Join me at Edinburgh Medical School on Monday 28th April for a talk about mHealth and Remote Care

April 18, 2014



mHealth GoogleGlass what type of Sherlock Holmes would Joseph Bell inspire today

On Monday 28th April 2014 I’ll be giving a lecture on mHealth and our experiences providing documented mobile video consultations at Edinburgh Medical School. The session is going to be video recorded and we’re going to be providing the first ever public demonstration of 3G Doctor with Google Glass which will be interesting.

After the talk the audience will also get the chance to check out a range of mHealth tech including the following:

> An tablet loaded with clinical and educational tools (as used by Medical School Students at the top US Medical School)
> 3G Doctor app
> Telcare’s Mobile embedded Glucometer and the Diabetes Pal app
> Alivecor’s FDA cleared and CE marked ECG smartphone case
> Google Glass
> S Health on the new Samsung Galaxy S5 and Gear 2 Smartwatch
> Mobile Connected Care Monitor
> Mobile Connected smoke alarm
> Mobile Sleep Lab
> Bluetooth low energy medication adherence tag/app

The talk will discuss how the 2,000 year old model of healthcare is broken forever before going on to discuss how mHealth provides the basis for a new model. I will also pay my respects to the incredible Dr Joseph Bell, former tutor at Edinburgh Medical School and inspiration of Arthur Conan Doyle, by giving the talk a Sherlock Holmes theme… …so you’ve been warned!

Full details are yet to be confirmed but space is limited and there are a few places available to attend along with the students (who have already been sent an email from their tutors). I’m particularly interested in having Medics and Patients join so if you can make it on Monday between 13:00-14:00pm and would like to join the seminar please comment below with your email and mobile number. Your details won’t be published and I’ll be in touch with you as soon as I can to confirm your ticket/timings etc.


The Future of Healthcare Imagined…

April 17, 2014


Haelo, an “innovation and improvement centre” joint venture between Salford Royal NHS Foundation Trust and the Salford Clinical Commissioning Group, have produced the abovevideo sharing views on how healthcare might evolve over the next 20 years through the ‘adoption of technology, patient owned data, patient-centred care and a focus on population health‘.

I’m not sure anyone in Healthcare should be trying to plan 20 years out as there are things that are inevitably going to happen within only 10 that are unthinkable to most of us today but here are a few thoughts I had on watching the video:

Dr Dimple Vyas Consultant Anaesthetist Calderdale and Huddersfield NHS Foundation Trust

I can get my bank account details over the phone, over the internet, wherever I want to be, whenever I want it and I cannot get my healthcare information. I cannot contact my healthcare professional when I want to. I’m looking to see if I can own my own healthcare record. I’m looking to see if I can have an iPad visit with my Consultant” Dr Dimple Vyas, Consultant Anaesthetist Calderdale and Huddersfield NHS Foundation Trust

This point of view really validates why I think the future of healthcare is going to be a mobile experience and why we’re more likely to drop the Health in mHealth than we are to drop the m. There is no doubt that eventually all healthcare services will be as comprehensively documented and accessible as Dr Vyas now expects them to be (if I’m wrong about this 3GDoctor is going to be a lot bigger than the NHS!). If you find this hard to appreciate try and imagine how you might be able to determine if the person sitting across from you on the train is listening to music on their smart earbuds or participating in a bio-interactive therapy session? Or how you might know if someone across from you is playing a game or sharing their health concerns and interacting with their family Doctor?

Sir David Dalton CEO Salford Royal NHS Foundation Trust

I think what’s going to change the future of healthcare is Digital. (it’) about giving power to Patients so that they can own their own healthcare records and so that they can provide the information they know about themselves and to give that to the people they’re asking to care for them or treat them. So I think that transfer of power is going to be by far and away the biggest thing that we do” Sir David Dalton, CEO, Salford Royal NHS Foundation Trust.

It amazes me that in 2014 we still have very senior people talking about the importance of “digital” (note: the companies making the most money and getting the most traction with new services no longer talk about the distinction between digital/non-digital as they have realised that being relevant to the consumer simply requires us to think about how customers use their mobile device) in the future of their organisations but they still hold an unwavering trust that concepts like ownership will suffice. Surely by 2014 every Professional involved with leading change in the NHS has used CTRL+C CTRL+V or backed up a hard drive and can see that the idea of talking about a digital file as though it’s a physical piece of property is unworkable?

Related: Join us on Monday 21st April 2014 at Imperial College London for Imagine the Future of Medicine.


If the ‘Born Mobile’ generation is baffled by the iconic Sony Walkman how will they ever understand unconnected Medical Devices?

April 16, 2014


For years it’s been obvious to me that the medical device industry is being radically disrupted by the mobile industry to the point where we’ll see it’s industry converge just like we saw Photography, Computing, Messaging, etc in the Nokia Decade. With Samsung now the newest big healthcare brand, smartphone cases that can enable your smartphone to capture and share an ECG available for less than $200, and FDA cleared medical devices now having their own embedded (Kindle style) mobile connectivity it’s becoming obvious to everyone but I think the video above showing how the ‘born mobile’ generation is baffled by the Sony Walkman really highlights the challenge the medical device industry faces.

One look at the current crop of medical devices being used by Patients and it should be obvious that the lack of thoughtful design and encyclopaedia-sized printed instruction manuals are going to generate frowns of frustration in a child who struggles to even work out the point of a Walkman, or the concept of using a mechanism to wind spools of tape around to select a tune:

So mum let me get this straight. My Blood Glucose levels are very very important and I need to prick my finger to test it regularly. Each little box of strips costs $50. Everytime I go to the Hospital costs thousands of $’s and you want me to remember how to act based on the number that appears on the monochrome LCD screen and I’m also supposed to text you these numbers every time I test even if I’m at school… …oh and I need to always carry this device and the lancing and strip kit and we need to keep a record of my results to share with the Doctor (or Hospital if I ever get rushed there). Okay I get it but can you explain why the inexpensive thermostat we have in the house is smarter, better looking and easier to use than this expensive and supposedly high tech medical device?

Glucometer

In my consulting work advising medical device companies I nearly always start the talk by asking if anyone has ever seen a printed instruction manual for the iPad. Smart people in the audience say there never was one and I then produce the one I got for my ‘iPad’ AED. It’s a great way to start a conversation about how the medtech industry fails in basic design when we discuss why the life saving $2500 “intelligent” defibrillator device that I carry everywhere in my car and am expected to use in the event of an emergency requires a detailed manual to operate and isn’t connected (that’s right there’s no Find My iPad for the iPad that’s apparently been designed to be used to save lives in an emergency).

ipad manual


Walgreens CMO shares insights on what it took to create the USA’s most popular mHealth app & mHealth revenues of $375M per month

April 14, 2014

Sona Chawla Walgreesn being relevant to the consumer starts with thinking about how they use their mobile

Consumers don’t think digital and non-digital, for us to think about being relevant to the consumer, we need to think about how they use their mobile device

Sona Chawla, CMO, Walgreens speaking with Adweeks Stuart Feil (HatTip: shared by Adam Pelligrini, VP of Digital Health at Walgreens, over in the mHealth group on Linkedin).

Related: Why we’re more likely to drop the Health than the m in mHealth


Did Google Glass really save the life of Patient in Hospital or was it just the EHR?

April 9, 2014



The Verge Doctor says Google Glass saved a mans life

I don’t question for one minute the scale of the opportunity that augmented reality (the next mass media) represents and I think it’s clear there are some great opportunities for Google Glass in emergency medicine and as a Patient aid but it’s very clear that there’s now a thriving ponzi scheme around the Google Glass technology as it has such visual impact that it appears to make it easy to bamboozle audiences with unrealistic scenarios.

This latest article claiming that Google Glass helped to save the life of a man in a hospital is typical of the fawning promotion of applications that I’m seeing being reported in the press. According to the article:

Dr. Steven Horng, working at Boston’s Beth Israel Deaconess Medical Center, was wearing Glass last year while working on a man whose brain was bleeding. Dr. Horng knew that the patient was allergic to certain drugs that would arrest the bleeding, but didn’t know which ones. With no time to leave the stricken patient, Horng says he called up the man’s medical records on Google’s wearable device, found the relevant information, and stabilized his condition

In my entire life I’ve never seen a Hospital bed with a Patient in it that doesn’t have a printed Drug Card that the prescribing Healthcare Professional must sign so I have no idea why a Doctor working in a teaching hospital of Harvard Medical School (that claims to be “one of the world’s leading hospitals”) is suggesting that a Doctor would have no alternative but to leave a Patient in their care to go and check for something as basic as drug allergies. I also imagine that it might also be the type of false claim that would concern Patients who aren’t being cared for by Doctors who are wearing Google Glasses eg. is Dr Horng suggesting that if your Doctor at BIDMC is not wearing these glasses on their skull they’re not able to practice safely?

In 2014 we’re at the stage where modern high quality hospitals enable the Healthcare Professional to access and make notes on a Patient’s medical records at the bedside via their iPhones, iPods and iPads eg. using apps like VitalPac:

VitalPAC

Watching the video that’s been made showing the Google Glass in use and it reinforces my confidence that the most obvious way that this technology will start saving lives is when it starts to be worn by Patients eg. US lawyers would have such a field day if they had video recordings of Hospital Doctors attempting to treat their clients critical Brain Haemorrhage without access to their medical information that it would overnight drive 100% adoption of modern mobile accessible Healthcare Record systems:

**** UPDATE: 10 April 2014 ****

It seems like Hospitals in the USA are rushing out Google Glass in Healthcare stories this week eg. this latest video (HatTip: Mashable ‘Sick Kids Use Google Glass to Virtually Visit the Zoo’) showcases a collaboration between the Children’s Memorial Hermann Hospital in Houston and their neighbours at Houston Zoo. Apparently ‘sick kids, who are unable to leave the hospital’ are being given Google Glass to wear so that they can connect with zoo employees wearing Google Glass in order to “virtually “visit” the Houston Zoo”.

I’m again struggling. This use case seems to conflict with the advice given when I got Google Glass (eg. Google suggests that the device was designed to provide bursts of information in a convenient way so that the wearer can get back to doing real world things rather than as a media consumption device) and surely it would be easier for the Hospital to just get some nice TVs and Tablets that the kids could use whenever they like to watch properly edited Zoo programs (with their parents and the new friends they could be making) like the 393 Videos that are posted on the Houston Zoo Youtube channel?


TopTip for mHealth developers: don’t think it’s as easy as just asking Clinicians to tell you what to build

April 9, 2014



Steve Jobs ask customers what they want Facetime

In the ideation process that I use in my consulting work helping companies develop successful mHealth services I find it very helpful to make teams aware that building mHealth strategies focused on what Clinicians tell them they want is a classic route to market failure. Key to this is helping groups realise that most people paid to work in the healthcare still think it is an industry that should be focused on providing office visits, have no idea that the 2,000 year old model is broken and have few insights into how the application of Mobile (the newest and most poorly understood Mass Media) will transform the tools that Patients and Carers use to maintain their health.

To try and help groups through this here are a few exercises I’ll try:

1) I get the group to look to their own mobile phones and tell me how much time they spent learning how to use it and how much time they spend using it. I then pick the unfortunate individual who has claimed to have spent the least amount of time (never be an outlier!) and show them how completely wrong they are. Most people are astounded when you show them how much time they’ve actually spent tending to their mobile – I could easily teach you to play the violin if you’d put in the same amount of practice.

2) Next with the help of a flip chart I try and have them suggest to me a list of things they wish their mobile could do. Sometimes I get brilliant ideas (normally from the school leaver that’s been brought into the meeting to fetch coffees but hung around because she thought it interesting!) but normally it quickly becomes obvious that some in the room are struggling to think of anything, others struggle to articulate their ideas and for others there will be a few things that they really wish for that I can reveal are already available (but they just haven’t been interested enough to try to use them).

3) Taking a closer look at the good ideas put forward I then try to explain why many of them don’t make a whole lot of sense to the trillion $ mobile industry because although we’ll all be familiar with using our mobiles most of us aren’t aware of how the mobile industry makes money (check out the Insiders Guide to Mobile) and the demands of other partners in the ecosystem eg. a phone that never breaks is going to slow replacement cycles and discourage customers from buying a replacement and kill sales of over priced accident insurance policy subscriptions that can make more money for retailers than you buying the phone.

4) The key take away from this self reflection on our own use of the most personal piece of technology we all have and continuously use is that spending lots of time doing something for normal people rarely means that they are spending anytime at all thinking about how that technology could be improved so that it better serves their needs.

5) I then attempt to get the group to list out the things in healthcare that they think we’ll all look back on in ten years and consider it to be unthinkable that we used to do that. I’ve listed some of those here to give you the general idea.

6) I then attempt to get the group to pick the one of these things they think is most likely to happen (it’s normally video consults or seamlesssly connected medical devices but that might be due to a bias I introduce) and map out how they think mobile will make this all achievable. With the right nudges it really does help groups realise the breakneck speed with which mobile technology is evolving but also highlights the way the Healthcare Professionals who are working with today’s systems will be disrupted and the reasons these smart caring individuals have for not seeing the opportunity and implementing this better future for Patients today.

What tips/tricks do you use or have you seen used to help others create effective mHealth Strategies?


Will the Smartphone controlled First Person View Drone transform how emergency services respond to major incidents and open their eyes to the 3G Video opportunity?

April 7, 2014



Are mobile phone controlled drones going to transform how we manage major road traffic incidents and wake emergency service planners up to the 3G Video Calling opportunity

It’s long been amazed me that mobile operators who have invested billions buying licenses and building out their 3G networks haven’t yet woken up the huge opportunity they have to enable members of the public to make video calls to emergency services and provide preferential ‘always best connected’ access for these callers.

Wondering what was going to cause this idea to take off and from watching this first youtube video made by Robert Scoble with the new DJI Phantom Vision 2 Drone (that retails at just $1000 and can be carried in a small holdall) it turns out it might be something that does actually ‘take off’.

It really can’t be long before all major motorway incidents are video recorded using such low cost easy to use technology because for one thing the insurance companies would see the cost of making it available to major incident teams as negligible (eg. more money will be spent on the cones that they are having placed on the road).

As soon as that’s happening it’s only going to be logical to send the recording to the emergency services response team (so they can better assess the response requirements) and then I think it’s going to be all too obvious that with plain old voice calls that the public are using we’re ignoring huge opportunities for getting insights and collecting evidence in emergency situations.


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