For the record, BlackBerry has conducted clinical trials with smartphones paired with Bluetooth-enabled medical peripheral devices for years. Three of the company's smartphones are among the five most popular smartphones in North America. At least one executive at BlackBerry-maker Research In Motion is a bit curious about all the hype around Apple's recent medical foray with the iPhone.

mobihealthnews recently had the chance to discuss wireless healthcare trends with Research In Motion's Fraser Edward who heads the company's Healthcare Marketing Group. In this second installment, Edward explains the points above and much, much more, including: which types of BlackBerrys physicians prefer, why wireless health needs to adopt a "belts and braces" approach, how RIM's latest acquisition -- Chalk Media -- fits into wireless health, and what the BlackBerry App World's advent signifies. Edward also shares his favorite App World app.

mobihealthnews: Last time we noted that Manhattan Research found twice as many physicians use iPhone this year than last year, but BlackBerry is still the most popular smartphone among physicians.

Fraser Edward: According to the statistics that just came out, three out of the five most popular smartphones sold in North America at the moment are BlackBerrys: the Storm, the Curve and the Bold. As for the other two devices on that list, I'm sure you can guess which ones they are.

mobihealthnews: Any sense of which are more popular with doctors?

Edward: Well, the challenge there is that we tend to sell to the carriers and the carriers sell to the end users, so we don't have hard intelligence on that. I would say, however, that the touchscreen does have a significant appeal to doctors. That said, device preference tends to rest on how you work. Those physicians who get pages all day long tend to be pretty visual -- and those pages can come through the BlackBerry device, as I said before. Maybe the physician will make a call based on that page or they will look at a medical reference app or medical image after getting the page. For that crowd, the larger touchscreen, which is the Storm, would be the preferred device. Of course, it also depends on which carrier you want to go with too or if you have had your number with AT&T for the past 15 years and you don't want to change. I do think the touchscreen and the larger screen form factors that the Storm represent are very appealing to a lot of physicians.

On the other hand, I do think that there are a lot of users in the medical community who have an administrative component to their work. Whether they are the leaders of their organization or just  in charge of a team, they probably have to deal with a lot of email. The people who tend to deal with a lot of emails day-to-day will likely pick the QWERTY keyboard device because it's just faster typing with a keyboard than without one. That's true for any touchscreen device, whether it's the Storm or the iPhone or whatever.

So, to pinpoint the phones that I've seen us getting a lot of traction on within the medical community -- it would be the Storm and the Bold. Maybe it's also just the names of them that are appealing to physicians. In the end, though, we do have that choice -- there's a reason there are pink BlackBerry devices and flip phone style ones and so on. Despite what model or carrier you might have, the applications all work and you can plug that BlackBerry device into the central server to tap into those services and applications that your employer might make available to you. 

RIM recently acquired a company called Chalk Media. Any healthcare angle there?

I think they are doing something that will revolutionize the industry. There is a lot of medical content out there, whether its video, podcasts or text-based offerings. The medical community has a real challenge in keeping up their medical education and getting the [CME] hours that they need. A lot of people are pulling down podcasts or information from these other sources but there is no way to give them credit for that, so what Chalk Media has done is developed something called Chalk Board. This application offers something called PushCast, to send content out to devices and then have the ability to know when somebody views it. You can then send them a quiz on it. You can ask them if they clicked on it. It's available when they are riding the train or at home and with the Bold, the Curve and a lot of these devices, you have a highly graphical interface that has more pixels on it more than the eye can see. It's like having a big screen TV in your hand so its a great user experience. People can digest it and respond to it through interactive questionnaires at the end of each session. Doctors can get accreditation for this because there is that audit trail, which, again, is a very BlackBerry model. It's not just about putting content out there to consumers and seeing if it works. You have to be able to control it, see if it works and see how the market responds to it. 

Chalk Media is not specific to healthcare but I think it will have a great draw there. Henry Ford Medical School is using this as a way to take advantages of their BlackBerry devices.

What other smartphone use cases are still under-utilized in healthcare?

Our CEO loves to talk about our devices as as "a six gear car" and most people only know how to drive around in them in first or second. It's a great analogy. Maybe you are using your smartphone for email, calendar, Epocrates, Pepid, Lexi or SkyScape or some of the other providers out there, but what about using it for viewing results? What about paging? What about continuing medical education? What about making sure that patients are staying on top of their diabetes management? What about your home care workers using them for time and billing? What about wound management? There are so many more things that you can add on once you already have that initial investment with the BlackBerry Enterprise Server. You already paid the one-time fee for the client license per device. You already, in most cases, have an unlimited data plan, so start using it more. 

Those use cases along will really start to shake the industry and how it works, let alone before we even get into electronic health records. At HIMSS this year you have people like McKesson and Siemens supporting BlackBerry now and have optimized browser experiences to get into their hospital information systems in the mobile realm -- taking advantage, again, of the security and privacy model -- and pushing it out there.

There is a real wealth of opportunity here, but we need to start getting the word out. I guess we both jointly achieve this by doing interviews like this with a great publication like yours to show the scope and scale of it. I would always bring the discussion back to doing it in a controlled way -- a managed way -- and ensure that the right audits are in place. There needs to be a balance between all the cool stuff that is possible with the belts and braces approach that is essential to make sure privacy is maintained. 

While I know that the BlackBerry App World is not directly under your purview, can you explain how it might fit into BlackBerry's overall health offerings strategy?

I think App World is all about accessibility and ease-of-use. The App World also crosses over to the consumer realm -- I don't think "patient" is the right word here -- consumer health is the broader idea. The App World crosses over to the individual who cares about their health rather than the provider who is delivering healthcare services. What App World represents is a marketplace for software companies. There are 25 million BlackBerrys in the market active today and over 50 million sold over the past ten years. The majority of those have been sold in the last couple of years -- the growth there has been phenomenal.

As other app stores have seen out there, there is definitely an appetite for this, but I think from the BlackBerry perspective there is a lot of quality in there. What we are trying to do is get the right applications in front of our customers and give them that experience where it is easy to buy, download over the air, and pay through PayPal as a starting point to get those applications on your device. On the consumer side of things it represents that next step, I know [mobihealthnews] was at the [American Telemedicine Association] event so you probably got a beginning of a sense of that, but I think it really is a curve that starts with "I want to lose a few pounds and exercise a bit more" and there are applications that help there. Then there are apps related to corporate wellness programs and there are apps for chronic disease management where the user might have a challenge in their life but it doesn't define them.

We are beginning to see more of these service with telemonitoring services that work with end users. These services just help users realize that they are trending in the wrong direction. I don't think it will ever be a life or death thing: You will never be walking down the road one day and someone will call you up and say you are going to have a heart attack. That's just never going to happen. I don't see that happening. These services will help you make healthier choices and they will help you improve your activity by giving you some information.

This is just another element of your phone, which is what you play games on, talk to your friends on, manage your calendar on -- it's also becoming a health coach. This concept of the health coach is an idea that will begin to play out over the next five years. App World can help us see the beginning of that. [Wireless health] services may have started with offerings from insurance providers, teaching hospitals and home care providers, but now we have these grassroots applications coming from the app stores that can show us better ways to exercise, better ways to eat and so on.

Is there one app that you personally find particularly helpful?

AllSports GPS is a great app and I use the GPS on my phone to go on my favorite runs or to go biking. I can see how I did versus my last run and then share it on Google Earth. I can train and track over time and some of these apps make that fun and exciting. The App World is an enabler to get apps like this one out there.

What's your take on Apple's plans to connect the iPhone to Bluetooth-enabled medical peripheral devices like blood glucose monitors? They demoed one such prototype device at a recent event and announced that they would open up a Bluetooth API for developers. 

We have been doing it for years. Our APIs, in many, many versions have been open to do that. We have been participating in shows like ATA and working with some of the providers there for many, many years now. We have conducted a variety of clinical trials that are now in their third and fourth generation and they have been proving medical efficacy of doing this stuff with a whole bunch of sensors. We also allow multiple applications to run at once on the device so you can have these applications running on the background and not have it the only thing running on your phone.

So I think Apple is a great company and they do some fantastic things, but I sometimes wonder on the PR side of things when they state something they are doing is revolutionary when we have been doing it for several years. We have demonstrated with major companies and major teaching facilities around the world. Personally, I have been involved with a trial here in Canada at the University Health Network, which is the largest hospital group in Canada, and we are now in our third clinical trial working with the heart and stroke foundation. We have over 100 patients with diabetes and hypertension that are using blood pressure monitors and various other Bluetooth devices that they use to pull information through their Blackberrys which they can then share securely with their health workers. You can read all about this case study on Blackberry.com. This is something that has been going on for years. It's not just something that we say we are going to do in the future we are doing it though wireless today. More importantly, the clinical community has had enough time to play with it to publish papers and show the real value of it rather than the hype of it. I think that is very important to the patient to help them with whatever they are trying to deal with in their life from a disease state point of view.