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Breaking Down the Mobile Health Apps by Number

Posted on October 31, 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.

Dan Munro has a great blog post on Forbes that offers an overview of the IMS Institute for Healthcare Informatics report on the mobile health app market. Check out his whole article for all the findings, but I was really intrigued by his list of study results:
1. Every app categorized as “health and wellness” or “medical” in Apple’s AAPL -0.11% iTunes store was reviewed
2. Of the 43,000+ mobile health apps assessed for the report – only 23,682 were classified with a legitimate health function
3. 5 apps accounted for 15% of all downloads
4. 16,275 were considered patient facing
5. 7,407 were considered provider facing
6. Smartphone use is lowest (18%) in the 65+ demographic
7. More than 90% of the apps tested scored less than 40 on a scale of 100
8. Apps were further categorized by 7 capabilities:
– Inform (10,840 apps)
– Instruct (5,823 apps)
– Record/Capture data (5,095 apps)
– Display User entered data
– Guide
– Remind/Alert (1,357 apps)
– Communicate
– None of the 7 capabilities (1,622 apps)

I always love data and this is some interesting data. Dan’s headline was also another interesting piece of data: “Over 50% Of Mobile Health Apps Are Downloaded Less Than 500 Times.” We’ve talked about this before. It’s one thing to build a mobile health app and another thing to get someone to actually use it. Many fall short of the later objective.

One other stat in the list above that stood out to me was the split between provider facing mobile health apps and patient facing mobile health apps. I would have thought that more of them would be patient facing. That’s a lot of provider focused mobile health apps considering the size of the provider market. Of course, each of those doctors do control a lot of consumer spend.

Patient Controlled Records Could Work Internationally

Posted on 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.

A few years back at HIMSS, I had the pleasure of meeting one of the most passionate and driven healthcare people you’ll find. His name is Gerald Theis, Founder of My Crisis Records. His passion for what he was doing was undeniable and there was no way I was going to bet against Gerald getting something done in healthcare. However, I did question how many US patients would really care enough to carry around and gather their health records.

Turns out, there are dozens of companies with a vision similar to that of My Crisis Record. I’m sure that Gerald could passionately explain why My Crisis Record is different or better than any competitors, but at the end of the day the core concept is very similar: A patient controlled health record.

Whether the patient controlled health record is carried on a USB stick, linked from a QR code, stored on your cell phone, accessed in the cloud, etc the concept is the same. In many ways the patient is acting like their own personal health information exchange.

The concept is a brilliant one except for one major flaw. US people don’t care about the flow of their healthcare information. The big exception to this is chronic patients who do start caring once they get past the denial stage. However, the majority of patients in the US are satisfied with the current flow of information between doctors. Certainly their satisfaction could be based on ignorance. Many patients likely think that doctors are sharing a patients health information all the time, when in fact they are usually not.

Could this change? Certainly, but it’s hard to base a business on people changing.

What I’ve found even more interesting is Gerald’s work to implement a My Crisis Record solution internationally. For example, he’s implementing it under the brand “My Smart Health” in Africa. The more I’ve learned about international healthcare, the more I think a patient controlled record could work internationally in places where they’re more focused on providing any sort of health services versus spending big bucks on EHR systems that aren’t interoperable.

All of this is bolstered by the widespread adoption of cell phones internationally. I can see how there could be real value in a patient controlled medical record on these people’s cell phones. From what I understand, you might not go to the same doctor twice. There’s not the same view of a primary care doctor that you go to all the time that has your record at their fingertips. Seems like the perfect opportunity for the patient controlled medical record.

We’ll see how it plays out. I guess I’m not very bullish on the patient controlled medical record in the US, but I can see a lot of potential globally. Maybe over time the US will learn and change as well. What do you think?

China’s EMR Market

Posted on October 30, 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.

Last week I wrote about what’s not happening in China: American firms getting a slice of the EMR market.

This time I thought it’d be interesting to look at what is happening with health IT in the world’s most populous country.

As I mentioned, that’s often easier said than done. The healthcare system has peculiarities, and the government doesn’t necessarily say what it’s planning. Some research firms have shied away from reporting on China’s EMR scene altogether.

But a case study released over the summer provides some fascinating market intelligence. The work by Arthur Daemmrich, associate professor at the University of Kansas School of Medicine, follows Shanghai Kingstar Winning Software Co. Ltd. as its founder seeks to increase its growth rate.

Three options that Zhou Wei was considering as the first quarter of 2013 drew to a close included continuing to grow organically, merging with another company and expanding into other geographies, including South Asia or even the United States.

Points worth noting:

  • Winning, with 1,000 employees, competed for hospital IT projects with five other large firms. A few hundred smaller companies provided more specialized offerings.
  • The government owned more than 90 percent of the country’s hospitals.
  • Winning had achieved 50 percent revenue growth in 2012 and expected the same in 2013, but Zhou was not satisfied. He felt that even more rapid growth was needed.
  • In 2008, 1 percent of China’s hospitals were using EMRs. By 2012, about 32 percent of higher-ranked hospitals — tier-II and tier-III institutions — had EMRs.
  • Medical record-keeping in China came nearly to a halt during World War II and the country’s civil war. Many leftover records were destroyed during the Cultural Revolution of the 1960s and 1970s. The country then began rebuilding its records infrastructure. Daemmrich wrote, “Outpatient visits and prescriptions were recorded on small booklets that patients kept and brought with them to the hospital or other specialized clinic. Most hospitals issued their own booklets, so patients could end up with several different sets of medical records at home.”
  • Zhou’s firm undertook a project at an 850-bed Chinese traditional medicine (TCM) hospital. At such institutions, treatments such as acupuncture and therapeutic massage are common. The company’s R&D director, Ma Wei Min, explained, “The interfaces of western medicine and TCM EMR systems are alike, because the patient flow paths at both kinds of hospitals are almost the same. But going back to the software writing stage, TCM EMRs required a different logic and very different terminology.”

It’s easy to get immersed in the health IT considerations of our own country and forget that other regions are undertaking similar efforts. In China, the goals of the EMR push are largely the same as they are in the United States, but it’s interesting how much local flavor comes into play. The fact that Winning’s founder was seeing 50 percent revenue growth but still expected more was amazing and speaks to the country’s pace of economic development. And the background on China’s record-keeping shows that the country’s task is not just to digitize processes that have long been in place, but to define exactly what a medical record is and how it should work.

EMR Vendors Struggle With Meaningful Use Stage 2

Posted on October 29, 2013 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.

CCHIT head Alisa Ray, clearly, is trying to put it delicately. EMR vendors are “struggling a little bit” when it comes to meeting 2014 criteria. “It  has been a slow start,” Ray told Healthcare IT News.

Usually, hearing this would lead to an inside baseball discussion of vendor operations, which wouldn’t be very exciting. But the thing is, meeting 2014 certification criteria is necessary to allow providers to meet Meaningful Use Stage 2. So vendor struggles in complying with CCHIT’s criteria should concern providers a great deal.

There are three areas of Stage 2 that are proving to be an issue for vendors: clinical quality measures, interoperability and automated measure calculation for reporting metrics, Ray said.

This has led to a real lag in certifications. About 40 companies had listed products with the CCHIT in 2011, but a scant 21 percent of those have stepped up and gotten certified in the 2014 criteria.

According to Ray’s chat with Healthcare IT News, “almost everyone has struggled and been surprised by the complexities” of meeting 2014 standards.  Despite having gone through the process yearly since 2006 with CCHIT, several have had to go through repeated certification trials to meet criteria.

ICSA Labs’ Amit Trivedi, meanwhile, noted that while there were close to 3,000 listings, with many having multiple listings — Cerner alone had 800 — so far there less than 300 on ONC’s Certified Health IT Products list.

There are signs that EMR vendors will catch up, the HIT story suggests. For example, vendors have been working particularly hard to offer Continuity of Care Documents or Direct messaging, a capability providers must demonstrate for Meaningful  Use Stage 2, said Matt Kohler, vice president of Network Infrastructure Services at Surescripts.

But vendors clearly have some serious development challenges ahead if they want to keep up with the pace set by Meaningful Use Stage 2.  If I were a provider reading this, I’d call my vendor right away and see where they were at in the certification process.

Apathy is the Biggest Mobile Health Blocker

Posted on October 28, 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.

There are a lot of things that people like to talk about for what’s holding back mobile health. They talk about the industry being very new, which is relatively true. They talk about the swarm of mobile health applications which provides consumers with the paradox of choice. Others point to some of the challenging regulations that cause problems for the adoption of mHealth. No doubt some laws make mobile health miserable (see Telemedicine laws across state lines). There are certainly many more reasons people offer. However, the biggest blocker to consumer adoption of mobile health technologies is Apathy.

Ever consumer health application is working against one of the strongest forces in the world. People just flat out don’t care. Yes, we all care about our health generally, but that’s very different than caring about your health enough to change your behavior. Yes, every mobile health app out there requires you to change your behavior. Even if it’s a touch or swipe of the screen, it’s still a change in behavior. Even if it’s carrying around a tracking device, it’s a change in behavior. The reality is that people don’t change their behavior when they’re apathetic about something.

I’ve always said that chronic patients are great for mobile health solutions. The reason why they’re great is that their chronic condition makes them start to care about their health. The same is true as we age. As we get older our days are numbered and we start to care much more about our health as we try to extend our life on this earth.

The problem is that both of these groups are very small. The majority of the population feels relatively healthy and so they don’t care about their health. Yes, I know there are exceptions, but they prove the rule. Watch someone who deeply cares about their health and you can see why the rest of the world doesn’t. It’s a lot of work to do all those things that keep you healthy.

Don’t get me wrong. I think there’s a ton of promise with mobile health technologies. In fact, it might be the only way that we are able to get people to care about their health. So far we haven’t been very successful. However, I have hope that the next generation of technologies will be able to change how we feel about health. In fact, it will happen in a way that most people won’t realize that what they’re doing is actually improving their health. That’s when mobile health technologies will finally reach their full potential.

Change is Good – 3 Changes That Are Transforming How Physicians Work

Posted on I Written By

The following is a guest blog post by Dr. Jose Barreau, CEO of Doc Halo.

They say that change is hard and that is generally true. Over the past few years there has been incredible fast-pace change in healthcare. But there are three things that physicians are using everyday with increasing frequency that are fundamentally changing the profession for the better.

1.    Online Medical Information: Gone are the days of textbooks. In Oncology, textbooks are outdated before they hit the shelf. Yes I still love the feel of a good book in my hand but it’s futile to resist. Now with one password physicians can search any disease and read an expert review within seconds. As senior physicians everywhere can attest to, many medical students are wandering the halls fully armed with the latest information and waiting for the opportunity to shine or strike depending on your view. I personally use several websites everyday in my practice. My personal favorite is UpToDate.com, which has excellent content in easy to read format. It also has content for patients. With these resources available on demand a physician becomes very efficient. They can prepare for a challenging patient encounter in a short period of time by reviewing the latest literature on an malady. The efficiency of quickly finding accurate peer reviewed information on any subject has changed the way physicians educate themselves.

2.    Electronic Medical Records: Yes, they take some getting used to but they are good. I clearly remember my fathers paper charts piled high and the Dictaphone chirping one hundred miles an hour when I as a kid. This did not look like fun to me. In today’s medicine EMR isn’t optional, it is a must have. With so many labs, imaging results and physicians involved in one patient’s care, this volume of information can no longer be managed with paper. We use Epic in our organization and once you take the time to become proficient it can be a very effective documentation tool and improve efficiency. I have colleagues that use Allscripts, McKesson, Cerner and several others and all have their strengths and weaknesses, but they provide value. There have been studies that show that efficiency is not improved wit EMR but these studies are not accurate and have many faults in their design. The key is for physicians to take the necessary time to become experts at using their EMR. This can take substantial time but it does pay of in the long run.

3.    Secure Texting Mobile Apps: The pager is not dead but it should be. First it was the physician’s home phone. Then many varieties of pagers emerged from voice to alphanumeric. With the advent of smartphones in every physician’s pocket this is changing rapidly. Why carry a pager when you can have a mobile app on your smartphone that sends and receives HIPAA secure messages. A few of the advanced enterprise solutions like Doc Halo can even integrate with an organizations single sign on system, call center software and send real time alerts. These advanced mobile app based communication systems have features such as “Off Duty” and “Auto Forwarding. They have directories and in network physician lists to help align the health care organizations. In addition in a recent survey 70% of users felt secure texting solutions improve patient care. Physician’s adopting this technology is certainly a trend and if these surveys are correct, a positive one.

These are three key things happening in medicine all around us and as physicians embrace these changes we all benefit.

About Dr. Barreau

As chief executive officer of Doc Halo, Dr. Jose Barreau leads Doc Halo’s development team and operations. He is one of the original founders of secure physician communication text mobile applications. The desire to exchange information quickly and securely with his healthcare colleagues eventually led to the development of the Doc Halo app.

Dr. Barreau is Board-certified in Internal Medicine, Hematology and Medical Oncology. He completed his fellowship in Hematology – Oncology at the University of Cincinnati in Cincinnati, Ohio and sub-specializes in breast cancer treatment.

As the Medical Director of the TriHealth Cancer Institute in Cincinnati, Dr. Barreau works to expand the use of multidisciplinary clinics, which will improve the quality of cancer care through better physician-to-physician communication. www.dochalo.com

Doc Halo, a leading secure physician communication application, is a proud sponsor of the Healthcare Scene Blog Network.

Prediction: AHIMA 2013 Will Be ICD-10 All Day All the Time

Posted on October 25, 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.

This will be my third year in a row attending the AHIMA Annual Conference (I think they call it the AHIMA Convention) which starts on Monday in Atlanta. I’m particularly excited for this year’s event because I have so many healthcare IT friends in Atlanta. Plus, I always have a great time at the event and learn a lot.

This year we’ll actually have three different Healthcare Scene bloggers (Jennifer Dennar, Mandi Bishop, and myself). So you can be sure to get some really varied coverage from the event from a number of different perspectives.

As I consider all the pitches I’ve gotten and think about the work of AHIMA, I can already tell that AHIMA 2013 is going to be dominated by one topic: ICD-10.

I honestly don’t think it’s even going to be close. I believe this is a very good thing. Hopefully the focus of attention on ICD-10 a little less than a year out from the ICD-10 implementation date is a good thing for the industry. You can be sure I’ll be doing what I can to help people better understand how they can prepare for ICD-10 and some of the tools out there.

Assuming I’m not too overwhelmed with all the AHIMA ICD-10 talk, next week I’d like to start a weekly series of posts on ICD-10. It feels right to call it ICD-10 Tuesdays. So, look forward to that series in the future.

Also, Agency Ten22 is holding the third annual tweet up at AHIMA on Tuesday evening. You can find more details and RSVP here. I’m reminded of the first tweetup. Beth from Agency Ten22 told me she had a nice suite. I told her I’d bring some Twitter friends and the AHIMA tweetup was born. Big thanks to Beth and her team for carrying on the tradition.

Finally, the rest of my travel for this year is booked. I’ll be at the Digital Health Conference (20% discount if you use the code HCS) in NYC in November and at the mHealth Summit in Washington DC in December. I hope to see many of you at one of these events.

The Shift from PC to Mobile

Posted on 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 of my favorite hospital CIOs is a man named Will Weider, CIO of Ministry Health Care. He’s also a fellow blogger that started blogging about the same time I did at Candid CIO. He sent out this tweet which provides a pretty amazing insight into the shift that’s happening with PCs.

Think about what it means that 4 years ago only 25% of PCs were mobile and now 50% of them are mobile. I expect that the users of those systems would probably like that number to be even higher, but replacement cycles take time to circulate out the old PCs that aren’t mobile.

I’d be interested to see what the stats are for the mobile PCs. How many are laptops, tablets, carts on wheels, etc. I assume when he says PC he doesn’t include smartphones in that number. Although, if trends continue as they are, your smartphone could become your future PC.

The idea of point of care computing in healthcare is a really important topic and trend. There’s nothing stopping it. It will absolutely be the future of healthcare. Are we ready to embrace it?

Mobile PHRs On The Way — Slowly

Posted on October 24, 2013 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.

On-demand mobile PHRs are likely to emerge over time, but not until the healthcare industry does something to mend its interoperability problems, according to a new report from research firm Frost & Sullivan.

As the paper notes, mobile application development is moving at a brisk clip, driven by consumer and governmental demands for better quality care, lower healthcare costs and improved access to information.

The problem is, it’s hard to create mobile products — especially a mobile PHR — when the various sectors of the healthcare industry don’t share data effectively.  According to Frost  & Sullivan, it will be necessary to connect up providers, hospitals, physician specialty groups, imaging centers, laboratories, payers and government entities, each of which have operated within their own informational silos and deployed their own unique infrastructures.

The healthcare industry will also need to resolve still-undecided questions as to who owns patient information, Frost & Sullivan suggests.  As things stand, “the patient does not own his or her health information, as this data is stored within the IT  protocols of the EHR system,  proprietary to providers, hospitals and health systems,” said Frost & Sullivan Connected Health Senior Industry Analyst Patrick Riley in a press statement.

While patient ownership of medical data sounds like a problem worth addressing, the industry hasn’t shown the will to address it.  To date, efforts to address the issue of who owns digital files has been met with a “tepid” response, the release notes.

However, it’s clear that outside vendors can solve the problem if they see a need. For example, consider the recent deal in which Allscripts agreed to supply clinical data to health plans.  Allscripts plans to funnel data from participating users of its ambulatory EMR to vendor Inovalon, which aggregates claims, lab, pharmacy, durable medical equipment, functional status and patient demographics for payers. Providers are getting patient-level analyses of the data in return for their participation.

Deals like this one suggest that rather than wait for interoperability, bringing together the data for a robust mobile PHR should be done by a third  party. Which party, what it will it cost to work with them and how the data collection would work are the least of the big problems that would have to be solved — but might be that or nothing for the foreseeable future.

Does mHealth Increase or Decrease Doctors Power Over Patients?

Posted on October 23, 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.


Does this tweet rub you the wrong way?

The idea of my doctor controlling me rubs me really wrong. There is nothing in this world that I abhor more than the idea of someone controlling me. There’s probably a reason that I work for myself as a blogger, but I digress.

Maybe control is the wrong word here. Doctors have a tremendous amount of influence over patients. I know that I trust my doctor to do what’s right for me. I go into the patient experience basically trusting my physician. I don’t think that mHealth changes that trust. I guess in many ways you could describe my view as a trust but verify positioning. mHealth helps me to verify much quicker. I think that’s a great thing.

What mHealth does do is hold doctors more accountable for the service they provide. This happens in many ways in mHealth. As I mentioned, it helps patients verify what they’ve been told by their doctor. mHealth also makes accessing and doing physician reviews much easier. Whether you like them or not, they’re here to stay and people are going to look at them. Doctors are going to have to be accountable for what’s said on those. Those are just a couple of examples.

I don’t think doctors should fear a loss of control thanks to mHealth. However, they should consider how mHealth will hold them more accountable for the work they do. That will be a dramatic shift for many doctors.