What Do Tomorrow’s Doctors REALLY Think of mHealth Technology?

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Nathan Ratner, a third-year medical student at the University of Minnesota and third-place finisher in last year’s Elsevier Hackathon in Finland, talks to Eric Wicklund at mHealth Intelligence, about the promise of mobile health technology.

mHealth Insight

The ability to look up information in an efficient and targeted way is critical to getting the right information, right when I need it.  For instance, UpToDate, which is an online resource designed by clinicians for clinicians, is a type of Wikipedia for healthcare professionals, and it has an incredibly wide database of peer-reviewed articles, written by MDs and PhDs. In addition, Johns Hopkins University produces an antibiotic guide. I use it through an app on my phone. Those are just a couple of examples of digital resources that I have utilized extensively throughout my medical education so far, and I plan to continue utilizing them throughout my career. It shows the potential for how much impact these kinds of services can have to really improve both the efficiency and efficacy of education”

I think despite survey results suggesting that ‘Half of US Medical Students believe that using a Mobile in front of Colleagues & Patients would make them appear less competent’ I think it’s clear that even medical students who are studying in medical schools that are failing them because they haven’t gone paperless with made for iPad course materials they still don’t think twice about using their mobile as a tool. How long before we update the dinosaurs and start examining medics on their ability to use a content loaded smartphone and requiring them to have/use it when with Patients?


The mobile phone or tablet is like the modern-day doctor’s bag. Suddenly we as physicians have vast resources at our fingertips that enable us to better educate patients about their disease process, our recommendations for a treatment plan and possible side effects or complications. This is a huge benefit to the therapeutic relationship”


The amazing thing is I think the Smartphone Medical from 2013 URL showed that it’s already so much more than that eg. your smartphone has a faster processor than a surgical robot from just a few years ago (and no one ever had a surgical robot or an ECG machine in their Doctors bag did they?).

“I would like to use mHealth to facilitate greater interaction with patients. This is not mentioned that often, but I think it is one of the greatest benefits of mHealth. When you have a situation where you have an expert who has all of this knowledge in their head, and they’re just dispensing edicts, such as, “This is what I think you have (and) this is what I think the appropriate treatment is,” whether intentionally or not, it can create an asymmetric power dynamic. However, if you are able to look up information with the patient, that facilitates a more collaborative relationship. Building that therapeutic alliance is more important than ever, because there are so many conditions that require a tremendous amount of active patient management and self-care in order to ensure successful outcomes”

I really hope when Doctors get to properly experience looking up information with Patients (this was the most transformational thing that I experienced 20 years ago at Medical School back in he early days of the internet) because when they do that its only a very small step before they realise Patients have more often than not got more time, interest and ability to look things up so we need to start teaching medics to work with Patients who have already looked things up.

“An easy criticism to make is we’re devaluing the doctor. People may say, “Well, anyone can just look this information up.”  But I don’t think it’s the access to the information that’s actually going to change medicine, because doctors still need to know all of this.  Medical school is not going to get easier. What’s going to change is how we share information, how we communicate, and my hope is that, as the system of global health becomes more robust for physicians, the same thing will happen for patients. I want to see the health literacy patients possess increase”

I see this as a common misconception amongst Doctors who don’t share online content with their Patients. It’s surprising that young medical students still think it’s possible (or desirable) for us to try and produce Doctors who know everything.

“I think the greatest risk is how information is shared with the general public. If it’s done right, then the good information gets through, and it’s accessible. When it goes wrong, patients can end up doing themselves a disservice. Patients do their own research and develop ideas about what may be wrong with them and what it will take to cure them based on that information. When physicians inform patients the interpretation of the patient’s research is not correct or does not fit the situation, physicians risk losing physician/patient trust. That’s happening now. Information that’s made accessible to patients needs to be done in such a way that there’s a clear bright line between the information that’s valid and information that is not. The mHealth ecosystem is being formed right now; if there isn’t a lot of care taken to really educate patients and form these systems so that there’s a clear delineation between what’s information you can trust and what’s information that may have an agenda behind it, you could see issues at a much bigger scale than we have now. But this is also one of the issues that mHealth can have a tremendous role in solving”

With government healthcare systems giving the health records of millions of their citizens to foreign advertising companies without even thinking about consent, the pharmaceutical giant Roche now owning FlatIron – the leading US provider of EHR’s for Oncologists and Teladoc and IBM Watson partnering to give 2nd opinions to Patients who are already under the care of an oncologist I think this is without doubt a major challenge but it’s not going to be solved by mHealth per se but by smart clinicians who are prepared to make themselves accessible and work transparently in order to help Patients and Carers trust them.

I’m most looking forward to services that can interact with patients in a way that help to give them critical information when they need it. I imagine a SIRI-like device that could access your medical record, know your history and, with the algorithm, be able to synthesize that information and give you a quick and reliable answer to the question, “Do I need to go to the emergency room for this?” “No, you called a bunch of times before about this, and you don’t need to worry,” or “Yeah, you should go to the emergency room.””

I think we’ll arrive at that situation by recording millions of fully documented Consultations with Doctors and incorporating the feedback from the Patient journey. A great reason in and of itself to evolve on from the 2000+ year old office visit only model of care.

“Medicine, especially at the primary care level, and even at the specialist level, will become more automated. It’s inevitable. One thing I hope to pursue through my career is to maintain the human element, to really emphasize communication and relationship-building within these technologies, like the economist Richard Thaler, who was awarded the 2017 Nobel Prize for Economics. All of his work was building humans back into these very analytical economic models, and I think there’s a lot of benefit and cost savings that comes with automation, but I do think that we run the risk of losing the human relationship, that research shows, is in fact critical to positive therapeutic outcomes”

I think it’s abundantly clear that in the drive for efficiency and profiteering the sick care system has disrupted the very thing that Patients want: a human relationship with someone who cares about them. It’s optimistic to hear a medical student expressing such an observation but hopefully it’s not another one of those common sense things that US medics are being taught to ‘grow out of’.

“Honestly, the thing I’ve been most interested in recently is the success of telehealth in sharing medical knowledge, especially for places where there are physician shortages. The two most prominent examples right now are stroke codes in rural hospitals, where there’s no on-staff neurologist. There’s a service that allows emergency physicians to immediately have access to a neurologist. For example, I’m in Minnesota, and in northern Minnesota there are some rural areas where there’s just no on-staff neurologist at these critical access hospitals, but with the push of a button they can have a neurologist – literally, a world-class neurologist at an academic health center here in the Twin Cities, on the video screen, and they can look up a patient’s records and talk through the entire management of the stroke with the emergency doctors. What that does is saves critical minutes and seconds from having to transport that patient to a different hospital, to being able to manage it right there and try to save as much brain tissue as possible”

Such a simple innovation that’s been obivous for years. It stuns me that we still have major Professional bodies representing tens of thousands of Doctors whining about the Physician shortage while just paying lip service to the opportunity to use the tools of our time.

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Apple gives a beta product demo and has a booth offering jobs at #HIMSS18


There’s no livestream from #HIMSS18 but in a classic example of what happens when you let pesky Patients come along to medical conferences: they point their mobile at the presenter, video what they see and share it.

Thank you “e-Patient Dave deBronkart” for so generously sharing this talk by Dr Ricky Bloomfield, Apple’s Clinical & Health Informatics Lead.

mHealth Insight

Apple Health is being presented at a Healthcare conference. 

I know it’s becoming a thing for Apple to talk at external conferences but it’s still very rare for their executives to present at a conference that isn’t organised by Apple Inc. particularly on such a low key stage (why didn’t HIMSS schedule this as a keynote talk in the main ballroom or as a fireside with Hal Wolf??).

“we’re very excited about this but it’s a first step and we think it’s very important to engage the ecosystem and we’re very excited about the response that we’ve got to see other EHR vendors and other healthcare systems come onboard and work with a standards based approach supporting the architectural implementation guide, and we’re also interested in doing a lot more and becoming and so shameless plug at the recruiting fair tomorrow we have a booth if you’re interested in learning more about what we do and possibly exploring job opportunities there feel free to stop by…”.

It would’ve been great to see this talk live streamed on Apple’s website (as they do with normal Apple product launches/presentations) particularly given that Apple are wanting transparency in all they do in healthcare and welcoming feedback (they are after all dealing here with people’s most private information).

“We announced this in January with 12 health systems and we now have over twice that listed and this list is growing quickly and the feedback that we have gotten since we announced this has been phenomenal.  People are really excited to be a part of this because they want to empower consumers with their health information”

Although I’m surprised to hear Apple referring to ‘Patients’ as ‘Consumers’ (as this could become very problematic down the road) it should be obvious that EHR Provider valuations are going to fall off a cliff when their investors see that this hasn’t just happened but it’s getting substantial traction.

“Consumers might not always know the branded name of a health system that they went to, they might just remember the location so (we made it possible to search via location)”

This must be quite awkward for the marketing teams at the big healthcare provider brands that are already involved. It’s obviously true but I’m surprised Apple isn’t feigning a little to them to let them think their brands have some value in the eyes of Patients (until they’re at least a little further down the road with this).

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That screenshot says 1000 words. I better get working on an update to the mHealth course that I produce for the Computer Society. How long before Patients are expected to share their record with their Doctor (instead of the other way around)?

I think my new module will be titled something catchy like: “Can you airdrop me a copy of that please?”.

Dr Ricky Bloomfield

It’s great that there’s a 37 year old Doctor giving this demo but it’s surprising that they haven’t got a more experienced clinician (perhaps a Family Doctor – and yes I know they’re like hens teeth in the USA) but Ricky has all the right credentials to help Apple disrupt the EHR market with a MobileFirst approach eg. prior to working for Apple on the HealthKit ResearchKit and Health Record products he was Director of Mobile Strategy at Duke University Health System and he used to blog as “The Mobile Doc” and he’s active on Twitter too @RickyBloomfield:

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NOTE: Katie McMillan at Duke Mobile App Gateway has authored a useful guide to getting started with Apple Health Record:

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mHealth Insights live from #HIMSS18

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Unfortunately my travel plans for HIMSS have fallen victim to the ‘Beast From The East’ (a storm that has brought sub-zero Siberian temperatures from Siberia to us here in the UK and Ireland) and it’s been so hectic at 3GDoctor the past few days I’ve not had time to try and replan my cancelled flight schedules. Fortunately I’ve managed to convince/beg the brilliant Dr Chris Bickford MD to step into my conference-floor-pounding-shoes and provide some opinions and live updates from the world’s biggest Health IT Conference and Exhibition being held in Las Vegas.

Chris has done this before (for example at the brilliant Singularity Universities Exponential Medicine conference in San Diego) and is a super smart and caring Doctor so if you’re there at the HIMSS Conference and would like to be video interviewed by Dr Bickford for this post please either find him or comment below with your mobile number (it won’t be published) and we’ll arrange a meet up for you via SMS.

* * * Refresh this page to see live mHealth Insights from Dr Bickford MD * * *

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Chris plans to attend the following Conference tracks that have a mHealth focus:


Description: The advances in and availability of data from disparate sources create new opportunities and frontiers in care coordination for complex patients. These can range from mHealth/IoT applications which support real-time patient engagement to unstructured data associated with social determinants to data based upon genomic-screening. Developing an interoperable infrastructure that supports these use cases is a process that has already begun.

Learning Objectives: Classify the sources of data required to provide coordinated care in serving complex patients. Evaluate how new approaches to improving interoperability between stakeholders to support improved approaches in caring for complex patients. Describe the challenges in workflow integration for providers and payers when supported by an interoperable system which supports new data sources from disparate sources

Speakers include: Dan Chavez, Executive Director, San Diego Health Connect
and Edwin W Miller, CTO, Aledade.

Monday 5 March (14:00pm Lando 4401): THE JOURNEY TO MOBILITY

Description: This session will highlight the opportunities and challenges associated with patients generating their own health data and the role of nurses in facilitating these new technologies and data sources.

Learning Objectives: Discuss the role of nurses in training patients to use new mHealth technologies.  Outline current innovative uses of mHealth data.  Describe the state of the industry is in terms of mobile technology.

Speakers include: Victoria L Tiase, Director, Research Science, New York Presbyterian Hospital.


Description: As the number of older adults continues to grow, connected health technologies can help close the gap between patients and providers and enable individuals to remain vital, engaged and independent as we age. Social robots, artificial intelligence, vocal biomarkers and facial decoding will analyze emotion, anticipate health problems, improve quality of life, enable better relationships with healthcare providers, and address the neglected crisis of caregiving. So rather than deploying technologies like online communication, wearables and mobile apps in competition with human interaction, we must free up technology to do what it does well — capture and analyze data — and enable healthcare providers to focus on the human elements: caring, emotional intelligence and judgment. When we start using connected health technologies appropriately, we can create one-to-many care delivery models, and enhance and support human interaction between a healthcare provider and patient. The New Mobile Age, as described in Dr. Kvedar’s new book, is a busi.

Speakers include: Joe Kvedar, Vice President, Connected Health, Partners Connected Health.

Tuesday 6 March (11:30am Marcello 4405): IMAGINE A HOSPITAL WARD WITHOUT CODE BLUE ALARMS

Description: Can you imagine a hospital ward with no code blue alarms? This speaker has been leading the team at Hamilton Health Sciences to achieve an audacious goal: to improve hospital safety by eradicating in-hospital cardiac and respiratory arrests. Through clinical research in support of Early Warning Scores, it was found that in-hospital arrests are often preceded by a period of abnormal vital signs. “We believe that most cardiac arrests in an acute care setting should be considered a failure to rescue.” Hamilton Health Sciences (HHS) has been on a journey since 2010 to implement their modified early warning score. In 2016, HHS undertook work to make their Early Warning Score real-time with the use of mobile devices and an automation platform. This session will discuss Hamilton Health’s journey and their outstanding results!

Learning Objectives:  Explain the process Hamilton Health Sciences undertook to create a digital early warning score.  Assess the effectiveness of the early warning score at Hamilton Health Sciences.  Discuss the challenges – clinical, technical, human behavioural – encountered during the early warning project.  Identify the lessons learned during the stages of the Early Warning Project.  Describe the strategic roadmap for future uses and improvements of the early warning score.

Speakers include: Alison Fox-Robichaud, Director of Medical Education, Project Lead HEWS, Hamilton Health Sciences Centre

Tuesday 6 March (12:00pm Level 1,Hall G,Booth 11657 ): MOBILE STRATEGY FOR THE HOSPITAL OF THE FUTURE

Description: This presentation will explore the various applications of location services in a healthcare setting with a focus on mobile technology. Learn about the long- and short-term benefits of a mobile strategy that can improve the patient experience and optimize operational efficiency for hospitals.

Speakers include: Robert Tabb Senior Director of Sales, Phunware, Inc.

Tuesday 6 March (14:00pm Level 2,Bellini Meeting Room,Booth 8700): THE VIRTUAL WAITING ROOM

Description: The last thing congested patients want to encounter is a congested waiting room. Eliminate the wait and liberate your patients with QLess. Patients can join a virtual waiting room by phone call, text message, mobile app, your website, or via an on-site kiosk. Our patented forecasting algorithms ensure your patients’ time is optimized and no one is left idly waiting. #TheWaitIsOver

Speakers include: Evee Burgard, VP of Marketing, QLess


Description: Navigating and accessing large hospital systems can be difficult for patients. Piedmont Healthcare, a $3.5 billon, seven-hospital system in North Georgia developed a mobile wayfinding platform allowing patients to use smartphones to get from home, to the right parking garage, and step-by-step guidance to their destination to vastly improve patient experience and address additional patient experience challenges of the growing health system. This session discusses the best practices for developing a hospital-branded mobile app including prioritizing patient experience, leading with wayfinding to drive adoption, realizing clinical improvements with feature-rich content, and evaluating analytics for ROI.

Learning Objectives: Identify key objectives of a mobile platform to promote patient experience.  Identify clinical improvement opportunities such as access to care, decreasing missed appointments and staff interruptions that can be addressed with a mobile way finding solution.  Recognize way finding as a significant motivation to adopting a hospital’s mobile platform.  Demonstrate the value of one hospital-branded, mobile platform with feature-rich content and multiple patient engagement opportunities. Assess ROI and sustained engagement of a mobile app based on real time analytics.

Speakers include: Katie Logan Vice President, Experience Piedmont Healthcare, Piedmont Healthcare

Tuesday 6 March (16:00pm Bellini 8700): The New Mobile Age: Tech Extending the Healthspan

Description: The New Mobile Age, Dr. Kvedar’s latest book, describes how connected health technologies will enable individuals to remain vital, engaged and independent as we age, and create a better healthcare system for everyone. But it has to be the right technology, designed for an aging population, not just what technologists and app developers think people want. The New Mobile Age is a business model but, more so, it’s a new way of life.

Speakers include: Joe Kvedar, Vice President, Connected Health, Partners Connected Health.

Wednesday 7 March and Thursday 8 March (9:30-6:30pm Interoperability Showcase 11955 VA Area): VA MOBILE: A TOUR OF THE VA APP STORE

Description: VA is growing its VA App Store (mobile.va.gov/appstore), which today features more than 30 web and mobile apps. These online tools help Veterans with mental health, health and wellness, women’s health and other pressing topics. VA also has developed a number of mobile apps to provide VA clinical staff with access to real-time Veteran information to inform clinical decisions. This session will provide demonstrations of many of these apps and discuss VA’s plans for additional mobile development.

Speakers include: Shawn Hardenbrook, Director of Web & Mobile Solutions, US Department of Veterans Affairs


Wednesday 7 March (10:00-11:00am Venetian Convention Centre Murano 3304): EFFICACY OF MULTIMEDIA IN PATIENT-PHYSICIAN INTERACTIONS

Description: Traditionally, patient education has taken one of two forms: written brochures or orally communicated instructions. There is substantial literature that indicates neither approach is effective, due to the lack of information retention. This lack of retention is usually due to disengagement and disinterest in information presented in the form of brochures or due to the inability to recall and reference verbally communicated information. The first, brochures, is often provided with no explanation from a clinician and the latter, verbal dialogue, is commonly not documented and archived. In 2017, we initiated a study involving the participation of over 400 patients for the purpose of determining the efficacy of 3-D multi-media patient education enabled through mobile devices. This session will reveal major findings from our research, and provide recommendations for implementing an effective patient engagement program focused on improved physician-patient interaction.

Learning Objectives: Assess areas for improvement in the delivery of patient education as a technique in addressing patient engagement needs.  Identify impacts of using integrated mobile computing devices for the delivery of multiple-media patient education in patient care.  Compare provider and patient perspectives about multi-media patient education content used during clinical consults (usability and value).  Apply concepts and lessons learned in the integration of multi-media patient education via mobile computing devices during provider-patient interactions.

Speakers include: Nick Patel Executive Medical Director, Palmetto Health-USC MG, Benjamin Schooley, Assistant Professor/Integrated Information Technology, University of South Carolina and Lakisha McNeil, Ambulatory Registered Nurse Case Manager, Palmetto Health.


Wednesday 7 March (10:00-10:50am Venetian Convention Centre Level 1 Casanova Booth 14000): HELPING TO EXPAND THE SCOPE/DELIVERY OF POP HEALTH

Description: There are many components to defining and delivering Population Health and Improvement. There are many new players and delivery options available. Through customer and industry use cases and examples, I will review how MicroStrategy is helping its customers improve the health and wellbeing of the communities and constituents they serve with improved insights and actions via Advanced and Predictive Analytics, Mobility, and innovative IoT and Security solutions. Come see and hear how to be involve

Speakers include:  Erik Senior, Sales Engineer, MicroStrategy

Wednesday 7 March (10:00-10:50am Sands Convention Centre Level 1, Hall G, Booth 11657): 20 QUESTIONS – WHEN DEVELOPING MOBILE HEALTH APPS

Description: The MEDIC team at Mohawk College is the national Technology Access Centre for digital health in Canada and has developed or deployed several complex mobile health solutions that impact millions of patients. Professor Bender is the Principal Researcher for the MEDIC Digital Health Centre at Mohawk College in Hamilton, Ontario, Canada and will share his experiences in developing and deploying mobile health applications in Canada, the USA and around the world.

Speakers include:  Duane Bender, Principal Investigator, eHealth & mHealth, Mohawk MEDIC

Wednesday 7 March (10:00-10:30am Venetian Convention Centre, Palazzo Ballroom): VIRTUAL HEALTH: TELADOC AND CUSTOMER CASE STORY

Description: Learn how Azure enables Teladoc to provide on-demand remote health care services through mobile devices, secure online video and phone, an attractive option for patients in need of fast help for non-emergency medical conditions.

Speakers include:  TBC.



Wednesday 7 March (10:30-10:50am Venetian Convention Centre, Level 2, Bellini Meeting Room, Booth 8700): CAN YOU HEAL ME NOW? VOICE IN HEALTHCARE

Description: Connected devices promise to make healthcare more efficient. But what of a growing pantheon of lifestyle devices including voice assistants like the Amazon Echo and Google Home? Why is voice a logical next step in the evolution of user experience? Attendees will see demonstrations of conversational agents across multiple web and mobile environments, and learn about real-world voice-first deployments of voice for outpatient education, home health, care management and clinical trial research.

Speakers include:  Nathan Treloar President/COO, Orbita, Inc


Wednesday 7 March (11:00-11:20am Venetian Convention Centre, Level 2, Bellini Meeting Room, Booth 8700): TEAM UP WITH PATIENTS FOR VALUE-BASED CARE SUCCESS

Description: Improving patient adherence and family engagement can lead to better health outcomes for your patients and financial outcomes for your organization. This session explores how putting mobile care management tools in patients’ hands allows clinicians to focus their efforts where they can have the most impact.

Speakers include:  Jennifer Bowers, Senior Clinical Strategist, Get Real Health 

Wednesday 7 March (12:30-12:50am Sands Level 1, Hall G, Booth 11657): WIRELESS, CONTINUOUS BLOOD PRESSURE & VITAL SIGNS

Description: Blood pressure (BP) monitoring is an essential component of patient care in both hospital and mobile health environment and is typically relegated to intermittent “spot check” arm cuffs, or invasive catheters which tether patients to machines. Challenges of current BP and Vitals monitoring, particularly in the hospital-setting, will be discussed. Development and future aspects of continuous non-invasive BP monitoring and wireless vital signs applications will be introduced.

Speakers include:  Younghoon Kwon MD, Cardiovascular and Critical Care Professor of Medicine, University of Virginia

Wednesday 7 March (13:30-13:50am Venetian Level 2, Bellini Meeting Room, Booth 8700): TAILORED CONVERSATIONS FOR CONSUMER ACTIVATIVATION

Description: Driving behavior change among healthcare consumers requires understanding how people use both language and technology to communicate and then leverage that understanding to effectively connect with them. This presentation highlights how mPulse Mobile’s solutions drive healthy behavior change through tailored and meaningful dialogue. Three case studies will be discussed.

Speakers include:  Chris Nicholson, CEO, mPulse Mobile

Wednesday 7 March (14:00-14:20pm Venetian Level 2, Veronese Meeting Room, Booth 8500): 4 DANGEROUS SECURITY HOLES IN YOUR MOBILITY POLICY

Description: Hackers know the easiest way to access and steal healthcare data is through mobile devices, as they are becoming ubiquitous among doctors, nurses and patients, and are always on and connected to the Internet. Sophisticated attacks and well-researched social engineering make any healthcare organization vulnerable to determined mobile attackers. Attend this session to learn about mobile security best practices and how to best secure both managed and unmanaged devices throughout your organization.

Speakers include:  Varun Kohli, Senior Director Strategic Market, Symantec Corporation

Wednesday 7 March (15:00-15:20pm Sands Level 1, Hall G, Booth 9900): HALO HEALTH SYSTEMS – SMART CLINICAL TRIALS

Description: Halo Health Systems is enabling creation of next generation clinical trials to reduce costs, provide greater operational efficiency and create higher levels of patient engagement. Halo Health Systems harnesses IoT and mobile technologies to create a flexible solution for pharma, clinical research organizations and clinical research institutes. halohealth.io

Speakers include:  V Mehta Co-Founder, Halo Health Systems



Description: In today’s world you’ll find savvy digital technologies that assist the patient through the continuum of care. Remote consulting. Telehealth. Internet of Things (connected mobile carts, IV pumps, sensor beds, etc). And this continuum of care can take place in the home, clinics, hospitals, or post-acute settings. Perimeters are no longer fixed and more devices are connected, assisting in delivering high quality of care. In this session, speakers will review common mistakes to avoid, scenarios to consider and how the secure, connected hospital can enhance the patient, clinician, and operational experience.
Learning Objectives: Outline seven scenarios highlighting why device and clinical system connectivity as part of IoT and convergence is necessary when delivering critically sensitive patient data for caregiver analysis and decision making. Identify best practices and common mistakes for planning IT platform transformation to support new telehealth and quality/prevention care models. Describe how clinicians can utilize data from connected devices and networks to deliver contextual information for precision-guided decision support across the continuum of care. Explain the typical stages and progression of digital transformation related to IoT, mobility and beyond. Provide attendees with a better understanding of how the latest technology tools available can improve operational efficiency, clinical outcomes and the patient experience by gathering and analyzing data across the continuum of care.

Speakers include: Gary Horn, Vice President – Technical Services CTO & CISO, Advocate Health Care, and Tom Bradicich, Vice President and General Manager Servers and IoT Systems, Hewlett Packard Enterprise.


Description: A new cadre of healthcare executives, Chief Experience Officers (CXOs), are driving innovations to improve communication, patient engagement, staff resiliency, and much more. Gaining prominence in healthcare organizations around the country, these change agents are creating sustainable system transformation that delivers optimal care to patients and families while empowering care teams and staff to achieve their highest healing potential. This speaker will present the hospital’s strategy for building The Office of Patient Experience and discuss how this academic research center is restoring human connections using mobile communication technology, building trusted relationships, and reconnecting people to purpose.
Learning Objectives:  Define the role of the Chief Experience Officer in healthcare and outline the attributes that make this emerging c-suite executive successful.  Describe how to unify quality, safety, efficiency and experience strategies; and discuss who to engage in multi-disciplinary teams by getting to the heart of what they do.  Analyze the impact that physician and nurse burnout has on patient care, safety and satisfaction; and discover ways to restore people to purpose, increase resiliency, and optimize performance.  Recognize the power of capturing patient, family and staff voice; and discuss ways to co-design innovations with these stakeholders to improve the healthcare experience for all.  Explain how healthcare technology is essential to elevating care team communication, improving workflows, engaging patients, families and staff, and hard wiring processes that drive better experiences for all.

Speakers include: Sue Murphy, Chief Experience and Innovation Officer, University of Chicago Medicine


Wednesday 7 March (16:00-17:00pm Venetian Palazzo G): DIGITAL COMMAND CENTER FOR EHR IMPLEMENTATION

Description: There is tremendous irony in many areas of IS&T. One of them is that so much of the go-live operations management process is often done on paper. One such example of this is how go-live command centers are managed. These command centers are often manned by staff who are constantly updating whiteboards, transcribing issues into electronic issue management systems, and manually generating status reports for overall progress. These procedures are quite cumbersome, and adds delay into the process of identifying support issues which may be pervasive. Leveraging technology to record support issues at the point of incident allows an easier input method and an issue to be triaged more quickly. Simple mobile apps and other technology can be used to record these incidents and electronic dashboards can be used to highlight pervasive issues and generate automated status reports of overall system health. A digital command center can add value and efficiency to an organization’s go live operations.
Learning Objectives:  Identify the process for a Digital Command Centre.  Analyze the metrics after a Go-Live.  Discuss process improvement for Steady State

Speakers include: Matthew Ernst, Director Training Documentation & Support, Thomas Jefferson University and Jefferson Health System  and Neil D. Gomes, Chief Digital Officer and SVP Tech. Innovation and Consumer Experience, Thomas Jefferson University and Jefferson Health System.


Thursday 8 March (08:30-09:30am Venetian Lando 4301): PUSH NOT PULL: USING DATA SCIENCE TO IMPROVE OR OPERATIONS

Description: Data science and machine learning – typically regression or classification analysis – are powerful tools for healthcare. While much of the attention given to data science in healthcare focuses on improving clinical outcomes, using these tools to identify opportunities for improving operational metrics have gone largely overlooked. While most hospitals administrators have a dashboard for operational data, including room utilization, the number of cases, first case on-time starts, turnover metrics, length of stay, etc., most use these tools in a “pull” manner; they start with something in mind and then look for the data. This causes problems when administrators aren’t clear on what to look for or just get lost in the reams of data. The problem is not lack of data, it’s lack of the insight of what data to use. Data science and machine learning – especially trend and anomaly detection – combined with innovative mobile data delivery mechanisms can turn “pull” into “push”, and uncover details that dashboards and EHR reports can miss.
Learning Objectives:  Identify what metrics mean the most when optimizing hospital operations and understand why dashboards and reports often fail to disclose opportunities for improvement.  Discuss how predictive analytics, machine learning, and mobile technologies were used to improve OR operations.  Explain why “push” is the preferred method of data gathering versus “pull”.

Speakers include: Ashley Walsh, Senior Financial Analyst, UCHealth  and  Sanjeev Agrawal, President and CMO, LeanTaas.


Thursday 8 March (08:30-09:30am Venetian Gallileo 904): IMPROVING FEBRILE INFANT CARE USING MOBILE TECHNOLOGY

Description: Implementing evidence-based clinical practices requires a multi-faceted approach. Electronic clinical decision support (ECDS) tools may enhance adoption of evidence-based practices. We developed a freely-available smartphone-based ECDS tool for use as part of an American-Academy of Pediatrics-sponsored national practice standardization project that aimed to improve the treatment of infants with fever. The application, CMPeDS: Pediatric Decision Support, was developed using evidence-based recommendations created by an expert panel. The app workflow and content were customized to align with the national project’s benchmarks, and the app interface was developed using human factors principles. Since release, CMPeDS has been downloaded by over 12,000 users who access project-relevant content >80% of the time. Our experience demonstrates how mobile decision-support technology can help disseminate current evidence-based practice on a national scale.
Learning Objectives:  Identify common processes clinicians use to make medical decisions.  Discuss strategies for enhancing medical decision-making and disseminating evidence-based practices in diverse settings using electronic decision support tools.  Recognize the importance of human factors principles to the design of a mobile electronic clinical decision support tool.  Develop a plan for creating a mobile electronic clinical decision support tool relevant to your own health system or patient population

Speakers include: Russell McCulloh, Assistant Professor, Children’s Mercy Hospital  and  Sarah Fouquet, Assistant Professor, Children’s Mercy Hospital.


Thursday 8 March (08:30-09:30am Venetian Gallileo 904): IMPROVING FEBRILE INFANT CARE USING MOBILE TECHNOLOGY

Description: Implementing evidence-based clinical practices requires a multi-faceted approach. Electronic clinical decision support (ECDS) tools may enhance adoption of evidence-based practices. We developed a freely-available smartphone-based ECDS tool for use as part of an American-Academy of Pediatrics-sponsored national practice standardization project that aimed to improve the treatment of infants with fever. The application, CMPeDS: Pediatric Decision Support, was developed using evidence-based recommendations created by an expert panel. The app workflow and content were customized to align with the national project’s benchmarks, and the app interface was developed using human factors principles. Since release, CMPeDS has been downloaded by over 12,000 users who access project-relevant content >80% of the time. Our experience demonstrates how mobile decision-support technology can help disseminate current evidence-based practice on a national scale.
Learning Objectives:  Identify common processes clinicians use to make medical decisions.  Discuss strategies for enhancing medical decision-making and disseminating evidence-based practices in diverse settings using electronic decision support tools.  Recognize the importance of human factors principles to the design of a mobile electronic clinical decision support tool.  Develop a plan for creating a mobile electronic clinical decision support tool relevant to your own health system or patient population

Speakers include: Russell McCulloh, Assistant Professor, Children’s Mercy Hospital  and  Sarah Fouquet, Assistant Professor, Children’s Mercy Hospital.


Thursday 8 March (11:30-12:30pm Venetian Palazzo B): HARVESTING WEARABLE DEVICE DATA

Description: There is an immense amount of non-clinical data points being recorded by remote wearable health devices and smartphone applications available to consumers. The challenge is how that data can be leveraged to improve population health management. This session provides an overview of how, what and why such data from wearable devices can be collected and integrated with clinical registry data to formulate a more comprehensive profile of patient health data. As a pilot project, the American College of Cardiology (ACC) identified a set of devices, mobile applications, and data elements and focused on a solution to capture data from these sources. This non-clinical data can provide additional insights to the longitudinal perspective of a patient that might otherwise be missing and can help guide physicians to effective healthcare decisions.
Learning Objectives:  Explain why it is important to capture ‘non-episodic’ health data from wearable devices and integrate it with registry data for a comprehensive clinical picture.  Define typical devices, apps and the data to be collected and the rationale for identifying the data elements.  Illustrate how non-episodic data can be collected from various devices and mobile applications using one-time user login and consent.  Identify and analyze challenges related to data and privacy concerns related to wearable devices.

Speakers include: Ajay K. Mittal, Associate Director IT, American College of Cardiology


Thursday 8 March (12:00-12:20pm Sands Level 1 Hall G Booth 9900): DIGITAL TRANSFORMATION OF YOUR HEALTHCARE SYSTEM

Description: This presentation offers a framework for incorporating innovative digital health methods – new diagnostic or treatment technologies, mobile apps, IoT, telemedicine and analytics – into your current healthcare system. Best practices for achieving digital transformation while maintaining data security are explored. And recommendations for overcoming common organizational obstacles are offered. The presentation provides an actionable roadmap for both health enterprises and emerging health companies

Speakers include: Alan Winters, Head of US Business Development, MobiDev


Thursday 8 March (13:30-14:30pm Sands Interoperability Showcase 11955 Theatre): OFFICE OF CONNECTED CARE/TELEHEALTH

Description: The VA presents the Office of Connected Care presentations -The VA Blue Button: Empowering VA Patients With Information. This session will provide an overview of how My HealtheVet improves patient access in pursuit of seamless -VA/Telehealth Services Overview – Enhancing Access, Quality, and Capacity. This session will provide an overview of VA Telehealth and current projects, as well as national VA telehealth targets and planned activities. It also will highlight VA Video Connect, which enables Veterans at home or on the go and/or teleworking VA providers, to connect by video using any device (e.g., laptop, tablet, smartphone, desktop with webcam) -VA Mobile Program: An Overview VA is developing web and mobile applications aimed at improving Veterans’ health by providing technologies that expand clinical care beyond the traditional office visit. This session will highlight current program successes, lessons learned and future plans. It also will explore how VA is leveraging technology to encourage Vets to be proactive participant.

Speakers include: Kim Nazi, Blue Button Project Lead, Office of Connected Care, Veterans and Consumer Health Informatics U.S. Department,  Neil Evans, Chief Officer, Office of Connected Care, Department of Veterans Affairs  and  Shawn Hardenbrook, Director, Web & Mobile Solutions, US Department of Veterans Affairs.


Thursday 8 March (15:00-15:20pm Venetian Level 2 Bellini Meeting Room Booth 8700)HOW DATA FRAG. SLOWS ADOPTION – DIGITAL HEALTHCARE.

Description: Real-world problems with non-standard device data. How fragmented data sources from mobile health apps, devices, personal sensors and devices, complicate care for millions of patients… by limiting physician access to coherent patient data. How the Continua standard helps improve continuity of care and outcomes by eliminating this fragmentation, and “siloization” of essential medical data for remote care delivery.

Speakers include: Mark Winter, Chief Executive Officer, Carespan USA, Inc



 Description: For many years, companies in the retail, telecom, insurance, and banking industries have used machine learning techniques to analyze terabytes of real-time data representing a wide range of customer interactions (across all channels), demographic characteristics, and lifestyle events. This session will explain how CIGNA has leveraged some of the machine learning techniques used to influence consumer behavior in other industries for their own purpose of influencing consumer behaviors towards lower medical costs and better healthcare outcomes. One example to be discussed is how they used a combination of claim data, demographic data, lab data, call center data, and click-stream data from web-interactions and mobile phone interactions to improve the timing, channel, and content they use to engage members with chronic conditions in coaching that lowers medical costs and improves healthcare outcomes for those patients.

Learning Objectives:  Recognize opportunities to use machine learning to increase patient/consumer engagement.  Analyze customer interaction data to identify ways to reduce total medical cost.  Apply machine learning and big data techniques to improve health outcomes for patients and customers.

Speakers include: Doug Melton, Senior Director of Customer Engagement and Experience Analytics, Cigna  and Christer A. Johnson, Principal, EY.

Friday 9 March (12:00-13:00pm Venetian Delfino 4004)USER-CENTERED DESIGN OF A MOBILE EPRESCRIPTION SERVICE.

Description: User-centered design, while already utilized in several technologically-focused industries, is a relatively new topic to the healthcare sector. We present the development steps of a mobile service that allow citizens of Veneto Region, Italy, to manage their drug prescription, dispensing and remote renewal request. A set of methods has been introduced to address users’ needs, co-design the mobile app and evaluate its usability. Despite the challenges faced, related in particular to the negotiation of design issues between users, technical team and developer, the mobile app resulted usable (95.4% of task completed) and perceived as user-friendly. The process also led to an early definition of a methodological and organizational framework for user-centered design of healthcare mobile solutions in Veneto Region.

Learning Objectives:  Analyze the user-centered design steps taken by the team.  Outline challenges you may face in a user-centered design process.  Influence usual development approach with user-centered design hints.

Speakers include:  Claudio Saccavini, Chief Information Officer, Arsenàl.It Consortium  and  Enrico Dal Pozzo, Anthropologist, ehealth service designer, Arsenàl.IT Consortium.




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From Cheap Phone Calls with Doctors to Machine Learning Second Opinions for Patients who are already in the Care of an Oncologist

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Teladoc taps IBM Watson machine learning for second opinion service

Can a quick phone call substitute for a Doctor Visit

mHealth Insights

This is a classic case of wait long enough and the crazy becomes real. Can you even begin to imagine the typical Patient experience?

1) Go to your Doctor with some symptoms
2) Get Tests done
3) Go to your Doctor and get test results and referral to an oncologist
4) Go to Oncologist and get diagnosis and treatment plan
5) Pick up prescriptions
6) Go home and press some buttons on your mobile
7) A Doctor you don’t know video calls you and based on a program run on your electronic health record information tells you (33% of the time) that your oncologist’s diagnosis is incorrect and that (66% of the time) you need to change the treatment.
8) Patients will be expected by their insurers to follow the advice given to them by a Doctor over a Video Call who has never read or understood why they are giving you this advice. Don’t accept this and you’ll not get approval for treatment.

I understand most other national Cancer Care systems are also fundamentally flawed but only in a topsy turvy world focused on serving the needs of the US Health Insurers does this make any sense. I imagine Apple are going to do very well with their new Healthcare clinics and strategic decision to not focus on Patients (and not reimbursement).

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I think IBM is going to make huge profits out of the misaligned incentives in the US sickcare system as the following is going to happen in quick succession:

1) A law firm is going to start advertising to Patients who are googling their diagnosis/medications encouraging them to use the second opinion service to see if their IBMWatsonOncologist has made an incorrect diagnosis (highly likely as they are going to be making decisions based on US Healthcare Records that are in many cases just detailed billing records) and treatment recommendation and if they are entitled to compensation.

2) Rival law firms will start advertising to Patients who are in the care of IBM Watson finding problems with the algorithms and winning claims against IBM

3) Either IBMWatson will go bankrupt or the medical indemnity insurers will require Oncologists to use the IBM Watson system before giving a diagnosis (otherwise their insurance will become unaffordable)

4) Oncology Patients will realise this is a race driven by expensive law firms and legalese and have to choose to either complete exhaustive tests, questionnaires and wearing of medical sensors or accept that they don’t want paint by numbers medicine and will let their Oncologist have their autonomy back.

5) Patients will become more accepting of the idea of sharing information electronically with a Doctor instead of Going to get help.

Can’t wait to find out more on Monday at HIMSS18 in Las Vegas. See you there?

Related posts:

If AI is supposed to be all about trust why has IBM Watson seemingly been programmed to generate hype & operate like a dodgy accountant? (Feb, 2017)

Can the IBM Watson team move beyond creating Paint by Number Style Medicine and grasp the disruptive innovation opportunity? (July 2013)

Will IBM’s Watson write for CNN before treating patients? (Feb 2012)


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Protected: mHealth Insights from the 31st Politzer Society Meeting & 2nd Global Otology Research Forum

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“Online consultations in general practice: the questions to ask” RCGP Report.

RCGP Online Consultations in General Practice the questions to ask

The Royal College of General Practitioners has been “working with a group of Patients, GPs, health service managers and academics to develop a set of questions that you might want to consider if you are a patient, clinician, practice or commissioner” interested in using these online consulting services.

Download the “Online consultations in general practice: the questions to ask” report (PDF).

mHealth Insight

At times the RCGP seems fixated on efforts to detract from efforts to evolve general practice beyond the office visit only model but I think this is a fascinating document and it will provide a great launchpad for discussions about how services should be designed.

“Online services provide a new way of consulting in general practice. Use of text based or video digital technologies has some advantages over established ways of consulting such as face-to-face meetings or the use of the telephone. It also carries risks.”

While I agree that booking an appointment is an online service it’s disappointing that the paper refers to “consulting with a Doctor” as just an “online service”. Similarly to how Video Consults with Doctors shouldn’t be described as ‘Virtual Consults’, I think there is a distinction that the report would benefit from making clear that becomes particularly obvious when you realise most internet access comes via the mobile phones that most of us carry and never switch off (which makes it unclear when a Patient using a mHealth service or a GP or Nurse who shares their mobile number with a Patient would consider themselves to be online or off-line).

I also find it a bit of dangerous presumption that documented mobile video consults are accepted to be inherently more risky than a conventional face to face meeting in a clinic or a plain old telephone voice call when surely we all know Patients are more honest with their Mobiles than their Doctors, surely we all know there are Patients having consults with overworked GPs that are little more than stranger encounters and the college is aware of the great work being done by RCGP members who are providing online tools to their Patients that are helping them to work at the top of their licence. (Related: “The biggest “disruption” in healthcare is honest, direct, accessible communication” (2012)

“We present some questions that you might want to ask if you are a patient, clinician, practice or commissioner, to help you to get the most out of the potential of these new services. The questions have been developed by a small group of patients, clinicians, health service managers and academics working with the RCGP and are currently being tested more widely, prior to be being published on the RCGP website”

I would’ve loved to have helped contribute to this work as it really does seem to be missing the most valuable potential contributors eg. how could the questions that “Practice Nurses” and “Carers” might want to ask have been overlooked?

I personally think Carers make the strongest solid use case for GPs to start offering mobile video consultation services because these invaluable volunteers deliver some +80% of total healthcare and they are all too often unpaid (and missing out on the opportunity to work/get paid) and medically untrained. In my experience the value of having a Video Consult with a Doctor on your mobile is probably most significant for Carers.

“Questions to ensure that the service is safe: Has the service been inspected by the health regulator, the Care Quality Commission (www.cqc.org.uk) (or its equivalent outside England), and am I satisfied with the report?”

It’s a bit odd that the RCGP has become a big fan of the CQC’s ability to protect the safety of Patinets. Perhaps everyone’s forgotten that the organisation (that gets by on a measly £262Million a year) published a banding system that wrongly labelled 60 GP practices as “potentially putting patients at risk” when they weren’t.

I think it’s important to appreciate that a Doctor video consulting service becomes safe when it’s properly documented for Patients and is provided by registered Doctors. Fail to document or let Patients even access records and we just continue to support the growth of pointless bureaucracy and clipboard-wielding parasites who ultimately take funding that we really need to be allocating to those who are actually providing care.

“Will the online provider have access to my GP records so that they know about my medical history?”

I think this is something that’s rapidly changing. As Patients get access to their records (something that the paper doesn’t refer to) mobile health apps like Apple’s new Health Record service are going to flip this question on it’s head eg. it will soon be more sensible to ask “will the service let me securely share my Healthcare Records with the remote Doctor”.

I think this is very interesting because we know Patients are more honest with their mobiles than their GPs so it’s likely that these Patient accessible records are going to be much more useful for GPs.

“Is it clear whether my personal information is being kept safe and confidential? Will it be shared with other parties (including my registered GP if appropriate) or used for purposes other than the direct provision of care? If the online provider wants to record my consultation, will I be asked for my permission to do so?”

I think these are great questions but they’re not going to be realistically solved by us hoping that Patients will remember to ask it at a time when they are all too often stressed and in urgent search of health advice.

I think the RCGP could have impact if members were to draw up an approved T&Cs and Privacy Policy that their members should work with when advertising their services online. By doing this RCGP members won’t be seen with their mugshots plastered all over the scammy websites that advertise free* or cheap subscription services directly to the public but hide behind protracted T&C’s and Privacy Policies that state they aren’t Healthcare Professionals and are nothing more than “providers of a website” and not responsible for healthcare or advice given while informing the 1% who bother to read the small print that they have (automatically because they visited the website) granted permission for the website owner (or the liquidators when it’s VC debt funding runs out) to share/sell everything with third parties who can use it unaccountably for whatever purposes they want.

“Does the online provider offer services for people who are not able to consult in English?”

It’s interesting to note that this report from the RCGP is only made available in English.

“Questions about how the service is provided: Is a free NHS service being offered or will I have to pay for it? If I have to pay, how much and what payment schemes are available?”

I think this is going to be one of the biggest challenges facing Patients. Already we’ve seen free* video consults with Doctors offered by a range of website owners including some of the biggest corporations in the world and I think this paper could’ve done more to help educate Patients and Carers to this major issue and perhaps even offered suggestions to regulators (like the GMC, advertising standards agency, etc).

It should be made obvious to our Patients that their personal health data is worth more money than a few minutes of a Doctors time and that there are unscrupulous business people who know this and see it as an opportunity to get rich quick. I think it would be very sensible if the RCGP lobbied for legislation to be put in place to force corporations that market “Doctor consults” to not be using that statement as just a marketing headline to masquerade their real business model (which is to profit from the selling on of Patient information that they get from giving away or subsidising Patients so that they have an easy to use inexpensive opportunity to chat with a Doctor).

It’s interesting to note that in countries like the USA you would be sent to jail for involvement in this type of activity (yet it’s still commonplace in the UK).

“How much do I know about the qualifications, background and interests of the doctor who is advising me?”

I think this is an interesting question because it presumes that the best model is the one we have today with office visits where the Patient selects the Doctor. I think it’s becoming increasingly obvious that as we use and share information more productively we should flip this model and have Doctors selecting Patients based on their own particular strengths, personality and experiences.

“Am I able to get a follow up appointment with the same doctor who saw me first time?”

I’m surprised the RCGP isn’t maintaining the line that we have used here at 3GDoctor for the last 10 years that states “the best place to get care is with your Family Doctor”. I don’t think it’s particularly healthy to be encouraging Patients to become dependent on a particular remote Doctor and through the use of modern medical record documentation tools it should be possible for Patients to find continuity with a different remote Doctor or to get follow on support and advice from their Family Doctor.

“Am I confident that I will be able to provide as safe clinical care online as face-to-face? If not, how will the risk be managed?”

I don’t think there will be any Doctors who are going to be able to confidently say they can provide clinical care remotely as safely as they can provide it in an office because there are clearly practical things you can do in an office to ensure the safety of a Patient (obvious things like lock the door and call for assistance) that won’t be possible in a remote setting over a video call, but this should never be a reason to not make it more convenient for Patients to connect with Doctors because the reality is you’re naive if you think alternatives won’t be sought by Patients or that marketeers working for quacks won’t reach these Patients online. In 2018 by making registered Doctors harder to access we’re just making the services of unregulated services more attractive (remember the global sham ‘alternative’ medicine market is already generating sales of $200Billion a year and it’s a lot harder to dispel misinformation than to create it).

“Can I be confident about the identity of the patient I am providing online care for?”

I think we should also provide the capacity for Patients to anonymously obtain the independent impartial advice of a registered Doctor. The BMA offer this to all Doctors in the UK so I wonder why many Doctors don’t think that Patients might also value this same type of anonymity.

We should appreciate that anonymous services can be a great opportunity to start helping Patients who are putting off seeking help because they are too nervous or uncomfortable about a concern to initially share it with their family Doctor.

“Am I confident that the consultation is confidential, for example that no one else is listening in without the patient’s permission?”

I think the much more significant threat comes from the websites offering video consults with Doctors that have business models that are all about selling information and recordings of video consults onto third parties.

“Will there be any changes to my current indemnity costs?”

It absolutely amazes me that Doctors who prescribe medicines to strangers via websites pay the same medical indemnity costs as those who only see registered Patients in their office where they have access to their health record and a familiarity with their family and social background.

With huge year on year increases in costs it’s time more Doctors starting asking their professional medical indemnity provider if they are providing cover for Doctors who are working for these websites with scammy T&Cs and Privacy Policies because if they are you as another member are subsidising their massively increased risk profiles.

“Will I be part of a peer network so that I can seek help or support and avoid any risk of professional isolation?”

A bit of an odd one that as I think the RCGP is incredibly well placed to help with this and is really failing it’s membership on this front eg. wouldn’t it be great if the RCGP offered a community service like Doctors.net.uk for members?

Related Posts:

Can a quick phone call substitute for a doctor visit?

The doctor will see you now: NHS starts outsourcing mobile video consultations

“So, exactly why would one need to video call a doctor vs. just talking to them?”

If Patients see you uncomfortable using a mobile they may doubt how current your medical knowledge is

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E&T: Health apps frequently neglect privacy of users, study finds

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Hilary Lamb at Engineering & Technology reports on a study that has found “Health apps frequently neglect privacy of users”.

mHealth Insights

“A European study has found that half of health apps could be sharing sensitive personal data via insecure connections, and the majority of these apps share health-related data with third-party companies. The study involved a collaboration of researchers from the University of Pireus, Greece, and Rovia I Virgili University, Spain, who are working to develop improved solutions to protect European citizens’ online privacy. The researchers looked at 20 free apps available on Google Play, all of which had been downloaded between 100,000 and 10 million times and had a minimum rating of 3.5/5. They studied how the apps stored and monitored personal data, such as information about past health conditions. Of the apps analysed in the study, 80 per cent shared health-related data to third-party companies, with the other 20 per cent storing data on the users’ phones. This data included text as well as images, such as X-rays”

While I recognise we have a dire situation in which caring Healthcare Professionals are shaking in their shoes for making the decision to share their mobile number with their Patients I find it amazing that people are really surprised by this finding. I wonder how people who think this is the big issue of the day react to discovering that the biggest Cancer Charities in the world are using private investigators to research the families of people who have cancer so that they can then profile them for highly targeted donation strategies based on their personal wealth etc?

The reality is most of these app users will have public Facebook profiles and likes that would probably tell you more about them than you’ll achieve by hacking the citizens mobiles or the websites they’re interacting with. With some resources and considered use of keyword advertising you can probably engage them too (because as we know most Patients are googling their condition/diagnosis).

I also think the research could’ve had a lot more impact had the top line findings included the names of the 20 free apps, the developers and their partners, if there was evidence that they were being recommended by Medics and Patient Associations, how long Patients used these apps for (we know most apps just get downloaded and soon after are deleted), etc.

I can easily point you to 20 free ‘health’ apps on Google Play that fall into their criteria that are just nonsensical and have 3.5* ratings and 100,000 downloads but they’ve got that because they’ve just gaming the app store, making money via scams and users aren’t Patients but are citizens using it for fun/discovery.  Here’s one I found within 5 seconds that meets all the researchers criteria and there are thousands of cookie-cutter similar apps that promise like this one does to give a ‘Doctor Diagnosis’ based on a paint by numbers approach to collecting basic symptoms:

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There is probably also no way that the researchers could identify if these apps weren’t just being used by ‘users’ that weren’t actual people/Patients eg. click farm operations can make lots of money from dumb mobile advertisers if they get the context right (it’s easy to imagine the dumb drug companies and the ‘charities’ they sponsor would be very gullible to spending on these type of ads), etc.

“Only half of these apps shared this data securely, using https connections to manage user login. More than half of the apps transmitted data using URL links: this made the data potentially accessible to anybody who could gain access to those links. 20 per cent of the apps did not refer users to a privacy policy or failed to do so in the language of the app. Some of the health apps required access to camera and microphone, contacts list, external storage, Bluetooth and location, despite their functionality not being dependent on this access”

I think it’s interesting to that only half of the apps shared personal Patient data securely but 80% referred users to a privacy policy. Until the app stores start enforcing standards Privacy Policies are meaningless: no one is reading them and they’re for the most part just providing a smoke cloud of false reassurance for Patients.

I’m a huge fan of Patient Champions and think it would be interesting to see what level of endorsement the apps reviewed by the researchers were getting from Patients (I don’t think that a +3.5 star app store rating is a proxy for this), Medical Professionals and healthcare provider organisations.

Related: NIH funded researchers spend $270 on misleadingly labelled iPhone apps & conclude that apps offered for ‘EDUCATIONAL USE ONLY’ can’t be relied on for ‘PROPER MEDICAL ADVICE’

“According to the study, the majority of the apps did not meet legal requirements or standards intended to protect users from inappropriate data use and disclosure to third parties. “We strongly support the use of mobile health apps, but users must know that apps’ popularity does not ensure privacy and security,” said Professor Agusti Solanas of Rovira I Virgili’s department of computer engineering and mathematics”

I think it’s clear this is like other minimally regulated markets (eg. the $B supplement industry) and I think a better piece of advice would be for Patients to download and use apps that have been recommended to them by their Healthcare Professionals (who have undertaken quality mHealth training from an accredited training body).

“The issue of health data being shared insecurely has been a concern for years. It has been reported that UK doctors frequently use their phones to share personal health data with their colleagues, including sending text and pictures via SMS to request their professional opinion. In 2015, the NHS was forced to remove health apps from its library of accredited apps after they were found to be leaking patients’ medical details online”

Of course Health data shouldn’t be shared insecurely but there are also issues with how health data that is being shared securely is being used and shared that this report doesn’t seem to touch on eg. Patients in the UK’s NHS gave their health data to medics and it was then given free of charge of an advertising company in the USA that we know is making billions in profits from doing things like selling adverts to referral agents that are masquerading as free helplines for addicts etc.

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and this is all before we start thinking what smart connected homes are chattering away about…


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