Tag Archive for: health apps

There’s an App for That…Or There Should Be: Utilizing Technology for Better Health Outcomes

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Health literacy has always been a passion project of mine ever since I was diagnosed with cancer. I stand by the notion that plain language and clear communication leads to better health outcomes. However, communicating with our care team isn’t always easy. How many of us have gone into an appointment only to leave the office 10 minutes later, wondering what happened and what our copay went to? Were all of our issues and questions addressed? 

This is where we have to come in as advocates for our own health, and below are a few ways to do this: 

  • Try and focus on one ailment per appointment 
  • Write down a list of questions you want addressed prior to the appointment 
  • Ask questions during the appointment – you are the expert of your body and health 
  • If something doesn’t make sense, ask for the information to be explained in another way. Patients are found to be more compliant if they know: 
    • How to take their medications properly 
    • Why specific blood tests and imaging are ordered (i.e. if they’re necessary) 

How do we keep track of all of this information, though? There are patient portals that keep track of our appointments and records, but those can often be hard to navigate, and they lack the capability of being able to enter our own information (i.e. about how we’re feeling). Additionally, different health systems have different portals, leading not only to lost passwords, but a missed opportunity for integrated healthcare. This is essentially senseless for cancer patients who have to keep track of multiple appointments and medications, all while trying to keep afloat in a system that wasn’t built for patients and their caregivers. 

However, there’s a role technology can play here. I’ve heard of patients carrying around large binders of their records from appointment to appointment, but if we’re being honest, I don’t believe a physician or other member of a patient’s care team is going to take the time to go through it. Instead, utilizing the power of the device that we’re constantly carrying around and looking at may be the way to go (in addition to a smaller folder or journal for those that are comfortable with paper). 

If we think about it, there’s an app for everything, and having an app to keep track of our cancer journey should be no different. What should this app be able to do? Here are a few things that I think are especially important: 

  • Keep track of: 
    • Medications (dosage, picture of what it looks like, how to take it and what to do if you accidentally miss a dose or take more than what is prescribed, ability to refill) 
    • Blood work (results and what they mean [featuring a scale of what’s low vs. normal vs. high], what to ask your doctor about in terms of next steps) 
    • Imaging (results and what they mean, what to ask your doctor in terms of next steps) 
  • Ability to connect with all members of your care team (primary care doctor, oncologist, nurse navigator even if they work in different health systems) 
  • Ability to connect with caregivers and share information with them 
  • A diary to describe daily thoughts, symptoms, and side effects, flagging specific keywords that can alert a member of your care team 
  • A calendar with appointments (date/time, office location, directions) 
  • Tips to assist with mental health (i.e. offering local or national support groups [both virtual and in-person], counseling that accepts insurance and/or is offered on a sliding scale) 
  • Exercise routines featuring different forms of exercise (yoga, pilates, HIIT, weightlifting, playing a sport, walking and running, etc.) based on you’re feeling side effect- and energy-wise 
  • Information about nutrition through the different phases of a cancer journey (pre-treatment vs. in-treatment vs. post-treatment) that includes recipes 
  • Most importantly, all of this information should be in plain language that’s easy to understand in whatever language the patient is most comfortable reading 

Having an app that features all of these capabilities, I believe, would push the needle forward in patient care, not only creating better health outcomes, but a more satisfied patient. What would you add to the list? 

November 2021 Digital Health Roundup

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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.

September 2021 Digital Health Roundup

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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.

How Can CLL Patients Avoid Pandemic Challenges Without Compromising Quality of Care?

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How Can CLL Patients Avoid Pandemic Challenges Without Compromising Quality of Care? from Patient Empowerment Network on Vimeo.

How can chronic lymphocytic leukemia (CLL) patients ensure that they receive quality care even during high-risk times like pandemics? Dr. Kathy Kim from UC Davis School of Medicine shares her recommendations for providers and information about remote monitoring devices for improved patient care.

See More from Best CLL Care No Matter Where You Live

Related Resources:

 

What Multi-Language Technology Innovations Are Available for Cancer Patients and Families?

What Key Questions Should CLL Patients Ask About Digital Tools Born Out of COVID?

How Can CLL Patients Mitigate Distance and Technology Barriers to Care?

Transcript:

Dr. Awan:

You know, with so many patients nowadays who are worried about their cancer care and how that will continue, and especially now with remote monitoring. How, what kind of tools do you have deployed and used, what would be your recommendations for us and how we can make us some of these new innovations and new methods to provide the best care for our patients?

Dr. Kim:

I think even when you’re thinking about using technology, again, it’s not one-size-fits all, it is what the provider is comfortable with and what the patient is comfortable with, and what you two can work together to improve your care. So, I think there are a lot of innovations that have been developed over many years, but this past year under COVID, we saw an acceleration of people adopting them because it was out of necessity that people didn’t come in to a setting where they might potentially be infected or to infect others. So, we certainly saw a huge increase in telehealth, which has been virtual visits, like we’re doing right now, we are virtually visiting with each other or telephone visits, so there’s been a huge upsurge in the number of hospitals and clinics and practices that have been able to implement telehealth with their patients. But there are other tools that again, have been in development that are now starting to take off under the last year, and those are remote patient monitoring devices, these are either specific medical devices, like blood pressure machines, glucose meters, some heart monitors, sleep monitors, you know things that, devices that check your oxygen saturation. So, there are many medical devices that are for use in the home, that are either covered by insurance or people can buy them at the drug store, and what has really come about this year is the ability to connect the data from the device you have in your home to your provider, so that’s been in place, but we really haven’t implemented it very many places, and now lots of places are allowing that connection to happen. So, the patient can use the device in their home and get it connected to the and have it sent to the hospital or to their doctor, so their doctor can be watching the data and also monitoring them, so that’s one really wonderful piece of progress that we’ve had in the past year. I would say the third area that again, has been around for a while but people haven’t used it so much has been mobile applications.

So, these are basically software that you can run on your smartphone or you can run it on a tablet or a computer that let you track your own information. So, I know CLL patients and many cancer patients have lots of documents from all the treatments, from all the visits that they have had, and it’s a challenge to manage all those medical records because you might go to multiple places, right? You’re not always going to the same place. So, now there are many applications that are integrated with the record systems that your hospital or doctor has, where you can aggregate all of your records in one place, and that way when you go to talk to another provider or have this second opinion or a consult, you have access to all your records that you can share. And then you can also track things that are important to you, so maybe you want to track how I feel, what my symptoms are under certain kinds of medications or when I do more physical activity, do I get more tired or do I actually feel better, you know track and by taking my other medications, and for many of us, just remembering to take your medications every day is hard enough if you have several medications and they’re at different times, you might not remember, did I take that one already or do I still need to take it? And so, these applications can also set up your medication schedule and help you to track whether you’ve taken them or not, so there are lots of these tools now available where you can start to manage all of these things and share that information with your doctor.

You know, with so many patients nowadays who are worried about their cancer care and how that will continue, and especially now with remote monitoring. How, what kind of tools do you have deployed and used, what would be your recommendations for us and how we can make us some of these new innovations and new methods to provide the best care for our patients?

I think even when you’re thinking about using technology, again, it’s not one-size-fits all, it is what the provider is comfortable with and what the patient is comfortable with, and what you two can work together to improve your care. So, I think there are a lot of innovations that have been developed over many years, but this past year under COVID, we saw an acceleration of people adopting them because it was out of necessity that people didn’t come in to a setting where they might potentially be infected or to infect others. So, we certainly saw a huge increase in telehealth, which has been virtual visits, like we’re doing right now, we are virtually visiting with each other or telephone visits, so there’s been a huge upsurge in the number of hospitals and clinics and practices that have been able to implement telehealth with their patients. But there are other tools that again, have been in development that are now starting to take off under the last year, and those are remote patient monitoring devices, these are either specific medical devices, like blood pressure machines, glucose meters, some heart monitors, sleep monitors, you know things that, devices that check your oxygen saturation. So, there are many medical devices that are for use in the home, that are either covered by insurance or people can buy them at the drug store, and what has really come about this year is the ability to connect the data from the device you have in your home to your provider, so that’s been in place, but we really haven’t implemented it very many places, and now lots of places are allowing that connection to happen. So, the patient can use the device in their home and get it connected to the and have it sent to the hospital or to their doctor, so their doctor can be watching the data and also monitoring them, so that’s one really wonderful piece of progress that we’ve had in the past year. I would say the third area that again, has been around for a while but people haven’t used it so much has been mobile applications.

So, these are basically software that you can run on your smartphone or you can run it on a tablet or a computer that let you track your own information. So, I know CLL patients and many cancer patients have lots of documents from all the treatments, from all the visits that they have had, and it’s a challenge to manage all those medical records because you might go to multiple places, right? You’re not always going to the same place. So, now there are many applications that are integrated with the record systems that your hospital or doctor has, where you can aggregate all of your records in one place, and that way when you go to talk to another provider or have this second opinion or a consult, you have access to all your records that you can share. And then you can also track things that are important to you, so maybe you want to track how I feel, what my symptoms are under certain kinds of medications or when I do more physical activity, do I get more tired or do I actually feel better, you know track and by taking my other medications, and for many of us, just remembering to take your medications every day is hard enough if you have several medications and they’re at different times, you might not remember, did I take that one already or do I still need to take it? And so, these applications can also set up your medication schedule and help you to track whether you’ve taken them or not, so there are lots of these tools now available where you can start to manage all of these things and share that information with your doctor.

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

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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

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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, recognized 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-panelist, 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 revolutionize 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