“Why do I invest in start-ups? Because they are the job creators and innovators of the future… …In healthcare, Doctor On Demand uses smartphones to connect patients with doctors. This allows people to see a doctor from the comfort of their home and gain immediate care without the need to spend money and time getting to a hospital. It also means that quality medical care is not limited to those that live within commuting distance of a hospital“
Being fortunate to get access to expensive smartphone prototypes it’s rare that I get excited by new smartphones especially really cheap ones but I can’t wait to review the $100 Android One I have in the post:
“Knowledge is a game changer. I’ve long been inspired by the Internet and how it opens the doors to opportunity. It provides access to knowledge, no matter who you are or where you are. For instance, it doesn’t matter if you’re a Nobel Laureate at a world-class research center or a young student at a rural school in Indonesia, with Google Search, you have the same information at your fingertips as anyone else.
If we look at how people are getting online and accessing information today, increasingly it’s through a smartphone. While 1.75 billion people around the world already have a smartphone, the vast majority of the world’s population—over five billion more—do not. That means most people are only able to make simple voice calls, rather than connect with family through a live video chat, use mapping apps to find the closest hospital, or simply search the web. We want to bring these experiences to more people“
Here’s a few thoughts of mine on what’s been seen so far:
> I think Google’s really missing a trick ignoring the mHealth potential
Clearly mHealth transforms our perception of mobile tech but if Googles ambitions materialise billions of citizens of the world will get their first ever documented consultation with a registered Doctor via the forward facing camera on the front of an Android One smartphone.
Why wouldn’t you want to profile something as amazing as that as opposed to using the device to just “find the closest hospital“?
> Dual SIM 3G – could this be the smartphone every Doctor wants?
Amazing that these devices are being brought to market together with Indian mobile network operators (in India network infrastructure is shared between telcos) and not markets like the UK/USA where networks are supposed to be trying to compete.
I’ve had this feature for years now but on a nice mainstream smartphone with a nice UX I see it making the Android One platform super popular with Doctors who all too often maintain 2 different phones (one for work and another for personal use) who would love to be able to avoid all the additional fuss (bulging pockets, charging hassles, etc).
> Why is Google so unconcerned about the health of their customers?
From Skateboarding in the middle into the direction of oncoming traffic without any personal protection equipment while listening to music on headphones:
To riding on the back of an overloaded moped without a helmet wearing inappropriate clothing while trying to take videos with your camera phone:
With more than a million people killed annually from road traffic incidents in low/middle income regions of the world, shouldn’t Google be more responsible with it’s adverts targeting this region?
The way I see it adverts showing the ‘cool kids’ with the highest disposable incomes ignoring public health and safety messaging will unfortunately do nothing to reduce the increasing rates of avoidable injuries and deaths.
I look forward to getting to trial the device later this week and posting a review of the mHealth contribution this device will make, in the mean time have you seen anything I’ve missed?
In a striking sign of how mHealth tech is becoming of growing interest to the mainstream tech industry (and vice versa) a new glucometer for diabetics has been launched at the TechCrunch Disrupt Tech industry conference in San Franciso.
I think it’s great to see more innovators trying to innovate with M2M tech but it’s a little concerning that in the intro video founder Glen Tullman is claiming the Livongo device to be “the first FDA approved two way interactive glucometer“:
Clearly Telcare has had a device in the market that is FDA approved and has embedded mobile connectivity (enabling two way interactivity) for years – click here to read some of my thoughts on this solution – and any Doctor or Endocrinologist (the key prescribers of glucometers to Diabetics) who is enlightened enough to be interested in mHealth and be considering the step change that is required for the move to seamlessly connected glucometers will be very aware of their solution (as you imagine Glen Tullman would also be as Telcare is a AllScript Development Program Partner).
It’ll be interesting to see how big a market Livongo Health can make for their very different approach to glucometer design. A few big challenges I think they’ll encounter with their approach will be:
> While a significant proportion of diabetics can’t use touch screens those Patients who will feel comfortable using a touchscreen interface will presumably have familiarity with the super slick expensively developed iOS or Android experiences so wouldn’t they just prefer to just use their own smartphones with an app and accessory like the discontinued devices IBGStar made for earlier iPhones/iPods (with there 30 pin connectors) or the newer bluetooth connected or very low cost headphone socket attached devices from brands like iHealth (that are already available widely in Apple stores):
> Although there’s not yet any pricing information being made available I wonder how much the price difference will be for the Livongo device featuring a touch screen UI and pedometer above Telcare’s otherwise similar offering and how the Healthcare Payers that will ultimately have to come onside and agree to pay for this will welcome the idea of paying for extra functionality especially when some of it won’t be utilised by Patients (eg. pedometer accuracy will be a challenge as most diabetics don’t wear their glucometers).
What are your thoughts on this new touchscreen M2M glucometer?
No surprises here (I watched Philip Kahn’s discussion of wearables closely) and I think Tomi Ahonen is spot on with regard to the economics and market success that this initial Apple Watch will achieve.
The likelihood is this isn’t going to be a financial hit for Apple (they should’ve made a hearing aid if they wanted that – but that gives them something for next year and the Apple Watch will ensure it has an all important prestigious brand) but it helped distract attention from their aggressive move into the $Billion payment industry and they really had no choice to do it when you understand the implications of this slide (that was shared in a different part of the keynote):
We live in a decade set to be defined by the convergence of health to mobile (mHealth) so what chance would Apple have of survival if it didn’t have a position in the smart watch market when in 2022 consumers could buy the same functionality you see in the Apple Watch for just $7 or they are 25x slimmer/lighter and adhesive (so could be attached anywhere on the body) or the battery lasted for a month or they were 50x more accurate at sensing valuable biometric data?
Will I be buying one?
Absolutely. I’ve already had a client ask me to get one as soon as possible for a Veterinary application – with a modified strap $350 is very cheap if the health sensing tech proves to be accurate and elite Veterinarians, Trainers and Breeders will think nothing of spending the money to get additional insights from the valuable animals that they care for.
Further related reading you might find useful:
It’s been less than a month since Sir Richard Branson joined the illustrious list of billionaires investing in mHealth startups (via an angel investment in DoctorOnDemand) and now he’s supporting (via his Virgin Mobile Australia brand offering free national rate calls for a day) an innovative campaign to encourage people to talk to and offer support to friends and family that they might not be getting to see much:
“New research from Virgin Mobile Australia has found that almost three in five Aussies (57%) are calling their family and friends less frequently since the rise of social media. To encourage people to have regular and meaningful conversations by picking up the phone, Virgin Mobile Australia are offering free national calls to our customers this RUOK? Day. I urge all other Australian telephone companies to follow suit and also offer free calls on RUOK? Day too. Nine out of 10 people said they feel genuinely cared about when they get a phone call from a loved one. It’s a simple act to call somebody up and ask if they are ok, but it can make all the difference. Asking “Are you OK?” is something we can all do to help someone who may be struggling with life. We want you to call someone up and simply ask them “Are you OK?” in aid of suicide prevention. We don’t need to be experts or have the answers if someone admits they’re not OK. As friends we can listen to what they’re going through and let them know we care“
With over 10,000 international tech industry visitors already confirmed to be visiting Dublin on the 4-6 November 2014 for The WebSummit, Europe’s biggest Tech Industry meeting, we thought it would be an unmissable opportunity to provide International visitors that are interested in mHealth the exclusive opportunity to experience some ‘behind the scenes’ access to organisations that are putting mHealth to work with a tour guided mHealth Tour on Monday 3rd November followed by a networking session with local mHealth innovators.
*** Please note the mHealth Tour is an independently organised event that is not linked in any way with The WebSummit ***
We’ll be picking up the costs of the transport and partners are generously providing the site tours so there will be no charge to join the mHealth tour. The goal is to organise something that is small and exclusive so we’ve intentionally limited numbers (the luxury coach we’ve booked has only 23 seats) and we’ll be very selective to ensure we have an interesting mix onboard who will benefit most from the shared experiences.
To ensure no one misses out a lot of the trip will be recorded (with Google Glass) and shared on YouTube and at the end of the tour there will be an open networking meet up where everyone is invited to join us – similar to the networker we hosted before last years eHealth Week in Dublin.
The tour will take in visits to:
> one of Ireland’s top Hospitals to let you experience how leading Consultants are using mHealth tools to advance Patient care.
> a GP Practice to get a feel for how Primary Care Services are provided in Ireland and a taste for the complex challenges that the frontline of the healthcare industry faces.
> a farm to let you experience how Veterinarians and Trainers are using mHealth sensor tech and wearables to continue to lead the world in the breeding and training of top flight Thoroughbred Race Horses.
> a top class Athlete Development Coach to experience how wearable sensor tech and video analytics are enhancing the quality of team selection and the performance of world class athletes.
On the afternoon of Friday 5th September 2014 there will be a meeting in Dublin to finalise details of the tour (refresh this page to view these as they’re confirmed) so please don’t hesitate to get in touch via the following form if you would to take the tour (or get involved in any other way):
Related: An Introduction to mHealth
A questionnaire being used by NHS District Nurses to gather information and review the care of vulnerable citizens has failed the Mother Test with Roy Lilley and immediately made the front page of the Daily Mail:
“The Duchess had a prearranged visit; the nurse turned up 45 minutes late but I suppose the elderly have all the time in the world to sit about waiting… …A chirpy, determined to be cheerful, very pleasant, younger edition of Gracie Fields appeared and ploughed through a form. Every single item (except 2) of information required to fill the form could have been pulled off practice data or social services records… …Huge duplication? Waste of a visit? Not really. Face-to-face you get a feel for how people respond and live their lives. Trip hazards, personal hygiene… to an experienced eye a visit is worthwhile… …Two questions? Oh, yes… here’s one: ‘Where would you like to die…’ It came as a bit of a shock. The Duchess thought ‘at home’. I said Hawaii. Can we get the tickets on an FP10? Here’s cracking question number two: ‘… if you ever need cardiopulmonary resuscitation do you agree to Do Not Resuscitate’. Bang! Right between the eyes! Out of the blue, no warning… do you want to be flat-lined? You can read it for yourself in this document, page 33; the form template. NHS Employers have written this guidance along with the BMA and the Carbuncle. NHS Employers? Yes, that’s what I thought. Here are a few issues that come to mind: Agreeing with the district nurse and signing (yes the form has to be signed) to a DNR has what legal significance? The form is not witnessed, does it matter? How is the elderly person’s competence judged as capable of signing? How are relatives informed? How is this decision transmitted to secondary care and when? Oh, and has anyone got any idea how an unwitnessed, fire-side chat with a district nurse, who is a complete stranger, might fit into the GMC Guidelines para 132 and the responsibilities of the administering clinician at the time. Of course DNR discussions can take place as part of an advanced care plan. A chat with our-Gracie is not advanced care planning. It is a chat with our-Gracie and that’s all; going over everything the practice already knows… …What of the vulnerable patient? Some will think ‘I don’t want to go to hospital they will let me die… they need the beds’. Others might think ‘if I don’t give the answer they want I won’t get taken to hospital’…. …And I’ll bet the farm, when the District Nurse has gone frail elderly, stick-thin, porcelain-skin, house-bound grannies, who survive at the mercy of whoever is sent on that day to give her 15 minutes of attention, who sees her family only on high-days and holidays; will sit in their chair, look at the four walls and in a desperately lonely moment won’t feel the tear splash into their lap; ‘I’m going to die… the district nurse knows I am and I am frightened’… …So, what do we have? A complete stranger turns up nearly an hour late and says; ‘Hello, how would you like to die?’ If this is your NHS it sure as hell ain’t mine. I am incandescent…”
So how can we make form filling more compassionate?
It’s important we all recognise the enormous value for Patients when we effectively document care but we must all refuse to stand for uncompassionate form filling.
Here’s a few suggestions for ways to make it all a lot more compassionate, if you have any of your own please feel encouraged to share them in the comments below:
> Patients need to be allowed access to the health record information carers are using to make decisions about their care.
> Forms must be accessible anytime anywhere and designed to be easy to use as this helps Patients choose when and where to complete any form filling, who they’ll complete it with (eg. on their own, with their carers and/or loved ones, etc.) and have the ability to make changes (eg. it should be presumed that I might want to independently change my responses at a later time).
> Interaction needs to be built in. As we move beyond printed paper forms we also need to move on from their static design. Branched Q&A’s avoid the need to read/skip questions that are irrelevant and feedback can be easily captured to help Patients/Carers make suggestions about how the data gathering is being done. It’s no longer just about enabling Patients to read what their Doctors write but it’s also critical that Doctors can read what their Patients write.
> Let me have a copy of everything I share with you.
> Make it clear what you’re doing with the information you’re collecting about me and limit it to enhancing and personalising my experience of your care services.