• Apps
  • KardioPro helps to tackle cardiometabolic disease

    Cardiometabolic disease, a cluster of inter-related risk factors that can lead to atherosclerotic vascular disease and type 2 diabetes, is the world’s leading cause of morbidity and mortality. It kills more people than AIDS and malaria combined and places tremendous strain on healthcare resources and costs. Currently, the epidemic of cardiometabolic disease worldwide is being diagnosed, treated and managed in separate silos. Healthcare systems rely on repetitive, duplicated tests and services, which inevitably leads to reduced patient outcomes and increased costs. To address this challenge, the Kardiogroup, a connected health company, has developed the first comprehensive cardiovascular risk reduction and treatment approach.


    The Kardio Ecosystem links connected health devices as a Technology Enabled Care (TEC) to validated Point of Care (POC) blood tests. It provides accurate and validated risk analyses, links to emergency care and access to treatment protocols informed by local and international guidelines.

     

    KardioPro, an mHeath app, is part of the ecosystem. It integrates with diagnostic tools, including a cardiolabs to measure patients’ blood pressure and Ankle-Brachial Index (ABI), a pulse oximeter, a professional wireless core body scale, and a glucometer.  Path Pro’s part of the configuration too. It provides the Alere Affinion Machine and the Abbott Istat POC pathology diagnostic equipment.

    Healthcare workers can use KardioPro to take measurements, connect to the KardioPro app from iPads or Androids, then visualise, track and share the results. It performs tests in 15 – 20 minutes, stores and organises results, simplifies patient monitoring and edits reports in PDF format so they can be shared by treatment teams. It also helps with the interaction of healthcare workers and patients to:

     

       Improve adherence

       Reassess treatments

       Reassure patients and explain to them the evolution of their health status

       Fix goals for patients

     

    The App:

       Is simple and easy to use

       Provides accurate risk analysis

       Has multi step reporting

       Provides treatment suggestions based on guidelines

       Delivers secure cloud based data capturing

     

    Tests performed by the app includes:

    1. HBA1C - Glycated Haemoglobin - This is used to test the 3 month average glucose of patients. It is used for screening for diabetes and used to monitor diabetic patients. 
    2.  Lipogram - This is a full cholesterol panel which is one of the important components in cardiovascular disease. It measures the different types of cholesterol in the body which is important in assessing cardiovascular risk in patients
    3. Crp - known as C-Reactive Protein - This is an inflammatory marker test can be used to determine if antibiotic therapy is required in patients who are ill.
    4. Urine ACR - known as Albumin to Creatinine Ratio - These are the two key markers to test for chronic kidney disease. 
    5. U&E - Urea and Electrolytes - This is an important and common type of biochemistry test. It is used to assess Renal Function in Diabetic patients and are important screening test for patients with hypertension.
     

    All health data generated by the device is secured and stored in an approved secure healthcare database. This is increasingly important with the rise in cyber-security threats.

    KardioPro is currently being used by 40 practitioners in South Africa. The solution has the potential to benefit resource poor communities across the continent. KardioPro is looking to expand internationally with interest to collaborate with international partners. 

  • Protecting our children from HPV

    One in every eight women in South Africa die from complications of  cervical cancer. Each year, 5,743 new cases of cervical cancer are reported. Almost half of these, 3,027 cases are fatal.

    About 80% of cervical cancers are caused by the Human Papilloma Virus (HPV). It infects the genital area and causes anything from a small genital wart to cervical and other cancers. Vaccination can prevent the virus infection developing on the cervix. 

    In 2014, the South African National Departments of Health (NdoH) and Basic Education launched a national vaccination campaign to prevent cervical cancer by vaccinating girls aged over nine against HPV. The vaccination was aimed at 500 000 girls from 17 000 public and special schools to provide them with protection before they can be exposed to HPV infection. 

    In co-ordination with the government’s Integrated School Health Programme (IHSP), school health nurses visit schools twice a year to vaccinate the girls. None of them are vaccinated without parental consent.

    As the vaccination campaign grew, collecting data became more complex and challenging. NDoH approached the Health Information Systems Program South Africa (HISP-SA) to lead implementation of a mobile data capturing application. It supports data capture during the campaigns. 

    The app’s part of the NDoH's routine health information system, DHIS2, sometimes referred to as webDHIS. It was customised for the campaign by HISP-SA’s Lusanda Ntoni and piloted in three provinces. Then, it was developed further using findings from field visits, and implemented during the 2016 campaign. 

    A Standard Operating Procedure (SOP) document helps vaccinators and data capturers to transfer HPV data from registers into the tracker capture app. There’s also a guideline for programme managers and information officers on accessing dashboards with information from the campaign on  webDHIS. These were updated as the app was implemented. 

    To date, the app’s been implemented in all nine provinces in South Africa, a task co-ordinated by HISP SA’s HPV project manager, Margaret Modise. It’s simplified HPV dashboards for monitoring and reporting and shows how a simple mHealth initiative can enhance the productivity of vaccination campaigns. Will this way of capturing data lead to more large-scale campaigns in South Africa?   

  • Hospitals need better cyber-security from their app developers

    The pace of innovation in healthcare is staggering. mHealth apps are helping to push it along. Innovators are speeding apps through development processes to bring them to market as quickly as possible. It often means cyber-security’s not a priority, leaving healthcare organisations to pick up the consequences.

    “There are a million different apps out there – the problem is the low barrier to entry into the healthcare market,” said Kurt Hagerman, CISO at cyber-security firm Armor Defense, in an article in Healthcare IT News.“When you look at the EHR vendors, they cannot be everything, they have to focus on a core set of services and then allow others to supplement those large, monolithic EHR systems with other apps.”

    With some EHRs having a narrow focus, there’s a rush to capitalise on using mHealth to provide personal health data and advice. These factors combined are a challenge for health systems to use the latest innovations without compromising protected health information and personally-identifiable information. 

    The first step’s educating developers about the healthcare industry and its unique requirements. Health systems working with app developers need to be explicit from the outset about their cyber-security requirements. Hagerman says “To protect confidentiality, integrity and availability, you have to build strong authentication credentials, you have to encrypt.

    Beyond education, it’s up to health systems to be better at enforcing cyber-security, ask app developers the right questions and demand the protections that defend patient health data. “A sense of urgency is building – you cannot just build an app, there are security requirements. The industry is starting to correct this a little bit,” he added.

    Healthcare providers need to construct a stronger message for developers. Better cyber-security’s crucial to protect patients’ personal data. They can’t afford to carry the risks of insecure and vulnerable mHealth.   

  • Magee and CMU’s app can combat pre-term birth

    Pre-term births are before babies have completed their 37 weeks of gestation. WHO has estimated that 15 million babies are pre-term each year, and it’s rising. Complications associated with pre-term births are the leading cause of the high mortality rates of children under five. Three-quarters of these deaths could be prevented with current, cost-effective interventions.

    An article in Medicalxpress says that maternal-fetal specialists at Magee-Women’s Hospital has collaborated with scientists at Carnegie Mellon University (CMU) to develop and test a personalised smartphone app to combat pre-term birth. It engages pregnant women living in remote locations.

    Research in the Journal of Medical Internet Research mHealth and uHealth, found that the app was successful in providing accessible and personalised obstetric care designed specifically to target risks of pre-term births. Tamar Krishnamurti explained that

    "Mobile phone apps are a great way to engage a vulnerable population in their health care because approximately 86 percent of American adults own a mobile phone, regardless of racial and ethnic groups."

    Users voluntarily logged into the app every one and a half days to complete daily risk assessments. Algorithms then provided specific, personalised risk feedback, with bespoke recommendations. If the app detects a decrease in self-reported cigarette use, it provides encouraging messages and resources about quitting resources. It  also provides basic pregnancy education, reminders about appointments and fetal health monitoring aids like a kick counter.

    When the app detects high-risk events, such as intimate partner violence or thoughts of suicide, it sends real-time alerts to medical staff. Women are then contacted directly and linked to appropriate medical and social service resources.

    While there are several apps to support pregnancies, few are developed through a  patient-centred scientific process and grounded in behavioural decision research. The next step in this technology is to conduct randomised controlled trials over entire pregnancy cycles to evaluate  the app’s benefits for behavioural and clinical outcomes, including adverse birth outcomes. It seems to offer Africa’s health systems and pregnant women effective opportunities to reduce substantially the number of pre-term births.  

  • Bouy determines a person’s medical condition

    Doctors and computer scientists in Boston and New York have developed Buoy, a free AI platform. It helps people to use their symptoms to determine their medical conditions and make better decisions. The eHealth tool began in 2014 at the Innovation Laboratory at Harvard. Buoy’s co- founder and CEO, Andrew Le says currently, medical information provided by simplistic web symptom checkers are often risky and unreliable. To overcome these limitations, Buoy leverages advanced machine learning algorithms to provide personalised and accurate analyses and diagnoses to users so they can quickly and easily have more control of their healthcare.

    Bouy asks users to enter their ages, genders, and symptoms. It then asks a few questions, such as the severity of their symptoms and their durations. It uses this information to analyse against millions of medical records to generate other important, more specific questions. After two to three minutes of analysis, Buoy has an accurate and detailed understanding of users’ conditions. It will then recommend appropriate healthcare alternatives. If immediate treatment’s needed, it provides directions on how to connect with a nearby healthcare providers.

    An article in eHealth news says Bouy’s been through a battery of quality control tests. The result’s that it can accurately analyse a wide range of symptoms, such as common colds, abdominal pains and how a change of running shoes has created muscular or skeletal issues.

    The study tried to determine how Buoy interprets a cough compared the top five web-based symptom checkers. It examined 100 standardised cases involving 33 different diagnoses with severity ranging from life-threatening pulmonary embolisma to benign, normal cough. Prevalence was assessed too, ranging from rare histoplasmosis to common cold. Results were that Buoy’s analyses were 92% accurate as compared to WebMD at 56%, Healthline at 53%, Mayo Clinic at 38% and Isabel at 28%. Buoy has over 5,000 users and is available as an app on Apple store and directly from Buoy.

  • An mHealth app increases smoking cessation chances

    Globally, over 1.1 billion people smoked tobacco. That’s an estimate for 2015 from the WHO. Many more men smoke than women. Tobacco is the only legal drug that kills many of its users when it is used exactly as its manufacturers intended. WHO has estimated  that tobacco use, both smoking and smokeless, causes about six million deaths a year across the world. Many of these are premature. It includes approximately 600,000 people estimated to die from the effects of second-hand smoke.

    Clickotine, is an mHealth app that aims to help reduce the number of smokers. It emphasises the chances of successful rehabilitation from tobacco use. Research in the Journal of Medical Internet Research  (JMIR) shows that a personalised app for smoking cessation can help smokers who wish to quit, but who prefer using less intensive clinical intervention.

    An article in mHealth Intelligence says Clickotine offers a user-friendly way for patients to engage with their needs. It is developed with effective personalisation and engagement features of a smartphone app but includes components to support personal intervention complying with US clinical practice guidelines (USCPG). A questionnaire starts up when Clickotine is opened. It probes users to record their smoking behaviours and quitting goals. They also create a user profile with their unique smoking behaviours and input for personalised updates and messages.

    A log tool allows users to record smoking behaviours like cravings, sentiments, and number of cigarettes smoked. It is one of the app’s most popular features.  An article published in PubMed.gov says people between 18 and 65 used the app to start quitting on their own. About 45% abstained for seven days. Almost 27% abstained for 30 days. It seems that mHealth apps could provide a good step towards smoking  cessation across Africa. However, they need more testing.  Will this app have the same effect in All Low and Middle Income (LMIC) countries?

     
  • CDC backs automated cause-of-death reporting app

    Every death tells a story. Taken together, they provide valuable insights about the deceased and the population around them. These details are crucial for the Center for Disease Control and Prevention (CDC). The longer it takes for them to access Cause of Death (COD) details, the less valuable the data becomes for surveillance and responses. Health Data Management has a report saying to address this challenge, the state of New Hampshire has launched a mobile app, eCOD, for doctors to use to submit prompt COD reports to CDC.

    eCOD’s an original solution. Its developers are excited about its benefits. “Historically, this has been a pen and paper process that takes a long time and keeps valuable data from the CDC they could use to track disease and make public health decisions,” Stephen Wurtz, New Hampshire’s state registrar and director of the Division of Vital Records Administration said in an article in MobiHealthNews. “With eCOD, physicians or the medical examiner, wherever they may be, can immediately report and certify the death and get that information to the CDC.”

    This real-time death data could transform public health surveillance and disease prevention. “From a surveillance standpoint, a state might have an obligation to the CDC to share data once a month or whatever, but with the enhancement of eCOD, we can currently disseminate information twice per day,” said Wurtz. “That’s unheard of. We’re talking hours. Other states are talking days and weeks.”

    The app makes it easier to collect and report information to formulate complete prompt COD profiles It also enables CDC to raise follow-on questions, all of which can be quickly collected and disseminated to improve public health surveillance and response. This is mainly due to the ability to update vital statistics twice a day instead of monthly.

    For complicated or combined death cases that need coroner’s office certifications, eCOD can speed up documentation before cases are completed. “They don’t have to make a complete report and have it certified before they can start centralizing the data and helping state and other government agencies,” Wurtz said.

    The app took a year to complete. Financed by the CDC’s National Center for Health Statistics and developed by CNSI an IT company. Pilots are underway to develop a national model for mobile COD reporting and certification.

    eCOD uses Validation and Interactive Edit Web Service (VIEWS), CDC’s death certificate audit programme, to ensure all information is accurate and understandable.  It’s a format that every person who needs to access the information can already interpret.

    African countries that face disease outbreaks can benefit from this simple disease surveillance system. It can ensure  that authorities and agencies have near real time data on outbreaks and help to save lives. 

  • iExhale mental health app raises US$1.86m

    Based in Los Angeles, iExhale, is an online mental health company. It’s, raised US$1.86 m in funds led by Dorilton Capital. iExhale developed an iOS app for people to exchange messages with licensed therapists. The company plans to use the funds to scale its initaitive and take the platform nationally. People can use the app to share personal information anonymously or offer support to others in iExhale’s social network.

    An article in the MobiHealthNews says iExhale’s currently available in California, offering its services to people aged 14 and above. The app aims to improve access to affordable, convenient mental health services. It’s similar to other mobile mental health services like Talkspace.

    The comapany has two key foundational factors to their mission. One is a considerable lack of practicing psychiatrists, psychologists and social workers throughout the country. The other’s an increasing willingness of patients to embrace telemedicine. It also belives that many people with no prior exposure to therapy may feel more comfortable when starting their treatment with a virtual visit rather than in person.

    iExhale’s benefit is that it’s a safe, non-judgemental environment where users feel supported and understood while life-affirming change is being encouraged. It provides profiles of all online therapists, which allows searches based on experience, area of expertise and special certifications too.

    When  people download the app, there’s a 48 hour window, known as Meet A Therapist,. Here, they can browse and meet therapists before booking sessions. This service’s also available to minors without parental consent because their questions are general, with large packages of therapy involved. When an underage client books a session, they must provide proof of legal consent, so parents or legal guardians are involved.

    After the 48-hour trial period, sessions cost US $64.99 for 45 minutes, nearly US$1.45 a minute. No subscription’s needed. If users don’t want to book sessions, they can log in to browse iExhale’s anonymous social support network, either selecting the “How Are You Feeling?” feature to express how they feel through writing, pre-loaded pictures or specific emotions. They can also offer support to others in a safe environment. Since there is no free-form commenting or direct user-to-user messaging, and the images and emoticons are pre-loaded, the company believes there is a less of a chance of bullying or teasing.

    This app is currently only availbale on iOS, although an Android version is in development. Depression is the leading cause of disability throughout the world and is especially prevalent among low-income African countries, where 75% of the people who suffer from mental illness do not have easy access to the mental health care they need. On average, developing countries only allocate 0.5% of their health expenditures to mental health, compared to more than 5% for high-income countries, says an article in Rand Corporation.

    WHO has said armed conflicts, genocide, violence, famine and displacement in Africa cause significant challenges to mental health. Rates of mental disorders often double after emergencies. While the iExhale app does offer greater access to people in these regions, the cost, the reliance on Internet connection and accessibility to smart phones are all obstacles.

  • Healthy.io’s mHealth Dip.io offers smarter dipstick diagnostics

    Dipsticks aren’t just for checking oil levels in engine. They’re an important part of simple tests that provide good measures of health and illness. Healthy.io pursues the art of colour-based diagnostics. Its app Dip.io uses smartphone cameras to analyse pictures of dipsticks used for urine tests matched against a background of a colour spectrum. Dip.io can analyse the digital photos to see if the results reveal the need to see a doctor or seek a prescription, especially a repeat.

    It’s available now for pregnancy, diabetes and protein levels. Healthy.io hasn’t stopped there. These set a foundation for more sophisticated tests, such as urinary infections and as pre-eclampsia in pregnant women to see if their blood pressures are too high.

    Vimeo has a video showing how to use Dip.io. A major benefit’s avoiding the need to go to clinics or hospitals for urine tests. For Africa, these efficiency gains can be considerable for patients and communities where they need long and costly journeys. Using dipsticks at home and having results promptly may help avoid some of these.

  • eHealth, Google and others are revolutionising healthcare in emerging markets

    Access to basic healthcare information is a challenge in many parts of the world. It’s especially demanding in developing countries. Google’s latest move in India may help increase access to healthcare information for millions of people.

    An article in The Market Mogul says Google identified this gap in Indian and has added health information to its Knowledge Graph. It’s a sematic search base that Google uses to supplement organic search results with summarised information.

    So, the next time someone in India uses Google to search common health conditions, it’ll show information cards illustrated with images. This information will include typical symptoms, details on how common the condition is, whether it’s critical, if it’s contagious and which age groups it affects. Google said that it’ll provide a condensed version if users have limited Internet connections. This goes some way to deal with India’s slow and intermittent mobile connections.

    An article in TechCrunch says Google’s initiative is in response to start-ups dedicated to democratising India’s healthcare. Lybrate, an online, web-based healthcare service’s an example. It aims to increase access to doctors and quality healthcare information. It’s app service allows users to ask doctors questions online, search surgeries nearby and make and manage appointments.

    Other developing countries benefit from mHealth initiatives too. Successful start-ups include Docway, Beep Health and Dr Vem! in Brazil. These use apps and the web to connect patients and doctors. Doctors have to be registered with the app, and  set their own consultation rates. Users can also browse doctor’s resumes before deciding to book appointments. Most users are parents looking for paediatricians. The next big group of users are elderly people with limited mobility.

    Are these online initiatives coming to Africa on a big scale? A more appropriate question may be when will they be available?