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Nokia May Exit Digital Health Business

Posted on March 2, 2018 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.

The digital health market has become phenomenally competitive over the last few years, with giants like Google and Apple duking it out with smaller, fast-moving startups over the choicest opportunities in the sector.

Even with a behemoth like Google, you expect to see some stumbles, and the Internet giant has taken a few. But seldom have we seen a billion-dollar company walk away from the digital health market, which arguably stands to grow far more. Still, according to a recent news report, that’s just what Nokia may be doing.

A story published in The Verge reports that the Finnish telecom giant has launched a strategic review of its health division. While Nokia apparently isn’t spilling the beans on its plans, the news site got a look at an internal company memo which suggests that its digital health business is indeed in trouble.

In the memo, The Verge says, Nokia chief strategy officer Kathrin Buvac wrote that “our digital health business has struggled to scale and meet its growth expectations… [And] currently, we don’t see a path for [the digital health business] to become a meaningful part of a company as large as Nokia.”

While it’s hard to tell much from a press release, it notes that Nokia’s digital health division makes and sells an ecosystem of hybrid smart watches, scales and digital health devices to consumers and enterprises. Its digital health history includes the acquisition of Withings, a French startup with a sexy line up of connected health-focused digital health devices.

This may be in part because it just hasn’t been aggressive enough or offered anything unique. In the wake of the Withings acquisition, Nokia doesn’t seem to have done much to build on Withings’ product line. Though much of the success in this market depends on execution, its current roster of products doesn’t sound like anything too exciting or differentiated.

It’s interesting to note that Buvac blames at least part of the failure of its digital health excursion on Nokia’s size. That doesn’t seem to be a problem for industry-leading companies like Apple, which seems to be carving out its digital health footprint one launch at a time and cultivating health leaders along the way. For example, Apple recently partnered with Stanford Medicine launch an app using its smartwatch to collect data on irregular heart rhythms. Arguably, this is the way to win markets and influence people — slow and steady.

In the end, though, Buvac is probably right about is digital health prospects. Nokia’s seeming failure may indeed be attributed to its sprawling portfolio, and probably an inflexible internal culture as well. The moral of the story may be that winning at the digital health game has far more to do with understanding the market than it does with having very deep pockets.

Key Articles in Health IT from 2017 (Part 2 of 2)

Posted on January 4, 2018 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

The first part of this article set a general context for health IT in 2017 and started through the year with a review of interesting articles and studies. We’ll finish the review here.

A thoughtful article suggests a positive approach toward health care quality. The author stresses the value of organic change, although using data for accountability has value too.

An article extolling digital payments actually said more about the out-of-control complexity of the US reimbursement system. It may or not be coincidental that her article appeared one day after the CommonWell Health Alliance announced an API whose main purpose seems to be to facilitate payment and other data exchanges related to law and regulation.

A survey by KLAS asked health care providers what they want in connected apps. Most apps currently just display data from a health record.

A controlled study revived the concept of Health Information Exchanges as stand-alone institutions, examining the effects of emergency departments using one HIE in New York State.

In contrast to many leaders in the new Administration, Dr. Donald Rucker received positive comments upon acceding to the position of National Coordinator. More alarm was raised about the appointment of Scott Gottlieb as head of the FDA, but a later assessment gave him high marks for his first few months.

Before Dr. Gottlieb got there, the FDA was already loosening up. The 21st Century Cures Act instructed it to keep its hands off many health-related digital technologies. After kneecapping consumer access to genetic testing and then allowing it back into the ring in 2015, the FDA advanced consumer genetics another step this year with approval for 23andMe tests about risks for seven diseases. A close look at another DNA site’s privacy policy, meanwhile, warns that their use of data exploits loopholes in the laws and could end up hurting consumers. Another critique of the Genetic Information Nondiscrimination Act has been written by Dr. Deborah Peel of Patient Privacy Rights.

Little noticed was a bill authorizing the FDA to be more flexible in its regulation of digital apps. Shortly after, the FDA announced its principles for approving digital apps, stressing good software development practices over clinical trials.

No improvement has been seen in the regard clinicians have for electronic records. Subjective reports condemned the notorious number of clicks required. A study showed they spend as much time on computer work as they do seeing patients. Another study found the ratio to be even worse. Shoving the job onto scribes may introduce inaccuracies.

The time spent might actually pay off if the resulting data could generate new treatments, increase personalized care, and lower costs. But the analytics that are critical to these advances have stumbled in health care institutions, in large part because of the perennial barrier of interoperability. But analytics are showing scattered successes, being used to:

Deloitte published a guide to implementing health care analytics. And finally, a clarion signal that analytics in health care has arrived: WIRED covers it.

A government cybersecurity report warns that health technology will likely soon contribute to the stream of breaches in health care.

Dr. Joseph Kvedar identified fruitful areas for applying digital technology to clinical research.

The Government Accountability Office, terror of many US bureaucracies, cam out with a report criticizing the sloppiness of quality measures at the VA.

A report by leaders of the SMART platform listed barriers to interoperability and the use of analytics to change health care.

To improve the lower outcomes seen by marginalized communities, the NIH is recruiting people from those populations to trust the government with their health data. A policy analyst calls on digital health companies to diversify their staff as well. Google’s parent company, Alphabet, is also getting into the act.

Specific technologies

Digital apps are part of most modern health efforts, of course. A few articles focused on the apps themselves. One study found that digital apps can improve depression. Another found that an app can improve ADHD.

Lots of intriguing devices are being developed:

Remote monitoring and telehealth have also been in the news.

Natural language processing and voice interfaces are becoming a critical part of spreading health care:

Facial recognition is another potentially useful technology. It can replace passwords or devices to enable quick access to medical records.

Virtual reality and augmented reality seem to have some limited applications to health care. They are useful foremost in education, but also for pain management, physical therapy, and relaxation.

A number of articles hold out the tantalizing promise that interoperability headaches can be cured through blockchain, the newest hot application of cryptography. But one analysis warned that blockchain will be difficult and expensive to adopt.

3D printing can be used to produce models for training purposes as well as surgical tools and implants customized to the patient.

A number of other interesting companies in digital health can be found in a Fortune article.

We’ll end the year with a news item similar to one that began the article: serious good news about the ability of Accountable Care Organizations (ACOs) to save money. I would also like to mention three major articles of my own:

I hope this review of the year’s articles and studies in health IT has helped you recall key advances or challenges, and perhaps flagged some valuable topics for you to follow. 2018 will continue to be a year of adjustment to new reimbursement realities touched off by the tax bill, so health IT may once again languish somewhat.

iOS vs Android Infographic

Posted on June 7, 2017 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.

The iOS and Android debate is a good one that never seems to end. The good news is that the debate is really only iOS and Android now. However, the reality in my mind is that most healthcare app developers need to do both regardless.

That said, I think that this infographic illustrates some differences in the culture of the iOS ecosystem and the Android ecosystem. It’s not really surprising when you realize that there are only expensive iOS devices and so it’s no surprise that people with iOS devices have more money. Whereas there are high end Android devices and there are low end Android devices. I wonder if the numbers would be very similar between those who have high end Android devices and iOS. I bet those populations would be very similar.

What are your thoughts on the debate between iOS and Android? Does it really matter at this point?


Via: InvestmentZen.com

Apple Is Making a Mistake Acquiring Gliimpse

Posted on August 24, 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.

The big news this week was that Apple has acquired PHR vendor Gliimpse. This was supposedly the first acquisition by Apple’s new Digital Health team. Plus, it’s the first big news since Tim Cook commented that Apple’s opportunity in healthcare “may even make the smartphone market look small.”

Many are touting this as a the start of the move by Apple into healthcare. No doubt it’s interesting that Apple would make a vertical acquisition like this, but it’s a mistake. Unfortunately, it’s a mistake that Apple is likely to do over and over again.

Apple certainly was and in many respects still is in a unique position to be able to innovate in healthcare thanks to its massive iPhone user population. They really could do some interesting things in healthcare since so many people have iPhones and so many healthcare companies want to say they’re working with Apple. The problem is that Apple doesn’t understand healthcare.

If you think this is a small thing, you’ve probably never tried to do a healthcare startup company. Healthcare is a unique market and requires a unique understanding to be successful. All the bravado in the world will only get you so far in the world of healthcare. Then, the harsh realities set in and you realize that the current against you is a lot stronger than you first realized.

Let’s take the example of the PHR Gliimpse (and generalizing to any PHR). This is a hard market with very little consumer demand. That’s been proven over and over again by hundreds of companies who have tried. The harsh reality is that most patients don’t care enough about their health to want to aggregate their health record. It’s worth noting that aggregating your health record is hard work. I even know one company that is paying doctors to send them health records and even then it’s hard to get doctors to act. Plus, there’s little value to healthy patients if they actually did aggregate their record. This is a tough, tough business.

Certainly, a case can be made for chronic patients that it’s worth the effort to aggregate this data into a PHR. Many have been doing this out of necessity. It was happening before cell phones became ubiquitous as people carried around massive folders or binders with their health records. While this value is understood, this makes for an extremely small market. When did Apple last do good in a small market? Is Apple going to really give up iPhone real estate when only a small portion of their users can actually get value from the PHR?

It’s great to have Apple interested in healthcare. However, I think the acquisition of a PHR company is a mistake and won’t yield them the rewards in healthcare that they seek. Of course, when you have a few billion to spend, what’s a few million on a PHR company? No doubt it’s a really small bet by Apple, but one that I don’t think will pay off for them. At least now they’ll have some people with health experience on the team and maybe they can innovate something new.

Airstrip’s Apple Watch Implementation of Sense4Baby

Posted on September 10, 2015 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.

Everyone in healthcare has been watching the Apple Watch and Apple just announced the next generation of their watch. As part of the Apple Watch announcement, Dr. Cameron Powell, CMO and Co-Founder of Airstrip was on stage demonstrating the Apple Watch implementation of Sense4Baby (which Airstrip acquired). Rather than try to explain the implementation, it’s much better to see it in action:

EHR Apple Watch Integration

Posted on May 20, 2015 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.

We’ve been writing about the coming of the Apple Watch for a long time here at Smart Phone healthcare. Remember when we use to call it the iWatch? I must admit that I hadn’t seen many really interesting healthcare applications on the iWatch. They all felt like retreads of things that were basically accomplished on people’s smart phone and weren’t that much better on the watch.

Today, I might have read about the first healthcare IT application on the Apple Watch that could provide value to healthcare. The announcement came from Kareo and here’s a list of key functionality that they’ve included in the Apple Watch from the Kareo EHR:

  • Secure messaging that allows the user to send, reply, and read messages via dictation. Messages can be sent to staff or patients using Kareo’s secure messaging system, improving overall patient engagement and practice communication.
  • An agenda that allows the provider to quickly reference their schedule and see the status of appointments checked-in, no show, late, checked out, etc., helping reduce wait times and improve practice efficiency.
  • Appointment reminders that can be sent five minutes before the next scheduled appointment. The notification subtly vibrates the watch, indicating that the doctor has an impending appointment.
  • Appointment information that is accessible within a notification or through the agenda, allowing the provider to review details such as the patient’s name, time of appointment, visit type, and reason for the visit.
  • “I’m Running Late” pre-set messages that allow the doctor inform other staff members when they are running behind and how much longer they expect to be. This improves practice communication and enables the front desk to give patients a more accurate wait time estimate.
  • Apple “Glances” that provide a quick overview of key practice metrics, including how many patients are scheduled throughout the day, how many patients are waiting to be seen, and which patients are currently waiting in an exam room.

EHR Apple Watch - Kareo

I’d like to see this in action and look forward to doing so the next time I see Kareo (possibly not until MGMA), but the features have some promise. I could see them being used pretty regularly. Especially the status updates on how many patients are checked in and how many are waiting. That’s really great information that is changing constantly throughout the day. The schedule for the day is great as well.

Kareo had previously announced some features for Google Glass. I liked that they were pushing the envelope, but it didn’t feel like something that doctors would grab onto. I think this Apple Watch implementation has a lot more legs to it. I’ll be interested to hear from Kareo doctors how it works in actual practice.

Full Disclosure: Kareo is a sponsor of one of the Healthcare Scene blogs.

Mobile Patient Recruitment

Posted on May 12, 2015 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 tweet was talking about mobile recruitment of patients for clinical studies using Apple’s research kit. So far it has signs that it will be a phenomenal success. I think there are still some lingering questions about the quality of the patients that are signing up and whether they really fit the study criteria, but they’re definitely making progress.

What’s interesting to me is that we almost seem surprised that connecting with patients through a mobile device is so popular. This shouldn’t be a surprise to any of us. More and more people are having cell phones and unlike many of the chronic patients who are older and less tech savvy, many of the clinical trial participants are younger people who are very tech savvy.

I’m still not sure if Apple’s research kit is going to be the main answer for this type of recruitment, but I do think we’ll be connecting with patients for clinical trials in a big way going forward. In fact, I think that’s true for a lot of healthcare. There’s still a mindset change that needs to happen for many people (including myself), but the next generation of patient will likely do most of what they do through their cell phone.

What other areas will be impacted by cell phone use? I did a webinar last week with Kareo that talked about the need to have a mobile optimized (likely responsive) practice website. I’m sure there are hundreds of others. Let’s hear them in the comments.

Other mHealth Apps for the Apple Watch

Posted on April 29, 2015 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’m already on the recorder that I don’t think that the Apple Watch is going to be a game changer for healthcare. After it’s launch I still believe that to be the case. In fact, I’m not sure if it will be a game changer for anything (not just healthcare). It’s an interesting novelty item and some elements of the interface are cute. The marketing is great as would be imagined from Apple, but they’re selling the sizzle and not the steak.

With that perspective out of the way, I was intrigued by this MacWorld article that lists 5 outside the box health apps for the Apple Watch. They basically said outside the box was something beyond heart rate (not a very high bar). Here’s what they listed:

WebMD – This is not their database of education. It’s a medication reminder, tracking and medication schedule app.

Skin – This app lets you scan your skin for areas of concern and then you can preview the scan on your watch. The app also evaluates the skin. I guess that’s one way to track changes in your skin over time.

ReSound Smart – This app controls your smart hearing adds and adjusts the volume, noise filters, etc. It also uses geotagged locations to adjust the settings automatically (something that likely works with your phone too).

Clue – This app helps women track their periods and get a full overview of their cycles. The watch app is mostly for accessing the data as opposed to entering the data.

BACtrack – Connects to a smart beathalyzer to give you an idea of your blood-alochol level. Also, reminds you after 15 minutes to do another test to get a more accurate result.

The ReSound Smart app is the most interesting one to me on this list. Although, my biggest problem with it is that it has a limited use case. You have to have hearing aids and you have to have smart hearing aids. I’m sure it’s a great product for people with hearing aids and no doubt I’d love something like it if I was in that situation but I’m not so it’s hard for me to really measure its value.

The rest of them didn’t seem all that interesting. Medication reminders is going to work well on the watch, so it’s good that WebMD is doing it, but we’re going to see that from 100 providers. Plus, is it that much better on the watch than to the smartphone itself?

I love interesting apps like this list provides, but I’m not seeing any game changers on this list of Apple Watch health apps.

Will Apple’s iWatch Be A Game Changer for Healthcare?

Posted on March 25, 2015 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.

In case you’re living in a hole, or at least have too busy to check it out, here’s the Apple iWatch trailer which outlines the soon to be released Apple smartwatch.

I haven’t worn a watch in years, so it’s hard for me to imagine me wearing one of these. Although, I’ve worn watches in the past and so I’d like to try it. The commercials I’ve seen for the iWatch are pretty compelling, but what I can’t tell is how much of that is “great advertising” and how much of that is “I really need this product.”

Now to the title of this article. Will the iWatch change the game in healthcare? My answer is no. Besides the fact that Apple has sucked out a lot of the mHealth related functionality, I just don’t think that enough people are going to buy and wear them for it to really change healthcare. Plus, I don’t think the fact that it’s a watch on your wrist as opposed to a phone in your pocket is going to be able to provide that much added functionality.

What I do think the Apple iWatch will do is help to push forward how we look at how we interface with our phone and the data that’s available to us. I think that’s a great thing and something we’ll all benefit from across a wide variety of devices and interfaces which are to come.

So, I don’t think that the Apple iWatch is going to revolutionize healthcare, but it is a nice step forward in new interfaces that will be one of many interfaces we use to access our health data and communicate with our various care providers.

What do you think? Will the Apple iWatch have more or less impact on healthcare than what I describe?

Cerner Wellness Integrates with Apple’s HealthKit

Posted on October 1, 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.

When Apple announced HealthKit, they announced a few healthcare partners including Epic. Many thought this was an interesting announcement, but I was (and still am) skeptical that anything really meaningful will come. As one person put it, we’re suppose to be excited that two of the most closed companies in the world are working together?

I recently saw the news come out that Epic’s main competitor, Cerner, announced that they’d integrated with Apple’s HealthKit. In fact, I believe their integration seems to have come out before Epic’s integration (unless I missed it, or maybe Epic just likes to keep quiet). Here’s a short excerpt from the Cerner announcement:

To me, HealthKit is about making it more convenient to manage your health and wellness, and share that information with the people that are helping you reach your goals. It’s less about trying to get real-time clinical insights or make new diagnoses. HealthyNow has the features that consumers and wellness experts are looking for in these apps, and by integrating with HealthKit, we’ve opened up the experience to a whole array of health apps for our members to choose from. This integration enables the feeding of key health metrics into our platform for sharing with health coaches, earning of incentive points, and identification of new opportunities to improve your health. By promoting healthier habits, consumers lower their premiums, health plans reduce their spend on treating avoidable diseases, and everyone lives a healthier life. (emphasis added)

The details on what Apple’s HealthKit would really do have been pretty foggy. Although, this paragraph illustrates where I figured HealthKit was going. Notice the part of the quote where I added emphasis. Cerner is just looking to suck data from HealthKit into Cerner. Maybe they have future plans to make Cerner data available to HealthKit, but the announcement seems to say they haven’t done so yet. This one way interface is exactly why I’m skeptical that HealthKit will really have a huge impact on healthcare.

What do you think? Have any of you integrated with HealthKit? I’d love to see if you have other views of where HealthKit might be headed.