This is something. Jay Parkinson on the Future Well blog has suggested that health apps are overrated. Then on Twitter came a remark that the post represented “fightin’ words.” While I think the tweet was in jest, I’m sure there are some who will take offense to the less-than-flattering remarks about our coveted health apps.
We love the concept of health apps for what they represent more than for what they really offer us. We want to feel that we’ve got it all in the palm of our hand. After all, technology might do for us what we won’t do for ourselves.
Like Jay I’m underwhelmed, but I don’t think that’ll always be the case. The post’s criticism should start a conversation about what’s real in mobile health and what isn’t. Even the fantasy of Health 2.0 has been questioned, and that’s a good thing. This dialog about reality versus rainbows and unicorns needs to continue.
Youngme Moon in Different: Escaping the Competitive Herd wrote, “The way to keep criticism from devolving into cynicism is to make it a starting point rather than a punctuation mark.” Jay Parkinson’s post is a starting point.
*This blog post was originally published at 33 Charts*
Just admit it: Deep in your heart you’ve always wanted to be an emergency medical technician, if at least for a few moments. If you’re located in San Ramon Valley, California, you can now live that dream: The local fire department has released an iPhone app that will alert you of any emergency activity in the area.
The well thought-out application will send out a push notification to users who have indicated that they are proficient in CPR whenever there is a cardiac emergency nearby. In addition, the closest public-access automated external defibrillator (AED) is located by the app. Current response status of dispatched units are shown and incident locations are pinpointed on an interactive map. There’s even a log of recent incidents including a photo gallery. For the old-school ham and scanner lads, it’s possible to listen in on live emergency radio traffic. The app is available for free.
While Braille can give the blind the ability to read, much of the text one encounters is not available in Braille (and our increasing dependence on touch-screen smartphones isn’t helping.) Two students at the University of Washington hope to solve this problem with their concept device, which they have termed the “Thimble.” The Thimble contains a fingertip camera and an electro-tactile grid which can read text and convert it to touch-sensitive Braille. The device can also interface with a user’s smartphone via Bluetooth for reading online content.
How could the health care reform legislation that President Barack Obama signed into law on March 23, 2010, not be the #1 story of the year? Whether you are for or against it, the Patient Protection and Affordable Care Act is nothing if not ambitious, and if implemented, it will fundamentally alter how American health care is financed and perhaps delivered. The law is designed to patch holes in the health insurance system and extend coverage to 32 million Americans by 2019 while also reining in health care spending, which now accounts for more than 17% of the country’s gross domestic product. The biggest changes aren’t scheduled to occur until 2014, when most people will be required to have health insurance or pay a penalty (the so-called individual mandate) and when state-level health insurance exchanges should be in place. The Medicaid program is also scheduled to be expanded that year so that it covers more people, and subsidized insurance will be available through the exchanges for people in lower- and middle-income brackets. But plenty is happening before 2014. The 1,000-page law contains hundreds of provisions, and they’re being rolled out in phases. This year, for example, the law created high-risk pools for people with pre-existing conditions, required health plans to extend coverage to adult children up to age 26, and imposed a 10% tax on indoor tanning salons. Next year, about 20 different provisions are scheduled to take effect, including the elimination of copayments for many preventive services for Medicare enrollees, the imposition of limits on non-medical spending by health plans, and the creation of a voluntary insurance that will help pay for home health care and other long-term care services received outside a nursing home. Getting a handle on the complicated law is difficult. If you’re looking for a short course, the Kaiser Family Foundation has created an excellent timeline of the law’s implementation (we depended on it for this post) and a short (nine minutes) animated video that’s one of the best (and most amusing) overviews available. The big question now is whether the sweeping health care law can survive various legal and political challenges. In December, a federal judge in Virginia ruled that the individual mandate was unconstitutional. Meanwhile, congressional Republicans have vowed to thwart the legislation, and if the party were to win the White House and control of the Senate in the 2012 election, Republicans would be in a position to follow through on their threats to repeal it.
2. Smartphones, medical apps, and remote monitoring
Smartphones and tablet computers are making it easier to get health care information, advice, and reminders on an anywhere-and-anytime basis. Hundreds of health and medical apps for smartphones like the iPhone became available this year. Some are just for fun. Others provide useful information (calorie counters, first aid and CPR instructions) or perform calculations. Even the federal government is getting into the act: the app store it opened this summer has several free health-related apps, including one called My Dietary Supplements for keeping track of vitamins and supplements and another one from the Environmental Protection Agency that allows you to check the UV index and air quality wherever you are. Smartphones are also being used with at-home monitoring devices; for example, glucose meters have been developed that send blood sugar readings wirelessly to an app on a smartphone. The number of doctors using apps and mobile devices is increasing, a trend that is likely to accelerate as electronic health records become more common. Check out iMedicalapps if you want to see the apps your doctor might be using or talking about. It has become a popular Web site for commentary and critiques of medical apps for doctors and medical students. Meanwhile, the FDA is wrestling with the issue of how tightly it should regulate medical apps. Some adverse events resulting from programming errors have been reported to the agency. Medical apps are part of a larger “e-health” trend toward delivering health care reminders and advice remotely with the help of computers and phones of all types. These phone services are being used in combination with increasingly sophisticated at-home monitoring devices. Research results have been mixed. Simple, low-cost text messages have been shown to be effective in getting people wear sunscreen. But one study published this year found that regular telephone contact and at-home monitoring of heart failure patients had no effect on hospitalizations of death from any cause over a six-month period. Another study found that remote monitoring did lower hospital readmission rates among heart failure patients, although the difference between remote monitoring and regular care didn’t reach statistical significance. Read more »
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