‘Everything is converging to the Smartphone’ now includes your bed!

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Philippe Kahn (one of the greatest inventors of all time) has been working with the most brilliant team of scientists, mathematicians, AI-gurus and engineers to “improve Ms and Mr Everyone’s sleep performance” and you can buy it now for just $199. No need to buy an expensive smart bed. Completely non-invasive (Philippe practically created the wearable mHealth device market but this is a ‘wearable-free” product) and paired with an intuitive app this is a classic example of how the BornMobile generation would redesign a SleepLab

Just look at the feature set:

  • Powered by AI, the Beautyrest Sleeptracker is the premier and only sleep monitoring device that is Alexa enabled to integrate into your smart home
  • Make your bed a smart bed: the only non-wearable solution that works with your bed regardless of the type of mattress, boxspring or bedding
  • Highly accurate sensors: analyze and monitor respiration and heart rates, and unique sleep behaviors such as body movement and wakefulness
  • Intuitive app: captures precise readings and translates into personalized sleep data; sleep cycle alarm detects the optimal wake time for you
  • Powerful processor: continuously learns your sleep patterns and rhythms, and delivers the most up-to-date information for effective sleep coaching
  • Individualized sleep coaching: the only solution in its class to monitor two sleepers independently and separate their sleep data for individualized reporting and coaching tips

When I read that spec list a voice in my head was shouting WTF?, I hope yours is too.

If The Sleeptracker® lives up to my expectations I’m pretty sure that at 3GDoctor.com we will soon be launching a specialised sleep advice service for Patients who use the technology. If you’re a GP who would like to work with us to help these Patients (in the UK/Ireland only due to registration/Medicolegal insurance requirements) please ‘make your bed a smart bed’ and get some of your Patients using it and get in touch with us because I’m sure we’ll be recruiting now that this is available at this price point (£155/€178 at today’s exchange rate). 

Related: Are we witnessing the end of smartphone innovation?

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Data brokers are trading your Health Information

“I usually buy my groceries at Sainsbury’s but only because it’s on my way home I don’t care for cars or own one I don’t like any form of housework and I have a cleaner who lets herself in while I’m at work on Fridays you’ll find me at the pub after work at home I’m far more likely to be browsing restaurant reviews rather than managing my finances or looking at property prices online I like the idea of living abroad someday I prefer to work as a team than on my own I’m ambitious and it’s important to me that my many thinks I’m doing well I’m rarely swayed by others views this motley set of characteristics attitudes thoughts and desires come very close to defining me as a person it is also a precise and accurate description of what a group of companies I had never heard of personal data trackers had learned about me…

…in 2014 when I became curious about the murky world of data brokers a multi-billion pound industry of companies that collect package and sell detailed profiles of individuals based on their online and offline behaviors… …I discovered that online anonymity is a complete myth. Particulars such as your postcode, your date of birth and your gender can be traded freely and without your permission because they’re not considered personal but pseudonymous in other words they can’t be traced back to you without the need for additional information so why does it matter if a bunch of companies you’ve never heard of know your age or your postcode you may think. Well it matters quite a lot about a decade ago Latanya Sweeney a professor of privacy at Harvard University proved that about 87% of US citizens could be uniquely identified by just three facts about them their zip code their date of birth and their gender in the UK where we have far fewer citizens serviced by much longer postcodes that probability is far higher Professor Sweeney proved this in a rather cheeky way when William Weld a former governor of Cambridge Massachusetts in the US decided to support the commercial release of 135,000 state employee health records along with their families including his own these records did not contain a name or a social security number but did contain hundreds of fields of sensitive medical information including drugs prescribed hospitalizations and procedures performed on these employees. For $20 professor sweeney purchased the voter records for Cambridge Massachusetts containing the names zip codes dates of birth and gender for every voter in the area and then cross-referenced this with their health records and within minutes she had pinpointed governor Welds own health record. Only six people in Cambridge shared his date of birth three of them were men and he was the only one living in his zip code. Professor Sweeney sent the governor his health records in the post…

…it’s not just large companies digging into your life it’s free apps and small startups as well I realized on my phone that every time I logged fitness data into the app Endomondo it was sharing my details including my location and gender with third-party advertisers. WebMD a symptom checker app was sharing even more sensitive information including the symptoms procedures and drugs viewed by users within its app with its third parties. Fitbit was sharing data with Yahoo. A pregnancy tracking app was selling on information about its users ovulation cycles and fertility cycles with people or advertisers…   …in 2015 Samsung was found to be recording people in the homes as they’d been sold TVs with voice recognition systems…

…that sinking feeling of being watched is not unique to me there have been several anecdotal reports of people being shown adverts based on things and conversations they were having in real life prompting concerns that Facebook and Google are eavesdropping on people via their personal devices to piece together what all these companies knew about me I spoke to a data profiler called iota. iota uses cookies to assign me to thousands of different categories including my job how many children I have and whether I’m likely to buy Star Wars memorabilia they don’t know my name but they know more about me than my neighbours do. iota also buys information from third parties such as the credit rating agency Experian which amasses a massive database of 15 different demographic types and 66 lifestyles all based on people’s post codes…

…in 2014 Ross Anderson a professor of privacy and security at Cambridge University found that the NHS had been sharing its hospital’s database which included details of hospitalizations for every citizen in Britain with the Institute and faculty of actuaries a body that was researching how likely people are to develop chronic illnesses at certain ages. Of course this resulted in an increase in health insurance premiums as the amount of data that is collected increases exponentially it becomes much easier to identify you for example your Fitbit measures your heart rate or your gait patterns and these can be used to estimate things like your height your weight or even your gender these are details that are very hard to mimic or change…”

I think this excellent TedxTalk by Madhumita Murgia (European Technology Correspondent at the Financial Times) explains how the BornMobile generation are slowly waking up to how information about them is being traded between tech companies and brands that are pretending to be in the healthCARE business.

It really makes you wonder why Google even needs the NHS to give it the private medical records of millions of Patients and helps you understand why Apple’s CEO thinks the mHealth opportunity isn’t in targeting reimbursement from insurance companies.

I think it’s also a good reminder why inexpensive documented video consults with independent impartial Doctors make sense for Patients. Sure you can have a FREE* Video Consult with a Doctor paid for by a company that makes billions in profit every year selling information about you to other companies, similarly you can have a  FREE* Recorded Telephone Chat with a Doctor paid by a health insurance company that might want to use that information to increase your future premiums or deny you coverage but it’s probably not going to be the brightest idea you ever had and you might want to reconsider who else you’re inappropriately placing your trust in.

I think we’re a few years from a Communities Dominate Brands reset in the market but it will come and it’s increasingly going to be insulting to underestimate Patients interest in the respectful use of their data.

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#TodayAtApple we’re going to be learning about #mHealth

We’ve been close to running the mHealth for Healthcare Professionals course in flagship Apple stores to coincide with major medical conventions but nothing has materialised as until only recently Apple leadership wasn’t talking publicly about it’s enthusiasm for this area. Hopefully the new #TodayAtApple initiative is going to make it much easier for local Apple branches to initiate and organise meetings for Medical and Patient communities. I think it’s obvious there will be queues around the block to get tickets to these as they’ll be really productive meetings.

WTF! and can you imagine the opportunities?

#TodayAtApple we’re going to be learning how to sleep better

#TodayAtApple we’re going to be learning about the mHealth opportunity in Psychiatry

#TodayAtApple we’re going to be learning about Clinical Trials

#TodayAtApple we’re going to be learning about Wearables

#TodayAtApple we’re going to be learning about Innovations in Ophthalmology

#TodayAtApple we’re going to be learning about the mHealth opportunity in Cardiology

#TodayAtApple we’re going to be learning how to better manage your diabetes

#TodayAtApple we’re going to be learning how to be a more effective Medic/Carer

#TodayAtApple we’re going to be learning about Social Media from a Patient

#TodayAtApple we’re going to be learning how to share a medical history with an iPhone

#TodayAtApple we’re going to be learning how to use your mobile as a medical device

#TodayAtApple we’re going to be learning how to use Facetime with your Patients

Search for a Today at Apple meeting near you. As no mHealth themed events are yet listed you might like to check out this comprehensive listing of mHealth events taking place around the world in 2017.

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mHealth Guide to the American Psychiatric Association Annual Meeting #APAAM17

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American Psychiatric Association Annual Meeting 2017

I think one of the best things about using the term ‘mHealth’ to refer to the convergence of Health to Mobile is that it by default prioritises mental health as many medics (particularly those who haven’t yet realised that their mobile phones turn them into cyborgs and give them super powers) would think that you’re talking about mental health if they didn’t know the m was being used to denote Mobile (the newest mass media).

I think it’s obvious that ‘go and get help’ doesn’t make sense to the BornMobile generation when they encounter mental health issues so while it’s great to see so many mHealth events being held all over the world it’s probably even more encouraging to also see major medical associations like the America Psychiatric Association (follow them on Twitter @APAPsychiatric) adding mHealth themed sessions to their annual meetings (help in San Diego for 2017).

Saturday 20th May 2017

Mobile Mental Health Meets Clinical Psychiatry: New Tools for New Models of Care
Time: 1:30 PM – 3:00 PM
Location: Room 29B, Upper Level
Speakers: John Torous MD, CoDirector at Digital Psychiatry Program @ Beth Israel Deaconess Medical Center/Harvard Medical School (Chair), Colin Depp, Steven Chan MD MBA, Digital Health & Behavioral Sciences Research, University of California (UCSF) & Co-founder, Health 2.0 Sac and John Luo MD, Interim CMIO UC Riverside Health, Director of Psychiatric Residency Training, University of California.
About: Technology (EHR, Telepsychiatry, Apps)

Poster Session 2: Medical Student/Resident Poster Competition
Time: 14:00 PM – 16:00 PM .
Location: P2-006, Exhibit Hall A, Ground Level San Diego Convention Center
About: Comparing Child and Adolescent First Mental Health Contacts With a Mobile Crisis Team
Author(s): Rachel H. Olfson, Student, Harvard Medical School

Sunday 21st May 2017

Connecting With Patients in the Life Space: A Pragmatic Approach to Web and Mobile Applications in Clinical Practice and Research
Time: 8:00 AM – 9:30 AM
Location: Room 29B, Upper Level
Speakers: Brian Grady MD, Director TeleMental Health; VISN5 TeleMental Health Lead, University of Maryland School of Medicine (Chair), Julie Kinn, Department of Defense Research Psychologist and Program Director, National Centre for Telehealth & Technology, University of Illinois at ChicagoNaomi Wilson, Clinical Psychologist Institute of Psychotrauma, East London NHS Foundation Trust & the University of Sheffield and Kelly Blasko, Mobile Web Program – Lead Psychologist, National Centre for Telehealth & Technology, The Pennsylvania State University.
About: Technology (EHR, Telepsychiatry, Apps)

Poster Session 3: Medical Student/Resident Poster Competition
Time: 10:00 AM – 12:00 PM .
Location: P3-140, Exhibit Hall A, Ground Level San Diego Convention Center
About: Mental Health and HIPAA in Today’s World of Social Media and Smartphones
Author(s): Amber Mansoor MD

Monday 22nd May 2017

Using Mobile Phone- and Web-Based Technology to Enhance Treatment and Support Recovery
Time: 8:00 AM – 11:00 AM
Location: Room 25C, Upper Level
Speakers: Anita Bechtholt PhD, Program Director at NIAAA, National Institutes of Health (Chair), Kathleen Carroll PhD, Professor of Psychiatry, Yale University School of MedicineDavid Gustafson PhD, Professor, Kansas State UniversityMarsha Bates PhD, Facility Manager and Social Worker Transitional Housing Center, Kathy Jung, PhD and Frederick Muench PhD, Director, Digital Health Interventions & Behavioral Health, Northwell Health.
About: Substance Use Disorders

Poster Session 6: Young Investigators’ New Research Posters 1
Time: 2:00 PM – 4:00 PM .
Location: P6-017, Exhibit Hall A, Ground Level San Diego Convention Center
About: The Relationship of Smartphone Addiction With Impulsivity Among Korean Smartphone Users: Vulnerability to Smartphone Addiction in Adolescents
Author(s): Hyun-sic Jo

Poster Session 6: Young Investigators’ New Research Posters 1
Time: 2:00 PM – 4:00 PM .
Location: P6-029, Exhibit Hall A, Ground Level San Diego Convention Center
About: Mobile Device Applications for Autism Spectrum Disorder: A Review of Current Evidence
Author(s): Jung W. Kim MD

 

Note: Sadly the APA has really outdated views on social media and although there’s a hashtag it’ll probably be just dominated by sales & marketing adverts as they’ve banned the taking of any images/video.

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What can GPs do about health needs that Patients don’t talk about & for which they haven’t had training?

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This interesting article by Dr Mark Griffiths (Professor of Behavioural Addiction, International Gaming Research Unit at Nottingham Trent University) highlights the challenge of getting GPs to see gambling problems as a primary reason for referral and a valid treatment option and reports that “very few GPs could probably treat a problem gambler”.

mHealth Insight

We’re living in a time where the family Doctor relationship is becoming a rarity (and while there is ‘trust’ a GP is still a stranger that only offers office visits) but it continues to amaze me that so many experts think the opportunity in the world of General Practice is just about having GPs ask more questions of their Patients and having GPs do more in-depth training on specific topics. I think the conclusions being reached by this subject expert in this post are particularly revealing because it’s clearly identified that:

  1. Patients can and will reveal information about their gambling problem if they are asked to by a survey in a waiting room.
  2. Most GPs aren’t screening for gambling problems.
  3. Most GPs couldn’t properly treat a problem gambler even if the Patient reported gambling as their reason for making the appointment.

Instead of having busy GPs blaming Patients for wasting their time or doing more to take GPs away from their Patients to do more specialist training or in projects that will increase Patient anxiety levels it’s time to flip the model:

  1. Wherever possible let Patients give their own history, answer all the questions that we’d like them asked in their own time in a place they feel most comfortable and enable this to be done using their mobile phone.
  2. Let senior Doctors triage the Patients
  3. Refer Patients directly to the Doctors who we know have the skill sets and experience to best help them with their needs (in this case a Patient who revealed gambling problems might get an appointment with a GP or Counsellor who has specific training in this field and perhaps even direct experience of a gambling problem).

Perhaps once this is all in place the NHS can then focus more on what it’s doing with the information Patients are sharing with their Doctor because at the moment their sterling efforts to share it with law enforcement agencies and powerful US advertising companies is completely undermining the trust Patients have.

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Are the world’s biggest Pharmacy Retailers about to be Amazonised?

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“Amazon is hiring a business lead to figure out how the company can break into the multibillion-dollar pharmacy market”.

I hope readers of this blog are applying for this job as disrupting this industry is going to be a walk in the park. To give you an idea of how easy consider this the boss of Europe’s largest Pharmacy Retailer recently told Chemist & Druggist that Amazon has no hope yet he has already installed a recording device belonging to Amazon in the boardroom of his HQ office!

While I can see challenges for Amazon I think having them competing in this market will be great for mHealth innovation because without the bricks and mortar business model and reliance on existing healthcare system revenue streams Amazon will be able to get on with the innovations that Patients and Carers are crying out for eg. can you imagine the expensive education the lawyers at Amazon would have given the civil servants at the HSE?

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

discussion relating to use of iphone book and pc by junior doctor

I had an interesting point put to me last night on Twitter from Dr Kunal Kulkarni that I think will be helpful for the mHealth training course that I provide to medics.

The original tweet posted was from 10 days ago when watching an interesting Channel4 TV programme called ‘Confessions of a Junior Doctor’ that showed a busy junior Doctor who had been working long hours under pressure and turned to a printed copy of the BNF,  a Hospital windows PC and his iPhone 6 Plus while he hurried to prescribe a steroid to a child in his care.

mHealth Insight

I think the discussion thread provides a good insight into the challenges that engaging on social media sites like Twitter can present to practicing Doctors. Even though Dr Kulkarni isn’t following the GMC’s advice to the letter (eg. he doesn’t list his own GMC registration number on his Twitter profile) he asks me to confirm that I am a practicing clinician after accusing me of accusing a Junior Doctor of bad practice (“If a member of the public reads your statement at face value, it suggests what the doctor is doing is bad practice. That’s not the case”).

I think this Twitter conversation might be useful in training medics on the challenges of social media as it shows how easy it is to discourage medics from making the effort to be helpful and share their thoughts eg. if I was a GMC registered Doctor there is enough confusion expressed by Dr Kulkarni in this thread for anyone to start a medical council disciplinary investigation against me for starting it.

For the record I think what I saw there in that program was to my mind worse than bad practice it’s CONVENTIONAL practice in an administrivia laden NHS and it’s why we have Junior Doctors leaving the Profession (and the Patients who really need them) and suffering from burn out whenever they try to tolerate it. There’s nothing inherently unsafe about using a brand new printed prescribing text book but clearly you as a Doctor don’t get to decide if that’s what’s on the ward when you arrive for your shift. The NHS has for very good reasons made this available free of charge to all staff because the benefits of always having such an important ‘essential’ reference document is obvious. It also saves them a heap of money if medics help them do away with the need to print and distribute new books and collect/recycle old books across all of the NHS’s buildings/wards every few months.

It clearly takes Mobile First thinking but I’m confident that in 2017 you shouldn’t be allowed to practice medicine without a smartphone loaded with high quality up to date content because clearly access to this information on a device you are familiar with using is critical to being able to do your work safely and to the best of your ability.

I think the thread also highlights the urgent training need there is because so many even young Doctors (yes even those who already use Twitter and have experience working for a ‘management consultancy firm’ that specialises in IT) have become wedded to the paper based processes that they have been trained to use.

The aviation industry has shown us it’s not sufficient to blame mistakes and deaths on fatigue when there are processes in place that haven’t been thoughtfully designed. All Doctors but especially Junior Doctors deserve better working conditions and their training and examinations urgently need to be modernised to ensure that they are capable of working with the tools of our time because it’s safer to be using a quality smartphone (perhaps with a mophie power pack if you need to work long shifts away from a power outlet?) than hoping the hospital ward you are working in has a poster on the wall or a printed book that hasn’t been thrown away/misplaced/recently updated or even (as we’re seeing since Friday following what’s being labeled as the ‘NHS cyber hack’) a PC that has been patched for known security issues and is working/available.

Get in touch if you face these challenges in your Medical School, Hospital or Clinic and would like us to run the accredited mHealth course we developed because such an investment in your staff can help ensure you don’t fall victim to easily avoidable malware attacks and your Patients will benefit from being cared for by Professionals who are confident using the incredibly powerful supercomputers that they already carry in their pockets.

Click here to download a copy of the BNF’s essential reference book app for your smartphone.

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Related Posts:

If you attend a Medical School that still doesn’t give you mHealth tools the data now shows that they are failing you (Feb, 2013)

Has your Hospital replaced error prone paper based Observation Systems with mHealth Apps? (Oct 2014)

Why do we blame Pharmacist Fatigue when fatal errors are originating from poor design & outdated tools? (Dec, 2016)

UPDATE 13:00HRs 16 May 2017

I tweeted a link to this post and Dr Kunal Kulkarni came back to say I was just “scaremongering to sell IT” and that how he or colleagues use their mobiles “has absolutely NO link” to his clinical acumen.

I think this is very interesting because I’ve only encountered it once before when training medics and it was a point of view held by another newly qualified Doctor. More senior Doctors absolutely love the energy that mHealth adds to a consultation (eg. a Paediatric Cardiac Electrophysiologist who pulls out an Alivecor in an outpatient consult, or an orthopaedic consultant who launches the 3D4Medical app and shows their Patient exactly what they’re talking about before adding their anoted images to their Patients records, etc.) but the young Doctors have got to be really skilled in their use of mobile technology and how they communicate what they are doing because otherwise some Patients/Carers may think they just don’t know what they’re doing:

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I think it’s clear twitter isn’t working for this debate (and find it very odd that a Junior Doctor in 2017 is claiming that they don’t benefit from the superpowers a smartphone gives them especially when many NHS facilities have had to close today or have cancelled appointments because of malware that would’ve been easily avoided if staff had been using smartphones or even just had been trained to properly use the old IT the NHS prescribes them) so I offered him an invitation to join me on a mHealthTV hangout and hope he takes me up on the offer (I’ll then update this post with that video discussion and readers can make their own mind up):

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Margaret McCartney: The NHS needs big, firm IT pants

UPDATE: 27 May 2017

Medics in the NHS are so obsessed with the value of printed drug reference books that they think it’s charitable to ship their old (dirty) copies to the BNF to colleagues working in lower income regions of the world. Why not just send them your old mobiles or use the money wasted on shipping heavy books to pay for inexpensive SD cards (that could be loaded up with the LATEST content) and send them out there in an envelope?

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