Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and HIPAA for FREE!!

Apple App Store Toughens Guidelines For Health Apps

Posted on September 13, 2016 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

In a precedent-setting move, Apple has released new guidelines for its iOS App Store which impose new limitations on health and medical app developers.  iMedicalApps contributor Iltifat Husain, M.D., who wrote a piece about the changed standards, said they contain “the most stringent language I have ever seen Apple used for the health and medical category of apps.”

According to Husain, highlights from Apple’s new developer guidelines include:

  • A warning that if an app could possibly cause physical harm, Apple could reject it
  • A warning that apps which provide inaccurate data or information that could be used to diagnose or treat patients will get increased scrutiny
  • A reminder that apps which calculate drug dosage must come from the drug manufacturer, a hospital, university, health insurance company or other approved entity. In other words, independent developers cannot post a medical app for drug dosages themselves.
  • A ban on marijuana-related apps
  • A ban on apps that encourage people to place their iPhones under a mattress or pillow while charging (such as some sleep monitors)

Historically, Apple has been relatively lax about hosting potentially dangerous health apps, Husain says. For example, he notes that apps purporting to measure a consumer’s blood pressure by using the iPhone’s camera and microphone tend to be quite inaccurate in their measurements, but that Apple had not screened them out.  Now things have changed for the better, Husain writes. “Apps [like these] would not get through the screening review process under Apple’s new guidelines.”

Husain argues that the new guidelines are more important than the FDA’s recently-updated guidelines on health apps: “There is no way the FDA can regulate the hundreds of thousands of health and medical apps and the updates made to them,” Husain writes. “The screening process is what has to change.” And given Apple’s market footprint and influencer status it’s hard to disagree with him.

At this point the question is whether Google will follow suit. After all, while the Apple app store hosted 2 million apps as of June, Google Play offered 2.2 million apps, according to one study, and as of February there were three Android users for every iPhone user. So If Google doesn’t put more stringent health app requirements in place as well, creators of dodgy health apps can still develop for Android and find a wide audience.

That being said, neither Google nor Apple are required to impose new restrictions on health apps, and are likely to be governed by commercial pressure more than medical appropriateness. Also, both parties are free to set any rules they choose, and uses might not be aware of important differences between the two sets of policies. In other words, if the goal is to protect consumers, relying on guidelines generated by app store hosts probably won’t fly over the long-term.

I’m not necessarily suggesting that the FDA or other regulatory body should come down on the app stores like a ton of bricks. That would be overkill, and as Husain notes, is probably beyond their capabilities.

But doctors in the know about apps might want to warn patients about their potential limitations, and offer some criteria as to what they can expect from health apps. After all, most consumers have experimented with one health app of the other, so even if the doctor doesn’t prescribe them, patients need to be educated about their options. So if you’re a mobile health savvy clinician reading this, consider increasing patients on these issues.

What If Your Doctor Knew All Your Health Searches?

Posted on June 30, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Back in 2013, the Pew Research Internet Project found that 72% of internet users looked online for health information. This was well before the most recent update to Dr. Google. It’s only a matter of time that those health searches will end up going through some sort of AI solution (Siri, Alexa, Galaxy, etc) we bring into the home.

Imagine if we connected this font of health information and questions together with the healthcare establishment. What if your doctor had access to all of the health related searches you were doing? Might he be able to provide better service to you and your family?

Yes, I realize that this idea will be extremely controversial. There are some major privacy challenges and issues with this idea, but there’s also a lot of potential benefits. It seems a little bit hypocritical that we ask doctors to be open and transparent with our health records if we as patients aren’t going to be open and transparent with our medical concerns. Certainly, we should be able to control what and with whom we share this information, but I believe that many will be willing to share it with their doctors.

Yes, this will require a pretty dramatic shift in how our medical professionals will handle a patient visit. However, if I’ve been doing a bunch of searches around back pain, imagine how much different my visit to the doctor for an earache would be. Could that provide the opportunity for the doctor to talk to me about my back pain searches?

It’s fascinating to think how this is almost the complete opposite of the office visit today. I’ve seen doctors that wanted to only deal with one issue at a time. Those doctors have learned the special dance that allows them to avoid talking about more than the presenting concern. Many doctors learn essentially a new language that makes sure that they get in and out of the exam room quickly without bringing up the rabbit hole of potential health problems a patient might be actually experiencing.

That’s the reality of today’s medicine. This is what we pay them to do. That’s changing with things like CCM where a healthcare provider is paid to dig in a little deeper. It’s certainly not enough to fully change these behaviors.

Until the reimbursement fully changes over to doctors getting paid to keep you healthy, a doctor knowing your health searches won’t be of interest to most doctors. However, once reimbursement changes, a doctor will become much more interested in what’s really ailing you. Your online searches certainly will say a lot about your health, both physical and mental.

April Fool’s Day – Health IT Edition

Posted on April 1, 2016 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Most of you know that I love a good April Fool’s day joke. I don’t like those that hurt people, but I love good humor (ask me about the time my wife said she was going into labor and wasn’t). You may remember my past years’ pranks about the #HIT100 Health IT Company, the ONC Reality TV show, and my personal favorite where we announced we’d be selling our own EHR software. Good memories all around.

This year I’ve been busy organizing the Health IT Marketing and PR Conference, but that doesn’t mean I can’t enjoy other people’s work. I’m sure I’ve missed some of the great health IT related April Fool’s day jokes, so let me know of others in the comments.

The big winner for April Fool’s 2016 for me was SnapChart from Twine Health. You’ll particularly enjoy it if you’re a SnapChat user, but it’s a great one either way. This video should demonstrate what I mean:

Well done Twine Health! I think even patient privacy advocates would appreciate SnapChart. “We all know that EHRs suck. Well this EHR only sucks for 7 seconds….BOOM”

Another honorable mention goes to Epic who has a long standing tradition of offering something entertaining on April Fool’s Day:
Epic April Fool's Day 2016
*Click on the image to see a larger version

Nice work by Epic to keep it topical with reference to Clinton and Sanders. However, the one that takes the cake is Jonathan Bush using MyChart. The only thing that would make me laugh more would be if athenahealth put out a video response from Jonathan Bush. Please?!

Cureatr decided to go old school with a new technology called the Faxenatr:

Howard Green, MD posted this announcement from Alphabet Inc and Google Inc’s company Verily Life Sciences about the UHIT (Universal Health Information Technology).

So many others I could mention outside of health IT. This one from Samsung about a 3D holographic projection was cool:


Although, when you look at what’s happening with VR, maybe it will be more reality than we realize.

Gmail’s Mic Drop is pretty funny. Well, at least it was until people starting losing their job because of it. The concept of a mic drop on email or social media is pretty interesting though. I wonder if there’s a way you could really implement something like it.

What other April Fool’s day jokes have you seen. It’s Friday. We all need a good laugh.

Top 10 Google Searches in 2014 – What Would Be Healthcare IT’s Top Searches?

Posted on December 16, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Each year Google releases it’s top trending searches in the US and the world. This list isn’t the most frequently searched terms (according to Google the most popular searches don’t change) but is a year versus year comparison of what terms were trending in 2014.

US Trending Searches:
Robin Williams
World Cup
Ebola
Malaysia Airlines
Flappy Bird
ALS Ice Bucket Challenge
ISIS
Ferguson
Frozen
Ukraine

Global Trending Searches:
Robin Williams
World Cup
Ebola
Malaysia Airlines
ALS Ice Bucket Challenge
Flappy Bird
Conchita Wurst
ISIS
Frozen
Sochi Olympics

Pretty interesting look into 2014. Also amazing that a mobile app (Flappy Bird) made the list for the first time. There’s two healthcare terms: Ebola and ALS Ice Bucket Challenge. I wondered what this list would look like for healthcare IT. So, I decide to take a guess at what I think would be the trending healthcare IT terms of 2014:

ICD-10 Delay
EHR Penalties
Wearables
Meaningful Use Stage 2
Epic
Obamacare
FHIR
Cerner-Siemens
HIPAA Breaches
Patient Engagement

What do you think of the list? Would you order it differently? Are there terms you think should be on the list?

Is The Future of Smart Clothing Modular or Integrated?

Posted on September 4, 2014 I Written By

Kyle is CoFounder and CEO of Pristine, a VC backed company based in Austin, TX that builds software for Google Glass for healthcare, life sciences, and industrial environments. Pristine has over 30 healthcare customers. Kyle blogs regularly about business, entrepreneurship, technology, and healthcare at kylesamani.com.

OMSignal recently raised $10M to build sensors into smart clothes. Sensoria recently raised $5M in pursuit of the same mission, albeit using different tactics. Meanwhile, Apple hired the former CEO of Burberry, Angela Ahrendts, to lead its retail efforts.

And Google is pushing Android Wear in a major way, with significant adoption and uptake by OEMs.

There’re two distinct approaches that are evolving in the smart clothing space. OMSignal, Sensoria, and Apple are taking a full-stack, vertical approach. OMSignal and Sensoria are building sensors into clothing and selling their own clothes directly to consumers. Although Apple hasn’t announced anything to compete with OMSignal or Sensoria, it’s clear they’re heading into the smart clothing space in traditional Apple fashion with the launch of Health, the impending launch of the iWatch, and the hiring of Angela Ahrendts.

Google, on the other hand, is licensing Android Wear to OEM vendors in traditional Google fashion: by providing the operating system and relevant Google Services to OEMs who can customize and configure and compete on retail and marketing. Although Google is yet to announce partnerships with any more traditional clothing vendors, it’s inevitable that they’ll license Android Wear to more traditional fashion brands that want to produce smart, sensor-laden clothing.

Apple’s vertically-integrated model is powerful because it allows Apple to pioneer new markets that require novel implementations utilizing intertwined software and hardware. Pioneering a new factor is especially difficult when dealing with separate hardware and software vendors and all of the associated challenges: disparate P&Ls, different visions, and unaligned managerial mandates. However, once the new form factor is understood, modular hardware and software companies can quickly optimize each component to drive down costs and create new choices for consumers. This approached has been successfully played out in the PC, smartphone, and tablet form factors.

Apple’s model is not well-suited to being the market leader in terms of raw volume. Indeed, Apple optimizes towards the high end, not the masses and this strategy has served them well. But it will be interesting to see how they, along with other vertically integrated smart-clothing vendors, approach the clothing market. Fashion is already an established industry that is predicated on variety, choice, and personalization; these traits are the antithesis of the Apple model. There’s no way that 20% or even 10% of the population will wear t- shirts, polos, tank tops, dresses, business clothes, etc., (which I’ll collectively call the “t-shirt market”) made by a single company. No one company can so single-handedly dominate the t-shirt market. People simply desire too many choices for that to happen.

OMSignal and Sensoria don’t need to worry about this problem as much as Apple since they’re targeting niche use cases in fitness and health. However, as they scale and set their sites on the mass consumer market, they will need to figure out a strategy to drive massive personalization. Apple, given its scale and brand, will need to address the personalization problem in the t- shirt market before they enter it.

The t-shirt market is going to be exciting to watch over the coming decades. There are enormous opportunities to be had. Let the best companies win!

Feel free to a drop a comment with how you think the market will play out. Will the startups open up their sensors to 3rd party clothing companies? Will Apple? How will Google counteract?

Will Google Use Health IT To Make You Immortal?

Posted on November 15, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

When Google Health, an attempt at a personal health record, turned out to be an unqualified failure, the consensus was that people just weren’t interested.

But health care is too big, important and data-ridden a field for Google to ignore. And now the company has moved on to a concept sure to be in demand: It wants to help you live forever. Google’s new anti-aging initiative, Calico, will apparently treat mortality as a big-data problem.

But is data the path to eternal life — or even a few more good years? I’d feel a little more comfortable booking a cruise for the year 2199 if Google had accomplished something in health care already.

Google officials, including cofounders Larry Page and Sergey Brin, haven’t said much about what Calico will actually do. But the project seems to take inspiration from 23andMe, a firm that Google helped to start and whose goal is “to make it possible to create a massive genomic database and thereby understand the permutations and mutations that happen to the human genome during the aging process,” according to the Washington Post.

Time explained in a feature article that medicine “is well on its way to becoming an information science.”

“Doctors and researchers are now able to harvest and mine massive quantities of data from patients,” the magazine continued. “And Google is very, very good with large data sets.”

When you put it that way, it sounds kind of reasonable. And if Google invents a medication, an app or a device that brings about a longer lifespan, then I will certainly take it, download it, wear it or whatever is required. But I doubt the human lifespan is quite that reducible.

The rich and powerful have often hoped to use their resources to overcome their mortality. And as Pete Shanks wrote, “immortality and transhumanist ideas generally have long been a source of fascination in Silicon Valley.”

Ray Kurzweil, Google’s engineering director, is a noted futurist who believes we’ll upload our minds to computers and achieve digital immortality by 2045. It’s not clear what role, if any, Kurzweil will have in Calico.

The human lifespan doesn’t seem to have budged in 100,000 years, but that’s not to say it’s impossible. I don’t doubt that humans’ maximum time on Earth could be increased. Maybe. Someday. For the longest time, humans didn’t fly or play Minecraft, either. And it’s been done in other species.

But Shanks was right when he wrote of Calico that “what’s most aggravating is the hubris involved.” A common fallacy among highly successful people is to think that expertise in one area will apply to other fields.

Google is great at search. Its map service is also ubiquitous, and I’ve heard that its driverless car works well. But when it comes to chaotic human data, the company’s algorithms might not work as well. Take free-form language, for example. When I use Google Translate to decipher the Chinese-language Wikipedia entry for “immortality,” I get sentences like this: “If you can maintain Chang Heng unchanged, it is possible to ‘live forever,’ but before the observation Everything in the world is now, whether living or heartless thing, and both are changing all the time.” It’s an app that can be helpful, but it doesn’t give me confidence that Google can overcome the limitations of our mortal coils. It can barely understand what we’re talking about.

And Google’s track record in health care is, of course, not so strong. Google Health, introduced in 2008 as a way for consumers to collect their health records online, was defunct by the end of 2011. Few consumers found it worth the effort of entering their data, given Google Health’s lack of capabilities such as appointment scheduling, InformationWeek reported.

Let’s hope that whatever Calico comes up with proves more useful. If it can be packaged as a free download, even better.

But I’d rather see Google invest its considerable resources in something with a higher chance of a payoff.

Risk Taking in Healthcare and the Foolish

Posted on April 29, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

“You have to take what people think is wrong or even foolish and make the breakthroughs of tomorrow.” – John Kheir, MD

I’m still in awe of the ideas that John Kheir, MD presented at TEDMED around injectable oxygen-filled microbubbles. The concept is fascinating and while I know nothing about the science or medical requirements of what he was doing, I was even more impressed with the challenges that John Kheir faced from “the establishment” when he through out what many considered to be foolish ideas.

This is what make’s Dr. Kheir’s quote above so powerful. The breakthroughs of tomorrow really are often consider foolish ideas today. We see these examples in the tech world all the time. When Google began it was foolish to think that they could index the web and let people search through it. The dominant thinking of the time was that a website like Yahoo would curate the vast amount of web content for the users. Google’s foolish idea has turned out pretty well. It makes me wonder what foolish healthcare IT ideas are out there that we should be embracing and supporting as opposed to suppressing.

When Dr. Kheir had his breakthrough idea of oxygenating the blood through an IV, he started to research whether some sort of micro container existed. He discovered that indeed microbubbles already existed and were used for ultrasound imaging. He reached out to one of the leading experts on microbubbles and asked if they’d been used to oxygenate blood and if not why not. The researchers response was fascinating. He replied, “I didn’t know it would be useful.”

I ask then, are there technologies out there today that we just aren’t using in EMR and healthcare IT because “we didn’t know it would be useful?”

Check out the Looking Ahead After TEDMED hangout I’m doing on Thursday, May 2, 2013 at 2:00 PM EST to hear more discussion about TEDMED.

Should EHR Vendors Integrate Google Search Into Their Software?

Posted on September 18, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One thing I love about Twitter is the on the ground insight you can get into healthcare. Here’s a tweet example of this:

When I read the tweet, I was fascinated by the shift that Eric Topol observed by his residents. I’m sure many doctors out there are cringing at the idea that Google instead of some “trusted” source of information is where new doctors are turning for health information.

I think this view is a little short sighted and ignores the sophisticated ways that people are using Google. I find myself doing this more and more as well as I search out information on the internet. When I’m searching, I don’t always select the top Google result. Instead, I regularly find myself checking the website for that result to see if that website is what I would consider a trusted source. I’m sure that many residents do the same thing as well.

Certainly this shift is not without its pitfalls. Some likely don’t look to see if the Google result is a trusted source. Even what may look like a trusted source might not be trusted. However, I believe this is the minority of people searching (in particular residents).

One other change that’s happening is that many people are triangulating the results from their search. Instead of blindly looking at a result from Google, when you’re making a decision like a doctor is making you’ll often take a look at multiple sources and compare how the results and information compares. Instead of treating Epocrates like the Bible, they’re looking at Epocrates and Medscape and Google and triangulating all that information into what is the best course of action or the best information. This is a very good shift and many in the latest generation just do this naturally.

Since this is largely an EHR site, it makes me wonder if more EHR vendors should be integrating Google searches into their EHR. It wouldn’t have to be blatantly Google. I think the web browser is likely the right implementation to consider. If you highlight a word in the Google Chrome web browser and then right click, it will do a Google search on the highlighted word. Seems like it wouldn’t be too hard to do the same within an EHR.

While the tweet might indicate that companies like Epocrates and Medscape our in trouble (see my post about Taking Down the Epocrates Monopoly), there’s no reason that these health information companies can’t capitalize on Google search results as well. They’ll just have to learn how to get their information listed in Google as opposed to stuck in an app.

AI (Artificial Intelligence) in EMR Software

Posted on December 2, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Today I had an interesting conversation with MEDENT. It’s an EHR company that’s in only 8 states. I could actually write a whole post on just their approach to EMR software and the EMR market in general. They take a pretty unique approach to the market. They’ve exercised some restraint in their approach that I haven’t seen from many other EHR vendors. I’ll be interested to see how that plays out for them.

Their market approach aside, I was really intrigued by their approach to dealing with ICD-10. They actually described their approach to ICD-10 similar to how Google handled search. There’s all this information out there (or you could say all these new codes) and so they wanted to build a simple interface that would be able to easily and naturally filter the information (or codes in this case). A unique way of looking at the challenge of so many new ICD-10 codes.

However, that was just the base use case, but didn’t include what I consider applying AI (Artificial Intelligence) to really improve a user interface. The simple example they gave had to do with collecting data from their users about which things they typed and which codes they actually selected. This real time feedback is then added to the algorithm to improve how quickly you can get to the code you’re actually trying to find.

One interesting thing about incorporating this feedback from actual user experiences is that you could even create a customized personal experience in the EMR. In fact, that’s basically what Google has done with search with their search personalization (ie. when you’re logged in it knows your search history and details so it can personalize the search results for you). Although, when you start personalizing, you still have to make sure that the out of box experience is good. Plus, in healthcare you could do some great personalization around specialties as well that could be really beneficial.

I’d heard something similar from NextGen at the user group meeting applied to coding. The idea of tracking user behavior and incorporating those behaviors into the intelligence of the EMR is a fascinating subject to me. I just wonder how many other places in an EMR these same principles can apply.

I see these types of movements as part of the larger move to “Smart EMR Software.”

Surprising EHR Tweet of the Day

Posted on September 28, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I saw this tweet and decided I couldn’t pass up posting it. When I read it, all I could think was, Yeah……right!! (yes, that last part is in the sarcasm font)

@NewIQ – David Whitaker
The next five years will be pivotal for EHR solutions. The cloud presents a real opportunity for the creation of a truly dynamic system.
Followed by…
I would not be surprised if the folks at Google or Facebook werent already working on a strategy. #EHR #cloud

I think the last thing Facebook is thinking about is anything to do with EHR. They might be interested in healthcare apps for “consumers” managing their health, but they couldn’t give a rip about EHR. They might even consider helping doctors connect with patients on Facebook (although, even that I think is unlikely), but not an EHR.

Google has probably thought of EHR back when Google Health launched. Obviously they chose to go with PHR and we see how that turned out. I don’t think Google could make a worse mistake than to try and create an EHR.

Yeah, Facebook or Google doing EHR…that would be surprising.