Smartphones will soon be diagnosing illness as well as advising on cures. Will we all become iPho-chondriacs?

Lena Bryce’s mobile phone got her pregnant. Dan Woolley’s kept him alive for days under a collapsed building. Fran Neri’s saved her from a life-threatening infection. A fast-growing array of downloadable applications for smartphones is turning the mobile phone into a doctor in your pocket, on constant call to diagnose ills and propose cures. Soon mobile apps could even provide lifesaving home treatment for millions. That’s the upside. Experts warn, though, that apps may turn us into a neurotic nation of phone-hugging iPho-chondriacs.

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After an onsite workflow analysis, Voalté worked with Huntington Hospital and Emergin to design an implementation plan to facilitate more effective communication among nurses and other caregivers. The initial implementation phase focused on replacing the pager with the iPod Touch which was then integrated to Philips monitoring through an Emergin Patient Monitoring Gateway.

The Emergin/Voalté solution then enabled “quick messaging” on the iPod Touch to facilitate real-time communication between caregivers. “The text messaging feature enables me to better prioritize my tasks and communicate more efficiently with my coworkers,” added Lee.

The results from implementation of the Emergin/Voalté solution at Huntington Hospital show a dramatic reduction in the number of phone calls made per shift and improved Press Ganey scores for the unit in the two categories, “noise in and around the room” and “response time to call bell.”

The Emergin, Inc The Voalte, Inc

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Voalté (nomenclature derived from Voice, Alarm, Text) consolidates all three functions on the versatile iPhone platform. The application enables users to send and receive text messages, make voice calls, and receive critical care alarms on the iPhone, providing faster response to patient needs.

“Our nurses were carrying hospital provided pagers, wireless phones, separate pagers designed to alert them of critical patient alarms….there were too many bells and beeps requiring attention, not to mention their pockets were literally overflowing with electronic devices,” said Ron Rutherford RN, Huntington’s director of informatics.

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Voalté successfully integrated an interesting innovative iPhone-based clinical communications project in Sarasota Memorial Hospital in September 2009(link).

After 3 months, when it has become already possible to speak about real results of the project, we decided to address the Vice President of Innovation of Voalté, Trey Lauderdale, and ask him several questions. We believe that the answers on these items are interesting for professionals of the branch.

Q:  So, Trey, if it’s not difficult, let’s start with a couple of words about your company.
No problem.
Voalté helps improve hospital mobile point-of-care communication by providing a complete solution for voice, alarms and text messaging on a robust expandable platform – the Apple iPhone. We were started in Fall 2008 in Sarasota, Florida.

Q: Great! Now I would like to ask several questions directly about the introduced software solution. How can you characterize the results after two months of program integration in Sarasota Memorial Hospital?
The pilot of Voalté One has been an amazing success at Sarasota Memorial Hospital. I truly feel we were able to strike a win-win relationship with the organization and we were lucky to have such a great hospital in our backyard. We were able to learn an unbelievable amount from their caregivers and it has greatly helped to improve the functionality we are able to offer as a company to our end-users. It was also a win for SMH in that they were able to help shape the future of point-of-care communication on the iPhone and were able to leverage the advanced communication functionality we could offer to them with this innovative platform.

Q: Could you, please, mention the most interesting responses from the patients and the clinic staff as the main users?
One of the most interesting comments we received came from two separate patients the day of go-live at the pilot unit. Almost immediately we were able to drastically reduce overhead paging in the hospital. There were two different patients who had been in the nursing unit a few days, and separately, they both asked their nurses if everything was OK in the unit. The nurses said yes, and asked why. Both patients said they noticed the unit was so much quieter than the day before and wanted to make sure everything was alright.
Keeping the nursing floors quiet is unbelievably important to nurse management because it helps patients sleep and rest better which leads to better patient outcomes. We were thrilled to hear our solution was able to effect noise in and around the room the day of Go-live.

Q: it would be interesting for our readers to learn about the basic parameters of solution integration(integration terms; the budget, counted for the one user; requirements to the staff; whether it is necessary to carry out training etc.)
We provide a turn key solution to the hospital to get iPhone’s in at the point-of-care. Hospitals don’t want (and really don’t have the time) to purchase piece-meal solutions that aren’t made to fit their workflow.
We provide the hardware, installation, integration to hospital’s PBX, integration to middleware, training to users, and go-live support to make sure the project is a success.

Q: If it’s not a commercial secret, are you going to integrate similar solutions in the USA and other countries? What level of interest in similar systems, including the interest of the state structures, is there now?
Our goal is to continue growing our market share in the U.S. acute care hospital setting. As we see new opportunities develop for our software, we will investigate them accordingly. Right now, we feel the greatest return on investment for our solution is at the point-of-care.

Q: As for you, which of mobile platforms, along with iPhone, have prospects for the mass use in clinics? Why?
The iPhone and RIM BlackBerry seem to be the two devices gaining the most traction in healthcare. RIM still has a strong presence due to it’s support by IT staffs and technical teams. Without a doubt, the iPhone is still the hot item right now, and the App store has helped make it even hotter. Apple claims more than 700 medical apps which is unbelievable- just think of the number of apps that will be out in a few years. The raw number of applications and the number of developers storming to the iPhone was a deciding factor in why Voalté selected to develop on the iPhone first.
One other platform worthy of mention is the Google Android. With the launch of the 2.0 firmware Google has started to get minimal attention in healthcare. The openness of Android platform allows developers to access a number of API’s they would not be able to get to on an iPhone. The result (in theory) should lead to deeper app’s available only on the Android. Only time will tell if developers fully embrace the Android in healthcare as much as they have the iPhone.

Q: It would be interesting to learn from your words what is the venture investors’ estimation of the start-up investments perspective in the mHealth sphere? What ideas for investment in the mHealth sphere will be the most popular during next 2-3 years?
mHealth, as in all new industries, will take a few years to gel before the market leaders begin to take form. We have big players entering the field (Cisco, GE, Philips, etc). I think it is great that they are getting involved so early, but I really think it is the smaller start-ups that will drive the greatest innovation and out-of-the-box ideas.
I think ideas that enable the automatic entering of person health data onto mobile devices and the web (PHR) will be the technologies that have the most success. Unfortunately, the average consumer is not going to take a proactive role in entering their health data into the cloud. I think the companies that find the easiest, most non-intrusive way to get data from the patient to the PHR are going to be the most successful and have the greatest effect on the market.

Q: When mHealth will become popular and start to bring profit on the mass market? What is necessary for this purpose?
That’s a tough question. I think there will be one vendor that finds a way to make this profitable, and the floodgate swill then open. As for time frame, I would say early 2011 to mid 2011 is when the mass market will begin seeing profit.

Trey, Thanks for wonderful interview!
I believe your answers will allow estimating at true worth the mHealth sphere and we’ll see even more interesting and useful decisions on the market soon!

Editor
Vitaliy Goncharuk

The iPhone Medical Apps is a project of The VIactivity LLC

(medical SEO, software development for iPhone and Android, production)

Earlier this year, Mike Dionne signed up for Polka, a smart-phone application that lets him use his iPhone to keep tabs on the health of his elderly father, who lives 80 miles away. It tracks his dad’s numerous doctors’ appointments, his insulin and medication schedule and other health information.

Then in August, a new doctor examining Mr. Dionne’s father detected an aneurysm, something the son was able to confirm from afar. Over the phone, Mr. Dionne consulted Polka, the application he and his siblings maintain on behalf of their father, and was able to tell the doctor when the aneurysm …

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“Wireless Health: Year End Report 2009″ from MobiHealthNews.com.

FDA may regulate smartphone apps. LifeComm closes. Best Buy stocks connected health devices. Apple invites LifeScan on-stage. The West Wireless Health Institute is founded. CardioNet’s reimbursement rate cut. Consumers want wireless health. Three-quarters of Americans are interested.

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The Droid’s Sensors Blogclick to enter

Apple recently profiled Memorial Hermann Healthcare System in Houston, Texas, which has outfitted some of its 19,500 employees across 11 hospitals with iPhones.

Based in Houston, TX, the fourth-largest city in the U.S., Memorial Hermann serves a metro area of more than five million people, providing everything from air ambulance services to a chemical dependency treatment center.

“Health care is a very real-time business,” says David Bradshaw, Chief Information, Planning, and Marketing Officer at Memorial Hermann Healthcare System. “We need anywhere, anytime computing, and iPhone is the best platform for the applications we’re choosing.”

Secure Access to Medical Data

With its built-in support for Microsoft Exchange ActiveSync, iPhone fits in flawlessly with Memorial Hermann’s existing infrastructure. “For me, that tight integration with Microsoft Exchange is very important,” says Dr. Robert Murphy, Memorial Hermann’s Chief Medical Informatics Officer.

“It’s as if you had the Outlook client on your iPhone,” Bradshaw agrees. “Accepting meetings, looking at email and attachments, downloading spreadsheets. It’s seamlessly integrated into our Exchange network.”

iPhone security features such as remote wipe and passcode protection keep patient information confidential while remaining transparent to users. “The security technology is absolutely not in question,” Dr. Murphy says. “Our security team has looked at the iPhone, and it not only meets the standards, it exceeds the standards.”
Physicians Gain Efficiency

The simple iPhone interface and Multi-Touch technology let busy doctors get up to speed quickly. “The phone itself is very intuitive — you don’t need an instruction manual,” says obstetrician/gynecologist Dr. Marco Giannotti.

And with hundreds of medical apps available, iPhone becomes an instant pocket reference for everything from anatomical charts to diagnostic tools, allowing clinicians the freedom to create their own application workflows.

iPhone gives doctors “the right information at the right moment,” adds Dr. Murphy. “Having that information available right at the point of care, you feel more confident in your decision-making.”

Medical Apps Deliver

The iPhone advantage is highlighted by apps like AirStrip OB, which enables obstetricians to monitor different stages of labor even when they’re not by a patient’s side. Developed by AirStrip Technologies, AirStrip OB links individual mobile devices to a central AirStrip server with HIPAA-compliant authentication, giving obstetricians remote access to live views of delivery room data — including fetal heart tracings, contraction patterns, vital statistics and nursing notes.

“AirStrip OB is an absolutely indispensable app on iPhone,” Dr. Giannotti says. “It fundamentally changes the way I’m able to interact with labor and delivery. In a tenth of the time, without pulling a nurse away from what she’s doing, I get all the real-time data I need at the touch of a button.”

The option of viewing heart tracings in landscape mode distinguishes iPhone from other devices, and makes AirStrip OB an even better tool for obstetricians. “It’s just off the chart how doctors who have iPhones are using AirStrip OB, compared to those who don’t,” Bradshaw observes.

Better Care via iPhone

With secure remote access to clinical data, must-have medical apps, and an interface that makes it easy to view and interpret key information, iPhone is clearly helping to improve health care at Memorial Hermann.

“There’s no question that iPhone is making a difference in how patients are cared for,” Bradshaw says. “Especially the ability to keep clinicians in constant contact with patients and the actual care setting. It’s all about them delivering on why they went to school and became a doctor or a nurse. iPhone simply helps us deliver patient care in a more efficient, productive manner.”

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Those are the basic FDA requirements that apply to bringing an app or other piece of software to market in the mhealth field. Undoubtedly, to those not accustomed to the FDA regulated world, those hurdles might seem high. In the next article, we’ll tackle the benefits and burdens of going through those admittedly rigorous FDA requirements from a business standpoint. In particular we’ll focus on the competitive advantages that can be derived from entering the regulated space, weighed against the cost of achieving those advantages.

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