DocbookMD taps Medweb for image sharing

By: Jonah Comstock | May 15, 2013        

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DocBookMD AppDocbookMD, which offers a secure physician messaging service, has partnered with Medweb, makers of a smartphone and web radiology PACS, to create Docbook Gateway, an HIE-like offering that gives physicians access to lab tests and X-rays on their smartphones without the need for an integrated EHR.

“This is the way HIEs were supposed to work,” DocbookMD CEO Dr. Tim Gueramy told MobiHealthNews. ”One of the bigger problems with HIEs is they almost silo their own data. They still don’t have great interoperability. We just wanted [Docbook Gateway] to be this simple thing that would work with anybody. HIEs have no mobile footprint. You always have to go log in somewhere else, now it’s just integrated in. It is kind of an HIE, but it’s very very specific to things the doctor needs on their mobile phone to treat you.”

Gueramy’s co-founder and wife, DocbookMD CMO Dr. Tracey Haas, added another distinction.

“Another important point to that is, here in Austin, Texas, half of our doctors still aren’t on an EMR and far fewer are on an EMR that’s connected to a radiology lab,” she said. “We’re independent of that. HIEs need to be connected to an EMR to work.”

Medweb’s existing technology stores radiology imagery on a single secure server. Technicians can then access it from workstations or on their medical device. The software that displays images on mobile devices uses a pinch and zoom interface. The interface also allows the user to make annotations directly on the images.

DocbookMD is a mobile-based, HIPAA-compliant physician-to-physician communications platform. The company secured contact lists of physicians from medical societies, so the app allows doctors to contact each other whether they’re in the same hospital or practice or not, as long as they know the name of the doctor they’re trying to contact.

“I’m a family doctor who no longer works in the hospital,” Haas said. “I felt it was very important for physicians like myself to communicate with the physicians in the hospital. That’s a communication point that’s really been neglected. We’ve got the entire community [using Docbook]. It’s already uploaded. You don’t have to invite your list of friends. They’re already there when you join in.”

In addition, a recently added feature called Care Teams allows doctors to add non-physicians into private Docbook networks, to communicate about a particular patient.

The new product, Docbook Gateway, integrates existing Medweb and DocbookMD infrastructures. Gueramy and Haas said the current way that radiologists and physicians communicate leaves a lot to be desired. Images are often sent by fax, and doctors and technicians don’t have contact information for one another beyond office phone numbers.

They echoed the often-heard sentiment that secure physician communication is rapidly becoming an unimpressive offering — providers like Docbook have to look further to provide a compelling value add.

“We looked at secure messaging as nothing more than putting some HIPAA regulations and technology on communication,” said Gueramy. “I don’t find that interesting. What I find interesting is working with communities that are already tightly connected, putting physicians first. And not giving them integration to a whole EMR, but just to get them the things they need — stat X-rays.”

Docbook isn’t the only mobile company offering what amounts to an HIE workaround. Another company, Doximity, also facilitates physician image sharing over a secure message system. The company’s founder Jeff Tangney recently told MobiHealthNews physicians were using Doximity and EMR screenshots as a “poor man’s HIE.”

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Slideshow: 7 startups using Microsoft Kinect for online physical therapy

By: Jonah Comstock | May 15, 2013        

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Reflexion HealthPhysical therapy is approaching a crisis, according to Dr. Kourosh Parsapour, founder and CEO of 5plus, a startup working on building digital health physical therapy tools. The specialty is experiencing provider shortages at the same time as the need for physical therapy and rehabilitation services increases — as the baby boomer generation ages.

“By 2030, the number of states with substandard physical therapy will increase from 12 to 48 states, and 1 out of 5 americans will be 65 or older,” said Parsapour during a panel discussion at the American Telemedicine Association event in Austin, Texas last week. “Last year, CMS reduced reimbursment to therapists by 12 percent.”

Telerehabilitation, where physical therapists work with one or more patients over video chat, is one technological solution for addressing that gap. Healthbox Boston startup Theravid, for instance, is working on an online portal which includes video instructions on different exercises, online workout reminders, workout tracking, and a secure messaging system to contact their therapist. TeleRehab Systems, a stealth-mode stroke rehabilitation startup, is developing a tablet-based system.

The technology that’s jumpstarting most telerehabilition startups, however, is Microsoft Kinect for Windows, an off-the-shelf 3D motion-capture sensor with an open API. Therapy games can interact directly with patients and even track their movements to report to doctors remotely. These interactions can be either realtime or asynchronous. A number of startups, many of which are coming through high-profile digital health accelerators, are leveraging those possibilities with soon-to-be released offerings.

Here are nine companies tackling digital rehab solutions, many of which Parsapour mentioned in his ATA talk or in an interview MobiHealthNews after the event.

Reflexion Health

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Reflexion spun off from the West Health Institute last year and has recently begun running clinical trials to validate the technology. The company offers a rehabilitation measurement tool,which uses Microsoft Kinect software to both instruct the patient on exercises through animations and measure whether or not they’re doing their exercises correctly. Physical therapists can prescribe exercises that are preloaded into the platform or design their own.

Keep reading>>

Latest ResolutionMD app adds side-by-side comparisons, multi-facility support

By: Neil Versel | May 14, 2013        

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ResolutionMD MobileCalgary Scientific claims its ResolutionMD Mobile diagnostic imaging app was the first of its kind to regulatory clearance for use on mobile devices, though competitor MIM Software gained Food and Drug Administration 510(k) clearance for an iPhone app in January 2011, months before ResolutionMD did the same.

ResolutionMD was the first to earn Food and Drug Administration 510(k) clearance for an Android diagnostic imaging app in April this year. GE Healthcare also has had an Android version of its Centricity Radiology Mobile Access for two years, but clearance came later.

Whether someone is first does not matter all that much when there are competitive products available, so Calgary Scientific is stepping up its game. This month, the Canadian firm released version 3.2 of its ResolutionMD system, available in both app and Web-based formats, the first update since the FDA clearance of the Android app.

ResolutionMD Mobile now has market clearance from US, Canadian and European regulators and has been validated on: Apple’s iPhone 3GS, 4, 4S and 5; all generations of iPad including the iPad Mini; the Samsung Galaxy tab 10.1 Android tablet; and LG Optimus LTE Android smartphone, according to the company. It is available in 12 languages.

While 3.2 is a “point” release and not a completely overhauled system, the new version does contain a number of improvements. ResolutionMD now permits split-viewing mode on mobile devices so physicians can compare studies side-by-side, as well as retrieval of entire patient histories. ”You get quick access to historical images,” Calgary Scientific President and CTO Pierre Lemire told MobiHealthNews.

Version 3.2 also adds “multi-tenant support,” which, according to Lemire, means organizations can manage many hospitals and imaging centers from a single server. “This is essential for a cloud deployment,” he said. Keep reading>>

Nike+ FuelBand’s rumored pinch-for-heart-rate feature unlikely

By: Brian Dolan | May 14, 2013        

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Nike Fuel BandLast week a widely spread rumor made it’s way to various tech blogs about the next generation Nike+ FuelBand: Reportedly, the second generation device is currently being tested by Nike employees who are wearing it out in the public because the prototype still has the form factor of the original. A report in gadget blog, Gear Live, claims that the next FuelBand will include Bluetooth 4.0 (aka Bluetooth Smart) auto-syncing, heart rate sensing, a faster UI, and accelerometer data accessibility via the API.

The report also claims that a Nike+ FuelBand Android app is also in the works, even though the company previously said it would not stray from Apple’s iOS platform.

“First, a heart rate monitor will be built-in to the upcoming FuelBand,” Gear Live’s Andru Edwards writes. “You scroll through your options to get to the heart rate monitor, and then pinch the FuelBand on the monitor area, and it will take your pulse. We weren’t able to confirm if it would save the results to your Nike+ profile for tracking purposes, or if it was just something to give you information when you used it.”

Based on Gear Live’s widely cited report, the next generation FuelBand would require users to “pinch” the device between two fingers to get a pulse reading. Meanwhile, other wearable devices like those offered by Basis and BodyMedia are able to passively read heart rate from the person’s wrist — no pinching required.

Would Nike really offer up a second generation FuelBand that was more difficult to use than devices made by its (much smaller) competitors? Devices that are already available in the market? The pinch-for-heart-rate feature would be a misstep for Nike. This part of the rumor, anyway, seems unlikely to come to pass, but if it does, it could prove to give other device makers a real leg up on the FuelBand 2.

How consumers might find digital health tools

By: Brian Dolan | May 14, 2013        

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Brian Dolan, Editor, MobiHealthNewsFor many years there has been a common refrain for mobile health app discovery: There’s no Consumer Reports for health apps. With tens of thousands of health-related smartphone apps, dozens of direct-to-consumer wearable health sensors now available, and various other websites and services — how is the increasingly health-conscious consumer to choose? Or, perhaps, if you believe that digital health tools are a new product category: How do consumers even hear about all these digital health tools in the first place? The discoverability problem is a big one, but there are many new and existing players doing something about it.

First off, while Consumer Reports has yet to truly step up and come up with a definitive and ongoing assessment of which digital health tools are best for consumers to adopt, it might do so in the future. In 2009 a Consumer Reports analyst compiled a fledgling list of health and medical apps that the writer says shows the diversity of health apps available at the time. Not a true “recommended” list, but — at the time, anyway — it certainly seemed like a start.

Earlier this year Consumer Reports provided some press for popular diet and fitness app MyFitnessPal. Consumer Reports asked 9,000 of its magazine subscribers about which diet plans they prefer, including commercial diet plans and do-it-yourself ones. The usual suspects came out on top for the commercial diet plan category (Weight Watchers, Medifast, Jenny Craig), but MyFitnessPal won the do-it-yourself diet plan category, besting diet plans like the Paleo Diet and the Mediterranean Diet.

The survey led NBC’s The Today Show’s blog to declare MyFitnessPal a top app according to Consumer Reports. That’s a coveted designation many health app developers have been wanting for years — even if it wasn’t as official an assessment as other have previously hoped.

Meanwhile the federal government has assembled its own budding list of “wellness resources” as the Digital Health LinkedIn Group’s Paul Sonnier pointed out in a recent group discussion.

The Department of Health and Human Services (HHS) writes on its HealthIT.gov site: “Whether you’re looking to maintain or improve your health, a large number of web sites, apps, and devices exist to help you track and manage your health and wellness. On your own, you can use such resources to better understand your health and meet your personal health goals. But you may also be able to use the information you collect to help your doctor better understand your concerns and conditions.” As HHS notes, the list “contains just a fraction” of digital health tools available currently, and the government is quick to point out that it doesn’t endorse any of the tools listed.

Apple has stepped up its curation of the iTunes AppStore over the course of the past year with new sections, including one on top iPhone fitness apps to “get moving”, which now includes top running, swimming, and cycling apps for the first time. AppStore users no longer are on their own wading through the tens of thousands of health apps if they don’t want to be.

There are many great review sites, like Greatist, a StartUp Health company, that often provide consumers with suggestions for digital health tools. Sites like Greatist could turn out to be the next generation Consumer Reports.

Meanwhile, brick-and-mortar stores like Apple, Best Buy, Walgreens and others are increasingly stocking health and fitness gadgets. While in-person retail sales are proving difficult for some businesses, these impromptu encounters with a relatively new product category like digital health might be crucial for adoption in these early days.

Health economist and Health Populi blogger Jane Sarasohn-Kahn noted over the weekend that digital health companies were marketing their wares to mothers — and those buying gifts for mothers — for Mother’s Day. Newspaper magazine insert Parade included a piece on Mother’s Day gift ideas that featured Fitbit’s “smart pedometers” as one suggestion. Men’s Health Magazine prodded sons and husbands to consider a Garmin Forerunner watch. Entertainment Weekly pointed to the Jawbone UP.

Sarasohn-Kahn concluded (and I agree): “From Parade magazine to Amazon, digital health is mainstreaming.”

Maybe Consumer Reports will join the fray someday. Maybe not. Despite that, the marketing and curation of consumer-facing digital health tools is now well underway.

Mayo Clinic-powered heart patient sensor commercially launches

By: Jonah Comstock | May 13, 2013        

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BGsensorandphoneMinneapolis-based Preventice announced the commercial launch of its first hardware product: the BodyGuardian Remote Monitoring System. The device, a small sensor attached to the body via a peel-and-stick patch, received FDA 510(k) clearance in August 2012. BodyGaurdian RMS uses an algorithm developed by the Mayo Clinic, sensor technology from STMicroelectronics, and wireless technology from Samsung.

The company also suggested to MobiHealthNews that at least one additional hardware product is in the works from the company. The second device will leverage a developer’s agreement with Avery Dennison for Proteus Digital Health’s disposable patch technology. That’s the same patch technology that powers BodyMedia’s possibly forthcoming VUE patch.

“We understand that in this ambulatory market, different devices will serve different purposes according to length of stay and quality of signal, and our strategy is to have different offerings,” Preventice Senior VP of Marketing Michael Emerson told MobiHealthNews.

The BodyGuardian RMS is for detecting and monitoring nonlethal cardiac arrhythmias in ambulatory patients. The company is not marketing it directly to consumers, since its FDA clearance is only for prescription use. Instead, Preventice will sell units to providers and organizations that work with providers. Emerson said the device qualifies for reimbursement under many health plans.

Patients using the system will receive a number of peel-and-stick patches, two sensor units, plus a dedicated smartphone with preloaded software. The patches are cleared to be worn for 30 days at a time, but Preventice recommends changing them more frequently. The devices are designed to be swapped out every morning and night, with the patient putting the device they’re not wearing in a charging cradle. This allows the sensor to collect data for all but a few minutes each day. The patch is water-proof and the sensor is water-resistant.

“Most patients have reported that they lose track that they’re wearing it after a few hours,” Emerson said. “It really disappears from your conciousness. We really have had no issues with longterm wear. Unless you have a spandex shirt on you really don’t even see it underneath a shirt or blouse.”

The device collects data on ECG, heart rate, respiratory rate, and activity level. The data is transmitted over a cellular network that can be accessed on a doctor’s mobile device or through a web portal. At the request of the hospital, that data can also be moved into an EHR, Emerson said.

The company has a number of customers lined up, according to Emerson, as well as some pilots and clinical trials set to launch. The Mayo Clinic will be running some pilots and will receive some of the devices as part of the ongoing agreement by which Preventice licensed the algorithm. Other trials will be run in Italy and France and will test the device with post-surgical cardiac patients, patients with congestive heart failure, and infrequently symptomatic patients.

Additionally, the company has a financial pilot in the works with an as-yet-undisclosed payor to establish whether the device delivers significant healthcare savings.