn’t perfectly suited to a clinical setting.

Microsoft also pointed out that the Surface tablet can be mounted and attached to a physical keyboard and mouse and become a desktop workstation. Rather than having a tablet for rounds and a desktop in the office, physicians could just use one device that easily converts between those two forms.

Although Microsoft touts its Surface tablet as a reasonably rugged consumer device, the company also recognizes the diversity of needs in the healthcare space. Unlike Apple, whose iOS is tied exclusively to its devices, Microsoft’s Windows 8 runs on over 1,500 partner devices. This is important, Microsoft execs say, because there’s no “one size fits all” when it comes to clinical workflow.

“There isn’t today nor will there ever be, the perfect device for all clinical workflows,” said Crounse. “I think most clinicians will find themselves using a range of devices.”

In addition to the Windows 8 operating system spanning a range of third party devices, it’s also a single OS across Microsoft phones, tablets, and PCs and is backwards compatible, allowing Windows 8 devices to integrate with hospitals’ legacy computer systems or to run Windows 7 computer programs.

Showcasing this idea of a Windows 8 ecosystem, Microsoft announced a number of pilots and partnerships at HIMSS.

– In a collaboration with Intel, Microsoft is launching a proof-of-concept pilot with the Cleveland Clinic. According to a press release, the Clinic will be “exploring the capabilities of Windows 8 and new Intel-powered mobile devices that enable clinicians to view a risk-stratified list of patients and call up their latest medical information.”

– Another pilot, with Pediatric Associates, will use Greenway’s newly announced PRIMEMobile EHR App for Windows 8.

– In addition to Greenway’s PRIMEMobile, Microsoft announced new EHR apps for Windows 8 from Pariscribe and MazikCARE. Allscripts and Epic already had offerings on the platform.

– The company highlighted a number of new apps for Windows 8. Clinical reference apps UpToDate and Electronic Preventative Services Selector both launched on the platform, as well as consumer apps from Johnson & Johnson, the CDC, and Mayo Clinic.

Finally, Microsoft is showcasing its Office 365 HIPAA-compliant cloud platform, which might help address some of the problems surrounding secure physician-to-physician communication in a healthcare setting.

“Office 365 was designed and engineered from the beginning to be HIPAA capable,” said Schmuland. “We’re one of the only cloud providers that has a business associates agreement. It’s a standard agreement that scales from large corporations, down to small platforms. We went through several iterations, so that we had a business associates agreement we knew would be broadly accepted.”

That HIPAA compliance extends to the Lync application, Windows 8’s messaging system, which means the platform is uniquely positioned to offer HIPAA-compliant video conferencing.

Healthcare is a focus as BlackBerry 10 rollout continues

By: Jonah Comstock | Mar 5, 2013        

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blackberry Z10In the month since BlackBerry’s global rollout of the Z10, the first smartphone running on its new operating system, began, BlackBerry has built a steady stream of hype about its daunting would-be comeback, with reports coming in that half of Canadian buyers and one third of purchasers in the UK are switching over from Apple or Android.

At HIMSS in New Orleans, Vice President for Global Sales Paul Lucier confirmed to MobiHealthNews that the new phone, which comes to the US on March 11th via T-Mobile USA, is showing strong sales so far, including a number of Apple and Android converts.

“We think it’s an indication that there’s fatigue out there and people are looking for something new,” he said.

Lucier also confirmed some of what we speculated on last month — that healthcare will be a strong focus for the company as it seeks to make its comeback.

“Healthcare’s an area we want to focus, whether it’s with tablet, smartphone, and also our software,” he said. Although the new BlackBerry 1o operating system will run on the PlayBook, BlackBerry has not announced a new tablet as part of the launch — just two smartphones, the touchscreen Z10 and keyboard-equipped Q10.

But Lucier said the operating system, like Windows 8, is form factor agnostic. Building on developments from the company QNX, which BlackBerry acquired a few years ago, the OS will run not just on smartphones and tablets, but also on all kinds of M2M systems. QNX was historically an embedded OS — Lucier said many cars today actually run on QNX’s operating system. Medical devices, like some used for remote surgical operators, also run on QNX. In the future, BlackBerry expects these devices and others to run BlackBerry 10 instead.

Lucier also said that going forward the company will be open to licensing its operating system to run on third party devices, like Microsoft does.

Speaking about the Z10 itself, Lucier highlighted security features like BlackBerry Balance that would make the BlackBerry stand out as a smartphone for health providers. Balance automatically partitions the smartphone, storing work and personal data separately and allowing each side to be remotely wiped or locked in isolation.

“On the enterprise side, Balance is going to be a huge factor,” he said. “We have a trusted, secure model people are interested in and comfortable with. We get a lot of good feedback. We certainly want to ramp up the focus on healthcare, make sure we have a solid ecosystem built up around it. There’s a lot of opportunities to get deeper into vertical strategies.”

Healthcare and Government Solutions lead Sara Jost also mentioned that the company has a number of health apps among the 70,000 apps the device launched with, including medical reference apps like LexiCorp. The company is working with EMR vendors as well, she said, offering HTML5 access to several EMRs and working further with those companies to increase functionality.

The company’s relatively small presence at HIMSS didn’t trumpet a huge focus on healthcare, but if the company’s rollout continues — including new announcements in the M2M space — it will be interesting to see how the BlackBerry booth at HIMSS looks next year.

MobiHealthNews coverage of the HIMSS13 event in New Orleans is sponsored by AirStrip Technologies.

Boston Children’s innovation officer: We need more hospital apps

By: Neil Versel | Mar 4, 2013        

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Naomi Fried, Boston Children's HospitalA little more than a month ago, Naomi Fried, chief innovation officer at Boston Children’s Hospital, tweeted: that most healthcare mobile apps are built for consumers and focus on health and wellness, while only 20 percent are clinical apps. She wrote: “We need more #hospital apps.” Naturally, this caught our attention.

“There’s a huge opportunity for mobile apps in the hospital environment,” Fried told MobiHealthNews in an interview ahead of the annual Healthcare Information and Management Systems Society (HIMSS) conference. Fried will be receiving a HIT Men & Women Award at HIMSS in New Orleans this week for being an up-and-coming innovator.

“It’s easy to build a consumer-facing app that doesn’t connect to a hospital system,” Fried says. However, she adds, “There is a great need in the hospital environment.”

One reason why consumer apps have proliferated is that they tend to be easier to develop than professional apps. “I would also say that [medicine is] a complex environment to build in,” Fried offers. Medical records are highly detailed, and healthcare has stricter privacy and security requirements than other fields. “There’s a lot of nuance in the healthcare industry,” she notes.

Fried has a message for entrepreneurs looking to get a piece of this $2.5 trillion industry: “Partner with someone who understands healthcare.”

According to Fried, mobile apps can facilitate easy communication among clinicians, something that is badly needed as payers and other healthcare purchasers demand greater emphasis on a team approach to medicine and shine a light on continuity of care. Among healthcare professionals, “We’re looking at leveraging the convenience, mobility and usability factors that come with most mobile apps,” Fried says.

The Harvard Medical School-affiliated Boston Children’s is taking on a lot of app development itself as it looks to meet the demands of its professional staff and patients alike. Keep reading>>

AstraZeneca, Exco InTouch, tackle COPD with mobile health

By: Jonah Comstock | Mar 1, 2013        

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A screenshot from Exco's clinical trial software.

A screenshot from Exco’s clinical trial software.

One of our predictions at the start of the year was that 2013 would be a year for pharma to make big moves in mobile health. European pharmaceutical company AstraZeneca has begun that process, announcing a pilot, in partnership with Exco InTouch, to address chronic obstructive pulmonary disease (COPD) in the UK using mobile and online tools.

The pilot will be administered via several National Health Service Clinical Commissioning Groups and funded by AstraZeneca, with Exco InTouch providing the technology and outreach to providers. The service will provide patients with an interactive app, through which Exco InTouch, AstraZeneca, and care providers will send patients educational materials and patients will track symptoms and treatments by filling out surveys. Patients will also use a BlueTooth-enabled inhaler, offered by AstraZeneca, that will automatically report data.

But the pilot isn’t just collecting data for posterity: Exco will adapt the messages sent to patients based on their responses.

“We’ll be providing information so they can make more informed decisions about their diet, their lifestyle,” Exco InTouch CEO Tim Davis told MobiHealthNews. “We built the system around the individual, optimizing for each individual. And we’re monitoring their responses in a blinded and secure way, reviewing in real time the data that comes back. We put together different patient personas. We’re constantly reviewing, see if we need to change things in real time.”

Exco InTouch was founded as a mobile clinical trial technology company, but Davis said they’ve been naturally progressing into healthcare pilots that go beyond clinical trials.

“We were very much a clinical trial house in our founding years,” he said. “But we found broad global experience in those clinical trials, so we had a lot of knowledge about mobile phone usage in different geographic areas and different therapeutic contexts. Our approach is to apply technology across the whole patient care continuum. Our scope now is a lot broader. We’re really making big steps forward in that.”

He said that doing clinical trials prepared them to work in other areas, because their technology is already cleared by regulatory systems all over the world, including the FDA clearance and HIPAA compliance. They also have existing relationships with a number of pharma companies, including AstraZeneca, who they’ve worked with on clinical trials in the past.

The two companies plan to expand the program outside the UK and into other disease cases, if it goes well. In the future, the app and two-way communication system might be a product sold to healthcare providers.

Davis said a number of pharmaceutical companies are looking to move beyond drug pilots, to explore the impact of mobile technology on disease management and treatment adherence.

“This is part of a broader initiative for AstraZeneca,” said Davis. “I must say that AstraZeneca do seem to be right there at the forefront of that, in terms of aspirations, but also the resources they’re putting behind it.”

Davis also gave MobiHealthNews an update on the relaunch of the Pfizer all-mobile clinical trial planend for later this year. Davis said the mulligan will be launched in Europe, rather than in the US, and that the biggest changes will be to the recruitment phase.

“There were some real positives to be taken from that program that were overlooked by the fact that it didn’t recruit as well as they thought they would. But what did work were the other elements of technology,” he said. “With the benefit of hindight, trying to recruit for a therapy area like overactive bladder in a purely internet play, was probably not the best idea.” He noted that the condition is under-diagnosed, and many people think it’s just a facet of getting old rather than a treatable condition, so they’re less likely to be searching for solutions on the internet. He said the new trial would likely include traditional recruitment vectors in addition to online ones.