The last week has seen the announcement of numerous health innovation challenges hosted by a variety of public and private sponsors each offering very attractive awards for developers.

Many of the challenges profiled below were announced at the Care Innovations Summit hosted by the West Wireless Health Initiative, CMS and Health Policy in Washington DC to explore ideas for reducing the cost of providing health care in America.

Farzad Mostashari M.D., ScM, National Coordinator for HIT, announced at the Care Innovation Summit a second DHHS sponsored challenge focused on tackling the challenge of hospital re-admissions. The “Discharge Follow Up Care Transitions” challenge will be supported by the ONC’s “Investing in Innovation” (i2) program.  The goal is to schedule follow-up appointments and post-discharge testing for patients who leave the hospital to ensure safer and more effective transitions. The total prize will be $5,000 and will include a three day site visit to a pilot community. The deadline to submit for the challenge is April 30, 2012.

The first ONC-sponsored developer contest was the “Ensuring Safe Transitions” challenge which was won by Axial Exchange, who was awarded $25,000.

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The Alzheimer’s Challenge 2012, sponsored by Pfizer, seeks simple, cost-effective, consistent tools that could be easily used to assess memory, mood, thinking and activity level over time to help improve diagnosis and monitoring of people with Alzheimer’s disease. The challenge includes awards totaling $300,000, including $25,000 to five finalists and $175,000 to one winner. The deadline for submission is March 16, with five finalists chosen by April 16. The winner of the challenge will be announced at the end of June 2012.

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The AllScripts Million Hearts Initiative Clinical Decision Support Challenge offers a $50,000 prize to the person or group that creates a publicly available resource that accelerates the delivery of optimal care for the millions of patients in the United States with cardiovascular disease through clinical decision support functionality. At a minimum, the winning solution will include a publicly accessible website or service providing the following four features:

1. Unambiguous prose expressions of clinical guidelines that support each of the core components of the Million Hearts initiative: ABCS: Aspirin for people at risk, Blood pressure control, Cholesterol management and Smoking cessation
2. Available download of unambiguous prose expressions of EHR-based CDS interventions aligned with the clinical guidelines described in (1) above
3. Available download of logical, computable (XML) expressions of EHR-based CDS interventions aligned with the clinical guidelines described in (1) above
4. Available download of comprehensive value sets that provide coded values for each of the data elements referenced in the XML-based interventions described above.

The goal of the challenge is to make important elements of the winning solution available to the community and other EHR developers under an open source license to help support the goals of the Million Hearts Initiative.

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The Janssen Connected Care Challenge begins February 27, 2012 and is offering $250,000 in total awards for approaches that will improve the patient’s transition from hospital to home. The challenge is designed to spur innovation and drive action towards achieving better care and better health at lower cost through continuous improvement.

Members of the Janssen Healthcare Innovation team will provide the three finalists with $50,000 each, as well as mentorship and support to further advance commercial development of the best ideas. The three finalists will take part in a Demo Day to describe their solution before the judges and via a live webcast. The winner will be announced and awarded $100,000 on May 23, 2012.

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Sanofi-Aventis has announced the 2012 DataDesignDiabetes Challenge and they are asking for the input of the public to help design the competition. I covered the 2011 DataDesignDiabetes Challenge extensively and had a chance to interview Anmol Madan, co-founder of 2011 challenge winner Ginger.io at the mHealth Summit.

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The Robert H. Smith School of Business at the University of Maryland is launching the “Innovation 4 Healthcare Challenge” for students nationwide to develop solutions that radically improve healthcare outcomes by using information technology to improve patient engagement with health care providers. The challenge will be led by the Smith School’s Center for Health Information and Decision Systems (CHIDS) and will culminate in an April 20, 2012 final round of presentations. Teams of as many as five members will compete for a $20,000 first prize and a pair of $5,000 runner-up prizes. The contest is supported by the Office of the National Coordinator for Health Information Technology (ONC) and is sponsored by Johnson & Johnson Services, Inc.

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WIMM Labs, developer of the WIMM One wearable computing platform, is currently hosting a developer challenge for micro-apps focused on the health and fitness market.  All developers who submit a novel, sophisticated, stable app with a thoughtful UI will receive a free WIMM One device ($199 value) and the creators of the two best apps will receive $250 Amazon gift cards. The deadline for submitting a micro-app to the competition is February 5, 2012. A winning micro-app will above all else take a complicated problem and sophisticated features and make them seem simple, available at a glance.

The mobile phone of choice for US officials appears to be Google Android phones, according to a recent report in CNN.

The phones that will be dispersed to numerous federal agencies as well as government contractors. The smartphones are first being deployed for use by U.S. soldiers.

Later on, some federal agencies are expected to receive the phones in order for secure sending and receiving  of government cables while away from their offices.

The iMedicalApps team has previously reported on tablet devices being used by deployed medics in the field. We noted that deployable staff including medics, nurses and commanders use software to document and track patient care, digitally manage and inventory medical supplies and monitor health in the combat zone. This is the first time, though, that we have seen credible information that has picked one mobile platform over another for use by the federal government.

The government chose to work on the Android platform first because Google already allows people to mess freely with its base code. Angelos Stavrou, an information-security director at George Mason University who is working on the project noted that federal officials did meet with Apple, but were told they couldn’t have access to the core iOS code. Stavrou explains,

“Android was more cooperative in supporting some of the capabilities that we wanted to support in the operating system, whereas Apple was more averse. They’re shifting the strategy now.”

Since the federal government has a strong emphasis on security, it is having its own developers modify the core Android OS in order to control what data is sent over the internet from the operating system as well as from apps running on the phones. The amount of data that is sent over the internet by a typical user is more then the federal government would likely allow for their personnel. The reason is that this data can be tracked or hacked by people that would seek to harm the government and thus the OS would be a security risk if left unsecured. Stavrou concurs,

“The government is actually working pretty hard in getting this technology to most agencies. Security is everybody’s concern.”

Interestingly, as more and more companies, agencies and people begin to adopt Android smartphones, there may be a shift in which OS developers make apps for initially. This includes medical apps. While the iTunes store has a plethora of medical apps, some of which cannot be found on an Android device, this preference could easily shift if there becomes a critical mass of people who would seek out medical applications designed specifically for the Android platform.

An additional challenge the government developers have to overcome is how to encrypt voice calls. This project is being funded by the Defense Advanced Research Projects Agency, the group responsible for early development of GPS and even the Internet. They are housed under the umbrella of the Defense Department and are working with the National Security Agency (NSA). An NSA spokeswoman describes the goal of the project.

“The ultimate goal is to give war fighters, analysts and other intelligence professionals access to classified information on the go — boosting innovation in the field, efficiency and productivity.”

Source: CNN

Jing Li, a scientist working at NASA Ames (@nasaames), has been developing a smartphone peripheral, or lab on a chip, with 32 nanosensor bars that are capable of “smelling” just about anything. Seriously. Each sensor bar is composed of a different nano-structure material, and as a result each responds to different chemicals in different ways, enabling the chip to not only differentiate between different chemicals, but also to monitor their relative levels in real-time.

“I was looking for the opportunity to apply nanotechnology to the electronic nose to improve its chemical analysis performance, when I realized NASA Ames had an impressive national reputation for initiative and leadership in nanotechnology,” Li explained in a feature on the NASA Ames website.

NASA originally developed the chip for space applications, the first usage was monitoring for fuel leaks around launch vehicles. The device has been used on the International Space Station since 2008, monitoring air-quality and checking for formaldehyde in the air. The Department of Homeland Security is now funding the development of the chip for use by consumers, and the Department of Defense is funding use of the sensor to alert soldiers when there is a chemical threat.

The device is clearly designed to fit onto an iPhone, though, for legal reasons, NASA won’t confirm with which device it is meant to be used. The chip only draws 5 milliwatts, thus having minimal impact on battery life. It’s primarily being developed to monitor carbon monoxide as well as chlorine, ammonia, and methane in your home.

Medical applications for the device are numerous. It has been shown, for instance, that there is a direct correlation between the level of acetone in the breath and the level of sugar in the blood, so it could be used as a non-invasive blood glucose monitor. There is also a correlation between nitrous oxide and lung cancer, simply breathe on your phone and get an alert that you should see a specialists for more thorough tests.

We have written about similar lab on a chip sensor devices developed by the Human++ program at imec in Europe, which use an array of chemical sensors each of which is sensitive to many volatiles in their own specific way so that the combination of their responses results in an ‘odor footprint’.

Imagine a smartphone app that could tell you if you have bad breath before a big date. Something tells me that would be a very popular app and potentially a decent business opportunity.

(Hat Tip to Gizmodo)

The Merlin.net network is a remote monitoring system for patients with implantable cardiac devices. It is able to record a patient’s heart rhythms, device therapy and device performance which is automatically sent to a designated clinic or a hospital’s health record.

Created by St. Jude Medical, which is a manuafaturer of medical devices worldwide, the Merlin.net Patient Care Network (PCN)  has been upgraded to version 5.0 which comes with some important enhancements for those living in the UK.

Headquartered in St. Paul, Minnesota, St. Jude Medical has four major focus areas that include: cardiac rhythm management, atrial fibrillation, cardiovascular and neuromodulation. The Merlin.net network is an example of how St. Jude Medical adheres to its overall objectives.

One of the newest features of version 5.0 is the ability to create a connection from the Merlin.net PCN directly to the clinic or hospital’s electronic health record (EHR) system.  Called Auto EHRDirect Export, this new feature allows for automatically recording of relevant patient information and uses secure industry standards for the tranfer of the data. This means that the data is fully encrypted and thus cannot be viewed by unauthorized people.

While physicians are able to access patient information from the secure Merlin.net website, version 5.0, integrates a new feature called Mobile DirectAlerts which allows alerts to be sent  automatically to a physician’s mobile device when a patient has an alert-triggering event. This increases the speed at which a physician can access patient information even when the physician is out of the office. This allows for a faster response time to potential clinical issues.

Additionally, with the new Mobile DirectAlert feature, it is no longer necessary for a doctor to login to a computer to find and access patient records following an alert since the information can be accessed via a secure connection and a smartphone. The notifications are compatible with multiple mobile devices, including the iOS devices, Android phones as well as Blackberry.  No word on whether Windows Phones are supported.

Dr. Francis D Murgatroyd, Director of Cardiac Electrophysiology at King’s College Hospital in London concurs.

“This mobile device technology allows physicians like me to access relevant patient information in a quick, timely and secure manner. This can include contact details, alert triggers and electrocardiograms. This is a great example of how innovative thinking combined with existing telecommunications technology can help the physician stay close to the patient when this is most needed.”

Telehealth and remote monitoring technologies have the potential to improve the lives of many. It can reduce the amount of time patients have to physically see a doctor, reduce the number of emergency hospital admissions and even shorten the amount of days a patient has to stay in a hospital. Because of this, the upgraded Merlin.net network has the potential to impact many lives.

Paul Turner, vice president of UK, Ireland, Canada Middle East and South Africa for St. Jude Medical explains,

“We designed the Merlin.net PCN updates to make patient and device data as accessible and convenient as possible for physicians managing patients with complex cardiac conditions such as heart failure. Findings in the recent DH study indicate that more than three million people in the UK can benefit from telehealth. We are very pleased to play our part in offering our own remote care solution, and delivering our patient-benefitting technologies throughout the UK.”

Source: Press Release

Kaiser Permanente is one of the largest healthcare organizations in the United States, serving just around 9 million patients. It has also been a leader in healthcare innovation through initiatives like the Kaiser Permanente Information Technology’s Innovation & Advanced Technology Group and Laboratory for Innovation.

Kaiser has now released a mobile portal for patients to access their medical records – medication lists, lab results, and more. Interestingly though, they have released a native Android app only. For iOS, Blackberry, and Windows users, there is instead a web-app.

Through either the web-app or Android native app, patients can now access their medical information from virtually anywhere. The app provides full access to patient information that currently resides on the KP health record system and certainly demonstrates the growing movement to empower patients. In addition though, the release of the Android app first may also reveal a surprising shift in the mobile development landscape.

Patients who want to access their medical information on their iPhone are instructed that they can download a shortcut from the kp.org website that will open up the mobile friendly version of the website. From there, they can access all their medical information.

With the new native and web app, KP patients will have 24/7 access to lab results, diagnostic information, direct and secure email access to their doctors, and will also be able to order prescription refills.  In fact, in 2011, more then 68 million lab results were made available through the website to patients.  All this can be accessed through the dedicated Android app and the mobile website.

“With the new offering, Kaiser Permanente patients have 24/7 access from their mobile devices to view their secure personal health record, email their doctors, schedule appointments, refill prescriptions and locate Kaiser Permanente medical facilities. Members who have the ability to act on behalf of a family member on kp.org now can accomplish the same tasks. Those caring for an elderly parent or someone with a chronic condition can now more easily check lab results, refill prescriptions and communicate with the doctor’s office on behalf of the patient.”

George Halvorson, chairman and CEO of Kaiser Permanente, explains the release of these new mobile offerings.

“This is the future of healthcare. Healthcare needs to be connected to be all that it can be. This new level of connectivity is happening real time, and it is happening on a larger scale than anything like it in the world. The fact that a Kaiser Permanente patient in an emergency room in Paris or Tokyo can simply pull out their mobile device and have immediate and current access to their own medical information is an evolutionary and revolutionary breakthrough for medical connectivity.”

Interestingly, this is one of the few times we have seen an Android release precede the iOS release. Developers, in the past, have often cited issues with cross-device compatibility, a smaller market, and security issues. In many ways, things have changed – there are now far more Android users than in the past for example. iOS challenges, such as the cumbersome approval process and constrained development parameters, haven’t changed much. With Kaiser releasing this app first on Android, we certainly wonder whether the development environment is changing.

Please share your thoughts in the comments below and in our Forum.

by: Michelle Kraft

Happtique, an online mobile health application marketplace, has announced it will develop a certification program to vet mobile applications for doctors, nurses and patients. The organization created the program based on feedback from providers and hospitals, Corey Ackerman, president of Happtique, told eWEEK. Happtique will evaluate which applications are appropriate for clinical use and those that are outdated or poorly built.

According to Happtique representatives evaluation criteria will include functionality, usability and security. Any application, whether it is in the Happtique mobile application store or not, is eligible to be reviewed by the organization. The program will be funded by charges levied on app developers. Happtique also stated it plans to provide constructive feedback for application developers on how to make their applications better, rather than criticizing applications publicly.

If an application fails, they can reapply, but their failure may or may not be made public based on the panel’s decision.

As previously mentioned by the iMedicalApps team, Happtique created a custom catalog of mobile health apps directed towards physicians and patients. Apps are sorted into specific clinical subtopics.

Cory Ackerman, Happtique President, said,

“With more than 20,000 healthcare apps in the marketplace – and more coming out every day –healthcare organizations and professionals are expressing the need for a bona fide mhealth app certification program.”

Happtique  announced it will be forming a “Blue Ribbon Panel” to create a certification program that Happtique will use to evaluate and certify mobile healthcare apps for medical professionals and patients. The panel will be responsible for developing quality and performance standards including procedures to be certified.

The panel will be a multi-disciplinary group with clinical experience, expertise in social media, mhealth technology, healthcare accreditation & certification programs, and patient engagement.  The panel will be chaired by orthopedic surgeon Howard J Luks, M.D.,  Associate Professor of Orthopedic Surgery at New York Medical College (Valhalla, NY), who serves as the Chief Of Sports Medicine And Arthroscopy at University Orthopedics, PC and Westchester Medical Center. Other members of the panel are Franklin A. Shaffer, EdD., RN, FAAN, Shuvo Roy, PhD, and Dave deBronkart.

Those of us lucky enough to own an iPad know how useful they can be in day-to-day life – we use them for electronic medical records, keeping track of literature, organizing notes, scheduling appointments, paying bills…playing Angry Birds.

However, the iPad isn’t just revolutionizing the way we interact with our apps, it’s revolutionizing the way some kids interact with their world. Educational apps are common place in tech-saavy families with young children, but a children’s hospital in Oklahoma has taken apps for kids one step further by incorporating them into their patient’s therapy routines.

The Children’s Hospital of Bethany is allowing kids with a variety of difficulties – from congenital defects to traumatic brain and spinal cord injuries – to expand their ability to learn and communicate with the use of educational and interactive iPad apps.

A recent article by Sonya Colberg on NewsOK describes the hospital’s use of iPads for the advancement of their children with various difficulties, saying it gives them more independence and opportunity.

Abbagale [a 3 year old with spinal muscle atrophy] gazed at a pink circle on the screen and her scribbles on the iPad turned pink. Seconds later, she chose a new color to draw with by gazing at a purple circle.

“I like that big smile,” [special education teacher Mindy] Cash told Abbagale.
“This [iPad] is allowing her to be independent…to give her communication,” [Cash] said. “It’s so engaging. It just captivates them.”

The possibilities of technology like the iPad helping children and adults with physical and mental disabilities are endless. We are certainly at an exciting time in the world of technology with so much potential right on the horizon.

What amazing and innovating uses have you seen for education, therapy, and rehabilitation with technology like the iPad?

Recently, Janssen Healthcare Innovation  announced the Janssen Connected Care Challenge for enterprising individuals and developers. The goal of the challenge is to provide technical solutions that improve the transition for a patient from the hospital to their home.

Jannssen Healthcare Innovation is a company that is part of the larger Janssen Global Services. Their overeall goal is to empower healthcare consumers and modernize healthcare delivery. The Connected Care Challenge is designed to spur innovation and drive action towards achieving better care and better health at lower cost through continuous improvement. 

Diego Miralles, M.D., Head of Janssen Healthcare Innovation, explains the contest.

“Within Janssen, we support continuous innovation – both internally and externally – to develop the tools, frameworks and standards that will transform healthcare. We hope that the Janssen Connected Care Challenge will inspire the best and the brightest entrepreneurs to develop effective, scalable solutions that can be deployed and truly make a meaningful impact in patients’ lives.”

Care transitions was identified by Janssen as an area that needs to be improved and streamlined. Janssen contends that a large driver of health costs is the lack of coordinated care when patients are discharged after a surgery or other inpatient stay.

“One in three patients aged 21 and older, discharged from a hospital to the community does not see a doctor within 30 days of discharge.  These patients are at the highest risk of being readmitted to the hospital.  While this is a problem for all payers, the estimate for Medicare is that readmissions cost $15 billion a year and $12 billion of these readmissions are considered preventable.”

The Janssen Connected Care Challenge is looking for approaches that will improve a physician’s connectivity to patients during the recovery process as well as after they are discharged from the hospital. They have a particular interest in technology that increases communication and facilitates information sharing between hospitals, patients, care givers, and community-based doctors. Ideally, these approaches will be affordable for both patients and hospitals, and can include “low tech” solutions such as text messages reminding patients to schedule a followup appointment with their doctor.

Submissions for the contest will be accepted from February 27, 2012 until March 25, 2012. From those submissions, there will be three finalists who will be awarded $50,000 each and have the opportunity to work with healthcare experts to refine their solution.

Each finalist will present their ideas to a panel of judges at a Demo Day in May. The final winner will be selected on May 23, 2012 and awarded $100,000 to help bring their concept to market. A total of $250,000 will be given away as part of the contest. Janssen Healthcare Innovation is also collaborating with the National Transitions of Care Coalition (NTOCC), which is providing valuable input on the evaluation criteria for submissions as well as identifying care transition experts to participate in the panel of judges.

Source: Wall Street Journal

One of the criticisms we often hear about mHealth in general is a general absence of data that validates the emerging devices and systems that are being pitched as transformative.

This, however, is soon to change. AliveCor, who’s ECG recorder is perhaps the most recognizable of the mobile health industry, is currently undertaking studies at Oklahoma University Health Sciences Center. West Wireless Health Institute is launching a year-long study in Mexico to test its Sense4Baby fetal monitoring system.

Two physicians in Australia are now aiming to create a home for this emerging body of literature with their launch of the Journal of Mobile Technology in Medicine. Dr. Chandrashan Perera, a neurosurgery resident, and Dr. Rahul Chakrabarti, currently working on his PhD, are behind this effort, which began after noting the sparse, scattered nature of medical literature around mobile health.

Their hope is that by creating a dedicated forum for this kind of work, they can both help build this body of literature and make it easier to find. This e-journal is planned to be published every three months. They are currently accepting submissions for their first issue, with an inaugural contest that will award cash prizes to the best submissions in addition to publication. The deadline for submission is January 31st. For more information, check out their site.

For Apple fans, MacPractice has been a popular practice management and clinical electronic medical record software for Apple computers.  They often partner with Apple for workshops geared towards medical professionals — as one of our physician editors witnessed while at his local Apple Store.

The iMedicalApps team has previously reported on the MacPractice software and we lamented that there wasn’t a native iPad solution for the software.

At that time, there was a workaround that allowed clinicians to login from an iPad to their Apple computer and view the MacPractice software remotely. Obviously, this isn’t an ideal situation.

That has changed with the upcoming release of Clipboard, a native iPad application that works seamlessly with the desktop software. MacPractice Clipboard streamlines the registration process, saves paper and staff time, and also reduces risk of data-entry errors due to illegible handwriting.

MacPractice’s CEO Mark Hollis explains why the app was created.

“In response to many requests from doctors’ offices to use the iPad for patient registration, we are announcing new Clipboard Apps for the iPad that work in conjunction with MacPractice MD, DDS, DC and 20/20 v. 4.1 desktop practice management and clinical software.”

While doctor’s have frequently requested a native MacPractice app, the task of creating the app has been an interesting challenge for the company. Traditionally, desktop software is designed to take full advantage of the size of a typical computer monitor. With the relative small screen on the iPad, the challenge was designing an app that still provided a quality experience to the user, while not sacrificing any of the functionality of the software.

“Another obstacle to implementing iPad apps as quickly as doctors can use them is simply all of the various security and privacy protocols that MacPractice needs to follow. Patient and medical information is obviously very sensitive, and there are a whole host of guidelines and standards, required by law in many cases, that MacPractice needs to follow to make sure its apps are certified and can be used by medical professionals.”

“Hollis says that most of the issue there is that MacPractice has to build in those standards by itself — Apple doesn’t have an official part of the iOS API, for example, designed to deal with medical certification. “It would be helpful,” says Hollis, if Apple did provide some official code to help deal with those issues. But for now, MacPractice has to make sure its own apps are valid, and that takes time and effort, obviously.”

Currently, the Clipboard app is in beta version. It will be released for MacPractice users soon. We will keep you updated on the status of this app and future developments from MacPractice.

Source: TUAW and MacPractice

One major contributing factor to the skyrocketing cost of health care in the US is the high rate of readmission among patients.

A recent Dartmouth Atlas Project report found that 2009 30-day surgical readmission rates were 12.9 percent, unchanged from 2004, while 30-day medical readmission rates rose to 16.1 percent in 2009 from 15.9 percent in 2004.

The study also found that patients failed to see a primary care physician within two weeks of discharge, a step that can often help avoid readmission and improve outcomes.

Pipette (@usepipette) is using mobile technology to try and address this problem and enable clinicians to keep close tabs on their patients during the critical 30-day period following discharge from inpatient setting. Their mobile application suite, which covers 100 percent of mobile devices using a variety of SMS, native apps and web apps, enables clinicians to passively capture crucial patient feedback regarding their day-to-day recovery.

The goal behind Pipette’s platform is to provide payers and providers a system that reduces costs, improves patient care and enables a reliable and effective method for improving patient compliance and outcomes. The best word to describe the company’s platform is “empowering”, both patients and clinicians, to take control of the recovery process.

Pipette was a member of the first class of startups at the Rock Health incubator and one of the few in that group with a clinical orientation. Co-founders Ryan Panchadsaram (@rypan) and Jimmy Do (@jimmydo) saw a clear opportunity to disrupt healthcare and together left their jobs at Microsoft and jumped into the startup scene of Silicon Valley.

I believe there is tremendous value in developing mobile applications that passively collect crucial, context-specific patient data that is otherwise only recorded in clinical settings, so I was thrilled to have a chance to speak with Ryan and hear his vision for Pipette.

See my conversation with Ryan below:

BTE: What is the inspiration behind Pipette? What exactly is the technology you guys offer?

Ryan: The inspiration for Pipette comes from what is lacking in the healthcare system today. When a patient gets discharged from a hospital the care team has no idea of what is happening with that patient when they are at home, no clue if they are actually making progress toward recovery. What we wanted to do was build tools that would empower a patient during their recovery and enable care teams to see how a patient is recovering.

We entered the Rock Health program back in June with an idea and a small prototype of it and we were able to iterate on that idea and build a product over the last five months. The Rock Health partners helped us understand what the pain points were and how to approach the space. What we ultimately created is a platform to monitor a patient post-discharge that coaches a patient in the right direction and if things go wrong with the recovery we are able to notify the care team.

BTE: So these are apps you guys are developing?

Ryan: You can think of them as apps because they run on a patient’s phone, but our technology is special because it runs across all platforms including iOS, Android, laptops, desktops, SMS and we have spent a good amount of time making sure we can reach as many devices as possible. We learned pretty quickly that if you just build for one platform its not sufficient for healthcare. When you build a health solution, you need to reach the majority of the patient population.

BTE: So what are the next steps for you coming out of the Rock Health program? Do you plan to stay out in the Bay Area?

Ryan: The next step for us is kicking off these pilots. It’s an exciting time for us because we’ll be actively working with a few of the Rock Health partners to trial, iterate, and improve our product. Essentially, we get to act like a consumer startup in healthcare, which is incredibly rare. My co-founder and I will be staying in the Bay Area. We were living here before we started Pipette when we worked at Microsoft in Mountain View, so we will definitely be staying around here.

BTE: So do you guys just collect patient information about pain thresholds or do you collect other patient data as well?

Ryan: We try to collect all of the information necessary to make the patient’s next doctor visit more meaningful and we also try to take that information and use our technology to predict valuable things on the hospital side. For instance, we can tell the hospital which six patients need attention now, then we tell them the five who, if they have time, they should call and check up on because they are not going in the right direction. So there is a lot of information that goes into our technology, it’s not simply a data collection tool, there is an intelligence element to it.

BTE: You mentioned earlier that you had one idea in terms of who would pay for your product going into the Rock Health program and ended up learning you needed to take a different approach. What helped to help you learn that lesson?

Ryan: Going into it we thought doctors and hospitals would be our primary customer. We assumed they would jump at the opportunity to better communicate with their patients, I mean, why wouldn’t a hospital want to provide a higher level of care? During the first couple months of the program we had a chance to talk to mentors, as well as conduct a series of interviews and we started pitching it as a communication tool between doctors and patients and it wasn’t getting the doctors excited, it wasn’t getting the administrators excited. They were like, ‘well, we don’t want to introduce more forms of communication because there are other channels for it, why would we want to add this extra burden?’

Through that understanding we had to reassess what problem we were actually trying to solve. We determined it wasn’t really a communication problem but rather we were solving for this event that happens, or the complication that happens. We realized that the people who felt the impact of these complications the most was the payer group as well as the consumer, the patient themselves, since they are the ones who actually feel the pain and have to be readmitted to the hospital. So just being able to have a bouncing board and being able to iterate our pitch in these early days of the Rock Health program helped us create the offering we have today.

BTE: So that is a big part of the value proposition of the Rock Health program, giving you access to all of the people you need to talk to while you work through your business model?

Ryan: Right, and knowing we were wrong in the first week in the program was invaluable! Every decision we have made while developing our product was the result of feedback we received from those early conversations and interviews. We were really able to identify specifically what problems needed to be solved.

I would encourage future Rock Health companies to take a step back in the first month when they are here and really question what they are doing and the fundamentals behind it. When you enter a three month program, you are running full speed the whole time and don’t really get that extra time you need to question what you are doing. The fact that Rock Health has a five-month program allows you to get that time and really do that self-assessment.

Iltifat Husain MD contributed to this post

For diabetics, mainly those who are insulin dependent, checking finger stick blood glucose levels is standard practice.

While effective, engineers at Brown University have designed a new biochip sensor that can check blood sugar levels by measuring glucose concentrations in saliva instead.

The significance of this is that  human saliva is typically about 100 times less concentrated than in blood, so in the past, getting accurate results has been elusive at best.

The technology is made possible by combining nanotechnology, nanoparticles and surface plasmonics. Plasmons are density waves of electrons, created when light hits the surface of a metal under precise circumstances. Plasmonics have various roles ranging from physics to lithography, microscopy to biotechnology.

The engineers at Brown etched thousands of plasmonic interferometers onto a fingernail-size biochip. They then measured the concentration of resulting glucose molecules on the biochip. The results were positive, demonstrating that  glucose levels similar to the levels found in human saliva could be detected.

“This is proof of concept that plasmonic interferometers can be used to detect molecules in low concentrations, using a footprint that is ten times smaller than a human hair,” said Domenico Pacifici, Assistant Professor of Engineering at Brown University.

This proof of concept has been published in Nano Letters, a publication of the American Chemical Society. Further applications for the biochip suggested by the engineers include detecting a wide range of chemicals or substances, including anthrax, and other biological compounds.

“To create the sensor, the researchers carved a slit about 100 nanometers wide and etched two 200 nanometer-wide grooves on either side of the slit. The slit captures incoming photons and confines them. The grooves, meanwhile, scatter the incoming photons, which interact with the free electrons bounding around on the sensor’s metal surface. Those free electron-photon interactions create a surface plasmon polariton, a special wave with a wavelength that is narrower than a photon in free space.”

“These surface plasmon waves move along the sensor’s surface until they encounter the photons in the slit, much like two ocean waves coming from different directions and colliding with each other. This “interference” between the two waves determines maxima and minima in the light intensity transmitted through the slit. The presence of an analyte (the chemical being measured) on the sensor surface generates a change in the relative phase difference between the two surface plasmon waves, which in turns causes a change in light intensity, measured by the researchers in real time.”

Domenico Pacifici explains the next steps, which includes developing further tests for the biochip.

“The proposed approach will enable very high throughput detection of environmentally and biologically relevant analytes in an extremely compact design. We can do it with a sensitivity that rivals modern technologies.”

While not specifically discussed in the article, the possibilities of integrating this technology into smartphones is quite plausible. We have reported on an edible microchip that is being deployed in the UK capable of transmitting physiological data to smartphones or computers.

Additionally, we have discussed the concept of a lab on a chip, where South Korean researchers believe that a biosample – sputum, saliva, blood, or even urine – could be applied to the screen of a smartphone for analysis. The possibilities of this technology are bright and we will keep you updated on future developments.

Source: Brown University

With the launch of the West Health Policy Center, Gary and Mary West have added another front in their philanthropic assault on the institutional inefficiencies of the health care system.

This time they are establishing a presence in Washington DC focused on enticing the most talented post-doctoral research fellows to compete for one of five fellowships targeted to the goal of using empirical data to identify $100 billion worth of systemic inefficiencies in the health care delivery system.

Independently funded by a multi-year, multi-million dollar commitment from the Wests, the Policy Center is the only non-profit, non-partisan organization with the single aim of lowering health care costs. Among other things, the Policy Center will initially work to create an efficient medical marketplace by advancing;

• Infrastructure Independent Care
• Price Transparency
• Rational Reimbursement
• Practical Regulation
• Appropriate Care Utilization

The Center’s first fellow is Dr. Peter Neumann, an internationally renowned researcher on the user of cost-effectiveness analysis in health care decision making. He currently serves as the Director of the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy at Tufts Medical Center in Boston.

The Center’s Chairman Don Casey is quoted in the Washington Post as saying, “You can’t move people out of the expensive places of care if you don’t set up a system that allows data and biometrics to be gathered conveniently and pushed through algorithms to a health provider so that he or she knows when someone is moving to a danger zone,” Casey said.

“We will be churning out primary research that we look forward to bringing to policymakers,” Casey said. “We want to change the paradigm to a system that combines mobile health into a bundled payment for insurers. That would give us far better outcomes at a dramatically lower cost.”

The day after its launch, the policy center announced it had formed a strategic partnership with the Humedica, a clinical informatics platform which is also a portfolio company of the West Health Fund.

The Policy Center is co-hosting, along with the Centers for Medicare and Medicaid (CMS) and Health Affairs, the Care Innovations Summit in Washington DC on January 26th.

Recording notes about a patient is standard practice among physicians and has often left patients curious about what is written down about them.

While federal law guarantees patients the right to examine and get copies of their medical records, it hasn’t always been an easy process to go through.

In fact, there has been some reluctance on doctors to reveal this information in a timely manner. Misunderstanding the notes is a concern for doctors. Many clinicians are troubled by the prospect that patients may get confusing news without a healthcare provider available to explain the context of the information.

Despite this, a recent survey published in the Annals of Internal Medicine suggests that the public has a desire to see them. In fact, most patients thought open visit notes were a good idea.

“The study surveyed 173 doctors and nearly 38,000 patients at three primary-care practices about sharing information with patients. After the survey, the practices joined a project called OpenNotes, in which patients were give electronic access to their files.”

The OpenNotes project demonstrates and evaluates the impact of sharing encounter notes between patients and their primary care physicians (PCPs) online.

“The project involves 3 diverse settings– Beth Israel Deaconess Medical Center (BIDMC) and its associated primary care practices in Boston, MA, Geisinger Health System (GHS) and its primary care practices in rural Pennsylvania, and Harborview Medical Center (HMC), a county hospital and safety net provider in Seattle, WA.”

The options for sharing information with patients doesn’t end there. In 2010 Quest Diagnostics released a free smartphone app called Gazelle that lets patients in 33 states including DC download their lab test results directly to their phone. Though, patients using Gazelle can’t get direct results on HIV, cancer or genetic diagnostic tests.  All other test results have a 48-hour delay on them in order to give physicians time to contact the patient first about the findings.

“No one wants to see their diagnosis of cancer on their own without a medical professional,” says Jonathan Darer, chief innovation officer for Geisinger Health System, which makes most patient information available online. “We try to manage that.”

Source: Washington Post