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Posts Tagged quantified self

Choosing the Right M-Health Tools for the Job

“People will share about their diarrhea on Twitter but they won’t use an app called ‘Diarrhea Near Me” said John Brownstein, Director of the Computational Epidemiology Group at Children’s Hospital Boston and founder of HealthMap, on why patient reported outcomes alone won’t solve our data problems in healthcare.

The third day of the M-Health conference coincided with the first day of the Global MHealth Forum, and the keynote presented the most aspirational view of the three conference keynotes.

HealthMap, which was recently acquired by Booz Allen, focuses on mining public data to predict epidemics and to chart the course of infectious diseases. We’ve seen this before with Google Flu Trends, but HealthMap goes beyond what people are searching for crawls over 200,000 websites globally including social media networks, news, government sites. HealthMap uses natural language processing to take it a step further by comparing this data to satellite images to see whether quarantine is working. While HealthMap considers itself a public data set for health, Brownstein is clear that partnerships with private sector are the only way to scale health programs, and that these programs must have a business model. Texting for health scenarios that partner with carriers are a good match. The carriers are looking for new customers, and SMS programs have proven to be very effective in developing countries. In a twist on that model, Orange partnered on a program in Liberia where health workers got free data access to any government health information sites and then used their own data for Facebook and Twitter, capitalizing on human nature that while we might buy our devices for work we spend a lot of time goofing around on them.

Validating Clinical Data To Reinvent Medicine

The second half of the keynote was a panel discussion focused more on how to deal with all of the medical data coming in, and reflected some of the concern and disappointment with sensors and quantified self movement. Even though the hype and funding for these activity tracker and sensor companies does not seem to have cooled off, there are a few issues that the healthcare industry has identified:

  • Too much data that we can’t make sense of. We haven’t previously been capable of tracking people’s vital signs 24/7 during daily life so it’s impossible to know what a “normal” data set looks like.
  • The novelty of trackers wears off after you calibrate. We’ve written about this before. Once you know how many steps something is or how many calories you’re burning, you don’t need to keep wearing the tracker.

Of course, there is also the often-cited issue of doctors not having the time, interest, or financial incentives to look at all this data.

The solution was to look at tracking in context of a care path or a specific issue, and to figure out how to provide insight along with the data both for the consumer and for the healthcare provider. Panelist Bryan Sivak, CTO of the US Department of Health and Human Services said he didn’t just want to know that he slept poorly but why he slept poorly. Sivak also outlined what he saw as the barriers to MHealth really taking off:

  • Questions of data ownership
  • Privacy and data protection issues
  • Standards of care
  • Incentives for providers
  • Design for clinician workflow

None of these are particularly new or daunting, which again points to the need for solid implementation and adoption evidence from m-health vendors.

James Levine, Professor of Medicine at the Mayo Clinic, wanted more thought put into what data we use and why, and provide the example that many over the counter blood pressure readings are not valid. Levine would like mobile health applications evaluated by the following criteria.

  • What is the medical benefit?
  • Is it cost-effective? What is the return on investment?
  • Is data interoperable? Is data protected?
  • Can you analyze the data the application collects?
  • Can you take action if you need to address something based on patient entered data?
  • How is it reimbursed?
  • Is it constantly improving based on patient input?

Teri Pipe, Dean of ASU College of Nursing, and as the moderator pointed out the only nurse on a panel at the conference, said that the promise of m-health is being able to know when to bring a patient into a clinic for treatment, and allowing them to stay at home when they want it. We would add to that, how do you help them manage when they are at home. She also felt that mobile health held great promise in the hands of nurses who can prevent ER visits from the field while being connected to the healthcare system via mobile. Teri used the example of fire departments having nurses on staff to treat minor trauma and injury onsite rather than sending people to the ER.

This was our first MHealth Summit, although it was the 6th annual, so we can’t compare to previous years. It seems like the overall tone was of cautious optimism. Attendees, panelists, and presenters all firmly believed in the promise of mHealth but there was not enough demostratable evidence, and certainly not enough examples of health systems, payers, and m-health companies overcoming the barriers we have in the market. Hopefully, as the first day keynote asked, 2015 will be the breakout year for MHealth, and we’ll see more success stories, ROI, and clinical validation at the summit next year.

Posted in: Healthcare Disruption, Healthcare motivation, Healthcare Technology, Healthcare transformation, M-health

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Wellpepper’s Top Health Tech Stories of 2013

It’s the time of year to reflect and make lists! It’s been a great year for Wellpepper: our first full year in business. We’ve enjoyed bringing new features to our users and learning more about the needs of both patients and healthcare providers. We’re committed to building useful tools that patients and providers love to use. We’ve been inspired at conferences meeting with end-users, hospital administrators, and other startups who share the same mission of changing how patients and providers engage around their health. We’ve experienced the power of social media, met new friends through Twitter, and learned so much from Tweetchats. As a young company, it’s been a year of firsts for us that, while monumental for us, pale in comparison with the changes going on in health IT, so rather than telling you more about us, let’s talk about the year in Health Tech.

There is no scientific basis to this list, just what we think stands out from the year in Health Tech.

Healthcare.gov

The beleaguered website was definitely the top Health IT story of the year. At Wellpepper we were unable to make it through the registration process ourselves, and ended up going to a broker to find out our healthcare options. As the news came out on why the site was so bad, it was pretty obvious there was a lack of accountability and no project management. It’s really unfortunate that the Affordable Care Act was mired in this mess of an implementation, but we’re very excited that former Microsoft exec Kurt DelBene is taking the reins. Ship It!

Quantified-Self Hits the Mainstream

tec-gift-guide-fitness-trackers.jpeg-1280x960Or, “everyone is tracking.” The mainstream press started writing about fitness gadgets and our Facebook feeds were full of friends who got new FitBits for Christmas. Not sure what this means about the trend though. We have found the FitBit to be really interesting to calibrate activities, for example, a game of Ultimate Frisbee but after you know how inactive or active you are do you really need to track? And do you become okay with your activity or lack thereof?

Meaningful Use Phase Delayed

The Centers for Medicare and Medicaid have delayed the deadlines for implementing Meaningful Use Stage 2. Stage 2 will be extended through 2016 and Stage 3 won’t begin until at least fiscal year 2017 for hospitals. Meaningful Use Stage 2 focuses on patient engagement, which is very minimally defined as patients interacting with healthcare information electronically. We’ve always said that electronic medical records vendors are not the best equipped to deliver tools that patients (ie consumers) want to use, so it’s not surprising that healthcare providers are struggling with this phase. That said, m-health is poised to deliver on these requirements.Wellpepper2-1195a

M-Health Comes of Age

While we can definitely debate where we are in the m-health hype cycle, there is no question that M-Health is a formidable category. The FDA is now monitoring and releasing guidelines, albeit with little clarification. Eric Topol made headlines by using an iPhone EKG on a plane to diagnose a heart attack and and advise the captain to make an emergency landing. Most positively, we’re hearing less talk of ‘apps’, and more talk of integrating mobile health into the overall patient experience and the official hospital records.

23andMe Ignores FDA

Source: Wikipedia commons

You might consider this one to be a bit specific, but it’s representative of a number of key stories in 2013: big data, the explosion of healthcare investing, and the dramatic gulf between current Health IT and other technologies, and between Silicon Valley and the FDA. 23andMe, which does cheap DNA testing, direct to consumer, was forced to stop providing genetic results and only include ancestry after effectively ignoring FDA warnings for over a year. Speculation is that they were trying to get to a million tests (they are at about 500K) so that they could prove their tests were valid and thereby circumvent long FDA approval processes. Those on the side of the FDA saw this as Silicon Valley thumbing their nose at patient safety and regulations. Those on the side of 23andMe saw this as tech disruption at its purest. As recipients of some of the last full genetic and ancestry tests before the shut-down, expect more from us on this topic. 😉

This one is not healthtech, but we’d be remiss if we didn’t mention the focus on costs of care. Time Magazine, and the New York Times both published rather scathing interactive features on the costs of healthcare in the US. One of Reddit’s top threads right now is about a $50,000 appendectomy. It’s great to see these issues called to light. Let’s hope we see progress in solving them in 2014.


NewYearWP

We’re pretty excited to see what 2014 brings Wellpepper and what new innovations, disruptions, and improvements are brought to the healthcare industry as a whole. Best to you and yours from all of us at Wellpepper!

Posted in: Health Regulations, Healthcare Disruption, Healthcare Technology, M-health

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My Life with Trackers

My Facebook and Twitter feeds are full of people talking about the new gadgets they got for Christmas. Tracking has gone mainstream as many of those gadgets are fitness and activity tracker devices. I thought I’d share a bit about what I’ve learned as an avid tracker for some of these newbies.

I have been using apps and devices to track my activities for over 7 years. When Nike in-shoe sensors came on the market in 2006, I was an early adopter and since then have upgraded to various GPS watches and apps like RunKeeper on my phone. I love tracking my runs and hikes. It adds an extra sense of accomplishment seeing exactly how far you’ve gone, elevation climbed and how fast you’ve traveled. Seeing my progress overtime was especially motivating and helpful when training for upcoming races.  It led me to want to track more. I definitely felt myself getting caught up in the quantified self movement.

flex

Fitbit Flex

So when we decided to get Fitbit trackers at Wellpepper, I was all over it. I was very excited to start tracking activities outside of runs.  I chose the wristband format while Mike and Anne chose the Fitibt Zips that clip onto your pocket or waistband. I liked the idea wearing the Fitbit at all times tracking all activities (including sleep) and thought I would have a better chance of not losing it. We found this to be true right away as Mike lost his first two Fitbits.  (Protip: Clip your Fitbit with your Fitbit inside your pocket.) Anne wasn’t too keen on the look of the sporty black wristband so chose the smaller out of sight zip and also appreciated that the Zip didn’t need to be charged. (However, both Anne and Mike had over a week of no activity recorded when their batteries actually died.)

Fitbit Zip

Fitbit Zip

Initial findings were very fun and intriguing: an Ultimate Frisbee game is about 8,000 steps and a good round of golf about 18,000 steps with up to 20,000 steps if that happened to be a bad round of golf. The most lucrative activity turned out to be dancing, it’s surprising how many steps you can take while dancing at a wedding! (23k)  Step counts varied between the different Fitbit types. As my steps were tracked by the movement of my arm, I definitely got credit for additional steps including a few 1000 from petting an upset dog during a thunderstorm. This caused some debates over the accuracy and fairness of the Wellpepper Fitbit leaderboard, which is definitely a fun and motivating feature of the Fitbit app. 

Fitbit 3Definitely the most surprising findings were how many steps could add up with regular day to day activities.   I found that I generally took around 1000 steps just walking around the house and getting ready in the morning.  A walk to the store to grab a few groceries could garner up to 2000 steps. Turn that trip into a walk to the farmer’s market and you could easily generate 4k steps! It was surprising how a few small decisions could turn a relatively normal day into highly productive and active day.  I found this infographic: The Exercise Experiment: A Tale of Two Days does a great job of showing the difference small choices can make.

Even more surprising, or even shocking, was how many steps I didn’t take on an inactive day.  I work from home and it’s not uncommon for me to grab a cup of coffee in the morning, jump on my laptop and get to work. Some days, the time can slip by and before you know it, the day is gone.  I never used to worry about it because when I am not working, I am highly active. However, after I came across The Truth about Sitting, I decided I needed to be more aware of my overall activity. I think this has been the greatest impact of the Fitbit. I thought that I might dive deeper into analyzing my runs or hikes, but it has actually created this awareness to keep me moving all the time. It reminded me of something John Mattison (CIMO of Kaiser Permanente) said at FutureMed:

It’s not about wearing a million sensors, we don’t need digital nannies, it’s about becoming more mindful.

Posted in: Healthcare Technology, M-health

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