• Apps
  • Asthma apps are about breathing

    For most of us, breathing isn’t difficult. I certainly don’t spend much time thinking about it, except for the occasional scary sea-swimming moment, caught clutching the sand after diving beneath an unexpectedly large wave. For asthmatics though, breathing can become impossible and the signs of deterioration are often small and subtle and only noticed by patients and their families once the patient is already in trouble, ‘trapped below the surface’ of a tight chest, needing urgent rescue through medical care, and often hospitalization, to avoid death. Keeping these patients out of the dangerously deep water of a serious attack is about helping them to identify danger signs long before they are serious, to take action, or to identify and avoid triggers that accelerate a plunge into the abyss.

    Open mHealth says that mHealth is about making “health data as useful and actionable” for patients and clinicians. The growing industry around mHealth is equally interested in reducing costs and the burden of care faced by health workers by reducing hospital visits. For asthmatics, both will sound like good news and they are no doubt pleased that innovators are not sitting idle.

    A number of companies now offer Apps and sensors to monitor breathing and help manage Asthma. Three quite different examples, sharing the same aim, are AsthmaMD that offers a Peak Flow Meter to measure lung function, iSonea that gauges adherence by monitoring wheezing, and Propeller Health’sapp and sensor, which attaches to a standard inhaler. All focus on helping asthmatics manage their condition and reduce the number of visits to healthcare providers. Ephraim Schwartz provides more detail in his June piece in mHealth News.

    AsthmaMD uses a Peak Flow Meter, a device that measures the force with which the patient breathes out, a key aspect of breathing particularly reduced in asthmatics. The meter syncs with an App via Bluetooth. When patients blow into the meter, a value is transmitted to the App, which then explains to the patient what the value means. The App will also track lung function over time and produces easy-to-read, color-coded peak flow charts, which provide healthcare providers with information to use to tailor treatment plans. They’ve reported a 10% improvement in lung function for active users, compared to a control group, and reduction in hospitalization and readmissions. It’s available over the counter in the US for $20.

    AsthmaMD apparently has 100,000 users and its developers have begun thinking about how to use their growing data source to answer questions about how to improve asthma care.

    iSonea’s device is called iSoneaAir. It records wheezes, a characteristic sound associated with obstructed airways. By measuring the wheeze rate, health workers are able to monitor patients’ progress outside of the clinical environment and assess how effective medications are before and after inhaling. “Doctors as well as insurers are looking at our application because it gives them a disease management focus,” said Ross Wilson, senior clinical manager at iSonea.

    The solution consists of an iPhone or Android App and the wheeze monitor, which is placed against the throat. The device syncs with the App via Bluetooth and wheeze recordings can be sent to health workers or stored in the cloud.

    The Propeller Health App, along with its sensor, tracks exact location, time and frequency of medication taken.

    Africa’s health challenges need solutions of their own, and the mHealth community in Africa is expanding its capacity to deliver. There’ll be lessons to learn from projects that gain traction elsewhere. Though probably none that will help me avoid the next big wave, or hold my breath longer when I get it wrong.

  • AliveCor is a life-saving mobile App

    These days, there’s an app for just about everything, from maps, to games, to mobile banking. Health’s part of the craze with numerous health and healthcare apps now available. These can track the number of steps you take, help document your food intake and even monitor your sleep. While these are all interesting up to a point, the extent that they change lives is debatable. An article in WNDU.com says there is now an app that not only changes lives, but can help save them.

    The AliveCor app works with the AliveCor Heart Monitor and records and saves single-channel ECG’s onto its server. The Heart Monitor is available for US$200 and can be used to track your heart rate anywhere. It is available for both Android and iOS. The technology can be downloaded for free by anyone with an app store on their phone.

    The technology uses electrical impulses from the user chest and turns them into ultrasound signals that are transmitted to the phone. The high reliability tracings it produces are very similar to LEAD I on regular ECG machines. These recordings are then saved into the cloud, where the information can be accessed at any time under confidentiality. The information can immediately be sent to a doctor who can make an informed decision without having to see the patient. The technology also allows you to save the readings as a PDF or send it as an email.

    Most international funding in Africa is devoted to child and maternal mortality, HIV, TB and malaria. Cardiovascular disease is often overlooked. According to the World’s Health Organization, the burden is increasing rapidly in Africa. Findings in a Cardiovascular Diagnosis and Therapy journal article show that in 2012, cardiovascular diseases accounted for 9.2% of total deaths in Africa.

    This technology has the potential to save countless lives. Hopefully, the inventors will continue to develop ways in which the heart tracings can be used and that the monitor will be available to African countries soon.

    eHNA covered a study of AliveCor in Sydney 2013.

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    Image from AliveCor website

  • Health app wins Uganda Community Innovation awards

    K-Free, a health solution app aimed at curbing and combating breast cancer, has won the 2014 Uganda Community Innovation awards. It beat 28 finalists. The award is organised by Orange Uganda in conjunction with Huawei Technology.

    The award pooled student developers from leading Ugandan Universities. They were asked to develop mobile apps relevant to community for health, education and agriculture.

    K-Free is an Android mobile app that helps detect breast cancer early by plugging an external pouch-like peripheral to a smartphone. The external device uses low-energy light to take images of breast tissue. After the light is beamed through the breast, computational analyses provides the results, which are immediately available to users.

    K-free was developed by three Makerere University Students, Joshua Sentamu, David Tusubira and Derrick Mutabi. The app is cheaper than a conventional mammogram and doesn’t compromise the quality of the results. As a prize, the K-Free developers won a twelve month internship at Orange Uganda.

  • Cloud-based healthcare Apps from Phillips and Salesforce.com

    Royal Philips and Salesforce.com have announced a strategic alliance to deliver an open, cloud-based healthcare platform. The concept is a platform based on patient relationship management, supporting health workers to support patients.

    The partnership leverages each company’s unique expertise. Philips’ medical technology, clinical applications and clinical informatics and Salesforce.com’s enterprise cloud computing and customer engagement. eHealthnews.eu carried the story. It relies on analytics to provide clinical decision support, creates opportunities for patients to be more active in their personal health management, and deals with device and data interoperability.

    It’s first two clinical applications are expected this year. Philips eCareCoordinator and Philips eCareCompanion will help clinical care teams support patients to manage their chronic conditions at home.

    “Together with Salesforce.com, we have a tremendous opportunity to reshape and optimize the way healthcare is delivered” Frans van Houten, Royal Philips’ CEO is reported as saying.Salesforce.com chairman and CEO Marc Benioff said, “Together with Philips, we are creating an open health platform and ecosystem to benefit everyone that cares about one of the most important issues of our time.”

    The platform will be open to developers, aiming to provide an environment for an ecosystem of partners creating applications.

    Whether clinical applications appropriate to African countries’ unique requirements will emerge is yet to be seen. However, the idea of strong commercial partnerships supporting collaborative ecosystems of developers is an idea that is likely to resonate with African developers. eHNA is always on the lookout for apps worth reporting on for our African readers. We’ll be watching this partnership for progress.

  • Birth control pill-tracking app

    MediSafe, a company based in Israel, has added a birth control pill tracking feature to its medication adherence app. MediSafe offers a cloud-based app system for medication adherence. Patients using MediSafe get a reminder to take their medication on their phone and are then prompted to record doses when they take them. If they don’t indicate that they’ve taken their medication, friends and family members are notified and can then take action.

    While a number of women were using MediSafe as an adherence app, the app wasn’t specifically designed for tracking birth control pills. “Female users have been using MediSafe for birth control pills for some time now, but it was a bit awkward,” MediSafe CEO Omri “Bob” Shor told MobiHealthNews. “You know a continuous medication is something that you take every day but it wasn’t really perfected for contraceptives.”

    Even before the new feature was launched MediSafe found that women who were entering birth control pill reminders increased their adherence by 23% and were adherent close to 94% of the time. Women can now make use of the new feature, which includes the option to assign friends or significant others the responsibility of reminding you, if you forget to take your birth control pills. 30% of the women who have singed up are already making use of this option.

    Similar platforms can be developed to address African specific healthcare challenges. There is no reason that HIV or TB medication can not be tracked through a similar application. eHNA’s reprted on South Africa’s SIMpill and Wisepill. There are certain to be more.

  • Ramadan's now safer for diabetics in Senegal

    Managing diets is a constant challenge for diabetics. Religious festivals and fasting can sometimes make it more demanding. The mRamadan initiative can help. It was launched in Dakar on June 16, 2014. It originated from the mDiabetes program currently underway in Senegal, and reported in eHNA. The pilot helps people with diabetes safely manage their health while fasting. Diabetics in Senegal can now receive free, daily SMS with recommendations for fasting before, during and after the Muslim Holy Month of Ramadan.

    mRamadan’s goal is to help diabetic patients in Senegal safely manage their illness and reduce the number of emergency hospitalisations that normally peak during Ramadan.

    While Islam exempts anyone too young, too old, pregnant, or not in good health, from fasting many diabetics say they try to abstain from food and drink during Ramadan. Some also stop taking insulin injections, which are needed to regulate blood glucose levels.

    According to Voice of America, Dr. Maimouna Ndour Mbaye, a professor of internal medicine and diabetology, says that “the first risk is hypoglycemia, which can be very harmful to the brain. There is also a risk of hyperglycemia, because when they fast, their diabetes is less controlled. They cannot take their medication on a regular basis as they do on a normal day. And this is a risk…and exposes [patients] to complications.”

    Mbaye said diabetics are also at an increased risk of dehydration. It’s often not advisable for diabetics to fast when they have other existing conditions, such as chronic kidney problems. These conditions can worsen, and in some cases become extremely serious.

    When Ramadan is over, diabetic participants will continue to receive their SMS support. It’ll include messages about the importance of checking in with a doctor to make sure their diabetes is still well-controlled, and to maintain a healthy and active lifestyle.

    Like mDiabetes, it’s easy to see how mRamadan can transfer to other African countries.

  • The mHealth super app

    Bill Gates remarked that “software is a great combination between artistry and engineering.”According to Natalie Hodge and Brandi Harless of Personal Medicine Plus, good mHealth apps are about combinations too, though for them it’s mHealth and Internet of Things (IoT), intersecting to produce the super app. They wrote about it recently in mHealthNews.

    eHNA’s had numerous posts about mHealth and a number on the IoT. This is the first time they’re together. It’s a novel idea, that if we connect all the apps that tell a patient how they are doing or what they should do next, we might end up with a health promoting, or healthcare, platform, or both. It would help people stay healthy and allow them, in some cases, to take their health into their own hands and bypass the conventional healthcare system. It’s the approach Google Fit is following too.

    Hodge and Harless suggest that winning super apps have six attributes:

    Use multiple proven technologies in mHealth in tandem Leverage proven engagement strategies Leverage application programming interfaces Use connected health devices Automate interpretation of data with actionable and immediate instructions for behavior change Build on evidence-based prevention principles.

    The themes match well with important eHealth topics, such as interoperability, analytics and sound stakeholder engagement. They also raise questions about risks of cybercrime and the complexity of conducting impact assessments.

    The list is different to those eHNA reported in eHNA’s piece on a new recipe for successful mHealth apps. Perhaps their combination would be good too.

    eHNA will watch for reviews of projects that show how the concept develops. We look forward to more posts on fortuitous combinations, particularly about new ways of using eHealth to improve health and healthcare.

  • Google's passionate about your fitness, and health

    Does the difference between health and fitness matter? Maybe not too much. Fitness is about 17% of the USA mobile app market according to reserach2guidence in its report mHealth App Developer Economics 2014 The State of the Art of mHealth App Publishing.

    The Verge has a report on Google’s unveiling of Google Fit, its personal health application, at the launch of the Google I/O developer conference 25-26 June 2014. Google Fit aims to collect data from popular fitness trackers and health related apps. It will allow a wearable device that measures data such as steps or heart rate to interface with Google’s cloud-based services and become part of the Google Fit network. These are important components of fitness, but health too. It’s an exciting development.

    The personal health application is expected to compete with Apple’s HealthKit application, the concept modelled on Apple’s Passbook app, an effective pocket accessory for keeping important information like boarding passes, tickets, gift cards and coupons.

    Forbes reports on it too, indicating that it’s too soon to confirm whether Google Fit will be an app or whether it will be built into the next version of Android, the operating system that currently runs on over 1 billion smartphones and tablets globally.

    Google announced several partners for its Google Fit initiative. It includes Nike, Adidas, Withings, RunKeeper, and Basis. Phew, it’ll be hard to keep up with these. App developers may want to start warming up – access to the software development kit should be available in the coming weeks.

  • Apps and transformers

    Transformers are toys from USA toy maker Hasbro and a science fiction film. Transformers can convert themselves with ease from conventional toys to assertive, combative characters, then back to ordinary toys. Technology enthusiasts are regularly claiming equivalent conversions to health and healthcare with mHealth and apps. There’s a steady supply of new apps and ideas. An interview  by the UK’s BBC  Jane Wakefield with Daniel Kraft, a doctor trained at Harvard and now leading medical school at the Singularity University in Silicon Valley, explores the future.

    Dr Kraft predicts that tricorders will scan people, collect information about their heart rates, oxygen saturation, temperatures and blood pressures and send it to their smartphones. These will link to artificial intelligence agents on smartphones that connect to super-computers such as IBM’s Watson, to provide instant and accurate diagnoses.

    Wearable devices such as Nike’s FuelBand or Jawbone’s Up are making people ever more aware of their health. These will help doctors to monitor patients remotely. There are apps for diabetics to monitor their blood sugar levels using their smartphones, and apps to track diet, pregnancy, menstrual cycles and blood pressure. Google Glass enables doctors to monitor patients’ vital signs and deal with developments in surgical procedural whilst not having to turn away from their patients. It can on ward rounds.

    Dr Kraft sees opportunities to help reinvent elements of health and medicine and “Do healthcare rather than what we are doing today, which is sickcare.” Does this imply that the skills and knowledge to treat sickness will diminish? Transformers can change both ways. If technology results in doctors giving up sickcare, who will do it in the future?

  • mHealth apps keep coming

    Jacob F Field claimed in the title of his book that history is “One Bloody Thing After Another: The World’s Gruesome History.” The constant supply of mHealth apps feels a bit like this, but without the haematological and gruesome links. Making sense and keeping up with it is hard going. Lt Dan’s article on HIS Talk connect brings together a list of websites that assemble data on mHealth apps.

    PatientView, a UK-based healthcare research and consultancy firm, has launched an mHealth app store that collects clinically validated, trustworthy mHealth apps for patients and care providers. It is supported by several organizations, including GSK, Janssen, and Novo Nordisk, some international telecom companies, and public health entities across Europe.

    The rating system that PatientView uses has five criteria:

    Gives people more control over their condition Easy to use Can be used regularly Allow networking with other people like them Trustworthy.

    Happtique has physicians and health systems as its end users rather than patients. It certifies mHealth apps before they are added to Happtiques, its apps formulary.

    HealthTap is a platform where anonymous users can put health and wellness questions to approved physicians, who provide the answers. It has an app store too. HealthTap allows its physicians to recommend apps that they would recommend to their patients or to each other. The library shows the apps with the most recommendations.

    In England, NHS Choices Health Apps Library shows the apps judged as clinically safe by the NHS, and that the information in them is from a verifiable source. It also tests that developers do not misuse personal information that the apps collect.

    Wellocracy has an mHealth app library for fitness enthusiasts. The site, which is run by the Partner’s Healthcare Center for Connected Health in collaboration with the USA’s Massachusetts General Hospital.

    Lt Dan’s post provides a set of valuable links for African countries that are expanding their mHealth strategies. It makes it much easier than slogging through one app after another.