Wearable computing?

Originally published on http://www.MedicalSmartphones.com

Right now, many people use smartphones. Soon, most people will be using smartphones. Many people walk around with a Bluetooth headset in their ear. So, we're already talking about wearable gadgets and computers. Some manufacturers have designed Bluetooth headsets to be fashionable pieces of high-class jewelry.

The future of wearable computing include self-tracking gadgets like the Fitbit and the Nike+ FuelBand. Those types of gadgets may be reserved for fitness geeks or people actively trying to achieve and sustain weight loss. However, other types of wearable computers will become standard issue for business executives and health care professionals.

Let's start with the smart watch. In the near future, we'll also see many people wearing smart watches that connect to our smartphones using low-energy Bluetooth. We know that Samsung is planning on releasing a smartwatch soon. Rumors of an Apple smartwatch will eventually come true. There are many smartwatches on the market and they don't resemble the clunky gadget that Dick Tracy used to wear.

How will smartphones evolve once the smart watch phenomenon takes off? Will we see smartphones getting smaller? Bigger? Willl everyone want a phablet so that they can be more productive by having a larger screen? Will the smart watch replace the smartphone entirely?

I think that could happen as we all wear more gadgets and computers on our body. For instance, why would you need to wear a smart watch and carry a smartphone if you also wore smart glasses? Google Glass is a new technology, but we'll see other manufacturers release similar smart glasses.

So, imagine that your smart watch is your phone. It has cellular connectivity. You don't need a Bluetooth headset since audio is built into your smart glasses.


Voice command and voice dictation. Plus, your hand/arm gestures will get sensed by the built-in accelerometer in your smart watch and get translated into commands. The days of typing on an on-screen keyboard may be over soon. It's time to practice your speaking skills so that you can dictate voice commands precisely. Voice recognition engines are getting much more sophisticated to recognize certain accents or speaking patters.

Wearable computers. Body computing. These terms are about to have new meaning. These technologies will become a part of everyday life. Plus, they will be highly effective in promoting behavior change, in coaching healthy behavior, and in assisting with disease self-management. The possibilities are endless.

Are you ready for wearable computing?

Will physicians "prescribe" medical apps for patients?

Author: Thuc Huynh, MD

Medical apps are a hot topic these days.  In 2009, medical apps were estimated to be worth $41 million dollars and in just one short year, 2010 showed revenues of $84.1 million dollars.

With this medical technology space booming, many companies are making bold statements that physicians, pharmaceuticals, and hospitals will be the future medical app dispensers for all patients.

But should we let this happen?

Imagine how practicing physicians do it now for medications.  If you're like most doctors, you have certain drugs you like to use for condition X, Y, and Z.  Even though there are many different drugs to treat it.  If one drug doesn't work, we prescribe a different drug until something does.

Developing a successful mHealth app – insights into a pharmaceutical company

Here are some snippets from a recent blog post on research2guidance titled, "What does it take to develop a successful mHealth app – insights into a pharmaceutical company." 

[This guest post was written by Alexander Romantschuk, Innovations Leader, Lilly Germany, Alexander studied molecular and surface physics at the University of Bielefeld, Germany. Since November 2005 he has held the position of European Medical Innovations Leader at Eli Lilly. Here he was responsible for numerous prototypes for internal medical clients. Since mid-2009 his team has been working on mobile devices and mobile applications. He is sharing his experience of the development of mHealth apps in a regulated health care environment. ]

Mobile app development – a field report from a pharmaceutical company
The pharmaceutical industry is highly regulated. The main reason for these regulations is to protect the consumer; patients who need to take drugs. Buzzwords like GxP, CRF Part 11, Data Privacy, Compliance, Regulatory and IT Validation are used regularly if an IT application is developed. From an IT process point of view there is no reason to distinguish between the developments of a normal web application or an application for a mobile device but in reality people’s minds make a big difference. Smartphones, mobile broadband and availability are still ‘new’ and especially for the conservative pharmaceutical industry it isn’t that easy to adopt these new concepts.

Legal, compliance and regulatory approvals
What about legal, compliance and regulatory approvals? As mentioned above the pharmaceutical industry is highly regulated. To answer questions around promotional material, copyright, contracts, disclaimer, data privacy, compliance to laws and regulations you need to get in contact with your legal and compliance department to gain approvals. In the end we have all the necessary approvals to go ahead. An important point for an international company is the understanding of different laws and regulations in different countries. If you desire to replicate an existing regulated app from Germany to Spain for instance, you need to contact your local Compliance, Legal and Regulatory department to answer the same question again based on local laws. That is a cumbersome and time consuming process.

Strong Adoption of Electronic Health Records, Other Digital Technologies Among Physicians

You may have read this last week:

Survey of Nearly 11,000 Doctors Shows Strong Adoption of Electronic Health Records, Other Digital Technologies

NEW YORK, July 7 /PRNewswire/ -- A new survey by Knowledge Networks using the Physicians Consulting Network (PCN®) – its panel of specialists and other health care professionals – shows how digital technology and other factors are transforming doctors' attitudes and habits. Compared to two years ago, primary care physicians (PCPs) and specialist doctors alike have dramatically increased their use of electronic health records (EHRs), and they are expecting to spend less time with sales reps in the coming six months.

Here's an interesting table that compares PCPs vs. specialists:

Table 1. PCPs, specialists seeking convenience, control
	PCPs		Specialists
	2010	2008	2010	2008
Using electronic records	50%	38%	52%	42%
Expect to decrease sales rep time	14%	9%	12%	8%
Own smartphone	55%	--	62%	--
Use smartphone for e-detailing*	17%	--	18%	--
Use smartphone for surveys*	29%	--	24%	--
* Among smartphone owners

I think it's fair to say that by 2015, we'll see much higher adoption rates among physicians using electronic health records, smartphones, and other forms of digital technology.

You can read the full press release here.

Testing Epocrates on the Droid

This is being republished from MedicalSmartphones.com

I've been testing Epocrates Rx (beta) on the Motorola Droid (running the Google Android OS) and my initial impressions are very positive. The Droid is a powerful smartphone running a super-fast 1 GHz Snapdragon processor, so the device is much faster than most smartphones, including the HTC Touch Pro2 or the iPhone 3GS. When you're browsing the web, content-heavy pages load very quickly. Google Maps with the spoken "turn-by-turn" navigation is also a great feature found on the Motorola Droid.

You can expect to see several future blog posts here on MedicalSmartphones.com as I test Epocrates on the Droid. As I test the software on Android, I'll blog about what I discover.

Today, I noticed that when I tap certain buttons, I'm not always getting the visual feedback that tells me that I touched an on-screen button. Normally, you'd see buttons change colors or change appearances when you touch it. This is a minor bug. Given that the software is still beta, this is not a big deal and I'm sure they'll fix those minor bugs when they release the final version.

I'm on ReachMD talking about smartphones

This is being republished from MedicalSmartphones.com

I'm on ReachMD talking about smartphones this week. As more physicians choose to use smartphones, they need to make choices about operating systems and functionality. You can listen to my commentary here and be sure to vote in the poll: http://www.reachmd.com/xmsegment.aspx?sid=5337

According to a recent Manhattan Research report, 80% of physicians will be using smartphones by the year 2013. Are you currently using a smartphone, or are you using an older device like a Palm Pilot? If you’ve never used a smartphone, get ready to have the power of the Internet right in your hand. You can check your e-mail anywhere you go, access automatically updated databases, and stay current with the latest medical news. By leveraging this type of digital information, you can use this powerful device right at the point of care. Plus, if you’re currently using an electronic health record, you may even have access to that EHR right from your phone. Now if we stop to look at a few specific smartphones, we’ll see that the Apple iPhone is very popular among physicians. However, this device lack a physical keyboard and some users have complained about the difficulty of using the on-screen keyboard. So, if you’re looking for a device that has a physical keyboard, consider the Motorola Droid running Google’s Android operating system or the Palm Pre running the new Palm webOS. Microsoft is also coming out with a brand new system called Windows Phone 7 Series. BlackBerry is rumored to be releasing a device that finally includes both a touch screen plus a physical keyboard, so you can have the best of both worlds. Be sure to vote in this week’s poll about smartphones: what feature is most important when you’re selecting a smartphone?

http://www.reachmd.com/xmsegment.aspx?sid=5337

Increasing smartphone use among U.S. physicians

This is being republished from http://www.medicalsmartphones.com/

How many doctors are currently using smartphones? Here are some snippets from a recent story on Medical Marketing and Media:

• About 80% of all US physicians will be using smart phones by 2012, and not just for drug reference or clinical information... according to Manhattan Research survey.
• An explosion of new healthcare professional-facing apps - over 1,500 in Apple's app store alone - will expand mobile device usage to include patient care and administrative functions, according to Manhattan Research survey.
• A recent SDI survey found that iPhones were used most among docs using smart phones to access medical information.
• "Handheld devices are becoming more and more useful to physicians, partly because of the boom in physician-oriented apps and portable content," said Monique Levy, senior director of research at Manhattan Research.
• Creating smart phone apps for physicians makes a lot of sense, considering that docs have been using PDAs, with applications, for a long time, said  Jeannette Kocsis, SVP, digital marketing, at Harte-Hanks Direct. The mobile-optimized web is also important, said Kocsis, particularly because updates are managed by the website host, as opposed to a physician having to update an application.

Does your doctor use a PDA or smartphone?

This is being republished from MedicalSmartphones.com


I know it's hard to believe, but so many doctors are falling behind on the use of mobile technology. They're still using PDAs that are over 5 years old and they aren't using modern smartphones. I recently attended an educational meeting where over 300 physicians had gathered. Although many were using modern smartphones, quite a few still had PDAs running the original Palm OS or Pocket PC. I'm surprised the batteries on these devices still provide enough battery life on these devices that are over 5 years old.

My wife (a family physician in private practice) and I have both gone through a few different smartphones. Our old PDAs are in our personal museum collection. What type of PDA or smartphone does your doctor use?

Epocrates Rx for Android and webOS

This is being republished from: http://www.medicalsmartphones.com/

Have you tried Epocrates Rx on your Google Android or Palm webOS smartphone?  The software is currently beta and you won't get any updates, but it's stable and it runs well. You can view photos of pills, check for drug-drug interactions, and use important tables and calculators. 

I know that many physicians rely on Epocrates on a daily basis. Are you one of those users? I still remember when Epocrates launched its company in 1998 and when PDAs were starting to enter the medical industry. Those were simple days of grayscale Palm Pilots and AAA batteries. Now, we have a wide selection of powerful devices like the Motorola Droid and the Palm Pre.

My top 5 Android medical apps

If you're thinking switching to an Android smartphone, do you know which medical apps are currently available for Android? Make sure to read this:

Top 5 Android Medical Apps

Don't forget to follow my other popular site: http://www.MedicalSmartphones.com/ If you're using an Android smartphone, then you've probably discovered that the list of professional medical apps is relatively short compared to the iPhone, Windows Mobile, and even BlackBerry. This trend will change dramatically this year as more medical app developers and publishers release medical apps for Android. Here's my current list of "top 5Android medical apps" (this list will probably change in a few months):

1. Epocrates (currently in public beta, but soon to be released)
2. Skyscape Android Reader (plus, the entire list of books and references)
3. Unbound Medicine (plus, the entire list of books and references)
4. UpToDate (via mobile web browser)
5. QxMD (calculators and pregnancy wheel)

When it comes to specific books and references, I would suggest the following:

• 5-Minute Clinical Consult
• Davis's Drug Guide 
• Taber's Medical Dictionary
• Pocket Guide to Diagnostic Tests 

I realize that we're going to see many new medical apps arriving in the next few months, so stay tuned and make sure to follow this blog for the latest updates.

Have you tried QuantiaMD on your smartphone?

If you're a physician and you use a smartphone, have you tried QuantiaMD? Take a look at my recent review of this innovative medical app for Android, iPhone, or BlackBerry.

Review of the QuantiaMD smartphone app for Android

What am I supposed to do with my large PDR?

Like many U.S. physicians, I receive a free copy of the PDR (Physicians' Desk Reference). Who still uses this large book? I've been using the Internet or a PDA/smartphone for many years and I don't know what to do with these large books. They could be saving thousands of trees by saving these books and sending CDs or a pamphlet that includes a hyperlink and a special code.

Speaking of the PDR, the mobile version of the PDR called mobilePDR is coming back! It used to be available, then it disappeared, and now it's coming back. It will be available for a variety of smartphones including:
           
Apple iPhone; Windows Mobile; Palm OS; BlackBerry; Symbian; and Android

Do you still use a PDR?

PDR Network combines the Health Care Notification Network (HCNN) and the Physicians' Desk Reference (PDR) to provide prescribers with a complete, end-to-end service. The PDR is the leading provider of print and online pharmaceutical information to physicians, and the HCNN is the only FDA-compliant network that electronically delivers specialty-specific product safety notices to prescribers. Improving patient safety and reducing physician liability requires prompt, expert delivery of important patient-safety information: PDR Network (formerly Medem) is ideally suited to fulfill this need.

Discussions on Sermo about smartphones

In case you missed it: Smartphone discussions on Sermo

Another study looking at cell phones and brain cancer

I don't think we'll ever see the end of this debate. Do cell phones emit enough radiation to contribute to brain tumors and cancer? Specifically, people are concerned about glioblastoma. Mobile phone companies and carriers will probably do everything to convince the world that the answer is "no." Activist groups and cancer patients will do everything to convince the world the answer is "yes." Meanwhile, we as health care professionals will probably shrug our shoulders and say, "we really don't know."

The Interphone study overseen by the World Health Organization may be one of the largest studies evaluating the association between cell phone use and brain tumors. Here's a quote from The Daily Telegraph :

A preliminary breakdown of the results found a “significantly increased risk” of some brain tumours “related to use of mobile phones for a period of 10 years or more” in some studies.

Now, keep in mind that phones have evolved dramatically and that older analog phones emitted higher levels of compared to modern digital phones (although smartphones and high bandwidth data plans are a different story).

To get a preview of some of the results from this study, click here.

2009 Connected Health Symposium

I really miss Boston. I usually look for any type of excuse I can find to visit because Boston is definitely my favorite city. In a few days, we'll be seeing the 2009 Connected Health Symposium take place in Boston. I wish I could be there, but I've decided to limit my non-essential traveling this month because I just got back from a trip to Baltimore from the AMA - National Task Force on CME Provider/Industry Collaboration.


If you're interested in the latest discussions surrounding health IT, health care reform, and much more, then you should make an effort to attend.

Connected Health Symposium 2009
Up from Crisis: Overhauling Healthcare Information, Payment and Delivery in Extraordinary Times
October 21-22, 2009
Boston Park Plaza Hotel and Towers

Hosted by the Center for Connected Health at Partners HealthCare 

The Connected Health Symposium asks how information technology -- cell phones, computers, the Internet and other tools -- can help people manage chronic conditions, maintain health and wellness, and age with independence.

To learn more about this event, click here.

e-Learning in the world of medical education

So much continuing medical education (CME) now occurs via e-learning technologies. It's so convenient to view activities on your computer, your smartphone/PDA, or even to listen to audio programs on an MP3 player like an iPod. It's easier than ever to stay current on medical news, clinical updates, and much more thanks to computing technology.

How do you leverage e-learning technologies? It's hard to imagine how you could keep up with all the safety alerts, the FDA warnings, clinical breakthroughs, and other important medical news without modern technology. Have you tried listening to some educational podcasts on your iPod? How about live webcasts?

Reports from the ACCME  (Accreditation Council for Continuing Medical Education) have shown that the uptake of e-learning for CME continues to climb each year. Now that travel costs are so high, fewer physicians are traveling to major medical meetings. Instead, they are learning through their computers.

Smartphones and brain cancer

Here we go again. I don't think we'll ever see the end of this debate. Watch this video that discusses the radiation risks associated with the use of smartphones.

We must remember that smartphones are not like ordinary cell phones. They are capable of much more data transmission (which translates to higher levels of radiation). So, do these devices cause brain cancer?

More doctors spending time online

It's no surprise that doctors are spending more time online, right?

The results of a Manhattan Research white paper titled: “How Digital is Shaping the Future of Pharmaceutical Marketing,” reveal that in 2002, physicians spent an average of 2.5 hours per week on the Internet for professional reasons. Compare that to now, where the average physician spends 8 hrs per week on the Internet. They are researching medical information, completing CME activities, and reading medical news. I'm sure Sermo has also bumped those Internet hours. The same report indicates that 64% of physicians use smartphones (that number seems a bit high to me if you consider the wide spectrum of physician ages).

The biggest area of change as we look into the future is smartphones. As these devices become more powerful, physicians will use them to access the web more regularly. Mobile web browsers are now able to view complete web pages and you can simply zoom in and out to view content. Soon, the days of websites being formatted for small screens will be a thing of the past.

As more doctors rely on the Internet, we're also going to see growth in electronic pharmaceutical marketing. Instead of printed journal ads in the New England Journal of Medicine and JAMA, we'll simply see electronic banners on more websites (like this one). I think we're all getting accustomed to ignoring ads and simply tuning them out.

Epocrates on the BlackBerry Storm

Last month, I had the opportunity to use a BlackBerry Storm as my own smartphone. I installed several medical applications (apps) on it, but I was quickly disappointed by the fact that it only has 120 MB (not GB, but MB) of memory for apps. It has plenty of storage space (thanks to an 8 GB storage card), but I need space for applications, not for things like MP3 files and videos. I quickly filled up that 120 MB of space and that was one of the reasons why I ended up returning it to Verizon.

Of course, I installed Epocrates to see how it would run on the BlackBerry Storm. I was very impressed by the way it operated and I noticed that Epocrates was always running in the background, even after a reboot (which took over 5 minutes!). Epocrates was fast and responsive and I think it ran really well on the BlackBerry Storm. Unfortunately, you're currently limited to Epocrates Rx or Rx Pro. You can't get Epocrates Essentials for BlackBerry right now.

You can read about my initial impressions of the BlackBerry Storm here at MedicalSmartphones.com.

I returned the BlackBerry Storm to Verizon Wireless and I have no regrets. I'm back to Windows Mobile (now running 6.5) and I'm sure that the BlackBerry hardware and operating system will continue to improve over the next year. The Storm 2 is coming out this fall and the price on the current Storm is very low ($50). I really hope that the Storm 2 has much more space devoted to apps.

If you're a healthcare professional and you're using a BlackBerry Storm, you've probably loaded Epocrates. What else are you running on your BlackBerry?

To keep up with all my smartphone discussions, visit: http://www.medicalsmartphones.com

Twitter as a drug adverse effect reporting system?

If enough healthcare professionals end up using Twitter, could it become a drug adverse effect reporting system? Most healthcare professionals use e-mail. Most browse the web. Most have mobile phones or smartphones. What's the most effective way to reach them about a drug recall, a drug alert, or some other type of public health message?

In my opinion, such campaigns must use a multi-modal approach. Use Twitter, e-mail, SMS, calls, and even letters. However, we must also keep in mind that the most effective method is to use something that leverages a viral-type of spreading mechanism.

If you've never used Twitter, you may not know how people can "spread" your Tweet by re-tweeting (RT) to others. Twitter is instant. People are Tweeting on their laptop, smartphone, or even on a standard mobile phone. When your message is popular and it gets retweeted, it can potentially spread like a virus.

So, that's probably why the FDA, CDC, and several other public health organizations are leveraging the power of Twitter. @CDCemergency (Verified Account) already has almost 500,000 followers. @CDCflu has almost 10,000 followers. CNN's Sanjay Gupta (@SanjayGuptaCNN) currently has almost 400,000 followers. My suggestion to them is to follow more of their followers. This way, the Twitter follow limit won't hinder people from following them.