Mobinil tests remote teledermatology in Egypt

By: Brian Dolan | Apr 25, 2011        

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Logical Images VisualDX

Example dermatology app for iPad: Logical Images' VisualDX

Patients outnumber doctors close to 2000 to 1 in Egypt, according to Khaled Bichara Group CEO of Orascom Telecom.

With that figure in mind, doctors in Egypt are using mHealth technology to provide ‘teledermatology’ to patients in low income areas who have not had access to specialists in the past. The pilot program launched as a partnership between Qualcomm’s Wireless Reach initiative, Egyptian mobile operator Mobinil, Click Diagnostics and the Egyptian Ministry of Health.

Using Mobinil’s 3G HSPA mobile broadband network, physicians on location photograph patients’ skin conditions, write up symptoms in text and transmit the information to remote specialists to obtain or confirm diagnosis. Medical staff at the clinics have been given handsets with high-resolution cameras and an application that enables them to send photographs and contextual information about skin conditions an appropriate specialist. The pilot phase of the program is being used to determine the potential success of a large-scale deployment of such a service across Egypt which would provide access to remote experts for a wide range of medical conditions to regions in need.

So far, the pilot results have shown more than 82 percent agreement between remote diagnoses and an in-person confirmation.

Advances in phone camera technology have made it possible in clinics throughout the world to use teledermatology where hi-res photos are required for accurate diagnosis. Prior to the advancement in mobile phones, the special field of dermatology relied on digital cameras, laptops, desktops and wired internet that made the process difficult to deploy and expensive to expand and scale. Small, but powerful smartphone devices combined with 3G broadband make services like these much easier to provide.

“From the beginning, Qualcomm has been committed to the success of this important pilot that demonstrates the use of 3G to support mhealth initiatives,” Moheb Ramsis, senior director of business development for Qualcomm North Africa stated in the release. “By using Mobinil’s state-of-the-art 3G HSPA network and smartphones enabled by Qualcomm’s advanced chipsets, clinics are able to connect to specialists and provide more efficient care to those in need around the world. We are proud to be a part of this program and its esteemed participants in supporting mhealth.”

Not long ago, Mobinil teamed up with Orascom Telecom in partnership with Great Connection to pilot the startup’s Mobile Baby service, which enables medical practitioners to send ultrasound images, video clips and 3D scans to and from referring physicians for remote medical diagnostics. The application works directly from ultrasound machines, with images delivered to any mobile phone via SMS, MMS and email. The service can be used both to get outside expertise on diagnosis as well as to allow patients to share pictures of their ultrasounds with friends and family.

In the US last year an emergency room physician conducted a wound care pilot using mobile phone cameras: Dr. Neal Sikka, an emergency physician at George Washington University, launched a six-month study in May 2010 that aimed to determine how accurately ER doctors and physician assistants could diagnose wounds from images patients took with their own mobile phones. Hollywood-based physician group Wound Technology Network also uses smartphones and 3G-enabled laptops to capture images of wounds for remote care.

For more on Mobinil’s teledermatology pilot, read the release.


VA creates app for post traumatic stress disorder

By: Brian Dolan | Apr 22, 2011        

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VA PTSD coachSomewhere between 11 percent and 20 percent of veterans of the Iraq and Afghanistan wars now have Post Traumatic Stress Disorder (PTSD), according to the U.S. Department of Veteran Affairs (VA). In light of these statistics, the VA has developed an iPhone app to help inform vets and others about PTSD.

The app, called PTSD Coach, offers reliable information on PTSD and treatments right on a patients phone. The app offers tools to screen and track symptoms while offering direct links to help if a user needs it. The app also provides tips and easy-to-use skills to handle stress symptoms in the moment. While the app’s surveys and checklists are valid self-reporting measures, the app is intended for use in conjunction with professional care.

PTSD Coach could also be helpful to family and caregivers of people with PTSD, according to the VA. The department plans to offer a PTSD Family Coach app in the future too. The current app is free to download from the iTunes store and an Android release is slated for June.

PTSD Coach was created by the VA’s National Center for PTSD and the DoD’s National Center for Telehealth and Technology. The NCTT was also behind a similar smartphone application, called T2 Mood Tracker, that helps members of the military who have been deployed track their mood and stress levels. The T2 app specifically tracks anxiety, depression, general well-being, life stress, post traumatic stress and brain injury. Users can also correlate changes to their medication regimen or home or work environment to changes in their moods. The tracking data can help physicians and therapists observe trends and provide treatment instead of relying solely on patient recall.

For more, read InformationWeek’s write-up or check out the VA’s information page.

FDA health app regulation won’t cost $30M

By: Brian Dolan | Apr 21, 2011        

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Brian Dolan, Editor, MobiHealthNewsIn recent months it’s become clear that the media is increasingly turning its attention to mobile health.

The attention, of course, is welcomed by most everyone working in mHealth today, but sometimes it’s painful to read the hyperbole, exaggerations, and misconceptions that are perhaps inevitable with the increase in coverage.

Proteus Biomedical is one company that has noticed this hyperbole. The media often uses words like “Orwellian” and “Big Brother” to describe the company’s medication adherence technology. A recent report over at Dark Daily piqued my interest by stating that Novartis had an exclusive deal with Proteus for all of its drug delivery technology, because we had reported the exclusivity was only for certain use cases, including organ transplant drugs. A rep from one of the companies confirmed the report’s inaccuracy. After all, if it were true it would be tantamount to Novartis acquiring the company, right?

A number of readers called my attention to a Bloomberg report published last week. One reader called the report “totally and completely absurd” among other things.

Bloomberg wrote that the US Food & Drug Administration may regulate the chips in mobile phones along with health apps. They also wrote that FDA clearance of apps and devices could cost device makers more than $30 million a pop. They also quoted someone as stating that the Apple AppStore offered between 20,000 and 30,000 “wellness apps.”

Let’s take these one at a time.

Sure, the FDA has yet to add guidance for ongoing regulation of mobile health apps and devices. It has been suggested that in some cases the FDA could consider smartphones as accessories to medical devices and deserve some regulatory attention. I have yet to hear someone claim that the individual components of smartphones would be subjected to the same review.

What about the costs of such regulation? While some medical devices can cost tens of millions of dollars or even hundreds of millions of dollars, the recent experience of at least two mobile health companies says otherwise. One medical app company and another mobile health device company that secured FDA 510(k) clearance told me that the process cost under $1 million — in the hundreds of thousands of dollars range. Sure, the 510(k) process technically means that the Bloomberg article’s headline is correct and “Apple’s IPhone Health Tool May Get Same FDA Scrutiny as Stents,” but that doesn’t mean it will cost anywhere near as much.

Finally, the article claims that the “online Apple store features 20,000 to 30,000 wellness apps.” That’s one metric we have tracked closely over the years and 20,000 apps, let alone 30,000, is way off the mark. Assuming “wellness” apps are ones intended for use by consumers (could an EMR app for physicians really be a “wellness” app?), our last apps report found that the AppStore offered just under 5,000 health-related apps intended for use by consumers. That was last September. Today, the total number of apps found in the Health/Fitness and Medical categories of the AppStore is still less than 15,000. That number includes those for healthcare professionals, which are usually about 30 percent of the apps, and the miscategorized, which typically hover around 20 percent.

You can watch a Bloomberg video report based on a distillation of the article discussed above over at YouTube. Each of the metrics are discussed in the video. Of course, the video’s introduction is: “I hope you never have to do this, but [if] you need to diagnose a heart attack, well, there is an app for that.”

It’s all downhill from there.

As the discussion heats up around mobile health and the industry enjoys the benefits and pitfalls of sitting atop the Gartner Hype Cycle, let’s do what we can to help the discussion avoid becoming “totally and completely absurd.” Bloomberg, of course, is not alone in the hyperbole but this report was particularly emblematic of the dangers of hype in mHealth. Thanks to those readers who sent it in.

Denver Health, Microsoft, EMC team for diabetes text messaging program

By: Brian Dolan | Apr 21, 2011        

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Microsoft's Jack Hersey

Jack Hersey, GM, US Public Sector Health and Human Services, Microsoft

This week hospital group Denver Health, Microsoft, and EMC announced early results from a text message powered diabetes program that aimed to help patients better self manage their condition.

Denver Health sent patients text message reminders about upcoming appointments and asked patients to text in their daily glucose readings. Denver Health case managers tracked the patients glucose control between the patients’ visits in an attempt to improve condition management, reduce admission rates and reduce costs.

“Denver Health designed the program with the understanding that many of their patients do not have regular access to computers or smartphones. Their Chronic Condition Management platform (CCM), which is built on Microsoft Office SharePoint Server 2007, Microsoft Dynamics CRM and SQL Server 2008, helps doctors and diabetics communicate via text message in between regular office visits,” Jack Hersey, General Manager, U.S. Public Sector Health and Human Services, Microsoft wrote in a recent blog post. “Medical staff establish appropriate reminders in the CCM system, which then automatically sends text message reminders to patients. These reminders prompt patients about their upcoming appointments and remind patients to text in their daily blood glucose readings. This allows Denver Health case managers to track patients’ blood glucose control in between visits. If a patient’s blood glucose levels are too low or too high, clinicians can intervene by directing patients to schedule an office visit to review their health status.”

While the companies were not forthcoming with specific details around the program’s results: Hersey wrote that participating patients are more engaged in the management of their disease, according to Denver Health, and doctors are able to quickly identify patients suffering from dangerously high and low blood sugar readings.

More over at Hersey’s blog post or in the press release below: Keep reading>>

Mayo Clinic JV creates apps for Kentucky hospital

By: Brian Dolan | Apr 20, 2011        

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mRemedy mytality Central Baptist HospitalIn January 2010 Mayo Clinic announced a partnership with smartphone application developer DoApps to form a new start-up, called mRemedy to create health apps for smartphones. Recently mRemedy announced a new offering, mytality, which marks a departure from the startup’s previous app offerings. Mytality is a suite of custom apps built for “clinics and hospitals and their patients” and includes medical trackers, medical directories, medical reference guides and more. Mytality currently works on Android and Apple iOS devices.

mRemedy announced that Lexington, Kentucky-based Central Baptist Hospital has signed on as the first hospital to offer mytality to its patients.

“The Central Baptist Hospital Mobile App enables finding a physician through the PhysicianLink connection, finding a location, or quickly sending a question,” according to mRemedy’s press release. “This app, along with a series of stand-alone apps: myWeight, myPressure, and myGlucose, offer individuals tools to easily track, analyze and share a variety of health indicators. Through an integrated diary, users can compare how their activities affect the health indicators that they track. A variety of new tracker features across a range of health care and wellness areas are coming soon.”

The first mRemedy app was Mayo Clinic Meditation, which launched around the time of the joint venture, for the Apple iOS platform. The app, which teaches users relaxation and breathing techniques cost $4.95 and is based on a program created by Mayo professor Dr. Amit Sood.

See the mRemedy press release for more information.

NJ hospital JV’s second offering: SleepTrak

By: Brian Dolan | Apr 20, 2011        

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IMPAK SleepLast year Meridian Health, a not-for-profit group of hospitals in New Jersey, teamed up with near-field communications (NFC) technology vendor Cypak to create iMPak Health, which is focused on creating wireless health monitoring devices and services. This week iMPak announced its second offering: SleepTrak, which follows on last year’s Health Journal for Pain.

According to iMPak, some 25 percent of American adults report insufficient sleep or rest every other day.

The iMPak Sleep Assessment and Monitoring card is equipped with an accelerometer and NFC technology. The user straps the credit card sized device on her arm at night to assess monitor sleeping habits and track overall activity levels and restlessness: “The SleepTrak card specifically utilizes a method widely used in Sleep Labs called actigraphy which is analyzed to create sleep efficiency scores,” according to iMPak.

Using an accelerometer to measure a user’s activity levels during sleep is similar to FitBit’s sleep tracking service.

“If a potential sleep disorder is clear, recommendations will be made to see a local physician specializing in sleep disorders,” according to the iMPak Health website, “at which time the data collected can be shared as baseline assessment results.”

SleepTrak synchs up to the user’s C7 Nokia Smartphone, which includes an NFC reader and requires the user to download the SleepTrak app from Nokia’s Ovi Store. Meridian Health SVP Sal Inciardi implied that iMPak Health has a partnership with Nokia to bring these devices to market. Keep reading>>