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Winners of the Surgeon General’s Healthy App Challenge were announced late last week, after the challenge launched earlier this winter at the mHealth Summit. The goal of the challenge was to highlight the ability of innovative new technologies to provide health information tailored to the needs of the user, and empower the public to regularly engage in and enjoy health-promoting behaviors.
>>Read more about the value of challenges to promote innovation from HHS Chief Technology Officer, Todd Park.
"I've been delighted with the response to the challenge," said Surgeon General Regina Benjamin, MD, MPH. "The winning apps will help many Americans to have fun while getting fit and healthy."
The applications were assessed by a team of judges that included figure skater Michelle Kwan and Shellie Pfohl, Executive Director of the President’s Council on Fitness, Sports & Nutrition. Criteria used to assess the apps included:
- quality of evidence supporting the app’s approach to healthy behaviors
- ability to tailor and download personal data
- the “fun” factor
In addition, all the apps submitted for review had to be available on readily accessible platforms, free for consumer use and fully operational without the purchase of additional products.
And the winners are…
The Centers for Disease Control and Prevention recently launched an iPad verison of the agency’s website. Carol Crawford, chief of the Electronic Media Branch at CDC, says the app, which is free, has been downloaded well over 5,000 times so far and has been well received.
What’s the advantage to all that content on a tablet? Joseph C. Kvedar, MD, founder and director of the Center for Connected Health in Boston, says, "these devices are always connected," and the mobility of the iPad is well suited to the CDC’s site, which often has late-breaking news on outbreaks and disease for consumers and health professionals. The information can be accessed more easily on the go in "tablet form." Kvedar says that while many iPad apps have been launched just as "gee whiz" sorts of features, accessing medical information on an iPad app can have a "just-in-time" feel that enhances accessibility and usability. And moving quickly among options such as podcasts that refer to a news item, or news that relates to a journal article—which the iPad app allows—can make it easier for users to take advantage of CDC’s many resources.
There are also tabs that give users quick access to social media channels (Facebook, Twitter, and YouTube) and CDC will also be creating original content for the iPad app.
A key advantage to an iPad app for health professionals is that it’s very similar to reading a page of a printed journal, and reduces the need to tote the paper copies or print out pages. That’s a view shared by Dr. Kvedar and Howard Bauchner, MD, the new editor of the Journal of the American Medical Association, who talked about that benefit in an interview with NewPublicHealth last year.
The CDC iPad app is also easily shareable by health professionals with patients to point out studies, guidelines and news. That shareable use of iPad content was highlighted frequently on the exhibit floor at the mHealth conference held outside Washington, D.C., late last year.
Weigh In: What advantages have you found to accessing CDC or other health data via iPad rather than on a computer?
Got a good idea for a health app or health innovation? The health agencies of the U.S. government want to know. Since 2009, the U.S. Department of Health and Human Services has invited citizens and tech and health experts, to submit their ideas for new health apps or strategies to help improve population health outcomes through open "challenges."
A recent challenge, still open to contestants, comes from the Office of the Surgeon General, deemed the Healthy Apps Challenge, to help provide tailored health information and empower users to engage in healthy behaviors. (Read about the Surgeon General's announcement of the challenge here.) Another challenge from the Office of the National Coordinator for Health Information Technology asks entrants to create a video of two minutes or shorter on how to use technology to achieve a New Year’s health resolution.
Ashoka Changemakers and the Robert Wood Johnson Foundation’s Pioneer Portfolio have created a challenge called Innovations for Health: Solutions that Cross Borders, with a goal of finding “health care innovations that have the potential to be adapted and applied in different countries experiencing similar barriers to health” – with a focus on both individual health and prevention at a population level. The challenge is particularly looking for new approaches or unique models of change that demonstrate a substantial difference from other initiatives in the field, and for solutions that have demonstrated impact and help vulnerable and under-served populations. The cash prize for the challenge is $10,000 each for up to three winners, and the deadline for ideas is February 13. (From among the entries, the Foundation will also be looking for ideas that show potential to help produce significant improvement in health and health care in the United States).
Why issue a challenge rather than a request for proposals in order to find solutions to so many critical health problems? NewPublicHealth recently asked just that of Todd Park, Chief Technology Officer of the U.S. Department of Health and Human Services.
NewPublicHealth: Health challenges are garnering quite a few contestants, judging by the traffic on the websites. Why are they such a good option for exploring new health solutions?
Todd Park: The challenges are a terrific way to engender innovation for a variety of reasons. One, they tend to attract both usual suspects and unusual suspects. So folks who may have highly complementary expertise or experience in other sectors are now applying their expertise for the first time to help solve a health or health care problem. In fact, the emerging academic literature on challenges in general indicate that the people who win the challenges tend to be, the majority of the time, folks who are unusual suspects; folks who actually come from other sectors who are applying their expertise for the first time to a problem in the sector from which the challenge is being issued.
And another reason why they tend to be – when done well – very successful engenders of innovation is that it’s a very broad-based response that you get. So as opposed to say a procurement where you ask a single organization to come up with the answer to a given question, you’re basically asking the planet for an answer to a question or a solution to a problem, so you get many more responses that are much more diverse than you would get from a narrow solicitation.
NPH: Is there a challenge winner from a non-health sector whose submission blew you away?
Patients treated for acute heart attacks in the United States are readmitted to the hospital within 30 days of their initial discharge more often than in other countries, according to a new study published in the Journal of the American Medical Association. The study found that 60 percent of severe heart attack patients admitted to U.S. hospitals were discharged in three days or less, yet 14.5 percent of the U.S. patients required another stay within a month. By comparison, 54 percent of study participants in other countries spent at least six days in the hospital and only 10 percent were readmitted to the hospital within thirty days. Read more on heart health.
A new tool from the National Diabetes Education Program offers users the chance to declare resolutions, such as losing weight and exercising more, and share the resolutions through social media. The site offers information and tools to bolster efforts to be healthier in 2012. Get more updates on new technology and apps to support better health.
The Department of Transportation has announced proposed improvements to Passenger Train Emergency System regulations for emergency passenger and crew evacuations. The proposed regulations include improvements to compartment doors, emergency lighting, signage and markings for emergency entrance and exit, and rescue access. The agency also recommends stronger requirements for debriefing passengers and crews after emergency situations and simulations. The comment period for the proposal closes March 5, 2012. Read more on transportation and health.
It's been an exciting year for us at NewPublicHealth! We launched in March, and nine months, nine conferences and 568 posts later, we are ready to ring in the new year.
Here's a glimpse into the inaugural year of NewPublicHealth, and the top posts by popularity.
- Power of Health IT for Public Health: A NewPublicHealth Q&A With Farzad Mostashari. This piece was a conversation with the National Coordinator for Health Information Technology in the U.S. Department of Health and Human Services (HHS), about the evolving public health informatics field.
- Dr. Douglas Jutte: My Patient's Most Pressing Health Concern Was a Broken Carburetor. Dr. Jutte provided a personal commentary on how unmet social needs—like access to nutritious food, transportation assistance and housing assistance—were sometimes the most critical in treating his patients. (Also check out a round-up of reader responses to this post.)
- Public Health and the Community Benefit: A NewPublicHealth Q&A With Abbey Cofsky. The Patient Protection and Affordable Care Act requires that non-profit hospitals, starting in 2012, perform a community health needs assessment, and that the assessment serve as the foundation of an implementation plan to address identified needs. NewPublicHealth spoke with Abbey Cofsky, program officer at the Robert Wood Johnson Foundation, about the public health opportunities this provision offers.
- The National Prevention Strategy: A NewPublicHealth Q&A With Surgeon General Regina Benjamin. Upon its launch, we spoke with the Surgeon General about the nation's plan for increasing the number of Americans who are healthy at every stage of life.
- Teen Birthrates Down in U.S. But Still Lag Behind Other Developed Nations. This article looked at the April Vital Signs report from the Centers for Disease Control and Prevention on the latest stats on teen childbirth, such as, "Girls born to teen mothers are about 30% more likely to become teen mothers themselves."
- Health Literacy: Reducing the Burden of a Complex Healthcare System. During Health Literacy Month, NewPublicHealth caught up with Linda Harris of the HHS Office of Disease Prevention and Health Promotion and Cindy Brach of the Agency for Healthcare Research and Quality about federal efforts to improve health literacy and to reduce the burden of a complex healthcare system.
- The County Health Rankings 2011: Mobilizing Action to Improve Health. NewPublicHealth's very first post announced the second annual County Health Rankings, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute that provides a standard way for counties to see where they are doing well and where they are not so they can make changes to improve health.
- What to Expect at the Health Data Initiative Forum: A Q&A With Todd Park. The Forum, presented by HHS and the Institute of Medicine, convened more than 500 people to showcase how health data can provide a rich seeding ground for new tools to support more informed decision-making by consumers, healthcare systems and community officials. NewPublicHealth spoke with Todd Park, Chief Technology Officer at HHS, to get his take on health innovation.
- HHS Leading Health Indicators: Health By Some New Numbers. NewPublicHealth was on the ground at the APHA Annual Meeting covering top news, including the announcement of the latest Leading Health Indicators from HHS, a set of the top national high-priority health issues and actions that can be taken to address them.
- Housing Policy is Health Policy: A NewPublicHealth Q&A With HUD's Raphael Bostic. Raphael Bostic of the U.S. Department of Housing and Urban Development (HUD) spoke with NewPublicHealth about the role of housing in health, and new collaborations across sectors that recognize that providing healthier, more affordable housing can lead to significant health outcomes.
Runners up included Q&As with CDC Director Thomas Frieden and Virginia Comonwealth University researcher Steven Woolf; a post on public health mobile phone apps and a commentary on the popular movie Contagion.
These were just a handful of the conversations that captured our readers' interests this year. Keep reading in 2012 for the latest in public health and new ways to prevent disease and health crises where they begin—in our communities.
Thanks for reading and for your always insightful comments. Have a happy, healthy New Year and we'll see you in 2012!
The recent mHealth Summit simultaneously showcased new mobile health apps and technologies, while presenters at workshops questioned just how ready the technology and the medical community are for each other. A new collaborative article by NPR and Kaiser Health News continues that discussion by addressing one doctor’s iPad pros and cons. The reporting will add to the questions and answers health departments, agencies, practices and hospitals field as they consider acquiring new technology.
>> Read the article.
Bonus question: Where do you stand in weighing the pros and cons of new technology for health and health care?
The one sure thing about the mHealth summit is that this is a field still in its early days. But attendance of first-time exhibitors Verizon, Qualcomm and AT&T, who each showed some new health monitoring apps and connectivity systems, was good news for the industry and the conference. More important, says Tom Brewer, project manager at the Northwest Regional Telehealth Resource Center, is the opportunity these big companies bring in helping smaller telecommunications systems fit into their larger networks. Brewer says that expanding telehealth and mHealth opportunities could improve connectivity and access for consumers in areas where broadband is limited.
Numbers underscore the nascent phase of the mHealth field. At a session yesterday on the value of mHealth, attendees were reminded that a month after download, only 6 percent of public health apps are still in use. From a business model, the purchase is completed. But from a public health standpoint, the promise of the app for diabetes or glucose monitoring, or calorie counts or smoking cessation, for example, has largely been lost, says Brewer. At least one app firm on the exhibit floor confirmed those numbers. A million of their apps have been downloaded in the last four years, but only 7 percent are still in use.
Yvonne Hunt, PhD, MPH, of the National Cancer Institute says that simply underscores the need for testing and evidence so that apps are designed with best practices and remain in use. (Read our Q&A with Dr. Hunt.) One way to increase use might be with automatic updates to downloaded apps, an option from several firms and a good question for providers to research before recommending an app.
Technology to watch:
- Cffone—mobile website for kids with cystic fibrosis that helps connect patients with each other and encourages adherence to treatment regimens.
- NIH alcohol consumption app that will be launched in early 2012—lets users key in the alcohol type and portion size in their drinks so they can see if they’re exceeding recommended daily limits and track their intake over time. Drinkers are often unaware of how much alcohol they’re consuming in a day or month, of the risks it can pose, such as impaired driving, exacerbated health concerns and drug interactions.
This morning, Surgeon General Regina Benjamin, MD, delivered the keynote address at the mHealth Summit, and announced the new Healthy Apps Challenge, in collaboration with the Office of the National Coordinator for Health Information Technology, to encourage developers and innovators to create mobile and other technological applications to help complement the nation's first National Prevention Strategy.
>>Read our Q&A with the Surgeon General on the launch of the National Prevention Strategy.
>>Hear from Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology, on the potential of health technology for public health.
The new app challenge is looking for apps that will engage individuals with tailored health information and empower users to eat healthy, get active and improve their emotional wellbeing – and enjoy it! Dr. Benjamin emphasized that last point. "Joy is so important," said Dr. Benjamin. "We each have to find our own joy in health." Dr. Benjamin finds her joy in dancing, and said she encourages her colleagues to have 60-second dance parties at work as a fun way to take a physical activity break.
Though the Surgeon General applauded the potential for technology to improve the public's health, she also called for a broader, system-wide change, as outlined by the National Prevention Strategy. "In addition to state-of-the-art medicine and technology, we need a new approach in our communities that focuses on the things outside the doctor's office that keep us healthy, from healthy housing to transportation to access to healthy foods," said Dr. Benjamin. "That calls for the nation to take a more holistic, integrated approach to health."
Dr. Benjamin said the National Prevention Strategy brings together 17 federal agencies from across government, together with stakeholders from the private and community sectors, to help move the nation, "from a system focused on sickness and disease to one focused on prevention. We need to stop the illness before it starts."
Dr. Benjamin told the story of how when she was sworn in as Surgeon General, much of her family couldn’t be there with her to celebrate. Both of her parents had passed away from preventable, chronic diseases. "I don’t want anyone else to suffer the loss of a loved one for something that could be prevented," said Dr. Benjamin.
Not surprisingly, there were some striking numbers tossed around on morning one of the third annual mHealth Summit today, including the number of worldwide Facebook users—800 million—and the percentage of U.S. households with cell phones—about 90 percent.
That Facebook number has great mHealth applicability. Keynote speaker Eric Topol, MD, vice chair of West Wireless Health Institute, a conference sponsor, told the story of a little boy whose doctors couldn’t diagnose his illness, until his mother put a photo of him—and his skin swelling—on Facebook and got back the accurate diagnosis of Kawasaki’s Disease, an autoimmune disease that can be fatal. That example is an important one because Facebook is relatively inexpensive to access. Other technologies discussed at the opening keynote today—including a smartphone heart imaging app that Dr. Topol says he has used for two years instead of a stethoscope, might take longer to adopt as physicians learn to use, store and charge patients and providers for the images.
Numbers do speak to the growth of the industry. Attendees at this year’s meeting grew from 2,400 last year to 3,600 in 2011, according to Scott Campbell, PhD, Executive Director and CEO of the Foundation for the National Institutes of Health, another conference sponsor.
The wow factor was certainly on the screen this morning—Smartphone microscope apps, and chip-loaded contact lenses to monitor glaucoma, for example. But speakers acknowledged that adoption is still in its early phases, even as the usefulness is quantifiable. Robert Kaplan, PhD, Director of the Office of Behavioral and Social Sciences Research at the National Institutes of Health, noted, for example that 63 percent of deaths worldwide are now the result of non-communicable diseases. "In order to combat these trends we need new tools and strategies and new innovations," says Kaplan, who added that "we believe that mHealth and wireless technologies are an essential part of our future. For example, research centers are looking at sensors and wireless phones to help monitor health in rural locations."
Kaplan made a strong case for scrutiny: "physicians are stubborn and they want evidence—we need evidence to document the benefits of health and I look forward to what lies ahead."
U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius acknowledged the relative slow growth of technology in medicine, "healthcare has stubbornly hung onto its cabinets and hanging files." But, Sebelius pointed out, "when innovation is slow, so is improvement. Americans still live sicker and die sooner than many people in nations around the world."
Sebelius focused on electronic health records and pointed out that part out that part of the healthcare problem is a lack of access to information about their own health, health information and how to find help. HHS says adoption has moved from 17 percent in 2009 to 34 percent and is on pace to triple shortly. "mHealth," says Sebelius, "is the natural extension of this trend."
Where government can play a critical role, says Sebelius, is in providing and driving research and as a catalyst. Benefits extend beyond health of individuals—Sebelius says 50,000 new jobs have been created by the growth of electronic health records.
Sebelius told the attendees that they can help move these technologies and their benefits forward, by being supportive of all innovations, not just those that involve health tools, such as "helping move toward patient-centered health systems." And, she added, the technologies will only be embraced if individuals know they’re safe and private.
>>Follow our continued coverage of the mHealth Summit.
The third annual mHealth Summit starts today. The summit brings together more than 3,600 leaders in government, the private sector, academia, health care providers and not-for-profit organizations to advance collaboration in the use of wireless technology to improve health outcomes in the U.S. and abroad. In advance of the meeting, NewPublicHealth spoke with Susannah Fox, associate director of digital strategy at the Pew Internet & American Life Project and contributor to the health blog, e-patients.net, about advances in mobile health and what’s yet to come.
>>NewPublicHealth will be covering the conference, talking with attendees and reporting from the ground of the mHealth Summit. Follow our coverage here.
NewPublicHealth: Where on its trajectory is mHealth?
Susannah Fox: About 85 percent of American adults have a cell phone. While many are still used only for phone calls, a third of the cell phone population has a Smartphone. It’s significant that that the audience is growing and what we thought last year about mHealth already has to be updated.
Last year only 17 percent of cell phone users used their devices to look up health information, so that’s a place where there is room for growth. By comparison, about 70 percent send and/or receive text messages and about 40 percent access the internet.
NPH: What will spur greater growth?
Susannah Fox: We’ll see some demographic changes. As people currently in their 20s, who are significant users of mobile devices, move ahead into different stages of their life, that can change how many people are doing mHealth searches.
The other thing that could change is that on the supply side, more organizations are making sure their websites and other content is mobile ready, making sure it’s possible to read something or forward something or share it on a social network site. And, add in mobile users to internet use and the differences between white adults and African American adults, for example, disappears. Mobile use could have an effect on other digital divides in the future, but for now, our research shows that its greatest effect is among minorities. For example, use of cell phones or mobile digital devices to find health information is 21 percent for Latino adults, but only 13 percent for White adults.
NPH: What else from a health perspective would someone use their mobile device for?
Susannah Fox: Going beyond search, there is text messaging and the opportunity for creating public health messages that are interesting and engaging and funny and that people want to forward to their friends.
In the health app market, up to date data shows us it’s pretty stable. Eleven percent of all adult cell phone users have downloaded an app that helps them manage their health, a statistically insignificant difference from the 9 percent of adult cell users who reported having used a mobile health app in September 2010.
And a new report shows that mobile enables people to be location-aware and let them find information that relates to exactly where you are at any time of the day or night. This could have an impact on health searches such as looking for clinics and providers.
We’re still really at the early adopter stage for online health though—social media, engagement in e-patient networks, health apps. It’s still a small group that really is engaged to share with others, or is tracking some aspect of their health on their mobile device. We’re watching to see when it will engage a wider population—will it be a monitor that reports to you? Or perhaps when clinicians engage and encourage patients to go online.