Top 10 digital health tweets of the week

By: Aditi Pai | Apr 4, 2013        

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MobiHealthNews curated some of our favorite tweets from this past week related to mobile health and digital health news and analysis below. Share some of your favorite tweets with us @MobiHealthNews or in our LinkedIn group and we might feature a few in our next Twitter round-up.┬áHere’s our list in no particular order. Keep reading>>


OneHealth raises $9M to help Safeway employees, Amerigroup members manage conditions

By: Jonah Comstock | Apr 3, 2013        

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OneHealthOnTheGoTobaccoCommunityOneHealth Solutions, a web and mobile platform geared at employee behavior change, announced a $9 million second round of funding from existing investor Lemhi Ventures. The money will go to expanding the service and supporting the added accounts of a number of recently added partners and customers. Since January, the company has inked deals with healthcare company Cenpatico, healthcare management organization Magellan, insurer Amerigroup, and, most recently, food and drug retailer Safeway.

OneHealth began in 2008 as OneRecovery, with the mission of working with addiction treatment centers to use social and gamification methods to help people dealing with addiction.

“We started in one of the hardest areas to create behavior change — substance abuse,” President and CEO Bruce Springer told MobiHealthNews. “The idea was always to expand, but we wanted to prove out the technology and the concept.”

The company offers a web and mobile platform to employees and health plan users. The mobile component, for iOS and Android devices, was released at the end of February. The platform is an anonymized, HIPAA-compliant social network aimed at sufferers of serious chronic mental and physical conditions including diabetes, asthma, depression, addiction, eating disorders, and many more. Each condition has a specific area of the site where patients can interact with one another, but also where the site provides condition-specific content and tools to help them. Springer said one plan for the new funding is to expand the number of conditions on the site and develop specialized tools.

When patients log into the portal, they report how they’re doing with their condition on a sliding scale from one to five. If they report a low score, their social network, including professional health coaches, is immediately informed. Springer said the average user of their site has three or four different conditions. In addition, the gamified content is integrated directly into the social support structure.

“We do milestones, we do achievements,” said Springer. “When you set goals in our service, you get acknowledgments every month where the community can support you in your mission to stay sober. The ultimate achievement is to become a peer ambassador. You are viewed as an anchor tenant because you’ve achieved it, and others want to be like you.”

According to Springer, in a pilot with Aetna with members dealing with substance abuse, OneHealth was able to reduce treatment center readmissions by 58 percent, for an estimated cost savings to the system of $9,000 per patient.

Springer also said that the company will be continuing to announce new partnerships over the coming months, including a major announcement on Monday.

“It’s been a long road since 2008 when the company was founded as a recovery play to today,” Springer said. “Now we’re finally to the point where we’re in scale and we’re seeing the road and these opportunities open up before us.”

Bluetooth Smart takes lead for fitness, medical

By: Jonah Comstock | Apr 3, 2013        

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Fitbit Flex__Colors

The Fitbit Flex is a Bluetooth 4.0- enabled activity tracker.

Bluetooth 4.0. or Bluetooth Smart, is emerging as the leading connectivity protocol for fitness devices, and the medical market is likely to follow soon, according to industry analysts in statements released by the Bluetooth SIG. Bluetooth SIG announced that since 2008 it has qualified 142 medical products and 56 fitness products.

In addition, IMS Research, now part of IHS Inc., projected that by 2016 more consumer medical devices would use Bluetooth Smart for wireless than any other technology, covering more than 50 percent of the wireless-enabled consumer medical device market with 5.7 million shipments. As for sports and fitness devices, ABI Research projects 120 million annual shipments in 2017, over 75 percent of the total market.

According to Bluetooth SIG chief marketing officer Suke Jawanda, the original Bluetooth BDR/EDR technology was optimized for sending continuous streams of data — like audio. Bluetooth Smart sends data in very short bursts, so the radio only has to be on for about three milliseconds at a time. As a result, it has much lower power use. Classic Bluetooth technology was fairly widespread in medical and fitness devices, but the power requirements made it less practical for continuously worn tracking and monitoring devices.

“When we take a look at the innovation in the plumbing layer, now it makes more sense to why Bluetooth Smart is, frankly, the de facto standard in sports and fitness and its becoming the de facto standard in health and medical,” Jawanda told MobiHealthNews. “Polar created a Bluetooth heart rate monitor. Under normal use cases, the coin cell battery that was powering that heart rate monitor would only last a few months. That same chest rate strap now, with Bluetooth Smart, is going to last a couple of years.”

Bluetooth SIG highlighted smart inhaler Asthmapolis and back-end patient monitoring software Swissmed Mobile as examples of consumer medical devices leveraging the technology as well.

“Fitness has been fantastic for us,” Jawanda told MobiHealthNews. “For Bluetooth Smart, that’s the first vertical that’s really popped where scale has begun to shift. I think medical is even a bigger opportunity and over the next two years could shift also.” He said the uncertainty of FDA regulation is likely keeping medical developers away from Bluetooth, which has smartphone app integration as a major selling point.

Jawanda said that as well as the low power usage and near-instantaneous communication, the big advantage to companies using Bluetooth is its widespread penetration, which allows a range of peripheral devices to easily communicate with each other, as well as with consumer smartphones, tablets and laptops.

Mango Health takes aim at medication adherence with game design principles

By: Jonah Comstock | Apr 3, 2013        

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Mango Health Mango Health, a Rock Health startup focused on using gamification principles to tackle medication adherence, launched its titular app after months of beta testing, a 16-week pilot, and not a small amount of hype. The company has raised $3 million so far.

Medication adherence is considered to be a $290 billion dollar per year problem, and it’s one that a number of mobile apps and connected devices have tried to tackle. Mango CEO and co-founder Jason Oberfest told MobiHealthNews that he thinks Mango is approaching the problem in an original way, owing to his and co-founder Gerald Cheong’s background at game company ngmoco.

“My sense of adherence initiatives in the industry is they’ve tended to focus on two primary areas: On the one side, better tracking of patient consumption of medication, and on the other side analysis of back-office patient data to identify at risk populations,” he said. “Our feeling is that the root cause of nonadherence is behavioral, and those approaches don’t address that.”

With Mango’s app, users enter their medications or supplements, timing, and doses. Like many existing adherence apps, Mango can remind patients when its time to take their medication. It also automatically alerts them to potentially dangerous interactions between medications, or with food and drink. The app also includes a personal health journal.

But it’s the game design principles that the founders hope will set the app apart. The app has an in-game currency users can earn by taking medications on time, and a leveling up system. By leveling and saving up, users can unlock real-world rewards with Mango’s partners, including donations to charities and rewards at stores like Target (which Mango just recently announced as a partner). The app also presents users with basic comparisons of their adherence against people with similar medication regiments or conditions.

Mango Health’s brand partners benefit from the partnership, Oberfest said, both because they have a general interest in improving people’s health and because health-oriented consumers are generally good customers to have, and Mango serves as a channel to get them into partners’ stores.

While many medication adherence technologies target older people with their products, Mango’s target demographic is 35 to 55-year-olds who were recently diagnosed with a chronic disease, according to Oberfest, although the pilot included users as young as 24 and as old as their late 70s. He said the pilot was very promising.

“For me, the most important measure is unaided return rate,” the number of people who continue to come back and use the app without prompting, said Oberfest, “And the unaided return rate that we were seeing was spectacularly good from my perspective. It far exceeded our expectations and was orders of magnitude more successful than the most successful social games we know of.”

Oberfest says the company has big plans going forward. Ultimately, he said, they plan to move beyond medication adherence to become “a hub for personal health management.” The company hopes to work with app and device companies tackling other health areas, as well as employers, payers, and providers. Expansion into Android devices is planned eventually as well, he said, although the company isn’t ready to commit to a timetable.

Study tests limits of public health texting efficacy

By: Jonah Comstock | Apr 2, 2013        

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Baby Bump TextA new study from the University of Pittsburgh School of Medicine, published in the journal Obstetrics and Gynecology, found that text messaging was ineffective at changing the minds of pregnant women who were not intending to get the influenza vaccine. In their study of 158 urban, low-income pregnant women, researchers found that text messages had no effect on whether expectant mothers got the vaccine, a treatment doctors consider to be especially important for expectant mothers.

“We know that pregnant women have a really increased risk, and we know that the vaccine is very safe and very effective, and despite that it’s vastly underutilized,” study author Dr. Michelle Moniz told MobiHealthNews.

All participants in the study received health text messages regularly, containing tips and information about pregnancy. However, only the intervention group received text messages specifically educating and instructing them about the flu vaccine. In both groups, only 32 percent of women got the vaccine, according to the clinic’s records.

The participants in the study were overwhelmingly low-income, uninsured, and unmarried women with a high school education or less, the kind of underserved population often targeted in texting interventions. The study specifically excluded women who had already gotten the vaccine, or who stated their intent to get it at their initial appointment.

The women’s stated reasons for not receiving the vaccine might shed some light on why the text messages were ineffective. Twenty-three percent said they were afraid of vaccine side effects, 15 percent said they disliked shots, and another 15 percent said they had a previous bad experience with the flu vaccine.

With the exception of side effects, these aren’t reasons that can necessarily be fixed with education. Text messages can be effective at reminding people of things they already know they should do, or for educating people about things they don’t know. However, they might not be the best vehicle for persuading people to do something they have already decided against, for whatever reason.

“Despite these concerns, more than half [of the study participants] reported that they would get or consider getting the flu shot if it were recommended to them by their prenatal care provider,” Moniz wrote in the paper. “The text messaging program assessed in this investigation did not translate into higher maternal vaccination rates, suggesting that it was not an effective replacement for direct face-to-face recommendation of influenza vaccination.”

In actuality, Moniz told MobiHealthNews, the vaccine is considered very safe and effective and is recommended for pregnant women by both the CDC and the American College of Obstetricians and Gynecologists. There’s even mounting evidence that the vaccine conveys neonatal benefits to the unborn child. Although the text messages in the intervention did include assurances about the safety and effectiveness of the vaccine, they didn’t delve deeply into specifics, nor did they include any tailored messaging. Moniz believes that adjusting the content could have a better effect.

“This has been documented again and again in studies looking at influenza vaccination in obstetric populations,” Moniz said. “The most powerful tool is clear, unequivocal support of a provider. … It might be this intervention would work if we sent messages more frequently, or if we stated specifically ‘your doctor (by name) wants you to get the flu shot.'”

Despite the lack of uptick in vaccination, the participants in both groups responded positively to the text messages, with 90 percent saying they liked the messages, 89 percent saying they found them helpful, and more than 70 percent saying the messages increased their satisfaction with their prenatal care.

“Although generally we’re very enthusiastic about the technology, I think it’s important that we continue to approach this in a rigorously scientific way and try to better understand the potential benefits and the potential limitations of this technology,” Moniz told MobiHealthNews.

10 iPhone hearing aid apps that preceded BioAid

By: Jonah Comstock | Apr 2, 2013        

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bioaidA British team at the University of Essex recently announced the launch of a free, open source app called BioAid to explore the project of turning the iPhone into a hearing aid.

The core concept is very simple, and has, in fact, been thought of and implemented by various companies at least since 2009: Smartphones have built in microphones and they can play audio through headphones. By creating an app that simply takes the audio feed from the microphone, amplifies it, and plays it in the headphones, you can create a rudimentary hearing aid.

From there you can add additional features that bring the app closer to what a real hearing aid does — algorithms that filter out certain noises or selectively amplify certain frequencies, for instance, or recording features that let you play back something you might have missed. Of course, how well a hearing aid app works depends not just on the app itself, but also on hardware: When the New York Times wrote about apps as a hearing aid substitute last May , they profiled a man who used a $5 iPhone app — but with a $100 external microphone and a $150 pair of headphones.

BioAid is novel in that its developers are offering it for free in order to solicit feedback from users to continue to develop the algorithm that mimics the normal noise filtering of the human brain. Also, the app both amplifies quiet sounds and de-amplifies loud ones. The team hopes to change the way hearing care is delivered. The app also allows the user to save different amplification profiles, something other apps on the market don’t offer — for instance, one for watching television at home and another for meeting friends at a crowded bar.

“The mobile phone is a great platform for rapidly transferring hearing aid technology from the laboratory to the hands of the public,” Nick Clark, one of the UK-based developers, said in a statement. “Standard hearing aids, which can cost thousands of pounds, are only dispensed by a professional after a hearing test. BioAid offers a simple alternative accessible to anyone with an iPhone or iPod. The hearing test is replaced by an exploratory process, allowing users to find which setting works best for them. In the short term, people unsure about visiting a hearing care professional might be swayed to do so by BioAid, which can only be a good thing.”

Here’s a list of iPhone apps available through the US app store that use the built-in microphone and headphone jack to help people with hearing loss. Some are regularly updated, others appear to be “zombie apps.” Some are free, while others cost up to $35. Some claim to be hearing aids, others shun that label. At least one is made by a hearing aid company. Keep reading>>