mHealth in a mWorld

Mobile technologies are one of the fastest growing markets in the world. The latest and greatest in mobile technology was displayed last February at Barcelona’s Mobile World Congress. Healthcare, education, urban planning and other sectors can greatly benefit from mobile technology and a recent report out from the GSMA and PricewaterhouseCoopers gives a snapshot of how mobile technology could save money, increase opportunities and enhance health and safety in the coming years.

According to it, in Sub-Saharan Africa, one million lives could be saved over the next five years with mobile health initiatives that help patients stick to their treatment plans and access information, as well as aid workers in monitoring the availability of medication and follow treatment guidelines. For example the Mobile Alliance for Maternal Action enables health care workers and pregnant women to share health information via SMS in South Africa helps HIV patients and healthcare workers comply with Antiretroviral Therapy programs, cutting missed appointment rates from 27% to 4%.

In developed countries, mobile health or mHealth could also lead to positive outcomes. In 2017, it could cut health care costs by more than $400 billion in four ways:

As telemedicine grows mobile-based services could become more common in helping with immediate care. The GSMA-PwC report estimates that mobile-based care for patients with sudden health incidents could reduce primary and emergency care visits by 10%. Already, companies like Sherpaa and Ringadoc let patients reach physicians 24/7 by phone, text or email.

In non-emergency situations, mobile technology could also play a role in helping doctors keep tabs on elderly or recently discharged patients remotely. With Sotera Wireless, for example, physicians can monitor patients’ blood pressure, heart rate and other indicators through a flip-phone-sized device worn on a patient’s wrist. GSMA-PwC’s report estimates that remote monitoring technology could lead to elderly care savings of up to 25% and improve patients’ quality of life.

As more hospitals use the electronic medical records (EMR), patient information will increasingly be captured and accessed from mobile devices. PatientSafe, for example, lets doctors and nurses log patient data and manage other workflow tasks from an iPod Touch. Mobile access to EMRs could lower the administrative burden on hospitals by 20 to 30% the report says.

Finally, the old SMS could also play a major role in saving money and improving patient care. Appointment reminder services, like that offered by Kaiser Permanente, have been shown to reduce costs and boost patient attendance. Companies like AllazoHealth and AdhereTech use SMS to remind patients to take their medication after sensors or algorithms note when a patient hasn’t taken medication or is likely to skip it.

There is a mobile healthcare revolution taking place around the world. A number of organizations and mobile technology industries are now sponsoring projects to explore new mHealth, applications.

If you are an entrepreneur already developing (or expect to develop) a mHealth app and intend to sell it in the US market you should have a look to the report FDA 101: A Digital Guide to the FDA for Digital Health Entrepreneurs. Released on March 25 by the digital health accelerator Rock Health, the report helps digital innovators to navigate the Food and Drug Agency’s regulations and premarket requirements around medical devices. It also explains when a mobile health app would be classified as a medical device by the FDA and would require a clearance.

According to the FDA 101 report, mobile health apps will be considered medical devices if they serve as implants, implements, instruments or in vitro reagents used in the diagnosis of a disease, or in the cure, mitigation, treatment or prevention of a disease or serve as an accessory in one of those functions.

The report also recommends entrepreneurs to hire an advisor to make their company’s methods more appropriate and fitted to FDA’s guidelines. Finally, it includes quotes of digital health entrepreneurs that have successfully navigated the process offering pointers and best practices to startups.

The mobile health space is booming thanks to an unstoppable flow of money into it. In 2013 first quarter 37 deals valued at $365M have been signed. That is 35% higher than the same period of last year, showing that 2013 will be another record year for the digital health industry.

Lessons Learned:

  • Over the past few years mHealth has transitioned from novel startups to a global industry.
  • Among the many factors that are affecting the transformation of the health industry, the growing ubiquity of cell phones, smartphones and mobile devices is at the top.
  • Technology is bringing change to every piece of the health industry: wellness, fitness, healthcare and medicine.
  • Many entrepreneurs and startups are seeing the opportunity in mobile health technologies and want to get in on the game, but many are not aware of how to develop their apps, devices or services so that they are in line with the FDA’s regulations. A recent report from Rock Health startup incubator provides them the guidelines to succeed.

The robot will see you now

Technology is about to revolutionize healthcare. How far will automation go? Will doctors still be necessary? This is what Jonathan Cohn analyzes in a feature at the March issue of The Atlantic.

Medical records are at the core of the health system. Over the last two decades -Cohn writes- there has been a long-lasting effort to store patients’ health data electronically. Although currently there are more than 400 vendors offering these records, the process continues to be frustratingly slow. So slow that, often, doctors still have to print, fax, and scan medical records when transferring them to another institution. To establish a common language so that all already existing electronic medical records can “speak” to one another remains a pending task.

If something as simple as to put electronically health information it is being so time-consuming, thinking of an intelligent robot diagnosing a disease may seem and idea exclusive of science-fiction movies. But the article states how a supercomputer called Watson could help to make it a reality sooner than later.

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IBM’s Watson computer became famous in 2011, when it beat two previous human champions on Jeopardy American TV quiz show. But IBM didn’t build Watson to win game shows. The company is developing the machine to help professionals with complex decision-making and reduce errors, for example, to point out clinical nuances that health professionals might miss on their own and get more accurate diagnosis and treatments for illnesses. This is not small thing. As The Atlantic’s piece exposes, “nearly 80% of all information in medicine consists of unstructured physician notes dictated into medical records, long-winded sentences published in academic journals, and raw numbers stored online by public-health departments”.

IBM’s Watson can digest up to 60 million pages of text per second and make suggestions much more quickly than any human. The machine is now learning to make diagnoses and treatment recommendations reading case histories at Memorial Sloan-Kettering Cancer Center in New York. Watson became a better at Jeopardy over time, the longer it played. Once completed its current task, Watson could continue learning to figure out medical problems sitting in on patient examinations and silently listening.

Marty Kohn, an emergency-room physician and IBM’s team leader training Watson, said last January at a meeting at the University of Utah that Watson could be “a game-changer” in fields such as oncology and primary care, where errors can be common. Kohn explained that about one-third of these errors appear to be products of misdiagnosis, one cause of which is humans’ tendency to rely too heavily on a single piece of information. “This happens all the time in doctors’ offices, clinics, and emergency rooms. A physician hears about two or three symptoms, seizes on a diagnosis consistent with those, and subconsciously discounts evidence that points to something else,” Cohn writes in The Atlantic.

If, one day, diagnostic aids such as Watson may “become as ubiquitous in doctors’ offices as the stethoscope,” only time will tell. Meantime, if you want to learn how IBM engineers and Memorial Sloan Kettering physicians are training Watson to personalize cancer care don’t miss this article and this video.

Lessons Learned:

  • New technology has the potential to have a big impact on the health care industry solving some of its greatest problems.
  • The quest to improve patient care, maximize medical efficiency and cut costs in health care industry has gained a powerful new ally: Watson, IBM’s revolutionary data-mining supercomputer.
  • Watson is being trained to improve cancer treatment. Physicians will take advantage of its information digestion capability and technology to automate claims processes to reduce misdiagnosis and select the most appropriate treatments for each patient.

Design Thinking, the innovation’s engine

When Thomas Edison invented the electric light-bulb, he didn’t know he was creating, also, an entire industry around it. He just envisioned how people would want to use what he made and he engineered toward that insight.

Edison’s approach is an early example of what is now called “design thinking”, a methodology that has become business innovation process’ fuel and engine. As Tim Brown (@tceb62), CEO of the design consultancy IDEO wrote in an article at Harvard Business Review in 2008, “design thinking can be described as a discipline that uses the designer’s sensibility and methods to match people’s needs with what is technologically feasible and what a viable business strategy can convert into customer value and market opportunity.

Design sensibilities include empathy, creativity, a human-centered focus and deep curiosity about the world while design methods consist of observational techniques, visualization, prototyping, sketching, storytelling, brainstorming, and so on.

Historically, design has been treated as a downstream step in the innovation process. Designers just come to put a beautiful wrapper around the idea. Now, companies are asking them to create ideas that better meet consumers’ needs and desires. Any industry can benefit by employing design thinking and achieve better results, including healthcare.

Recently, the US federal government took the Department of Veterans Affairs’ current health record system, which looks and feels like a receipt, and challenged designers to reimagine a new electronic medical record output to describe a patient’s health history. The challenge received over 230 submissions. The winner, will hopefully, replace the actual format.

Design thinking process applied to innovation consists of four key stages.

Define the problem: Sounds simple but doing it right it is perhaps the most important of all. In design thinking observation takes center stage and requires cross-functional insight into each problem by varied perspectives.

Create and consider many options: Design thinking requires that no matter how obvious the solution may seem, many solutions be created for consideration. And created in a way that allows them to be judged equally as possible answers. Looking at a problem from more than one perspective always yields richer results.

Refine selected directions: Even the strongest of new ideas can be fragile in their infancy. Design thinking allows their potential to be realized by creating an environment conducive to growth and experimentation.

Pick the winner, execute: At this stage prototypes of solutions are created and testing becomes more critical and intense. At the end the problem is solved and the opportunity is fully uncovered.

“Design Thinking starts with a need and ends with an idea for a product or service” – Paul Yock (Founder of Stanford Biodesign Program).

 

At Design Health Barcelonawe will apply design thinking to deliver change within healthcare. To design clinical experiences that meet patients’ needs, different teams of fellows will immerse for eleven weeks at three clinical settings in Barcelona, Sant Joan de Deu Hospital, Clínic Hospital and Guttmann Institute. They will identify dozens, even hundreds, of unmet needs, understand them and select the most promising ones to, finally, get the winner idea. In the following months, and until the program finishes, they will mature and evolve them until they are ready for the patient.

If you want to know more about design thinking we recommend you to watch this video to learn how to think like an artist or Design & Thinking the movie (here is the trailer) and then share your comments with us! Do you think that design thinking has the potential to change our lives?

Lessons Learned:

  • Thinking like a designer can transform the way organizations develop products, services, processes, and strategy.
  • Design thinking is an approach to solve problems understanding consumers’ needs and developing insights to solve those needs.
  • Design thinking relies on our ability to be intuitive, to recognize patterns, to construct ideas that are emotionally meaningful as well as functional and to express ourselves through means beyond words or symbols.
  • Design thinking brings together what is desirable from a human point of view with what is technologically feasible and economically viable.
  • Design thinking is as much a mindset as a process.
  • Design thinking is a system of three overlapped spaces: inspiration, ideation, and implementation.
  • Only through contact, observation and empathy with end-users you can design solutions that fit into their environment.