• Apps
  • 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.

  • eThekweni District has an HIV/AIDS app

    HIV/AIDS remains one of the leading causes of death worldwide. Avert has estimated that   more than 7 million people in South Africa live with HIV. About 70% of the total global prevalence lives in sub-Saharan Africa, with South Africa carrying the highest burden of the epidemic in the world in 2015. HIV/AIDS is a major health concern in South Africa, with 380,000 HIV incidences and 180,000 HIV/AIDS fatalities in 2015 as reported by Avert. KwaZulu-Natal tops the chart of the country’s nine provinces with nearly 20% of HIV/AIDS patients. 

    In 2015, eThekweni District in KwaZulu-Natal’ started using mHealth to help improve services for people living with HIV. Access to HIV/AIDS treatments services remains a challenge, with only 48% of adults receiving Antiretroval Treatment (ART) in the country. South Africa, like many other African countries, face many health challenges, patient and community barriers against the smooth delivery of HIV/AIDs treatment and services.

    Health system barriers include a growing shortage of staff due to high turnover, highly congested and poorly coordinated healthcare facilities and a knowledge gap between healthcare providers and their patients. Patient barriers are long distances, transport costs and longer waiting times before receiving primary healthcare or treatment. Lastly, HIV/AIDS related stigma and discrimination remains prevalent in communities.

    Health-e News has a report saying the project includes an app so healthcare providers can track individual performances of caregivers in every ward, while indicating where health services are inefficient. The app enables healthcare providers to login with their own personal username to report on their activities and interventions. Managers can use the app to monitor activities in each ward. The project focuses on HIV patients and has received a twelve-month grant of £96,944 roughly R1 547 086 in 2015.

    Integrating apps like these in healthcare can increase efficiency in the delivery of HIV treatment and services and can build trust between healthcare providers and their patients. It should help improve co-ordination, address staff shortages, allow healthcare providers to monitor and track their patients’ status, and enable managers to improve the functioning of facilities. It could help other districts too.

  • Four apps for ER doctors

    Emergency Rooms (ER) are busy. mHealth that eases workload and makes ER doctors’ working lives better are worth it. In Med Page Today, Dr Iltifat Husain has identified four that help.

    GoodRx for Doctors, described by Dr Husain as “fantastic … for helping your patients be compliant with their prescriptions,” it included a bookmark to find medications prescribed frequently but may be unaffordable for patients. An equivalent for Africa’s health systems would be well received by communities.

    OrthoFlow was developed by UK orthopaedic surgeons and doctors working in Accident and Emergency. Dr Husain says it’s “A great fracture management app that essentially puts an orthopedic surgeon in your pocket.” It helps with fracture management and understanding essential features of fractures, such as how much displacement needs changed management.

    STD Tx Guide, developed by the US Center for Disease Control and Prevention (CDC) provides alternative antibiotic regimes for patients allergic to penicillin (PCN). The app was updated recently to include new guidelines.

    Gout Diagnosis avoids tapping red or painful joints. Dr Joshua Steinberg took a validated study on gout diagnosis and created an app. He’s a bit of an appthusisast. They’re all available from iTunes.

    Africa’s mHealth plans could include investment programmes in ER services. These would have to be in parallel with investment in mHealth for citizens and communities.

  • Red Cross app launched in South Africa

    Being nosey’s a generic human trait. There’s an app that helps. Following a successful launch in Kenya in April this year, the South African Red Cross Society (SARCS) has announced the official launch of its app, created and developed in partnership with Connectik, says an article in ITWEB Africa.

    App users can see where local projects are. When they’ve found out what’s going on near them, they can volunteer, sign up to receive emergency alerts during national and local crises, make donations, register for training courses and events, and see blood donor locations. The launch of the app is the first nation-wide initiative for SARCS' new senior leadership. It’s the organisation's major stepping-stone as it seeks to digitise and improve services.

    SARCS hopes the app will provide help to mobilise its resources by increasing membership, volunteer base and programme delivery. It should also improve community engagement.

  • Do these mHealth principles fit Africa’s healthcare professionals?

    As mHealth expands, choices and decisions about which apps to use and which to avoid become increasingly challenging. The American Medical Association (AMA) has adopted a set of principles in Safe, Effective mHealth Applications that can help. They may help Africa’s healthcare professionals and health systems too.

    The AMA’s position’s that doctors are optimistic about eHealth and its potential medical benefits. It’s also clear that some mHealth apps and devices aren’t safe and can pose threats to patients’ health and safety. Resolving this needs more evidence to show mHealth’s accuracy, effectiveness, safety and security.

    The AMA’s principles aim to encourage integration of eHealth innovations, such as mHealth apps and associated digital devices, trackers and sensors, into clinical practice. It does this by promoting coverage and payment policies based on whether mHealth apps and related devices are evidence-based, validated, interoperable and actionable. The principles are:

    1. Support establishment or continuation of valid patient-doctor relationships
    2. Have clinical evidence to support mHealth’s use to ensure safety and effectiveness
    3. Follow available evidence-based practice guidelines to ensure patient safety, healthcare quality and positive health outcomes
    4. Support healthcare delivery that’s patient-centred, promotes care coordination and facilitates team communications
    5. Support data portability and interoperability to promote care coordination of medical home and accountable care models
    6. Abide by licensure laws and medical practice laws and requirements in the state in which the patient receives services facilitated by mHealth
    7. Require doctors and other healthcare practitioners using mHealth to deliver services to be licensed where patients receive services, or as authorised by the state’s medical board
    8. Ensure delivery of services using mHealth is consistent with practice laws
    9. Ensure patient privacy and data security in compliance with laws and regulations and promote patient awareness of varying levels data privacy and security afforded by mHealth.

    Given the lack of regulation of mHealth apps, regardless of whether the apps related device is encrypted, the AMA advises physicians to alert patients of the potential privacy and security risks for any mHealth apps that they prescribe or recommend, and document the patient’s understanding of such risks.

    A next step is an AMA assessment of the potential liability risks to doctors is using, recommending or prescribing mHealth. Fierce Healthcare has a report highlighting an important difference between prescribing drugs and mHealth. An approved medication basically remains unchanged, but mHealth keeps changing with numerous updates, and not updating's potentially worse.

    These principles offer a valuable start for Africa’s doctors and health systems to introduce effective mHealth regulation. As Africa’s mHealth expands, the need for, and value of, regulation will increase too. A lead by Africa’s medical profession will help.