• Apps
  • Apple's CareKit family expands with new apps

    Apple has announced the launch of a series of health apps linked to its CareKit tool set, including the Iodine’s Start app that monitors depression, Glow’s Nurture and Baby apps to monitor pregnancy and maternity, and One Drop’s app to monitor diabetes. An article in Fortune says they’re part of a concerted effort to personalise healthcare by leveraging the power of self-tracked data in a centralised platform which brings together individuals, patient communities, caretakers, and medical professionals to track symptoms, medication use, and other care information says.

    CareKit aims to deliver users a seamless and centrally integrated platform where they can enter all their relevant health information. The Glow’s pregnancy apps, for example, now tap into the Connect data-sharing feature to make it easier for pregnant women who have developed fevers to alert their doctors or caregivers. The Start apps using the medication-tracking feature to help people comply with their prescribed therapy. It also uses Connect to allow users to send progress reports to their doctors.

    One Drop CEO and founder Jeff Dachis says they worked hard to put users’ experiences and needs at the forefront. The diabetes monitoring and maintenance app allows users to enter their food intake, track symptoms like pain and hunger, measure those inputs against glucose levels. Doctors can then recommend medication dosages. 

    Dachis says he believes clinical trial data on One Drop, set for release later this year, will vindicate its potential to help users’ health. “You can either be a lifestyle product or a product that delivers actual results, and I think for the most part we’ve seen a lot of digital health stuff touch on lifestyle,” said Dachis. “But just now we’re starting to broach the threshold for delivering actual clinical results through digital platforms. And I think it’s part of a huge sea change from healthcare to self-care.”

  • Cardiio makes every beat count

    “Simply magical” is their marketing line, and it seems almost true. Download this Cardiio app. Open it. Look straight into the front camera of your iPhone and within seconds it’ll register your heart rate. No contact with the phone is required. Cardiio’s available for iOS. The basic version’s free. The Pro version costs R140 in South Africa. 

    How does the magic work? It’s actually pretty straight forward, based on research by the Massachusetts Institute of Technology MIT Media Lab that’s demonstrated that every time your heart beats, there’s a subtle change in the blood flowing through your face. It’s not detectable to you and me, but the tiny increase in volume causes more light to be absorbed, less light to be reflected, and this is easily tracked by your phone’s camera. Cardiio uses the information to calculate your heart rate.


    Cardiio says if the test’s performed in a well-lit environment, the measurement’s accurate to within three beats a minute of an electronic pulse oximeter, the device health workers attach to your finger to collect formal heart rates in hospitals and clinics.

    Cardiio built tools tool. They help with record keeping, integrate with other tools, such as RunKeeper and Health Graph, and for sharing with friends and social media apps.

    With Cardiio, you can record what you’re doing when you test your heart rate, such as waking up or going for a run, and use the information with built in analytics to calculate your fitness levels, estimate life expectancy, and set and manage personal health goals. The app will help you be fitter too. You can select from a list of workouts, each designed by one of a team of international coaches.

    How much of the analytics has been confirmed by scientific methods is hard to find. It’s the kind of validation that’s becoming increasingly important for these types of technologies expand. 

    A neat Cardiio report shows how your results compare to others. Last week it told me that I’m 16% healthier than the average person in Slovakia. That doesn’t mean much to me, but it also showed that I’m about as healthy as Barack Obama, which feels great. So now I’m convinced. It’s simply magical.


    Image from http://cdn.blessthisstuff.com/ 

  • Uber takes on the flu in South Africa

    Uber has quickly become a house hold name, and not surprisingly. It’s now available in 409 cities worldwide. With winter fast approaching in the southern hemisphere, and with it flu season coming along, Uber’s expanding its service to healthcare. Discover Vitality, a health insurance company, has revealed a partnership with Uber & Dis-Chem to bring the flu vaccine to consumers in South Africa, says an article in IT NEWS AFRICA.

    Today between 1000 and 1500, Discovery Vitality members living in selected areas in Johannesburg, Pretoria, Durban, Cape Town or Port Elizabeth can have a qualified Discovery-accredited Dis-Chem nurse visit them within minutes to administer the flu vaccine for up to five patients per visit. 

    The vaccine’s free for Discovery Vitality members. They’ll have to pay R100 for the driver when they order with the Uber app. 

    How does it works

    Open the Uber app or download Uber at com/app Slide across to the UberHEALTH view with the cross icon Set your pickup location and request a ride as normal.

    This innovative thinking of combining healthcare aspects with a taxi service is what we have come to expect from Uber. Hopefully, it’ll be a success and can be replicated in other cities across Africa.

  • Big Health's Sleepio's a step towards a big sleep

    Fictional private investigator Philip Marlowe first emerged in the Big Sleep. Author Raymond Chandler’s euphemism for death was “sleeping the big sleep.” Less apocryphal, and more beneficial, Sleepio can help overcome insomnia and improve a wide range of personal health indicators. It’s a Big Health service built from gold standard clinical evidence that can help people achieve the healthy requirement of seven to nine hours of uninterrupted sleep a night.

    Sophie Bostock, Big Health’s operations lead, presented her achievements at the Royal Society of Medicine’s 12th Innovation Summit in April. She described the need for a good night’s sleep for about 40% of the population who are deprived of the luxury, and 10% of the population who suffer from chronic insomnia.

    Sleepio’s starting point’s Prof Colin Espie’s research and book Overcoming Insomnia and Sleep Problems: A Self-Help Guide Using Cognitive Behavioral Techniques. Sleep deprivation disrupts people’s circadian rhythms, lowers self-control and creates emotional imbalances. These can lead to a cycle of poor sleep, anxiety and inappropriate compensatory behaviour, and onto a wide range of health problems, such as:

    Craving unhealthy foods Risky behaviours Smoking Memory loss Catching a cold Depression High blood pressure Deviant, unethical behaviour Less attractive appearance Lower earnings. 

    The online service applies Cognitive Behaviour Therapy (CBT), which is not widely or promptly available in health services. Users can use a wearable to keep their own sleep diary, with a weekly review and changing negative sleep. With a 126% increase in sleeping pill prescriptions over ten years, and the increasing global priorities emerging to reduce obesity and support mental health, the app and its services offer a lower cost, preventive part of the solutions. 

    Sleepio’s been by covered twice by Nature. In 2013, Insomnia: Chasing the Dream In April 2016 Mental health: There’s an app for that described one of its main impacts.

    It was Ernest Hemingway who said “I love sleep. My life has the tendency to fall apart when I'm awake, you know?” Sleepio can help with both.

  • Which apps protect against this silent killer?

    It can be fatal. Risks include blindness, kidney disease, stroke, heart attack and amputation. The risks are largely avoided through early detection, lifestyle changes and where necessary, treatment, but up to a quarter of people don’t know they have it.

    Diabetes is a silent killer and according to the WHO’s 2016 Global Report its prevalence has more than doubled since 1980. According to the report, the rise mirrors increasing obesity and deceasing levels of physical activity.

    With numerous apps appearing to help you improve your health, which ones might be good for diabetics? Below is a 2015 list of top diabetes apps from Healthline.

    "Everyone has a role to play - governments, health-care providers, people with diabetes and those who care for them, civil society, food producers, and manufacturers and suppliers of medicines and technology are all stakeholders," says the WHO.

    Apps can be part of the solution too. Which ones are working to reduce diabetes and help diabetics in African countries? eHNA's found interesting initiatives in Tanzania and Senegal. We're on the lookout for more.

  • India has a smart diagnostic device for CHWs

    In rural areas, results from diagnostic tests can take an age. Device Talk has a post saying India Swasthya (Health) Slate’s here to help.  A device has been used as a mobile platform connecting to a digital thermometer, blood pressure monitor, heart rate sensor, 3-lead ECG system, blood sugar monitor and a water quality meter.

    Now, the unit uses Bluetooth to communicate with a Swasthya Slate app on an Android phone or tablet to run 33 diagnostic tests. They extended range includes rapid pregnancy, urine protein, rapid typhoid test, dengue and HIV 1 and HIV 2 testing. It stores data in the cloud very easily and quickly and doesn’t need an Internet connection. It can use SMSs to upload data, and results are back in a few minutes. It’s already being used in Nigeria. 

    The average learning time to first correctly use the device is claimed as ten minutes. By 45 minutes, users can use the apps with less than 1% errors arising from slips like accidental button pressing. A You Tube video has a demonstration.

    Swasthya Slate also has value for health and epidemiological research. This increases its value as a tool for patients and rural CHWs. At a price of about US$600, it’s not hard to see how it offers good value for money.

    Kanov Kahol, a team leader of Affordable Health Technologies Division, Public Health Foundation of India, is credited with conceiving the device. He was previously an assistant professor in the School of Biological and Health Systems Engineering, Arizona State University, and held a similar post at the an assistant professor adjunct in Mayo Clinic, which has a major site in Phoenix.

  • Patients rely more on mHealth than on doctors

    In the not-so-distant past, patients had one source for healthcare expertise, their doctors. They relied on doctors to diagnose their illnesses, monitor their symptoms, track changes in their health, manage their diseases and personalise their care. Recently, mHealth and the Internet of Things (IoT) has started to transform healthcare and the way citizens and patients interact with it, says an article in Insights. As mHealth expands across Africa, the phenomenon will need addressing.

    More patients are armed with wearables and healthcare apps that allow them to monitor their own health data. It also provide them with access to continuous guidance and information from the devices they carry with them every day.

    While the emerging trends are encouraging individuals to take responsibility for their health and providing them with ample tools to do just that, digital health tools are a double-edged sword for the healthcare. Patients are more engaged in their own wellness which has lead to healthier and better informed patients. As a consequence, they rely more on these tools and less on healthcare professionals. 

    Why go to the doctor when you can Google symptoms and diagnose and treat your symptoms yourself? Many people have become our own doctors completely sidelining medical professionals for some conditions. While this might be hugely beneficial for minor health issues such as a cold or finding information on how to treat a blister, it can bevery dangerous when self diagnosis is incorrect and the seeming unimportant symptoms are the signs of something much more serious. 

    It’s not hard to understand the appeal of mHealth apps, wearables and IoT medical devices. They’re more convenient and less expensive than doctors’ visits and provide a continuous stream of information. 

    The recent Makovsky/Kelton “Pulse of Online Health” survey featured on ITNOnline indicates that almost 66% of individuals would use mHealth apps to prevent and manage disease by:

    ‪Tracking diet and nutrition, 47 % ‪Receiving medication reminders, 46% ‪Tracking symptoms, 45% ‪Tracking physical activity 44%

    79% said they’ use a wearable device to:

    ‪Track physical activity, 52% ‪Track symptoms, 45% ‪Manage a personal health issue or condition, 43%.

    While mHealth can encourage and support people to live healthier lives, it also provides an opportunity for deeper and more meaningful health conversations with doctors. The challenge is that doctors are overwhelmed with the wide array the data brought to them without a way to process and analyse it. 

    While there are a number of possible solutions, most healthcare providers don’t have the ICT tools to leverage mHealth data. Forbes spoke with Dr. Lawrence Kosinski, an Illinois-based gastroenterologist who spent three years developing a standalone, cloud-based algorithm to manage mobile data from patients with chronic gastrointestinal disease. His system has improved patient outcomes, reduced hospital visits, and given him a better understanding of population health management. However, developing his platform needed time and resources that most doctors don’t have. 

    Healthcare providers and digital partners must create ICT infrastructures that enable doctors to collect, analyse and share mHealth data. It’ll provide doctors with a more detailed overview of patients’ health and make sure that the data and communication gaps don’t grow. Africa has the opportunity to manage these as mHealth expands.

  • Apple's now released CareFirst

    About a year ago, eHNA reported on Apple’s ResearchKit. It’s now launched CareFirst, a framework for hospitals, health systems and developers to build apps to improve the management of patients' health. CareFirst builds on ResearchKits success in medical research. Apple COO Jeff Williams said "It's no longer about research, but using apps to learn more about health. With ResearchKit, the simple goal was to improve medical research. The same tools can be used to help people with their healthcare."

    More apps are due out soon. You can find out more about it in the video on iTunes. There’s also a video about how Blue Cross Blue Shield uses it. There’s already a queue of USA hospitals ready to use it. Will Africa’s health systems take it soon? If they do, what will they use it for?

  • Mobile eye test kit launched in Kenya

    About 80% of blindness is avoidable. Existing eye care tools are expensive, difficult to use and access. Many people in Africa aren’t treated quickly enough, or treated at all.

    To address this problem, a Kenyan doctor’s partnered with London School of Hygiene and Tropical Medicine to develop the Portable Eye Examination Kit, known as Peek. Its an eye test kit using a mobile phone, says an article in All Africa.

    Peek can be downloaded on any smartphone and will be used to screen nearly 300,000 pupils in 400 schools in Trans Nzoia County in the next three years. Other counties lined up to benefit include Uasin Gishu, Nandi, Elgeyo Marakwet, West Pokot and Narok.

    After children are screened, they’re referred to a hospital, and both the parent and headteacher are informed of the diagnosis and treatment. Records are captured in a cloud-based data system. Using Peek’s about 50 times cheaper than buying eye testing machines, said Dr Rono from the Kitale District Hospital Opthalmologist Unit. 

    "This app uses smartphone technology to carry out various eye tests including visual acuity, colour vision as well as lens and retina imaging. We have used it over the last year in Trans Nzoia," said Dr Hillary Rono.

    Peek Retina slips neatly over the built-in camera on smartphones. Used with the Peek app, users must hold the phone close to someone’s eye, and it’ll auto-focus to show the retina on screen. The high quality images means cataracts are seen clearly enough for treatment classification, detecting signs of glaucoma, macular degeneration, diabetic retinopathy and signs of nerve disease. Other health problems such as severe high blood pressure and diabetes can be identified too with a good view of the retina.


    Image from Peek

  • There's a new mHealth evaluation framework

    As mHealth marches on across Africa, is it any good? The Commonwealth Fund’s been wondering about it, and come up with an evaluation framework. It’ll help to identify mHealth’s value for patient engagement, quality, and safety. It takes the critical, constructive perspective of the difference between mHealth and eHealth’s potential and probable benefits. Probable is invariably less than potential.

    The team completed a systematic search of iOS (Apple) and Android app stores and analysed apps for people with chronic illnesses. It then assessed the extent to which apps are likely to be useful in patient engagement efforts. Usefulness was determined by: 

    Description of engagement Relevance to the targeted patient population Consumer ratings and reviews Most recent app update.

    It found that among the 1,046 healthcare-related, patient-facing apps, 43% iOS apps and 27% of Android apps seemed likely to be useful. 

    Patient engagement was defined across several criteria. They were the ability for apps to enable collaboration, activation and participation, information-sharing, and decision-making in one’s own health. 

    Quality was defined as reliability of information for the targeted population, users’ propensity to recommend it, and usability. Two aspects of safety were used: the ability for an app to deal with dangerous information entered by a patient, such as low blood sugar or suicidal thoughts, and the commitment of the app developer to respect patient information privacy and security.

    Apps were considered useful by judging them on a range of factors. They were unlikely to be useful if they had minimal functionality beyond traditional media such as books and videos, weren’t relevant to the searched illness, were poorly rated or reviewed by consumers, or were not intended for broad use, such as inaccessible without specific login credentials. 

    The apps search was wide and specific. Terms used for the search were: alcohol, arthritis, asthma, bipolar, cancer, cirrhosis, cognitive impairment, chronic obstructive pulmonary disease, COPD, coronary artery disease, dementia, depression, diabetes, drug abuse, elderly, heart disease, heart failure, high blood pressure, hypertension, kidney disease, liver disease, lung disease, obesity, pain, smoking, and stroke.

    The findings are that a minority of apps appear likely to be useful in engaging patients. The overall position is that 43% iOS apps and 27% Android apps were assessed as possibly useful. Some of them were on both platforms.

    For Africa, mHealth plans and projects can apply these findings to ensure success. It’s clear that not all mHealth’s good mHealth.