By Tim Bredrup

PositiveID Corporation, a developer of medical technologies for diabetes management, recently announced it has obtained certification from AT&T for PositiveID’s iglucose™ mobile health system, designed to simplify diabetes management for the millions of individuals impacted by this growing disease. This certification gives PositiveID’s FDA-cleared iglucose system access to the AT&T network, which has the largest global presence of any U.S.-based wireless provider.

iglucose is the first and only pocket sized, FDA cleared, mobile health device specifically designed to transmit blood glucose readings anytime, anywhere. By seamlessly communicating glucose readings from a glucometer to the iglucose diabetes management portal, the data can be shared with family members, caregivers and healthcare professionals. Sharing can occur via text message, email, fax, or through the iglucose diabetes management portal itself.

press release | www.PositiveIDCorp.com

AT&T and Calgary Scientific have recently teamed up to offer ResolutionMD, a FDA approved mobile diagnostic viewer, as part of AT&T’s broader medical imaging and information management solution.

ResolutionMD is a secure, cloud-based app that displays medical images on a provider’s tablet or smartphone.

One of our editors recently commented on a radiology study that used ResolutionMD in order to test bandwidth speed in diagnostic imaging (3G speeds proved troublesome for mobile diagnostic imaging).

This technology  integrates into existing PACS, RIS or EMR infrastructure and allows doctors the ability to view images without being tied to a workstation. AT&T plans to make ResolutionMD available to its AT&T Medical Imaging and Information Management customers in the first half of 2012.

The technology is meant to help providers store, access, view and share patient medical images and information inside hospital systems and outside with referring physicians and other authorized facilities over a highly-secure infrastructure.

Calgary Scientific is a small company that aims to be the leader in providing accessible, advanced visualization solutions in the medical imaging market, as well as becoming the industry forerunner in web and mobility enablement technologies.

Its products include PureWeb, a Software Developer Kit (SDK) that allows systems integrators, corporate, OEM and independent software developers to web-enable and mobilize their data-intensive, security-sensitive apps. Calgary Scientific also has various iterations of ResolutionMD, including ResolutionMD Mobile, ResolutionMD Web and Resolution MD Clinical.

A demonstration of what ResolutionMD can do is seen below.

Randy Rountree, executive vice president of Global Sales & Marketing for Calgary Scientific, commented on the alliance.

“Demand for access to current and prior patient images along with radiology reports is growing at a very high rate.This requirement for image information is seen across the healthcare enterprise, in remote locations and must be available to clinicians 24 hours a day. Our work with AT&T ensures that this vital information is always accessible in a highly-secure manner and includes many of the diagnostic analysis tools needed by physicians to assess and rapidly diagnose a patient’s condition.”

Additionally, the article notes that AT&T plans to make ResolutionMD available as an option to its AT&T Medical Imaging and Information Management vendor-neutral cloud-based service. This will provide secure access to viewing, storage and sharing of medical images from PACS on an as needed, pay-as-you-go model for image storage.

Source: Press Release

The mHealth Summit is the largest annual gathering dedicated to mHealth in the world and convenes a global group of researchers, health professionals & industry. As a media partner for the Summit, iMedicalApps will be presenting an exclusive series of interviews with keynote and prominent speakers titled “mHealth leaders speak to iMedicalApps” between now and the December meeting.

There are few academic institutions in the world with a reputation for excellence and prestige that matches the University of Chicago. During my interview with Eric Yablonka, Chief Information Officer (CIO) of University of Chicago Hospitals & UC Pritzker School of Medicine, it was very clear he has a deep appreciation for his employer’s rich history of academic achievement and innovation and takes it as a personal challenge to spend his tenure at UChicago making his own permanent mark of progress on the community.

Yablonka’s message echoed that of Don Casey, CEO of the West Wireless Health Institute, the first mHealth thought leader featured in this series leading up to the 2011 mHealth Summit in early December, that a critical element in the design and deployment of next generation wireless mobile connectivity is the ability to leverage a common infrastructure for all connected care solutions, both wired and wireless.

“Wired to wireless we want to leverage a common infrastructure because its more cost effective, it will lower the cost of delivering care, not increase the cost, and then you want to get a leveraging piece over on the infrastructure and the deployment, which is what we did at our Children’s hospital six or seven years ago.”

One comment Yablonka made, which caught my attention and has been spinning around in my head ever since, was his matter-of-fact assertion that at long last;

“Connected medical devices are not just ‘nice to have stuff’ anymore, proving themselves to be truly life saving stuff now.”

I feel like years of excessive hype and repeated under-performance have created a apathetic culture among physicians and health care professionals that has been very difficult for device makers to overcome. Yablonka’s statement leaves me hopeful that, at long last, the connected medical devices which promise to revolutionize health care delivery and business models have once and for all broken through the market barriers they have struggled so long to overcome.

Read my extended discussion with Eric Yablonka below.

iMA: Why are you participating in the mHealth Summit?

EY: I am coming to the conference primarily to learn and share, and I think DC is a great forum for that because it brings together all of the relevant stakeholders. The FCC and FDA are critically important stakeholders and the industry is going to have to work together with them. They are really smart people required by law to deal with these issues, and its a very difficult set of issues for them to deal with.

iMA: It’s amazing how many generations of tablets there were on the consumer market when the iPad launched, but now its like tablets have been reinvented.

EY: That’s very true, the tablet is not new. Our chair of radiology was using a tablet 7-8 years ago, which I believe was an HP or Compaq tablet running Windows software, but all of a sudden you have a new form factor and a new operating system that causes consumers to wet their pants and then all of a sudden, whether you are a government agency or medical device manufacturer you are asking yourself, “What do I do with an iPad? How do I get it into my ecosystem? Is it a medical device or isn’t it? What do we do about the software developers vs the hardware developers?” All of these are very new issues and quite frankly a lot of the medical device manufacturers, including Phillips, Siemens, Welch Allen, GE, you can only imagine that in a couple of years a lot of their devices are going to be Android powered. There are reasons for this shift. First, you have a common platform. Second, you can cut your manufacturing costs by getting out of proprietary solutions. So I definitely see medical device manufacturers going to Android as the future software platform, which will help them significantly lower costs and consolidate product development under one common architecture.

iMA: You mentioned having worked in four hospitals before settling down here in Hyde Park, do you have a medical background or are you purely a technologist/informatician? And now that you are the CIO here at UChicago, what do you love about your job?

EY: I have been in health IT since 1984, prior to that I was in insurance for three years before I got out of college. When I landed my first job in a health IT shop I found my true calling and have been involved in it ever since. Its always been very interesting work, I appreciate the health care sector, its very mission oriented. We do this stuff for the patients, we consider ourselves part of the care team, and while we don’t lay hands on the patient, we support the people who do. So our staff is very committed to the organization and its evident in what we do.

There are a couple of things I love about the job. We have the most brilliant faculty, we do the most amazing things for our patients. Our patient care is excellent, I have worked in five hospitals and this is simply an exceptional institution, and the fact that our patients are so important to us, and we have such committed faculty, many of whom both teach and do independent research, is a very powerful combination. Simply, its a very stimulating environment doing great things with great people.

iMA: The research aspect of informatics is very useful, and as you said as an academic medical center you have unique access to practitioners also conducting their own research. How do you think your job here has given you a unique understanding of the research element of informatics and how do you think the availability of this data has fundamentally changed the practice of medicine?

EY: I think its a very stimulating environment, in that we are not merely looking at the proven treatment protocols for patients, but with their consent and agreement we are looking at clinical trials and other types of research protocols which are new science, and in many ways being in that type of environment where we are bringing research from the bench to the bedside is very very exciting. Its true translational research, and some of our research informatics initiatives we have going forward will truly enhance our translational research capabilities, allowing us to use our electronic medical record data in ways we haven’t been able to in the past, so in that respect its very exciting. From an IT perspective we have a very robust infrastructure, both on the wireless side as well as our services-oriented architecture and other technologies to improve the quality of care to our patients and our physician workflows, while leveraging the same infrastructure to support our researchers. There are probably not three out of four hospitals in the country doing that type of work, which is very exciting. We have the ability to innovate, not only on the medical side through our faculty, we can also innovate on the IT side, which is why I am here.

iMA: So you see a lot of alignment in the organization?

EY: I think we have a lot of interest in doing great work and we bring our leading edge thinking and critical thinking to that, as well as the faculty and physicians bring that to patient care, and when you put that all together it can be a very powerful combination. So, as you alluded to, its just different than a community hospital, it’s even very different than a major teaching hospital in a true academic medical center. There are things that go on that are just incredible.

AT&T announced recently that they currently support 13 million so-called “emerging devices” on their network, which are consumer electronics which have embedded connectivity or work in tandem with existing smartphones. AT&T Emerging Device Organization launched in 2008 with the mission of “introducing wireless capabilities into a wide variety of emerging wireless devices beyond the traditional handset.”

The company recently announced the appointment of its first chief medical information officer (CMIO), Dr Geeta Naggar. Additionally, AT&T has partnered with the Department of Health and Human Services Office of Minority Health and American Association of Diabetes Educators to launch a new mHealth initiative to test mobile devices for diabetes self-management.

Some examples of the companies developing the 13 million emerging devices include Zephyr Technologies which struck a deal to embed AT&T 3G/4G technology inside its body-worn sensors. BlueLibris is an “On Star for people”, allowing device owners to press a button to talk and transmit medical data such as heart rate and blood pressure. AT&T is providing Vitality GlowCaps wireless network connectivity for the intelligent pill caps designed to help patients take medicines regularly using phone call or text message reminders.

Separately, AT&T announced it will be redesigning its 2,200 stores to include a “wall” featuring these emerging devices, presumably including mobile health devices and wearable sensor technologies. This is a very big deal for start-ups in the mobile health sector, everybody should be trying to get their products on the “wall”, and its an even bigger deal for the consumer patient who can now access body computing devices at a relatively low cost.

This move will likely be considered a direct threat by Apple and I predict it won’t be long before we see a similar wall at Apple Stores featuring every connected health device available, a topic we addressed last week on iMedicalApps.

It’s also reasonable to presume Verizon, Sprint, T-Mobile and other competitors in the brick and mortar cellular business will follow AT&T’s lead and welcome developers of emerging devices to put their products on their shelves. They will also likely embed their proprietary 3G/4G technology into these consumer health products to create additional monthly revenue from existing subscribers.

While the Smartphone itself is a very powerful mobile computing device, if it can be bypassed in the transmission of critical patient data, this would remove a layer of complexity in the workflow of mHealth technologies and services. The companies with the best chance of emerging as best-in-breed mHealth providers may well be those thinking beyond the smartphone app today.

Zephyr Technologies has struck a deal with AT&T to embed AT&T’s 3G/4G technology inside its BioHarness™ wearable biosensor technology. This deal has major implications for the future of the company’s mobile apps, and gives the company a jump-start on its competitors.

Zephyr’s stated mission is to “Measure Life” and they license their products to academic researchers, military, athletes, physicians and anyone else who wants to build custom mobile applications using the company’s wearable sensor technologies and remote monitoring devices.

“With the BioHarness™, connected by AT&T, cardiologists will be equipped to remotely monitor ECGs, athletes will have the ability to share live performance data, and medics will have on-demand visibility into the condition of military personnel – all occurring seamlessly over the AT&T network,” said Glenn Lurie, president of emerging devices, resale and partnerships, AT&T. “Today, smartphones capture Zephyr’s BioData and send it to the cloud for analysis, presentation and health record purposes. By Embedding wireless into the BioHarness™, we’re arming healthcare professionals with the technology needed to access timely data in ways not previously possible.”

Zephyr’s OmniSense Mobile Health Platform combines the ZephyrME, an mHealth patient app used to capture patient physiological data measured with Zephyr’s body-worn sensors, with ZephyrMD, a physician app that enables the real-time monitoring of each patient using the ZephyrMe app.

The company’s key competitive advantage is the comfort and design of its wearable sensors, as well as the affordability. Arguably, the weakest element of their solution is its mobile app. This deal with AT&T will effectively remove the mobile app from the equation, connecting the sensors directly to the network, thus simplifying use for patients and allowing access to mobile health technologies for patients who don’t own Smartphones.

Zephyr’s Bioharness™ was granted FDA 510(k) approval in December 2010, but the Annapolis, MD-based start-up has been proactive distributing their product internationally, showing itself to be a clear market leader in the wearable sensor sub-sector of the mobile health market and establishing distribution on four continents; North America, South America, Europe and Asia.

One critical reason for Zephyr’s early success was a strategic investment from Motorola Ventures for an undisclosed sum, which provided the company an invaluable partner in the form of a major multinational mobile device company, as well as access to mature distribution channels that penetrate nearly every corner of the world. This network allowed the company to access less regulated markets even before receiving FDA approval.

Zephyr’s high profile customers include Under Armor, which embedded Zephyr’s Smart Fabric into its E39 shirt to measure physiological vitals of athletes participating in the NFL combine (see video below), as well as The Department of Defense.

Last week Brian Dolan had an interesting speculative piece on the intriguing question of, “which mobile health start-up will be the first to land a major exit through acquisition”? The conclusion Dolan draws, with input from Zeo Co-Founder and CTO Ben Rubin, puts Body Media at the top of the short list of companies with high nine figure exits on the horizon.

I believe this deal catapults Zephyr into the club of “best in breed” mobile health start-ups and makes them a very attractive acquisition target. Exactly how much Zephyr will ultimately be worth is largely dependent on how they are able to brand and distribute these new products. Could this deal be the key to bringing body area network technology to shelves at Walgreens or CVS?

The video below from Under Armor profiles the E39 device they co-developed with Zephyr and its benefits for high performance athletes.

When I was handed my first pager, I was stunned. It looked like the beeper that Will Smith used to flash on the Fresh Prince of Bel Air (and not even the later seasons, I’m talking about the early, crazy outfit seasons!). So I asked why I couldn’t simply use my phone or, for that matter, why we didn’t all use phones. The answer was simple – reliability. The paging system, of which this rather archaic looking item was part, was very reliable. But was that enough? No. The hospital also maintains it overhead paging system just in case. And if that goes down – yep, there’s a back up there too. In health information technology, reliability is everything. And for the iPad, that could prove to be a major barrier to adoption in the medical community as it faces off with other medical tablets, at least if the FCC’s recently voiced concerns prove to be true.

We all know that AT&T has been having issues with their telecommunications network since the inception of the iPhone.  The NY Times did a great piece on the 3G woes and how the public finger pointing between AT&T and Apple has exposed some serious problems with their partnership – the funny thing is, the article is 2 years old yet still holds true today.  It seems AT&T was not prepared for the surge in usage brought by the iPhone, a phone that guzzles data and network resources much like a Humvee uses gasoline.  So its wasn’t surprising that the reaction was less than warm when Steve Jobs announced AT&T had once again won exclusive rights to the data plans for an Apple product, this time the iPad [it was the only time during his presentation when the audience actually jeered him].

And now, the FCC is expressing concerns the iPad, of which there could be millions on the AT&T network, could overwhelm the existing infrastructure. Two high profile FCC officials, Phil Bellaria, Director of Scenario Planning, and John Leibovitz, Deputy Chief of the Wireless Telecommunications Bureau had the following to say on their blog:

Widespread use of smartphones, 3G-enabled netbooks, and now, perhaps, the iPad and its competitors demonstrate that wireless broadband will be a hugely important part of the broadband ecosystem as we move ahead….With the iPad pointing to even greater demand for mobile broadband on the horizon, we must ensure that network congestion doesn’t choke off a service that consumers clearly find so appealing or frustrate mobile broadband’s ability to keep us competitive in the global broadband economy.

This isn’t necessarily a deal-breaker for every healthcare provider. Hospitals and health systems, for example, generally rely on local Wi-Fi networks through which a mobile device could access an EMR. The providers for whom this is more likely to be an issue are the private physicians and physician extenders (physician assistants and nurse practitioners) who work in multiple hospitals, surgery centers, nursing homes, and so on. These providers are more likely to rely on a commercial data network to access their own clinic’s EMR when, say, doing a bronchoscopy on a patient at an outpatient surgery center or on-call for a nursing home. For them, slow or absent connectivity even 1% of the time is unacceptable.

This issue is certainly not intrinsic to the iPad – it’s an effect of Apple’s relationship with AT&T. And AT&T has recognized this problem and is moving to improve its infrastructure. But time is not on Apple’s side. Lenovo, HP, and numerous other vendors are releasing new tablets at a dizzying pace with a range of features and prices. And the healthcare community is certainly looking closely at tablets right now, as various EMRs are being adopted by healthcare providers across the country. So now is the time for tablet vendors to reach out to the medical community. And carrying the baggage of an unreliable data network is certainly going to be a strike against any tablet hoping to gain traction in the medical community.