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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.
Next week, the third annual mHealth Summit, the largest event of its kind, brings together leaders in government, the private sector, industry, academia, providers and not-for-profit organizations to advance collaboration in the use of wireless technology to improve health outcomes in the United States and abroad.
The conference takes place in Washington, D.C., December 5-7, 2011, and embodies a collaborative spirit by pairing interesting speakers from different fields—for example, Secretary of the U.S. Department of Health and Human Services, Kathleen Sebelius, and Eric Topol, MD, Vice Chairman of West Wireless Health Institute will both speak at the Opening Keynote and Surgeon General Regina Benjamin, MD, and Verizon Wireless Executive Vice President, John Stratton, will lead the Tuesday morning keynote.
NewPublicHealth will be on the ground at the Summit to capture the conversations, new collaborations and innovations in mobile health, from a perspective of what can feasibly be applied to public health and the potential for mobile technologies to help the public health field connect with hard-to-reach populations and bridge disparities.
While we’re collecting stories from the conference floor, we want to hear from you:
- What are you excited about in the mHealth field and the wide world of health technology?
- What do you think is the power of mHealth and other health technology for the work you do?
- What steps into mHealth or health technology are you exploring or pursuing?
- What public health technology projects are your role models?
- What type of data or services do you have that would lend themselves to mobile or open online access?
>>Need some ideas? Check out our set of health technology stories—some of our favorites include a national text message campaign for moms; a supercomputer that can troll the blogosphere for patient-driven data; emergency updates through Facebook; a round-up of public health smartphone apps; and thoughts from the Office of the National Coordinator for Health Information Technology on the power of health IT for public health.
Share your thoughts in the comments below.
At least 13 people in 18 states have died of a bacterial infection linked to cantaloupes contaminated with the bacteria listeria, according to the Centers for Disease Control and Prevention. The New York Times is calling this the the deadliest outbreak of food-borne illness in the U.S. in more than a decade. An additional 59 people have become ill. Get more updates on food safety.
The U.S. Department of Health and Human Services has announced today grants of more than $100 million to 61 states and communities – serving more than 120 million residents – to fight chronic disease, the leading cause of death in Americans. Grants will focus on tobacco-free living; active living and healthy eating; preventive services, including prevention and control of high blood pressure and cholesterol; creating healthier environments; and reducing health disparities. Groups such as Trust for America's Health have applauded this effort for moving the country toward a prevention-oriented approach to health. View more community health and prevention stories.
A group of health developers, designers and entrepreneurs met in San Francisco this week for the Health 2.0 Code-a-Thon, a live event to bring different perspectives together and build exciting new applications and tools for improved health care in a short amount of time. The California Endowment Health Journalism Fellowships' Reporting on Health program offers highlights of the innovations developed there, including an online and mobile platform for virtual Alcoholics' Anonymous support, a slew of apps to support coordinated care and medication management, and an app that rewards people for healthy behaviors. Read more innovative health technology stories.
Today, as many school sports begin practices, officials remind parents, children and coaches to take precautions to prevent sports injuries. According to the American Academy of Pediatrics (AAP), about three million children and adolescents ages 14 and under are injured each year playing sports or participating in recreational activities, and more than 775,000 are treated in hospital emergency rooms for these types of injuries.
Jon Divine, M.D., previously director of Sports Medicine at Cincinnati Children’s Hospital Medical Center and now head team physician at the University of Cincinnati, says one way to reduce injuries is to help kids get and stay in shape before tryouts and practice begins. Additional tips:
- Acclimate children to hot weather workouts by gradually increasing time outdoors in the heat and humidity about ten days to two weeks before official practice begins to help prevent heat injuries.
- Make sure children drinking plenty of fluids and take frequent breaks: every 10-15 minutes while they play outdoor sports.
- Young athletes with asthma should check with their physician about using an inhaler preemptively, and should make sure to have an inhaler easily and immediately accessible during practice and games.
- Make sure children wear a well-fitted helmet if they play football, softball or baseball to prevent severe injuries such as concussions. Many head injuries result from helmets not being fitted or used correctly.
- Athletes who take a blow to the head should not return to the same practice, game or contest and should be evaluated by a physician prior going back to tryouts, practice or games.
Several vetted websites offer additional resources to help prevent youth sports injuries:
Pencils, check. Notebooks, check. What about back-to-school apps? The U.S. government has an app store that can help gear up your gadgets for the back-to-school season.
Some of the apps need to be downloaded to a phone; others can be accessed using a phone’s web browser. And while these apps are free, always check on the government website, since future apps could have a price tag. Not all government apps are available on every smartphone platform, so check to see if an app is supported by the smart device you use.
Federally-funded health centers provide a variety of health services. Type in your zip code to find the closest clinic. People who use the services pay what they can. Care includes: vaccinations and check-ups for kids, treatment, and pregnancy care. Some centers also offer mental health services, dental care and prescription drugs. Back-to-school is a great time to make sure children are caught up on vaccinations.
Before you do your back-to-school shopping, find recall information from the Consumer Product Safety Commission, National Highway Traffic Safety Administration, Food and Drug Administration, and U.S. Department of Agriculture (USDA). The app lets users type a product’s name into a phone to see whether the product has been recalled, see photos of recalled products and find out how to return or be reimbursed for many recalled products.
The Food and Drug Administration (FDA) has proposed guidelines for a small number of health-related smartphone apps the agency could oversee. The concern: medical apps that could present a risk to patients if they don’t work as intended. The FDA is proposing to regulate “medical apps,” including those that function like medical devices that diagnose, treat, cure or prevent disease. An example might be an app that turns a smartphone into an electrocardiography (ECG) machine to find out if a patient is experiencing a heart attack.
NewPublicHealth spoke with Joseph Kvedar, M.D, director of the Center for Connected Health in Boston about oversight of medical smartphone apps by the FDA.
NewPublicHealth: Are these proposed guidelines a good idea?
Dr. Kvedar: In many ways, this is good news because I think there has been a bit of a chill in the mobile health industry for some time now because people were unsure what the FDA would regulate. And a number of companies didn’t add innovations because they were worried that the mobile phone itself might become a focus for FDA regulation. So their proposal is that they will be regulating certain uses of mobile technology in healthcare. This is not a bad place to start. It’s an advisory looking for commentary, so we have the option and the opportunity to give them some of our feedback on this.
NPH: What do you think should be the guidelines for determining regulating vs. not regulating a type of app?