News 1/19/12

There were some great comments on the In-Car Health post from earlier this week.

From Heidi Pape Laird: "I could see interactive voice commands and responses where you ask for calming music, or a seated exercise suggestion or a meditation, but nothing too stressful, exciting or distracting."

From Chris Wasden: "I think the key is passive monitoring….The seat can weigh me, the steering wheel can gather some information such as pulse, temperature, chemical info. I think that there is something here, but not sure the business model."

From David Lester: "While I agree that this may appear to be overkill at present, I think it is important to begin to explore these different opportunities. The value of this will be realized when all of these recorded activities come together. Hopefully it will be an integrated solution based on the best available components."

I can see the value of the car as a place for monitoring, as long as it’s passive and non-intrusive, and especially if it is integrated with other data about the patient. I think that last point, about integration, will be the biggest challenge. We’ll have to see who can start pulling some of these disparate services together. I know we’ll see carriers like Verizon or Qualcomm fighting to do it, but there are also platform companies like Microsoft and HealthVault or an underdog like RunKeeper. In the back of my mind, I have a nagging feeling it’s going to be the payers that pull it off.

I appreciate Chris Wasden’s response to my post about FDA regulation: "I met with senior leadership of the FDA last week on this topic and was quite impressed by their attitude and approach. They will be providing some guidance in the future that makes things more clear, but in general their view is that they want to only regulate a small subset of the mhealth world. We got on the topic of algorithms and intelligence in apps and they said if all you are doing is making electronic a paper based system or tool that has already been vetted over time, then they don’t need to regulate that. If you are providing fairly low levels of intelligence in the app, that won’t require their review either." I’m hoping I can find the same people at the FDA to give me a pass for my app. Thanks, Chris.

It’s been an off couple of weeks for news with the holidays and the silence before CES. But with CES done, we are seeing a lot of announcements from vendors, mostly fitness related, but still interesting.


UnitedHealth announces partnerships with mobile health companies CareSpeak, Lose It!, and Fitbit. CareSpeak offers a health-specific, two-way SMS platform for patient communication and engagement. Lose It! is a nutritional app that helps user track intake and work towards weight goals. I used Lose It! a couple of years ago and had great results. I burned out after a couple months, but my snack intake has remained low despite not using the app anymore. Fitbit offers the snazzy pedometer for activity and sleep monitoring, associated mobile app for tracking nutrition, and most recently a connected scale. I consider this to be a pretty big deal for mobile health companies as long as it is more than just a PR play. I want to see how United rolls these out to members and if/how they tie them together and incentivize members, hopefully with financial savings.


ZocDoc made some superstar additions to its Advisory Board. Joining: former Senators Bill Frist, a Harvard-trained cardiac surgeon of HCA and end-of-life/Terry Schiavo fame, and Tom Daschle. ZocDoc continues to extend its impressive list of dignitaries. The story also states that ZocDoc is used by 800,000 people each month, but my bet is that this is probably total searches and not booked appointments. The number was 700,000 about 4-5 months ago, so I’m not sure if this is a good trend considering the amount of money and press ZocDoc is getting. The number of open slots available on the system has gone from 500,000 to 550,000.


Independa announces a partnership with LG to incorporate Independa’s Angela platform into LG TVs in long term care facilities. In a move to extend its reach as an elder care player, the new offering by Independa will enable those in long term care facilities to communicate with loved ones and caregivers, enter health-related information, and use Facebook or the web, all on a platform designed for the non-tech savvy senior and with all data incorporated into Independa’s CloudCare platform. The idea seems great to connect isolated seniors, as long as long term care facilities have LG Pro:Centric-enabled devices. I’ve heard of other companies working on similar smart TV integration for health services. One other thing, can we please make 2012 the year that people stop calling everything "game-changing?"

iHealth Lab announces its iHealth Smart Glucometer. It connects to the dock of Apple mobile devices and automatically sends readings to iHealth’s portal. The device is still awaiting FDA approval. The press release says the system uses industry standard test strips, but it would be sort of crazy to make a glucometer and not make money by selling your own test strips.


Fitbit, the maker of the popular connected pedometer, introduces its Aria Wi-Fi Smart Scale. The scale, much like the Withings scale, tracks your weight, but instead of sharing it with third parties, it sends it up to the Fitbit portal, where users can now automatically track activity, sleep, and weight. The scale can recognize up to eight people, so it can be enjoyed by the whole family. Fitbit is becoming quite the force in the quantified self movement.



Not to be outdone, Withings announces its Smart Baby Scale. The scale does just what you’d expect — weighs your child and automatically shares the results with Facebook friends or remains private through the Withings smart phone app. I think parents are supposed to buy this to help them track their child’s weight and automatically plot it on a growth chart. I’m really struggling with this one. It seems incredibly dumb and a waste of money but maybe there are enough high-strung parents out there to sell a few of these. Who owns a regular baby scale, anyway? I’m much more excited about the Withings Smart Baby Monitor, but haven’t seen any news about that. By the way, the video above is priceless, as the guy demoing the scale manhandles the doll and then the app malfunctions and he says "it’s quite slow" and "it froze."

A new retrospective study in the Archives of Dermatology finds that live teledermatology consultations resulted in clinical improvement almost 70% of the time. I don’t have access to the full text, but based on the abstract, it looks like the telederm outcomes were only compared to the the outcomes without telederm, or from treatment by the referring physician. Am I missing something, or is this just to put some data behind the claim that telederm works as a viable treatment option?


I found this story on recent smart phone sales interesting. It’s pretty impressive how Apple is trending up and closing the gap on Android, with the biggest loser being RIM’s BlackBerry. According to the report, iPhones accounted for 37% of smart phone sales over the last three months.

Despite the chart above — which shows the poor performance of Windows Phone — this story highlights reasons to not write off Microsoft as a mobile platform vendor. The reasons: ease of app development, UI, global reach, and hardware. I think Microsoft is beaten like Apple was beaten in the mid-1990s and it’s going to take a very impressive turnaround to claim mobile territory. Maybe it can leverage its global reach with Nokia to win in emerging markets, but I think real growth in the US is not going to happen.


Healthcare mobile app store Happtique announces that it will be creating a certification program for mobile health apps for providers and patients. Developers will pay to submit apps to be certified. It is estimated that it will take six months to develop the certification program. This is an inevitable course for Happtique. What I’m most curious about is how transparent the certification criteria and process will be.

RunKeeper’s CEO talks about the head start his company has to be the platform for integration of personal health data. I personally think RunKeeper should focus on fitness, but since it just raised a large amount of capital, this is a guaranteed extension. The problem is that the two markets, fitness and health, are vastly different in terms of user motivations, effort to acquire users, and customer channels.

Physicians Interactive Holdings (PIH), a division of Skyscape, raises $17 million from Merck’s Global Health Innovation Fund. PIH provides tools, many of them mobile, for physician education and reference. PIH also recently announced a mobile health advertising platform for vendors of mobile apps. It’s an interesting investment to me. I realize Skyscape generates revenue from pharma and so do many others, but now pharma owns part of the company that develops products to help clinicians with treatment decisions at the point of care. This seems like a huge conflict of interest. If medical schools are going to ban pharma companies from academic medical centers — something that’s been a trend in academic medicine that has severely limited lunch options on medical campuses –then medical schools should stop licensing products for faculty, residents, and students that are developed or owned by pharma.


The Lancet, which is the UK rival of JAMA and NEJM, releases an iPad app to provide subscribers access to articles on the go. It allows readers to annotate and share articles. This is an awesome way to stay current if you’re a Lancet subscriber.

Congrats to HIStalk Mobile sponsor Kony for being selected mobile platform vendor for Independence Blue Cross (IBC) of Pennsylvania. Kony has had a lot of success in the payer space and I think we’ll likely see more announcements like this in the coming months.

Nuance announces the 2012 Mobile Clinician Voice Challenge. Nuance is looking for mobile and web developers to integrate speech into their apps. The winners get good press and free licenses for Nuance’s speech platform for 12 months.


This story claims the Telcare connected glucose monitor, which is a dedicated glucometer device with a wireless card in it, is going to officially launch this week. I was told by Telcare at the mHealth Summit that the device would be comparable in price to other glucometers, but users would have to buy Telcare test strips. Also in the news, Telcare reached the semifinals of the CES Last Gadget Standing Competition.

This was an interesting study assessing ICU nurse perceptions of tele-ICU. The most important findings were that 79% of nurses thought knowing the telemed physician was important and that 61% were more likely to contact the telemed physician if they knew them personally. That bias seems like it could impact care.

Harvard Business Review has an good story on why patients aren’t typical consumers. It comes down to what consumers/patients are able to process and what decisions we should expect of them, regardless of the amount of "big data" available to them. The example of a good application from the story is one from Mayo that helps maximize the value of a meeting between patient and provider. I think we’ll see more of this type of application in 2012.


Despite having a smaller market share of the total smart phone market in the US compared to Android, iPhones accounts for 25% of mobile web traffic while Android only accounts for ~15%. This intuitively makes sense, as the average iPhone user is a heavier mobile data user than the average Android user. The iPad, interestingly, has about the same amount of mobile traffic as the iPhone.

This is a story on passive monitoring and specifically Ginger.io, the Android-based service that monitors mobile phone use and activity to identify trends and habits. Ginger is conducting its first trial with Cincinnati Children’s and teens suffering from inflammatory bowel syndrome.

This amusing story was written by a medical student about startups selling products to physicians. I think all of the points are valid.


The above infographic depicts the similarities and differences between iOS and Android. It’s not a bad basic, high-level synopsis. The best is the quote at the end from Symantec: "Even though iOS and Android both have their weaknesses, the mobile platforms are still more secure than their PC counterparts." The real problem stems from the fact that more people are trying to bring their own Android or iOS devices to work than their own PCs.


Travis Good is an MD/MBA involved with HIT startups. More about.me.

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