Mobile and future meaningful use requirements

By: Brian Dolan | Feb 3, 2011        

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LygeiaWordleChilmark Research analyst Cora Sharma recently penned a thoughtful post on how mobiles might impact future meaningful use requirements — and vice versa. Sharma sees future opportunities for mobile in data capture, advanced clinical processes, data sharing and patient engagement. Each of these have ties back to next stage meaningful use requirements.

“Hospitals worried about the compliance of their non-employed physicians would do well to look into the mHealth ecosystem for tools that will encourage these physicians to comply — even though deploying HIS-integrated Apps will entail the usual governance, implementation and security costs,” Sharma writes. Sharma sees early adopters performing eRx and formulary checks today, but CPOE, CDS and mission critical clinical processes are not yet wide spread.

One side of meaningful use requirements that should be of particular interest to mobile health: The Patient and Family Engagement goal. This requirement includes “patient reminders, patient preferences for communication channel, online secure patient-physician messaging, timely electronic access to clinical data, bidirectional electronic self-management tools, and more,” according to Sharma.

Mobile could help physicians meet this goal by providing patients with reminders via text message or communications through a secure mobile messaging app. And, of course, some patients might find access to their own clinical data and other resources via their mobiles helpful.

Many more details and worthwhile analysis in Sharma’s post on future MU requirements and mobile
The image above (known as a “Wordle”) was created by Lygeia Ricciardi and posted on Ted Eytan’s blog in August. It’s a graphical representation of the meaningful use document — More about the Wordle in the original post that contained it here.


Five mobile security tips for hospitals

By: Brian Dolan | Feb 3, 2011        

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Mobile SecurityDuring a recent interview with Becker’s Hospital Review, Dr. Barry Chaiken, the former chair of HIMSS and now chief medical officer for Imprivata, shared five tips for hospitals still trying to formulate a security strategy for the mobile devices their physicians, nurses and other staff are increasingly using. If you’re not familiar, Imprivata is a security solutions provider. While these are very high-level strategies, Chaiken’s list should be heeded. Security issues are more often than not an under-discussed issue in mobile health, especially for healthcare professional users.

1. Keep all data in the cloud: “Hospitals should really be working so none of the data can be saved on actual devices,” Chaiken said.

2. Use creative passwords. OK, enough said.

3. Limit how devices are utilized. “A hospital may want to set up access in such a way where physicians can only use a mobile application through a cloud so that the hospital can control what information is being seen,” Chaiken said. Fair enough, however, stripping these devices down to core functionalities may dampen their appeal. I wonder to what extent hospitals are already limiting the uses of mobile devices among their physician population.

4. The ultimate goal should be zero breaches. Agreed.

5. Keep up with trends in technology. “Hospital CIOs should keep abreast of the latest updates in technological advances, mobile devices and applications…” Chaiken said. Implication? Read MobiHealthNews.

Mark Trigsted, who is an executive vice president at another security-centered company focused on mobile health, Diversinet, summed up how many feel about mobile security in a recent panel discussion: “There are two schools of thought out there: One group believes, ‘Yes, we can do anything and it’s automatically secure.’ The other is of the opinion that ‘No, we can’t do anything because it’s impossible to secure [mobile].’ So, at Diversinet, we’re trying to mitigate that.”

Be sure to visit Becker’s Hospital Review for the full post with more quotes from Chaiken and discussion on his key considerations for mobile device security.

Epocrates goes public, raises $86.4 million

By: Brian Dolan | Feb 2, 2011        

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wall-streetMedical app publisher Epocrates went public this morning. Along with its selling stockholders, Epocrates raised more than expected: $86.4 million before costs. This is Epocrates third IPO attempt: In 2008 it filed for a $75 million IPO, but withdrew it because of the economic downturn. Last summer Epocrates filed for another $75 million IPO.

Apparently, being patient paid off.

The newest publicly traded mobile health country offers one of the most popular medical applications for healthcare professionals. Epocrates says some 45 percent of physicians in the US use its app, which helps them look up drug data on Apple, BlackBerry and Android devices, phones and tablets. Epocrates makes money through deals with pharma companies that send “clinical alerts” through its platform. It also has a premium version of its app.

Epocrates offerings took a new direction at last year’s HIMSS event where the company announced plans to create an electronic health record (EHR) for small physician practices. Last year’s IPO filing revealed that Epocrates had acquired Caretools, the makers of the iChart EHR iPhone application, for $400,000 in 2009. Caretools founder Thomas Giannulli joined Epocrates in August 2009 as the company’s Chief Medical Information Officer. MobiHealthNews interviewed Epocrates’ executives at HIMSS last March to learn more about the EHR offering (read the interview here).

Epocrates EHR offering is still forthcoming.

While it has been working toward its IPO, Epocrates has stayed busy. Last July around the time of its second IPO filing, the company announced a deal with Pfizer that enabled physicians to contact the pharmaceutical company directly from the Epocrates app. In November 2010 the company bought medical apps developer Modality for $13.8 million in cash. Epocrates partnered with Walgreens in October 2010 for drug reference. In December the company also announced that it was no longer going to support the Palm webOS platform.

Given its pioneer status in mobile health, it’s no surprise that the some of the original founders of Epocrates have already left to found their own startups. One launched mobile-centered Doximity. Another was recently featured in the New York Times for starting a concierge medical practice business.

Epocrates is now trading on NASDAQ as EPOC.

Massive Health to build apps that appreciate patients

By: Brian Dolan | Feb 2, 2011        

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Massive Health CEO Sutha Kamal

Massive Health CEO Sutha Kamal

Massive Health, a new mobile health startup we first mentioned back in December, announced today that it has raised $2.25 million from unnamed angel investors, Felicis VC, Greylock Discovery Fund, Andreessen Horowitz, Mohr Davidow Ventures and Charles River Ventures. Massive’s co-founders are Sutha Kamal and Aza Raskin, the former creative lead at Firefox.

In December Raskin explained Massive’s interest in healthcare: “Health care needs to have its design Renaissance, where products and services are redesigned to be responsive to human needs and considerate of human frailties.”

In a blog post today Kamal built on the startup’s positioning. Massive is going to begin by focusing on smartphone apps for chronic disease management.

“There are some great wellness and fitness apps out there. Whether it’s Nike+, or Cyclemeter (my personal favorite), if you want an app to help you get and stay active, you’re spoiled for choice. But what if you’re actually ill? Then there’s nothing sleek or sexy to help you manage your disease. You’re back to the world of clinical health applications that aren’t especially friendly, easy to understand or use, and certainly aren’t social. Today’s apps don’t appreciate that you’re a person. That’s simply not good enough,” Kamal writes.

Kamal’s declaration that “today’s apps don’t appreciate that you’re a person” is stirring.

Massive Health Co-Founder Aza Raskin

Massive Health Co-Founder Aza Raskin

In MobiHealthNews’ own recent report on smartphone apps, we noticed that the number of apps intended for use by users with chronic conditions had not grown as quickly as other types of apps. Chronic conditions apps were in fact the slowest growing type of app in Apple’s App Store. As of last September there were only 250 iOS apps that purported to help users better manage diabetes, hypertension, heart disease, asthma and other chronic conditions. That’s less than 4 percent of all health related apps for iPhone users.

The adoption of smartphones in the US is climbing — currently about 31 percent of Americans have a smartphone, according to a recent Nielsen report. Health care providers, however, argue that — in their experience — smartphone apps are not a viable option right now.

Last March Dr. Joseph Kvedar, director of Partners Health Care’s Center for Connected Health, explained: “In one of our primary care practices, only 60% of diabetics we enrolled in our home glucose monitoring program were Internet users. In our CHF population, it’s even less. I always note this when talking about technology choices and program design. There are so many really exciting iPhone apps out there for example, but we haven’t tried to deploy one in our setting because the population of patients who would find it useful, let alone familiar, is tiny.”

Given the design talent that Massive Health brings to mobile health, I have no doubt their offerings will drive usability of health apps. The bigger question, however, isn’t usability: It’s usage.

Can better design drive adoption of smartphone apps among the patients who need them most?

Today a group of investors placed 2.25 million bets that it will.

Dr Soon-Shiong acquires GlowCaps-maker Vitality

By: Brian Dolan | Feb 2, 2011        

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Vitality's GlowCapsPharma entrepreneur and billionaire Dr Patrick Soon-Shiong has acquired Vitality, the company that developed GlowCaps. Vitality CEO David Rose stated in the company press release that while the financial terms of the acquisition have not been disclosed, Vitality’s investors achieved a ten-fold return on their investments. In 2009 InformationWeek reported that the company had raised about $4 million, including investments from Dr. Soon-Shiong.

The Boston Globe reports that Dr. Soon-Shiong negotiated the deal with Vitality’s co-founders courtside at an LA Lakers game. Dr. Soon-Shiong is partial owner of the team.

Vitality’s flagship product, GlowCaps “illuminate, play a melody, and even ring a home phone so patients don’t forget to take their medication,” according to the company’s description. “GlowCaps send weekly emails to remote caregivers, create accountability with physicians through adherence reports, and automatically refill prescriptions.”

Dr. Soon-Shiong expects to help Vitality expand it product line up to other wireless health products for consumers. (Dr. Soon-Shiong is also the executive director of UCLA’s Wireless Health Institute — MobiHealthNews interviewed him in May 2009 about his views on wireless health.)

GlowCaps improved adherence rates in a study conducted by Partners Health Care by 27 percent — leading to adherence rates of 98 percent. AT&T has also been a big supporter of Vitality — its network provides the connectivity for GlowCaps. Earlier this month AT&T and Vitality announced they would begin selling cellular-enabled GlowCaps through

“Our country needs a health care system designed to keep people healthy rather than waiting for them to get sick,” Soon-Shiong stated in the release. “As part of this goal, medication adherence is key. However, many people do not take their medications as prescribed which leads to unnecessary sickness and costly hospitalizations. GlowCaps addresses this problem brilliantly making the medication packaging smart.”

Vitality Co-founder and President Joshua Wachman was quoted in an interview with the Boston Globe: “Our roadmap is to create more things that help people make better decisions every day. We think about things like tracking vitamins and pills, the food you eat, your stress level, or your sleep quality. We’re really in the behavior-change business.”

Both Rose and Wachman will stay on as CEO and President, respectively, according to the company. Vitality will also keeps its management headquarters in Cambridge, MA, but it plans to hire additional local resources. It also already has teams in Los Angeles, San Diego and Toronto.

Read on for the full press release:

Keep reading>>

Davos: A song to Apple is a drug to Proteus

By: Neil Versel | Feb 2, 2011        

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Neil VerselLast June, when I was affiliated with, ahem, a competing publication, I publicly chided the World Economic Forum for shutting the press out of its first-ever mobile healthcare event. “It seems as if the industry is in danger of being co-opted by the business community’s elites, possibly to the detriment of small entrepreneurs, consumers and the spirit of transparency,” I wrote.

It took a lot of nerve, I thought, for an international organization to come to this country—the meeting was held in La Jolla, Calif.—invite several U.S. government officials, then not allow media through the doors.

The World Economic Forum, of course, is the organization behind the exclusive meetings on global business and policy that take place each winter in Davos, Switzerland. This billionaire boys’ club convened last week in the Alpine resort to discuss the world’s problems.

I’m just going to assume that my invitation to Davos got lost in the mail. But at least this conference had some degree of transparency and I can say that I learned a bit about mobile health. We can thank, in part, Qualcomm CEO Dr. Paul Jacobs.

Jacobs chairs the WEF Global Agenda Council on the Future of Mobile Communications, and was the impetus for the La Jolla meeting. Last week in Davos, Jacobs was part of a high-level panel on preventing and treating chronic disease, and Qualcomm webcast the session live.

How high-level? Other panelists included UN Secretary-General Ban Ki-moon, Merck Chairman Richard Clark, General Mills Chairman and CEO Kendall Powell and Julio Frenk, dean of the Harvard School of Public Health. (How elitist was the summit? The session’s moderator, CNN’s Dr. Sanjay Gupta opened by addressing, “Your excellencies.” Dr. Francis Collins, director of the National Institutes of Health, had to introduce himself when asking a question from the audience.)

Jacobs talked about regulation of cell phones as medical devices and the embedding of wireless technology in existing devices. He also addressed how wireless technologies can aid in healthcare data collection in developing countries. “Because the regulatory burden isn’t there [in developing countries], we think that we can demonstrate efficacy and we can demonstrate that these are actually self-sustaining economically, and then bring those cases back [to the developed world],” Jacobs said

He added that the World Economic Forum could be “very helpful” in communicating to Western leaders news of successful projects in low-income nations.

OK, so that wasn’t exactly great depth. Jacobs did mention a Qualcomm-sponsored program to provide remote speech therapy over a 3G wireless network for rural Peruvian children who have had surgery for cleft palate.

But if you want real detail on some of the innovation on display in Davos, it might help to talk to some of the entrepreneurs lucky enough to score an invite, such as Proteus Biomedical CEO Andrew Thompson. Silicon Valley technology blogger, Robert Scoble, who got a coveted press pass, did speak to Thompson, and posted audio of his fascinating interview.

“We make medicines that talk to your cell phone,” Thompson said.

That’s right, Proteus makes pills with additives that activate when swallowed, then send signals through the body like a heartbeat that can only be detected by a sensor worn on the body. The sensor, embedded in a bandage, can tell what medications the patient takes, and also detects heart rate, respiration, temperature, sleep patterns and even body angle, then transmits data to a phone via Bluetooth.

The product hasn’t been approved for use in the U.S. or Europe yet, but Thompson said tests are underway to prove the effectiveness. He thinks Proteus already has the business model down.

A song to Apple is a drug to Proteus,” Thompson explained. With the iPod and iTunes, Apple made music more personal and customizable, and monetized the hardware, the system and the data. The cost to the consumer has gone down even though Apple’s profits have skyrocketed. That’s exactly what Thompson expects the smart pill to do to the pharmaceutical business.

Now that’s the kind of technology I hoped to learn about when I started enquiring about the La Jolla meeting. Doesn’t the world at large deserve to discover what international business and policy leaders are learning?