Epocrates adds personalized app recommendations

By: Chris Gullo | Nov 2, 2011        

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epocratesEpocrates announced a major update to their chart topping drug reference app this week, including a customizable app directory and faster access to medical content.

The updated app includes a customizable home screen for faster access to frequently used features, a new notification system, and, most notably, an App Directory. The App Directory allows users to download medical apps from within Epocrates, with recommendations provided  based on the user’s provided areas of interest.

The App Directory includes both paid and free apps, and currently features Epocrates EHR, Netter’s Anatomy Flash Cards, Growth Evaluation Tool, BMI Tool, Pregnancy and Infant Care MRC and Epocrates CME. Epocrates said that clinicians are “overwhelmed” by the thousands of clinical apps available today, and the new App Directory within the Epocrates app hopes to address that.

MobiHealthNews’ contributing editor Neil Versel recently shared this thoughts on why private app stores could be the ‘Next Big Thing’. What sets Epocrates’ list of curated apps apart from other curated app store offerings is that Epocrates suggests particular apps for individual users based on that user’s profile. Apple recently put together a new, curated section of its AppStore that presents medical and health apps intended for use by professionals. The curated, medical app store under development by Happtique helps healthcare organizations create their own appstores to better enable enterprise-wide distribution. Unlike Epocrates and Apple’s curated lists, however, Happtique said it would not be in the business of deciding which apps were “good” or “bad”.

“Mobile apps are only as valuable as they are useful,” stated Rose Crane, president and chief executive officer of Epocrates, in a press release. “We’ve advanced the user experience of our world-class drug reference app and added a singular channel to discover, store and access reliable tools. Furthermore, this is a fresh foundation for new partner engagements and opportunities to deliver even more value-add resources to our network.”

Epocrates consistently remains a top free download in iTunes medical category. Leading up to the recent relaunch of their mobile app, the company named Facebook’s mobile chief, Erick Tseng, to its board of directors this summer.

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Read the press release below. Keep reading>>


75 percent of nurses own smartphones or tablets

By: Chris Gullo | Nov 1, 2011        

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Springer Survey Nursing SmartphoneAccording to a new study conducted by textbook publisher Springer Publishing, 74.6 percent of nurses in the US use smartphones or tablets. Of those smartphone owners, 43.7 percent own an iPhone or iPod Touch, 29.8 percent an Android phone, and 22 percent an iPad. The survey was conducted in September 2011.

Curiously, the number of respondents that said they owned a smartphone or tablet (821) matched the number who said they were primarily employed at a college or university. While it’s not clear, we believe that means about 821 of the respondents were nursing students. No surprise if the majority of nursing students use some form of smartphone or tablet, but that would make the overall metric coming out of this survey less compelling.

The publisher’s survey include responses from approximately 1,100 respondents. Many of the respondents possessed Master’s degrees in nursing (40.5 percent).

In a separate survey conducted by physician mobile and online community QuantiaMD this summer, eighty percent of physicians said they owned a smartphone and 1 in 4 MDs owned both a smartphone and a tablet. Manhattan Research surveys indicate that more than 80 percent of US physicians now use a smartphone or PDA.

According to the Springer survey results, despite the substantial amount of smartphone and tablet owners, almost half (46.4 percent) of the nurses surveyed have never downloaded a medical app. Of those that did, 27 percent downloaded only free apps, 22.7 percent downloaded both free and paid, 3.8 percent only downloaded paid apps. Perhaps not surprisingly, the majority of respondents said Epocrates was their favorite app.

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Read the full survey results here.

Massive Health’s first experiment: The Eatery app

By: Brian Dolan | Nov 1, 2011        

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The Eatery 1Massive Health, a closely watched Silicon Valley-based mobile health startup, launched its first iPhone app this morning. It’s called The Eatery and it’s a free app only available for iOS device users. The app joins the more than 1,300 diet related apps available in Apple’s AppStore.

“You don’t need a logbook. You don’t need a calorie counter. You don’t need to scan another barcode. The Eatery is totally different [from] other apps. We don’t waste your time with details that don’t matter,” the app’s description reads.

Andrew Rosenthal, who is heading up business development for Massive Health while completing his MBA at Harvard Business School, told MobiHealthNews in an interview this morning that what makes Massive Health different from a lot of companies working in mobile health is its focus on user engagement. “We build things that people are going to love to use. Our approach has always been to focus on user engagement partly because no one else does. The more someone loves something, the more they use it, and the more opportunities we will have as a company to help them be healthy.”

The Eatery app’s most engaging feature is the “Fit or Fat” food rating system, which sees community members providing feedback on the photos of food other app users submit. Massive Health was partly inspired by an old Internet site, Hot or Not, which allowed users to rank the attractiveness of people who submitted photos to the site. Rosenthal said that future versions of Fit or Fat might, for example, only show pictures of food snapped by vegetarians to those following that diet, but the current version of the app tees up any random users any user’s food photos for ranking. Worth noting, the current app also identifies the person who took the photo of the app if that user authorized the app to connect through their Facebook account, Rosenthal said.

While the app aims to automatically tag photos of food with locations of restaurants, bars, or coffee shops for those users who location-enable it, MobiHealthNews found that on a few occasions the app chose wrong. In a comment on one of our food photos, Massive Health CEO Sutha Kamal wrote that the app was typically right when it guessed location.

At the Hacking Medicine event at MIT last week, Massive Health’s CEO Sutha Kamal told the 100 MIT engineering students in attendance to keep three things in mind: Develop quickly, think about feedback loops, and make sure you ask the right questions. Rosenthal said that many of the healthy eating apps available today fail to ask the right questions or create appropriate feedback loops. Keep reading>>

Implanted glucose sensor company scoops up $54M

By: Chris Gullo | Nov 1, 2011        

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Sensors for Medicine and ScienceSensors for Medicine and Science (SMSI), which is developing an implantable glucose monitoring sensor, announced this week that it received $54.1 million in fourth round funding. Delphi Ventures led the investment, which also included contributions from return backers New Enterprise Associates (NEA), HealthCare Ventures, Anthem Capital and Greenspring Associates.

The company plans to use the funds for product development and regulatory approvals.

SMSI’s continuous glucose monitoring system includes a small sensor, which is implanted under the skin, and an external watch-like display for viewing readings. According to the company, the sensor requires no battery and, in a pilot study, was able to deliver accurate readings every few minutes for a period of six months.

Another innovative (and well-funded) company working in the continuous glucose monitoring space is Echo Therapeutics, which is developing a non-invasive, transdermal delivery system. In Echo’s system the skin is permeated with the Prelude SkinPrep, and a biosensor is placed on the permeated site. The Symphony system then wirelessly provides the patient’s glucose level each minute to a remote monitor, which tracks glucose levels and glucose changes and provides visual and audible alarms if the patient’s levels move outside a personalized target range.

“This financing demonstrates our investors’ confidence in our ability to deliver promising human clinical results as we prepare to move a very important investigational product closer to commercialization,” stated Tim Goodnow, PhD., President and Chief Executive Officer, SMSI in a press release. “We are extremely proud of the technological advances our team has achieved and look forward to the day when we are helping people better manage their diabetes.”

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Read the press release below. Keep reading>>

Boston Scientific offers CardioTeach iPad app

By: Brian Dolan | Oct 31, 2011        

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Boston Scientific CardioTeachLast week Boston Scientific launched an iPad app for physicians called CardioTeach, which medical professionals can use with their patients to discuss cardiovascular diseases. The app covers a number of diseases including atrial and ventricular arrhythmias, coronary artery disease, heart failure, heart rhythm disorders and peripheral vascular disease.

The app helps physicians to customize and annotate anatomical illustrations; overlay cardiac devices, such as pacemakers and lead wires, onto anatomical illustrations; add notes for emphasis, clarification or personalization; email completed graphics and information to patients, caregivers or other healthcare professionals.

The app’s release includes a testimonial quote from Dr Leslie Saxon, Chief of Cardiovascular Medicine at University of Southern California: “Most medical device apps are designed to educate physicians on a specific product or therapy. CardioTeach is unique because it lets clinicians better educate patients about their overall heart and vascular health and available treatment options. I like CardioTeach because it allows patients to have something they can reference after they leave my office and when thinking about or explaining what went on during the office visit. It also allows my patients and families to educate themselves prior to and between visits.”

Saxon worked with Boston Scientific on the concept version of its Latitude app about two years ago. At the 2009 Body Computing Conference in Los Angeles, Boston Scientific showed off a concept iPhone app, called Latitude Connected, that is currently focused on cardiac rhythm care management, but its full range of functions enable physicians to access patient records, monitor implanted devices, tap into patient support networks and schedule follow-up care. The prototype application was developed and conceived by Dr Saxon in conjunction with an iPhone development team in USC’s Viterbi Engineering School.

Boston Scientific is also a founding member of the USC Body Computing Center, which officially announced its founding members earlier this year.

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For more on Boston Scientific’s new app, read the press release below:

Keep reading>>

How should we evaluate a health app’s efficacy?

By: Brian Dolan | Oct 27, 2011        

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Brian Dolan, Editor, MobiHealthNewsWithout actually trying it out, an early critic may have faulted the first automobile for not having a horse to pull it. After all, how else would a vehicle of the day transport a person from one location to another? Horses were a necessary part of the equation back then; the rubric of the day made their participation mandatory.

Such may be the state of mobile health efficacy studies.

Before we go any further, it’s worth noting that I applaud the research discussed below for tackling the efficacy of health apps, especially since this study began at a time when mobile health was a largely unknown field discussed as a fringe topic in some healthcare circles. To be sure, the efficacy of mobile health services needs more attention, but I believe it requires a deeper study than the one discussed below.

A recent paper published in the international, peer-reviewed Translational Behavioral Medicine journal found that of the 204 “weight loss” apps available from Apple’s AppStore as of September 25, 2009, not a single one adhered to all 13 of the evidence-informed practices for weight loss programs suggested by government agencies at the time. The 13 practices researchers looked for among the apps were at the time common to all of the following governmental agencies: the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), the Food and Drug Administration (FDA), and the US Department of Agriculture (USDA).

The study checked whether the apps adhered to these 13 evidenced-based practices: (1) Provide BMI assessment and explanation. (2) Recommends a diet rich in fruits and vegetables. (3) Recommends certain amount of physical activity each day. (4) Recommends certain amount of water consumption. (5) Encourages user to keep a food diary. (6) Tracks calorie balance of calories in vs. calories out. (7) Recommends a weight loss goal of 1 to 2 pounds a week. (8) Recommends portion size control. (9) Recommends users to read nutrition labels. (10) Provides a means to track weight. (11) Keeps a physical activity journal. (12) Provides a way to plan meals. (13) Provides a way to seek social support.

This study, which was conducted by researchers at Duke University and George Washington University, found that only one app adhered to 12 of these evidence-based practices and 50 apps adhered to exactly none of them. These evidence-based practices, of course, were developed before the creation of smartphone medical apps. They are not best practices for smartphone-based weight loss apps, but rather best practices for weight loss programs in general. Might they still apply to smartphone apps? Sure. Are they the be-all-end-all litmus test for weight loss apps? Of course not.

It’s important to note that the researchers never tested these weight loss smartphone apps. They never downloaded them. (We have seen this head-scratching method of study before.) The analysis of the weight loss apps’ adherence to these 13 evidence-based practices was based solely on the apps’ descriptions in the iTunes AppStore. The researchers acknowledge in their paper that the apps may adhere to more or less of them than their descriptions let on.

If you’re going to make a claim that an app is ineffective, at least test it with a patient population first.

It is also frustrating that this study only saw publication last month, yet the research includes apps published more than two years ago. It is frustrating that the researchers do not take into account how efficacy may be affected by the unique qualities the smartphone platform provides — qualities that are impossibly represented in a evidence-based guideline list conceived before smartphone apps existed.

Should the efficacy of mHealth rest on the shoulders of researchers that never take the time to download the apps they critique? Should the efficacy of apps be subject solely to a study of whether they adhere to evidence-based practices conceived prior to their platform existed?

Do cars need horses to pull them?

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