Interview: UnitedHealth Group on mobile health

By: Brian Dolan | Nov 23, 2010        

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Dr Migliori UnitedHealth GroupMobiHealthNews recently interviewed Dr. Richard Migliori, executive vice president of UnitedHealth Group, about the payor’s mobile health strategy, activities, apps and services. Migliori said that mobile health can help improve access to care and help the increasingly overburdened physician base better meet the needs of patients. Migliori explained the role of mobile apps backed by employer incentives in bringing about the payer’s vision for mobile health. Interestingly, United, itself, is among those employers that are using mobile health apps to help employees achieve wellness benchmarks.

Here’s an edited transcript of our interview with Dr. Migliori:

What is UnitedHealth Group’s mobile health strategy?

For us, our mobile health strategy is one in which we try to make the healthcare system work better for more people. Currently, the ability for people to access more sophisticated tools that we and others in our industry have built has been constrained to just a few different routes. One of which is nurses calling patients to share insights about healthcare analytics. Another is mailings to peoples’ homes, and those frequently get ignored. Still another route is through [Internet] portals that tend to have varying levels of adoption. What we look at mobile health as is an opportunity, not as an end in itself, but as a means by which people can take advantage of the informational assets that we can bring to help them make better health decisions.

Also, we are starting to recognize that there is an opportunity to link better with the physicians that are serving our clients (their patients) by providing them with better access to our data. Day to day decisions made by both patients and physicians are the greatest determinants of effectiveness of healthcare. We have spent the last few decades building decision support capabilities by analyzing claim data and other data streams, including pharmacy data, laboratory data, health risk assessment data,  biometric data, and the like. We provide people a reflection back on the data that has been submitted on their behalf so that they can recognize the challenges that are confronting them on a personal level. We can then provide them with some — if not advice — at least some recognized opportunities that they should consider.

As I said, we have been providing people with those insights through various routes, but what we have found is that when we use mobility — telecommunications and other forms of electronics — we are able to reach more people. So, what we are focusing on is using this mobile health technology to help people make better decisions.

So far, what kind of insights or information has United provided through mobile platforms? Keep reading>>

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By 2014, $1.7B market for mobile apps in healthcare enterprise

By: Brian Dolan | Nov 22, 2010        

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ChilmarkPhysician

Chilmark Research: US physician adoption of smartphones and apps

The market opportunity for mobile apps in the healthcare enterprise is currently $100 million, according to a recent report from Chilmark Research. Because of the rapid evolution of mobile devices, physician demand, and the healthcare enterprise’s need to improve quality and efficiencies, the market will climb to $1.7 billion in three years time, Chilmark Research predicts.

“Currently, 63% of physicians are using an mHealth App in the enterprise,” says Cora Sharma, lead analyst at Chilmark Research. “However, the majority of these are clinical reference Apps with no tie-in to an enterprise’s healthcare information systems (HIS). Physician adoption of mobile devices, including extremely rapid adoption of touchscreen tablets such as Apple’s iPad, will lead to equally rapid adoption and deployment of mHealth App solutions by these enterprises – not just to help them comply with meaningful use or to satisfy physician demands, but also in an effort to improve operational efficiencies and quality of care delivered.”

Chilmark believes that tablets’ larger screen size will move mHealth apps away from the restricted smartphone platform, which it believes has a “restricted” feature sets. Tablets will enable clinicians to make use of “mHealth Apps with improved bidirectional data flow through a touch interface,” the research firm stated in its release.

“One area that will reach saturation in the very near future is medical content,” Chilmark Principal John Moore writes on his firm’s blog. “Companies such as Epocrates, Medscape and Skyscape have been providing this capability for a number of years to physicians and we peg current adoption and use north of 60 percent. By the end of 2013, this market will reach saturation. This may partially explain Epocrates’ acquisition move yesterday, picking up Modality for $13.8M. Modality will provide Epocrates with critical relationships to many health content publishers and further solidify and strengthen its position in this market. But of Modality’s some 140 iOS-based Apps, only half are heath and life sciences related. Might Modality provide Epocrates the opportunity to expand into new markets now that the health content market is reaching saturation?”

The new Chilmark Research report is the result of roughly three months of dedicated research by the firm’s lead analyst Cora Sharma who interviewed numerous leading adopters of mHealth Apps (Beth Israel Deaconess, Children’s Hospital Boston, UPMC and others) as well as both traditional HIT vendors, best-of-breed mHealth vendors and consultants.

The core focus of Chilmark’s latest report is on enterprise mHealth Apps that link into a healthcare enterprise’s HIS including EHR, CPOE, eRx, CDS and Charge Capture. Chilmark predicts that these types of apps will be “competitive differentiators” for healthcare enterprises who seek to not only meet meaningful use requirements and structure themselves for payment reform, but also to improve internal workflow for higher efficiency.

For more, read Chilmark Research’s press release
Also, check out the report’s information page in Chimark’s Research Store

Round-up: Reactions to the mHealth Summit

By: Brian Dolan | Nov 18, 2010        

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Brian Dolan, Editor, MobiHealthNewsThe mHealth Summit 2010, which took place in Washington DC last week, found coverage in a number of trade and business publications and blogs. Here’s a round-up of some of the more interesting commentary to come out of the event where more than 2,400 attendees convened:

Wireless health care: M-powered – The Economist: “No doubt a dose of scepticism is warranted about m-health. But given the growing evidence of its usefulness and the new business models from emerging markets, there is reason for hope too. As Mr Gates pointed out this week, ‘Middle-income countries are where most innovation in health care is going to come from.’” The Economist

Mobile phones become tools of health promotion – The Washington Post: “But the optimism was tempered by the acknowledgment that there are hurdles to be overcome. The wide variety of mobile devices, operating systems and network speeds creates complexity. The business models have yet to fully take shape as to who pays for services and who profits. And with a field as regulated as health and human services, a need to establish standards still exists.” WashPo

Cell Phone Science – Bill Gates – The Gates Notes: “Peter Lillehoj and Chih-Ming Ho of the University of California, Los Angeles, received a grant to develop a disposable malaria biosensor based on a SIM card platform. The SIM card-biosensor will allow malaria detection to be performed using a cell-phone, which will make diagnostic testing more widely available in rural and remote areas. Terry Ferrari of World Vision will be field testing the use of two cell phone modules that will help community health workers in Mozambique caring for pregnant women and newborns to assess, to take action, and to refer cases with complications and emergencies. Another mobile-phone based tool being developed by Marc Mitchell of D-Tree International uses clinical algorithms to quickly identify women at risk during labor and delivery and assist with emergency transfer to a hospital. If these tools are successful, they could significantly reduce maternal and infant mortality rates.” The Gates Notes Keep reading>>

Quick hits: CMS Innovation Center; New medical MVNO

By: Brian Dolan | Nov 17, 2010        

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WiThings WiFi ScaleA proving ground for mHealth reimbursement: No news here really, but it’s now official: CMS has launched The New Center for Medicare and Medicaid Innovation. CMMI Website

Health smartphones for newly announced medical MVNO? Cytta says it is now a medical mobile virtual network operator that will offer “health smartphones” on its network. Release

Stroke prediction: St. Jude study shows effectiveness of telemonitoring for predicting stroke. MedGadget

Employers are ready to raise the stakes for health incentives. LA Times

What if your doctor could monitor your weight at a distance? WiThings adds “share” function to the web portal connected to its WiFi-enabled scales. WiThings

In case you missed it: STD diagnostic testing via a mobile phone. WIRED

Survey: Healthcare is a top market for iPad

By: Brian Dolan | Nov 17, 2010        

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iPad in HealthcareAccording to enterprise mobility vendor Good Technology, healthcare is among the top three industries adopting Apple’s iPad for business use. Good’s estimate is based simply on its own user base, which includes some 4,000 enterprise customers. Good’s customers have deployed iPads at a varying rate from one iPad to more than 1,000.

“We took a close look at our customers who have deployed iPad devices so far,” John Herrema, senior vice president of corporate strategy at Good Technology, stated in a press release. “We found that the financial services sector dominated, accounting for 36 percent of Good’s iPad activations to date. The technology sector came in second at 11 percent, followed closely by healthcare at 10 percent. We believe these industries are embracing the iPad because its unique design makes it easier to perform time-sensitive, mission-critical tasks.”

While the iPad has certainly enjoyed a lot of attention from the healthcare sector, BlackBerry-maker Research In Motion has been courting the industry with its new, long-awaited tablet, PlayBook. Earlier this year on-stage at the launch event for PlayBook, TouMetis CEO and President Mark Willnerd showed off a medical app that displayed patient data for orthopedic surgeons who could use the app to design new knee replacements and more. In the PlayBook press release RIM also gave EMR access as a potential use case: “For example, a medical records application can attach image files to a patient’s medical record, with the option to open or preview the record, or view the list of available images before it is downloaded to the BlackBerry smartphone.” Finally, at a recent Adobe MAX event, RIM co-CEO and Founder Mike Laziridis took the stage following the first live demo of the BlackBerry PlayBook. The demo, of course, was of a medical app: Client Outlook’s eUnity imaging application.

While Good’s Herrema suggestion that the iPad’s design is enough to win over the healthcare sector, the story is much more nuanced. For more on the iPad and other tablets vying for a stake of the healthcare market, be sure to read our report: iPad vs. the Tablets in Healthcare.

More from Good’s press release here

Study: Telemonitoring of CHF did not improve outcomes

By: Brian Dolan | Nov 17, 2010        

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A recently published study in the New England Journal of Medicine found that telemonitoring of patients with chronic heart disease did not improve outcomes. The study included 1,653 patients who had recently been hospitalized for heart failure. About half the group underwent telemonitoring, while the remainder had usual care. The “telemonitoring” solution used was a telephone-based interactive voice response system that collected daily information about symptoms and weight and was then reviewed by clinicians.

The study examined readmissions, death, hospitalizations for heart failure, number of days in hospital and number of hospitalizations. According to the study: ”Among patients recently hospitalized for heart failure, telemonitoring did not improve outcomes. The results indicate the importance of a thorough, independent evaluation of disease-management strategies before their adoption.”

The results are in sharp contrast to a review of 25 studies that included more than 9,500 heart failure patients published earlier this year.

This past August, a group of researchers that reviewed 25 studies concluded that remote monitoring of patients with chronic heart disease cuts healthcare costs, improves quality of life and reduces the number of hospital admissions. The review included results from some 9,500 patients. It compared telephone and remote monitoring to standard care.

The group that used telephone support were patients who provided health data like heart rate and rhythm, blood pressure and weight to a care provider over the phone, while telemonitoring users had their data transmitted via a wired or wireless transmission to their care provider. Within the telemonitored group, 102 patients died per 1,000 compared with 154 deaths per 1,000 under standard care. Telephone support and standard care had similar mortality rates: 112 deaths per 1,000 for telephone support vs. 127 deaths per 1,000 for standard care.

More on the new study over at NEJM