The hype over mobile health is deafening on most days and downright annoying on some. So it is with some reluctance that I admit that mobile has the potential to be a game-changer in health. I’ve professed enthusiasm before, but that was largely around the use of wireless sensors to measure physiologic signals and SMS text as a way to deliver messages to patients and consumers. For several years, the industry has been awash with smartphone apps (by a recent count more than 40,000). At the Center for Connected Health, we started looking at mobile health as far back as 2008 and could not justify the excitement around smart phones and apps at that time, mostly because our patient population did not demonstrate significant enough adoption of smartphones to justify development in this area.
I felt very unpopular at all of the major conferences. I talked about our success with text messaging as a tool for engaging pregnant teens in their prenatal care and helping patients battling addiction to stick with their care plan, while others were touting the virtues of their various apps.
It’s worth noting that our primary focus at the Center for Connected Health has been patients with chronic illness. As such, we are every bit as concerned about the 85 year old with congestive heart failure as we are about the young professional with hypertension. However, across the population of people with chronic disease, smartphone adoption has lagged. I felt like our strategy was vindicated when my friend Susannah Fox published research showing that folks with two or more chronic illnesses (independent of other variables such as age and socioeconomic status) use technology in the context of their health less than others.
The world of patient care appears to be catching up to the rest of mobile. Not that I would ever endorse the irrational exuberance shown for mobile health apps in general, but some recent data points that changed my thinking are worth noting.
Continue reading “Could Mobile Health Become Addictive?”
Filed Under: Tech, THCB
Tagged: Apps, Joseph Kvedar, mHealth, Mobile health, public health, Smartphones
Aug 22, 2013
Dr. Leslie Kernisan recently wrote a great piece about app prescribing, asking, “Should I be prescribing apps, and if so, which ones?” Since Happtique is all about integrating apps into clinical practice, I jumped at the chance to add to this important discussion.
Dr. Kernisan is right to be concerned and somewhat skeptical about app prescribing. More than 40,000 health apps exist across multiple platforms. And unlike other aspects of the heavily-regulated healthcare marketplace, there is little to no barrier to entry into the health app market—so basically anyone with an idea and some programming skills can build a mobile health app. The easy entry into the app market offers incredible opportunity for healthcare innovation; however, the open market comes with certain serious concerns, namely, “how credible are the apps I am (or my patients are) using?”
Continue reading “App Prescribing: The Future of Patient-Centered Care”
Filed Under: Tech, THCB
Tagged: Apps, Ben Chodor, Happtique, HIT, Innovation, Leslie Kernisan, Mobile health, Patients, Physicians
Mar 28, 2013
The progeny of the iPhone and the iPad will change the shape of your institution — and your balance sheet.
One of the more striking images, to me, out of the online spew in the last few months was from the inauguration. It was a wide view of an inaugural ball. There was the president waltzing with the first lady, and a crowd of several hundred watching them. What was striking about that image was that the several hundred people held several hundred small glowing rectangles in their hands. Practically every member of the crowd was carrying a smartphone and was photographing or videotaping the moment.
The scene was commonplace in its moment, remarkable only in the perspective of history — but such a short history. We could not have imagined so many people carrying smartphones at Obama’s first inaugural only four years ago. Four years before that, we could not have imagined any. The iPhone had not been invented.
There had been attempts at smartphones before the iPhone, and devices like tablets before the iPad. But the rampant success of iOS devices did far more than establish two profitable niche. It changed our relationship with the world.
Continue reading “The Ghost of Steve Jobs and Your Bottom Line”
Filed Under: THCB
Tagged: Apple, Apps, Doctors, Eric Topol, FutureMed, Joe Flower, Mobile health, Patients, Steve Jobs
Mar 19, 2013
I recently had the great fortune of attending Health 2.0 in San Francisco. The conference was abuzz with new medical technologies that are harnessing the power of innovation to solve healthcare problems including many new mobile medical application companies showcasing their potential. As I walked and talked around the exhibit floor, one thing caught my ear, or I should say one thing didn’t catch my ear. Among the chatter about these products, the concern about FDA regulation of this product segment, or even FDA regulation in general was noticeably absent. While many of the application developers are well aware of potential FDA involvement, most would be hard-pressed to outline the impact this would have on their companies and products.
Being labeled a medical device, which is the direction the FDA is leaning, could have a significant impact on business model organization, top-line revenue, and product deployment. For unprepared start-ups, FDA regulation could signal an end for their company. This is in stark contrast to well informed developers who are preparing themselves for the change and would most likely be able to leverage these regulations to their advantage.
Continue reading “A Coming Storm: FDA Regulation of Mobile Medical Applications”
Filed Under: THCB
Tagged: Apps, FDA, FDA regulations, Health 2.0, medical device, Medical Device Manufactures Association, Mobile health, Patient Safety, Ryan Minarovich, Startups
Oct 24, 2012
There is a corner of the health care industry where rancor is rare, the chance to banish illness beckons just a few mouse clicks away and talk revolves around venture deals, not voluminous budget deficits.
Welcome to the realm of Internet-enabled health apps. Politicians and profit-seeking entrepreneurs alike enthuse about the benefits of “liberating data” – the catch-phrase of U.S. Chief Technology Officer Todd Park – to enable it to move from government databases to consumer-friendly uses. The potential for better information to promote better care is clear. The question that remains unanswered, however, is what role these consumer applications can play in prompting fundamental health system change.
Michael W. Painter, a physician, attorney and senior program officer at the Robert Wood Johnson Foundation, is optimistic. “We think that by harnessing this data and getting it into the hands of developers, entrepreneurs, established businesses, consumers and academia, we will unleash tremendous creativity,” Painter said. “The result will be improved and more cost efficient care, more engaged patients and discoveries that can help drive the next generation of care.”
The foundation is backing up that belief with an open checkbook. RWJF recently awarded $100,000 to Symcat, a multi-functional symptom checker for web and mobile platforms. Developed by two Johns Hopkins University medical students, the app determines a possible diagnosis far more precisely than is possible by just typing in symptoms as a list of words to be searched by “Dr. Google.” Symcat also links to quality information on different providers and can even direct users to nearby emergency care and provide an estimate of the cost.
Continue reading “App-Happy Health Care Full of Optimism, Money”
Filed Under: Health 2.0
Tagged: Apps, behavior change, CDC, Data, entrepreneurship, HDI, Health 2.0, HHS, Michael Millenson, Mobile health, Startups, Symcat, Todd Park
Aug 2, 2012
I read a few months ago that the number of available iPhone apps had exceeded a million, with new apps now appearing that are intended to help sort through the mountain of other apps. We have reached the age of meta-apps.
Parenthetically, I have always loved that “meta”concept. In college, when people asked why I majored in philosophy despite the fact that I was pre-med, I explained that my intention was to become a metaphysician.
In any case, there are now many thousands of medical apps, and the number seems to be growing arithmetically! (Perhaps it was exponential at first, but I suspect the viral replication phase for apps has peaked, so anyone who uses the term exponentially at this point probably needs to review their 8th grade algebra.) In spite of this seeming plethora of handy apps, there are still a few I have yet to encounter and would like to see created, although I will probably receive some comments on this post alerting me to the fact that some of what I am looking for has already been produced.
So here are, in no particular order, 7 apps I would like to see:
Continue reading “From Nursify to Visit Minder: Seven iPhone Apps We’d Like to See”
Filed Under: THCB
Tagged: Apps, David Sack, Health 2.0, Mobile health, office workflow
Jul 27, 2012
Just as the little mobile wireless devices radically transformed our day-to-day lives, so will such devices have a seismic impact on the future of health care. It’s already taking off at a pace that parallels the explosion of another unanticipated digital force — social networks.
Take your electrocardiogram on your smartphone and send it to your doctor. Or to pre-empt the need for a consult, opt for the computer-read version with a rapid text response. Having trouble with your vision? Get the $2 add-on to your smartphone and get your eyes refracted with a text to get your new eyeglasses or contact lenses made. Have a suspicious skin lesion that might be cancer? Just take a picture with your smartphone and you can get a quick text back in minutes with a determination of whether you need to get a biopsy or not. Does your child have an ear infection? Just get the scope attachment to your smartphone and get a 10x magnified high-resolution view of your child’s eardrums and send them for automatic detection of whether antibiotics will be needed. Worried about glaucoma? You can get the contact lens with an embedded chip that continuously measures eye pressure and transmits the data to your phone. These are just a few examples of the innovative smartphone software and hardware — apps and “adds” technology — that have been developed and will soon be available for broad use.
Continue reading “Medicine Unplugged”
Filed Under: THCB
Tagged: Apps, Eric Topol, information literacy, mobile devices, Mobile health, paternalism, personal health information, Skype, Social Media
Jun 21, 2012
I was chatting with a friend the other day about how to get people’s attention in this information-overload age, and we decided that the use of buzz words was a critical component of success. So I decided to test this catchy title and see if it leads to any more reader traffic than I usually get.
Really, I’m not messing with you. There is something to the idea of buzz word use in our search engine optimized world, but as I reflected on these three technology trends, I thought it worth pausing for a moment to reflect on just how game-changing each is for those of us in the connected health space.
Of all the top-of-the-hype-cycle buzz words in health care right now, mobile tops the list. And while we probably can’t cure cancer, reverse aging and find the true meaning of life with mobile technology, it really has revolutionized the world of healthcare.
Continue reading “Wireless Big Data in the Cloud”
Filed Under: Uncategorized
Tagged: Big Data, buzz words, Mobile health, the cloud
May 9, 2012
In 1990, when I got my first health care job driving ambulances, not a soul in the New Orleans EMS department had a cellphone. Not even the head of the service. The mayor, his chief of staff and the police chief each had one. That was about it. These phones weighed like 15 pounds and were hardwired to a car battery. And we ambulance drivers documented our care on “run sheets” found on metal clipboards but, since so few people bothered to read them, we also wrote key vital signs and other metrics on a three-inch-wide piece of white tape smacked across the patient’s abdomen.
Today, everyone in New Orleans — and everywhere else — has a cellphone. These cellphones have the computing power to find, and add to, and direct everything that anyone would need to know about a patient anywhere in the world… but they don’t do it! Today’s “do-everything” cellphones are the size of your wallet, yet most ambulance crew run sheets are still paper, found on metal clipboards. And most good patient data is still found on those three-inch-wide pieces of tape.
Why? I’ll give you one good reason and one bad one.
Continue reading “Heady Times for Health Care in the Cloud”
Filed Under: Uncategorized
Tagged: athenahealth, Cloud Computing, EHR, Entreprenuership, HITECH Act, Jonathan Bush, Meaningful Use, Mobile health, Privacy laws
Apr 30, 2012
Despite a constant buzz around the idea of using mobile technologies for patient engagement, the depth and breadth of these solutions has remained consistently thin and frankly dated. Today, healthcare organizations who are adopting and deploying engagement solutions are focusing these efforts on marketing/patient retention (e.g., simplifying transactional processes such as appointment scheduling, prescription refills, etc., online access to lab results & records) and accelerating payments (online bill-pay). Despite all the talk about using mHealth for care provisioning, our research for the upcoming report that will be released later this month, mHealth Adoption Trends for Provider-Patient Engagement, finds a market that is still in an early, embryonic stage of development.
So why the disconnect between the hype of mHealth for care provisioning and reality? Of the many potential reasons, there are two that are dominant: a lack of solutions with proven clinical efficacy and few financial incentives to drive adoption.
While there is little argument that increasing the interaction between a care team and their patients is a good thing, the best means for accomplishing this feat are still unclear. A year ago, Group Health published results from an internal study testing just what impact this increased communication may have on outcomes and patient satisfaction. What they found comes as no surprise to us as trusting advocates of patient engagement. In this study, Group Health provided patients suffering from depression a relatively simplistic form of engagement wherein patients were able to communicate with their care team through the EMR portal. The results, impressive: antidepressant medication adherence increased 33%, overall depression scores decreased, and satisfaction with treatment improved 61%.
Continue reading “mHealth Apps & Patient Engagement – Moving Beyond Transactions”
Filed Under: THCB
Tagged: Apps, Group Health, Mobile health, patient engagement, Reimbursement
Apr 12, 2012