9.11.2011

Wireless Body Area Networks: Driving mHealth By Delivering Value to Patients, Providers and Payers || via @imedicalapps & @healthgrid

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Wireless Body Area Networks (WBANs), or simply Body Area Networks (BANs), represent a tremendous emerging opportunity for mHealth and will be a great stimulant for entrepreneurship and sustainable business models in this nascent sector for at least the next decade. This is the first post in a series about the promise and opportunity of Body Area Networks and the innovations that will drive the emergence of this advanced segment of mHealth.

BANs, enabled by vast networks of non-invasive and unobtrusive wearable sensors and peripheral devices, are emerging to a marketplace finally mature enough to stimulate a vibrant consumer base. Consumer mobile technology is for the first time just as powerful if not more powerful than the mobile technology used in the enterprise.

Potential applications of BANs include:

  • Vital Signs Monitoring: Smart band-aids provide increased mobility and comfort while delivering essential real-time information.
  • Proactive Cardiovascular Monitoring: Identify potential heart attacks before they happen using sensors implanted in (or worn on) the body to monitor sophisticated vital signs over wireless networks.
  • Organ Implantation Monitoring: Monitor organ transplant recipients after discharge for signs of transplant rejection using implanted sensors.
  • Seizure Monitoring: Wearable sensors allow clinical neurologists to monitor epileptic patients remotely in real-time and provide each patient biofeedback to help manage their condition.

BANs have the potential to drive cost-savings, improve efficiency, and increase sales of prescription drugs. The data collected by BANs will create significant business opportunities for start-ups in the cloud computing, data management/analytics and bioinformatics verticals.

WBANs require solutions that blend both hardware and software elements and are typically developed by more than one company or vendor (particularly start-ups) working together under strategic partnership or joint venture. Products in this space tend to be derived from academic research, primarily due to the minimal private investment in R&D, leaving most breakthroughs in BAN technology to public research institutes and laboratories.

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A recent report, published by CSMG, a global wireless consulting group, nicely summarized a few of the major implications of BANs for the business of mHealth:

  • Cost Savings: BANs have the potential to radically undermine the ever-growing cost burden of managing chronic conditions. A BAN-based vital signs monitoring solution could be a cost-effective alternative to the last few nights of a patient’s hospital stay. At a cost of thousands of dollars per day for a hospital room, this application alone could have a tremendously disruptive impact on the health care cost curve.
  • Improved Outcomes: Improved compliance, the ability to monitor and balance drug dosage to increase treatment efficacy, and more timely treatment will reduce the length of hospital stays and the need for expensive procedures.
  • Increased Sales: While the low-hanging fruit for prescription compliance may be in solutions such as smart pillboxes, there is a significant longer-term opportunity to improve efficacy and compliance through the use of BAN-based monitoring.
  • Improved Test Outcomes: Another potential area where BANs could prove particularly valuable is in the monitoring of clinical drug trials. The ability to calibrate dosage, gather improved data, and ensure total compliance will help pharmaceutical companies improve their chances of getting drugs through the trial process and to market.
  • Context Awareness: BANs that capture patient physiological information using Smartphones have available dozens if not hundreds of contextual data points (i.e. geospatial) against which this physiological data can be compared to find correlations. This could be critical information when diagnosing and treating a patient suffering chronic seizures.

There are vast silos of raw patient data that can be captured and analyzed by ever increasingly intelligent algorithms trained to identify the signal from the noise and use the learned information to improve patient care and enhance efficiencies and cost savings across the full care cycle.

The companies positioned to benefit during the early adoption of BANs include developers of wearable sensor technology, peripheral devices, Smartphone applications, network providers, software-as-a-service (SaaS) providers and bioinformatics specialists. Each of these sub-sectors have the potential to represent at least 1 million new jobs for the American economy over the next 15 years, high-paying jobs for the educated unemployed.

It will take another 2-3 years for WBANs and the applications that leverage them to earn acceptance as mainstream technologies amongst consumers/patients and medical professionals, but their eventual adoption will give rise to an unprecedented era in medical technology innovation.

There are several angles one can take when analyzing the current and potential market for BANs, so I will begin by breaking it down by sensor vertical in a series of posts that highlight the disruptive technologies and innovative companies in the following segments;

  • Accelerometer/Gyroscope
  • Blood Glucose
  • Blood Pressure
  • Electroencephalogram (EEG)
  • Electrocardiogram (ECG)
  • Pulse Oximetry

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More to come…

Sources:

  • Simmons and Chan. “Body Area Networks: Driving mHealth Growth” (March 2011) CSMG.
  • Chen, Gonzalez, Vasilakos, Cao and Leung. “Body Area Networks: A Survey”. Mobile Network Applications (2011) 16: 171-193.
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Body Computing and the future of health care.

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Sensimed uses telemetric contact lens to track intra-ocular pressure in glaucoma patients || via @imedicalapps & @healthgrid

Sensimed uses telemetric contact lens to track intra-ocular pressure in glaucoma patients

 Brian Edwards 10 days ago
mHealth

Triggerfish01Glaucoma affects about 4 percent of the population over 40 years of age, and is an asymptomatic, progressive and irreversible disease which leads to blindness unless adequate treatment is provided early on. For those unlucky to have a severe form or remain undiagnosed, the disease takes a great on their vision and quality of life.

The disease is diagnosed by measuring intraocular pressure (IOP), a simple test performed by most opthamologists during office hours. However, these static measurements of IOP do not tell the full story of what is happening in the eye over time. A more effective test  is to measure intraocular pressure  dynamically, as this will correspond more closely to the risk of optic nerve damage. However, there has not been a cost-effective method to perform this measurement for most patients. Until now, that is.

 

Sensimed, a Swiss medical technology company, has released details of a continuous IOP monitoring platform that uses a soft, disposable contact lens containing a pressure sensor and are recruiting patients for a trial in the United States. The device is already marketed in Europe. There are four key components of the telemetric pressure measuring system, which they call Triggerfish™:

Sensor:

  • A micro-electronic mechanical system sensor (MEMS) and a telemetry microprocessor are embedded in a soft, hydrophilic, disposable soft contact lens. All sensor elements are embedded in the lens outside the patients line of sight. MEMS devices are microscopic electronic devices that can detect tiny movements and are the basis of the accelerometers and gyroscopes built into most smartphones.

Antenna & Data Cable:

  • A circular antenna is taped around the eye which sends energy and receives info and is connected to the portable controller (see diagram below)

Recorder:

  • A battery powered recorder stores measurements and wirelessly uploads to opthamologist’s desktop application

Software:

  • Data analysis and bioinformatics software on the opthamologist’s computer.

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The company is soliciting patients diagnosed with primary open angle glaucoma (POAG) for a San Diego-based clinical trial to assess the safety and effectiveness of the Triggerfish device in recording of relative fluctuation in IOP.

In a recent uncontrolled trial of the Triggerfish platform published in the Journal of Glaucoma(1) this past May, ten healthy volunteers wore the system for a 24 hour period, with assessments of best-corrected visual acuity, surface wetting ability, and mobility of the Sensor were assessed after 5 and 30 minutes, 4, 12 and 24 hours.

Subjective wearing comfort was scored by users and activities documented in a notebook. Subject comfort scored high and did not fluctuate significantly over time. Best-corrected visual acuity was significantly reduced during sensor wear. Three subjects developed a mild, transient corneal abrasion. In all but one patient the Triggerfish device obtained usable data of a telemetric signal recording with sufficient sensitivity to depict ocular pulsation.

Sensimed is based in Lausanne, Switzerland and has been marketing its device in Europe since it was approved by regulators there in 2009. Triggerfish is still pending FDA approval.

 

(1) De Smedt, Stefan MD; Mermoud, André MD; Schnyder, Corinne MD. “24-hour Intraocular Pressure Fluctuation Monitoring Using an Ocular Telemetry Sensor: Tolerability and Functionality in Healthy Subjects”. Journal of Glaucoma. May 11 2011.

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One day soon your doctor will prescribe you a medical app || via @imedicalapps & @healthgrid

Mark my words – the day is not far off when physicians will be prescribing patients Smartphone apps and wearable sensor devices just as routinely as they prescribe pharmaceuticals, physical therapy and other treatment options today.

Ambulatory patient monitoring is one example of a clinical diagnostic technology that is on the verge of achieving full mobilization via consumer Smartphone devices and wearable sensors. Traditionally this technology could only be used with a high degree of reliability in a clinical setting. However, Wireless Body Area Network (WBAN) technologies are enabling clinicians to remotely monitor patients in real-time and even provide biofeedback to patients based on each individual’s personal physiological data, all via Smartphones.

I have been working for nearly two years with Chicago-based Wave Technology Group to develop a business model for their ambulatory EEG Smartphone app, which will enable real-time M2M monitoring of high-risk epileptic seizure patients by clinical neurologists. While initially developing the business plan for Wave it was difficult to think about app distribution models beyond the App Store, which would mean embracing a direct to consumer approach to engaging users.

However, after researching the history of ambulatory EEG monitoring it became clear these services are typically only performed on a prescription basis because of the complex and expensive nature of the procedure and the various wearable technologies it requires. Rather than fight an unwinnable uphill battle, we decided to embrace the established clinician-patient dynamic of treatment by prescription and adapted our model to use this dynamic to our advantage.

The difficulty posed by Smartphone apps replacing clinical monitoring technology will be encountered in customer support, as patients will be asked to assume unprecedented responsibility for managing their own condition.

What will be the implication of the rise of prescription strength apps on the App Stores model?

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My most read commentary to date.

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2011 Mobile Health World Congress: The Gamification of Health Care is Upon Us || via @imedicalapps & @healthgrid

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I had the pleasure of covering the first day of the Mobile Health World Congress in Boston, which is a great event that draws an interesting crowd of leading industry thinkers representing all segments of the mobile health business.

Several compelling start-ups debuted their apps at the show and numerous industry trends have emerged which I will feature in several posts over the coming weeks. The most predominate trend I gleaned from the presentations, product demos, and conversations I had with fellow attendees is the excitement about the so-called “gamification of health care”. Gamification is the idea that you can apply the basic elements which make games fun and engaging to things that typically aren’t considered a game, or in other words the use of game play mechanisms for non-game applications.

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Gabe Zichermann, writer at O’Reilly Media, defines the main purpose of gamification as helping people get from point A to point B in their lives. Zichermann and others believe many lack the “systems thinking (and discipline) required to get to that goal”, what games do well is expose complex learnable systems that users can engage with to achieve personal mastery “and thus accomplish something aspirational”.

The one company most invested in the gamification of health concept is Humana, so it was fitting that Raja Rajamannar, SVP and Chief Innovation and Marketing Officer at Humana gave the opening keynote address, during which he featured numerous initiatives the company has launched over the past few years which he asserts are meant to “make fun things healthy, and healthy things fun”. The company has made impressive efforts to build social, virtual and mobile tools for their members to use, each highly personalized for a unique purpose specific to their health profile, but simultaneously community oriented and built around friendly competition and point-based reward systems.

Actions and rewards are fundamental to the concept of gamification. The simplest form of rewards is points, the key question game developers need to answer is what actions or milestones are points awarding? The most popular gamification platforms are Zynga and FourSquare, which use points or badges to reward individuals as they accomplish certain milestones or surpass the achievements of fellow game players. These companies have come to define consumer expectations for gamified user experiences.

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Humana Games for Health (HG4H) is a bold and innovative effort by the company to use “video games to keep your mind and body fit”. One of these games is the Humana Horsepower Challenge, which is profiled in detail in the presentation below from Slideshare.
The Horsepower challenge by Humana Overview
View more presentations from Tommy Seilheimer
The challenge has one simple goal, to get children to be more active. It accomplishes this goal by distributing pedometers to each student in classes that enroll in the challenge. Each pedometer stores up to two weeks worth of data and wirelessly uploads to a remote access point (RAP), which is placed strategically in a location that the students walk past everyday. The kids are each given a username and password, which they can use to log into the site to see their personal step history as well as the cumulative steps of their class and other competing classes around the world. Each participating student can personalize their horse and each class earns currency they can use to upgrade their school bus, such as new paint colors, gold rims and a gold grille. Classes use the collective steps of all students to compete against other classes in a race around the world. Very cool stuff I wish we had when I was in fourth grade.

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Humana Vitality was launched in early July as a “sophisticated health-behavior-change model supported by an actuarially sound incentive program”. The program will be included with all Humana commercial members’ medical plans when they begin a new plan year. The “game” involves the player undergoing a health assessment to determine their “Vitality Age”, a scientifically calculated representation of their risk-adjusted, or “true” age, and allows members to easily understand how their current behaviors are impacting their health.

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The company also just launched HumanaVille, a “virtual neighborhood” connecting seniors (age 65+) with health and wellness resources. The company us hoping to tap into the growing interest in Internet activities among seniors The HumanaVille community includes locations and activities such as town square, health clinic, library, fitness center, games and relation spots. Users can interact directly through online chat and community discussion forums to post original content, ask questions and respond to one another.

It’s clear that Humana is intently focused on becoming the leader in using game theory to improve their members’ tools for managing their health.

Another company featured at the World Congress that is embracing game mechanics in the design of their mobile app is Medullan. The company is based in Cambridge, MA, and is developing an app called Plum, currently in private beta, which Medullan refers to as a Workplace Wellness Engagement solution providing users simple, interactive virtual “trackers”. User interface is designed to meet the “one handed one-thumb” use model for all on-the-go trackers, such as the tracker meant to help users quit smoking which simply has users select a “street cone” each time they cheat and sneak a cigarette. The cone diverts the user from their previously smoke-free path and sends them back to square one on their track to accomplishing their self-assigned quitting goals.

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The coming wave of gamified mobile health applications will enable rich consumer experiences and allow users to leverage their increasing digital dependence on their Smartphone to keep their physical health in check and on target.

Below you can see the Twitter flow and commentary from conference attendees, very interesting real-time feedback on the activities and ideas all shared under the hashtag #mhealth11.

 

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The rise of games for health.

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USC Center for Body Computing ‘Body Slam Competition’ all about Games for Health

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USC’s Center for Body Computing, along with sponsors AgaMatrix and Zephyr Technology, is hosting a $5,000 “best mobile health game” contest called the Body Slam Competition.

Judging guidelines for the contest include:

  • (1) originality
  • (2) aesthetics of the user interface
  • (3) entertaining gameplay
  • (4) how the game creates meaning and change in how the player thinks, feels, or behaves with regard to their health

Entries are due before September 11th and should be submitted to bodycomputing@med.use.edu. The top 5-10 game apps will be announced on September 14th and finalists will present their apps at the Slam competition at USC on the evening of September 22nd.

While $5,000 never hurt anyone, more importantly these type of contests are a great way to build brand recognition and earn street credibility with consumers searching your company on Google before purchasing your device. It certainly pays to have a first page of Google search results for your company with nothing but news about your company’s strong showing,  strong reviews, and well placed social media featuring your product.

Contests also tend to draw many of the mHealth industry’s top startups and leading innovators into the arena together for a sort of micro-battle of the best and brightest in the business. The Data Design Diabetes Challenge sponsored by Sanofi-Aventis is one example of a similar contest.

The Body Slam competition comes on the eve of the USC Body Computing Conference 5.0, which begins September 23, 2011. To register for the event visit the Body Computing website.

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Qualcomm and Life Care Networks partner to battle cardiovascular disease using mobile phones || via @imedicalapps

Qualcomm and Life Care Networks have partnered to launch an initiative called the Wireless Heart Health project to aid in the prevention and treatment of health conditions such as cardiovascular disease in underserved communities in China. According to the World Health Organization (WHO), chronic diseases, such as cardiovascular disease, are a major problem in China with close to 3 million deaths a year.

Because of the prevalence of mobile phones in China, an idea formed that would allow critical medical care to be given in areas of China that would otherwise never have access.

“With a grant from Wireless Reach, the Wireless Heart Health project is deploying a 3G-enabled cardiovascular screening and monitoring system, developed by Life Care Networks, for resource-scarce community health clinics in Shandong, Anhui and Sichuan provinces, as well as the Chongqing municipality.  Community Health Association of China is assisting in clinic selection, project implementation and impact analysis.”

The smartphones contain added sensors (such as ECG) that aid in diagnostics.

“The new 3G system includes smartphones with built-in electrocardiogram (ECG) sensors; web-based, electronic medical record software; and 3G wireless workstations located within the clinics.  Each workstation includes a computer terminal with Internet access, providing health care workers with instant access to electronic patient records, including ECG data.  The project also includes training sessions for all participating community health center clinicians.”

The Wireless Heart Health project allows smartphones to automatically send critical patient data to a cardiac specialist at a call center.  This call center contains doctors that provide feedback to patients and clinic staff over the phone or through text messages. Physicians can remotely provide service for simpler cases or suggest a specialist follow-up in-person. Finally, Qualcomm expects to make some of the ECG-enabled smartphones available for patients to rent and take home.

For further reading, please view Yahoo Finance.

 

 

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Qualcomm takes their wireless health technology and vision to China for wireless ECG experiment called Wireless Heart Health in western China.

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6.06.2011

Head Tracking for iPad: Glasses-Free 3D Display

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Another amazing innovation in human-computer interaction that is so close you should be able to reach out and touch it...

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USC ICT Virtual Humans - At the Museum of Science Boston

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This is absolutely amazing and very much a technology that is right around the corner for consumers.

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6.04.2011

Three mHealth startups win Rock Health slots | FierceMobileHealthcare

[1]Three mHealth startups have won coveted spots on business incubator Rock Health's new accelerator platform. Rock Health just announced 11 overall winners in its first class yesterday.

The program provides $20,000 in startup cash, plus five months of training sessions, mentoring, and workshops with business gurus from places like Harvard (the alma mater for all four of Rock Health's founders), and healthcare/eHealth experts with the Mayo Clinic, Epocrates and Doximity, Rock Health co-founder Halle Tecco tells FierceMobileHealthcare.

Right now the winners are all at different stages of development. Some are still polishing their initial idea, while others have prototypes they're beta-testing and a few are nearly ready for market, Tecco says. The program's goal, she explains, is to develop each participant's business plan, prototype and other key elements so that in five months, the companies are ready to pursue true six- or seven-figure venture capital to bring their products to market.

The three mHealth candidates include:

  • CellScope: This University of California-Berkley-developed company is working on smartphone attachments for at-home diagnostic testing. The first prototype, now in development, will diagnose children's ear infections, Tecco says. It works like this: A microscope-type device is attached to the smarthphone, and takes a high-resolution, microscopic picture of the inside of the ear. The image then can be transferred to a medical professional for diagnosis. The ultimate product, according to Tecco, will diagnose a "portfolio" of conditions, including other types of infection and possibly even cardiac conditions.
  • Pipette: Physicians will use this smartphone-based product to provide reminders and prompts to keep patients compliant with their treatment regimens, Tecco says. For example, if a patient has a new regimen of diet, drugs and therapy, the physician can craft a series of texts, messages or questions about pain, mobility, drug compliance, and other topics.

    The messages are automatically delivered according to the parameters the physician sets up, she explains. For example, with a CHF patient, the physician might include daily reminders about measuring their weight, and automatic questions each week about the patient's diet. Patients respond to the prompts, and the physician uses the information to determine if the patient needs follow up.

    One interesting note: The company's founders originally targeted the technology for service companies like hotels and restaurants, to interact with customers during travel. Ultimately, they saw a greater opportunity in healthcare, and switched focus to physician/patient use, Tecco says.

  • Skimble: This fitness app is the furthest along of all the mHealth candidates, and already has an offering in the iTunes app store. "It's doing quite well," Tecco says. The app is a relatively straightforward fitness product, providing personalized workouts and exercise guidance. One innovative item: It does offer some analytics that allow users to build on today's exercise or fitness data to craft future workouts, and ensure steady improvement. "We really wanted to make sure we had one fitness product in our portfolio," Tecco says.

To learn more:
- read the Rock Health press release [2]
- get more detail [3] at Xconomy
- check out coverage [4] at AllThingsD

Related Articles:
Rock Health gives mHealth startups platform [5]
Interactivity, time determine success of hospital apps [6]
Childrens Hospital of Boston launches app store competition [7]

via fiercemobilehealthcare.com

Rock Health has been one of the most exciting news stories of 2011 in the digital health space and just this week announced its first class of start-ups, including three mHealth companies. Rock Health was co-founded by Harvard MBA student Halle Tecco, who has emerged as a rising thought leader in the intellectual battle to bring innovative digital health technology to consumers though her incubator's focus on attracting successful entrepreneurs to take risks in the under-appreciated Connected Care sector. I expect big things from these companies as their products mature and they graduate as the inaugural Rock Health class.

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Wireless applications makes monitoring health easy | CTIA-The Wireless Association® Blog

via blog.ctia.org

Great feature on remote patient monitoring solutions. mHealth is absolutely (IMHO) the most under-appreciated emerging sector of information technology.

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4.04.2011

Ai Weiwei China's Best Known Artist Arrested in Beijing

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via readwriteweb.com

Ai Weiwei, designer of the "Bird's Nest" Beijing's 2008 Olympic stadium, was detained today in Beijing as he attempted to board a flight to Hong Kong. His Beijing studio was also raided and his staff and family taken into custody. Ai had apparently been making plans to relocate his studio to Germany and has long experienced government pressure to silence his creative expression. I think this is a huge mistake by the Chinese government. If they want to avoid the fate of the Middle Eastern and North African governments that have seen their people rise up against autocracy they would be wise to not so blatantly harass the country's most revered artist.

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4.02.2011

"Baby Boomers need to realize the world they expected is not the world they are living in"

Lee Kuan Yew is supernumerary minister as Mini...Image via Wikipedia"The baby boomers need to realize, the world they expected is not the world they are living in."

Lee Kuan Yew, the father of Singapore, was interviewed last week on Charlie Rose and arguably his most interesting comments were those addressing the US debt burden and the reality facing American Baby Boomers as they approach retirement.  It is almost impossible to find a single American politician that will be this brutally honest with the American people about the challenges we face as a civilization because of the failure of leadership demonstrated by the Baby Boomer generation.

One can only hope this leads to a rapid and radical turnover in our current political leadership, with much younger minds taking control of navigating a geopolitical dynamic that is far too complicated and interconnected for our parents generation to understand.
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