• mHealth
  • Wearable heart rate monitors don’t tick the box

    A cynical insight from Napoleon Bonaparte was “If you wish to be a success in the world, promise everything, deliver nothing.” I doesn’t fit wearable mHealth, where reliable results are everything.

    Research in the Journal of Medical Internet Research (JMIR) says some wearables have considerable promise, but have to do much better at delivery.

    It sees an important role for wearable sensor technology in clinical research and healthcare. Before it can, it must undergo rigorous evaluation prior to market launch and its performance should be supported by evidences. The researchers found that match between three heart rate monitoring devices and an electrocardiography (ECG) reference was weak.

    Many studies have tried to validate wrist-worn photoplethysmography (PPG) heart rate monitors, but contrasting results question their utility. A big problem’s inadequate methodologies.

    Validation strategies should consider the nature of data provided by both the investigational and reference devices. There must be uniformity in the statistical approach to the analyses too. Investigators should test the technology in user populations and in appropriate settings for the planned uses. Developers, suppliers and scientific communities need robust standards to validate new wearable sensor technology. 

    There’s a lot more to do before wearables can become mainstream clinical devices. The findings and recommendations should be considered be Africa’s health systems as they advance their mHealth strategies and plans.

  • Intermountain Healthcare integrates telehealth and mHealth in a connected care platform

    Information silos are huge obstacles to integrated healthcare. And integrated care is the kind most of us want for ourselves and for our loved ones. It's a key eHealth challenge.

    In a report in Research Information, research platform outfit Dimensions says they’re usually created unintentionally, and are a phenomenon to “escape” from.

    Intermountain Healthcare, based on Salt Lake City, US, seems to be free of these troubles. A report in mHealth Intelligence says it’s integrated 35 different telehealth and mHealth services into Connect Care Pro, a single connected care platform. Objectives are to improve care coordination and keep care in communities, both of which could be good for patients and health systems. It took five years to plan. 

    The services it supports include: 

    Virtual or tele-programmesTelestrokeTelehealth programmes for behavioural healthTelehealth programmes for newborn critical careTelepharmacy serviceseHealth services using connected health devices.

    The legacy was a history of launches of several telehealth and mHealth programs and pilots that didn’t integrate easily. Intermountain sees their integration initiative as the next telehealth phase.

    The initiative has valuable lessons for our African countries' mHealth and telehealth programmes. It makes sense to start constructing equivalent platforms without delay. It’ll be easier and cheaper than waiting until more silos need integrating. Even more important, it’ll bring extra patient and healthcare benefits, sooner, for our patients, our families and ourselves. 

  • GPS tracking finds a role for dementia patients

    Location, location, location’s not just a property agents’ mantra for house hunting and valuations. It’s essential for dementia patients and their health workers and family carers too. Knowing the whereabouts of the patients and loved ones can be supported by GPS. A NHS organisation in Dorset, UK’s testing a tracking device in shoe insoles to know patients’ locations and help to keep them safe.

    It was reported in a BBC Radio 4 programme that alerts are sent to carers’ mobiles when users stray from designated areas. The can be a nursing home yard or garden. The GPS can pinpoint patients precisely to map. When they stray, they can be found, minimising the risk of harm and needing hospital care. 

    Alz Products makes trackers prices at £75 and a £26 monthly fee. They can be transferred to other footwear, so it’s a price per user. 

    A report from the South Central Region of the Dementia Action Alliance South Central Region says there are 670,000 people with dementia in England and 550,000 friends and family acting as their primary carers. Socio-economic costs across healthcare, social care and wider society are estimated at £19b in 2011. It’s more than cancer, heart disease or stroke costs.   

    These kinds of impacts from imaginative innovation offer Africa’s eHealth programmes direct patient and healthcare benefits. They need a significant place in their strategies and plans.

  • Drones are good for your health

    Stuck in in deep marshland in Norfolk, a very rural, flat part of England, or anywhere else, isn’t a good health initiative. Being rescued by a drone is. A report on the BBC website says a 75 year old man was separated from his friends while walking near Titchwell, a particularly wet and soggy part of the county. He was missing for 21 hours, and stuck in a marsh.

    Police used a drone to find him, and it did. He was admitted to hospital and treated for hypothermia. It’s another example of good drone use.

    Without the drone, the outcome could’ve been different. It’s another graphic illustration of the case for drones. Africa’s eHealth strategies for emergency services should have plenty of them.

     

  • mHealth can help to reduce hospital readmissions

    Using mHealth to improve hospital services’s a common theme in Africa’s eHealth strategies and plans. Reducing readmissions’s an important part of these initiatives. A report from MobileSmith says how three mHealth solutions can help. 

    How to Reduce Preventable Readmissions with Healthcare IT describes:

    Efficient mHealth strategies for reducing hospital readmissionsStrategic use cases for prompt implementationSix best practices for cost-effective apps for engaging patient and doctors. 

    Efficient mHealth should provide:

    Relevant discharge communicationFamily and carer engagementImproved medication adherenceChronic disease control.

    The six best practices are: 

    Research and know target patient groupsThink big, start small, act fast, so avoid mHealth that does everything for everybody, so unlikely to be user-friendlyPolish user interfaces and experiencesKeep mHealth freshEstablish secure data exchangesAdopt analytics. 

    Underpinning each of these’s the core goal to empower patients. mHealth’s the bridge that healthcare can leveraging now to empower patients. It can only work with easy-to-use mHealth so patients are encouraged to become more proactive towards their health. These themes need expanding in Africa’s next wave of mHealth strategies and plans. They also need setting alongside high priority patient groups and clinical conditions.

  • Cancer detecting pen to be piloted in Texas

    We often hear from surgeons that distinguishing cancerous tissues during surgery may be difficult. This  is a challenge that has been tackled by a group of researchers from the university of Texas who have developed a revolutionary pen. The MasSpec Pen is coupled to a mass spectrometer and can identify cancerous tissue during surgery in real time.

    The MasSpec Pen is able to diagnose cancer within twenty seconds during surgery.  The pen is placed over a tissue and uses touch to make a diagnosis. A foot pedal triggers the device to release water droplets which extract molecules from the tissue. The water is drawn into the mass spectrometer.  It then analyses the molecular compositions to determine if the tissue is cancerous or not. This also eliminates time waiting for results to return from the pathologist.

    While the diagnosis may be quick, the accuracy is still spot on. During a trial, 300 patient samples were analysed and the MasSpec Pen was able to detect four types of cancer; breast, thyroid, ovarian and lung cancer with over 96 % accuracy.  This could allow surgeons to remove all cancerous tissue and prevent further complications later on.  Similarly, it will eliminate the risks of unnecessary removal of normal tissue.

    Over the next several months, three of the devices will be installed in Texas hospitals.  The cost of this revolutionary pen is still being debated, but this could well be a useful tool for rural and remote hospitals in Africa to quickly and easily detect cancers.

  • HearX Group makes hearing screening more accessible

    In 2015, eHNA reported on a South African start-up, HearX Group, founded by Prof De Wet Swanepoel and Dr Herman Myburgh.  They developed a low-cost smartphone app that detects hearing loss and connects patients to health services.  

    The product uses a smartphone and headphones along with a custom-developed software application to detect hearing loss.  This inexpensive alternative to conventional screening is 50-70% less expensive and can be administered by non-specialists and screeners with even basic literacy and low digital skills.

    Today, the company boasts a suite of apps and mHealth devices geared towards improving hearing screening in underserved and remote communities, and especially among children.  Other products included in their collection include hearZA, mHealthStudio, hearTest and hearDigits, as well as a partner product in vision called Peek Acuity.  

    Now, HearX group has taken their solution beyond Africa.  A recent collaboration with the American Academy of Audiology saw the launch of America’s first-ever intensive hearing screening mobile app, hearScreen USA.  This was launched at the Academy’s annual conference April 2018 and is freely available on smartphone devices.

    In many nations, the general awareness of hearing impairment is low and shortage of resources has caused a lack of screening programmes.  HearX Group could soon be turning this into a problem of the past with further collaborations in Africa, Europe and Asia.

  • ATM pharmacy will help South Africa achieve its 90-90-90 goals

    Over 7.1 million people in South Africa (SA) are living with HIV.  This is the largest epidemic of HIV in the world.  The country has the world’s largest ART programme, which helps towards achieving 90-90-90 targets.

    Also helping to achieve targets is an innovative Pharmacy Dispensing Unit (PDU), developed by Right To Care in collaboration with Gauteng Department of Health.  The PDU works like an ATM for medication; tele-pharmacists, cloud based electronic software and robotic technology combine to enable medication dispensing.

    This pioneering solution allows patients to quickly and conveniently collect their repeat prescriptions at various community shopping centres where it is being piloted.  It’s even online over weekends and public holidays so that patients can collect medications at their convenience.  Patients are also offered service in all eleven languages and there is a support site to help understand the technology for first time users. 

    The PDU system which is run by qualified pharmacists and pharmacy assistants integrates with the clinical management of patients with chronic conditions at public facilities. It also supports adherence.  Medication receipts indicate the date for the next collection and patients even receive collection reminders by SMS.  If a patient collects their medication late, they are flagged for follow-up at the facility. 

    This ATM-like approach to dispensing medication demonstrates innovative thinking to overcome challenges in ensuring people stay on HIV treatment or treatment for other chronic illnesses.

  • Malawi uses eCCM app to combat child mortality

    In Malawi, Health Surveillance Assistant’s (HSA’s) serve as a link between the the local community and the national healthcare system.  They make use of the WHO and UNICEF community case management (CCM) clinical decision tool to identify those requiring urgent referral to hospitals and those who can be treated at the local points-of-care before going back home.  The Supporting LIFE project has created an mhealth app that replicates this CCM tool to ease decision-making and workload for HSA’s.  

    The app supports a similar workflow to the paper-based CCM tool, allowing the HSA to enter patient information on an easy to use touch-screen interface.  It’s developed for the Android platform and is functional in an offline environment, making it ideal for countries like Malawi, where internet connectivity is a problem.  Power was also an issue during the Malawi pilot, so HSA’s were also provided with mini solar powered chargers for their devices. 

    During the pilot 3 indicators were measured to assess the potential impact of the app;

    Improvement in the number of children correctly referred to a health facility as a result of using the app.Increased attendance rates, as a result of correct referrals made by HAS’s using the app; andDecreased re-consultation rates through correct diagnosis and referral from the app

    The results of the pilot were presented at an mHealth strategy workshop and provided the health ministry and key policy makers with valuable data to improve the health systems in Malawi.  HSA’s using the app reported mostly positive responses.  

    While such projects offer great community benefits and health system improvements, further assessment is needed around the feasibility of scaling nationally, as well as integration with core systems like the DHIS2.

  • Low-cost video laryngoscope developed in South Africa

    “Innovation is change that unlocks new value” - Jamie Notter. This is what Cape Town Anaesthesiologist, Dr Caroline Corbett, is doing with her video laryngoscope invention.  SmartBlade, is a cost effective, novel and real-world solution to the management of a difficult airway. 

    It uses forward-thinking smartphone technology to link with video laryngoscopy, thus allowing clinicians to easily intubate difficult airways. The clinician can suction a soiled airway or perform apnoeic oxygenation, both without interrupting attempts to intubate. 

    The customised mobile application also facilitates video conferencing, image capture, recording and secure data storage.  SmartBlade aims to become a standard of care in advanced airway management. 

    This novel device won the WFSA-Fresenius Kabi Anaesthesia Innovation Award in 2017.  The South African Society of Anaesthesiologists (SASA) is proud of this accolade and looks forward to seeing it being used in South African hospitals in the future.