SUSPECT Before You Download that Health or Wellness App

From July 9, 2018 blog post at Midwest Matters

 

 

Some resources for reputable health apps

• Medical and Health Calculator Apps and Calculators for all (University of Toledo)

• Mobile Health Apps & Sites: Consumer Health (Metropolitan State University)

B.C., feds spend millions on reward points for Canadians who use new healthy living app [news story]

From the 29 July 2015 Metro article

The B.C. and federal governments are spending millions of dollars to buy reward points for Canadians who engage with a new app that encourages healthy lifestyles.

Called “Carrot Rewards,” the $7.5-million smartphone app was created in partnership with company Social Change Rewards with $5 million from Ottawa and $2.5 million from the province as an innovative way to send Canadians mass messages about public health and nudge people to make better choices.

People who sign up for the free app will get reward points of their choice – be it for flights, groceries or movie tickets – in exchange for completing small actions such as using the B.C. Shopping Sense tool to make healthy grocery choices or completing a Heart and Stroke Foundation risk assessment.
…

[Medical Journal Article] Developers neglect privacy and security in health apps

From the 9 March 2015 article

Health applications are enjoying a boom. There are already some 100,000 on the market on iOS (Apple) and Android platforms, generating 4.5 billion dollars’ worth (around 3.3 billion euros) of business. In Spain, a third of smartphone users will have installed at least one health application this year, according to a report from The App Date.

However, as Borja Martínez, researcher in the Telemedicine and eHealth Group at the University of Valladolid, explains to SINC: “These applications do not handle information securely and this is especially serious in apps that use clinical or medical data that are particularly critical for the user”.

These applications don’t have secure data processing and this is especially serious in apps that use clinical or medical data

Martínez is the lead author of a study that reviews these problems and proposes a series of recommendations for developers to improve the handling of information that should be confidential. The work was published in January in the ‘Journal of Medical Systems’.

This young engineer points out that “the developers, in their haste to get their applications out before the rest, neglect certain aspects that should be considered, especially privacy and security of data handled. Today the majority of health apps do not offer the user sufficient measures to protect their data”.

Risks

In their opinion, “the main risk is that someone can hack into the personal medical information of another individual or, even worse, modify it”.

A clear example, warns the researcher, “would be an app that saves electronic medical histories. If a third party unconnected with the app were to access the stored information and change any patient details, such as take away an allergy to certain medication, it could put the life of this person at risk should the case arise”.

Also, “another significant problem is that health professionals and the patients themselves are not aware of the methods that apps use with regard to the privacy and security of their data. Many take it for granted that the application is secure and others couldn’t care less. I believe that greater collaboration between countries is necessary to create international laws which are in charge of monitoring these aspects,” he says.

What can be done? According to Borja Martínez, “many things [although] it all boils down to developers analysing the type of data that their apps are going to be dealing with and applying the necessary security and privacy methods”.

Each case is different, he states….

Related articles

• Developers neglect privacy, security in health apps
• Developer hacks Android Wear to show iPhone notifications (Video)

[Report] Most Consumers Encounter Challenges Using New Types of High Tech Devices, Accenture Survey Finds | Full Text Reports…

Most Consumers Encounter Challenges Using New Types of High Tech Devices, Accenture Survey Finds | Full Text Reports….

From the press release

NEW YORK; Jan. 5, 2015 – Most consumers experience challenges using several new types of smart high tech devices, according to a new report from Accenture titled Engaging the Digital Consumer in the New Connected World.

Overall, 83 percent report various problems when they use new device types such as wearable fitness monitors, smart watches, smart home thermostats, in-vehicle entertainment systems, home connected surveillance cameras and security systems, and wearable health products.

The biggest challenges consumers face are that the smart devices are “too complicated to use” (21 percent), “set-up did not proceed properly” (19 percent), and “did not work as advertised” (19 percent).

“For these new connected device categories, high tech companies need to go back to the drawing board and rethink their product development approaches to focus on the entire customer experience,” said Sami Luukkonen, managing director for Accenture’s Electronics and High Tech group. “They should make fundamental strategic changes that no longer focus on product feature differentiation but rather holistic, digital experience differentiation.”

 

Related resources

• How to Choose A Better Health App (by LEXANDER V. PROKHOROV, MD, PHD  at KevinMD.com on August 8, 2011) contains advice in the following areas

• Set realistic expectations
• Avoid apps that promise too much
• Research the developers
• Choose apps that use techniques you’ve heard of
• See what other users say
• Test apps before committing

• Sources of Trusted, Reviewed and Evaluated Apps
  iMedical Apps   –Mobile medical app reviews, commentary by medical professionals
  Gallery of Mobile Apps and Sites – from the US National Library of Medicine
  Mobile Resources Selected by the MSKCC Library for Patients and Families   from the Memorial Sloan-Kettering Cancer Center LibraryInformation For Patients from the University of Michigan LibraryGuide-Health Sciences Mobile Device Resources – Resources by Subject
   Scroll down in the right column of this guide until you get to Information for Patients

   

[Reblog] Could mHealth Apps Be a Reprise of the EHR? The Need For Clinician Input

From the 14 February 2014 item at The Health Care Blog

……

“…. many app developers have little or no formal medical training and do not involve clinicians in the development process and may therefore be unaware of patient safety issues raised by inappropriate app content or functioning.”

Without the insights of seasoned real-world doctors and nurses, apps could end up with the same safety issues that are plaguing electronic health records, many of which were also developed with little regard to physician or nurse input.

In other words, just because it’s a “health” app doesn’t mean its necessarily so.

Related articles

• Patient Safety Movement Continues Its March Toward Eliminating Preventable Patient Deaths
• Debate heats up over safety of electronic health records
• Could mHealth Apps Be a Reprise of the EHR? The Need for Clinician Input

[Press release] UMass Medical School, WPI developing smartphone app to address stress eating

Last week I started using  the USDA nutrition/exercise SuperTracker after a hiatus of three years.
Agree –  stress is indeed a reason for overeating, this app would most likely help me.

From the 2 February 2015 University of Massachusetts press releaseBy Megan Bard, UMass Medical School Communications,and Michael Cohen, WPI Communications

Researchers at UMass Medical School and Worcester Polytechnic Institute are developing a stress-eating smartphone app that will help users better understand why they overeat, with the support of a $2 million award from the National Institutes of Health.

Sherry Pagoto, PhD

Bengisu Tulu, PhD

Development of the “RELAX” application and a pilot clinical study to evaluate its effectiveness will be led by Sherry Pagoto, PhD, associate professor of medicine at UMMS, and Bengisu Tulu, PhD, associate professor in the WPI Foisie School of Business, joint principal investigators on the grant.

“Most commercial apps available today focus on tracking diet and exercise, but do not help the user understand why they are eating so much and/or exercising so little,” Dr. Pagoto said. “Our clinical and research experience suggests that stress is a very common trigger for overeating and it is a barrier to exercise.”

RELAX will have two components: a mobile application that will enable patients to track their daily activities using a smartphone and a web-based tool clinicians can use to access patient information to help inform treatment.

“We want to use technology to help patients in real time, during their daily activities, and also to enhance the effectiveness of the time they spend face-to-face with their physician or counselor,” Dr. Tulu said.

Using text inputs, barcode scanning and GPS technology, the RELAX patient app will track eating patterns, daily activities, exercise, patient-mood and stress inducing events. The app will provide the patient with an itemized list of foods consumed, indicate the times of day identified as high-stress moments and illustrate the relationship between food intake and stress. The information collected will help the user to better understand his or her habits when it comes to emotional or stress eating.

For example, the patient-facing application will provide coaching for dietary choices or guided stress-reduction exercises to lessen the likelihood of overeating.

“Imagine a person driving into the parking lot of a fast-food restaurant, at a certain time of day, and getting prompted with a message asking them to think about what they are feeling and whether or not it is the right time to eat,” Tulu said.

Clinicians will be able to access their patients’ information collected through the RELAX patient app using the web-based application. The web tool will present information as easily digestible visual displays and feedback reports for the clinician to review.

Much of the time during traditional weight-loss counseling sessions is spent reviewing paper self-monitoring records and soliciting information from the patient about factors impacting their adherence, such as stress and stress eating. By using the RELAX web tool, clinicians can more quickly get to the heart of causal factors behind the patient’s eating habits, which can be difficult to identify using traditional counseling. The research team believes RELAX will help patients achieve better outcomes with fewer visits to their doctor or counselor.

The researchers hope the interactive design and the clinician’s ability to engage with the patient in a more data-rich way, both unique features of the RELAX application, will enable a more comprehensive approach to counseling patients about weight and stress management.

Read the entire article here

[Reblog] MyFitnessPal Works If You Use It | The Health Care Blog

MyFitnessPal Works If You Use It | The Health Care Blog. (November 24, 2014)

By MIKE LEE

You may have seen some news regarding a study MyFitnessPalrecently did with UCLA.

I wanted to take a minute to address this study, since we participated in it directly. We are excited that we got to work with some very smart people to answer a question we also wanted to know the answer to. We jumped at the opportunity to find out—is having your physician introduce you to the app and help you sign up enough to kickstart a health journey?

What we learned is that just introducing people to MyFitnessPal wasn’t enough. People have to be ready and willing to do the hard work.

The app itself does work—if you use it. Our own data and the data from the study show that the more you log on, the more you use the app, the more success you will see. Users that logged in the most lost the most weight. In fact, we already know that 88% of users who log for 7 days lose weight.

We make tools designed to make it as clear and simple as possible for you to see the path to achieving your fitness goals. We are not, however, making a magic bullet—because there is no magic bullet. Ultimately, you’re the one who has to do the work.

And my, how much work you guys have done.

You have:

• lost over 180 million pounds
• logged over 14.5 billion foods
• burned 364 billion calories
• supported each other with over 82 million status likes in the last year alone
• and much more!

The first thing I say when people talk to me about MyFitnessPal is that user success is our true North. We are relentlessly focused on user success. We believe that if you are succeeding at reaching your goals then we will succeed as a company. We’re going to keep working to make our app even more accessible, simple to use, and motivating so we can help even more people succeed.

Of course, it’s our job to make the app as engaging and easy to use as possible. It’s not exactly where we want to be, yet. But we’ll keep working hard to get there. To that end, we’ve made lots of updates since this study was done. From a product perspective, in the last year and a half we’ve:

• streamlined the logging experience
• made logging streaks more visible
• added more ways to get push notifications and reminders
• added insights to help you get more out of logging
• made a recipe tool that allows you to quickly log recipes from anywhere across the web

As long as you keep working on your goals, we’re going to work on better ways to help you get there.

Thanks for everything you do, making the MyFitnessPal community so amazing, and helping us toward our vision of making an even healthier world.

Mike Lee is the Founder and CEO of MyFitnessPal

States’ Apps Target Health and Safety

States’ Apps Target Health and Safety.

Excerpts from the 26 June 2014 article at Pew Chartitable Trust

Among the state apps focused exclusively on health or public safety:

• The Minnesota Air app provides real-time information about air quality conditions in 10 reporting areas across the state, as well as pollution forecasts for the Twin Cities and Rochester.
• The Every Woman Counts app in California lets women know when it’s time to make an appointment for mammograms and Pap tests.  Users enter information about their screening history and select a schedule for their exams, and the app sends them reminders.
• The MyVaxIndiana app enables parents to keep track of their children’s vaccination records. The information comes from a state immunization system and is updated by health care workers, schools and doctors.
• The NMWatch app in New Mexico uses GPS mapping to allow residents, emergency managers and responders to monitor up-to-date wildfire activity. It not only helps people who need to know whether to evacuate, but it alerts those with respiratory problems who might be affected by thick smoke in their neighborhood.

Connected Citizens

More state agencies that oversee health or emergency management have recognized that they need to embrace mobile technology to stay connected with citizens.

“It’s a natural progression,” said Theresa Pardo, director of the Center for Technology in Government at the University at Albany, a research center that focuses on innovation in government technology. “I think these new apps are really powerful. What underlies them is a massive effort to identify and integrate in sophisticated ways data that is relevant to an individual, particularly in the event of a crisis.”

Communicating critical, life-saving information during emergencies and directing the public to services after disasters is an enormous challenge for states, said Karen Cobuluis, spokeswoman for the National Emergency Management Association, the professional association for state emergency management directors.

 

…..

A Long Way to Go

While states are moving rapidly to make advances in digital technology, they still have a long way to go when it comes to overseeing their apps and mobile device projects.

In an October 2013 survey of state chief information officers, 58 percent called their state’s efforts to manage apps and mobile device projects “mostly” or “totally” fragmented and uncoordinated.

The association’s Robinson said that most states today don’t have an “enterprise-wide, well-coordinated roadmap” for investing in and deploying mobile technology. “It’s serious for the states because of the implications. There’s no shared strategic direction,” he said. “We need to address how we’re managing mobile devices.”

Robinson of NASCIO said that in many states, apps are being launched agency by agency, which creates more complexity. Plus, states often lack the in-house technical expertise to develop their own apps, so they’re forced to use outside contractors.

 

 

 

Related articles

• New Flood App Brings American Red Cross Safety Information to Mobile Devices
• 3 police agencies tout mobile apps
• As health data platforms emerge, are health apps headed for a HIPAA showdown?
• McAfee Says Mobile Malware Threats on the Rise in 2014
• Delhi Traffic Police launches Android app for citizens
• List of Top 5 Best Women Safety Apps
• Dover Police Department Launches Mobile App 6-9-2014

[News article] mHealth still untapped resource for docs

From the 18 April article at Healthcare IT news

mHealth still untapped resource for docs
People cite privacy concerns for lack of adoption

For the most part, providers are still wary over the mHealth movement. And this caution just might be preventing them from big care improvement opportunities, say the findings of a new study.

The study, commissioned by mobile professional services firm Mobiquity, finds some 70 percent of consumers use mobile apps every day to track physical activity and calorie intake, but only 40 percent share that information with their doctor.

[See also: mHealth market scales to new heights.]

Privacy concerns and the need for a doctor’s recommendation are the two factors hindering the use of mobile and fitness apps for mHealth reasons, say officials with the Boston-based Mobiquity, which produced “Get Mobile, Get Healthy: The Appification of Health and Fitness.”

That, officials said, means the healthcare community has to take a more active role in promoting these types of apps and uses.

“Our study shows there’s a huge opportunity for medical professionals, pharmaceutical companies and health organizations to use mobile to drive positive behavior change and, as a result, better patient outcomes,” said Scott Snyder, Mobiquity’s president and chief strategy officer, in a press release. “The gap will be closed by those who design mobile health solutions that are indispensable and laser-focused on users’ goals, and that carefully balance data collection with user control and privacy.”

[See also: FCC creates mHealth task force.]

The study, conducted between March 5 and 11, focused on 1,000 consumers who use or plan to use health and fitness mobile apps.

According to the study:

• 34 percent of mobile health and fitness app users say they would use their apps more often if their doctor recommended it
• 61 percent say privacy concerns are hindering their adoption of mobile apps. Other concerns include time investment (24 percent), uncertainty on how to start (9 percent) and not wanting to know about health issues (6 percent).
• 73 percent said they are more healthy because they use a smartphone and apps to track health and fitness
• 53 percent discovered, through an app, that they were eating more calories than they realized
• 63 percent intend to continue or increase their mobile health tracking over the next five years
• 55 percent plan to try wearable devices like pedometers, wristbands or smartwatches
• Using a smartphone to track health and fitness is more important than using the phone for social networking (69 percent), shopping (68 percent), listening to music (60 percent) or even making/receiving phone calls (30 percent).

“We believe 2014 is the year that mobile health will make the leap from early adopters to mainstream,” Mobiquity officials said in their introduction to the survey. “The writing is on the wall: from early rumors about a native health-tracking app in the next version of Apple’s iPhone operating system to speculation that Apple will finally launch the much-anticipated iWatch, joining Google, Samsung and Pebble in the race to own the emerging wearables market.”

[See also: Realizing the mHealth promise.]

 

……..

Related articles

• Could your smartphone be the key to maintaining positive habits?
• Opportunities in mhealth: Docs use apps to make them more efficient, want mobile EHR access
• Improving Lives Through Wearable Technology
• Building Patient Compliance through mHealth
• mHealth Market (Devices, Applications, Services & Therapeutics) – Global Mobile Healthcare Industry Size, Analysis, Share, Growth, Trends and Forecast to 2020
• Smartphones are fading. Wearables are next
• Here’re the Reasons Why Wearable Gadgets are Not Picking Up Sales

[Press release] In search of a few good apps

In search of a few good apps.

New JAMA article suggests review and certification process for mHealth apps

BOSTON–While the Food and Drug Administration (FDA) has released guidelines for the regulation of mobile health (mHealth) apps that act as medical devices or as accessories to medical devices, the vast majority of mHealth apps remain unregulated and unevaluated. In a Viewpoint article, “In Search of a Few Good Apps”, published in JAMA on March 24, 214, co-authors, David Bates, MD and Adam Landman, MD of Brigham and Women’s Hospital (BWH) and Adam Powell, PhD, president of Payer+Provider Syndicate, call for the creation of mHealth (mobile health) app review and certification organizations to evaluate apps that are not regulated by the government.

“This article gives health care providers, patients, policymakers and mHealth app developers a perspective on how the issue of determining which apps are most useful might be addressed,” said Bates, who is Chief Quality Officer at BWH and chaired the Food and Drug Administration Safety and Innovation Act (FDASIA) Workgroup that made recommendations to the government about regulation of HIT and mobile apps. “Establishing an unbiased review and certification process is a key step in helping mHealth apps achieve their potential.”

The concept for this Viewpoint article was conceived by Landman and Powell after discussing their mutual concern about the lack of oversight over the accuracy, quality, and security of mHealth apps at the BWH Hackathon, an event sponsored by BWH’s Innovation Hub (iHub).

“Dr. Powell and I examined numerous mHealth apps and it was difficult to assess app credibility,” said Landman, Chief Medical Information Officer for Health Information Innovation and Integration and an emergency medicine physician at BWH. “The currently available reviews of mHealth apps have largely focused on personal impressions, rather than evidence-based, unbiased assessments of clinical performance and data security. With more rigorous certification criteria and unbiased accrediting bodies, both clinicians and consumers could be more confident in their selection and use of mHealth apps.”

In the article, authors describe the potential for multiple organizations to be created that could review and objectively certify mHealth apps for quality, accuracy, security and safety, similar to the role that Health On the Net Foundation (HON), a non-profit, non-governmental organization, plays in evaluating the quality of online medical content.

“People are increasingly turning to their smartphones for assistance in improving their health, but are having difficulty determining which apps are the securest and most effective. We hope that our article will instigate action that will enable clinicians and patients to make more effective use of mHealth apps,” said Powell, lead author of the article. “We foresee a potential future in which physicians will be able to confidently prescribe apps to their patient, and will have the tools that they need to interpret the resulting data. The establishment of an unbiased app certification and review process will play a key role in getting us there.”

 

Related articles

Wellocracy aims to help trackers choose and use health apps and devices

 

Related Resources

Free and low cost Health Apps sources include

• Health and Wellness Information Apps for locating information for personal health and wellness
• Health and Fitness Tracking Apps to help you enter and store your personal health and fitness information quickly

And these may be helpful when selecting health apps

• How to Choose A Better Health App (by LEXANDER V. PROKHOROV, MD, PHD at KevinMD.com on August 8, 2011) contains advice in the following areas

Set realistic expectations
Avoid apps that promise too much
Research the developers
Choose apps that use techniques you’ve heard of
See what other users say
Test apps before committing
iMedical apps has mobile medical app reviews and commentary by medical professionals. Most apps are about apps geared toward professionals and are not free.
The iMedical app forum now includes a medical librarian corner, with some patient/consumer apps

• iMedical apps has mobile medical app reviews and commentary by medical professionals. Most apps are about apps geared toward professionals and are not free.

[Reblog] Who is making your medical app?

Who is making your medical app?.

Buyer beware!!
iMedicalApps was created for health professionals. The reviewed apps are basically for professional use.
However, there the Forum section (now offline for revision) did at one time include a health science librarian section which I believe included consumer level app reviews/advice.

From the [15 ?] December blog at iMedicalApp

Medical apps are one of the fastest growing sectors in the app market. Medical apps broadly encompass any mobile app that is health related whether targeted to patients, physicians, students, etc. These apps range from providing easy accessibility to previously published texts, health advice, health monitoring for chronic diseases, treatment and dosing guidelines, etc.

 

A new responsibility that arises in the medical app world is management of transparency and conflict of interest issues. Generally, medical professionals are sensitive to concerns of industry involvement in medical education. There are policies in place that manage issues surrounding COI. These include regulating free drug samples, dinners, financial compensation, etc.

However, despite astute awareness when it comes to the aforementioned examples, there remains the question of why there is not more COI sensitivity in the medical app world. Consider for example an app made by a pharmaceutical company – it can suggest its own medicine for a specific disease, or even more subtly, list its drug first.

A recently published book, Conflict of Interest in Medical Research, Education and Practice(Lo and Field, 2009) lists potential sources of conflict by the pharmaceutical industry. Within medical subspecialties, medical professionals are beginning to notice the importance of authorship disclosure and transparency of the role of the industry (dermatology, psychiatry, to name a couple).

The paper sheds some light on the ethics surrounding increasing transparency for the medical app consumer. The paper points out the need for an increased awareness by all for the need for transparency as more and more of these apps are targeted at non-professional individuals who are potentially more susceptible as they are often not aware of COI issues in this context.

The utility of medical apps is clear–they will provide increasing value in management of patient care as we continue to move to electronically based medicine and medical recording. The need for increased transparency of authorship and industry relations is also clear. Medical apps have been added to the healthcare provider’s armamentarium to provide quality care. Just as we exert caution in avoiding biases with medications, treatments, and medical technologies, we must treat apps we recommend for our patients with the same good conscience.

 

Related articles

• mHealth: Smart apps for smarter care? (childrenscause.wordpress.com)
• Medical apps gain sophistication, draw wider use (billingsgazette.com)
• The Top 3 Problems with Mobile Medical Apps (aclsmed.wordpress.com)
• How to get FDA approval for mobile medical apps (solutionventing.wordpress.com)
• IBM Will Soon Let Developers Run Apps On Watson, Its Smart-As-A-Human Computer (IBM) (businessinsider.com)

 

[Reblog] Quality and Safety Concerns for Medical Apps

From the 18 September 2013 post by Michelle Kraft at the Krafty Librarian 

I just read a brief perspective article in the journal Evidence Based Medicine, “Medical apps for smartphones: lack evidence undermines quality and safety.”  It is a quick little read and it brings up some very real and interesting points which I will try to summarize.

1. There is no official vetting system for medical apps – Some apps are blatantly wrong and dangerous, some are out of date therefore also dangerous.
2. Lack of information and clinical involvement in the creation of the apps – There is a paucity of information regarding the creator of the app. Some apps have no physician involvement.
3. Companies (authors specifically mention Pharma) creating apps could create conflicts of interest and ethical issues – Pharma apps could produce drug guides or clinical decision tools that subtlety push their own products.

The FDA will regulate some apps but not all.  The FDA will regulate apps that control a medical device or displays, stores, analyzes patient data (example: electrocardiogram).  They will also regulate apps that use formulas or algorithms to give patient specific results such as diagnosis, treatment, recommendation or differential diagnosis.  Finally they will regulate apps that transform a mobile device into a medical device (example: apps that use attachments or sensors to allow the smartphone to measure blood glucose).

That still leaves a ton of medical apps hanging out there in the app stores which are largely unregulated.  The article states, “Until now, there has been no reported harm to a patient caused by a recalled app. However, without app safety standards, it is only a matter of time before medical errors will be made and unintended harm to patient will occur.”  Basically it is the Wild West in the medical app arena.

There are two groups that are trying to evaluate medical apps.  iMedicalApps.com and the Medical App Journal review various apps directed toward medical professionals.  I take issue with the article authors who state these sites are a “good starting point for peer-reviewing apps, the current assessment criteria do not address the scientific evidence for their content, but rather matters of usability, design, and content control.”  While I don’t use the Medical App Journal as often,  I use iMedicalApps.com quite often and they do more than just assess the usability and design. I have read reviews where they question the medical correctness of apps, intended audience, and have even pushed for more information regarding authorship/responsibility.  Several of their reviews questioned an app’s update schedule and updated content.  They have also investigated, questioned, and reported instances of fraud and plagiarism with medical apps.  I think iMedicalApps does a very good job in a very flooded market, but there are areas for improvement.  As with any website that relies on a large number of reporters/reviewers, there is some variance in the quality based on the reviewer.  I haven’t found any reviews that are bad, just some are better and more thorough than others.  Perhaps a little more explanation or transparency regarding how they determine the accuracy or validity of medical app might be helpful, or a standardized checklist about the things they look at.  I realize evaluating the latest UpToDate app is different compared to an app on EKGs.  UpToDate already has an established proven product where as there is more to investigate and validate with an app that isn’t a version of an already established product.

The authors believe the medical community needs to be more involved with regulating medical apps.  They suggest:

1. Official certification marks guaranteeing quality
2. Peer review system implemented by physicians’ associations or patient organizations
3. Making high quality apps more findable by adding them to hospital or library collections

1.  I like the idea of having an official certification indicating quality, but there are two things that must be addressed prior to that.

First you have to get the organizations to actually take responsibility for looking at apps that are in their area of expertise. The field is already cumbersome, I am not sure many organizations are able to handle that. Although I have found that several journals have now included app reviews.  While they can’t come close to scratching the surface of medical apps, these journals often have MDs, RNs, MPTs writing reviews and evaluating the content.  Specifically I have found some good reviews in the physical therapy and nursing journals.

Second, there is growing problem with fake certifications. If an app is created by a company or people who already don’t care about its accuracy or is a plagiarizing a product, they probably have no qualms about lifting the image of the certification and posting it on their website.  They could create their own certifications to fake (but legit sounding) orgs and post those on their app’s site too.  Official certification is a good idea and I like it but there needs to be more to it to make sure it truly represents quality.

2. I personally believe the writers at iMedicalApps.com are on their way to something of a peer review system.  Right now they only have one person review an app.  While that completely makes sense from a writing perspective, perhaps they can implement some sort of peer review process where more than just one person is reviewing the app, yet still retain the one voice post for ease of reading.  Perhaps they could  reach out to a few medical professionals who are leaders in their field to review specific apps.  Thus giving the reviewed app a little bit more weight.  This along with astandardized check list or illustrating how they review the medical accuracy of an app would make the information on their site even more important and provide an excellent way of separating the wheat from the chaff.

3. An online repository of approved apps would be great.  Some hospital IT departments that have mobile device policies have this, but they seem to be only hospital type apps like Citrix or database subscription apps like LexiComp, PubMed, UpToDate, etc.  While these apps are important, there is little worry about apps like LexiComp, UpToDate, or PubMed because they were well established medical information products before their app.  Their app is just an extension of their verified product.  I don’t see a lot of  IT departments that have investigated having a pool of apps that aren’t hospital specific or from database subscriptions.  Additionally, IT would either need to rely on an outside sources like iMedicalApps or content experts within the field in that hospital to build the app pool.  IT would have no way of verifying the authenticity and validity of an app on pediatric emergency medicine.

Finally, getting hospitals to buy bulk licenses to apps is tricky at best.  With exception of a few places like Epocrates, Unbound Medicine, Inkling, and Skyscape (many of those companies dealt with institutional subscriptions before app stores….remember PDAs?) there are very few places that sell or license apps to a group of people.  The purchasing of apps was created as an individual service.  Now academic medical centers may have a foot in the door with iTunes U, but I have heard that discussions with Apple and their app store and hospitals is an “interesting” process.  The same principle applies to library repositories.  Instead of IT aggregating the apps, the library would do that.  There are a lot of library’s that already have great lists suggesting various medical apps.   But the vast majority of medical libraries have app resources guides, suggesting apps that the individual must buy.  Also just like with an IT repository of apps, the librarian must rely on sites like iMedicalApps.com or their own physician suggestions to ensure they are listing quality apps.

Like I said it is the Wild West when it comes to medical apps.  That is because the whole app industry is a new frontier.  There are quality and accuracy problems with other apps in the app stores. A pedometer app with errors is not going to kill somebody, but an inaccurate medical app can.  Yes, the medical community needs to get involved in evaluating apps, but so does Apple and Google.   Right now Apple’s iTunes store feedback and ranking system while good for games, is not adequate for medical apps and can easily be subject to fraud.  Additionally, Apple is extremely tight lipped about its app store rules and regulations.  Some apps have extreme difficulty getting approved, while others fly through approval process only to be mysteriously removed later.  There is no transparency to the Apple App Store.  For example, there is no information about the app Critical APPraisal which was determined to be a plagiarized version of Doctor’s Guide to Critical Appraisal.  The app was available in the App Store July 2011.  However, if you searched today for the app, you wouldn’t be able to find it in the App Store, it simply disappeared.  Unless you happen to read the article in BMJ, iMedicalApps.com, or a few other British publications, you would have no clue as to why the app was removed.  When it comes to dangerous apps, disappearing them from the App Store is not good enough. You must have transparency when it comes to medicine.

**Update**

According to an updated BMJ article, the doctors accused of plagiarizing The Doctor’s Guide to Critical Appraisal to use in their app Critical APPraisal, have been cleared of plagiarism by the Medical Practitioners Tribunal Service.

“A regulatory panel rejected charges by the General Medical Council (GMC) that Afroze Khan, Shahnawaz Khan, and Zishan Sheikh acted dishonestly in knowingly copying structure, contents, and material from a book, The Doctor’s Guide to Critical Appraisal, when developing their Critical APPraisal app, representing it as their own work, and seeking to make a gain from the material.”

Shahnawaz Khan and Afroze Khan were also accused of dishonestly posting positive reviews of the app on the Apple iTunes Store without disclosing that they were co-developers and had a financial interest in the app.  The GMC found that Shahnawaz Khan  no evidence that he knew that the app, which was initiallly free, would later sold for a fee. His case was concluded without any findings.  However, the GMC panel found that “Afroze Khan’s conduct in posting the review was misleading and dishonest.” Yet they considered this type of dishonesty to be “below the level that would constitute impairment of this fitness to practise.”  The GMC panel said it was an isolated incident and did not believe it would be repeated in which they “considered his good character and testimonials attesting to his general probity and honesty and decided not to issue a formal warning.”

Related Resources

Health Apps (Free and Low Cost)

Free and low cost Health Apps in this section include:   Health and Wellness Information Apps for locating information for personal health and wellness Health and Fitness Tracking Apps to help you enter and store your personal health and fitness information quickly   And these may be helpful when selecting health apps   How to Choose A Better Health App (by LEXANDER V. PROKHOROV, MD, PHD  at KevinMD.com on August 8, 2011) contains advice in the following areas Set realistic expectations Avoid apps that promise too much Research the developers Choose apps that use techniques you’ve heard of See what other users say Test apps before committing  iMedical apps has mobile medical app reviews and commentary by medical professionals. Most apps are about  apps geared toward professionals and are not free.          The iMedical app forum now includes a medical librarian corner, with some patient/consumer apps

Related articles

• FDA plans to approve some medical apps (wwlp.com)
• Evaluating mobile weight loss apps on use of evidence-based behavioral strategies (eurekalert.org)

 

Side effects of civic technology partnerships may include healthier cities

From the 7 August 2013 Smart Chicago Collaborative article

One of the success stories in Chicago’s civic innovation community is the rapid spread of health related apps that have come out of both the volunteer civic technology community and paid development efforts. This started last year with Tom Kompare’s Chicago flu shot app that helped Chicago residents find free flu shots near them. (Later on, this flu shot app spread to Boston and Philadelphia.)

Professionally, Kompare is a web developer with the University of Chicago. In his spare time, he’s one of the most active civic technologists in Chicago.

Kompare’s flu shot app was just the start of the Chicago Department of Public Health partnering up with civic technologists on a number of projects including Foodborne Chicago, the Chicago Health Atlas, and Tom Kompare’s newest app Back to School.

Back to School is an app built for parents to make sure that their child has the immunizations they need to go back to school. CDPH hosts several immunization events for school children throughout the city and the apps helps parents find events near them. This will be also good trial run for the larger immunization effort that CDPH will run this fall.

Not only do these two apps use the same data format, this data format is now a proposed national standard.

Read the entire article here

Solve the outbreak!

Related articles

• CDC iPad App Lets You Solve Disease Outbreaks (mashable.com)
• New CDC App Turns You into a Disease Outbreak Detective (forbes.com)
• CDC app lets you solve disease outbreaks at home (onlineathens.com)
• Play Disease Detective With New CDC App (medicalnewstoday.com)
• CDC Launches Free App ‘Solve the Outbreak’ (counselheal.com)
• CDC app turns iPad users into disease detectives (bizjournals.com)

Public Health--Research & Library News

Do you want to be a disease detective?  the Centers for Disease Control and Prevention (CDC) have released a new app, Solve the Outbreak.

New outbreaks happen every day and CDC’s disease detectives are on the front lines, working 24/7 to save lives and protect people. When a new outbreak happens, disease detectives are sent in to figure out how outbreaks are started, before they can spread.  with this new, free app for the iPad, you can play the role of an Epidemic Intelligence Service agent. Find clues about outbreaks and make tough decisions about what to do next: Do you quarantine the village? Talk to people who are sick? Ask for more lab results?

With fictional outbreaks based on real-life cases, you’ll have to puzzle through the evidence to earn points for each clue. The better your answers, the higher your score – and the more quickly you’ll save lives…

View original post 33 more words

Patients who self track their data: Curb your enthusiasm

From the 17 January 2013 article by KEEGAN DUCHICELA, MD at KevinMD.com

…

1. There’s not strong data to support self-tracking.  We can make some inferences about how self-tracking would work in a clinical setting by looking at the studies done on telemonitoring, which also generates a large volume of attribute-rich data.  Some studies have shown benefit in outcomes, especially for diseases like diabetes, COPD, and hypertension.  However, hard measures like mortality have not been improved by telemonitoring devices.  Data on hospitalization and ED visits, especially in the elderly, have been mixed.  People (especially the engineers who created these wonderful devices and apps) love to think that more data points are better. But to date, we just don’t have a robust set of well controlled studies telling us what self-tracking is useful for, what devices or apps to use, how to interpret the data, or how to integrate it into medical care.

2. Physicians may not want the data.  Imagine that a 45-year old man who had just started exercising after years of inactivity gives their doctor all of their heart rate measurements from the past month.  All 5000 measurements.  There’s no way their physician is going to want to touch that data.  Buried inside those data points will be erroneous and clinically meaningless measurements which, without review and context, will be fodder for trial lawyers when something bad happens.  It’s data overload to the Nth degree, because let’s face it … anything can be tracked.  Once data gets put into the medical record, it’s assumed the physician has reviewed the data and acted on it accordingly.  No one wants something in the patient’s chart that not only has limited medical use but carries substantial legal risk.

Finally, we need to pay physicians to analyze and counsel about the data, similar to how we pay for EKG interpretation or reading an x-ray.   Fee-for-service still rules the roost, and nothing gets done unless someone pays for it…

 

Read the entire article here

There’s no app for that: health apps that don’t work

iTunes Store, impresion en iPhoto y iPhone en México (Photo credit: marcopako )

 
From the 15 November 2012 article at HealthNewsReview.org

 

A report by The New England Center for Investigative Reporting – published by the Washington Post – is headlined, “Many health apps are based on flimsy science at best, and they often do not work.”

It begins:

“When the iTunes store began offering apps that used cellphone light to cure acne, federal investigators knew that hucksters had found a new spot in cyberspace.

“We realized this could be a medium for mischief,” said James Prunty, a Federal Trade Commission attorney who helped pursue the government’s only cases against health-app developers last year, shutting down two acne apps.

Since then, the Food and Drug Administration has been mired in a debate over how to oversee these high-tech products, and government officials have not pursued any other app developers for making medically dubious claims. Now, both the iTunes store and the Google Play store are riddled with health apps that experts say do not work and in some cases could even endanger people.

These apps offer quick fixes for everything from flabby abs to alcoholism, and they promise relief from pain, stress, stuttering and even ringing in the ears. Many of these apps do not follow established medical guidelines, and few have been tested through the sort of clinical research that is standard for less new-fangled treatments sold by other means, a probe by the New England Center for Investigative Reporting has found.”

 

Related articles

 

• There’s an app for anything that ails you, even if it doesn’t work (wcvb.com)
• Medical apps may actually hurt health instead of helping (reporternews.com)
• Calling shenanigans on mobile health apps that make false claims (medcitynews.com)
• FTC finds popular kids apps collect data without telling parents (mercurynews.com)

 

Let’s help patients with the tradeoffs in medicine

Hillary Clinton Health care elderly (Photo credit: Wikipedia)

 

mHealth and mobile heath technologies are all the rage these days. (See my previous post,The Future of Healthcare is Already at Your Fingertips [INFOGRAPHIC]

 

While mobile devices are useful in diagnosing and gathering information (as tracking devices), it is probably best to use them wisely and not let them distract you from all life has to offer.

 

 

 

From the 27 October 2012 article at Kevin MD.com

 

…we need to consider our own tradeoffs as researchers and practitioners when talking about health communication and engaging everyone in their own health. The tradeoff for aiming to engage people more and more is that we run the risk of overwhelming people.

Some of us are like e-Patient Dave: we want full access to all of our data, and, indeed, we should have it. But as someone living with chronic autoimmune illnesses and immersed in a never-ending data stream of self-tracking, monitoring, and constant, moment-to-moment tradeoffs, I acknowledge that I don’t always want to be engaged. I already spend plenty of time dealing with my health data, and sometimes, I would rather find a new hike to do with my kids this weekend than upload more data or peruse more graphs.

In short, let’s help people choose between the butter and the butter money in smart ways, and on their terms.

[Read the entire article here, “butter and butter money” is more or less the translation of a French saying…akin to having cake and eating it too]

Found this comment to be succinct and on target

 

carolynthomas • 20 hours ago

 

Merci bien, Prof Witteman. Despite BuzzKillerSmith’s odd comment here, it seems to me that you have hit upon a critically important link between reality and wishful thinking, between homeowners and your father-in-law contractor, between both patient and physician. (And if these tradeoffs were being as effectively addressed in day-to-day health care as BKS seems to believe, we wouldn’t have stent-happy cardiologists implanting all those unnecessary stents, would we now?)

Your quote “designing for the way people are, not the way we wish they were” seems especially appropriate in the discussion of health care and emerging technology. When I attended Stanford University’s ‘Medicine X’ conference last month, I was astounded by the number of young, tech-savvy “Quantified Self” proponents gushing over The Next Big Thing in health care technology – particularly all those self-tracking smartphone apps. (I shouldn’t have been astounded – we were in the epicentre of Silicon Valley, after all!) Completely missing was any insight from the health tech startups onstage that the demographic most likely to “need” this kind of technology (especially older users living with multiple chronic diseases) is clearly the group least likely to actually use it.[My emphasis] More on this at: “When The Elephant In The Room Has No Smartphone” – http://myheartsisters.org/2012…

So the tradeoffs in emerging health technology are, just as you are doing in both your career and in your diagnosis, to respect the fine line between what’s out there and what we need to do.

 

 

 

Related articles

• What Do You Mean, I Can’t Have It All? (engagingthepatient.com)
• Let’s help patients with the tradeoffs in medicine (kevinmd.com)
• Switched On: Tablets and tradeoffs (engadget.com)
• Addressing Health Literacy: A Variation of Perspectives (engagingthepatient.com)
• How big data is transforming health care and predictive analytics (zdnet.com)
• Making Captured Data Meaningful In the Age of Mobile, Participatory Health (semanticweb.com)
• Patient-Centerness in Healthcare (ehealth.johnwsharp.com)

 

The Future of Healthcare is Already at Your Fingertips [INFOGRAPHIC]

From the 8 August 2012 post at Mashable Lifestyle

The mobile healthcare industry has made significant strides within the healthcare provider community. Rock Health found 75% of small and medium size medical and dental offices will purchase tablets within the next year. And almost 40% of physicians use medical apps on a daily basis.

The digital healthcare field is also alleviating the costs of patientcare and increasing the scale at which doctors and nurses can help people. The healthcare industry is already strained, Ziegler says, and a shortage of primary care physicians in years to come will only exacerbate the problem. She says mobile apps can bridge that gap.

But patients have been slower to realize the impact apps could have, Ziegler says, potentially because the apps force people to take notice of their health.

“No one wants to actively track what they are always doing, so we really want to make the experience passive,” she told us, adding, they are working to make tech and apps that “provide incentives for people to manage health more efficiently.”

Consumers are also generally unaware of how quickly the space of mobile health is growing, David Tao, Chief Research Officer at Greatist, tells Mashable. He says once consumers realize the vast industry already accessible, more consumers will begin utilizing the products.

“Mobile health isn’t a replacement for healthcare, it’s a supplement,” Tao says. “These companies aren’t replacing doctors’ keen eye or experience, but the apps are just bettering communication between doctor and patient.”

Related Resources

• Health and Wellness Information and Tracking Apps (Flahiff’s Health/Medical Resources site)
• Health and Fitness Tracking Apps (Flahiff’s Health/Medical Resource site)
• And these may be helpful when selecting health apps
  • How to Choose A Better Health App (by LEXANDER V. PROKHOROV, MD, PHD  at KevinMD.com on August 8, 2011) contains advice in the following areas
  • Set realistic expectations
  • Avoid apps that promise too much
  • Research the developers
  • Choose apps that use techniques you’ve heard of
  • See what other users say
  • Test apps before committing
• iMedical apps has mobile medical app reviews and commentary by medical professionals. Most apps are about  apps geared toward professionals and are not free.
• The iMedical app forum now includes a medical librarian corner, with some patient/consumer apps
• Evaluating Health/Medical Information
  • The Penn State Medical Center Library has a great guide to evaluate health information on the Internet.
    • The tips include
      • Remember, anyone can publish information on the internet!
      • If something sounds too good to be true, it probably is.
      • If the Web site is primarily about selling a product, the information may be worth checking from another source.
      • Look for who is publishing the information and their education, credentials, and if they are connected with a trusted coporation, university or agency.
      • Check to see how current the information is.
      • Check for accuracy. Does the Web site refer to specific studies or organizations?
  • The Family Caregiver Alliance has a Web page entitled Evaluating Medical Research Findings and Clinical Trials Topics include
    • General Guidelines for Evaluating Medical Research
    • Getting Information from the Web
    • Talking with your Health Care Provider
  • Additional Resources
    • Consumer’s Guide to Taking Charge of Health Information (Harvard Center for Risk Analysis)
    • How to Evaluate Health Information on the Internet (US National Cancer Institute)9iiu9
    • Quackwatch (a private corporation operated by Stephen Barrett, MD)
  • And a Rumor Control site of Note (in addition to Quackwatch)
    • National Council Against Health Fraud  National Council Against Health Fraud is a nonprofit health agency fousing on health misinformation, fruad, and quackery as public health problems. Links to publications, position papers and more.

Related articles

• Phones, tablets may become most popular tech devices for docs since the stethoscope (infographic) (medcitynews.com)
• Does smartphone = smart healthcare? (docmate.com.au)
• Mobile health apps: a new opportunity for healthcare marketers (worldofdtcmarketing.com)
• More Consumers Get Health Info On Mobile Devices (informationweek.com)
• INFOGRAPHIC: Smartphone = smarter healthcare? (mobile-ent.biz)
• How Smartphones Are Facilitating Better Health Care (thinkprogress.org)
• U.S. HealthWorks Adopts iTriage App to Connect with Patients (prweb.com)
• Who Do You Trust When it Comes to Healthcare Information? [INFOGRAPHIC] (mashable.com)
• How Smartphones Are Changing Health Care (iphonesavior.com)

Self-Tracking May Become Key Element of Personalized Medicine

 

Allan Bailey brought his type 2 diabetes under control for the first time by using a continuous glucose monitor.

 

From the 5 October 2012 article at UCSF News Center

A steady stream of new apps and devices that can be synced to ever-more sophisticated mobile phones is flowing into consumers’ hands, and this technology is revolutionizing the practice of self-tracking, in which individuals measure and collect personal data to improve their heath.

Self-trackers are using these tools to monitor sleep, food intake, exercise, blood sugar and other physiological states and behaviors. In some cases, they are using the data to identify what triggers or worsens flare-ups of chronic health disorders on their own, or with the help of an online community. In others, patients are even working together with physicians and scientists to conduct experiments, pooling their data for analysis that may shed light on the cause or best treatment for their disease.

This phenomenon was explored at a Sept. 28 symposium at Stanford University, where attendees and presenters — including two UCSF physicians — asserted not only that self-tracking can help patients to improve their lives, but also that self-tracking has the potential to change medical practice and the relationship between patients and their health care providers. The event was part of Medicine X 2012, a three-day conference on social media and information technology’s potential impact on medicine..

…

Already 60 percent of U.S. adults are tracking their weight, diet or exercise routine; one-third of adults are tracking some other indicator or symptom, such as blood sugar, blood pressure, headaches or sleep patterns; and one-third of caregivers are monitoring health indicators for loved ones, Fox said…

..

Self-tracking may not be for everyone, Abramson said, but it may be especially helpful for those who are diagnosed with medical problems for which conventional treatment typically offers little benefit; for those with symptoms and syndromes that are not adequately diagnosed through conventional medicine; for those who want to change their behavior; for those who want to identify environmental, dietary, contextual or social contributors to their symptoms; or for those who simply want to be more involved in their own health care.

 

Related articles

• Stanford Medicine X: Reflections on Day 1 (thebiopsy.wordpress.com)
• Bluetooth device to track blood sugar levels (thehindu.com)
• Fora Care to Unveil New Mobile App, Featuring Advanced Mobile Connectivity of FORA Diamond Series Blood Glucose Monitoring System at EASD 2012 in Berlin at Booth #3C41 (demandroid.info)
• Self-tracking may become key element of personalized medicine (medicalxpress.com)

 

The problem with transformative technologies in medicine

http://www.healthxchange.com.sg/healthyliving/HealthatWork/Pages/top-5-health-apps-to-download.aspx

Yesterday I reflagged an item about the  Free UMSkinCheck Mobile App.
While these self check apps are wonderful consumer and patient tools, they are not without “problems”.
This KevinMD.com post outlines health app use challenges as folks gathering data without knowing what to do with and reimbursement issues (physician consultations outside of the office).

Article ends with statement “Until our system puts more value on avoiding unnecessary treatment and keeping people well we will be stuck in this struggle between patients who want to avoid seeing the doctor and doctors who can’t afford to let patients do that.”.

The problem with transformative technologies in medicine

by ROB LAMBERTS, MD(KevinMD.com post, 17 July 2012)

Eric Topol wrote a post on The Health Care Blog where he looks to a future enabled by emerging technology: “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….

…

large number, if not the majority, of ear infections are undiagnosed and clear on their own at home without intervention.  Now add to this a technology which gives us the ability to see all of those undiagnosed ear infections, and we have to muster even more willpower to resist the urge to treat them all.  This is the same problem as we have encountered with PSA testing: be careful gathering data you don’t know how to handle.

But even without considering this important objection to improved data-gathering, there is another problem which stands in the way of this type of technology: reimbursement.  It sounds great to enable people to avoid visits to the doctor’s office by having tools that previously were only accessible at an office visit.  It sounds like a very good way to save money and wasted time spent in waiting rooms with outdated magazines.  But this technology presumes that doctors will be willing to act on this information without seeing the patient in the office.  It presumes we will be willing to offer free care.  If the time I spend sifting through patient-collected data rises exponentially, the payment I get for that time cannot remain at the present level: zero.

If our goal (as it should be) is to spend less money on unnecessary care, we will get to it much faster if we somehow give proper incentive.  Our encounter-based payment system stands in the way of any progress in this area.  The only way most of us get paid is to see people and deal with problems.  This makes doctors reluctant to offer any care outside of this setting, and puts undue pressure on intervention (to justify the encounter to the payors).  Until our system puts more value on avoiding unnecessary treatment and keeping people well we will be stuck in this struggle between patients who want to avoid seeing the doctor and doctors who can’t afford to let patients do that….

Related articles

• Will Information Technology Squeeze Physicians Out Of Their Central Role In Health Care? (the healthcareblog.com, July 11, 2012)

  “Turns out that while most of us (90%) would like be able to make a doctor’s appointment and check lab results online….85% of us also still want the option of be able to talk to our physician face-to-face.  These are the finding from a recent 2012 study conducted by Accenture.””

What is significant about the finding cited above is that patients at least get it.  They understand the value of a having a relationship with a knowledgeable physician or similar health care provider.  In spite of, and for some, because of the plethora of health information outlets on the web people want to know that they always have access to your family doc when the chips are down.”

“Here’s what I mean…based upon some 20+ years working in health care:

From the get go…going back to Hippocrates…health and health care delivery has been about the relationships between people starting with the  physician-patient.relationship.

The most important diagnostic tool a physician has at their disposal is not a smart phone…but their ability to talk with and observe  patients verbal and non-verbal behavior.

 “Talk” is not only how physicians diagnose problems and recommend the appropriate treatments…talk is also how patients are able to engage in the health care.  Perhaps the most overlooked aspect of talk (and touch) during the medical exam is the therapeutic benefits patients derive from being able to express heart-felt fears and concerns to someone who hopefully cares.”

• Now Your Smartphone Can Be Used To Diagnose Ear Infections At Home (singularityhub.com)
• Now Your Smartphone Can Be Used To Diagnose Ear Infections At Home (forbes.com)
• Back to the Future: Predicting the Future of Healthcare (Part I) (drchrono.com)
• Three mobile tools that could transform how cardiovascular disease is managed (medcitynews.com)
• Company developing #mhealth ECG device for iPhone, ipad raises $10.5M (medcitynews.com)
• Dr Topol to med students: “When I was in medical school, the term “digital” was reserved for the rectal examination” (casesblog.blogspot.com)

[Reblog] Cancer Tracking Goes Mobile – Free UMSkinCheck Mobile App

[Reblog from Taubman Health Science Center Newsblog]

Cancer Tracking Goes Mobile

July 12, 2012 by irinazey

The sun is definitely shining brightly outside – do you know how your skin is affected?

University of Michigan Medical School and University of Michigan Health System have developed a free app to photograph your skin and monitor any suspicious moles or lesions in an effort to make skin cancer screening cheaper, faster, and more convenient for the average person.

Screenshots from UMSkinCheck

Under the supervision of lead developer Dr.  Michael Sabel, UMSkinCheck walks you through a full-body skin self-exam, lets you track moles/lesions for change over time, and set up notification reminders for recurring self-exams. It also comes loaded with information on sun safety and a risk calculator to help determine individual risk based on personalized data.

Read the full story from UMHS here or download the app free from the iTunes storehere.

On a related note, from A blog I follow ,As Our Parent Age- Timely Topics for Adult Children

“Yet another friend has skin cancer. She always used sun blocking lotions, but also enjoyed staying out in the sun for long periods. (I have her permission to write this much.)
My friend tells me that she now understands that sun blocks, no matter how effective or powerful, are only one piece of a skin protection puzzle. Staying out of direct sunlight during the the most intense times of the day is another large puzzle piece.”

This is a good blog to follow, I can’t express it any better than what the author states on the about page

 “As Our Parents Age is my effort to record the experiences of loving and living with aging parents, but it is also a vehicle to help my husband and me understand and learn more about aging parent caregiving. I am highlighting interesting issues, identifying high quality web resources, and sharing memories. Other posts are on topics that my husband and I would have liked to know more about at the beginning of our foray into the aging child – aging parent phase of life.”

Related articles

• The problem with transformative technologies in medicine

  by ROB LAMBERTS, MD(KevinMD.com)
  “…Now add to this a technology which gives us the ability to see all of those undiagnosed ear infections, and we have to muster even more willpower to resist the urge to treat them all.  This is the same problem as we have encountered with PSA testing: be careful gathering data you don’t know how to handle.

  But even without considering this important objection to improved data-gathering, there is another problem which stands in the way of this type of technology: reimbursement.  It sounds great to enable people to avoid visits to the doctor’s office by having tools that previously were only accessible at an office visit.  It sounds like a very good way to save money and wasted time spent in waiting rooms with outdated magazines.  But this technology presumes that doctors will be willing to act on this information without seeing the patient in the office.  It presumes we will be willing to offer free care.  If the time I spend sifting through patient-collected data rises exponentially, the payment I get for that time cannot remain at the present level: zero.

  If our goal (as it should be) is to spend less money on unnecessary care, we will get to it much faster if we somehow give proper incentive.  Our encounter-based payment system stands in the way of any progress in this area.  The only way most of us get paid is to see people and deal with problems.  This makes doctors reluctant to offer any care outside of this setting, and puts undue pressure on intervention (to justify the encounter to the payors).  Until our system puts more value on avoiding unnecessary treatment and keeping people well we will be stuck in this struggle between patients who want to avoid seeing the doctor and doctors who can’t afford to let patients do that…..”
• Skin cancer app tracks changes head to toe (futurity.org)
• Checking For Skin Cancer? There’s An App For That (detroit.cbslocal.com)
• Skin Cancer Self Exam By Use Of Mobile App (medicalnewstoday.com)
• UMSkinCheck – Encouraging you to Take Naked Pictures of Yourself! (coolest-gadgets.com)
• Screen yourself for skin cancer with this free iOS app (news.cnet.com)
• UM Offers New Skin Cancer Mobile App (detroit.cbslocal.com)
• Screen yourself for skin cancer with this free iOS app (news.cnet.com)
• Illness Detection Add-Ons – The ‘UMSkinCheck’ App Can be a Lifesaver (TrendHunter.com) (trendhunter.com)
• Skin Cancer Symptoms (cancercenter.com)
• Skin Cancer Risk Factors (cancercenter.com)

We Can’t App Our Way Into Better Health or Healthcare – Health Is Social

We Can’t App Our Way Into Better Health or Healthcare

From the 9 March 2012 post at Health is Social

It’s cool and all that we can track our every step, our every weight, our every heartbeat, our every glucose reading.

Cooler still is to receive relevant feedback based on all the tracks.

Cooler yet is to gain proper interpretation of what the feedback means.

Even cooler is for us to get healthier and to deliver better care with all this tracking.

That last sentence – it’s not *just* cooler: it’s crux.

We can build all kinds of mobile applications. We can track all sorts of things.

But if we track the wrong things, we’ll simply railroad ourselves – or at least hop on the wrong train.

It’s not enough to track all those pushups and all those marathons.

In fact, how do you know that all those sweaty visits to the gym aren’t slowly making invisible tears in your muscles – how do you know that all those tears aren’t inducing a chronic state of tiny inflammatory processes that one day will lead to a myocardial infarction?

You see, the problems in front of you aren’t the problems in front of you: for an app that tracks your gym activity *might* be blinding you to some other problems.

Building and using more and more apps won’t convey us into better health or healthcare. Yes, they can help nudge and guide us – and that’s important as long as the contexts and processes into which those nudges and guides are the right ones.

An app is a module.

Health is a whole.

 

How Smartphones Could Impact Public Health

(Chart via Pew.)Smartphone owners now outnumber regular cell phone owners for the first time, according to a new study.

From the March 3, 2012 article in the Boston Globe

…

This smartphone proliferation has tremendous potential from a public health perspective. When Ispoke with Frank Moss at Bluefin Labs for the story, he described a day when doctors would simultaneously prescribe medicine with an app to help patients better monitor their care (you can read more of Moss’s ideas about mobile health in his New York Times op-ed). When you consider that smartphone penetration is already higher in African American and Latino communities (49 percent in each group vs. a national average of 46 percent) and that these two groups are historically disadvantaged when it comes to accessing health care (just browse the February headline roundup from the Kaiser Family Foundation for examples of these disparities), it would be revolutionary to begin targeting health care apps and devices to these populations.

When we consider looking that the gadgets being pushed into the marketplace to help us monitor our health (many of which I tried while reporting the story) we forget that they’re all targeting ”fairly affluent people,” says Jane Sarasohn-Kahn, a health economist who often blogs about public health at Health Populi. “When we look at the burden of chronic disease, it’s the African Americans and Latinos, the poor and less-educated, and very old or very young that don’t have access to healthy food or safe places. These populations have spent as much money on their mobile phones [as the rest of the country], but the platform technology hasn’t penetrated into poor urban areas.”

Sarasohn-Kahn hopes that Medicaid will start developing applications to target these populations, and points to the recent move by a former CDC scientist to develop an asthma inhaler outfitted with GPS and Wifi enabled sensors. When distributed in urban populations, the inhalers allow the doctors to better track their patients, and allow epidemiologists to learn more about the health of these groups. Right now, the smartphones are spreading at a rapid clip through the country. We just need to be smart enough to know how to help them nudge us all toward better health….

Best Time For A Coffee Break? There’s An App For That

From the 16 February 2012 Medical News Today article

Caffeinated drinks such as coffee and soda are the pick-me-ups of choice for many people, but too much caffeine can cause nervousness and sleep problems.

Caffeine Zone software app developed by Penn State researchers, can help people determine when caffeine may give them a mental boost and when it could hurt their sleep patterns. The software takes information on caffeine use and integrates it with information on the effects of caffeine to produce a graph of how the caffeine will affect the users over time. …

…The app is available on iTunes for free with advertisements and for purchase without ads. It only works on Apple devices – the iPhone, iPod Touch and iPad.
Penn State

 

For information on how to select health apps (with links to select health apps), please visit my Health Apps Web page

Related articles

• Best time for a coffee break? There’s an app for that (eurekalert.org)
• Best time for a coffee break? There’s an app for that (esciencenews.com)
• How to optimize your caffeine intake: there’s an app for that (boingboing.net)
• Time for Coffee? Ask Your Smart Phone (psychcentral.com)
• Optimizing Your Caffeine Intake With an App (science.slashdot.org)

Study: For Now, Web-Based Healthcare Tools [and Possibly Health Apps] Are Mostly Ineffective [With Links to Reviewed Health Apps For All]]

Health apps designed for the general population have potential in tracking health indicators (as food eaten, glucose levels) and also  communicating information and support among users. For example, Spark People  provides answers from dietitians & fitness trainers on message boards. One may connect with other members in support teams.

While it is very easy to find Health apps (iTunes, I believe,  is the largest supplier), it is very challenging to find easy to use apps that have been professionally reviewed.  The article below highlights one drawback of most present web-based healthcare tools- usability. It seems highly likely, that by extension, that health care apps are largely lacking in usability also.

Here are a few resources I used to create short lists of reputable easy to use health apps.

• Hasman, Linda An Introduction to Consumer Health Apps for the iPhone Journal of Consumer Health on the Internet2011 Oct-Dec, 15(4):322-329.  “The 19 apps listed in this article are culled from approximately 350,000 total apps”.
   [Article available by subscription only,  I got this (for free!) through the interlibrary loan dept at my local library, it contains about 19 good sites, some I will add to my health apps page]
• iMedicalapps – Medical Librarians corner iMedicalapps includes medical app reviews and commentary by medical professionals
  The Medical Librarians corner included these great resources

  • Patient/Family Mobile Resources (Memorial Sloan-Kettering Cancer Center Library)

  • Mobile Device Resources for Patients (Henry Ford Health System)

Study: For Now, Web-Based Healthcare Tools Are Mostly Ineffective

From the 13 January 2012 ReadWriteWeb column

A study published in the Journal of the American Medical Informatics Association accents the limits of web-based health management tools that are currently available.

Researchers focused specifically on tools for managing diabetes, but the drawbacks could extend to other tools designed to help patients do everything from lose weight to quit smoking. The study concluded that “despite their abundance, few practical web-accessible tools exist.” In many case, the tools suffered from poor design that made them difficult to use….

….Of the 92 web tools analyzed in the study, 60% had three or more usability errors, included limited use of visual interaction and navigation that was not intuitive. Just 6% had no usability errors..

..The study recommended companies offering such tools work on improving attrition, standardizing quality indicators and making indicators transparent for patients and doctors choosing the best web-based tool.

“Web-based tools have the potential to improve health outcomes and complement healthcare delivery, but their full potential is hindered by limited knowledge about their effectiveness, high prevalence of usability errors and high attrition rates,” Yu wrote….

One of the biggest problems facing web-based health tools is patients often use them inconsistently.

Related articles

• Study: For Now, Web-Based Healthcare Tools Are Mostly Ineffective (readwriteweb.com)
• Apple Makes Finding Medical Apps for Professional A Little Easier (jflahiff.wordpress.com)
• Are Health Apps the Cure for Anything That Ails You? (jflahiff.wordpress.com)
• Health and Wellness Information and Tracking Apps (jflahiff.wordpress.com)
• How Do You Get Patients To E-Consent? (informationweek.com)
• 21st Century Learning & Web 2.0 Tools (sandragolisportfolio.wordpress.com)
• Report: Net privacy tools are confusing and ineffective (news.consumerreports.org)
• Healthcare Collaboration: A Dream for All (recruitingforhealthcarejobs.wordpress.com)
• Study Reveals How Social Media Benefits the Healthcare Industry (sproutsocial.com)

[Report] Mobile Social and Fun Games for Health – Summary with Links to Examples of Games

From the Web site The Incredible Adventures of the Amazing Food Detective  – a free online health game about how to eat right and exercise sponsored by Kaiser Permamente thrive

The report Mobile Social and Fun Games for Health, free through registration, is sponsored by  mobi health news research.

While it focuses on industry trends, it does give some good overviews of how the public views and uses social media and health gaming.

Some insights from the report

• “Game designer Jane McGonigal argues in her recent book, Reality is Broken, that “games are already improving the quality of our daily lives, fighting social problems such as depression and obesity, and addressing vital twenty-first-century challenges.” McGonigal believes that gamers “will be able to leverage the collaborative and motivational power of games in their own lives, communities, and businesses” to change the world. “
• There is a growing clinical trial evidence base that shows that games can improve players’ health behaviors and outcomes in areas such as addiction control, healthy eating, physical activity, physical therapy, cognitive therapy, smoking cessation, cancer treatment adherence, asthma self-management and diabetes self- management.
• “Kaiser Innovation Center’s Dr. Yan Chow  [states] “game thinking gives people permission to fail, and that is new and important in healthcare.” “

• “The provider community is in need of better educational tools to improve efficiency and lower costs. Care providers of all stripes are interested in employing new ways to help patients understand their diseases and regimens to help them better take care of themselves. to new technology, they see a pressing need to identify and market a new suite of offerings that will function together to improve health outcomes. “
• The report gives examples of two companies which use multidisciplinary teams to develop and market games.

•  Tw0 of some examples of games for health in development

“Beating Heart,” which “introduces heart health to young adults by letting them get their heart rate when they touch their iPhone and also allowing them to share this information with friends.” scientists, exercise scientists and physicians working together,” Patrick said. “No one discipline owns more than a minority share.”

“The Magic Carpet” game where the harder the user blows into their phone, the more an interactive magic carpet pictured on the user’s phone moves.

• Some examples of health games now availableMindbloom – Grow the Health You Want  [uses]a tree metaphor to represent the different branches of a person’s life — health, relationships, lifestyle, leisure, finances, spirituality, creativity and career. Users focus on making small meaningful changes to improve the quality of their lives. There are five elements that drive consumer engagement within this game

  MeYou Health—everyday wellbeing with small actions using community support

  “MeYou Health promotes everyday wellbeing by  encouraging small actions and fostering social ties that drive meaningful behavior change. Daily Challenge is the application that encourages users to take small, achievable steps toward healthy living every day. Getting started only takes a few minutes. Once you sign up, you get an email at 7 am to do one small task, across a wide range of wellbeing domains, from physical activity to eating well to emotional health and more. Feedback includes social proof of action from your personal connections.

  OneRecovery is an online support network for individuals in recovery from alcoholism, drug abuse and eating disorders.  It is a place for members to share stories, work on their recovery and mutually support one another in real time.  The web and mobile program combines social networking technology, game mechanics and evidence-based clinical principals to support sustained engagement and behavior change.

  Vive Coach – A  corporate wellness application.Vivecoach team wellness challenges combine the convenience of mobility, the power of community and the appeal of gaming to get employees excited about doing something good about their health.  Vivecoach challenges include step count competitions, weight loss challenges, and exercise challenges that may appeal to large groups. They also include smaller group or niche challenges called “Cold Turkey” challenges focused on giving up things like soda, sweets, junk- food, or cigarettes. Challenges for flossing and sleeping have also been used. Vivecoach encourages the company administrators or any employee to create new challenges.

  The Amazing Food Detective: Based on a skit developed internally at Kaiser and then produced by an outside game designer, the game utilizes eight short mysteries and 24 fun arcade mind-games. Kids play the role of detectives fighting childhood obesity.Escape from Diab is a sci-fi adventure and video game developed to prevent kids from becoming obese and developing related illnesses as diabetes.”Medical device developers are looking at gaming elements to bring deeper customer engagement with their products to increase sales.”

Related articles

• From E-patient Hackers to Health Games on Mobiles (scienceroll.com)
• Anti-Resolution Apps – MeYou Health’s App Helps You Break a Habit Without a Resolution (TrendHunter.com) (trendhunter.com)
• Keas’ Social Game Aims To Make Healthy Living Fun (forbes.com)
• Can Video Games Keep You Vital? (everydayhealth.com)
• Start-Ups Look to Social Gaming to Make Health Care Less of a Pain (online.wsj.com)
• Top Medical Social Media Stories of 2011: Month by Month (scienceroll.com)
• Are Health Care Startups the next big opportunity ? (Halle Tecco/Leslie Ziegler) (empreendersaude.com.br)
• Jane McGonigal on Gaming at BlackBerry DevCon Americas 2011 (VIDEO) (blogs.blackberry.com)
• Gaming for Social Change: An In-depth Interview with Jane McGonigal (forbes.com)
• Renowned Game Designer Jane McGonigal to Speak at BlackBerry DEVCON Americas 2011 (blogs.blackberry.com)
• Gamer Heal Thyself With Jane McGonigal’s SuperBetter (fastcompany.com)
• “Gaming is good for you” by Jane McGonigal (designgames11.wordpress.com)
• Renowned Game Designer Jane McGonigal to Speak at BlackBerry DEVCON Americas 2011 (devblog.blackberry.com)
• Jane McGonigal on Gaming at BlackBerry DevCon Americas 2011 (VIDEO) (devblog.blackberry.com)
• Social trends and game play: pervasive gaming – the next techno bubble or just an emerging snowball from the 1980s? (davidjrodger.wordpress.com)
• Gaming for Good, Gaming for Green (downtoearth.sequoialab.com)
• The best GamesBeat stories of 2011 (venturebeat.com)
• Worker health scheme launched in Scotland (premierlinedirect.co.uk)
• Firms with business insurance ‘may benefit from introducing health and wellbeing schemes’ (premierlinedirect.co.uk)
• Herbalist-Mathematicians Transform Clinical Herbal Education With Game Software (prweb.com)
• The Importance of Gaming – Jane Mcgonigal Shows Why Video Games Can Save the World (TrendHunter.com) (trendhunter.com)
• Tombstone Hold ‘Em, Anyone? (kylemackiemasters.wordpress.com)
• 5 Sites To Find Fun And Free Massively-Multiplayer Online Games (MMOs) (makeuseof.com)

Top 10 Youth Health 2.0 articles of 2011

Top 10 Youth Health 2.0 articles of 2011

From the 26 December Youth Health post by Dr. Kishan Kariippanon (@yhpo)

1. #9 cool public health and social media articles

2. Is technology to blame in cybersafety?

3. Stanford Medicine 2.0 Conference 2011 – The Report Card (Guest blog by Prajesh C)

4. iPhone Apps for STI/HIV Prevention

5. Mark Scott (ABC) on social media leadership

6. Social media and Indigenous culture

7. Youth Health 2011 Sydney conference presentation

8. Sexual health iPhone Apps

9. Wanted: a Social Media Expert?! (Guest Blog by Kate Nelson)

10. A simple QR code evaluation

Related articles

• Top 10 Youth Health 2.0 articles of 2011 (youthhealth20.com)
• Bringing the social media revolution to healthcare – Lee Aase and the 7th HARC Forum (jflahiff.wordpress.com)
• Health 2.0 Code-a-thon sends IT innovators scrambling (medcitynews.com)
• At Health 2.0, apps help you sleep, breathe better (video) (zdnet.com)
• What is the future of Health 2.0 in Europe? (scienceroll.com)
• David Harlow’s Health 2.0 vlog (healthblawg.typepad.com)

Consumer and Lifestyle App Reviews (Diabetes, Gluten-Free, and Weight Loss Management)

From the Web page of the American Dietetic Association

Thousands of diet and nutrition apps are available for phones and tablets… so many, in fact, that there are apps to find apps. So when searching for the right apps to help you safely manage your health, don’t make your selection based on the same criteria used to rate Angry Birds. Understand which apps are helpful and based on fact, not fad. Turn to the food and nutrition experts—registered dietitians—for science-based reviews of the most popular apps on the market.

Three Academy of Nutrition and Dietetics spokespeople have reviewed top-rated, free iPhone apps for those looking to lose weight, manage their diabetes or eat gluten-free:

• Marisa Moore, MBA, RD, LD, reviews the 10 top-rated free iPhone apps for managing diabetes.
• Jessica Crandall, RD, CDE, reviews the 10 top-rated free iPhone apps for gluten-free eating.
• Sarah Krieger, MPH, RD, LDN, reviews the 10 top-rated free iPhone apps for weight management.

Ratings are on a scale of 1 to 5 stars.

Diabetes App Reviews »		Gluten-Free App Reviews »		Weight Loss App Reviews »

Related resources and articles

Health and Wellness Information and Tracking Apps(jflahiff.wordpress.com)

Health Apps (Health and Medical News and Resources selected by Janice Flahiff)

mHealth Moving Fast, Raising Hope, And Questions

mHealth Moving Fast, Raising Hope, And Questions 

From the 6 December 2011 blog item by Elsevier Global Medical News

Hopes, ideas, and hundreds of apps, are floating in the hallways during the third annual mHealth [Mobile Health] Summit***, marking the beginnings of a field that is still in its infancy and carries with it more questions than answers.

The federal government is pushing mHealth, launching programs like theHealthy Apps Challenge, which Dr. Regina Benjamin, the U.S. Surgeon General, introduced in her keynote speech. Health and Human Services Secretary Kathleen Sebelius, introduced the SmokeFreeTXT program, a text messaging service that helps teens quit smoking. Ms. Sebelius has also established theText4Health Task Force last year to look at other uses of texting in promoting healthy behavior.

“As our phones get more powerful, they are becoming our primary tools for doing everything from getting directions to deciding where to eat, Ms. Sebelius said during her keynote speech on Monday.  “And increasingly, that includes using our phones to track, manage, and improve our health.  In the iTunes store alone, there are nearly 12,000 different apps related to health – a number that will probably have gone up by the time I finish speaking.”…

…we sometimes come away from a conference, such as this week’smHealth Summit, with the feeling that the only ones making a living with mHealth are conference organizers. Maybe it was the format…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.

That is not to say they are no advances occurring here in the US. One of the keynote speakers, cardiologist Eric Topol, gave several live demos during his talk of the mHealth tools he is already using including stating that he has not used a stethoscope in two years, instead preferring to use mobisante’s ultrasound wand and iPhone App.  Then there was our conversation with WellDoc’s CTO who informed us that they are currently being deployed at a number of institutions and hope to have a host of CPT codes that doctors can bill against in late 2012. And there was the small start-up we spoke with who has done the hard work of first identifying what the value proposition is for all stakeholders in a community (payers, providers and consumers) and then developed an extremely compelling solution (think analytics & automated quality reporting, tied to reimbursement, tied to consumer engagement) that has a lot of promise in a market where physicians’ pay will increasingly be based on outcomes and ability to meet pre-defined quality metrics…

…Addendum:
For a slightly different take, check out the post by VC firm Psilos’ Managing Partner Lisa Suennen’s. Well worth the read.

Read the entire news item with a link to a video interview

Press releases may be found here

mHealth Summit 2011 – Videos Available

• mHealth: Closing the Gap Between Promise and Adoption (iHealthBeat- Reporting Technology’s Impact on Health Care)
• mHealth Summit 2011 – Videos Available (International Medical Association News)
• HIMSS: Most hospitals still developing mobile policies (MobileHealth News)
• Physicians in Scotland use iPhone 4 and Skype to remotely manage lung and pleural ultrasound (iMedical Apps, Dec 2011)
• UK patients able to get health advice via free iPhone medical app, review of NHS Direct app (iMedical Apps, Dec 2011)

Related Resources

• Get Mobilized! An introduction to mobile resources and tools in health sciences libraries (Medical Library Association)

  Archived 2011 online class including “lecture notes”, resources, class discussions, and related slides/videos

• Health Apps (in Health and Medical News and Resources selected by Janice Flahiff)
  a short list of information and tracking apps derived from the above Get Mobilized class

Related articles

• mHealth: Seemingly Stuck in Neutral (chilmarkresearch.com)
• Importance of mHealth for Peacebuilding (/technologyforpeace.wordpress.com/)
• Physicians aren’t taking mobile health seriously (KevinMD.com)”Although I realize that many actively practicing physicians cannot attend all technology meetings, I would consider mHealth Summit to be that one meeting a year that an ambitious physician mobile health entrepreneur would take the time to attend. Therefore, I am assuming that this correlates with a low number of physician entrepreneurs in the marketplace. Although large numbers of physicians are certainly using smartphones, there is still a notable lag in the incorporation of mobile health within the traditional medical practice.

  For example, case examples of physicians recommending health apps to their patients and then measuring changes in medication adherence or health outcomes are not common. Additionally, mobile phone sensors as a dominant outpatient diagnostic tool is also uncommon although cardiologist Dr. Eric Topol mentioned that his mobile phone vscan ultrasonic sensor has now replaced his stethoscope in his outpatient clinic. Exchanges on twitter such as the one listed below may mirror the fact that perhaps physicians aren’t taking mobile health seriously:”

   

• Mobile health and the globalization of medicine (kevinmd.com)
• mHealth Moving Fast, Raising Hope, And Questions (jflahiff.wordpress.com)
• Mobile health: Hallelujah or bah humbug? (finance.fortune.cnn.com)
• mHealth Summit 2011 – Videos Available (imianews.wordpress.com)
• mHealth Moving Fast, Raising Hope, And Questions (egmnblog.wordpress.com)
• Sensei, Inc. Presenting at mHealth Summit (prweb.com)
• Zeo Sleep Monitor CEO at the 2011 mHealth Summit (medgadget.com)
• Physicians Play Important Role in mHealth Integration (egmnblog.wordpress.com)
• 10 startups from mHealth 2011: Meddik (medcitynews.com)
• Converging Ideas at the 2011 mHealth Summit (rwjfblogs.typepad.com)
• Mobile health: Hallelujah or bah humbug? (finance.fortune.cnn.com)

***”The largest event of its kind, the 3rd annual mHealth Summit brings together leaders in government, the private sector, industry, academia, providers and not-for-profit organizations from across the mHealth ecosystem to advance collaboration in the use of wireless technology to improve health outcomes in the United States and abroad.”