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Medical Apps

Cardiovascular Medicine, In the News, Medical Apps, Research, Stanford News, Technology

MyHeart Counts app debuts with a splash

MyHeart Counts app debuts with a splash

At Stanford Medicine, we’ve been anticipating the debut of MyHeart Counts, an iPhone app and cardiovascular research study, for some time. The researchers told us it had the potential to be the largest study of measured physical activity and heart health, and we were pretty darn excited. And we were also pleased to see the buzz surrounding Apple’s Monday morning announcement of ResearchKit, the app’s open source software host. Both MyHeart Counts and ResearchKit have been warmly received by both the tech and medical community and, just days after its release, the number of MyHeart Counts users is already in the tens of thousands.

We’re talking about data in medical research that’s never been encountered before

“Following the news, many researchers who spoke to The Huffington Post could barely contain how thrilled they were about the new iPhone feature, calling it ‘revolutionary,’ ‘groundbreaking’ and a ‘new dawn’ when it comes to scientific research,”  wrote on Tuesday. She went on to outline seven ways ResearchKit could change research for the better, and she quoted Stanford’s Alan Yeung, MD, an app architect and medical director of the Stanford Cardiovascular Health:

In most medical studies, 10,000 is a large number, but if we can really hit our mark and have a million people download it, you can do much larger population studies than anything that has been done in the past. So even though we might be slightly restricted in the beginning, we have plans to reach everybody in the world if possible.

This amount of data has never been available before, and if we multiply it by a million, let’s say, we’re talking about data in medical research that’s never been encountered before.

Enrolling 10,000 people in a medical study would normally take a year and the collaboration of at least 50 medical centers, Yeung told Bloomberg. “That’s the power of the phone.”

He said he also believes the app will make it less likely for participants to enter false reports because the device itself will keep track of their exercise. Researchers also plan to test how best to help people modify their behavior.

And the app isn’t just for avid techies or exercise enthusiasts. Physician-blogger Mike Sevilla, MD, wrote earlier this week that ResearchKit has the potential to improve medical care. “Imagine the synergy that will be created with the right app technology, engaged patients and interactive medical teams. Just mind blowing… The potential here is limitless.”

Strong words for a strong app. Check it out for yourself (there’s more info in the video above), because, yes, your heart counts.

Previously: Stanford launches iPhone app to study heart health, Even moderate exercise appears to provide heart-health benefits to middle-aged women and What needs to happen for wearable devices to improve people’s health?
Image by Ken

In the News, Medical Apps, Technology

Tips for women-entrepreneurs entering the medical technology field

Tips for women-entrepreneurs entering the medical technology field

In an article recently published in MedCity News, Kathryn Stecco, MD, a medical device entrepreneur who completed her residency in general surgery at Stanford, offers tips for women spearheading entrepreneurial endeavors in the medical technology industry. The piece is timely, as some have dubbed 2015 the “year of the technologically engaged patient.”

As Stecco writes, women with a medical background and an interest in technology have lots of opportunities, from working at small start-ups or large corporations to becoming a chief medical officer or finding a niche in law or finance. And, of course, they can start their own company. Unfortunately, though, few choose the latter option: Stecco notes in the piece that only three percent of technology companies are started by women.

To encourage more women to take the entrepreneurial leap, Stecco’s fundamental advice is to start with a big idea that fills a real unmet need. Beyond that, she suggests:

  1. Pursue a practical solution:  Focus on products that are safe, effective and easy to use for both physician and patient. If the product doesn’t make physicians’ lives easier, they won’t use it. The product must produce meaningful clinical data that speaks for itself.
  2. Build relationships – early – with clinicians: Medical entrepreneurs must be out in the field developing ties with physicians and getting their input early in the design process. No matter how well designed your product or how impressive your patents, physicians will have the last word on the usefulness of your product. They are vital to your success.
  3. Be prepared to shift gears:  Don’t fall into the trap of becoming so enamored of an idea or a product that you lose sight of its real likelihood of succeeding in the marketplace. You must have the flexibility to move on to something else when changes in the environment cause the ground to shift under your feet and your plans to be upended.
  4. Enjoy the ride!  Successful entrepreneurs make adversity the energy that fuels their creativity. They don’t learn their most valuable lessons in the classroom but in the trenches. They thrive on the long hours, the unpredictability, the rush that comes from building something important and valuable.

Previously: An online film festival for medtech inventors, Stanford alumni aim to redesign the breast pump and Medical technology entrepreneurs discuss challenges facing start-ups at Stanford event
Photo by jfcherry

Behavioral Science, Health and Fitness, Medical Apps, Public Health, Technology

What needs to happen for wearable devices to improve people’s health?

What needs to happen for wearable devices to improve people's health?

15353072639_f3a79557df_z“Wearable devices” are pieces of technology that are worn in clothes or accessories, and they often have biometric functionality – they can measure and record heart rates, steps taken, temperature, or sleep habits. Numerous tech companies have begun manufacturing and marketing such devices, which are part of a larger movement often referred to as the “quantified self” – where data about one’s life is meticulously gathered and recorded. Only 1% to 2% of Americans have used a wearable device, but annual sales are projected to increase to more than $50 billion by 2018.

Health and fitness apps are also proliferating, from software that maps where you run or provides a digital workout community, to programs that count calories or suggest how to improve your sleep. But what’s the real impact for people’s health?

Earlier this month, a report from the Journal of the American Medical Association called into question the idea that wearable devices will effect population-scale changes in health. There is a big gap, the authors claim, between recording health information and changing health behavior, and little evidence suggests that this gap is being bridged. Wearable devices might be seen as facilitating change, but not driving it. Mitesh Patel, MD, MBA, from University of Pennsylvania, and colleagues wrote:

Ultimately, it is the engagement strategies—the combinations of individual encouragement, social competition and collaboration, and effective feedback loops—that connect with human behavior.

The difficulty of population health is that changes have to be sustained to have meaningful effects, and that is quite difficult. The authors identify four steps that must be taken to bridge this gap towards sustained change.

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Cancer, Medical Apps, Stanford News, Technology

Using a smartphone and the Folding@home app to advance disease research

Using a smartphone and the Folding@home app to advance disease research


Smartphones now have the power that personal computers had a few years ago, and more and more people have them. So researchers are developing ways to harness that computing power to solve pressing biomedical problems.

As described in a Stanford News piece, Stanford’s Vijay Pande, PhD, in partnership with Sony, recently developed a smartphone app that “folds” proteins while the phone’s owner sleeps. “There are a ton of people with really powerful phones, and if we can use them efficiently, it sets the stage for something really great,” said Pande, a Stanford chemistry professor.

This particular mobile app, called Folding@home, investigates the biology of diseases, including cancer, Alzheimer’s, and Parkinson’s disease. It’s an extension of the Folding@home distributed computing project started in 2007, and it’s now available on GooglePlay.

Disease biology is dependent on proteins, which are complex linear chains of molecules that become “folded up”, like snarled balls of yarn. The chain needs to be absolutely correct; any mutation that shifts a few molecules out of place will cause the protein to not work optimally, not work at all, or, worse, work in a way that does damage to the organism.

Understanding protein configurations is key to developing cures for disease. While real proteins take milliseconds to curl up, simulating this process with computers takes thousands of hours. But if 10,000 people download and use the Folding@home app, and it runs 8 hours a day while the phone is not otherwise in use, the team’s first research question could be solved in three months.

The app’s first focus is a kinase protein found in breast cancer. It seems that different people’s tumors respond differently to the several drugs available; currently, doctors use a guess-and-check method to choose a drug, but information derived from the proteins could enable doctors to choose correctly on the first try. In something as time-sensitive as cancer, this could save lives.

Next up for the app is a project related to Alzheimer’s disease. Eventually, if enough people enroll, the researchers could launch several projects simultaneously, allowing people to choose to take part in one that is personally meaningful.

Image of a protein Argonne National Laboratory

Events, Medical Apps, Medicine X, Stanford News, Technology

Countdown to Medicine X: Specially designed apps to enhance attendees’ conference experience

Countdown to Medicine X: Specially designed apps to enhance attendees’ conference experience

Figure 3 - BlanketLast year’s Stanford Medicine X conference explored ways in which technology could be used to augment the attendees’ experiences. During breaks between sessions, organizers used specially developed software to transform television screens set up in the lobby outside the main auditorium into interactive spaces where participants could exchange ideas. On one screen, attendees used their mobile phones to text their reflections on previous sessions or respond to prompts such as: “What’s your dream for health care?” The texts appeared as yellow sticky notes on a virtual corkboard. Another screen served as a digital journal where participants could text comments about what they learned and have them displayed to a wider audience. As people walked up to the screen to read the contextually relevant content, they naturally started conversations. In an effort to bridge the divide between the people who were physically present at the conference and those who were watching the live-stream from other locations, an additional screen broadcast tweets from around the world in real time.

This year, conference organizers have developed three iPhone apps for Medicine X based on Apple iBeacon, a Bluetooth-powered location system. “When we heard about the iBeacon technology, it was clear that it would fit really well into a conference setting as well as being useful for allowing people to interact with the large-screen displays,” said Michael Fischer, a PhD student in computer science in the MobiSocial Lab at Stanford, who helped develop the app. “We brainstormed all the possible ways that the iBeacon technology could help people participate in the conference and came up with some ideas that we are excited to test out at the upcoming conference.”

In anticipation of this year’s conference, I reached out to Fischer to learn more about how the apps will further enhance attendees’ experience at Medicine X. Below he explains how they will facilitate networking among participants, allow them to provide feedback or rate speakers and serve as a sort of “flight-attendant call button.”

Can you briefly explain how the apps work?

One app allows us to extend the Wellness Room, so that people can request items without having to go to the room and miss part of a session. The Wellness Room provides special amenities, such as warm blankets or a place to rest, to assist patients in managing their conditions during the conference. The room was designed to help patients physically attend the conference who might have otherwise not been able to. For example, a previous ePatient attendee had a medical condition called cryoglobulinemia, which causes proteins known as cryoglobulins to thicken if the ambient temperature drops too low. If this were to occur, it could lead to kidney failure and would be life threatening. So it’s crucial for this patient to keep warm. Using the iBeacon technology we were able to develop a system that allows people to use an iPhone to request a blanket or other item be delivered to their seat. There will be iBeacons on all the tables in the room so that the phone will automatically know where you are sitting. All the requests will be forwarded to a volunteer who will bring the item directly to the table.

Another app will be used during the breaks to help people get to know each other. The application works by displaying short bios on a nearby TV screen. In this way, the screen acts as a type of watering hole that people can gather around. When new people approach, their bios will be added to the screen. When a person leaves the proximity of the screen, the bio will be removed. We’ll have multiple screens set up around the conference. Our hope is that people can find a group that they might not yet be familiar with. The service is opt-in and people can switch to and from stealth mode at any time. Conference-goers will also have the option to forgo this app altogether.

Lastly, we have developed a feature that will be used at check-in. We want to create an experience that will surprise and delight people from the moment they step into the conference. There is a tradition at Stanford during freshman year that when you first come to your dorm, the dorm staff yells out your name. It is pretty big surprise and makes you feel part of the community instantly. We wanted to replicate that experience as best we could for the conference.

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Medical Apps, Stanford News, Technology

A Stanford physician shares his experiences creating evidence-based medical apps

iPad_080814A piece published earlier this week on iMedicalApps spotlights the work of Steven Lin, MD, a clinical instructor in family medicine at Stanford who is the co-creator of two evidence-based medical apps. The first app he helped develop was Ilithyia, a point-of-care clinic prenatal app, and the second is L’Allegro, which helps physicians select the appropriate antidepressant for patients. From the piece:

Dr. Lin first thought about creating an app as an intern when he noted the large gap between what he had learned in medical school and what was happening in practice. He had knowledge but it was often difficult translating that knowledge into point of care practice. He first concentrated on prenatal visits as he wanted to find the evidence base for current practice and make that available to himself as well as his fellow interns.

He started with researching guidelines, community standard of care, and even insurance allowances for visits and labs. He then took this information and made a framework of sorts. Each visit had allotted information- labs, guidance, findings, etc, and this framework became the basis for how he organized his app.

Lin and partner, a programmer who was finishing his final year of high school when they started working together, plan to “work with the Society for Teachers in Family Medicine and plans to create a mobile version of their study cases” for third app.

Previously: Heart bypass or angioplasty? There’s an app for that, A conversation about smart-device use among resident physicians and Stanford AIM Lab launches patient exam iPad app
Photo by Stanford EdTech

Medical Apps, Sleep, Technology

Can sleep trackers help you get a better night's rest?

Can sleep trackers help you get a better night's rest?

As the number of self-tracking gadgets grows, many people are beginning to experiment with monitoring lifestyle habits in an effort to improve their health. In fact, seven in ten American adults say they track at least one health indicator, according to data from the Pew Research Center’s Internet & American Life Project. But there has been some concern about the accuracy of such technology.

A recent CBS News segment took a closer look at the effectiveness of sleep trackers and outlined the differences in information collected by the devices and data collected by sleep specialists in a clinical setting. Stanford sleep expert Michelle Primeau, MD, also commented, “The reason why these devices are so good is [using them] puts greater emphasis on sleep.”

Previously: Why sleeping in on the weekends may not be beneficial to your health, The high price of interrupted sleep on your health, Exploring the benefit of sleep apps and Designing the next generation of sleep devices

Medical Apps, Mental Health

Smartphone app detects changes in mental health patients’ behavioral patterns in real time

texting_070214In an effort to improve diagnosis, treatment and monitoring for mental health patients, researchers have developed a smartphone application that detects changes in patients’ behavioral patterns and transmits them to medical professionals in real time. PsychCentral reports on researchers’ findings showing the app can provide useful insights to health-care providers about patients’ daily activity and mood:

Researchers conducted two clinical trials in which the application was installed on the smartphones of 20 patients suffering from bipolar, unipolar/depressive, or schizoaffective disorders, as well as on the phones of 20 healthy participants.

Over the course of six months, the app acquired data from patients’ phones and sent the information to distant computers, where advanced algorithms analyzed the data to detect changes in patients’ sleep, communication, mobility, and vocal patterns.

The researchers further developed a visualization system that displayed the summarized information to psychiatrists, providing them with instant insight into the behavioral trends of their patients.

Psychiatrists in the trials reported that the system has already positively affected their interaction with patients, offering a useful objective “window” into the patient’s daily routine.

Patients have full control over who is allowed to access the app and information it collects. The system does not acquire or record the content of calls or texts and any identifying parameters of the patient or of his contacts are irreversibly masked and are obviously not used, according to a release.

Photo by jDevaun

Medical Apps, Public Health, Technology

Physicians discuss willingness to write prescriptions for health apps

health_appsThe mobile health market is rapidly growing, and it’s estimated that within five years 50 percent of mobile device users will have downloaded mobile health apps. While past surveys have shown that patients are eager for doctors to recommend such apps, it remains unclear if physicians feel comfortable prescribing them.

Over on MedPage Today, writer Kristina Fiore explores the potential of physicians prescribing health apps, such as BlueStar, which is approved by the U.S. Food and Drug Administration and helps patients monitor diabetes. Several of the clinicians contacted for the story said they are open to the idea, assuming that patients are comfortable using the app and that data shows the app to be effective. From the article:

Sue Kirkman, MD, of the University of North Carolina at Chapel Hill, said a prescription app could be helpful, but its usefulness may be limited in that the patients “who want the app and are willing to enter data and respond to prompts may already be the more proactive ones.”

Kirkman added that she hopes potential insurer reimbursement for apps opens the door wider to support of reimbursement for self-management tools such as contact with diabetes educators.

“Right now, pretty much only face-to-face visits are covered, not the ongoing contacts by phone, fax, email, etc., that are really needed to help someone sustain behavior changes and self-manage their diabetes optimally,” she said.

Previously: Text message reminders shown effective in boosting flu shot rates among pregnant women, Texts may help people with diabetes manage care, Why physicians should consider patients’ privacy before recommending health, fitness apps and Designing a mobile app to help patients and doctors identify personalized food triggers
Photo by Intel Free Press

Cancer, Media, Medical Apps, Technology, Videos

Weekend viewing: A roundup of TED talks on health, fitness and happiness

Weekend viewing: A roundup of TED talks on health, fitness and happiness

In case you haven’t seen it, the Greatist has a nice roundup of top TED Talks on fitness, health and happiness. If, like me, you look for practical tips on how to apply medical research and technology tools to create a healthier life, you might be interested to browse this selection over the weekend.

Among the videos highlighted is a 2011 talk by Daniel Kraft, MD, titled “Medicine’s future? There’s an app for that.” Kraft, an inventor and Stanford School of Medicine-trained physician, is an NIH-funded faculty member affiliated with the Stanford. In this TED talk he discusses apps to track quantified-self metrics and tools to improve personalized medicine. He also surveys ways medical professionals are–or soon will be–using technologies such as robotic surgery, nanomedicine, virtual patient visits, and crowdsourcing data on an exponential scale to address major challenges in health care today.

From the video:

By leveraging these technologies together, I think we’ll enter a new era that I like to call Stage Zero Medicine. And as a cancer doctor, I’m looking forward to being out of a job.

Previously: Why networks of “micro-experts” are a valuable resource for the medical communityBig Data in Biomedicine videos now available onlineBertalan Meskó discusses how mobile technologies can improve the delivery of health care and Stanford surgeon uses robot to increase precision, reduce complications of head and neck procedures
Video by TED

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