Survey: ACOs not sold on RPM technology

By: Aditi Pai | Jul 8, 2013        

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Example of RPM technology: Sotera’s ViSi Mobile

In a recent survey, more than half of the accountable care organizations interviewed were unsure of the effectiveness of remote patient monitoring and its ability to generate a positive return on investment.

This week, Spyglass Consulting released a study on remote patient monitoring based on telephone interviews from more than 100 healthcare organizations including home health agencies, standalone community hospitals, multi-hospital delivery systems, government agencies and payers. A majority of the organizations in the study are in the process of becoming or already are accountable care organizations (ACOs). Questions were aimed at learning how these organizations viewed remote patient monitoring (RPM). The study began in March 2013 and ran for two months.

While RPM technology can be used for disease management, it also reduces the risk of hospital readmissions. Of those interviewed, 55 percent used RPM technology to address: penalties focused on excessive readmissions of Medicare patients, value-based financial incentives for chronic disease management and patient-centered care models focused on patients taking a more active role in managing their health.

This study also found that ACOs face challenges integrating RPM technology with existing clinical care processes and ACOs lack the tools to turn raw patient data into clinical analytics and decision support tools.

Spyglass Consulting released its last report on remote patient monitoring in 2009, which also included around 100 organizations. At the time, a large majority of the organizations using RPM technology at the time saw positive benefits and outcomes with chronically ill patients. That group surveyed also found the technology easier to use and less expensive.

In April, a report from research analyst firm GBI Research predicted that by 2019 the remote patient monitoring market in the US will reach $296.5 million, up from $104.5 million in 2012. Just a month earlier, Kalorama Information released a report stating that the the US market for remote patient monitoring increased from $8.9 billion in 2011 to $10.6 billion in 2012, an increase of 19 percent. Kalorama’s numbers looked at what the firm calls “advanced remote patient monitoring”, which it defines as technologies that have wireless or remote capabilities and can potentially interact directly with an EHR.


FDA clears Singapore company’s Bluetooth ECG

By: Jonah Comstock | Jul 8, 2013        

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EPI Mobile Health Solutions, a Singapore-based company, has received FDA clearance for a smartphone-enabled ECG device — one which the regulatory agency refused to import last fall. The company claims on its website to be “the world’s first, patented Electrocardiogram (‘ECG’) function integrated onto a mobile phone,” likely referring to its EPI Life mobile phone offering. EPI Mobile Health has been selling its devices overseas since at least 2011, the same year AliveCor, the first smartphone ECG makers to secure FDA clearance, debuted at CES.

EPI Mobile Health Solutions was cited in an Import Refusal Report by the FDA in September 2012. According to the document, the FDA rejected EPI’s attempt to import its recently cleared device, the EPI Mini, into Seattle, Washington because the company had not yet secured 510(k) clearance at the time.

EPI MINIEPI Mini isn’t a smartphone case like some of its competitors, but rather a separate device that collects ECG readings through the user’s fingertips. The data is sent to the user’s phone via Bluetooth, according to the company’s website. The data is then automatically sent to EPI’s 24-hour health concierge service, which sends an interpretation of the results back to the user via text message. Users who sign up for a subscription service can also store and track their ECG data in a virtual health record they can access online. Up to five different users can be registered on a single device.

The company has had clinical trials published in the journals Heart and European Heart Journal Supplements. In a study of 240 ECG readings from 30 patients, 98 percent of the readings from the EPI’s original device, EPI Life, correlated with readings from a hospital standard 12-lead ECG. EPI Life is a mobile phone with the same ECG-reading method as EPI Mini integrated into it. It’s larger and weighs more than the Mini and takes up to 30 seconds to read a user’s heart rate.

San Francisco-based AliveCor received its FDA clearance in December 2012. It was followed up by Cardiac Designs’ ECG Check app, which received not only prescription but over-the-counter clearance in March. Like AliveCor, EPI is only cleared for prescription use. Like previous clearances, the FDA documents specifically stipulate that the EPI Mini is not a diagnostic device.

According to the clearance document the EPI Mini is “intended for use by adults who suffer from cardiovascular disease, are considered high risk for possible cardiovascular events or are concerned about their heart function and rhythm,” the clearance document says.

The existing competitors in the space have been busy in the last few months as well. Cardiac Designs ECG Check is now available for purchase from their website for $99. Meanwhile AliveCor recently made their device available for iPhone 5 and began selling its device in the UK and Ireland.

Microsoft launches Bing health and fitness app

By: Aditi Pai | Jul 3, 2013        

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HF---egg-nutrition_131D9C82Last week, Microsoft announced Bing Health and Fitness, an app that tracks diet, health and exercise, according to an official Microsoft website, Bing Blogs. The app syncs to Microsoft HealthVault, which brings in data from other health trackers such as blood glucose monitors, electronic scales, and activity and medical monitors. Bing Health and Fitness is a part of the Windows 8.1 Preview, a pre-release of Windows 8.1, the OS that runs on all Windows devices including computers, tablets and phones.

Along with Health and Fitness, the preview also includes a Food & Drink app and updates to the Bing Maps app. According to an official Windows blog post, Windows 8.1 will launch later this year through the Windows store.

The fitness tracker offers users a space to monitor and record workouts. The app not only tracks exercise, but also offers more than 1,000 exercise videos and tutorials. To search within the database, a user browses by body part, duration, difficulty or equipment type.

The diet tracker will identify foods, provide calorie counts and nutrition facts and show how much exercise is needed to burn off the calories. The nutrition tracker has more 200,000 foods cataloged and offers weekly or monthly reports with self customized nutrition goals.

The health tracker allows the user to record his or her weight, height, vaccinations, blood glucose and cholesterol numbers. 3D body maps and the symptom checker help users understand the human body. 3D body maps shows the mechanics of different body parts while the symptom checker offers suggestions for potential conditions based on the user’s symptoms. Bing Blogs says this feature is meant to be a reference guide, not medical advice. In this section, Bing also offers information and articles about popular conditions, medications and procedures.

In March, Microsoft HealthVault launched an app for the Windows 8 operating system to run on tablets, W8 phones, and computers.

Mobile operator finds more people use smartphones for diet than exercise

By: Jonah Comstock | Jul 2, 2013        

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Couch-to-5KMobile operator US Cellular released new data on consumer use of health and fitness apps. Just 10 percent of US Cellular customers use a mobile phone or tablet for health or fitness on a regular basis, according to a survey conducted on behalf of the company by Consumer Insights. The survey of 527 post-paid customers was conducted online in early April.

That 10 percent figure is pretty close to the Pew Internet and American Life Project’s figure from November of last year, which found that 11 percent of all mobile phone users had downloaded an app to help track or manage their health (a figure that’s been roughly unchanged since 2010).

In the US Cellular survey, of those who used a mobile phone or tablet for health and fitness regularly, 64 percent said they used it to look up nutritional information, 61 percent said they used it to track nutritional intake (like a calorie counter app) and only 56 percent said they used it to track workouts, the company told MobiHealthNews in an email. Interestingly, Pew’s results found app users more likely to have downloaded fitness apps (38 percent) than diet apps (31 percent).

US Cellular also found that out of all smartphone users, 16 percent use their phones to help them eat healthier meals and 12 percent said their devices help them spend less time planning and preparing meals. Additionally, 9 percent said mobile devices helped them stay in better shape and 8 percent said mobile health devices helped them lose weight.

Eleven percent use their phones to either increase their workout frequency or to help them stay on a regular exercise schedule. Finally, the survey found that 10 percent of smartphone users used their phones to help “manage or treat a health issue successfully.”

US Cellular mentioned several apps in its press release about the data: workout app Couch-to-5k, a Google Play app called Restaurant Nutrition, and Water Your Body, an app for keeping track of daily hydration.

The health and fitness data was part of US Cellular’s Better Moments survey, which sought to take a long view of how customers use their smartphones, how smartphones enrich their lives, and what areas smartphones could be improving but are falling short in. The survey found that 69 percent of respondents “don’t fully utilize the features and services on their phones” and “of those, about 31 percent say they want to use more features but don’t know how.”

In response to the survey findings, the company released guidelines for creating a parent-child agreement about mobile phone use and scheduled several workshops around the country to teach people about more things they can do with their phones.

AirStrip hopes Microsoft Surface is its ticket to PC desktops

By: Neil Versel | Jul 2, 2013        

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AirStrip ONE running on a Windows 8 device

AirStrip Technologies, maker of mobile patient monitoring software, is the first healthcare software vendor to join a new Microsoft application development program aimed at expanding the reach of Surface touch-screen tablets into the business world.

Microsoft’s new AppsForSurface initiative, introduced Monday, is part of a new corporate strategy, called the Microsoft Devices Program, to market Surface tablets and convertible PCs to enterprises through reseller channels. If, as some tech-industry watchers believe, the move is meant to boost lagging Surface sales and finally get independent software vendors interested in creating apps for Surface and Windows 8, it seems to have hooked AirStrip.

As a mobile app developer, San Antonio-based AirStrip sees the Microsoft connection as its ticket into physician desktops.

“It was important for us to not only do iOS and Android, but also go into Windows,” AirStrip CEO Alan Portela tells MobiHealthNews. Joining AppsForSurface and building a mobile Windows versions of its cardiology and obstetrics apps “gives us a desktop version of AirStrip,” according to Portela.

That’s because Surface tablets have the same Windows 8 operating system as new PCs, and higher-end Surface Pro devices can run the vast amounts of Windows 7 software on the market. That means that apps can look and work the same on mobile devices as they do on office computers.

Portela noted that clinicians have happily flocked to mobile devices and apps because that technology tends to be more user-friendly and convenient than traditional, PC-based health IT. “We can bring the look and feel of mobile technology, which is what clinicians want, to their older desktops and laptops,” the AirStrip chief says. “They can now have the same interaction no matter where they are at.”

Healthcare reform also is driving demand for mobile access, according to Portela. “The Affordable Care Act and sequestration has accentuated the need for mobility” by encouraging a shift toward patient-centric care that does not have to take place in traditional settings, he says. The Microsoft initiative, Portela says, “will accelerate adoption of mobility in healthcare.”

AirStrip has been pushing the unified view since at least February, when the company launched its AirStrip One system, a mobile platform that provides clinicians with an integrated view of patient data from multiple sources, including EHRs, medical devices and patient monitors.

Microsoft also has been sharing the story of Palmetto Health in Columbia, S.C., an early enterprise adopter of Surface Pro. There, physicians are carrying Surface computers that offer the power of a PC and the portability of a tablet, according to an account from Dr. Bill Crounse, Microsoft’s worldwide senior director for health.

“The problem with the iPad is it just doesn’t have the horsepower to do the complexity of our EMR. You have to go to a remote sign-on which is extremely slow,” Palmetto Health physician Dr. Nick Patel is quoted as saying.

Microsoft has a long way to go to catch Apple in the tablet market, but the convergence of tablet, smartphone and PC is just beginning.

For more on tablets in healthcare, be sure to get your copy of MobiHealthNews’ 2013 report: iPad vs the Tablets in Healthcare.

Spanish company testing stretcher with wireless heart monitor

By: Neil Versel | Jul 2, 2013        

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mBeatA Spanish startup company is testing and pursuing regulatory approval for a wireless stretcher that allows for continuous monitoring of heart and stroke patients even when patients are being moved.

Imaxdi, based in Vigo, Spain, has embedded its own, patented heart monitoring technology into a stretcher and has been testing prototypes for about six months at hospital in the autonomous Spanish region of Galicia. Imaxdi presented the concept at a Spanish conference on emergency medicine in June, and has a patent application pending in the US.

“People have problems with wires when moving around stretchers,” Imaxdi CEO Miguel Moure tells MobiHealthNews. “We can move the stretcher wherever you like,” Moure says. The monitors do not need to be disconnected when a patient gets moved or when a technician brings in an imaging unit, for example.

The wireless stretcher is a collaboration between Imaxdi, the Galician chapter of the Spanish Society of Emergency Medicine – known as Semes Galicia – and the emergency department at Hospital de O Salnés in Pontevedra, Spain. It uses an Imaxdi product called mBeat, which continuously measures ECG readings, oxygen saturation and blood pressure.

Imaxdi developed both the hardware and the software, according to Moure.

The mBeat monitor connects to mobile devices following the low-energy Bluetooth Smart protocol. It right now is being used to speed diagnosis of heart conditions in six ambulances in the remote Canary Islands, where specialty care is limited and transporting patients to the mainland is risky and expensive, Moure said.

Imaxdi has completed testing of mBeat for a CE Mark is awaiting final approval, according to Moure. Once the certification has been secured, the company will put the device on the market in Spain and Poland, which, Moure said, has similar medical device regulations as Spain. Future plans call for selling mBeat across the European Union and eventually in the U.S. and Latin America.

“We also are trying to develop a home version” for monitoring of patients post-discharge, Moure says.

Imaxdi is looking bring both mBeat and the yet-unnamed stretcher system to market in partnership with a medical equipment supplier, either through a joint venture or a licensing agreement, according to Moure. “Our goal is not to produce the product,” Moure says. “We are an R&D company.”

Imaxdi completed a first round of funding, worth about 500,000 euros, last year, and currently is seeking additional venture capital.

For more about mBeat, see this video from Imaxdi.