• Apps
  • Will the new Apple watch be a big hit?

    Apple is renowned for technological advancement and innovation.  During their annual product launch this year, Apple announced the new series 4 watch.  It’s not your average wearable.  This watch boasts mHealth features such as electrocardiogram (ECG) monitoring and fall detection, and allows you to share this data with your healthcare practitioner.

    These features are impressive.  Apple is snapping up opportunities to break into the rapidly expanding mHealth market, from fitness tracking to a health app and now wearable ECG.  But there’s a nagging concern too.  What impact will this wearable ECG have on the healthcare system?  Could Apple’s new innovation spur an increase in unnecessary healthcare utilisation?

    These are concerns that I seem to share with other healthcare practitioners who worry that consumers may incorrectly attempt to diagnose complex cardiac conditions themselves.  There are also concerns about the sensitivity and specificity of the device, which if not great, could spark a mass of panic-stricken consumers due to false positives.

    While this new innovation is an important movement towards better patient management, it is vital that the counsel of healthcare practitioners is not diminished.  Consumers must be advised to use it cautiously to augment their healthcare management rather than replace professional management. 

    Similarly, the medical community needs to work more closely with companies like Apple who drive much needed innovation.

  • Medical apps need better UX and UI

    With the ubiquitous use of smartphones today, mobile users have great expectations from their apps: fast loading time, intuitive workflows, ease of use and aesthetic appeal. Digital health and mHealth organisations hoping to compete successfully in this vivid ecosystem, can no longer ignore user experience(UX) and user interface (UI) design as an essential component of their product strategy.

    So, what is UX and UI? 

    UX is the process of researching, developing, and refining all aspects of a user’s interaction with a product to ensure that it is meeting the user’s needs. UI is more cosmetic and takes into consideration the visual interaction with a product, including the colour schemes, the size and colour of a button, the consistency of a theme and so on.  

    Simply put, UX makes apps useful, while UI makes apps beautiful. Together these aspects play an important role in highlighting the value of your product and creating a lasting connection with your users.  They also have a positive impact on the bottom line, by reducing development time, increasing sales and improving customer retention. 

    With over 318 000 health apps across the most popular app stores, the difference between a successful and unsuccessful mHealth app will lie in the quality of its UX and UI.  The importance of good UX and UI cannot be overemphasized.

  • Japan extends healthcare to the home

    Welby My Karute is an innovative app developed by Welby Inc, a Tokyo based IT company to support the management of healthcare. The use of such apps for monitoring patient's lifestyles and chronic diseases is a growing trend in Japan.  Medical institutions using this app rely on the information provided to improve treatment and care and reduce the incidence of healthcare visits.  

    The aim of this app is to encourage patients to keep a record of their lifestyle at home, which is then shared with dieticians, doctors and other medical workers. This serves as a “watcher” as it keeps an eye on the patient without them seeing a doctor. Data such as meal choices, blood pressure, pulse, sleep patterns and whether they take drugs appropriately can be shared with computers at the hospital to inform patient management and disease monitoring. 

    Patients have stated that the app makes it convenient for them as they tend to miss hospital checkups due to having other commitments such as work.  This provides a useful use case for Africa, where patients struggle with similar challenges.  Coupling this app with suitable patient incentives can help patients and clinicians shift healthcare away from being reactive, but rather proactive and preventative.

  • Malawi uses eCCM app to combat child mortality

    In Malawi, Health Surveillance Assistant’s (HSA’s) serve as a link between the the local community and the national healthcare system.  They make use of the WHO and UNICEF community case management (CCM) clinical decision tool to identify those requiring urgent referral to hospitals and those who can be treated at the local points-of-care before going back home.  The Supporting LIFE project has created an mhealth app that replicates this CCM tool to ease decision-making and workload for HSA’s.  

    The app supports a similar workflow to the paper-based CCM tool, allowing the HSA to enter patient information on an easy to use touch-screen interface.  It’s developed for the Android platform and is functional in an offline environment, making it ideal for countries like Malawi, where internet connectivity is a problem.  Power was also an issue during the Malawi pilot, so HSA’s were also provided with mini solar powered chargers for their devices. 

    During the pilot 3 indicators were measured to assess the potential impact of the app;

    Improvement in the number of children correctly referred to a health facility as a result of using the app.Increased attendance rates, as a result of correct referrals made by HAS’s using the app; andDecreased re-consultation rates through correct diagnosis and referral from the app

    The results of the pilot were presented at an mHealth strategy workshop and provided the health ministry and key policy makers with valuable data to improve the health systems in Malawi.  HSA’s using the app reported mostly positive responses.  

    While such projects offer great community benefits and health system improvements, further assessment is needed around the feasibility of scaling nationally, as well as integration with core systems like the DHIS2.

  • Apple health app stores personal medical information

    Giving patients access to their medical records is an increasing priority. It can help them to manage their conditions and comply with medication and treatment requirements

    Apple is determined to make people’s lives easier. It’s created a new app that people can use on their iPhones to access, view and store their medical records on their person. Data on the app includes; allergies, test results, prescription drug list, immunization records or general health histories. Patients can also add files to the menu, provided they comply with Clinical Documented Architecture (CDA).

    Medical records information’s transmitted electronically from participating providers to patients’ iPhones. It needs patients to opt into the service via the health app and be able to browse through their data as well as receive new notifications when updated.  

    Jeff Williams, Apple’s chief Operating Officer (COO), assures that the app’s data is password protected an encrypted. It even denies Apple access to the information unless it is shared by patients.

    An announcement by Apple says patients with multiple chronic conditions will probably have considerable benefit.

    There’s a tricky bit about portals and patients accessing their medical records. A study reported on eHNA found for some patients, access made no difference to their health outcomes compared to patients who didn’t have access.

  • An HIV-free future: improving adherence to antiretroviral treatment

    It is common knowledge that HIV and AIDS has long been an overwhelming challenge in Africa. East and sub-Saharan Africa is the most affected region in the world.  Statistics indicate that at least 19.4 million people are living with HIV in this part of the continent. South Africa alone has the biggest HIV epidemic in the world with 7.1 million people living with HIV.  In 2016, there were at least 270 000 new infections and 110 000 AIDS-related deaths in the country.

    These statistics are worrying, but there is hope. It is estimated that 61% of adults and 51% of children in East and Southern Africa are on anti-retroviral therapy (ART). Antiretroviral medications (ARVs) are life-saving drugs that have turned HIV into a manageable chronic condition. The disease is no longer a death-sentence and when HIV-positive people take their ARVs responsibly and strictly.

    Adherence to ART is often an overlooked issue despite its incredible importance. In order for an HIV-positive person to achieve an effective level of viral suppression, adherence to ARVs needs to be more than 95%. This means that there is very little room for those living with HIV to skip their ARVs.

    Remembering when to take medication on time can be challenging for many reasons. People use different methods to remind themselves, but in most cases, these methods are not always reliable or effective.

    MyTherapy, a medication reminder and health tracker app designed in Germany, is an effective and easy-to-use app that has been proven to raise adherence levels significantly. In a short space of time, the app has improved adherence by over 45% and currently has over 500,000 users.

    While the app’s main function is to help its users keep track of their medication intake, it has also been designed to improve their overall health and sense of wellbeing. Users can record important measurements, like blood pressure and weight, and track their symptoms, and for those living with HIV, the app allows users to enter lab-results data, such as blood tests, kidney-function tests and viral load.

    The app is easy-to-use and all users have to do is enter the relevant data and set alarm times. The app is designed to handle complex medication regimens, perfect for ART which requires multiple medication intake per day, and all recorded data can be printed out at the end of each month in easy-to-read graphs, which is useful for the user’s doctor. Furthermore, while the app does rely on self-efficacy and self-discipline, users can invite family and friends on the app to help them stick to their treatment plans, ensuring that various parties are involved to promote adherence further. MyTherapy also takes data protection and privacy seriously, and users also have the option to use a passcode to prevent others from accessing the app and seeing personal data.

    ARVs are exceptional drugs that have changed the face of HIV and AIDS forever.  There is potential for an HIV-free future, only if those living with the virus are responsible and take their ART strictly.

    Knowledge of HIV/AIDS is continuously expanding. Information in the article's taken from Avert and the NCBI. 

  • Three mHealth apps help with treatment adherence

    Adherence to medication is an increasing problem in primary health care in Africa. It is important for many things, from birth control to antibiotics to ARTs. When medications are forgotten or skipped, most treatments are no longer as effective.  This becomes both costly for the healthcare system and detrimental to a patient’s health.

    Factors impacting adherence are multifaceted and include social, economic and psychological motives.  A sub-Saharan study in 2017 reported the most common barriers to adherence were;

    ForgettingLack of access to adequate foodStigma and discriminationSide-effects of the medicationTraveling

    With the uptake of smartphones in Africa, mHealth apps targeting treatment adherence could be a simple solution.  Here are the top 3 downloaded treatment adherence apps on Google Play Store. 

    PatientPartner

    This app turns patient education into an adventure game and shows patients the importance of sticking to a treatment schedule.

    Medisafe

    In addition to medication reminders, this app will notify friends and family if the user defaults. Medisafe also launched a low-tech version that sends reminders through automated phone calls and text messages. 

    MyTherapy

    After logging their medications on the MyTherapy app, users will receive reminders and alerts to take their medications.  Other features on the app include symptom tracking, healthy lifestyle tips and friends and family support groups.

    Improved adherence means a healthier society and ultimately, a reduced burden on healthcare systems.  Moreover, access to adherence data from these apps could help doctors and policy makers make better informed decisions about how to improve the healthcare system.

  • Kenya introduces an ePharmacy app

    MyDawa is an eHealth platform that allows consumers to purchase medications and other health and wellness products via a mobile application.  The platform was launched to the Kenyan market in March 2017 and has already attracted more than 30 000 registered users. 

    After downloading the app from the Play Store or App Store, registered users can simply search medications they require, upload a medial prescription if necessary, add to their cart and proceed to payment.  Once the order is completed, medications and products purchased will be delivered to the consumer at their convenience. Purchases that require a prescription are verified by a pharmacist before dispensing to the consumer’s mobile cart. 

    The MyDawa solution allows customers to gain the advantage of having increased transparency, convenience and affordability.  Products sold on the MyDawa app are 40% below the market price, and even 3rd party products are sold 20% cheaper than usual.  The app’s popularity in Kenya is driven by rising healthcare costs and value conscious consumers.  Payment on the app is made simple and allows consumers to pay via M-Pesa.

    This a great example in Africa that emphasizes the need for healthcare vendors to continue to embrace disruption in the industry, to become more efficient, to lower costs, increase accessibility to healthcare and provide patient-centric care.

  • mHealth sigue expandiéndose, pero África y Sudamérica están detrás

    El mercado de mHealth ha estado creciendo constantemente y se mantendrá. En su informe “mHealth App Economics 2017 Current Status and Future Trends in Mobile Health”, Research2Guidance (R2G), una empresa de asesoramiento de estrategia e investigación de mercado, evalúa cómo los intrusos digitales se están apropiando del mercado de la salud.

    Este año, hay 325,000 aplicaciones de salud y acondicionamiento físico disponibles en todas las principales tiendas de aplicaciones. Son 78,000 más que el año pasado.

    La mayoría de los profesionales de eHealth vienen de Europa, 47% y 36% de los EE. UU., Un 83% combinado. Asia-Pacífico representa el 11%. Sudamérica y África están en el 4% y 2% respectivamente, lo que confirma la necesidad de un mayor desarrollo de capacidad humana. 

    Otros hallazgos incluyen:

    Android adelanta a Apple en los números de aplicaciones de salud84,000 editores de aplicaciones de salud lanzan aplicacionesAmpliación de la demanda y la brecha de oferta, con un alto número de desarrolladores y bajas tasas de crecimiento de las descargasInversión de US $ 5.4bn en empresas de eSalud que abastecen al mercadoLos usuarios descargarán aproximadamente 3.6bn de aplicaciones en 201718% no está desarrollando aplicaciones de salud debido a regulaciones inciertas53% de los profesionales de eHealth esperan que los seguros de salud sean el canal de distribución futuro con el mejor potencial de mercado. 

    Dos tipos de aplicaciones pueden tener un gran impacto en la atención médica. La Inteligencia Artificial (IA) es vista como la tecnología más disruptiva. Se considera que la combinación con el monitoreo remoto es la tecnología que más perturbará la atención médica. El perfil: 

    AI 61% Monitoreo remota y asistencia 43% Wearables 34% IoT 30% Realidad virtual e inteligencia 27% Impresión 3D 22% Blockchain 18% 5G 8% Otro 5%. 

    Parece que hay una oportunidad para que los sistemas de salud de África respalden y amplíen su oferta de aplicaciones de salud local.

  • eHealth Africa pilots AVADAR to track Toward Polio Eradication progress

    In response to the reported cases of wild poliovirus in Nigeria, eHealth Africa (eHA) partnered with Bill & Melinda Gates Foundation, the  WHO, and Novel-T to pilot a mobile surveillance app for Acute Flaccid Paralysis (AFP) in children. It’s a condition of a rapid onset of weakness of people’s extremities, and includes Guillain-Barré syndrome.  AFP often causes weakness of respiration and swallowing muscles, progressing to maximum severity within one to ten days. 

    WHO defines AFP surveillance as six goals:

    Track wild poliovirus circulationUse data to classify cases as confirmed, polio-compatible or discardedMonitor routine coverage and surveillance performance using standard indicators in all geographical areas and focus efforts in ones that are low-performingMonitor seasonality to determine low season of poliovirus transmissions to help to plan National Immunisation Days (NID)Identify high-risk areas to plan mop-up immunisation campaignsProvide evidence to certification commissions of interruptions of wild poliovirus circulation. 

    Standard indicators are: 

    >90% of expected monthly reports>1/1000,000 annualised non-polio AFP rate per 100,000 children under 15>80% of AFP cases investigated within 48 hours>80% of AFP cases with two adequate stool specimens collected 24-48 hours apart and less than 14 days after onset>80% of specimens arriving at laboratories in good condition>80% of specimens arriving at a WHO-accredited laboratories within three days of despatch>80% of specimens for which laboratories’ results sent within 28 day turn round. 

    AFP surveillance’s one of four cornerstone strategies of polio eradication. The objective’s to identify all cases of polio through a system that targets any case of AFP as a potential case of polio.  AVADAR’s a surveillance tool on android mobile devices provided to health workers and community informants. It aids AFP detection and reporting both in health facilities and local communities.