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Mobile health is now

August 4, 2010

I love mobile technology and the possibilities it holds for health, both on the patient/caregiver side and physician/HCP side.  I’ll be writing more on the topic over the coming weeks and months (and hopefully I’ll actually stick to my new resolution to blog at least once a week ), but here are a few data points to set the stage:

  • Nearly 2/3 of U.S. physicians use a smartphone  for medical or clinical purposes according to both Google and Manhattan Research
  • 95% of physicians who use handheld devices/smartphones download applications to access medical information (SDI Research)
  • Wireless adoption within healthcare has grown over 60% in the past year (ABI Research)
  • The global market for handheld mobile devices in healthcare is forecast to grow to $8.8 billion in 2010, with patient monitoring devices accounting for about 2/3 of the total (Kalorama Research)

In short, the intersection between medicine/health and mobile is happening now.  Two of the best sources of information I have found to keep up on the trends are  Fierce Mobile Healthcare (the business side) and iMedicalApps (the clinical side).  Fierce Mobile is part of the Fierce empire (Fierce Biotech, Fierce Healthcare, Fierce Biotech, Fierce Bunny – oh maybe that one is in development) and provides a solid round-up of news in the space. iMedicalApps is a physician-led site where practicing doctors provide commentary and reviews of mobile medical technology and applications.  For people interested in understanding what is really valuable to a physician (vs. what agencies tell you is valuable), then the site is a must.

There are also conferences galore where you can explore the topic.  One that looks promising is the mHealth Summit in Washington, D.C. in November.  I have no real insight on it but it appears to have top-quality speakers and  is well-priced (tickets below $500). I am beyond sick of attending $2000 conferences which are also funded by high-paying sponsors. Typically the content is so basic that I leave having learned nothing new, at least from the formal meeting.

Mobile health seems to hold so much promise that in late June  the venerable World Economic Forum convened its own mHealth Summit in San Diego. Paul Jacobs, CEO and Chairman of Qualcomm, and Chair, World Economic Forum Global Agenda Council on the Future of Mobile Communications wrote, “With nearly 5 billion mobile phones in use, there is an unprecedented opportunity to leverage humanity’s most pervasive global platform to transform the health care sector and empower people to take charge of their own health. By helping to shape future policy and encourage innovation in this critical area, we can make a real contribution to human health, all over the world.” You can watch video of the conference and download proceedings.

Just last week (July 26 and 27) the FDA and FCC held a public meeting to initiate inter-departmental dialogue and coordination on the topic. With mobile health, the regulatory lines begin to blur. To their credit, the agencies are attempting to define the issues that they’ll need to address as the sector takes off.

So if you thought mobile health was the future, guess again.  Mobile health is now.

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Data for All

June 26, 2010

After all the time, money and paper spent on HIPAA, we are now discovering that many patients actually don’t want to hide their data, they want to share it openly. Why? Because they believe it may lead to more effective therapies in their lifetime.  PatientsLikeMe (PLM), a well-known social network for patients with chronic or fatal diseases, was one of the first companies to promote the idea of public access data. In 2008, after learning that a small clinical study in Italy suggested that lithium might postpone the progression of ALS (commonly referred to as Lou Gehrig’s disease),  PLM encouraged those taking the drug to track their regimen and its effects using tools created for them by PLM programmers. Those participating discovered that lithium was not the panacea they had hoped – the drug had neither positive nor negative effects on their ALS.  While this was not a scientifically orchestrated study funded by pharma, overseen by a KOL principal investigator, and run by a Top 5 CRO,  its findings were later validated by such a study published last month (May 2010) in Lancet Neurology. It showed that lithium did nothing to slow the course  of ALS.

While this type of qualitative/directional research will not replace double-blind, placebo trials, it does show the benefits of data collection and aggregation freom the real world of patients. We all know that trials are based on proscribed audiences, not everyday people. So it is important to have the data from the real world in addition to that of the “ideal patient” world.

The MIT Technology Review wrote a story about this.  They spoke to Mark Roberts, a physician and professor of Health Policy and Management at the University of Pittsburgh, who offered this assessment: “The beauty of observational trials is that you can see how an intervention works in the real world.  For example, many trials eliminate patients with secondary ailments, such as renal failure or chronic obstructive pulmonary disorder.  All my patients have those things, so how do I know it works in people I see?” Exactly!

Similarly, the patient-driven social network TuDiabetes launched TuAnalyze, an application that lets those with diabetes track, share and compare their data. Members of the community choose how much information (if any) to share about their hemoglobin A1c levels. The program was developed in collaboration with Children’s Hospital Boston with funding from a CDC grant.

So the open data movement is on. Let’s see where things go over the next year.

Health Care Costs 101

May 5, 2010

OK, this is not really social or digital in nature, but it’s important. The California HealthCare Foundation has put together Health Care Costs 101, an overview of the latest (2008) national health care spending trends. Why 2008? Because that is the latest available data from the U.S. Department of Health and Human Services and Centers for Medicare and Medicaid Serves (CMS) Office of the Actuary. Thank you to CHCF for putting together this impressive report.  I am a huge fan of the organization – they publish iHealthBeat (a website and free daily newsletter about technology and healthcare) and have supported Amy Tenderich’s  Diabetes Mine Design Challenge for the past few years.

There are so many interesting statistics I don’t know where to start.  Here are a few highlights:

  • In 2008  healthcare spending was $2.3 trillion = 16.2% of GDP = $7,681 per person
  • How is the money spent? Not what you’d expect given all the hoopla about pharma in the press. Only 10% goes toward Rx drugs. The lion’s share goes to Hospitals (31%) followed by Physician and Clinical Services (21%).
  • Who pays for all of this? Public sources via federal, state and local governments (Medicare, Medicaid, Medical, etc) account for 47%.  Private sources (private insurance, fee-for-service, etc) contribute 53%.
  • Prescription drug spending grew 3.2%, an all-time low, and the smallest increase of any major health care goods and services category.
  • With the implementation of Medicare’s Part D drug coverage in 2006, a larger share of drug spending is now being paid for by the public sector.  In 2005, government paid for 28% while in 2008 that share rose to 37%.
  • Medicare’s share rose dramatically (from 2% in 2005 to 22% in 2008) as it absorbed drug spending once paid out-of-pocket, by private insurance, or by Medicaid (on behalf of those eligible for both Medicaid and Medicare programs).

Definitely review Health Care Costs 101 – CHCF has made the data so easy to digest. Plus,  there are great charts and graphs you can show in your own presentations!

Diabetes Mine 2010 Design Challenge is Open!

March 22, 2010

Amy Tenderich is one of the pioneers of the e-patient movement. She is a respected, prolific writer who created one of the most well-read and trusted diabetes blogs around called Diabetes Mine. For the past three years Diabetes Mine has hosted a contest to promote innovation in the design of tools used by diabetes community. The competition all started as a result of a letter Amy posted on her blog in 2007 to Steve Jobs.  She voiced what many in the diabetes community felt about their pumps , pens and monitors:  “Medical devices are also life devices, and therefore need to feel good and look good for the patients using them 24/7, in addition to keeping us alive.”  She implored the Apple CEO to help spur innovation in the medical device community and show them what was possible.

One of Amy’s ideas was to use crowdsourcing, a key tenet of Web 2.0, to foster the change diabetics were seeking. This led to the formation of what-is-now an annual Design Challenge. Such is Amy’s influence that many heavyweights came forward to support the effort. The California HealthCare Foundation (CHCF) underwrites the annual competition (I’m a huge fan of CHCF’s iHealthBeat) and the renowned design/innovation firm IDEO also supports it.

The 2010 contest welcomes entries from anyone “passionate about diabetes and product design” from patients to caregivers to designers to developers and engineers. This year there will be 3 Grand Prize winners who each receive $7,000, and perhaps more importantly, introductions to venture capitalists and a consult with the experts at IDEO.  Two additional $1,000 awards will be granted to “Most Creative Idea” and “Best Kids’ Concept.”  Deadline for submissions (which must be in the form of a 2-3 minute video) is April 30th. In 2009 the contest received over 150 entries, from multiple non-invasive ways to measure glucose (through the skin, eyes, and even via chewing gum), to a variety of Smartphone applications, to high-tech foot scanners for early detection of diabetic neuropathy. The Grand Prize winner was a system that turns the iPhone into the controller for a combined glucose monitor and insulin pump.

Ultimately what this competition proves is that those living with diabetes are no different from other consumer population.  They want their devices to be comfortable, easy to use and attractive in addition to being functional.  So how can the medical device and pharma industries take advantage of the remarkable ideas generated by the design submissions.  Look at them. Watch the videos. Listen to what the inventors are saying. Start with the 2009 entrants and once 2010 is complete view their submissions, too.  This is what your market  is looking for.  And take note:  Samantha Katz,  last year’s Grand Prize winner, was actually hired by Medtronic Diabetes to help design their next-generation insulin pumps.

The Connected Physician

February 23, 2010

There is so much going on in the world of physician communication via digital, mobile, social. It is amazing how much some doctors are sharing online. When I first started out in the healthcare biz, physicians would never open up like this. I have observed this trend on blogs and Twitter.

So I was not surprised to learn from a recent Manhattan Research study that physicians are (finally) more apt to connect with patients online. According to their Physicians in 2012: The Outlook on Health Information Technology study, 39% of physicians currently email, secure message, or instant message their patients, which represents a 14% increase since 2006. Within that group, dermatologists, medical oncologists, neurologists, endocrinologists, and infectious disease specialists are the most active. The top activities include:

  • Answering clinical questions
  • Discussing symptoms and/or treatment options
  • Determining whether an office visit is necessary

Physician acceptance is a big part of moving physician-patient online communication forward. The statistic above means that over 60% of physicians are not partaking of the Internet to talk to patients. Liability issues, privacy and doubts about benefits to practice efficiency are among the reasons cited.

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Pharma review sites

February 9, 2010

In the past I have written about drug review sites like iGuard.org. Social/digital pharma blogger extraordinaire Jon Richman recently wrote a post about “The Best Pharma Products According to Patients” on Dose of Digital. He provides deep analysis about iGuard in particular which has over 2 million users at this point.

Briefly though the 4 sites he has been tracking are:

It’s good to know about these sites if you’re in the industry and what to know what people are saying about your product(s). Take a look.

Check out ScienceRoll

February 4, 2010

I do not know Bertalan Mesko, MD personally but this Hungarian physician and PhD-to-be in personalized genomics publishes some of the best content related to Health 2.0 on the Web. His blog is ScienceRoll and he tweets @berci.

Bertalan has assembled an incredible list of online/2.0 resources by specialty on his consulting site Webcina. Colleagues frequently come into my office and ask, “I need to get up to speed on [insert disease], where should I look online?” Now I have a great place to send them in many cases.

The evolving list includes:

But there is so much more to ScienceRoll – slide decks, interviews, commentary. The depth and breadth of content are impressive. Unbelievable really. Check it out!