Medify

Medify claim to be a better way for patients to discover medical research, using an interactive layer over data from clinical trials and making the result interactive and approachable. Medify claim to enable the average consumer to make sense of big data in health, but I wonder how robust the dataset is and how they compare datasets from different trials and avoid data bias. Medify could be seen as a competitor to Medline Plus (http://www.nlm.nih.gov/medlineplus), which already has great consumer search outputs. Medify provides an added social layer to the data that Medline Plus doesn’t have by integration of Facebook, which is interesting, but may amplify the issues with data.

Jiff

Jiff claims to be the “Facebook of Health”, but reminds me more of the “Google+ of health” with its “Circle of Health”. This is essentially a private social network for health and medicine and is currently in private beta. Jiff claim to be addressing the future of health collaboration, but it will fail or succeed on adoption by healthcare professionals and there is little evidence it will be of value to them. The question that springs to mind is why wouldn’t I just use Facebook or Google+ to connect with my family about my health? Personally, I just don’t understand Jiff’s value proposition. That being said, Jiff is HIPAA-compliant (see http://www.hhs.gov/ocr/privacy/) and was a finalist at TechCrunch Disrupt, so does have some backing.

CellScope

CellScope make smartphone attachments for home use. The attachments produce high-quality images for physicians to use for remote diagnosis of ear infections and skin problems. This is a nice solution to avoid the need to take a child to see a physician. More and more we are seeing attachments to smartphones that make them viable as diagnostic instruments. The company claims that the costs of the attachments are “very low” and the trade-off between the cost of the attachment and the need to make a physician appointment means that this is a very viable option.

Bodimojo

BodiMojo claims to be a healthy social network for teen girls to promote healthy choices. They want to build a ‘tribe’ for young girls and promote positive body image through social story and rewards. I think BodiMojo will be successful only if they can get the incentive right for their target demographic and I wonder if an education or advice component would add greater value. One main query would be the approach of a complete platform – why not build out an app within Facebook?

Ginger.io

Another “Big Data” start-up that has been getting quite a bit of traction. Ginger.io provides a mobile app for patients to track their health – much like a patient diary. In addition, they can converse with physicians through the app and end alerts to their care team. On the physician side, the platform claims to allow “effortless” monitoring of the patient and identification of high-risk patients. In addition, Ginger.io has a dashboard for researchers that collate data both from patient-reported outcomes and “passive” data from mobile sensors. It’s quite a compelling offer and they are clear that the patient owns their own data and that all shared data is aggregated and anonymised.

Simplee

Simplee is a way to manage your health bills and save money (if you are US-based). For me, it seems to be a Mint (www.mint.com) for medical finance. Simplee tracks healthcare expenses and suggest possible health plans to suit patients. I don’t really have much knowledge of this area, so can’t really comment further.

Image courtesy boostmobile, Flickr creative commons

Yesterday, the UK Health Secretary Andrew Lansley opined:

“So many people use apps every day to keep up with their friends, with the news, find out when the next bus will turn up or which train to catch. I want to make using apps to track blood pressure, to find the nearest source of support when you need it and to get practical help in staying healthy the norm.”

“Information about your health is a service – just like the GP surgeries, Walk-in Centres and hospitals that millions of people access every week. With more information at their fingertips, patients can truly be in the driving seat.”

“Innovation and technology can revolutionise the health service, and we are looking at how the NHS can use these apps for the benefit of patients, including how GPs could offer them for free.”

It’s nice to see the government acknowledging the ubiquity of mHealth, and a nice move to encourage both the technorati, health firms, startups and Pharma to start producing good quality, helpful native (and mobile web) apps to benefit patients. I expect we have a way to go before the high-quality information becomes the norm, but I applaud the health secretary for his stance.

Source: http://www.dh.gov.uk/health/2012/02/apps/

One huge barrier to use and efficiency is the need for automation of records and the ability for patients to access, and contribute to, their own health records electronically. A large part of this, aside from the technological hurdles, is the security aspect: there is a need to ensure privacy of patient data and a duty of care to avoid any lapse in security.

It is well known that in the banking and financial services industry, transactions over the web and through electronic means are at risk of the same security and privacy invasion, and so measure have been taken by commerce and institutions to combat these. In online credit card transactions, measures taken include addition of the CSV number to ensure the person using the card has the card in their possession. By the same token, some institutions require a unique code for each transaction or login using a ‘dongle’ (or ‘fob’ code generator) that uses a seed code form the institution and an algorithm to determine a code generated at a specific date/time which the institution’s website would recognise when entered within a short timeframe. This kind of security has been in effect for several years, but now has been incorporated into a credit card (Currently only available in South Korea) to replace the inherently more less secure CSV.

We should consider the advances made here in the financial services industry and relate that back to how to grant patients access to their own health records in a secure manner.

The announcement

So what’s next? Companies are starting to manufacture connected devices that can communicate our health status automatically. I recently saw a demo of bathroom scales that tweeted the user’s weight every day, and a blood pressure cuff that connected to iPhone and transmitted a daily reading over the internet. Of course, we can debate whether people want others to know if they have grown ‘vacation handles’ (or if they trust companies like Microsoft with their personal health information), but this at least illustrates that we need to consider the interfaces and devices with which we share information, and understand that it’s not just our fingers that do the talking when it comes to health status updates.

Naming no names, at least two of the clients I work with are stuck on IE6, a browser that was launched in 2001. That’s 10 years old! These companies contribute the 11.4% of people globally who are currently still using the browser. There are many reasons to upgrade from IE6, not least the added speed, addition of tabbed browsing and privacy features, but the single most important reason for upgrading is to fend against the security flaws that are present in that browser.

When working on web applications that are for internal use with our clients, we always have to ensure backwards compatibility with IE6, which is becoming increasingly challenging in terms of the amount of coding and testing we need to do. In fact, a number of high-profile websites no longer support IE6, including some Google services. The latest web service to drop support for IE6 is wordpress.com, where this blog is hosted. This is an issue for me at the moment, as it means I am losing readers, but I think anything that encourages companies to speed up their upgrade procedures is a good thing.

To those who no longer are forced to use IE6, welcome to teenhood from the noughties!

#HCSM (US)
#HCSMCA (Canada)
#HCSMEU (Europe)
#HCSMLA (Latin America)
#HCSMAsia (Asia)
#HCSMANZ (Australia & New Zealand)
#HCSMEUFR (France)
#HCSMES (Spain)
#HCSMUK (UK)

Look forward to chatting with you at #HCSMEU (@hcsmeu). We meet on Twitter at 1pm CET every Friday. Just search for #HCSMEU.

At the event, I attended a number of panels and I would like to share my notes on some of the panels here. So, I want to talk about a solo piece from
Aza Raskin (@azaaza), founder of the startup Massive Health, who talked about how consideration of feedback loops can help change patient behaviour with regards to lifestyle choices and disease self-management.

Feedback loops
Raskin maintains that the secret to changing behaviour is to examine and change these feedback loops associated with health behaviour. For example, a morbidly obese person is likely to be very aware that their condition will have a serious negative impact on their health, and so dieting and exercise to reduce weight/BMI/waist circumference is very important to avoid stroke or myocardial infarction or all the diseases that obesity is a risk factor for. However, we all know that dieting and exercise are very difficult to start and even more difficult to maintain on a long-term basis.

Cake
He uses cake as a good example of a feedback loop in action:
A person sees one piece of cake and knows that they shouldn’t eat it, however if they do eat it, there is no immediate consequence (possibly other than guilt or sticky fingers). This demonstrates that people do not consider the cumulative negative effect on health that the cake contributes to, and therefore this cake is part of a long-term feedback loop with consequences way off in the future. The same with cigarettes – smokers know that a cigarette will essentially shorten their life, but those consequences are at the end of the life, not at that moment.

So, it is clear that long feedback loops do not encourage ‘good’ behaviour and, therefore, there is a need to find a way to make it easier for people to adhere to good behaviours for the duration of that feedback loop, either by creating shorter feedback loops (giving often or instant feedback to people on how well they are doing) and/or rewarding people for modifying their behaviour.

Marshmallows
To illustrate the idea of rewards for behaviour modification, Raskin described an experiment where young children were presented with a marshmallow. The children were told that they could eat the marshmallow now, however if they waited without eating the marshmallow, they would get a second marshmallow on the researcher’s return (thus the promise of two marshmallows – an exciting prospect for a 4-year-old!). Although the original study was investigating the effect of age on the development of delayed gratification, the point Raskin was making was that the children who waited rather than eating their marshmallow modified their behaviour in order to gain a benefit/reward.

Amusing video of something similar that Raskin showed:

Oh, The Temptation from Steve V on Vimeo.

I think this gives food for thought (possibly not marshmallows), as if we can apply this rhetorical theory into the programmes that we produce and find a way to make it work, this could have a great positive impact on patients lives.

Whether this is for clearing stock of the iPad or a more permanent offering remains to be seen. However, this does support my predictions that the Motorola Xoom will not be considered over the iPad, or even the iPad 2 in a pharma salesforce or hospital environment.