Review of #COVID19 Medical History Taking Questionnaires

Obviously there is 50+ years of history of computers being used to help take Patient histories but most medics are only learning about Patient History Taking questionnaires as a result of the COVID19 PanicDemic so I thought it might be interesting to review what’s being produced and upload videos here (as they’ll probably all disappear as quick as they appeared. Let me know if you’ve seen any I can trial and I’ll record a demo and upload it below:

Apple COVID-19 Screening Tool:

 

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Join us at London Futurists: What should we learn from the Covid-19 crisis?

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Starting at 14.00 UK time (GMT) on Saturday 14th March this online Zoom discussion is scheduled to run for around 90 minutes and will include a number of initial short talks followed by a group discussion (in which all online attendees can participate) of the lessons that futurists can learn as individuals, nations and as a global community from the Covid-19 crisis.

Talks/Panelists will include:

“Taking a Mobile First approach to the management of Infectious Disease”
David Doherty, mHealth Insight

“Options for developing medical cures faster”
Steve Buss, Citizen Scientist

“Seeing the crisis differently”
Adah Parris, Cultural Strategist

“Reforms for the post-coronavirus age”
Tim Pendry, Crisis Advisor

About the London Futurists

The acceleration of technology means that the near future may bring radical changes to all of us. Major developments in technologies like anti-aging, nanotech, genetics, computing, robotics, and geo-engineering are going to make the next few years very exciting – and possibly also very dangerous. We could gain god-like powers – but we might also lose sight of our humanity, and destroy everything that we used to hold dear.

What’s your view? Are things improving? Too slowly or too quickly? Are we are entering a new golden age? Or is the potential “Technological Singularity” something to fear? What does it mean to talk about “Human 2.0” and “Humanity+”? Or perhaps you view such talk as techno-hype? Maybe you just like the practical side of technology and want to find out more about possible paradigm shifts?

Anybody is welcome to this group – you don’t have to be a Techno Geek or work for some futuristic company to be in our group. The future applies to us all!

Register here to attend (completely FREE).

* * * Update: copy of my #PanicDemic slides * * *

* * * Video Recording coming soon… * * *

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Global Health Matters (the bimonthly newsletter of the National Institutes of Health Fogarty International Center) features a Focus on Mobile Health

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Download newsletter (.PDF)

It’s very sad that in 2020 we’re now seeing the NIH adding it’s weight to this incredibly dangerous promotion of using mobiles as laboratory equipment… 

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The European Commission funds the launch of the EU mHealth Hub

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The European mHealth Hub is funded by the European Commission under the Horizon 2020 research and innovation programme, under the action “Establishing EU mHealth Hub including evidence for the integration of mHealth in the healthcare systems” (Grant Agreement No 737427) and is a project promoted by the United Nations International Telecommunication Union and the World Health Organisation that has been developed by the Andalusian Agency for Healthcare Quality and has already attracted 19 partners including the CAMPANIA REGION, EHTEL (EUROPEAN HEALTH TELEMATICS ASSOCIATION), EMPIRICA GMBH, ERICSSON NIKOLA TESLA D.D., FOUNDATION TALLINN SCIENCE PARK TEHNOPOL – CONNECTED HEALTH CLUSTER, ESC (EUROPEAN SOCIETY OF CARDIOLOGY), DOM ZDRAVLJA ZAGREB – CENTAR (HEALTH CARE ZAGREB – CENTAR), HL7 INTERNATIONAL FOUNDATION, I~HD (EUROPEAN INSTITUTE FOR INNOVATION THROUGH HEALTH DATA), MDOG (MIJN DATA ONZE GEZONDHEID), SPANISH MINISTRY OF HEALTH – MINISTERIO DE SALUD, OSAKIDETZA (BASQUE HEALTH SERVICE), PCHA (PERSONAL CONNECTED HEALTH ALLIANCE), PROMIS (PROGRAMMA MATTONE INTERNAZIONALE SALUTE), JÄMTLAND HÄRJEDALEN REGION, SPMS (SERVIÇOS PARTILHADOS DO MINISTÉRIO DA SAÚDE, SHARED SERVICES FOR MINISTRY OF HEALTH), UNIVERSITY OF AGDER, and the UNIVERSITY OF APPLIED SCIENCES TECHNIKUM WIEN.

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mHealth Insight NOT @ GSMA Mobile World Congress 2020

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The GSMA is currently lobbying the Spanish Government to have Mobile World Congress cancelled (so that it can claim back insurance). UPDATE: The 2020 Mobile World Congress has been cancelled.

I had no plans to travel to Mobile World Congress as while it used to have dedicated mHealth conference tracks these were stopped a few years back and this year there was going to be no mHealth presentations which is a surprise considering that the senior management of Apple (the world’s most profitable mobile company) has publicly stated that they’re going all in on healthcare and in 2016 their CEO Tim Cook has stated that Apple’s mHealth revenues will dwarf the entire $Trillion smartphone market.

If you’d like to check them out you can click the following links to read my reviews and guides to Mobile World Congress here: Reviews; 2008/2009/2010/2011/2014   Guides; 2012/2013/2014/2015/2016/2019.

I attended the first Mobile World Congress (and even before that when it was the 3GSM Congress held in France) and have been advising the GSMA in various capacities over the years (helping organise meetings, select topics etc) so I thought it would be helpful to host a webinar on Monday 24 February 2020 to talk about the importance of mHealth to the Mobile Industry. The webinar will be live-streamed from a Hospital in Central London.

The webinar will be free to attend and you can find out more and watch the livestream on the dedicated conference website by clicking here.

https://mhealthinsight.com/mwc-2020/

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What is the clinical value of mHealth for patients?

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An interesting paper asking “What is the clinical value of mHealth for patients?” has been published in Nature by Simon P. Rowland (Department of Surgery and Cancer, Imperial College London), J. Edward Fitzgerald (KPMG International), Thomas Holme (Department of trauma and orthopaedic surgery, Epsom and St Helier University Hospitals NHS) and Alison McGregor (Nuffield Department of Primary Care Health Sciences, University of Oxford).

mHealth Insights

“Despite growing interest from both patients and healthcare providers, there is little clinical guidance on how mobile apps should be utilized to add value to patient care”

We saw a paper similar to this back in 2018 and I think it’s a classic case of not being able to see the wood for the trees.

I think this is because medical educators despite the evidence still aren’t teaching students to use the tools of our time.

If you are a medic who needs to modernise your skills please consider taking the “mHealth for Healthcare Professionals” certified programme that I developed to help educate healthcare workers about the opportunities presented by mobile technology for advancing access to and quality of healthcare.

In 2020 you fail the MRCGP exam automatically by having a mobile phone on your person. Examiners should be testing you on how you use your mobile with Patients because when Patients see you uncomfortable using a mobile they may doubt how current your medical knowledge is.

“We categorize apps according to their functionality (e.g. preventative behavior change,digital self-management of a specific condition, diagnostic) and discuss evidence for effectiveness from published systematicreviews and meta-analyses and the relevance to patient care”

This is a common misunderstanding that medics have about mHealth. It’s key to understand that basic features of mobile are often the most valuable apps used for mHealth. We don’t have to have Patients download apps to their smartphones before mHealth can totally transform care eg. it’s as easy as saying ‘here’s my number’.

I wrote all about this over at Mobihealthnews 10 years ago: Successful mHealth applications are already here.

“There are only a small number of clinical scenarios where published evidence suggests that mHealth apps may improve patient outcomes”

This is a classic misunderstanding of the motivations for publishing evidence. 9 years ago a hospital here in Ireland published evidence stating how appointment letters, reminders etc should be replaced by SMS but the HSE ignores it and still wastes millions every year on more expensive and less useful snail mail and missed appointments.

It’s important to appreciate that because mobile first designed care is typically a lot more efficient and less expensive than the services it doesn’t benefit from being published in the same way that a new therapy or drug would (as these innovations come with new growth opportunities for the healthcare businesses eg. increased staffing and/or costs that they can pass onto payers like the government or insurance companies).

If you think mHealth apps aren’t getting adopted without evidence being published in clinical publications study the emergency call business. The entire Irish out of hour Doctor rota is organised using SMS for years. +99% of all calls have been made using mobile phones for 10+ years now in places like UK/USA/Ireland. Very little/anything can be found on pubmed but lots of work has been done behind the scenes by engineers. If they hadn’t figured out things like caller ID, location awareness, mobile phone design etc etc the services we see today would be completely unmanageable.

“The World Health Organization (WHO) Global Observatory for eHealth (GOe) defines mHealth as medical and public healthpractice supported by mobile devices”

When I coined the term mHealth I realised this issue was going to be a problem. It’s incredible that most people still don’t realise that the biggest part of the mobile industry still lies in the $T networks that cover the world… Before you have any hope of appreciating the mHealth opportunity you must understand that the m is for mobile the newest and least understood mass media.

“In total, 2.5 billion peopleworldwide own a mobile phone and there is huge potential for mHealth to facilitate unprecedented access to specialist clinicaldiagnostics and treatment advice. In the US 56% of physicians have discussed mHealth with patients and 26% have been asked about mHealth by a patient (PWC Provider Survey)”

I would doubt the value of a ‘Provider survey’ as most ‘providers’ still use fax machines. The vast majority (+99%) of Patients in the US have used their phone to call someone for medical advice or to look something up. Note: Facebook is very much a mHealth app.

“Despite growing interest from both patients and healthcare providers, there is little clinical guidance on how mHealth apps should be utilized to add value to patient care, where value might include improvements in speed and accuracy of diagnosis, personalized treatment regimes, behavioral change advice, patient education or improved access to established therapies such as cognitive behavioral therapy (CBT)”

It’s mostly about training. The Internet and Mobile has totally transformed education but the Universities have for the most part not yet realised:

Please be patient im still learning

“This article discusses the potential valueof mHealth apps for patients and the challenges that cliniciansface in discussing mHealth apps in clinic”

I see this is a major hurdle to the value of this paper. It’s focused on how mHealth apps can support the 2000 year old office visit model but the biggest opportunity is clearly for the newest mass media to take us beyond that model.

The Doctor office visit only model no longer works because we can look it up.

It’s like thinking a paper on how mobile will transform the post office will be interesting whereas the real opportunity lies in how mobile has transformed (and continues to transform) communication.

“Despite the citations of diagnostic mHealth appsthere is huge potential and evidence is starting to emerge todemonstrate clinically significant improvements in morbidity andmortality outcomes in specific scenarios”

I think we’re long past talking about ‘Current limitations’. Check out the Smartphone Medical from 2013. I think it’s clear none of the papers authors have ever seen an experienced medic using a quality mHealth diagnostic app like that developed by Alivecor and unfortunately I think this substantially undermines the value of this paper.

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mHealth Events to attend in 2020

mHealth Events 2015

In 2019 there were just 22 mHealth events held around the world (in the USA, Israel, UK, Spain, Dublin, France and India). You can click here to view the events that were held in 201920182017, 2016, 2015, 2014, 2013, 2012, 2011 and 2010.

If you know of any events please add them as a comment below and I’ll update this listing to make this another definitive listing:

“How would the BornMobile generation redesign Medicine?” & “The Future role of the Doctor“ Lectures
UCD Medical School, Ireland
5 February 2020

The European mHealth Knowledge and Innovation Hub Launch Event
Geneva, Switzerland
18 Feb 2020

mHealth in times of Crisis: the Coronavirus
London, UK (& Free Livestream)
24 February 2020

mHealth App Developer Workshop
London, UK
26 February 2020

Digital Health Oxford (Video Consultations in Healthcare: examples from the US & the UK)
Oxford, UK
3 March 2020

Are you an innovator working in mHealth?
Birmingham, UK
4 March 2020

WHO Symposium on the Future of Digital Health Systems 2.0
Copenhagen, Denmark
4-5 March 2020

HIMSS 2020 Global Health Conference & Exhibition
Orlando, USA
9-13 March 2020

London Futurists: What can we learn from the COVID19 Crisis
WEBINAR
14 March 2020

mHealth Israel: Confronting CORONA – Global Best Practices
WEBINAR
19 March 2020

High Street Clinic Conference
London, UK
19 March 2020

Apps in Healthcare
Berlin, Germany
19 March 2020

High Street Clinic Conference 2020
Royal Pharmaceutical Society HQ London, UK
19 March 2020

mHealth App Developer Workshop
Leeds, UK
24 April 2020

IMPACCT: mHealth in Clinical Trials 2020
Boston, USA
July 2020

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