Tag: Mobile health

Digitizing Human Beings

Dec 26, 2011• 12

By Eric J. Topol, MD

Our day-to-day lives were reformatted when the consumer mobile wireless device era, beyond cell phones, was ushered in by iPods in 2001 and followed in short order by Blackberries, smartphones, e-readers, and tablets. Nurturing our peripatetic existence, we could immediately and virtually anywhere download music, books, videos, periodical, games and movies. Television is soon to follow. But these forms of digital communication and entertainment are a far cry from digitizing people.

This decade will be marked by the intersection of the digital world with the medical cocoon, which until now have been largely circulating in separate orbits. The remarkable digital infrastructure that has been built—which includes broadband Internet, cloud and supercomputing, pluripotent mobile devices and social networking― is ripe to provide the framework for a most extraordinary upgrade and rebooting of medicine.

When I was finishing my internal medicine training in 1982 the term “digital” in medicine referred exclusively to the rectal examination. Now, 3 decades later, there are 4 domains of what comprises digital medicine―genomics, wireless sensors and devices, imaging and health information systems. Each of these digital medical technologies are on exceptionally accelerated growth curves. In 2012, complete DNA sequencing of all 6 billion bases of a diploid human genome will be accomplished in 2 hours at a price well under $4000. Already DNA sequencing is having an impact in medicine for specific gene-drug interactions, targeting of cancer therapy by defining tumor driver mutations (comparing somatic versus germ-line DNA), and demystifying life-threatening idiopathic diseases. Just a few years ago wireless sensors got their start for consumers in the health and fitness space, with wearable accelerometers in running shoes, bracelets, necklaces or clips. Now a brain wave sensor can be used to continuously monitor one’s phases of sleep and wakefulness.Continue reading…

mHealth: Seemingly Stuck in Neutral

Dec 19, 2011

By John Moore

As many readers know, Chilmark Research has been a strong proponent of mHealth for several years. Despite this enthusiasm, we sometimes come away from a conference, such as this week’s mHealth Summit, with the feeling that the only ones making a living with mHealth are conference organizers. Maybe it was the format of this particular conference – too many presentations that were not well vetted for relevance and content. Maybe it was the lack of exhibitors – where is the rest of the legacy HIT market who are all claiming to be bringing mHealth solutions to market? Maybe it was hearing too many mHealth vendors with weak value propositions asking the Feds to step in and jump start this market. Or maybe it was the over reliance on government presentations and an ill-fated alliance with HIMSS, who sponsored less than visionary sessions. Hard to point to any single thing that contributed to this ho hum feeling, so let’s just chalk it up to all the above.

That being said, however, the mHealth Summit, now in its third year, is the best conference one can attend in the US if one wants to get the global pulse on all things mHealth.

From its humble beginnings where the first conference was quickly over-subscribed and held in a small DC amphitheater, this year’s event drew over 3,000 attendees to the massive Gaylord Resort outside of Washington DC for three days of countless sessions running concurrently covering every aspect of mHealth one could imagine. While most sessions were structured as panels with several short presentations, one was thankful that presentations were indeed short for few had substance. But nearly every session had one stellar presentation that kept one hopeful. Those were the gems of this event and like any event, the networking that occurs in the halls.

More BYOD Worries

Nov 25, 2011• 1

By John Halamka, MD

I’ve written about the increasing trend to Bring Your Own Devices (BYOD) to work and the accountability it brings to the CIO.

Every day I receive articles highlighting the increasing risk of mobile devices on the network:

The explosion of Android malware

The hacking of Siri

The vulnerabilities of the iPad

It’s very clear that in 2012 and beyond we will have to move beyond policy-based controls and we’ll have to implement technology based controls that may cost up to $10 per device per month. Given our 1000+ mobile devices, that could be a $150,000/year increased operating expense to protect consumer devices brought from home.

In many ways, 2012 at BIDMC will be the year of increased compliance and we’ve just named an interim Senior VP of Compliance to build an enterprise-wide compliance team.

CIOs – it’s time to tell your CFO to expect an unplanned 6 figure expense to protect your institutional data while at the same time embracing the mobile devices that will enhance productivity and user satisfaction.

mHealth – Potentially Valuable, But Not Ready For Primetime

Aug 15, 2011• 11

By TED DRISCOLL

mHealth – otherwise known as mobile healthcare – sounds like just what the doctor ordered to help make healthcare delivery cheaper and more effective. And since the Internet today essentially resides in everybody’s pocket, it would seem as though it’s ready to be implemented. But we have what amounts to a “last-three-feet” problem. So I’m not sure mHealth is ready for primetime, mostly because I don’t think our conventional healthcare system is ready or capable of embracing it.

The goal is to have patients wirelessly send appropriate clinical information to their healthcare providers in a timely manner. This would save time-consuming trips to the doctor on their part and, for doctors, ultimately make it easier to retrieve key patient clinical data. Such a system could detect events just before they happen and allow early critical intervention. The problem is that at this point this is just a goal, not reality.

I have looked at a half dozen startups in this space but haven’t made a commitment to fund any of them. In many cases, their technology looks promising, but it isn’t clear how the company would actually generate consistent revenue. Would the healthcare system reimburse mHealth? Would the doctor know how to interpret the flood of real-time data? Would our system drown under a deluge of alerts, many of which resolve naturally? There is a wealth of questions around these issues.Continue reading…

Is FDA Getting Ready to Stifle Innovation in Diagnostic Software?

Jul 27, 2011

By DAVID E. WILLIAMS

FDA is proposing regulation for mobile medical applications. Not a bad idea. But I have some concerns about what it will mean for clinical diagnostics software. Here’s the definitional passage:

Mobile apps that allow the user to input patient-specific information and – using formulae or processing algorithms – output a patient-specific result, diagnosis, or treatment recommendation to be used in clinical practice or to assist in making clinical decisions. Examples include mobile apps that provide a questionnaire for collecting patient-specific lab results and compute the prognosis of a particular condition or disease, perform calculations that result in an index or score, calculate dosage for a specific medication or radiation treatment, or provide recommendations that aid a clinician in making a diagnosis or selecting a specific treatment for a patient.

Apps that provide differential diagnosis tools for a clinician to systematically compare and contrast clinical findings (symptoms/ results, etc.) to arrive at possible diagnosis for a patient.

Where is there mHealth, really?

May 4, 2011• 4

Health 2.0 aficionados will know that I’ve been railing against the term “mobile health” or “mHealth” for about three years. Health 2.0 is simply the next thing in health technology, and will remain so (whatever that might be). Sure we have a definition, but it’s about what’s happening not how it happens. Calling something mHealth traps it to a device, in particular a cell phone, and ignores the rest of the ecosystem of the technology and culture that the cell phone is but one part of–that’s the concept we call “unplatforms.” mHealth is like talking about cooking in the kitchen and only talking about the fridge. It’s damn important but you need a stove, a sink and more to make it all work.So if you have a mHealth strategy, as Susannah Fox might quote LOLcats, “URDoin it Rong”.

However, the place where it makes sense to talk abut mHealth is where there are only cell phones, and that place is large tranches of the rural developing world. This came up for me twice yesterday. once in a long chat with DataDyne‘s Joel Selanikio who has a really cool product called EpiSurveyor that works not via SMS but via an app on simple phones and enables very cheap and easy data collection. The other was in a high profile announcement by Johnson & Johnson (a major funder of text4baby btw), which via its Babycenter subsidiary is introducing–with USAID, State Department & the mHealth Alliance– $10m program supporting the use of cell phones for maternal health in developing countries.

So for the health worker in the rural Bangladeshi village, lets have an mHealth strategy. For those of us in the developed world, we need an overall strategy to deal with data and applications–whatever devices they are using.

Health IT Future: A Tale of Three Watsons

Feb 15, 2011• 12

By MICHAEL L. MILLENSON

If you want to see the future of health information technology, take a look at the dueling visions of two Thomas Watsons that are on display this month in a game show and a trade show. The juxtaposition unintentionally demonstrates what doctors and patients will be doing together and also what they can do separately.

What I’ll call Game Show Watson is a computer named for IBM founder Thomas J. Watson, Sr. This Watson is appearing on the TV show Jeopardy to play a highly publicized set of matches against two human champions from Feb. 14-16. Although viewers will actually see a black computer screen with a revolving blue globe, Game Show Watson itself, in the tradition of “Big Iron” mainframes, consists of ten refrigerator-sized servers located offstage.

In contrast, the Watson at the trade show is not one computer, but thousands of them, all contained inside the mobile devices that are descendants of the telephone first demonstrated by Alexander Graham Bell and his assistant, Thomas A. Watson. (That Watson was also an inventor is a topic for another time.) The Telephone Watsons, on display for the tens of thousands of attendees at HIMSS11 from Feb. 20-24, are giving rise to a new field known as “mobile health.”Continue reading…

Physician Executives Should Not Ignore How Smartphones Will Transform Healthcare

Jan 31, 2011• 15

By KENT BOTTLES

Physician executives who ignore smartphones and their healthcare applications will miss the most important disruptive technology trend in the next five years. Physician executives who understand how smartphones will transform the industry for providers, payers, patients, and employers will thrive in their careers.

Rajeev Kapoor, a former executive at Verizon, describes the smartphone-enabled transformation: “The paradigm of healthcare has changed. You used to bring the patient to the doctor. Now you take the doctor, hospital, and entire healthcare ecosystem to the patient.” (http://ow.ly/3GIir) Susannah Fox of the Pew Research Center’s Internet and American Life Project offers a specific example when she talks about the celiac disease patient who uses her smartphone to evaluate food products in the grocery store.

“You cannot call your gastroenterologist every time you buy a new product.” (http://e-patients.net/index.php?s=fox) David Jacobson of Wellpoint notes that “The technology of telehealth is well ahead of the socialization of the telehealth idea and we are at a tipping point for utilization to begin taking off.” (http://ow.ly/3GIir)

The Global mHealth Developer Survey found that today 78% of respondents said that smartphones offer “the best business opportunities for mobile healthcare” in 2011; by 2015, 82% said smartphones would dominate the industry. Cell phones, tablets, and PDAs trailed smartphones in popularity according to the survey. (http://ow.ly/1aVf9V)

The Doctor Will Sync You Now

Nov 24, 2010• 24

By MARKUS POHL

Takeaway: mHealth developers expect the importance of app stores to diminish. mHealth apps will predominantly be distributed through traditional healthcare channels by 2015.

Our firm, Berlin-based research2guidance, conducted a global mHealth developer survey in order to identify emerging trends in this new market.

One of the most striking results of the survey was that leading mHealth developers believe that in the years to come mHealth applications will cease to be distributed primarily through the app stores as is currently the case, and that traditional healthcare distribution channels like hospitals and specialized healthcare product vendors will become the predominant distribution channels.

This would represent a significant shift when compared to the market today, as the smartphone app store model has been the key driver behind the initial success of mHealth applications over the last two years.

More than half of all respondents (53%) believe that app stores are currently the best distribution channel followed only by healthcare websites (49%). Traditional health distribution channels like doctors (34%), hospitals (31%) and pharmacies (16%) are ranked as second and third tier distribution channels today. Despite the fact that mobile operators are regarded as players who will help the mHealth market to grow, they are not seen as appropriate distribution channels either now or in the future.

Q: What are the best distribution channels for mhealth solutions today?

mHealth: Is It a Market?

Nov 11, 2010• 3

By JOHN MOORE

I’ve been attending the mHealth Summit for the last 3 days and an over-arching theme has been: mHealth is unlikely to ever become a market in its own right.

Backing up this claim have been the countless projects/products being presented at this event with very few having a model that is scalable across a broad population base. There is also the issue of a lack of clear, repeatable and sustainable business models for mHealth. None have been laid bare for before all to see and learn from in any of the sessions I attended (maybe we are just very early in the evolution/adoption cycle). Likely 90% of the mHealth technologies presented at this conference have been funded by grants that are unsustainable (most often for pilot studies by academic institutions) making one wonder: Where’s the money? Where’s the scale? Where’s the opportunity? Again, circling us back to the title of this post…

Is there really a mHealth market?

This is the wrong question to ask.

The question is not whether or not there is an mHealth market, the question is: How will mobile technologies and devices change care delivery models? Mobile technology is not going away anytime soon and is simply becoming more and more a part of our daily lives, both personal and work related. It is rapidly becoming ubiquitous. Likewise, as I have said many times before, health does not occur when you are sitting in front of a computer, it is mobile, it is with you, it is you.