Posts

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:

  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

Download Medisafe

Mobile Doctor’s Appointments? Do They Work?

Dr. On Demand Dashboard

Dr. On Demand Dashboard

Hate the doctor’s office and don’t want to go to Urgent Care or the E.R.? There’s an app for that. Doctor On Demand is a mobile application that allows you to have a video appointment with a doctor from your own home. On their website they claim, “At Doctor On Demand we provide fast, easy and cost-effective access to some of the best doctors, psychologists, and other healthcare providers in the country. Our patients can have Video Visits with these providers on their smartphone or computers at any time of day.” Recently a friend of mine used this app for the first time because of a strange lump in her armpit, so I decided to sit in to see what it was all about and if it can actually replace an in-person visit.

Before

First thing you do is download the app, create an account, and fill out your health and insurance information. Then, you are given the option to choose a specific doctor or specific time. If you chose the specific time route, you are assigned a doctor. My friend chose a specific time and told me that it was a very easy, user-friendly process. To prepare for the appointment, you fill out all your symptoms and take pictures of your problem (if applicable) to have on hand. I asked my friend why they chose Doctor On Demand over a traditional doctor, Urgent Care, or E.R., and she said this way she won’t have to waste time stuck in a doctor’s office, could be seen quicker, and the appointment times worked better with her work schedule. However, she was hesitant because the doctor would not be able to feel or see the issue in person, which may affect the diagnosis.

During

Once your call begins, the doctor begins by reviewing your chart before coming on camera. Next, the doctor comes on camera and asks to explain the problem and the symptoms she was having. The appointment is set up like a FaceTime call. The doctor assigned to my friend was very friendly and attentive. This when those photos you took beforehand are useful because then she asked my friend to upload the photos for her to look at.

After

After the issue was thoroughly explained, the doctor was unable to diagnose what was going on without further testing. She did explain the several possibilities of what could be occurring and what tests may be needed. However, in the end the doctor did recommend that my friend go see a doctor in-person to get an accurate diagnosis.

Overall

In conclusion, my friend was reassured that it didn’t require immediate attention and that she shouldn’t worry. She also felt better and more relax about the few days it would be before she could be seen by a doctor. She and I would both recommend using Dr. On Demand, especially for the simpler alignments, such as colds, because the doctors are able to write prescriptions to your local pharmacy saving you the time wasted in a waiting room. My friend had this to say about her overall experience:

“This was a quick solution to put my mind at ease that something more serious was not going on before I was able to schedule an in-person doctor’s appointment”

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.

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.”


Did you find this blog post useful? If so, please consider donating so that we can continue to provide you with valuable content.

Donate Here

 

Resource Links

[1] Accenture 

[2]

Digital Tools for Clinical Trials

There is progress being made in the clinical trials arena!

The Apple Research Kit was introduced several months ago and is making headway in the world of clinical trials, facilitating clinical trial enrollment, navigation and process for patients.

The Apple Research Kit is an open-source software framework for collecting clinical trial data. Researchers and developers of clinical trials are encouraged to use the kit to develop apps for patients who will use their iPhone to contribute data and participate in clinical research.

Patient Recruitment Made Easy

Several major institutions have developed apps using the kit for clinical studies on asthma, breast cancer, cardiovascular disease, diabetes and Parkinson’s disease. Other providers and developers are sure to jump on the band-wagon as recruiting patients by iPhone is much easier and user-friendly than posting fliers or sending out applications by mail. The major institutions that developed the first apps say that instead of the national year-long effort to recruit patients, they got thousands of volunteers within a day of launch.

Digital Tools for Clinical Trials tweet

Besides helping to recruit patients, ResearchKit could also help solve other problems in clinical research.

Objective Data Gathering

Apple Research Kit

iPhone, with the user’s consent, can gather objective data with advanced sensors like an accelerometer, barometer and gyroscope. Apple is introducing other quantifiable metrics, like an app that requires patients in a Parkinson’s trial to regularly complete touchscreen exercises that would measure tremor incidence. And in the future, other sensors or apps will become available that could track all sorts of metrics useful for clinical research. And what a boon for patients! They can use metrics and the iPhone to track data automatically and easily, certainly reducing visits to a provider and helping patients in more remote areas by making participation in a trial much more accessible.

Frequent Data Gathering

Most iPhone users keep their iPhone close to them at all times, ensuring that data is gathered consistently, rather than at scheduled hospital visits. The data can be gathered instantly and sent automatically as long as the user consents.

Concerns About Privacy, Ethics, and Compliance

Some have questions about information privacy or the ethics involved in recruiting patients remotely. Can Apple and others keep the information gathered private?

And who is to say that all participants are over the age of consent when there is no one checking IDs at the door?

The ResearchKit is presently available only to those with an iPhone. These people tend to be more wealthy individuals – is this a problem? Are these the patients that clinical trial researchers want to recruit?

And currently, there is no easy way for participants to pose questions.

These concerns and others are certainly problems that Apple is aware of and is working on.

All in All, A Step Ahead for Clinical Research

With all the iPhones in use by countless patients all over the world, there is a trove of excellent data that certainly can be useful for clinical research. Apple and the clinical researchers and developers working with the ResearchKit are trying to help patients by gathering and analyzing this data. And with sensors and trackers available at their fingertips, patients can participate in research more easily than before.

Fabio Gratton, CEO of CureClick, a crowdsourced clinical trial recruitment platform, believes ResearchKit is a promising tool to help the cause of clinical trials:

“66% of trials today fail to meet recruiting goals, and 80% fail to finish on time due to both recruiting and operational challenges. That is why we created CureClick, which is the first clinical trial recruiting platform to use crowdsourcing through social media to identify patient volunteers. We believe that ResearchKit is another innovation that can help streamline the trial process, both in identifying patients and gathering data from participants in an efficient and real-time basis”.

“ResearchKit is a high-potential platform,” says Mikey Wills, CureClick’s lead designer, “But it still needs strong front-end development to make it a viable tool for clinical trial sponsors.”

Last month CureClick was tapped by Thread Research, another southern-California digital health firm that has been working closely with Apple to develop ResearchKit-powered apps, to assist in the development of the PRIDE Study app in partnership with UCSF, helping to create the largest database yet of the physical, mental and social issues that uniquely affect gay and transgender men and women. To date the app has helped recruit over 15,000 study participants.

The goal, through this partnership, is to address the general challenges the industry faces in getting patients to participate in the clinical trial process.

Consider Clinical Trials!

And perhaps #mHealth will lead the way to more awareness about clinical trials. More and more data is being collected via mobile phone. Many are used to using phones with fitness apps, nutrition apps, using their phones to track how they exercise and how they eat. If phones can help patients enroll, navigate and take part in clinical trials – so much the better! The more patients that consider clinical trials, the more research will progress and the more patient outcomes will improve.

Sources:

http://cureclick.com/news/the-next-disruptor-of-clinical-trials/

https://www.apple.com/pr/library/2015/03/09Apple-Introduces-ResearchKit-Giving-Medical-Researchers-the-Tools-to-Revolutionize-Medical-Studies.html

http://thehealthcareblog.com/blog/2015/03/12/apple-research-kit-is-open-source-but-is-it-open/

http://www.engadget.com/2015/03/12/apple-researchkit-sign-ups/

http://www.ibtimes.co.uk/apple-wants-collect-your-dna-deliver-it-your-iphone-1499897

http://www.theverge.com/2015/3/10/8177683/apple-research-kit-app-ethics-medical-research

http://www.forbes.com/sites/dandiamond/2015/03/09/apple-now-wants-to-cure-cancer-and-it-wants-you-to-help/

 

 

 

 

Interconnectivity in Healthcare: Patients, Providers, Technology, Research

Patients Included!

The future of healthcare involves patients and providers working with business to develop tools and processes contributing to better Doctors20health for all. The recent Medicine X 2014 conference at Stanford University is an example of this type of collaboration. Medicine X and Doctors 2.0 (an international conference that takes place in Paris in June) are two medical conferences where patients are not just “invited” but are an integral part of the program.

Attended by more than 650 people and watched via webcast by thousands more, Medicine X was created by Dr. Larry Chu and his team of healthcare professionals and empowered patients. The conference focuses on social media, mHealth, health information technology and how they can improve the provider/patient relationship. An excellent review of the conference summarized the key sessions.

Patients” and technology’s influence on the new pharma

Discouraged by the lack of transparency in clinical trial results, Matthew Charron, a patient panelist asked pharma to be more cooperative, helpful, engaged and transparent..

Chronic illness and depression

Patients and caregivers relayed their fear and anxiety in dealing with challenges. Resources are available. How can technology help connect people with these resources?

Self-tracking

How can self-tracking help the patient with a chronic illness? And can self-tracking be counter-productive? Patients questioned the use of self-tracking and clinicians mentioned the challenges of reviewing and analyzing the large amounts of data that people track and bring to visits. The challenge here is to make the resource more empathetic and to make the data be more easily organized.

Technology and socioeconomics

Underserved populations have a low level of health literacy and a high level of depression. Outreach needs to be easy and affordable and available in different languages. How can technology best reach these groups?

Big data

How can we best use data to help people find a doctor or rate a provider? And how do we best teach patients how to use the data they have? Patient satisfaction is important, but how best to report it and use it is just as important.

The future

The future is positive for change and improvement. Patient involvement and collaboration with providers and business will result in improved healthcare delivery through technology. Ongoing discussions and learning opportunities are necessary and available through many patient advocacy groups and organizations such as The Society for Participatory Medicine and Stanford MedicineX’s new  online academy for ongoing learning.

 

 

Spotlight on StupidCancer: mHealth Comes to Patient Support Groups

Spotlight

If you are a patient and haven’t yet researched or joined a patient support community, you should.

Communities exist for chronic cancer patients, chronic disease patients, rare disease patients and patients with almost any disease you can think of. Founders of these communities are often patients themselves and started the community with the thought of helping other patients through the medical and emotional maze that comes with the territory of living with a serious illness.

Websites such as Ben’s Friends or HealthUnlocked are networks of different patient communities relating to different diseases. PatientsLikeMe works more like a database with a member login and the ability to search for others with the same disease. It touts more that 250,000 members, and over 2,000 conditions represented.

Imerman Angels offers one-on-one cancer support. Patients are matched one to one with another patient, hopefully who lives nearby, is about the same age, with the same diagnosis and some of the same problems and issues.

And now, there is something more….. StupidCancer, an organization specializing in young adult cancer is developing a mobile app that will match cancer patients globaly, digitally and anonymously, via SMS, one to one, with another cancer patient.

StupidCancer states on its website,

“Stupid Cancer ….empowers those affected by young adult cancer through innovative and award-winning programs and services. We are the nation’s largest support community for this underserved population and serve as a bullhorn for the young adult cancer movement.” 

Adolescents and young adults account for 72,000 new cancer diagnoses each year. What better than a cool mobile app to appeal to the younger generations? StupidCancer’s Instapeer is an app that works much like an online dating service. You can screen and filter and choose, all anonymously, to be matched to another cancer patient in order to converse, support and help one another through living with cancer. See the Instapeer images below to get a feel for how the app works:

Instapeer screen shots

Instapeer screenshot2

Instapeer screenshot 3

StupidCancer feels that current cancer peer matching services need a 21st century makeover – a more relevant process that is in sync with today’s empowered healthcare consumer.

The Instapeer campaign on Indiegogo claims that Instapeer is for any cancer patient, but it will most likely appeal to the younger and more tech-savvy candidates.

The Indiegogo page lists the medical advisors involved in the development process and also offers numerous “perks” for contributions of increasing amounts.

I spoke with Matthew Zachary at Stupid Cancer and asked him how he came up with the idea.

“No one else was doing it. It’s a revolutionary idea that young cancer patients are really excited about. At the recent OMG Cancer Summit for young adults this year, when I assured the audience that we would have an app by Labor Day, Instapeer got a standing ovation.”

StupidCancer anticipates 500,000 users adopting Instapeer by 2016.

Resources:

http://www.csrwire.com/press_releases/36244-Stupid-Cancer-s-Instapeer-Mobile-Health-App-Set-to-Revolutionize-Cancer-Support