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November 2021 Digital Health Roundup

Fifty years of research have led to a lot of innovations. Technological advances mean that doctors are better able to monitor our health, and health and fitness apps can motivate us toward a healthier lifestyle, but studies show the benefits aren’t always equitable. In addition, more technology means more compromised data. Experts are warning governments to tighten up regulations, while others are asking for expanded and permanent access to telehealth.

Expanded Telehealth Coverage

The American Telemedicine Association (ATA) is asking the U.S. Department of Health and Human Services (HHS) to extend the Covid-19 public health emergency through the end of 2022, if not longer, reports healthcareitnews.com. The public health emergency has allowed for the expanded coverage of telehealth, but it is uncertain how and when the expanded coverage will end. The ATA is hoping HHS will give patients ample notification about the future of telehealth. While there has been support for the expanded telehealth rules to become permanent, Congress has not acted on that. The ATA is concerned that patients, who have become dependent on telehealth during the pandemic, will abruptly lose access to care if the public health emergency is not expanded, giving Congress time to put permanent policies in place. Read more about the ATA’s request to HHS here.

Digital Health Data

More access to care is good, but leading independent experts are warning countries to protect digital health data in order to prevent medical inequities and human rights abuses, reports ft.com. The group of experts produced a report that lists the benefits of telehealth, but also provided guidance for governments to use that would protect healthcare consumers from misuse of health data. Recommendations include increased regulations to protect children and providing equitable access through digital infrastructure. Learn more here.

The threat of healthcare data breaches is real. In 2021 more than 40 million patient records were compromised, reports healthcareitnews.com. The breaches can paralyze networks and lead to disruption of care. Find a list of 2021’s ten largest data breaches reported to the U.S. Department of Health and Human Services here.

Health Apps

Technology-based health apps are more beneficial to people with higher socio-economic status, reports medicalxpress.com. Researchers found that middle and higher socio-economic health and exercise app users achieved a higher level of physical activity while users with lower socio-economic status received no clear benefits from using the apps. Researchers suggest that the findings indicate that further use and development should take into account the needs of users with lower socio-economic status to prevent inequalities among users. Find out more here.

Remote Monitoring

Doctors at Kentucky Cardiology in Lexington, Kentucky found that patients weren’t always keeping accurate records of their blood pressure at home, so they looked to technology for a solution, reports healthcareitnews.com. They contracted with a remote patient monitoring technology that automatically recorded the patient’s blood pressure results. Staff members were able to monitor the readings and contact the patient if they saw a reading that was unusual. Staff members were also notified if a patient was not taking their blood pressure. In those cases, staff members were able to contact the patient and review the how to do the readings or troubleshoot any issues. The program has been a big success and grown quickly and reached 86 percent patient engagement. Learn more about the remote monitoring program here.

National Cancer Act

Fifty years ago, the signing of the National Cancer Act of 1971 enabled fifty years of groundbreaking research and discoveries for the treatment of cancer. Many were technological innovations being highlighted by cancer.gov in celebration of the anniversary. The technologies include:

  • CRISPR, a gene-editing tool
  • Artificial Intelligence
  • Telehealth
  • Cryo-EM, short for cryo-electron microscopy, a process that generates high-resolution images of how molecules behave
  • Infinium Assay, a process that analyzes genetic variations used in cancer research as well as a variety of other applications
  • Robotic Surgery

Learn more about each of these technological innovations and the National Cancer Act of 1971 here. Also, look for more about the National Cancer Act of 1971 in this month’s upcoming Notable News.

October 2021 Digital Health Roundup

The popularity of telemedicine is being embraced by insurance companies, and for now, the best place to identify skin cancer is still at the dermatologist’s office. Patients are concerned about privacy threats when it comes to technology in healthcare, and it turns out they have good reason to be. Fortunately, there are things being done to address the issue.

Privacy of Medical Records

A new survey shows that patients are concerned about privacy of medical records and the use of facial recognition technology in healthcare, reports upi.com. A large portion of the survey respondents perceive facial recognition technology as a privacy threat, but the use of the technology in healthcare has increased over the past few years as a way to prevent medical errors and provide extra security. With nearly 60 percent of respondents saying they are concerned about the security of these technologies, researchers are tasked with gaining public trust by increasing protections of healthcare information. Find more information here.

It seems that patients have reason to be concerned. Ransomware attacks are having negative effects on patient care, reports fiercehealthcare.com. A new report shows that ransomware attacks on healthcare organizations can lead to longer stays, delays in care leading to poor outcomes, and increases in patient transfers. The ransomware attacks are also linked to increased mortality rates. The report emphasizes the importance of increasing cybersecurity in healthcare to protect patients. Learn more about the report findings here.

Cybersecurity

Recognizing the cybersecurity vulnerabilities in healthcare, the U.S. Food and Drug Administration (FDA) recently released a best practices document as a resource for the healthcare industry, reports healthcareitnews.com. The document focuses on developing a cybersecurity communication strategy and offers aspects to consider in the event of a security breach. The FDA also plans to address medical device vulnerabilities so that patients who are dependent on medical devices will know what kinds of questions to ask their healthcare providers regarding the security of their devices. Get more information here and see the FDA best practices document here.

The U.S. Government is also investing in the future of information technology in public health, reports thehealthcaretechnologyreport.com. The Office of the National Coordinator for Health Information Technology (ONC) has an initiative that will help to develop the health information technology workforce and will help to increasing the number of workers in the field from underrepresented communities. With funding from the American Rescue Plan, ten universities that serve diverse communities have cooperative agreements to build up the healthcare technology workforce over the next four years. Learn more about the initiative and the ten institutions that are participating here.

Skin Cancer App Fails

A setback for healthcare technology occurred recently when a flaw in a direct-to-consumer app used to detect skin cancer was identified at a European annual meeting of dermatology, reports medicalxpress.com. Researchers found that the app, which is available in Europe, incorrectly classified more than 60 percent of benign lesions as cancerous, and almost 18 percent of Merkel cell carcinomas and almost 23 percent of melanomas as benign. The problem appears to be that the app depends on available images to determine the status of a lesion, but there are not enough images of rare skin cancers available for better accuracy. Find more information here.

Telemedicine

If you love virtual visits to the doctor, you are in luck! Insurers are now offering new types of health coverage specifically for telemedicine, reports modernhealthcare.com. Some insurance companies have plans that require online visits for nonemergency care. The plans tend to have lower premiums and patients select a doctor for their virtual visits who can refer patients to in-person doctors within the network if needed. However, there is some concern that virtual care as the primary means of care may not be ideal. The concern is that things might get missed, like early signs of disease that a doctor would not be able to pick up on through a virtual visit. Learn more about the new type of insurance plans here.

September 2021 Digital Health Roundup

More and more technologies, from gaming technology to artificial intelligence, are being used in the quest to beat cancer. Electronic appointments are helping with taking medicine, and steps are being taken to protect patient data.

The Federal Trade Commission (FTC) is working to combat breaches of personal data by making health apps more accountable when it comes to telling patients their data has been exposed, reports mobihealthnews.com. In a recently released statement, the FTC announced that health apps will need to notify users, the FTC, and possibly the media when data is compromised, and if they fail to make the notifications, they could be fined more than $40,000 a day. Learn more here.

Electronic directly observed therapy (eDOT) is a technology that is becoming more popular for providing medical services to patients, especially when it comes to taking medicine correctly, says ardorcomm-media.com. The eDOT appointments can be scheduled live, or they can be recorded. Providers can ensure that medications are taken properly and on time, and they can observe any side effects that may occur. Providers can also provide coaching or training during the appointments. The eDOT appointments require less time and resources than in-person visits. Find out more here.

Researchers are using 3D printing to create models of glioblastoma tumors, reports reuters.com. The models are made by taking part of the tumor from the patient’s brain and using it to print a 3D model of the tumor and then to fill it with the patient’s blood, creating a viable tumor. Researchers are then able to test how well various treatments will treat the tumor before they try them on the patient. Glioblastoma is the most common brain cancer in adults and is an aggressive cancer with poor prognosis. Learn more here.

Researchers have been inspired by gaming technology to create a virtual tool to study cancer, reports webmd.com. The tool, a virtual cancer tracker named Theia, for the Greek goddess of sight and clairvoyance, allows researchers from around the world to interact and study the cancer using 3D models and virtual reality. Get more information here.

A new type of artificial intelligence (AI) is being developed to detect lung cancer, says genengnews.com. It is a blood testing technology that can potentially detect over 90 percent of lung cancers. The test is called DELFI, which stands for DNA evaluation of fragments for early interception, and it can detect the fragmentation of DNA from cancer cells that circulate in the bloodstream. Researchers are hopeful that if lung cancer screening is as simple as a blood test, more people may get screened, and the cancer could be detected at earlier, more treatable stages. Learn more here.

Digital Health Roundup: June 2021

Digital healthcare is creating a better experience for patients and employees; one hospital has the data to prove it. Seniors, in particular, benefit from telehealth, and a bipartisan group of senators is trying to ensure that telehealth access is here to stay, but data privacy is a concern that experts say needs to be addressed.

Mobile healthcare apps may have some serious privacy problems, reports mobihealthnews.com. A study of more than 20,000 medical, health and fitness apps showed that the apps collect personal user information, but that it is not always secure, and the privacy practices are not always made clear. The study showed that 88 percent of mobile health apps could collect and share user data that includes contact information and user location. While the study also revealed that only 4 percent of the apps actually share user data, experts remain concerned about the privacy and data collection risks. Get more information here.

When it comes to virtual visits with their primary care doctors, a new study shows that telehealth is an effective form of care for senior citizens, says healthcareitnews.com. The study analyzed more than 300,000 telehealth visits which showed that virtual healthcare visits were successful in treating and solving the needs of patients in most cases. Researchers found that seniors were most likely to use telehealth visits for upper respiratory infections, urinary tract infections, and skin conditions. The study is encouraging for the future of care for seniors, as the effectiveness of telehealth visits is important for patients with mobility and other challenges that may prevent them from being seen by a provider in person. Learn more here.

Lawmakers are aware of the benefits of telehealth to seniors and those in rural areas, and they are trying to protect them. A bipartisan group of senators introduced a new bill this month that would continue access to telehealth for elderly and rural patients, reports pymnts.com. The Protecting Rural Telehealth Access Act aims to permanently expand patient access to telehealth. The bill would allow healthcare providers to offer virtual care, including consultations through telephone calls, to Medicare patients anywhere in the country. While the demand for telehealth is no longer as high as it was during the height of the Covid-19 pandemic, the demand is still higher than it was pre-pandemic especially in rural areas where access to care is often limited. Learn more here.

Digital healthcare technology is not only beneficial to patients in their own homes, but also during in-person visits. A New York hospital is using digital technology to improve patient satisfaction ratings, reports healthtechmagazine.net. Since 2018, Lenox Hill Hospital has been using a digital rounding platform to gather patient information and coordinate patient visits with nurses, the food and nutrition team, and other staff members. Collecting patient information in the digital rounding app from all staff members who visit the patient helps the teams anticipate and address patient needs. Hospital leadership says the system makes patient interaction proactive rather than reactive. The rounding platform was built with the input of nurses and has led to improvement in better experiences for patients and employees. Learn more about the Lenox Hill digital rounding program here.

May 2021 Digital Health Roundup

Now that it is here to stay, the focus has turned to what the future of digital healthcare will look like. The patients are weighing in and have some ideas about the areas digital care is most helpful and whether they prefer seeing their doctor online or in person. Lawmakers in the United States are addressing what measures will be taken to address access to telehealth and other health technology advances. Healthcare leaders around the world are busily prioritizing how digital tools will be used. One of the things they are focusing on is how to improve health outcomes, and that’s always good news for patients.

Healthcare leaders from 14 countries were asked about their plans for digital healthcare in the next three years, reports weforum.org, and two-thirds of them said that improving resilience and planning for future crisis topped the priority list. The second-most priority is the continued move to remote care with many healthcare providers investing in digital health programs, such as artificial intelligence (AI) and machine learning. Another focus is applying digital tools to improve value-based care, where providers are paid for improving health outcomes rather than for the number of patients treated. By 2026 it is expected that two-thirds of medical imaging will use AI to detect disease. The increase in technology systems will help lessen the load of hospitals and increase healthcare services at walk-in clinics and in-patient centers and home care, which will help bridge the healthcare gaps in rural and underserved areas. In developing countries digital healthcare helps by providing remote access to medical care and specialists. Some of the obstacles to digital care include lack of technology experience among staff members, and data security challenges. More information can be found here.

In addition to healthcare leaders, lawmakers are weighing in on the future of digital care through the reintroduction of the CONNECT for Health Act, reports hcinnovationgroup.com. First introduced to Congress in 2016, the act has recently been reintroduced by a bipartisan group of 50 senators. The comprehensive telehealth bill provides for expanded and permanent access to telehealth services made possible by legislation during the COVID-19 pandemic. The temporary COVID19 measures have made it possible for Medicare beneficiaries to access telehealth services and have allowed more types of providers to offer telehealth services, and these measures are set to expire unless action is taken. Since it was first introduced, several aspects of the bill have been adopted by the Centers for Medicare & Medicaid Services (CMS) that remove restrictions on telehealth services for mental health, stroke care, and home dialysis. The new version will allow more people to access telehealth services by permanently removing all geographic restrictions on telehealth services and providing the Secretary of Health and Human Services the permanent authority to waive telehealth restrictions. In addition, the bill would allow health centers and health clinics to provide telehealth services, which is currently temporarily allowed by the COVID-19 measures. The bill also requires a study to learn more about how telehealth was used during the COVID-19 pandemic. Find more information about the CONNECT for Health Act here.

Of course, when planning for the future of digital healthcare, it’s important to take the patients into consideration. As it turns out, says healthcareitnews.com, patients still prefer in-person care for long-term healthcare needs. However, that doesn’t mean they don’t like virtual visits at all. A recent survey found that 62 percent of respondents had some type of virtual care visit between March 2019 and March 2020 and now nearly one-third of respondents are more likely to choose virtual visits than they were before the pandemic, and 35 percent say they are just as likely to use virtual care. Mental healthcare and routine care were the preferred type of virtual visits. Another survey showed that age is a factor in whether or not patients use virtual. Patients aged 18 to 56 said they preferred video conferencing with their primary care provider while those over 57 said they preferred in-person care. Learn more about patient preferences here.

Another patient preference to consider is where they find digital tools most useful. A recent poll, reported in pharmaceutical-technology.com, reveals the most suitable areas for digital health tools were metabolic disorders, like diabetes and obesity, followed by cardiovascular diseases, infectious disease, and sleep disorders. Oncology was ranked fifth on the list of most suitable areas to use digital healthcare tools. Tied with oncology were pain management, respiratory diseases, and behavioral disorders. There were 336 responders to the poll taken from February 2020 to April 2021. Find out more here.

As long as lawmakers and healthcare leaders stay focused on improving patient care, the growing use of technology in healthcare should provide for better health outcomes for patients, now and in the future.

April 2021 Digital Health Roundup

Advances in digital health are great, as long as everyone has access to what’s being offered, but not everyone does, and that creates what’s known as the digital divide, the gap between those who have access to internet services and those who don’t. In an effort to close the divide, a new federal program has been approved, reports govtech.com. The $3.2 billion dollar program, called the Emergency Broadband Benefit Program, was established by the Federal Communications Commission (FCC) to help cover internet service costs for qualifying households. Funded by the December 2020 COVID-19 relief bill the program provides a discount on monthly internet services, and a one-time discount to purchase a laptop, desktop, or tablet from participating providers. While the program has been authorized by the FCC, a start date has not yet been set, but program updates and information can be found here at www.fcc.gov/broadbandbenefit, and the sign up process is expected to begin by the end of this month. The FCC has also provided a link to frequently asked questions about the program that can be found here. In addition, there are other companies working to make internet access more affordable. Those organizations and more information about the Emergency Broadband Benefit Program can be found here.

The FCC notes that access to broadband, or high-speed internet, is critical to economic opportunity, job creation, education, and civic engagement. With that type of impact, it’s only natural to conclude that as healthcare becomes more and more digitally dependent, broadband is also critical to ensuring the best health outcomes for patients. Unfortunately, there are a number of areas and populations where broadband isn’t available. Almost 100 percent of urban Americans have high-speed internet access, but only 65 percent of rural Americans do, and the number is even lower in Tribal areas. A total of 30 million Americans lack access to the benefits of broadband service.

So, to bridge the digital divide and bring broadband to more Americans, the FCC has begun several key initiatives, including the Emergency Broadband Benefit Program. Get more information about the other initiatives here, and find detailed information about broadband, how it works, and what it’s advantages are, and how to get it in your area here. Check broadband availability in specific areas here.

Proof of the digital divide in healthcare came last year during the pandemic when telehealth services grew in mostly wealthy and metro areas, reports healthcareitnews.com. A study examining insurance claims shows that while telemedicine visits increased, they didn’t offset the full decline in office visits. The study also revealed that the telemedicine services were mostly used in metropolitan areas and areas with lower poverty levels and by people with private insurance. Hopefully, programs like the Emergency Broadband Benefit Program will help make telemedicine more equally accessible. Learn more about the study here.

Hoping to better understand the impact of telemedicine, the Medicare Payment Advisory Commission (MedPAC) is recommending a continuation of telemedicine services. MedPAC is advocating to continue telemedicine flexibilities for Medicare and Medicaid services that were implemented during the COVID-19 public health emergency (PHE) to ensure access to and quality of care, reports policymed.com. MedPAC recommends the continuation of the telemedicine services paid for by Medicare and Medicaid for another year or two and states the time should be used to determine the impact of telemedicine for patient care. The information could provide a greater understanding about how access to telehealth impacts quality of care. Learn more here.

Meanwhile, the digital health technology continues to advance. Soon we could all be getting healthcare house calls from drones, reports mhealthintelligence.com. The drone is still being developed, but it can carry medical and test supplies in its waterproof compartment and facilitate telehealth visits, all while surveying living conditions. The hope is to use drones in rural areas where access to healthcare isn’t as readily available as in urban areas. Learn more about the telehealth drones here.

March 2021 Digital Health Roundup

Is technology making healthcare easier or harder to access? It turns out, it depends on who you ask. While those who have easy access to digital resources are benefitting from the influx of technology in healthcare, many of the most vulnerable people in our population could get left behind as the technological wave pushes through the healthcare industry. There’s no stopping the wave, though, with advances in diagnosing skin cancer and healthcare education, technology is changing healthcare as we know it right before our eyes, and research shows that most patients are okay with it.

The Covid-19 pandemic caused a surge in digital healthcare, but it has also led to conversations about the digital divide: the vast space between those who have easy access to technology and those who do not. At medpagetoday.com, David Nash, MD, MBA, FACP takes an interesting look at the increased use of technology in healthcare and the digital divide it creates for some patients, especially the elderly, noting that a patient’s connectivity might need to be considered a vital sign that doctors routinely ask patients at every visit. Read more about this perspective and who is least likely to utilize digital technology in healthcare here.

However, there is more to consider at forbes.com where Kal Vepuri, founder and CEO of Hero, says that technology is finally democratizing healthcare and that it is patient driven. The influx of the tech industry into healthcare is thought to have advantages such as making healthcare more convenient, and helping patients stay healthy and connected – even for the elderly, says Vepuri, as long as the tech companies keep seniors in mind when developing healthcare technology. Read more here.

The good news is that when patients have the access to healthcare technology, they are okay with using it. A recent study published at jamanetwork.com found that patients would be okay with robots performing some medical tasks in the hospital emergency room setting. Participants in the study were asked if they would find it acceptable for a robot to perform tasks such as taking vital signs, facilitating a telehealth interview, obtaining nasal and oral swabs, and turning a patient over in bed. Most participants said that using robotic systems to facilitate healthcare would be acceptable, and of the patients who interacted with a robotic system for a triage interview, the majority reported that their experience was equal to the quality of a person-to-person interview. Learn more about the study here.

Patients aren’t the only ones being impacted by technology in healthcare. Doctors and medical students have access to a number of new learning tools, says techgenyz.com. Technology is impacting healthcare education in a variety of ways. Artificial intelligence, virtual reality, computer assisted learning, and wearable technologies are all transforming the way healthcare is learned and practiced. Find more information about how each technology is used in healthcare education here

The traditional way surgeons are trained is over a century old, but technology is changing all that. In an interview with Dr. Justin Barad, surgeon, CEO and co-founder of Osso VR, techrepublic.com explores how virtual reality technology is changing the way surgeons are being trained. Barad says that Osso VR offers better opportunity for doctors to train and assess themselves and learn new procedures, much like pilots practice with simulated situations. Research shows that when people train with virtual reality technology, their performance goes up by 230 to 300 percent, which will ultimately help improve patient outcomes. Learn more about Osso VR and how it is being used to improve surgical training here.

Researchers are also continuing to use technology to find ways to diagnose cancer in its early stages. Sciencedaily.com reports that new technology is helping to better diagnose melanoma, the deadliest form of skin cancer. Computer-aided diagnosis (CAD) systems have been developed to help in diagnosing suspicious pigmented lesions (SPLs) on the skin that can indicate cancer, but because they are trained to look at skin lesions individually rather than compare multiple lesions as a dermatologist does, the CAD systems haven’t had much effect on diagnosing melanoma. However, a new CAD system can now use a photo of a patient’s skin to successfully distinguish SPLs from non-suspicious lesions with 90 percent accuracy. The researchers have made their CAD system algorithm available to others and hope to eventually turn the system into a product that could be used by primary care doctors all over the world. Learn more here.

February 2021 Digital Health Roundup

Over the past year, with Covid-19 shutdowns keeping people home and out of their doctors’ offices, technology has taken an even more important role in healthcare. From virtual doctor appointments to navigating patient portals, now more than ever, patients need to understand how technology can benefit their health. Each month, Patient Empowerment Network (PEN) will round up some of the most notable digital health news pertinent to empowered patients and their caregivers.

Digital Health

So, what exactly is digital health? According to the U.S. Food and Drug Administration (FDA) at fda.gov, digital health includes a broad list of categories, such as health information technology, wearable devices, telehealth and telemedicine, and personalized medicine. The influence of digital technology in healthcare is almost infinite and is revolutionizing the healthcare industry, improving the ability to diagnose and treat disease and to improve the way healthcare is delivered to each individual. In addition, digital tools help to empower patients by giving them more control over their health. Patients can use digital technologies to make more-informed decisions and manage their healthcare. Providers use digital health to make healthcare more affordable, more personal, more efficient, and higher quality. The coming together of technology, patients, providers, information, and connectivity lead to overall improvements in healthcare and better health outcomes. Find more information about digital health and how the FDA is focusing on it here.

How Will Technology Influence Healthcare in 2021?

You may be wondering where you are most likely to see technological influence in your healthcare in 2021. There are several areas. Artificial Intelligence (AI) saw a lot of advancements in 2020, and it is expected to be further used to advance healthcare in 2021, says medcitynews.com. In the oncology field, technology advances are changing the way disease is being diagnosed through pathology, which traditionally is a manual process. In 2021, the trend is moving more and more toward digital pathology, which saves times and labor costs. AI advancements are also being used in areas of triage, diagnosis, and analysis. Digital technology can be used to collect and share patient data from a variety of sources so that doctors can determine the best diagnosis and treatment.

Technology is also expected to continue to expand patient access to medical care through telehealth, increasing personalization of care, quality control, and screening protocols. Get more information about the ways AI is predicted to advance healthcare in 2021 here.

Another area that continues to be widely used in healthcare is Virtual Reality (VR), technology that simulates an experience, according to a recently updated article by news-medical.net. Medical training is one of the most prevalent ways VR is used in healthcare. Students can learn how to manage any type of medical situation through VR simulation giving instructors the opportunity to see how the student would respond in real life. VR is also used to simulate surgeries and give medical professionals visual access to the inside of the human body, without having to dissect cadavers. In some cases, VR training is believed to be superior to more conventional forms of medical training. Learn how VR is being used to treat mental health and addiction, manage pain, shorten physical therapy recovery times, and educate patients here.

Patient Access to Care

One of the most important aspects of digital healthcare is access. Patient portals are being used more and more, but not all patients have access to them, reports healthcareitnews.com. A study involving kidney patients found that many patients aren’t actively engaged in their care and that interventions are needed to make sure all patients have access to patient tools. Patient portals provide access to personal records and educational resources, but studies show that black patients, older patients, and patients who use Medicaid as their primary insurance were not as likely to use patient portals as white patients, younger patients, and patients with other types of insurance. Researchers found that patients who used the portals had more knowledge and better health status, and that they had less disease-related stress. While the use of portals is promoted by health systems, they may actually be widening health disparities for patients who aren’t using or don’t have access to the portals. The study suggests that more effort needs to be made to ensure that all patients have access to the digital tools that can help improve their patient outcomes. Learn more here.

Recognizing that technology is advancing care for many, but that it can also further expand the digital divide, a new group to address the disparities in access to healthcare has been launched, reports healthcareitnews.com. The Telehealth Equity Commission, made up of groups who attended the American Telemedicine Association’s EDGE policy conference, plans to use a data-driven approach to help improve telehealth policy. Learn more here.

One thing is certain: digital technology is here to stay, and its influence on patient health is expanding. To ensure that you have access to all the latest digital healthcare, become a Digitally Empowered patient through Patient Empowerment Network’s free Digitally Empowered™ Course. The course will help you to become more tech-savvy so you can research your condition, ask informed questions, and take an active role in shared decision making with your care team. Access the course here.

App Spotlight: Medisafe

Think. Did you take your medications today?

You’ve probably heard the statistics: 50% of patients don’t take their medications as prescribed. That might mean they take the med at the wrong time, forget proper technique for an injection, eat food before taking the med when they aren’t supposed to, or just forget to take it altogether!

Unfortunately, medications can’t work if they’re not taken.

Taking medications incorrectly can be dangerous, and for 700,000 people this mistake results in a trip to the hospital and thousands more dollars spent. Folks over the age of 65 are often taking upwards of 14 meds a year which can be very difficult to manage alone.

What can you do to make sure you’re staying on track? Here are a few quick tips to help manage medications:

  1. Set up reminders for all your medications, including meds you take as needed and directions for taking the meds
  2. Connect with your friends and loved ones! Those we love help keep us honest. If they know we’ve missed a dose, they can help get you back on track. Talking about your health with
  3. Ask questions! Your doctor and care team are there to help you through this journey, but it helps to be your own best advocate. Let them know if you’re having trouble taking certain medications so they can figure out a more fitting option!

If you’re struggling to keep track of your medications, or have a loved one with a new prescription, try Medisafe and join the other 4M Medisafers who are setting themselves up for success.

MEDISAFE APP FEATURES

Virtual Pillbox

Medisafe’s familiar pillbox design makes it easy to start right away. With four quadrants, it’s easy to keep track during the day and know which pills you’ve already taken.

Digital Reminder 

No matter what phone you use, Medisafe is your digital reminder companion – we’ll never let you forget your next does. 

Forgot to take your meds? Add a Medfriend who will be alerted in case you do slip and they too can help keep you on track.

Health Education

Medisafe gets you started by educating you about your meds and condition, then keeps you going with motivational progress reports, helpful daily tips, and discount prescription offers tailored to you.

Learn More

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The Power of Content Curation for Healthcare Communities

“Getting information off the Internet is like taking a drink from a fire hydrant” – Mitchell Kapor

Information is power and patients are becoming more empowered through increasing access to medical information online. However, one of the biggest challenges we face is trying to filter the vast repository of online content to find trustworthy content. As cancer research advocate and health blogger, Debra Madden (@AdvocateDebM), points out, “for better or worse, information is much more accessible today than it was in the late 1980s thanks to the Internet. But a major challenge now is separating the wheat from the chaff, being able to identify the many resources on the Internet that are not reliable and recognize those that are reputable sources of consistently high-quality medical and health information.”

Instead of more information what we really need is more accessible, understandable and credible information on which to base our healthcare decision-making. One solution is to curate reliable, up-to-date medical information in a format that is easy for patients to access, digest, and understand. Content curation is defined as the process of gathering information relevant to a particular topic or area of interest.  While this definition sounds simple, there’s a world of difference between simply gathering information and being an effective curator. A good curator knows how to find, aggregate, and synthesize reliable information, putting it into context for their communities and sharing it in a format that is easy to access and understand. Beth Kanter, a specialist in social media communication for non-profit organizations, characterizes a content curator as someone “who offers high value to anyone looking for quality content because finding that information (and making sense of it) requires more and more time, attention and focus.”

Health science blogger, Lisa DeFerrari (@after20yrs), devotes time on her blog to sharing the latest research on breast cancer. “A lot of the inspiration for what I do on my blog, and a lot of what I’m learning too, comes from the people I meet in my advocacy work and online”, she says. “Many of us have an interest in knowing what’s going on in cancer research and understanding what kind of progress we’re making against this disease. I believe that being up to date about the major developments in research empowers us in taking care of our own and our loved ones’ health.” Lisa describes the activity as one in which she shares her own learning process with readers, “I felt that this was an area where I could contribute given my own experience with breast cancer and my advocacy work as well as my interest in research. I look for updates that seem interesting and relevant from a patient perspective and share what I see as the basic, need to know, details for my readers.”

Mayo Clinic-trained women’s heart health activist and heart attack survivor, Carolyn Thomas (@HeartSisters) was once described by cardiology conference organizers as a ‘knowledge translator’. “I love that job description,” she says, “I like trying to make sense of complex medical gobbledygook. There actually is a social science readability rating scale called “SMOG: a Simple Measure of GobbledyGook!” – one that most medical journals would fail, by the way.”

The ability to curate trusted content is a key skill for patient advocates. Hereditary cancer advocate, Amy Byer Shainman (@BRCAresponder), believes “patient advocates not only have a responsibility to curate trusted content but that it is an imperative if you are even going to be calling yourself a patient advocate.” Not only is curation of value to the health community, but it also benefits the curator by enhancing their credibility and leadership among their peers. Amy, Carolyn, Lisa, and Debra are all leaders in this field. In interviewing each of them this month, I found they were eager to share their tips and recommendations on developing the skill of content curation. Listed below you will find a summary of their recommendations, alongside my own tips for effective content curation.

Eight Steps to Effective Content Curation

1.) Consider the source

Curate content from reliable and credible sources only. This is the most important first step in curating trustworthy content. Debra’s first step is to go directly to the small library of oncology texts she has built over the years (e.g., DeVita, Hellman, and Rosenberg’s Cancer Principles & Practices of Oncology, which is considered by many to be the definitive oncology reference). “However”, she says, “even if these texts weren’t available to me, there are multiple exceptional online resources that are easily accessible. These sites are available to anyone with access to an Internet connection, are typically free without subscription costs, and provide links to additional helpful sources of information and references on related topics.”

Debra recommends conducting online searches of medical journals published by professional cancer associations, including the American Society of Clinical Oncology (ASCO) and the American Association for Cancer Research (AACR). She advises whenever possible, for research purposes, it’s best to obtain access to full-text journal articles versus solely the abstracts. Debra also recommends conducting an online PubMed search. PubMed comprises greater than 26 million biomedical literature citations from MedLine, which is the U.S. National Library of Medicine (NLM)’s bibliographic database. “PubMed provides free access to abstracts within Medline as well as links to full-text articles, importantly, in some cases, access to the full-text journal articles is also provided for free. Unfortunately, in other instances, although full journal articles can be accessed by linking from the abstract in PubMed, the publishers charge a fee for obtaining the full text, which can become extremely pricey.” Debra’s tip in such cases is to conduct a Google search on “full text medical journal articles free,” which will return sites that provide links to the increasing number of journals that provide free online full-text articles.

Her final recommendation is to conduct a Medscape search. “After a free, one-time, and simple registration process, Medscape provides access to professional, original medical content that includes comprehensive review articles, patient education articles, journal commentaries, expert columns, and medical news”, she says. “In addition, Medscape enables users to select their preferred specialty which then delivers a personalized site with topics of most interest.”

Amy recommends finding a go-to source for credible information. “My go to patient advocate for the latest hereditary cancer/BRCA research is Lisa M. Guzzardi, RN (@LguzzardiM)”, she says. “Lisa is a HBOC (Hereditary Breast & Ovarian Cancer) patient advocate dedicated to providing up to date evidence based research for consumers at risk and also clinicians. She is on top of all the latest scientific journals and research pertaining to HBOC.”

2.) Subscribe to newsletters and alerts

Lisa told me that she relies on a number of sources that she tracks for the latest articles and reports about cancer research developments, including medical news aggregators, cancer research news subscription services and google alerts. “I scan these regularly”, she says, “looking for those stories that seem to have the most potential interest or impact from the patient perspective.”

Set up Google Alerts for the healthcare topics of interest to your community. Add Google Scholar which indexes most peer-reviewed online journals of Europe and America’s largest scholarly publishers. You can also use tools such as Flipboard and Newsle and subscribe to other health-related curators on Scoop.it a curation platform.

3.) Learn how to read behind the headlines

Every day we read headlines heralding medical breakthroughs, and it’s important to know how to discern the true reality behind the headlines. Does the news item support its claims with scientific research? If so, read through the article to find the most important findings from the study. Look for expert commentary from physicians or other qualified healthcare commentators within the article. Note if the author mentions any limitations concerning the research (again they often don’t). Most peer-reviewed articles list their research’s limitations in their conclusion, so you may need to dig deeper by reading the original published journal article. Debra cautions that “the facts are not always convenient, and those who speak out in the popular media may have an agenda or bias. Unfortunately, the reality is that when discussing health and medical research, screening, interventions, etc., many news stories tend to emphasize and often exaggerate potential benefits while minimizing or even ignoring possible harms. In addition, it’s important to recognize the different types of bias that may also impact how research is designed and implemented, how data is collected and analyzed, and/or how or whether results of such research are presented in the medical literature. Understanding potential research bias and how it may impact study results and its reporting enables advocates to critically review scientific literature, an important skill in evaluating and accurately presenting the evidence.”

4.) Cite the original source

Always cite the original source when curating content. Read Citing Medicine: The NLM Style Guide for Authors, Editors, and Publishers to learn more about how to publish citations.

5.) Provide context and add perspective

Content curation is not about collecting links or being an information pack rat; it’s about being able to summarize the key points, adding your own perspective and putting things into a context that makes sense to your community. Carolyn describes the process as “a combination of my own personal experience or opinion juxtaposed with what others before me have learned about this topic. What have researchers in the field found? What do physicians’ current treatment guidelines recommend? Or, how have other patients experienced what I’m talking about?” She points out, “I’m not a scientist, but I can now interpret a journal abstract pretty well and distil the key points in a simple, clear fashion. I never write things like “Studies suggest that…” without actually citing a credible reference for a study or two that support what I’m about to say.  And I look specifically for methodology issues (No women included in this study? Or only lab mice? – not interested!)”

6.) Publish to a content hub

You can post your curated content to a blog or you can use a content hub, as I do, such as Scoop-it. Creating a content hub is another opportunity to build a community of shared interest and amplify your content.

7.) Use the right tools

Some useful tools include Pocket, which integrates with 500+ apps for easy curation, Evernote, a cross-platform, freemium app designed for note taking, organizing, and archiving, and news aggregator app, Feedly.

8.) Tap into the power of social media

Share your curated content via your social networks and make it easy for others to share it too. Add a relevant hashtag and use a twitter scheduling tool like Buffer and Hootsuite to schedule tweets so that you can reach a global audience.

Final Thoughts

As you can see from these examples content curation is an important skill for patient advocates. Amy believes, “being well versed in the science of your own health story plus the ethical implications, philosophical implications, and emotional components of your health story is key to being a credible patient advocate.” To develop these skills, Debra recommends the scientific training and educational opportunities offered by nonprofit organizations such as the National Breast Cancer Coalition (NBCC)’s Project LEAD®, the Research Advocacy Network (RAN), and the Cancer Information & Support Network (CISN); as well as conference-based educational opportunities, such as through the RAN’s Focus on Research Scholar Program, which culminates with attendance at ASCO’s Annual Meeting; the Alamo Breast Cancer Foundation’s Advocate Program as a component of the Annual International San Antonio Breast Cancer Symposium (SABCS); and the Drug Information Association (DIA) Patient Fellowship Program.

I leave the final word to Lisa, who says that “as patient advocates we bring a different perspective to the discussion.” That perspective is an important one, and learning how to do it well is a way to add inestimable value to our communities.


Editor’s Note: For a comprehensive list of the Best App-Making Software, please click here.

Stay On Top Of Your Health – With The Help Of a Smartphone App

After visiting the doctor, you are usually on your own. You are responsible for taking your meds on a regular basis and for keeping track of your symptoms. This can be challenging in everyday life – especially when you need to take more than one pill per day. According to a study by the World Health Organization 50% of all prescribed meds are either taken incorrectly or aren’t taken at all. But non-compliance can be fatal: in the US about 125,000 people die annually because of not following the doctor’s prescription[1]. This is why it’s so important to take your meds as prescribed and to keep track of your vitals and symptoms. But it’s also just as important to take over the reins when it comes to your health. Because it’s your body and your health you need to stay on top of it. I would like to introduce you to a smartphone app that can simplify how you manage your health – a digital assistant that helps you to stick to your treatment plan: MyTherapy.

[1] http://www.medscape.com/viewarticle/818850

MyTherapy_Reminder

I know exactly what you think: “Wow, just another pill reminder.” But MyTherapy is much more than that. MyTherapy is a health app that reminds you to take your meds, check your vitals and to get active. In short: with MyTherapy you have your whole therapy in one app. Therefore, the app translates your therapy into a simple to do list and motivates you to check off your tasks and to empty the list. The integrated scanner makes it easy to find your meds by scanning the barcode on your medication package.MyTherapy_Scanner

The built-in health report allows you to stay on top of your vitals. You can print your report and share it with your doctor. This is a great way for you to take your health into your own hands.

MyTherapy_Graph

MyTherapy is made in Germany and strictly protects your privacy: you can use the app without subscribing and your personal data won’t be shared with third parties. MyTherapy is free of charge and can be downloaded on the Google Play Store and App Store. The app is available in English, German, Spanish, French and Italian. Further, MyTherapy is developed in cooperation with patients and established doctors. They all work together to constantly improve the app. Several studies – among others with Germany’s largest university hospital Charité Berlin – confirm MyTherapy’s positive impact on medication adherence and its outstanding usability for patients of all age groups.

Building A Digital Ladder Of Engagement

Building A Digital Ladder Of Engagement

In my previous articles, I have written about using social media to connect with other patients and advocates, communicate with health care professionals, and access information to help make more informed choices about our own and our loved ones’ care. I am a passionate believer in the transformative potential of social media in healthcare, but I am also aware that each of us has differing levels of digital skills. Whether you are taking your first steps on the ladder of digital engagement, or you have reached the top, digital literacy is an important skill in your patient empowerment toolkit.

This article is for those of you who want to climb further up the ladder to become more digitally savvy with social media. And for those of you who have already reached the top, before you click away from the article believing this isn’t for you, please stop a moment. Think back to when you took your first step on that ladder. Remember the day you sent your first tweet, wrote your first blog post or asked a question in a Facebook group? Were you encouraged and supported in taking the next step in digital engagement? Was it a steep learning curve? Or was there someone to reach out a hand to help you climb the next step? If we are to truly call ourselves patient advocates, isn’t part of our role to help bridge the digital divide for all patients? I want to encourage you to think about how we might work together to extend a helping hand to those patients and their carers who are just starting out online.

What is Digital Health Literacy?

Digital health literacy is the ability to use information and communication technologies to find, evaluate, create, and communicate health information. It builds upon a foundation of health literacy, which is the degree to which individuals have the capacity to access, understand and use information in ways that enhance health. Reading these two definitions, it becomes immediately clear that those who have limited skills in either area are at a critical disadvantage when it comes to managing their own and their family’s health. Giving people access to relevant health information – and support in using that information – will help individuals make more informed decisions about their health care. Increasingly access to information and support is to be found online.

First Steps

If you are new to patient advocacy what first steps should you take to get up to speed? A good place to start is by gaining a better understanding of what it means to be an empowered patient. The Patient Empowerment Network has recently teamed up with Intake.Me to bring you their ePatient courses. These virtual classrooms are designed to help patients take those first steps on the path of patient engagement and advocacy. Follow this link to take the first two classes and be sure to check in regularly for more classes.

App icons on white cloud with smart tablet and ladderWhen you are ready to take your next step on the digital ladder, it’s time to join a social media site. Social media encompasses social networking sites (such as Facebook, Twitter, LinkedIn), blogs, wikis, video and photo sharing sites (such as Flickr, Pinterest, Instagram, YouTube), social bookmarking sites (Reddit, Digg), online communities, and user-generated content sites. With so many channels to choose from it might seem overwhelming at first to know where to begin, but as with any new skill start small and you will build up your expertise with time. Facebook and Twitter are the two of the most popular channels for healthcare conversations. You may already have your own account on these platforms, but if you haven’t it is very easy to set one up. Simply go to www.facebook.com and https://twitter.com/signup to sign up. Both have helpful step-by-step instructions to guide you through the process and at any time you can simply click on the “Help” button if you get stuck.

Facebook

On Facebook you can connect with other patient advocates and join Facebook groups related to your disease or condition. Many organizations have a Facebook presence and by liking their Facebook page you can keep informed of their activities and find other patients to connect with. As Facebook is a public platform and everything you post there can be viewed by a public audience, it’s important to consider the level of privacy you are comfortable with. You can adjust your privacy settings in Facebook at any time so your posts are visible to an audience of your choosing; for example “friends only”; “friends of friends”; or “public”. If you decide to set up your own page or group for your cause, you can easily do this in Facebook. Visit www.facebook.com/pages/create for instructions.

Twitter

While Facebook groups and pages are useful resources for patients, Twitter takes the healthcare conversation to another level. Think of it as a digital town square. Here you have a greater mix of patients, physicians, healthcare professionals, medical researchers, and the public all coming together in one virtual space to discuss healthcare matters.

Your Twitter profile is the first place someone will look when they go to your profile. If they find only a default Twitter picture and no bio details, your advocacy credentials may be called into question. Complete your profile by adding your name, a picture, and some brief details about your advocacy work so people can learn more about you.  It’s a good idea to listen first before leaping into the Twitter fray. This is true for any new community, whether virtual or in real life. This way you can understand the normative interactions existing on the platform. You don’t even have to tweet to learn from Twitter; there is a lot to learn from just following the right people but your experience will be richer if you join in with others in their conversations. If you are not sure what you should tweet, try something simple like introducing yourself, @mention someone you already know on Twitter, or retweet (RT) something that will be helpful to your followers to get your first conversations started.

Find People To Follow On Twitter

Start by following the Twitter accounts of organizations and groups related to your disease or interest. Go to their website and click on the Twitter follow button if they have one. Twitter will also populate your account with suggestions of similar groups and individuals on Twitter. Pretty soon you will have built a list of relevant accounts to follow. It’s a good idea to organize these accounts into lists; e.g. “organizations”, “researchers”; “patient advocates”; “hospitals”. You can create your own lists or subscribe to lists created by others (here’s a list of patient advocates on Twitter which I created). Find people who can serve as online role models for you. If you are already a seasoned Twitter user, reach out to someone new and offer to mentor and guide them.

How To Find Health Related Conversations On Twitter

(1) Advanced Search

The easiest way to find conversations of interest is to click the native search facility at the top of your Twitter screen and enter your keyword – for example “diabetes”. You then have a further option of performing an Advanced Search. This allows you to narrow down your search using parameters such as specific keywords, language, people, location, and date range.

(2) Hashtags

A hashtag is simply a keyword preceded by the #symbol. Hashtags create a hyperlink which will bring up every public update tagged with the same hashtag keyword. To create a hashtag, simply place # before a word; e.g. #diabetes. Familiarize yourself with the relevant hashtags related to your topic of interest. Hashtags are a useful way to search for health related topics and organize conversations around a keyword topic.

(3) Twitter Chat

A Twitter Chat is a public Twitter conversation around one unique hashtag. This hashtag allows you to follow the discussion and participate in it. Twitter chats can be one-off events, but more usually are recurring weekly chats to regularly connect people. The chat will be hosted and the host will ask questions along the way to stimulate discussion and sharing of ideas. There are chats for most disease topics and a full list can be found by searching the database of the Healthcare Hashtag Project. This is also a useful resource to find Twitter users to follow. In addition you will find past transcripts of chats on the website so you can familiarize yourself with the chat and its norms before taking part.

When you are ready to join in a chat, login to your Twitter account at the specified time and search for the relevant # (e.g. #diabeteschat). You don’t have to tweet; you can just follow the conversation, especially if you are still getting used to tweet chats, but do introduce yourself and mention that you are new to the chat. Twitter chats can be quite fast-paced and you may feel as if you aren’t keeping up with every tweet. Don’t worry. You can always catch up at your own pace later by reading the chat transcript available after the chat has finished. You can also use a “chat-room” tool, such as TweetChat to help you focus solely on the chat – only tweets with the hashtag will appear on your screen so you can filter out any other twitter conversations not related to the chat.

(4) Conference Live-Tweeting

Twitter is fantastic for taking the content of conferences beyond the walls of a conference venue. It is becoming more popular for conference organizers and attendees to “live-tweet” sessions directly from the conference. You can follow along on Twitter using the conference hashtag. Many conferences register their hashtag with the Healthcare Hashtag Project or include the hashtag on their conference website.

These are just some of the many ways in which your patient advocacy can be enhanced through social media. If you have been hesitant or unsure where to start, I encourage you to take that first step by setting up an account on Twitter or Facebook. Don’t be afraid to reach out to others for help along the way.

A Rising Tide

The aphorism “a rising tide lifts all boats” was first used by President John F Kennedy in a speech to describe the idea that when an economy is performing well, all people will benefit from it. This wisdom can equally be applied to the empowered patient movement. One of the ways in which we lift each other up is through strengthening our connections online. So ask yourself, who will you lift up today?

Can the Apple Watch Be the Next New Thing in Cancer Treatment?

Apple watches are cool devices for checking email on the go and staying in touch. But researchers at MD Anderson Cancer Center wondered if they could also be a useful tool for helping breast cancer patients with their treatments.   This past December, a study was launched in collaboration with Polaris Health Directions who provided Polestar™, a health management app.

Participants in this trial will use the Apple Watch to answer questions about their symptoms, treatment side effects, and mood. The watch will also monitor physical activity, quality of sleep, and heart rate. The end result of all this monitoring? First, researchers hope to more accurately monitor each patient’s health during treatment, intervening earlier if needed. Secondly, cancer patients are undergoing huge lifestyle changes. The Apple Watch and Polestar app can help patients remembering drug ingestion schedules, and connect them with other patients who are experiencing similar challenges.

Cori McMahon, PsyD, director of Behavioral Medicine at MD Anderson at Cooper, “I think a huge piece of addressing the uncertainty felt by cancer patients is advancing their health literacy. When patients are able to monitor their own behaviors, they are able to better understand the correlations between those behaviors and how they are feeling, and even change those behaviors to improve their quality of life.” The hope is that cancer patients will feel more in charge of their medical journey. That has shown to increase positive thoughts and feelings – a definitely non-technological but time-proven aid to battling illness.

Across the pond, researchers at King’s College Hospital in London are also utilizing Apple watches and related apps in their own study. Cancer patients familiar with “chemo mind” will recognize the difficulty in keeping track of medication schedules. Thanks to a nifty feature on the Apple watch called the Taptic Engine, the cancer patient is gently reminded to take his or her medication by a soft pat on the wrist. This feature also monitors body temperature which helps doctors head off possible side effect complications quickly.

Both of these studies are concerned with patients feeling more in control of their disease management. As more cancers move from acute to chronic, lifestyle changes become very important in managing the disease. Thanks to products like the Apple watch and associated apps, patients can become more active drivers of their health – and surf the net as well!


References:

http://mobihealthnews.com/content/md-anderson-cancer-center-kicks-apple-watch-pilot

http://www.phillyvoice.com/cooper-breast-cancer-patients-use-apple-watches-aid-treatment/

http://mobihealthnews.com/43537/london-hospital-pilots-apple-watch-for-chemo-patients

Designing With The Patient in Mind

Incorporating patient values, preferences and needs into digital health interventions.

“We are stuck with technology when what we really want is just stuff that works.” Douglas Adams, The Hitchhikers Guide To The Galaxy.

A new report by Accenture [1]reveals that just two percent of patients at hospitals are using health apps provided for them. The research, which assessed mobile app use among the 100 largest U.S. hospitals, found that 66 percent of the hospitals have mobile apps for consumers and 38 percent of that subset have developed proprietary apps for their patients. However, a mere two percent of patients at those hospitals are using apps provided to them. This staggeringly low figure represents an alarming waste of resources in the healthcare industry.

Accenture found that “hospital apps are failing to engage patients by not aligning their functionality and user experience with what consumers expect and need.” For example, only 11 percent of the apps surveyed offer at least one of three functions most desired by patients: access to medical records; the ability to book, change and cancel appointments; and the ability to request prescription refills. Brian Kalis, managing director of the health practice at Accenture, recommends that hospitals “must adopt a more patient-centric approach when developing new mobile health apps, or when revamping existing mobile apps.”

Respondents to a 2013 pilot study of 250 patient and consumer groups worldwide specified five main requirements of mobile health applications:

  1. Give people more control over their condition, or keep them healthy
  2. Be easy to use
  3. Be capable of being used regularly
  4. Allow networking with other people like them
  5. Be trustworthy

Whilst all patients rated these five specificities as important, the degree of importance varied. For instance, those with a long-term chronic condition, such as diabetes, specified that their top priority for a health app is to help them manage their condition; while people with a condition that affects personal mobility, such as a rheumatological condition, placed ease of use as a top priority for their apps.

As I wrote in a previous article, app developers appear to be motivated more by the cleverness of a technology than actual improvements in health outcomes. The lack of user involvement is one of the major reasons why health apps have failed to deliver thus far. We cannot design health care solutions or services without taking into account patient values and preferences and the context in which they live their lives.  If an application does not solve a real problem for the patient it will not be adopted.

The most successful health applications are those that understand the real-life problems that come with living with a condition and create solutions that meet real needs and make real impact. As Amy Tenderich, founder of Diabetes Mine has said, “we will use tools that answer our questions and solve our problems. We will avoid tools that help us do what you think we should do and we won’t use tools that add to the work of caring for ourselves.” Alex Butler, in an article entitled How To Build Successful Mobile Health Applications, wrote, “The question is not, ‘Does it solve a problem for the developer, or even the patient’s clinician?’ The real question is, ‘Does it help the patient directly?‘ If an application is in any way a hindrance, or adds any further time to the investment people must make into their healthcare, it will not be used.”

Craig Scherer, cofounder and senior partner of Insight Product Development, a design innovation consultancy that specializes in medical devices, consumer healthcare, and drug-delivery systems recommends an a design-approach which:

  • Understands the ergonomics and the physical experiences of how the device will be used
  • Curates the information that is most relevant to the user
  • Puts the device in the context of an user’s environment and lifestyle

Ergonomics concerns physical comfort and ease of use; curation means making the most importation information visible first; and finally, it’s important to understand how the device will work in the patient’s own environment. Developers must consider all aspects of the user’s interaction, not just the product itself. Adrian James, co-founder of Omada Health, a digital health company that designed a 16-week diabetes prevention program, recognised early on that one of the first steps in creating the company was getting user feedback – even before there was a product. “We’d walk with people through their homes,” James explained, “we’d hear their story, and then we’d put this concept in their hands and just let them tell us about what it was.”

Build It And They Will Come

An oft-repeated pattern reflects the pervasive notion that if we simply build a solution the “right way,” patients will embrace it. Not so. Dameyon Bonson, a national advisor on suicide prevention in Australia, is currently leading up a Movember funded research project using digital interventions to help men take action on mental health. He firmly believes “that there has been a rush to be ‘first’ to develop mobile health, taking the minimal viable product (MVP) approach a little too literally. MVP doesn’t mean serving up anything quickly; a lot of these mobile applications seem to have then been made ‘in a rush’. Evidence, and I mean good evidence, needs to support the development and I don’t think that (evidence) actually exists just yet. Simply automating what currently exists into mobile application, in my opinion is fraught with failure, and costly. Very costly. We are talking about the merging of two completely different worlds, mental health and technology.”

An app must seamlessly integrate into a user’s lifestyle to be accepted and well used; it needs to fulfill some kind of utility that is integral to our daily lives. It must also engage the end user. Dr Mitesh Patel and colleagues have recently argued that “the successful use and potential health benefits related to these devices depend more on the design of the engagement strategies than on the features of their technology.” Stanford behavioral health expert Stephanie Habif believes that emotional resonance is an important factor in designing successful health applications. “It’s not just enough to infect the brain and implant the knowledge”, she said, “You have to stir up the desire engine. You have to tap into emotion.”

Health Does Not Happen In A Silo

The most successful health applications understand the real problems that come with living with a disease or condition, and offer something that genuinely helps. A failure to recognize the complexity of health systems and the reality of patients’ lives will continue to lead to short-sighted digital health initiatives. It is patient input into a solution’s design, ongoing practice and evaluation that ultimately holds the key to the development and adoption of innovative therapies and clinical solutions that truly meet patients’ needs. After all, to quote Darla Brown – a cancer patient who co-created digital health company Intake.Me – in a Stanford MedicineX session on patients as entrepreneurs, “who knows better than the patient what will have the most impact on their ability to get and stay well?” Co-panellist, Michael Seres, a digital health entrepreneur and founder of 11Health, a connected medical device company, describes himself as a “digital entrepreneur by accident and necessity.” “I was in hospital post [bowel] transplant with a stoma [a surgically created opening from an area inside the body to the outside] that leaked and healthcare professionals asking me to measure output. I just assumed there was a solution, so I did what I assumed everyone would do. I asked other patients. Let’s face it the greatest under-utilized resource in healthcare is patients. We usually have a solution for a practical problem. One thing is certain; we understand the end user needs. 20,000 patients online told me that there was no real solution to my problems so I built one. I had one big advantage, I understood what I needed. It always amazes me that in healthcare we spend millions building solutions that the end users don’t want. Why? Well often we are never asked. Would Amazon build a platform without consulting the end user? Would GM produce a new car without understanding their consumer? So why do we do it in healthcare? At every step I consulted patients and healthcare professionals as to whether it made sense. It just seemed obvious to me to do it this way.”

We have now entered an age in which the digital world will revolutionise health care, much as it has done in other industries. Yet while digital technology is poised to transform healthcare, its full potential will never be realized unless stakeholders work alongside patients in co-designing solutions that will truly engage, enable, and empower the end-user. To quote the late Jessie Gruman, founder of the Center for Advancing Health, in an open letter to mobile health developers, “While I can’t promise you that consultation with us is the magic key to successful, well-used apps, I can tell you that without it, your app doesn’t stand a chance.”


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Resource Links

[1] Accenture 

[2]

Are We Ready for Mobile Health?

Are we ready for mHealth in 2016?

Mobile health, also called mHealth, is a term used for the practice of medicine and public health supported by mobile devices. It is a growing industry fuelled by the rise in ownership of personal mobile devices. A new national survey shows that more than eighty percent of US residents between the ages of 18 and 49 currently own an app-enabled mobile phone. Fifteen percent of the population have purchased wearable devices that connect to their phones adding functionality such as tracking capabilities. These devices worn on the body or incorporated into garments and accessories such as wristbands and watches, have given rise to a development known as the “quantified self” movement. By routinely tracking everyday behaviors, such as sleeping patterns and activity levels, wearables aim to move individuals closer to better health habits. According to the International Data Corporation Worldwide Quarterly Wearable Device Tracker, wearable device shipments reached 76.1 million units in 2015, up 163.6% from the 28.9 million units shipped in 2014.  But beyond the hype of the industry’s claims about the scale of wearable technology, how ready are we to use them in a clinical setting?

In spite of all the buzz and excitement, the reality is that the industry is still at the early stages of development and adoption. Many doctors question the clinical value of activity trackers and struggle to know what to do with the deluge of data wearables produce. Recording individual numbers is of little value when there is no system to extract meaning from it and show how it all works together. In an online survey conducted in September 2015  just 5% of respondents indicated that their organizations were “very prepared” to develop patient insight from emerging data sources like wearables. Nearly a quarter indicated their organizations were “very unprepared” and nearly half called their organizations “unprepared.”

Providers have concerns about reliability, interoperability and reimbursement. Research conducted at UCSF Center for Digital Health Innovation compared the data reported by consumer wearable devices to relevant clinical gold standards in multiple studies over the past two years. It found that very few devices currently on the market perform with the reliability of a medical-grade device. It’s a key point to note. Most health-related wearables aren’t regulated in the same way as medical-grade devices. Physicians are not only worried about the accuracy of the data being collected, but also have questions about unauthorized device use and data leaks. Consumers also need to trust that the data collected in their health apps will not be used for other purposes of which they are unaware. We can add to these concerns the fact that most health apps are limited in functionality, operate in isolation from each other and are interoperable within existing healthcare systems.

Even for those consumers who see value, faced with a multitude of fitness trackers, the unregulated and fragmented world of mHealth makes it difficult to select applications that provide true health benefits. User retention is also an issue. According to an MIT Technology Review report, about two-thirds of consumers who have downloaded an mHealth app have stopped using it. There are further consumer concerns such as privacy issues, the ability to transfer data across platforms and software, high data entry burden and cost factors which also limit mHealth efficacy.

mhealthGiven the questionable clinical relevance and poor usability scores, is mobile health technology of any real value in health care? While activity trackers can help you get fit, consumer wearables and apps have yet to be clinically proven. However, there is another type of health technology which shows more promise in a clinical setting. These target a specific clinical issue, for example a wristband which can detect seizures for people with epilepsy, a mobile app which helps manage cancer pain, a smart pill dispenser, and apps for monitoring post-operative quality of recovery of patients at home. A global survey conducted by market research company research2guidance, showed that people with chronic conditions are the most common target audience for app developers, and hospitals have replaced physicians as the second biggest target audience. A recent article in the Wall Street Journal reports that hospitals are developing mobile apps to help patients manage serious medical conditions and feed information back to their doctors between visits, often in real time.

Research conducted by Mayo Clinic showed that patients who attended cardiac rehabilitation and used a smartphone-based app to record daily measurements such as weight and blood pressure had greater improvements in cardiovascular risk factors. They also were less likely to be readmitted to hospital within 90 days of discharge, compared with patients who only attended cardiac rehabilitation. MD Anderson has also stepped up patient care with its new Apple Watch feasibility study. Its cancer center is distributing 30 Apple Watches to patients in various stages of treatment for breast cancer. An app called emPower will run on the Apple Watches and the users’ phones. Patients will use the device to answer quick multiple-choice questions about their mood, symptoms, possible treatment side effects (like headaches or nausea), and more. The provider will also use the device to capture activity and heart rate data to help them anticipate potential issues before they worsen and intervene sooner.

Apple’s release of its ResearchKit earlier this year opens up a promising avenue to extend mHealth applications to medical research. ResearchKit is an open-source set of tools that researchers can use to create a clinical research study. It can facilitate unprecedented, real-time access to potentially tens of millions of people, who will participate in research by submitting data through their iPhones. Within a day of launching, 11,000 participants signed up for a Stanford University cardiovascular trial. Stanford said at the time that it would normally take a national year-long effort to get that kind of scale.

What makes a health app successful?

Developers appear to be motivated more by the cleverness of a technology than actual improvements in health outcomes. A new study from the New York University School of Medicine Department of Population Health reports that only 29% of smartphone owners using health apps say the apps have made a big impact on their health. That’s compared with 60.3% who see little to moderate improvement and 10.5% who say their health did not improve or even declined. A recent global study which analysed the views of patient and carer groups to determine what they want, but are not getting from current apps, reported that respondents wanted an app which provides trustworthy, accurate information alongside a guarantee that their personal data are secure. Respondents also wanted more meaningful and timely communication with their healthcare provider, including the ability to easily schedule a doctor’s appointment, or refill a prescription. Other factors included the ability to self-manage and make informed choices, taking into account different levels of health literacy and differing patient experiences with a medical condition or user experiences when health.

What can developers do to improve the current design and broaden the appeal adoption of mHealth applications?

The involvement of end users during the process of inventing and designing new technologies is a critical success factor. We cannot design health care solutions or services without taking into account patient values and preferences and the context in which they live their lives.   The lack of user involvement is one of the major reasons why health apps have failed to deliver thus far. Developers should involve patients, carers, and healthcare professionals at each stage of the app’s development, making sure it is in line with their needs. If an application does not solve a real problem for the patient it will not be adopted. The most successful health applications are those that understand the real-life problems that come with living with a condition and create solutions that meet real needs and make real impact. This can only be done by co-creating applications with patients and their carers.  It is patient input into a solution’s design, ongoing practice and evaluation that ultimately holds the key to success. After all, who knows better than the patient what will have the most impact on their ability to get and stay well?

mHealth Potential and Pitfalls

The rise in mobile and wireless technologies has the potential to transform the way healthcare services are delivered, particularly in the management of chronic diseases. Numerous studies have shown that patients who are “activated” in their care experience better health outcomes at lower costs compared to less activated patients. By creating an ecosystem of connected, wearable devices, we can deliver more timely care and monitor patient activity in real-time, thereby reducing hospital readmission rates, improving outcomes, and delivering cost savings. Global consulting firm Accenture recently conducted a study revealing that the United States would save approximately ten billion dollars annually with the introduction of a wider range of digital health services.

Mobile health technologies also have the potential to make healthcare more patient-centric, shifting the balance of power in the patient’s favour. Instead of being solely dependent on health providers, patients can manage their health more proactively. A new study presented this month at the American Medical Informatics Association conference in San Francisco reports that mHealth makes patients feel empowered in caring for their diabetes, leading to tangible health improvements in just a few weeks, as well as a heightened sense of control.

But for health consumers to fully tap the benefits of mHealth, the technology needs to be able to provide meaningful and actionable insights, alongside a UX that is easy and engaging. The value of an app or wearable will remain limited if it does not provide access to actionable data. Tracking metrics in isolation is not enough; you also need to know how to extract meaning from the numbers to turn data into smarter health decisions.

Key factors for adoption by providers and payers include technical support for integration, creating practical reimbursement models and ensuring interoperability within and across healthcare systems. The National Health Service (NHS) in England has begun to address issues of app curation and evaluation by creating its own apps library of health issues. By giving them official backing the NHS hope to give clinicians, patients and carers more confidence in using health apps. In the US two new academic partnerships are set to tackle app curation The MIT/Harvard partnership, Hacking Medicine Institute, believes the most effective apps will be chosen by consumers, not their doctors. Meanwhile a partnership between Columbia University’s HITLAB and Las Vegas-based Social Wellth is focused on putting apps through a rigorous set of standards.

As the mHealth market matures and standards improve, clear winners will emerge. The industry needs to shift its focus on delivering clinically effective tools that make a real impact in the lives of individuals. Only then can we truly declare mHealth a game-changer in health-care.

Events

Empowered #patientchat – How Does Technology Benefit Patients

You’re Invited! We hope you‘ll join us for our next Empowered #patientchat discussion as we explore health technology. Health technology is defined by the World Health Organization as the “application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives”.

Technology has transformed every aspect of our lives, and that is especially true in healthcare. It has revolutionized research and treatments, the structure and operations of the medical field, and the way healthcare is delivered. But how is all this health technology impacting patient’s lives, and is it really for the better?

We hope to see you Friday, March 9th on Twitter (or tchat.io/rooms/patientchat) at 10:00 am Pacific / 1:00 pm Eastern. Be sure to include the hashtag #patientchat in all your responses!

Guiding our discussion will be the following Topic (T#:) Questions:

T1: Would you (or do you) use technology to help manage your health? Why or why not?

T2: If you don’t use health technology, why not? What are the barriers and challenges?

T3: Has technology changed healthcare to benefit patients? If yes, how so?

T4: What area of healthcare might positively benefit from health technology that isn’t already?

T5: What emerging health technology gives you hope for the future?

T6: If you had unlimited resources to make a major change in healthcare, what technology would you create?

Click HERE to learn more about the Empowered #patientchat Series plus read tips on how to participate.

I'll be at the Empowered #patientchat on Fri 3/9 at 10amPT | 1pmET. Join me! Click To Tweet