Post image for iHealth showcases continuous monitoring wearable devices at CES 2014

Recently at CES 2014, iHealth Lab, a subsidiary of Andon Health, presented three new continuous monitoring wearable health devices. They include an ambulatory ECG device, a blood pressure monitoring vest and a pulse oximeter wristband device.

Traditionally, ambulatory heart monitoring has been used to determine the cause of palpitations and syncope and, to a lesser degree, to identify burdens of known atrial or ventricular arrhythmias. Continuous ambulatory blood pressure monitoring is another useful tool that not only helps separate white coat hypertension from essential hypertension. Additionally, data collected on blood pressure variability and nocturnal hypertension has important prognostic implications.

Unlike ambulatory heart rate and blood pressure monitoring, continuous ambulatory pulse oximetry has less of an established use though one could imagine use in some areas like sleep apnea.

Here, we’ll quickly review these three new offerings.

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Post image for Jawbone UP24 vs Fitbit Force, a physician’s recommendation for best activity tracker

Editors Note — Fitbit has now recalled the Fitbit Force, please read this post to see why. We are no longer recommending the Fitbit Force be used by anyone. We thank the people in the comments section for their support and being outspoken on why the device needed to be recalled. 

In 2013, three companies (Fitbit, Jawbone, and Nike) made up 97% of the fitness tracker market. While my favorite tracker one year ago was the Nike FuelBand, the newly released Jawbone UP24 and Fitbit Force ran to the head of the class with class-leading battery life, third party connectivity, and robust feature sets.

Having personally tested many of the most popular fitness trackers, I’m often asked which is the best. My answer almost always comes down to the Jawbone UP24 or the Fitbit Force.

After spending a month going back and forth between the two options, I’ll share my answer.

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2014-02-05 12.17.03EM:RAP is a podcast heard by over 18,000 Emergency Medicine health care professionals — and is the most well known Podcast amongst the Emergency Provider community.  So it’s big news they have launched their own iPhone app.

Personally, I’m a huge fan of EM:RAP — I find their monthly podcast to be a must listen and the quality of content is tremendous.

But I have to be honest — I’m a bit disappointed in the app. (read more)

Post image for Educational app for clinicians teaches the basics of ventilator management

A new app called Basics of Mechanical Ventilation teaches some of the basic concepts of ventilator management.

Developed by the Department of Surgery’s Division of Trauma/Surgical Critical Care and the Department of Respiratory Therapy at Lehigh Valley Health Network, this app is targeted towards med students, residents, respiratory therapists, and other healthcare professionals who work in the critical care setting.

The app tries to be a good pocket tool for ventilator management.  (read more)

Post image for Android Physiology at a Glance app might not be worth glancing at

Purpose of the Review

  • Will medical students find this book adaptation a helpful reference?

Introduction

Physiology at a Glance is a book written by Jeremy P.T. Ward, Head of the Department of Physiology and Roger W.A. Linden,  Emeritus Professor of Craniofacial Biology, both from the Schools of Medicine and Biomedical Sciences at King’s College London. The book features concise illustrations, data tables, and friendlier text to provide an introduction to physiology that integrates with the medical school curriculum.

The app Physiology at a Glance, 3rd Edition is an adaptation developed by MedHand Mobile Libraries, available for both iOS and Android. We will be taking a look at it below.

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Post image for iMedicalApps publishes a How to Guide on mobile medical applications

iMedicalApps strives to deliver quality review of mobile medical apps, news, and commentaries related to the role mobile devices are playing in the practice of medicine on a daily basis. We were recently invited to contribute a piece to the International Journal of Clinical Practice (IJCP) on how clinicians can find and apply medical apps to their practice based upon our experience.

In the latest issue of IJCP, we shared our perspective in a piece titled, How to identify, assess and utilise mobile medical applications in clinical practice. The publication is essentially a guide for medical professionals looking to utilize their personal mobile devices (e.g. smartphone, tablet computer) in clinical practice.

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Post image for How fitness trackers could be used inpatient and outpatient to monitor medication effects

Iltifat Husain MD contributed to this piece

Mobile fitness trackers have made a huge splash in the past year with a large number of new devices released. While their initial benefit relates to the ability to track daily activities and daily caloric expenditures, the devices also offer added benefits.

One such matter is the ability to wear these devices during sleep, offering insight into a user’s sleep rhythm and a way to determine the quality of sleep had. While the mechanism is based solely on the idea that if a user is tossing, turning, and moving through the night, they must not be sleeping well, and not as in-depth of a sleep study, it does support a basic sleep assessment. With that being said, there may be an applicable way of using this beyond the outpatient setting.

Currently, my fiancee is sick with an upper respiratory infection. Her symptoms include cough, fever, malaise, and body aches. While normally active, she has seen a decrease in activity and complains of overall poor sleep. However, you don’t have to take her word for it. Since mid-December she has been using a Misfit Shine, which she wears on her wrist or around her neck and has been tracking her daily activities via the device.

Thus, I present some of her data, demonstrating some interesting measurements on her activity and her sleep pattern. I present first a sample, from last week, of a day where she was fairly active with time spent at the gym and a Zumba class. Note the activity tracker and the sleep component. (read more)

Post image for Apple’s focus on a “Healthbook” app could improve public health, force doctors to adopt mobile

Last week the New York Times reported that Apple met with the FDA to discuss mobile medical applications. While it’s no secret Apple has been on a hiring spree focused on talent with expertise related to mobile health, this has been the surest sign to date that Apple has plans to release a dedicated health app in future iterations of iOS.

The reliable 9to5mac claims Apple is working on a “Healthbook” app, similar to the Passbook app currently on all iPhones. It will enable users to store blood pressure recordings, heart rate, glucose levels, and other health metrics.

Improving Public Health

There are millions of iPhones that have been sold, and the feature that makes it great for a public health tool is also a feature many technology purists hate — uniformity. If Apple were to create a standard health metric tracking application – Healthbook, it would be easy to teach individuals how to use the app because of the uniformity factor. Unlike Samsung’s forays into similar applications, you wouldn’t have to worry about different phones and different operating systems. With Apple you know you will get the same user experience, on the same device, and you can feel comfortable the app will get robust updates and support.

This type of uniformity is not only important for the user experience, but would also make physicians significantly more comfortable in using this app with their patients. (read more)

Post image for Echocardiography Atlas by Epocrates is an outstanding reference app for clinicians

Echocardiography is a cornerstone of assessment of cardiac function.

While traditionally reserved to the domain of cardiology, echo is now being increasingly used as a point-of-care tool by intensivists, emergency medicine clinicians, and others.

As such, there is an increasing need for mobile tools to learn and review echocardiography, and not just for cardiologists.

Epocrates’ Echocardiography Atlas is a comprehensive reference app that contains a large library of echo images and video. After giving it a spin, we were left pretty impressed with the quality of this app.

Here’s why.

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Post image for Current challenges in mHealth behavioral intervention research

Satish Misra MD contributed to this article

We recently talked about strategies that clinicians and developers can use to make apps focused on behavioral change more successful.

In many ways, though, these lessons are based on a trial-by-error approach to development.

More needs to be done, we’d argue, to improve the current research body of behavior change. At the recent mHealth Summit, there were a number of events that touched on this need.

Taking a step back, there were three prominent themes:

  • Researchers need ways to study technology
  • Researchers need to work in interdisciplinary teams
  • We need new ways of capturing information

Here, we’ll explore how each of these ideas can help drive the development of a stronger evidence base for the use of mhealth tools to drive behavior change.

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Post image for NeuroSlice app for Android aims to teach neuroanatomy with a large library of images

Purpose of the Review

To determine the usability and functionality of the neurological app NeuroSlice.

Introduction

The human nervous system is a complex, sophisticated system. To really understand and diagnose pathology like strokes, neurodegenerative diseases, and so on requires a detailed knowledge of anatomy. In addition, imaging studies can provide insight as to the integrity of brain structures and it’s important to be able to understand what you’re looking at.

Google’s Play Store has plenty of imaging apps but it can be hard to figure out which one is the right one for you.

Today we will take a look at NeuroSlice, an app developed by Dr. Sanjay Manohar.

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Post image for How to change your patients’ behaviors with your health app

Exercising too little can lead to obesity.

Ingrained habits can lead to continued smoking and substance addiction.

Forgetfulness can lead to medication noncompliance and hospital readmissions for diseases like heart failure. What is the one thing these medical issues all have in common? Behavior.

These medical issues are influenced by patient behaviors. As providers, we often craft the perfect-sounding assessment & plan for our patients’ health, but these efforts are for naught if patients aren’t equipped with tools and support to change their habits or behaviors.

Many believe that mhealth apps can modify patient behaviors. However, as Brown University emergency medicine physician Dr. Megan Ranney points out, statistics show that few patients use their health app more than once.

There are many ideas for how to avoid that common pitfall and use mhealth tools for more effective behavior change. Here are some we recently learned from researchers and innovators in mobile health.

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