• Apps
  • mHealth may have no cost or utilisation difference

    mHealth’s often promoted as being the saviour of health systems as demand outstrips supply. It’s seen as an essential part of the solution to the extreme shortage of resources of Africa’s health systems. A study in PeerJ has found that mHealth’s short-term impact may be limited, and may even make no difference for patients monitoring their chronic diseases. It claims that positive mHealth results haven’t used Randomised Control Trials (RCT) to evaluate the impact on healthcare costs, and have failed to provide study participants with truly comprehensive monitoring systems. 

    There were 160 patients in the study, They’d made health insurance claims from Scripps Health, based in San Diego. Claims were related to three conditions; hypertension, diabetes, or cardiac arrhythmia, and sometimes a combination. It included the use of one or more mobile devices for six months.

    Withings Blood Pressure Monitor for hypertension Sanofi iBGStar Blood Glucose Meter for diabetes AliveCor Mobile ECG for arrhythmia.

    These patients also had access to an online health management system that provided them with detailed device tracking information. It was designed by collaborations with device manufacturers, a connected health leader, healthcare provider, and employee wellness programme. It was a unique and inclusive service. The control group received a standard disease management programme. 

    The result was little evidence of differences in healthcare costs or utilisation due to the mHealth service. The control and intervention groups were equivalent for most healthcare utilisation outcomes, suggesting there aren’t large short-term increases or decreases in healthcare costs or utilisation by using mHealth to monitor chronic health conditions.

    A major concern for health insurers was that patients using mHealth may use health services more than patients having conventional healthcare, so cost more. This apprehension’s misplaced by the study’s finding that healthcare costs and utilisation are similar for both. It also shows that claims for mHealth’s positive impact on costs and utilisation may not be justified.

    Only short-term effects were included in the results. Potential long-term decreases in healthcare costs and utilisation using mHealth for monitoring are beyond the study’s scope. Nevertheless, the findings offer important insights for Africa’s health systems into some of the probable benefits of mHealth monitoring for the three conditions.

  • Dermio, the online dermatology app

    Using photos for assessing some skin conditions is a proven way to seek faster treatment. Dermatologist David Soleymani has developed Dermio, an app that connects patinets to doctors to diagnose and make treatment recommendations for skin conditions. Using the app which is available from iOS, or the Dermio website, users can submit a photo of their skin condition, answer several questions about the condition, then wait for the doctor's diagnosis and treatment plan. Patients receive feedback within 24 hours, says an article in Chicago Tribune.

    Any prescriptions needed are sent directly to the patient's pharmacy through the app. The cost for an online consultation is $40, compared with a typical insurance co-payment of $75 for a visit to a specialist. The app provides patients with diagnosis and treatment options without having to take time off work or travel to a specialist.

    "Instead of coming in, if you have an embarrassing skin condition, you don't have to subject yourself to the waiting room and the nurses," said Dr Soleymani."You can do it privately in the comfort of your own home." The service is convenient and could help serve economically and geographically underserved populations. He said "There's a whole populace living in rural communities: the elderly, students living away from home. I developed the app with these people in mind to give them dermatological care on demand." 

    Dermatology is one of the medical specialties where remote medicine is expanding fastest because diagnoses can usually be made after visual inspection, said Rachel Pritzker, a dermatologist at Chicago Cosmetic Surgery and Dermatology in Chicago's River North neighbourhood. "We can clinically see our exams via pictures. In general medicine, you can't measure a blood pressure online, whereas you can try to make a diagnosis based on a picture, which is easily accessible online now with all of our iPhones," she said. 

    There is some concern about Dermio’s limitations. Photos from patients can be blurred, no matter how many times patients retake them, making diagnosis tricky. It’s also harder to appreciate some of the finer details of a physical exam. In dermatology, its important to know if something is raised or if it's scaly, and pictures don’t always capture these details.

    Despite some of these obvious challenges, the app can help serve communities that would not seek help. Some African communities located hundreds of kilometers away from the closest specialist could benefit from the app’s service. Patients could send their photos and hear back within a day if the conditions are serious and need treatments, or, if they’re mild skin irritations needing simple and basic treatments, saving them unnecessary travel and expenses.

  • Health Alerts app has health emergency updates

    As global news and agencies collect information on impending epidemics and natural disasters, we need to know too so we can take appropriate action. AmericanEHR has released Health Alerts, a mobile app, to help. It brings you timely information on outbreaks and incidents about public health emergencies such as diseases, infections, natural disasters, drug recalls, travel medicine, says an article in AmericanEHR.

    The information is pulled directly from live feeds provided by trusted sources for public health information, including: 

    Centers for Disease Control and Prevention (CDC) WHO US Food and Drug Administration (FDA) International Society for Infectious Diseases (ISID) US Department of Agriculture (USDA) US Department of Health and Human Services (HHS) International Society of Travel Medicine (ISTM) European Centre for Disease Prevention and Control (ECDC) Public Health Agency of Canada (PHAC). 

    It’s projected that a coordinated outbreak prevention strategy can help save tens of thousands of lives annually. CDC reported that preventing infections from antibiotic-resistant germs through more efficient coordination among healthcare facilities and public health departments, up to 80% of infections could be prevented in the next five years. 

    The app aims to reduce the spread of these types of diseases and infections by providing clinicians, public health agencies and healthcare facilities with real time alerts and updates to stop or slow down outbreaks. When people are aware of the latest health bulletins and the symptoms to keep a watchful eye on, means lower healthcare costs, and faster, more accurate responses to health threats as they materialise, so healthier populations.

    Health Alerts is free to use with an AmericanEHR account. The app’s available for iOS devices such as Apple’s iPhone, iPad, and iPad Mini. It’s currently a limited release to select clinicians and patients as the developers gather feedback from the medical community. 

    African countries that battle with an array of deadly diseases and virus outbreaks could benefit from this type of app. Providing healthcare officials with real time updates could help them plan and prepare for the incoming patients, saving valuable time and countless lives. Enabling people to avoid disasters and epidemics could reduce the numbers needing treatment.

  • WHO's eLENAmobile nutrition app's launched

    The WHO has added to its collection of mobile apps with the release of eLENAmobile, a nutritional guidelines app. It provides users access to the latest WHO nutrition guidelines and evidence-informed guidance for nutrition interventions, says an article in iMedicalApps.

    eLENAmobile provides offline access to content from the WHO e-Library of Evidence for Nutrition Actions (eLENA). It’s a single point of reference for WHO’s nutrition guidelines, recommendations and related information, including supporting materials such as scientific evidence and background materials. It aim’s to help countries successfully implement and scale-up nutrition interventions by informing and guiding policy development and programme design.

    The app’s designed to work without an Internet connection, crucial for health workers in areas without adequate connectivity. In order to access eLENA’s full content, including links to guidance documents and full-length systematic reviews, users need to connect to the online platform.

    The app has six sections:

    Recently added, showing the latest content that has been updated or added to the system Health conditions contains a list of medical conditions including obesity and respiratory conditions. Click on individual illnesses to find out more about nutritional guidelines and recommendations Life course breaks down information according to milestone such as infant, reproductive age, pregnancy and older adult Nutrients section covers common nutrients that we should consume, provides a short description of them and details their nutritional importance Intervention type describes ways to improve and encourage better nutritional habits A-Z listing shows all the nutritional information in the app in an alphabetical order.

    Users can now download eLENAmobile for iPhones and Android smartphones, at Google Play or the Apple App Store.

    If you’re using it in the field, we’d love to know how you find it. Let us know at news@ehna.org or simply tweet your views to @eHealthNewsAfri #reachusall.

  • SkinCare app helps people with Spina Bifada

    Steven Magee, author of Electrical Forensics and a radiation expert, sees two types of skin. “The human skin evolved in a natural electromagnetic radiation environment and is now in a very unnatural man-made one that is making many people sick.” While this might be a challenge for all of us, people with Spina Bifida (SB) have more to deal with. They’re directly vulnerable to chronic skin complications such as wounds, and most of these are preventable by adhering to self-care routines.

    A research team from Pittsburgh University and MGH Institute of Health Professions, a Massachusetts General Hospital graduate school, has set out its initiative to help in BMC Medical Informatics and Decision Making. They’ve developed SkinCare, an mHealth system to support self-care and management of skin problems. It’s part of the iMHere mHealth suite, for Interactive Mobile Health and Rehabilitation, and reported in eHNA. The SkinCare team of Bambang Parmanto, Gede Pramana, Daihua X. Yu, Andrea D. Fairman and Brad E. Dicianno also work on iMHere.

    The SkinCheck app consisted of four main features: reminders, skin imaging and reporting, wound tracking, and secure messaging. The reminder feature is designed to allow a patient to schedule a daily visual inspection or wound care task. A patient can set up her/his own schedule, choose a time, ringtone or vibrate, and add notes such as the body area that needs to be checked. The schedule can be repeated every day—or any day of the week—and can be modified or removed. The reminder will pop up at the scheduled time, sounding the ringtone associated with it. The reminder will continue to sound until the patient clicks “Check Skin,” confirming that the patient has received the reminder and is proceeding to perform a visual inspection or care for the affected area.

    SkinCare needs four main functions:

    Self-care task schedule and reminders Monitoring skin condition monitoring and communications using imaging, information about the skin problem, and consultation with clinicians Wound tracking Secure two-way messaging between patients and clinicians.

    These operate in an mHealth system comprising a clinician portal and a two-way communication protocol connecting patients and clinicians. It provides reminders to perform daily skin checks and reporting skin breakdown and injury using a combination of skin images and descriptions. Data’s sent to the portal where clinicians can monitor patients’ conditions. Two-way communications can help to track healing progress in healing over time and provide instructions about caring for wounds.

    SkinCare’s essential feature is that it’s part of an mHealth family for people with complex and chronic conditions. It’s easy to see its strategic context, which is a very valuable boon for Africa’s health systems.

  • iMhere to help

    People with complex and chronic conditions invariably need support to help them to manage their care. A team from Pittsburgh University’s taken on the responsibility of developing mHealth solutions that fulfil this role. The iMHere, meaning Interactive Mobile Health and Rehabilitation, initiative’s reported in the US National Library of Medicine National Institutes of Health. It’s goal’s to “develop and implement a novel mHealth system to support complex self-care tasks, continuous adherence to regimens, monitoring of adherence, and secure two-way communications between patients and clinicians.”

    It’s a novel architecture comprising a clinician portal and a two-way communication protocol connecting patients and clinicians. It has five generic activities: 

    Requirement analysis to identify clinically important functions needing support Design and development of the apps and the clinician portal Development of efficient, secure real-time bi-directional data exchange between the apps and the clinician portal Usability studies on patients Implementing the mHealth system as part of clinical services.

    Nine app features were identified as relevant, Five were considered a set of priorities. They’re:

    Medication Skin care Bladder self-catheterisation Bowel management Mental health.

    Three phases of the usability studies discovered issues for self-care workflows, navigation and interfaces and communications between the apps and the portal. The apps have been utilised extensively and consistently by patients, even those addressing complex issues such as medication and skincare. Utilisation curves are typical of successful benefits realisation, with an increase in use in the early stages, the first month for iMHere, followed by a plateau. 

    Both the apps and the Universities approach offer models to Africa’ health systems. By extending across a mixed care group with generic challenges, it’s easy to see iMHere’s strategic fit to health and healthcare challenges.

  • ARC app helps recovering addicts

    Edinburgh, Scotland has come up with a way to help residents battling addictions. A teams developed the Addiction Recovery Companion (ARC) ARC, an aapp that helps you to focus on your recovery by helping to organise your time and find local services, facilities and groups to support you. All of the features of ARC are designed in conjunction with recovery services and the recovery community in Edinburgh, says an article in iMedicalApps.

    ARC allows users to:

    Easily access details of council support services, local recovery events, hubs and communities using its Recovery Network Find local support using the meetings button and sort by day, location and fellowship Use the calendar to help users schedule time, book in your meetings and stay organised Use motivational features such as quotes, stories or activities to keep motivated Record important day to day moments and experiences in the diary to keep track of thoughts, feelings and memories Keep track of what’s going on in the area using the Community Calendar. Reach out to the people using the emergency button when things are really tough. 

    The app can be downloaded from ITunes and is compatible with iPhone, iPad, and iPod touch. You have to be 17 to download it. Its designed to be replicated for other countries and regions. African countries can add the idea to their app to do list.

  • Is no app better than a bad app?

    Most USA hospitals offer their patients mHealth services. Does this mean we should all follow suit? Perhaps not. A new report by Accenture found that although 66 of the 100 largest US hospitals offer consumers mHealth apps, only 2% of patients use them. Furthermore, failure to focus apps on services that patients want most could cost each hospital more than $100 million a year in lost revenue, says an article in Healthcare IT News.

    The report is Losing Patience: Why Healthcare Providers Need to Up Their Mobile Game. Accenture found that 38 of those top US hospitals have developed health apps in-house rather than by hiring a mobile app vendor. By not aligning their functions and user experience with what patients expect, many of these apps are failing to win over patients. For example, only 11% of the hospital apps offer at least one of the three most desired functions: access to medical records; the ability to book, change and cancel appointments; and the ability to request repeat prescriptions. It also found that around 7% of patients switched healthcare providers because of a poor experience with online customer service, including mHealth.

    What’s clear is that when developing new mHealth apps, or when revamping existing apps, a patient-centric approach is critical. Information must be tailored to each individual, believes Brian Kalis, managing director of the health practice at Accenture. To address the issue, hospitals should engage with prominent digital and mobile health companies that offer unique solutions to help them better understand what their patients want and how they fit into the healthcare ecosystem.

    When it comes to the question of buy versus build, Kalis suggested that mHealth's not a matter of either or. It should be both.

    As mHealth’s pace and scale grows faster and larger, hospitals must keep up. Mobile engagement is becoming increasingly important to the success of healthcare, so healthcare can’t afford to fall behind.

    The report holds important lessons for African countries. Creating a string of apps that don’t address patients’ wants and needs is costly and wasteful. Hospitals should rather assess the real needs and develop apps that address them. In this instance, less could be more, and could prevent hospitals from wasting limited resources.

  • CradleCount addresses Nigeria's infant and maternal mortality

    Kesandu Nwokolo, a young Nigerian woman, has developed CradleCount, a mobile app to help reduce infant and maternal mortality in her country. CradleCount helps pregnant women and healthcare workers to calculate reliable expected delivery dates. Pregnant woman can then plan ahead to make sure their births are either in a hospital or at home with a skilled birth attendant, says an article in AllAfrica.  

    It’s estimated that roughly six out of ten women have their babies at home without supervision by a skilled birth attendant. Errors in estimating expected delivery dates often leads to babies being delivered somewhat unexpectedly. "This is the problem faced by pregnant women in Nigeria and Africa, if this is not addressed, there will be increased pregnancy related complications resulting in more maternal and infant mortality,” says Nwokolo.

    The app informs pregnant women how many days to their deliveries and has alerts that remind them to register and follow up with their antenatal care. It sends regular pregnancy and health tips to expectant mothers too. A statement obtained by the News Agency of Nigeria (NAN) says, the app is well designed with good aesthetic values and doesn’t require an Internet connection to work.

    According to UNICEF, Nigeria is the second largest contributor to the under-five and maternal mortality rate in the world. Organisations like WHO, and National Demographic and Health Survey (NDHS) confirm that statistics show that everyday, about 90 women in Nigeria die of pregnancy related conditions. 

    CradleCount is available to download free through Google Play store. It can offer benefits for many pregnant women in Africa.

  • MTN and mLabs support young mHealth entrepreneurs

    Thirty young developers from Khayelitsha and Gugulethu townships in South Africa are competing in the MTN SA Foundation Community App Challenge in partnership with mLab. To win they have to produce the best apps in the education and health categories, says an article in IT-Online.

    The challenge aims to empower young developers who want to start their own businesses and make a difference in their communities. The overall winners will qualify to enter the 2016 MTN Business App of the Year Awards as well as financial support towards advertisement of the winning app.

    “We are very excited to be partnering with mLab for the MTN SA Foundation Community App Challenge. Such initiatives support our strategic intent of creating sustainable value for our stakeholders as well as developing a force of entrepreneurs who have the right skills set to grow their business, contribute to the growth of the economy and create much-needed jobs,” says Kusile Mtunzi-Hairwadzi, GM of the MTN SA Foundation.

    The previous winners included Voonja App, a community announcement solution, New Start App that deals with male circumcision issues and Pink Drive, an app that deals with breast and prostate cancer. Each of these apps were awarded R30 000 worth of advertising and were incubated and mentored by mLab for a year. 

    An expert panel of judges is currently adjudicating the prototypes of the 30 talented graduate app developers. eHNA wishes all the best to the participants.