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Why Hasn't Mobile Moved Medicine Further Yet?

Why Hasn't Mobile Moved Medicine Further Yet? | Healthcare and Technology news | Scoop.it

The advent of the smartphone and mobile "apps" has opened the floodgates in hospital and clinic settings. With the ease of communication and newfound ability to access the web in the palm of our hand, the world has grown smaller for everyday users. Given its current host of systemic predicaments, the medical industry has justifiably shifted its attention to these new technologies to rectify inefficiencies.


Mobile technology raises expectations for health care consumers with the obvious prospect of improved communication between providers and patients. From having your physician's prescriptions on-the-go to being able to rapidly authorize medical record transfers in emergent situations, a promising solution to chronic issues obstructing submaximal care is at our doorstep.


Why, then, have we not reached our full potential? StartUp Health reported a burgeoning digital health sector with $6.9 billion in funding over 551 deals in 2014. Mobile health savvy health insurance company Oscar has captured significant market share with a whopping $320 million of funding and 40,000 members to date. While these strides prove consumer and investor belief in mobile technology, few applications have proven valuable to stakeholders' stringent criteria despite the sheer number of available applications.


No single firm has demonstrated an intimate knowledge of the medical industry with delivery of high-quality tools that engage users. The lack of a clear winner in this noisy space has stunted broad adoption. For this reason, heavyweights in the technology industry like Google, Amazon, Facebook and Apple are exciting new entrants to the mobile health scene. In addition to the modular infrastructure offered by these established giants, the greatest value is their proven track record in customer validation and the user experience.


Established technology firms are by no means a shoe-in to win. The inherently low barrier to entry in the mobile health space is a double-edged sword. Though sparse quality control mechanisms are responsible for the sheer volume of subpar apps, they are also the reason why no innovator can be excluded from disrupting the space with the help of hired digital development shops. Excluding the fundamental challenges of operating within the health care industry (i.e. security and compliance standards), the delay in realizing the impact of mobile health technology can be distilled to four fundamental failures.


First, the end user is often forgotten. Often times, hospitals will excitedly reveal a mobile app that provides useful information but has such a poor interface that consumers fail to engage. Fewer apps have engaged users better than Instagram with over 300 million monthly active users. Instagram represents an exceptional product stakeholders in digital health care should not trivialize and learn from greatly. With two-thirds of the Americans owning a smartphone, the problem today is less so the access to digital tools than it is the actual engagement with them.


Second, the balance scale tilts heavily towards "wellness" and less towards "care." Though the return on investment for a mobile app may be greater for a healthy user willing to pay to track health and fitness metrics, those who actually need the increased vigilance in our health system are patients suffering from chronic disease or recovering from surgery. From the perspective of optimizing health outcomes and preventing frivolous costs, the attention needs to shift to vulnerable populations stressing the system. Furthermore, some insurance companies incentivize members by providing mobile apps under the moniker of "mHealth;" this terminology runs the risk of misleading individuals into skipping preventive care visits with their doctor. These apps should optimize medical management in the appropriate clinical context through physician supervision with appropriate FDA regulation as an "mCare" effort instead. The FDA already applies a risk-based approach for assessing mobile medical apps considered accessory to regulated medical devices or transformational into a regulated medical device. More of this patient-centered innovation is needed to solve our system's real issues.


Third, we fail to play to the strengths of smartphones in medicine. Smartphone technology is fundamentally advantageous because users have the freedom to move and communicate without restriction. Given that outcome metrics for the fields of orthopaedic surgery and rheumatology are predicated on physical mobility and patient-reported response to interventions, smartphone technologists should target these specialties first to realize benefits of afflicted patients in real-time. Joint replacement is one of the most common surgical interventions in the world, and being able to track steps taken, or the steps not taken, using the phone's native pedometer has the potential to alert a surgeon of post-operative complications in advance. The current strategy is focused on creating the best apps for the fittest individuals, but the most impactful technologies would be directed towards streamlining assurances of patient safety and physical activity for those with musculoskeletal conditions.


Finally, collaboration is lacking. Smartphones track and store the "small data" of millions of potential patients. When put together, the data tells a greater story. Numerous insidious diseases, from major depression to ovarian cancer, could be detected earlier and managed better when sharing our stored mobile data. While there do exist standout organizations like Fitbit which offer an open developer API, the current landscape is not set up to exchange user data. One such organization that recognizes the meaningful macroscopic conclusions that can be drawn from sharing mobile data is Open mHealth. Founded on the value of facilitating the sharing, storage, and processing of mobile data using an open infrastructure, Open mHealth has already made great strides among individuals with diabetes and veterans with PTSD.


Today, the smartphone is one of the greatest commercially available technologies. With emerging wearable devices like Apple Watch and Jawbone, who knows what our go-to device will be tomorrow? Thus, validation of mobile technology in medicine cannot hinge on today's version of devices. The evidence supporting application of mobile technologies to the medical workflow must maintain modularity and iterative capacity. One example of modular capacity is Apple's open source ResearchKit. Though in a perfect world Apple and Google would have partnered to cover nearly all smartphone users, ResearchKit has the laudable benefit of availability across all current and future iOS devices. Thus, validation is needed just once for survivorship of mobile technology in medicine to be ensured.


The potential for mobile technology in medicine is great, but the current landscape is not yet set up to transform the health care industry. There exists no reliable winner in the marketplace because either our goals are misaligned or our focus has been misplaced. If the objective is to help the well become more well, then we are thriving. However, if we choose to unbridle the capability of mobile technology in medicine by remembering the end user, helping the suffering, playing to the strengths of our resources, and enabling collaboration, we are on the precipice of a truly transformational era in modern medicine.

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New dimensions for wearable tech | Healthcare IT News

New dimensions for wearable tech | Healthcare IT News | Healthcare and Technology news | Scoop.it

And here you thought Google Glass was the ultimate head-mounted game-changer for healthcare.

Another (admittedly smaller) Mountain View, Calif. tech company is hoping its own futuristic goggles will be just as transformative to healthcare as many expect Google Glass will be. Atheer Labs has developed what it calls "wearable augmented reality."

Leveraging Atheer’s three-dimensional immersive computing platform – offering wearers a way to interact with and manipulate data and devices that surround them – its 3D glasses, among many other uses, could be coming to clinical setting soon.

As Soulaiman Itani, founder and CEO of Atheer Labs, pointed out in press statement late this past year explaining the technology, there's a lot to think about when designing wearable computers. For example, "people cannot wear glasses that are more than 100 grams for longer than twenty minutes," he said.


"We were able to get all of the functionality and immersive experience in 75 grams," he said, "and we’re now putting it in the hands of the developers."

So for the past years or so the Atheer Developer Portal has offered access to the wearable device technology, and smart people have been working on applications that "augment the world around the user in 3D," enabling interaction via touch, voice or head motion.

Healthcare is in Atheer's sights. It's been showing off the technology at various healthcare conference, touting the ways it could change workflows offer new insights into smarter care delivery.

Sina Fateh, MD, is executive vice president at Atheer Labs, where he's in charge of optics development and the visual experience of the wearable technology. An ophthalmologist, Fateh has "expertise in binocular vision, smart glasses, visual image processing, and digital eyecare," according to Atheer officals.

Fateh tells Healthcare IT News the "augmented interactive reality" offered by these new 3D goggles can "enable clinicians to better serve patients in today’s hospitals by increasing efficiency, safety and privacy."

Efficiency gains could be in the offing too, he says. "Clinicians currently rely on desktop computers or tablets to access patients’ information. With the Atheer AiR platform, clinicians can now see information on a mobile heads-up display and have access to all this wherever they are, at the patients side, or on-the-go, and all hands-free.”

He says the glasses could also help in terms of safety and sanitation – "clinicians to access and navigate patient information with gesture control without the need to ever touch a physical surface" – and offer new dimensions to the patient record: "stereo see-through optics that allows clinicians to see medical records and images in high-resolution right in front of their eyes."

How are these 3D glasses different from, say, Google Glass, or other immersive reality technology such as Oculus Rift?

For one thing, this technology was specifically developed with input from "scientists, doctors, researchers" and other medical technologists, says Fateh.

"On a more technical level, Google Glass is a small, monocular display that can present only very limited information to the wearer, unlike Atheer’s binocular glasses which provide a large display area in front of you for a rich experience," he says.

"The interaction is also very different, with Google Glass relying on voice commands and a touchpad on the side, whereas the Atheer glasses are able to see your hands and fingers, enabling the user to naturally reach out and touch, tap and swipe the digital information they see displayed."

And while Oculus Rift is a virtual reality platform, "where the user is transported into a virtual simulated world and separated from reality," Atheer's is an "augmented reality platform that overlays relevant information onto the real world you see around you."

Notably, the AiR platform is fully compatible with the existing Android platform, he adds – enabling most Android applications to run directly.

In the next year Atheer will be "field testing" the technology in hospitals and other clinical settings, says Fateh: "We are eager to see our technology be put to use, and work with early adopters to identify other uses for it that will hugely impact the future of healthcare."

The company already has early users developing medical apps, and as early as 2015, these workflows "will be put into use in a selected number of medical facilities," he says. "It will probably take another year to get this technology into most modern medical facilities."



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Millennials want personal health records on the go | Healthcare IT News

Millennials want personal health records on the go | Healthcare IT News | Healthcare and Technology news | Scoop.it

Could younger patients be the key to achieving Stage 2 meaningful use patient access requirements? A new report finds strong desire for online medical records among the 18- to 34-year-old generation, with 43 percent of millennials saying they want to access their portals via smartphone.

In its fifth annual survey on the usage of electronic health records, Xerox sees more and more Americans expecting and demanding online access to health data. While aging Baby Boomers are showing keen interest in online access, Millennials are also increasingly expecting they can see their medical information where and when they want it.


The poll shows that the younger generation is much more interested in their medical records (to the tune of 57 percent) than any other content contained in online patient portals. They also say they'd like more personalized recommendations to improve their health and tips about additional services from their doctor (44 percent each).

The survey of 2,017 U.S. adults found that nearly two-thirds (64 percent) of those polled don't use online patient portals at all; still, more than half of that group (57 percent) say they'd be much more interested and proactive in their personal healthcare if they had online access to their medical records.


Many patients are unaware that such tools even exist, according to the report. Among those who don't use patient portals, 35 percent didn't know they were available to them and 31 percent said their physician had never mentioned them. Among Americans who do use PHRs, meanwhile, 59 percent say they have been much more interested and proactive in their personal healthcare since they received access.

"With providers facing regulatory changes, mounting costs, and patients who increasingly seek access to more information, our survey points to an opportunity to address issues by simply opening dialogue with patients about patient portals," said Tamara St. Claire, chief innovation officer of Xerox's commercial healthcare division, in a press statement.


With Stage 2 meaningful use's 5 percent view/download/transmit requirements still vexing many providers, the survey suggests that better educating both Millennials and Baby Boomers about portals could help increase patient engagement, accoding to Xerox.

If Millennials expect easy and mobile access to health records and wellness data, Boomers are more interested in using online access to manage their chronic conditions -- and in even greater numbers than younger, arguably more tech-savvy patients -- the poll shows:

  • Those who don't use PHRs say they'd be more engaged in their care if they received access to medical information online (56 percent of those ages 55 to 64, and 46 percent of those ages 65 or older).
  • Those ages 55 to 64 accounted for the highest percentage (83 percent) of Americans who say they already do or would communicate with healthcare providers via a patient portal.
  • Some 70 percent of Boomers say they do or would schedule appointments; 64 percent access/review medical records/test results; 60 percent ask their physicians questions; 58 percent order prescription refills, and 40 percent request a referral.

Providers able to guide "different generations to take advantage of the information available at their fingertips" could see gains in meaningful use readiness and chronic disease management, said St. Claire in a statement. "Educating patients will empower them to participate more fully in their own care while helping providers demonstrate that electronic health records are being used in a meaningful way."


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