June 19th, 2012 by Dr. Val Jones in Health Policy, Opinion
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Along with the invention of smart phones, an entire medical mobile application (app) industry has cropped up, promising patients enhanced connectivity, health data collection, and overall care quality at lower costs. Last year the FDA put a damper on the app industry’s quick-profit hopes by announcing that it intends to regulate certain medical apps as medical devices. In other words, if the app is used to connect with a medical device or to turn a smart phone into such a device (whether it can check your blood sugar, blood pressure, heart rhythm, etc. or suggest diagnoses), it must undergo safety and efficacy checks by the FDA before it can be brought to market. That process is likely to inflate app development costs exponentially, thus creating a chilling effect on the industry.
I actually think that FDA oversight is a good thing in this case, since it could protect patients from potentially misleading health information that they might use to make treatment or care decisions. But more importantly, I wonder if a lot of this fuss is moot for the largest, sickest, segment of the U.S. population?
For all the hype about robo-grannies, aging in place technologies, and how high tech solutions will reduce healthcare costs, the reality is that these hopes are unlikely to be achieved with the baby boomer generation. I believe that the generation that follows will be fully wired and interested in maximizing all that mobile health has to offer, but they’re not sick (yet) and they’re also not the proverbial “pig in the python” of today’s healthcare consumption.
I’m not saying that mobile health apps have no role in caring for America’s seniors – their physicians and care teams use tablets and smart phones, their kids do too, and a small percent of seniors may adopt these technologies, but I’m a realist when it comes to massive adoption by boomers themselves. Wireless connectivity, texting, personal digital health records, and asynchronous communication is just not in their DNA. Take away a teenager’s smart phone and he or she is likely to be completely flummoxed by reality. Now give that phone to a baby boomer and the flummoxing will be roughly equivalent, but centered upon the device. The teen can’t live without the constant phone/internet connection, and the senior is overwhelmed by the lack of human interface and unfamiliar menus.
What makes me so sure of my pronouncements? I just spent a month making house calls to almost 70 different Medicare Advantage members in rural parts of this country. And I can tell you that almost none of them used any sort of smart phone app to manage their health. These “odd creatures” actually enjoyed face-to-face human contact, they used their phones almost exclusively to talk to people (not surf the Internet), and they took hand-written notes when it was important for them to remember something. They even had paper calendars that they used to schedule their physician appointments and keep records of their medications and procedures. How “weird” is that?!
When I asked one of the seniors if she’d be interested in using a cell phone to check her blood pressure and have that automatically uploaded to her doctor’s office she replied,
“I’m too old to learn that stuff, dear. I’m lucky if I can find my slippers in the morning.”
The reality is that the average app user isn’t sick, and sick people don’t see a need for apps… yet. Â So our challenge is to meet seniors where they are instead of trying to change their habits. House calls are the best way I know of to get a full appreciation for individual quirks, compliance challenges, and health practices. If we are really serious about reducing healthcare costs in our aging population, it may take some low-tech solutions. As un-sexy as that may be, it’s time that we put down the iPhone and practiced some good old-fashioned medicine.
June 18th, 2012 by Dr. Val Jones in News, Opinion
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This news flash from the land of no surprises… The Journal of The American Medical Informatics Association recently published a study analyzing physician use of online technology. They hypothesized that certain types of physician specialists (such as dermatologists?) would display higher adoption rates of Internet-based communication technology (including things like social media platforms, podcasts, health apps, and widgets). But instead they discovered that adoption of these technologies was correlated with male gender, younger age, and practicing medicine in an academic hospital setting. In other words, young geeky dudes are the ones who are most likely to use techie medical widgets. Who’d have guessed?
All kidding aside (and in case you hadn’t noticed, I’m a middle-aged, female physician who does not practice medicine in an academic setting. I have a blog, a podcast show, and was recently rated one of the top 10 MDs to follow on Twitter – so I must be a serious, category-blowing geek), this does have implications for healthcare. First of all, according to the US Department of Labor, ~80% of family healthcare decisions are made by women, and we consume a disproportionate amount of healthcare resources too. So in my opinion, healthcare technologies should be built by/for women and marketed to them more aggressively. Because if we’re trying to drive adoption of these things to streamline care, facilitate access, and reduce utilization, then we’ve gotta get the ladies on board too.
This study only confirms to me that we’re not there yet – guys are still more likely to use health apps/widgets, etc. But just as “progress” has been made in the video gaming industry (where only 12% of gamers were girls in 2001, that has grown to 40% in 2009) I think we can make similar gains in healthcare. And it’s for a much better cause than “getting really good at playing Grand Theft Auto.” Health apps have the potential to help people manage their diseases and conditions, avoid unnecessary trips to the doctor, and get them to the right healthcare provider at the right time.
So all you geeky (I say that with the utmost respect as a geek myself of course), male software developers out there – please befriend a few female physicians and work with us to get the tech trends moving in the right female direction. We’re all together in this game of life, right? đ
January 4th, 2012 by Iltifat Husain, M.D. in News
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The start of January has some exciting new technologies on the horizon. Recently, Wahoo Fitness announced their new product, BlueHR â a fitness heart rate monitor â can sync to your iPhone 4s via bluetooth and without the need for addition adaptors.
All users have to do with the BlueHR device  is to strap it around their sternum, and they will be able to monitor stats such as their heart rate and the number of calories they are burning via their smartphone. It currently uses Bluetooth 4.0 technology, and as such, the only smartphone that currently has that capability is the iPhone 4S.
We wrote an in-depth article about Bluetooth 4.0 when the iPhone 4s was released, commenting on how it could be a boom for mobile health devices due to the following features of the protocol: Read more »
*This blog post was originally published at iMedicalApps*
January 3rd, 2012 by Nicholas Genes, M.D., Ph.D. in Opinion
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I’ve been using my iPad in the ED, with my white coat’s sewn-in iPad-sized pocket, for some time now — mostly for patient and resident education, and to look up dosages or rashes. Hitting up my Evernote database or Dropbox documents is also useful. Occasionally I’ll use my iPhone, for its LED light (when the otoscope can’t reach to where I need to see) or rarely, its camera (in compliance with my hospital and department photo policy, naturally).
Our ED’s EHR isn’t quite accessible enough via iPad for me to quickly check results or place orders at the bedside — right now it’s just too cumbersome. But there’s been progress — enough so that I start to wonder about the flip side: instead of reviewing iOS medical apps and pining for an optimized EHR experience on the iPad, what if there are features of the iPad that could limit the utility of medical apps?
Well, there are some product design issues, like impact resistance and bacterial colonization, that have been discussed. But the operating system, iOS 5, has some quirks, too. Some have received a lot of attention. Some are maddening in their capriciousness. Read more »
*This blog post was originally published at Blogborygmi*
December 30th, 2011 by Berci in News, Video
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2011 was a very intense and exciting year regarding the developments and new insights of the relationship between medicine/healthcare and social media. Here are my favourite stories from 2011 selected and featured month by month.
January
I had the honour to be included in the Advisory Board of the Mayo Clinic Center for Social Media; I wrote about how a Samsung Galaxy Tab changed totally my online activities, how Google Translate can be used in medicine and featured HealCam, a medical alternative of ChatRoulette.
February
Facebook diagnosis by surgeon saved a friend; there was a lively discussion whether pharma companies can edit Wikipedia entries about their own products, it turned out Wikipedia can be a key tool for global public health promotion; and Scienceroll won the Best Medical Technology/Informatics Blog category for the third time in a row in the Medgadgetâs Weblog Awards.
March Read more »
*This blog post was originally published at ScienceRoll*
