There is a concern for the mobile health movement --- is this a hype? As seen in the recent interview of Dr. Eric Topol by John Nosta. The reason for the concern is the expectation of killer apps or home runs, and Dr. Topol did list a few.
This is not different from the early days of internet or the dotcom era when the search for killer apps fed by funding frenzy that led to a bubble. Our experience with the internet has been one of an evolution over time, and a revolution after 15 years with many successes that offer valuable products. Google first appeared as a useful website to find information on the internet, which was limited at the time, and it was certainly not a revolutionary force changed our lives. Over time, its offers on search and map did become an integral part of our lives, a revolution completed. There are now so many internet services have transformed our lives, I am not sure if anyone is still try to conclude which are killer apps of the internet.
I believe mobile health will be very similar to the internet revolution. Initially, we will be looking for killer apps or home runs. Dr. Topol will have to tell the story of the airplane passenger saved by the iPhone ECG many times. This is also the time to ask questions about what issues/challenges faced by healthcare today can be addressed by mobile technology.
It was fascinating to read the blogs by Dr. Janice Boughton on Why is American Healthcare So Expensive. Some of them are written like a nicely organized customer needs list when we began to design every new product in the medical device industry. The challenges faced by Dr. Boughton everyday cry for better connection with medical information of her patients and devices that can help her in routine procedures so she can focus on cases truly demand her expertise.
I will resist the urge to ask or answer what are home runs so far for the mobile health revolution. The force of this movement is coming from engaged healthcare consumers wanting useful tools to manage their own health, is coming from early adopting healthcare givers embracing improved productivity, and finally is coming from payers need to dramatically reduce cost to make healthcare available and affordable for everyone.
Thursday, January 31, 2013
Sunday, January 13, 2013
Mobile Health Revolution - Lifestyle Change
We have made long strides in reducing mortality associated with cardiovascular diseases in the last 30 years. As a biomedical engineers, I would proudly attribute the success to ICD, cardiac pacemaker, and many other interventional procedures and new drugs that save lives. Once a while, there is an inconvenient argument that suggests the successful campaign on anti-tobacco use may have played as an important role as all of advances in medical technologies. That will be a difficult debate without a lot of data for cause-effect, but there is no debate that lifestyle is the most important factor that influences lifelong health.
In today’s calling to reduce overall healthcare cost, innovations that improve our lifestyle is also the biggest opportunity for mobile health solutions.
First to share a personal anecdote. I started to record daily weight about 10 years ago. After enough entries, I began to plot them, and monitored the trend more closely. To my disappointment, the weight did not drop. However, the standard deviation, or the day-to-day change, reduced overtime. The frequent monitoring provides a feedback to adjust diet, and remind me not to have that second piece of apple pie.
I see a good mobile health solution here. The App I am using today (‘My Weight HD’ or the FitBit system) provides some but an incomplete solution. I like to have a weight scale that sends data wirelessly to my cellphone after each weight. I need an App that provides simple tools to annotate, analyze and trend. This is a solution I would happily pay now, because I know it will help me keep a healthy weight, and avoid paying a lot more in the future in care for high blood pressure, diabetes, or sleep apnea. In the last 10 years, I did not lose any weight, but thanks to that little excel sheet, I did not gain any weight either.
The revolution in mobile health is in its solutions to empower healthcare consumer to be more knowledgeable about our own health, and provide tools for us to manage our own health. It is that one apple a day that keeps doctors away, one of the most effective way to reduce healthcare cost.
Saturday, January 5, 2013
Better Sleep in 2013
Good sleep was elusive sometimes last year, as I spent many nights with colleagues in sleep labs monitoring patient’s sleep and conducting clinical studies.
My interest in sleep apnea spurs more curiosities about sleep. During the 2012 Sleep Society Meeting, there were still fascinating findings presented about fundamental roles of sleep. For example, lack of sleep greatly reduces our ability to synthesize learning from the day, an important trait from evolution of not forgetting animals almost killed us.
For many people, sleep apnea is the main obstacle from getting a good night sleep. It is the most common sleep disorders that affects 1 in 20 people. The easiest way to find out if you have sleep apnea is to ask if anyone witnessed frequent stops of breathing during your sleep. There are several questionnaires can be found on the internet (Epworth Sleepiness Scale, Berlin Questionnaire, and STOP-Bang) that evaluate symptoms of daytime sleepiness and risk factors associated with sleep apnea. Overweight and high blood pressure have strong connection with sleep apnea. There are many sleep labs available for diagnosis and treatment of sleep apnea. If a lab-based sleep study is too burdensome, the technologies for home sleep test are very good today, and are becoming a part of standard care.
There are also new development in treatment of sleep apnea in addition to CPAP, the standard care in the last 20 years. Dental devices for mild to moderate sleep apnea are gaining acceptance. These devices are less intrusive than CPAP, and are easier to use and maintain. Another efficient therapy that can be effective for some patients is positional therapy, which keep patients from sleeping on their back, the most vulnerable body position for occurrence of sleep apnea. This category includes devices from elaborate tennis ball approach (Rematee) to digital health solution (NightBalance). The Inspire Device and several other implanted neurostimulators in development target moderate to severe sleep apnea. We hope to report results from the ongoing safety and efficacy clinical trial in 2013.
So there will be better sleep in 2013 after wrapping the clinical study and done with watching others to sleep. The other aspects for better sleep, in the spirit of new year resolution, is to keep better sleep hygiene. I have a few for myself and more for my wife, who claims to be a night owl (I have found no scientific evidence for the genetic basis of an evening person)
New Year Resolution for Better Sleep in 2013:
Unfortunately, the resolution is already broken for the year before it was written. They are still good rules to live by. Did you hear me?
My interest in sleep apnea spurs more curiosities about sleep. During the 2012 Sleep Society Meeting, there were still fascinating findings presented about fundamental roles of sleep. For example, lack of sleep greatly reduces our ability to synthesize learning from the day, an important trait from evolution of not forgetting animals almost killed us.
For many people, sleep apnea is the main obstacle from getting a good night sleep. It is the most common sleep disorders that affects 1 in 20 people. The easiest way to find out if you have sleep apnea is to ask if anyone witnessed frequent stops of breathing during your sleep. There are several questionnaires can be found on the internet (Epworth Sleepiness Scale, Berlin Questionnaire, and STOP-Bang) that evaluate symptoms of daytime sleepiness and risk factors associated with sleep apnea. Overweight and high blood pressure have strong connection with sleep apnea. There are many sleep labs available for diagnosis and treatment of sleep apnea. If a lab-based sleep study is too burdensome, the technologies for home sleep test are very good today, and are becoming a part of standard care.
There are also new development in treatment of sleep apnea in addition to CPAP, the standard care in the last 20 years. Dental devices for mild to moderate sleep apnea are gaining acceptance. These devices are less intrusive than CPAP, and are easier to use and maintain. Another efficient therapy that can be effective for some patients is positional therapy, which keep patients from sleeping on their back, the most vulnerable body position for occurrence of sleep apnea. This category includes devices from elaborate tennis ball approach (Rematee) to digital health solution (NightBalance). The Inspire Device and several other implanted neurostimulators in development target moderate to severe sleep apnea. We hope to report results from the ongoing safety and efficacy clinical trial in 2013.
So there will be better sleep in 2013 after wrapping the clinical study and done with watching others to sleep. The other aspects for better sleep, in the spirit of new year resolution, is to keep better sleep hygiene. I have a few for myself and more for my wife, who claims to be a night owl (I have found no scientific evidence for the genetic basis of an evening person)
New Year Resolution for Better Sleep in 2013:
- Go to bed before 11, and
- Keep TV, tablet and phone silent between 10 and 7
Unfortunately, the resolution is already broken for the year before it was written. They are still good rules to live by. Did you hear me?
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