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Study Offers Snapshot Of Provider App Preferences

Posted on March 20, 2017 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.

A recent study backed by HIT industry researchers and an ONC-backed health tech project offers an interesting window into how healthcare organizations see freestanding health apps. The research, by KLAS and the SMART Health IT Project, suggests that providers are developing an increasingly clear of what apps they’d like to see and how they’d use them.

Readers of this blog won’t be surprised to hear that it’s still early in the game for healthcare app use. In fact, the study notes, about half of healthcare organizations don’t formally use apps at the point of care. Also, most existing apps offer basic EMR data access, rather than advanced use cases.

The apps offering EMR data access are typically provided by vendors, and only allow users to view such data (as opposed to documenting care), according to the study report. But providers want to roll out apps which allow inputting of clinical data, as this function would streamline clinicians’ ability to make an initial patient assessment, the report notes.

But there are other important app categories which have gained an audience, including diagnostic apps used to support patient assessment, medical reference apps and patient engagement apps.  Other popular app types include clinical decision support tools, documentation tools and secure messaging apps, according to researchers.

It’s worth noting, though, that there seems to be a gap between what providers are willing to use and what they are willing to buy or develop on their own. For example, the report notes that nearly all respondents would be willing to buy or build a patient engagement app, as well as clinical decision support tools and documentation apps. The patient engagement apps researchers had in would manage chronic conditions like diabetes or heart disease, both very important population health challenges.

Hospital leaders, meanwhile, expressed interest in using sophisticated patient portal apps which go beyond simply allowing patients to view their data. “What I would like a patient app to do for us is to keep patients informed all throughout their two- to four-hours ED stay,” one CMO told researchers. “For instance, the app could inform them that their CBC has come back okay and that their physician is waiting on the read. That way patients would stay updated.”

When it came to selecting apps, respondents placed a top priority on usability, followed by the app’s cost, clinical impact, capacity for integration, functionality, app credibility, peer recommendations and security. (This is interesting, given many providers seem to give usability short shrift when evaluating other health IT platforms, most notably EMRs.)

To determine whether an app will work, respondents placed the most faith in conducting a pilot or other trial. Other popular approaches included vendor demos and peer recommendations. Few favored vendor websites or videos as a means of learning about apps, and even fewer placed working with app endorsement organizations or discovering them at conferences.

But providers still have a few persistent worries about third-party apps, including privacy and security, app credibility, the level of ongoing maintenance needed, the extent of integration and data aggregation required to support apps and issues regarding data ownership. Given that worrisome privacy and security concerns are probably justified, it seems likely that they’ll be a significant drag on app adoption going forward.

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.

Steps In Integrating Patient-Generated Health Data

Posted on May 24, 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.

As the number of connected health devices in use has expanded, healthcare leaders have grappled with how to best leverage the data they generate. However, aside from a few largely experimental attempts, few providers are making active use of such data.

Part of the reason is that the connected health market is still maturing. With health tracking wearables, remote monitoring set-ups, mobile apps and more joining the chorus, it might be too soon to try and normalize all this data, much less harvest it for clinical use. Also, few healthcare organizations seem to have a mature strategy in place for digital health.

But technical issues may be the least of our problems. It’s important to note that providers have serious concerns around patient-generated health data (PGHD), ranging from questions about its validity to fears that such data will overwhelm them.

However, it’s possible to calm these fears, argues Christina Caraballo, senior healthcare strategist at Get Real Health.  Here’s her list of the top five concerns she’s heard from providers, with responses that may help put providers at ease:

  • Fear they’ll miss something in the flood of data. Add disclaimers, consent forms, video clips or easy-to-digest graphics clarifying what consumers can and can’t expect, explicitly limiting provider liability.
  • Worries over data privacy and security: Give consumers back some of the risk, by emphasizing that no medium is perfectly secure, including paper health records, and that they must determine whether the benefits of using digital health devices outweigh the risks.
  • Questions about data integrity and standardization: Emphasize that while the industry has made great process and standardization, interoperability, authentication, data provenance, reliability, validity, clinical value and even workflow, the bottom line is that the data still comes from patients, who don’t always report everything regardless of how you collect the data.
  • Concerns about impact on workflow: Underscore that if the data is presented in the right framework, it will be digestible in much the same way as other electronic medical data.
  • Resistance to pressure from consumers: Don’t demand that providers leverage PGHD out of the gate; instead, move incrementally into the PGHD management by letting patients collect data electronically, and then incorporate data into clinical systems once all stakeholders are on board.

Now, I’m not totally uncritical of Ms. Caraballo’s article. In particular, I take issue with her assertion that providers who balk at using PGHD are “naysayers” who “simply don’t want to change.” While there are always a few folks fitting this description in any profession, the concerns she outlines aren’t trivial, and brushing them off with vague reassurances won’t work.

Truthfully, if I were a provider I doubt I would be comfortable relying on PGHD, especially biometric data. As Ingrid Oakley-Girvan of Medable notes, wearables giant Fitbit was hit with a lawsuit earlier this year alleging that its heart rate monitoring technology is inaccurate, and I wouldn’t be surprised other such suits arise. Digital health trackers and apps have transitioned from novelty to quasi-official medical device very quickly — some might say too quickly – and being cautious about their output just makes sense.

Nonetheless, PGHD will play a role in patient care and management at some point in the future, and it makes sense to keep providers in the loop as these technologies progress. But rushing them into using such data would not be wise. Let’s make sure such technologies are vetted before they assume a routine role in care.

Are There Too Many Healthcare Apps?

Posted on May 4, 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.

Today Anne Zieger wrote a blog post arguing that there are too many healthcare apps. It’s a really interesting take on the plethora of healthcare apps out there and the need for there to be apps that handle more than one specific condition or measurement. Anne argues that patients don’t want to open a whole bunch of different apps to manage their health. Plus, she points out that the highest cost patients are often chronic patients whose health needs to be managed across multiple diseases and multiple data points.

While I find Anne’s analysis interesting, I’m prone to think that we actually need more healthcare apps. I say that because I don’t think the current crop of healthcare apps are really moving the needle. So, we need more healthcare apps that actually attack the right problems. Piggybacking Anne’s comments, I’m not sure the current crop of apps are going to scale to the complexity of a patient, so we likely need new healthcare apps that work with that complexity in mind.

The reality I’ve seen with most healthcare apps is that they lack ambition. Can you name a healthcare app that illustrates the ambition to improve the health of a patient and lowers the cost of healthcare as we know it? Those are big claims to make and so you don’t see anyone claiming it. Claims aside, are there any companies that are really doing it?

My experience shows that there are a few apps that in a very limited scope are able to improve the health of the patient. Although, very very few of them have done the studies necessary to be able to claim that. They have plenty of anecdotal stories about how their app improved someone’s life. However, they don’t yet have the data to prove what they believe their app is able to accomplish.

It’s going to take a lot more ambition from healthcare app developers to really attach the problems that vex healthcare. Keeping someone healthy is an extremely complex issue and won’t likely be solved by a 99 cent app.

If that’s too big of a vision for you as an entrepreneur, how about you start with a simpler concept. Show me an app that changes people’s behavior. Let’s start with something that simple and scale from there. Most health apps aren’t even brave enough to take on that challenge. I’m not blaming them. It’s hard, but that’s what will make it so valuable.

What Are We Doing to Identify the Best Health Apps?

Posted on September 23, 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.

Tom Sullivan asks a great question about mobile health apps. How many of them really matter? I coyly replied on Twitter that it’s only the ones that get used. In the article Tom Sullivan links to in the tweet above, Jack McCarthy says the following:

With some 165,000 health-related apps available, in fact, a mere 36 comprise nearly 50 percent of downloads. Not to be confused with 36 percent, that’s a total of 36 applications, according to a study by the IMS Institute for Healthcare Informatics that analyzed 26,000 apps.

That’s pretty startling to think that 36 apps comprise half of the mobile health app downloads. However, these shear numbers aren’t really a problem on their own. I’ve seen hundreds of apps that shouldn’t have more than a few thousand users. They’re so niche that their entire target market is small.

The biggest problem I see is how are doctor or patients suppose to find these niche health apps amidst the other 165,000 health related apps. That’s like finding a proverbial in a haystack and we’re not talking about a little mini haystack, but a massive haystack.

The best we have today is great mobile health websites like mobihealthnews and iMedicalApps that do what they can to keep up with all the changes. They do a good job covering the industry, but even if they both covered 1 app a day (which is not an easy endeavor), then we’d still only learn about 730 apps a year of the 165,000 out there. That’s 0.4% of the health apps that exist or what we’d call a rounding error.

This is not an easy task. How do you filter the wheat from the chaff (and there’s a lot of chaff)? I have a feeling in the medical world that the various specialty specific medical societies will be one filter for mobile health apps. Those societies could perform a really great service for their members by identifying the health apps that apply to their specialties and helping vet those apps out.

How do you think doctors and patients will be able to filter through all the health app noise? Is this an opportunity for an entrepreneur?

How Many Received Health Apps, Wearables or Other Health Related Gifts for Christmas?

Posted on December 25, 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.

We’re basically taking this week off (like many of you) and enjoying time with family. However, I thought it might be fun to see what people have gotten as part of their Christmas haul.

How Many Received Health Apps, Wearables or Other Health Related Gifts for Christmas?

I’m sure the numbers will eventually come out, but you can be sure that it was a banner year for wearables this Christmas. I guess this really isn’t a change in our culture. Before we’d get treadmills, weights, and Jane Fonda videos. Now we get wearables to help us achieve the same goals. Sadly, I think most of them will end up like the other exercise equipment: gathering dust.

I hope you all have a Merry Christmas and a Happy Holidays!

56% of Consumers Never Use a Mobile Health App or Device

Posted on November 11, 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 is a pretty interesting stat. Although, you could certainly change the stat and say that 44% of consumers have used a mobile health app or device. I guess sometimes in this mobile health world we think that everyone is trying out mobile health apps left and right. I guess the reality sets in that many aren’t using their mobile devices as health apps. Although, I wish I knew how the study measured who was using a health app or not. I bet many don’t realize they’re using a health app, but they are using one.

The challenge with most health apps isn’t the initial use. It’s getting people to use the app as part of their daily habits. I’m sitting right beside this treadmill that my wife bought many years ago. I believe the number of years we’ve had this treadmill is possibly more than the number of times my wife has used it to exercise. I have a bike, some fitness DVDs, and other exercise equipment that has a similar story. To my wife’s credit she does get out and run pretty often, which requires some shoes. (I mostly play ultimate frisbee and other sports. Thus why I haven’t used the equipment)

The same goes for so many mobile health apps and devices. My wife has downloaded or had access to many of those. None of them have cracked her daily routine. Although, I think that Janssen’s Care4Today app is getting close. I’ve asked her to write a blog post about her experience using that app for a future post.

The point being that it’s really hard for a health application to get widespread adoption. Not to mention regular use. Sure, many of them can put up some flashy numbers about downloads. The better number you should look at is Daily Active Users. A look at that stat will tell you a lot more about how an apps being adopted than some nebulous download number. Plus, getting Daily Active Users is a really tough challenge to overcome.

Discover The Best Health Apps With AppRx by Health Tap

Posted on June 3, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Well, Health Tap has once again come out with a new and useful way to help people find legitimate healthcare information. In an effort to help people sift through the 40,000 health and exercise apps available, AppRx was created.

AppRx is a directory of apps that have been recommended and reviewed by some of the world’s leading physicians. If you’ve ever tried looking through apps, it can be hard to figure out which ones should be trusted. Because, not all health apps should be regarded as so.

It’s a simple idea, but one that I think is long overdue. I just checked it out, and it looks like it is very easy to navigate. You can search for specific apps, or select from a variety of categories. There are 23 different categories, that cover everything from ab workouts to mental health to pregnancy. You can even set it to show just iOS compatible apps or Android compatible apps. To be honest, I think that’s one of my favorite features! Back when I only had an Android device, I got so frustrated when I was searching for a certain kind of app, and only iOS apps would show up.

You can also sign up for a newsletter, which sends you an app of the week — this weekly publication highlights a certain app that comes highly recommended from physicians. So if you want to try out new apps that already have the seal of approval from a physician, this might be a good newsletter to subscribe to!

I am excited to use this website — not only for my personal use, but to help find apps to write about on here! There are already some app certification programs in the works, such as Happtique, but until apps start getting the mark of approval from that, AppRx is a great alternative. I use Health Tap a decent amount, and I do trust that information I get from there, so it will be nice to have this additional resource.

Skimble: A Fitness Tracker and Personal Trainer

Posted on June 13, 2011 I Written By

Last week I wrote about the RockHealth Competition that chose a select group of developers to participate in an intense development program to help improve healthcare apps.  One of these companies is Skimble who offers one app that is not entirely groundbreaking, and a second that is a little more intriguing.

The first app is a GPS Sports Tracker that monitors your sporting activities so that you have a better idea of how you are exercising and what type of progress you may be making.  There are tons of apps out there with a similar purpose, but something that makes this one unique is the sheer number of sports it tracks.  They support over 45 sports to include snorkeling, ping pong, and badminton.  They also track just about any team or individual sport you can think of.

The other app is a virtual workout trainer that actually looks pretty cool.  There are all kinds of workouts you can download.  From simple home workouts to actual weightlifting in a gym, it runs the full spectrum of workouts.  There are some workouts that are free and others that require a membership, but at $9.99 for a whole year, they are substantially more reasonable than a gym.  The app tracks your workouts and ensures that you are performing the right exercises to achieve your goals.  All in all it looks like a worthwhile app amongst a whole lot of worthless stuff.

Both apps are for the iPhone and iPad and can be found on the iTunes store.

Looking at the quality of these two apps it is easy to see why these developers would be selected to really move to the forefront of health app development.  It will be exciting to see what else they will offer in the future.

3M Unveils Advanced Mobile Healthcare App

Posted on May 9, 2011 I Written By

The software helps physicians keep track of patients’ whereabouts, manages dictation, and captures charges.

By Nicole Lewis InformationWeek
may 06, 2011 11:43 AM
3M has unveiled a health application that it says will enable physicians to better coordinate and manage their daily schedules, review patient information, dictate progress notes, and log accurate charges on their mobile devices.Announced Tuesday, company officials say the 3M Mobile Physician Solution was designed with features and functionality that address many aspects of a physician’s daily tasks, and will work with many devices including the iPad, iPhone, Android, Blackberry, and Windows Mobile devices.

Recent research has shown that users of health apps want more information, and are looking for features that will help them manage and keep track of patient data.

The 3M Mobile Physician Solution offers four main modules:

— 3M Mobile Patient Lists allows physicians to sort through patient information to identify their room number, access scheduled appointments, or locate information that shows when the patient will be seen by other doctors.

— 3M Mobile Rounds enables physicians to access patient medications, allergies, vitals, and lab test results.

— 3M Mobile Dictation allows physicians to record and transmit dictated progress notes to the facility’s dictation and speech recognition systems. Physician voice files are automatically linked to the correct patient, eliminating the need to enter patient identifier numbers, and reducing errors and promoting faster transcription turnaround time.

— 3M Mobile Charge Capture enables physicians to capture professional fee charges for any patient encounter by selecting and pairing the correct billing codes with the appropriate diagnosis or procedure.

“3M Mobile Physician Solution is the first software we’ve released that integrates 3M’s coding logic and brings 3M’s coding expertise to the physician in real-time and at the point of care,” said Steve Retz, business manager, document creation products at 3M health information systems.

By integrating coding logic into the physician equation, doctors can access codes on their mobile devices instead of referring to the codes listed in a book. These codes provide information on professional fees for visits and consultations, as well as billing codes with the appropriate diagnosis or procedure.

Additionally, these codes can act as a guide to show when a charge isn’t appropriate given the patient’s demographics, for example, if a charge is coded for an adult procedure on a pediatric patient. Retz said the software also helps prevent lost or missing charges, so physicians receive the full reimbursement to which they are entitled. He also pointed out that the technology will assist with ICD-10 coding.

“We feel 3M Mobile Charge Capture with physician advice will ease the migration to the new ICD-10 coding standard, which will be disruptive to the current charge-capture process because physicians will have to record charges with much more coding specificity,” Retz said.

The 3M Mobile Physician Solution integrates with electronic health records and physician practice management systems using standard healthcare data exchange technology (HL7). The company declined to say how much the new system costs, but did say the software is being offered at a special introductory pricing through September 30 of this year.