#MHS11 MHealthSummit Startup Health

This is a live blog post from the mHealth Summit. The summit is taking place from December 5-7th at the Gaylord National Convention Center, National Harbor, MD.

This is a live blog post, as such the notes are made in real time and posted with minimal editing. I am sharing these via Facebook, Twitter and my blog to help others get a snapshot of the activities at the conference. You can follow the tweet stream at #MHS11 or follow the mHealth Summit's twitter account @mhealthsummit.

StartUp Health: Bridging the Gap between Health & Wellness Entrepreneurs, Payers and Providers

http://www.mhealthsummit.org/program_special_startup.php

A panel moderated by: Steven Krein, Co-founder of StartUp Health

Peter Levin - CTO and Senior Advisor to the Secretary of Dept of Veteran Affairs - Promoter of the BlueButton 

Don Casey, CEO of West Wireless Health Institute & former Worldwide Chairman for Johnson & Johnson's comprehensive care group and member of the Company's Executive committee

Stephen Ondra, MD - Senior Policy Adviser of Health Affairs, Dept of Veteran Affairs.

BlueButton - What does it mean to Entrepreneurs.

Outcomes, Cost and Control model. BlueButton improves access, compliance. Real benefit is as a catalyst to move to patient centered care.

BlueButton is simple formatted Text File. (ASCII).

At the VA it tracks 17 items in a health record, including self-entered data. Now they are starting to include data from VISTA - The VA's EMR.

http://www.VA.GOV/Bluebutton

Two ideas that utilize the BlueButton File:

- Help physicians deliver information to patients

- Help patients manage their own care.

There is of course RainbowButton.com to allow data donation anonymously.

Don Casey thinks there is a market for an app to find physicians that accept blue button data.

Did you know that over 500,000 people have downloaded their BlueButton data from the VA and with adoption by United Health and Aetna the market in private health care markets puts BlueButton access at over 17M.

Q: Is EMR Adoption taking up more time for doctors. 

A:  Yes - Doctors often hate the technology. They don't hate what it is trying to achieve.

They want products that help their patients, fit their workflow and help them be more efficient.

West Wireless Health development preferences:

- Diagnostics

- Analysis

- Devices

Q: How do get doctors to the table to participate in the change process.

A: we need to align incentives. It is starting to happen. Switch from fee for service to pay for performance and no reimbursement for readmission within 30 days are having a radical impact.

Billions being invested in EMRs. Most are not developed for workflow improvement but for billing management. The transition from revenue cycle management to clinical outcomes will force a radical change.

1. What problem are you solving

2. Who will pay for the solution

3. Is there something unique about your offering

4. How will this lower the cost of health care

Who pays: 

18% of US Population managed by capitated health plans. (Kaiser, Geinsinger)

Large Self Insured: IBM, Exxon etc.

High Deductible Self-Directed Health Plans

We need to be more be more sophisticated in how you approach health care and mHealth:

- Clinical Applications

- Revenue and Workflow management

- Health Care industry (Pharma etc)

- Health and Wellness (Consumer wellness and prevention)

$1B of innovation money

Beacon Communities

$19B to be spent over next several years.

((tag: mhealth, mhealth summit, mobile))

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#mhs11 super session - value proposition of mHealth

The initial drive will come from payers - the government, employers and insurers.

To really transform we need to engage consumers to manage their own vitality.

The move from fee for service to pay for quality. CMS ha changed hospital systems approach to quality due to payment reform.

A lot of development going in to home based monitoring. People recover better at home. Also least regulated.

Technical and regulatory obstacles:

- security because we need to share actionable information
- how to manage medical liability for large databases.

Mark Scrimshire
B: http://ekive.blogspot.com
....Sent from my iPhone

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#MHS11 Mhealth Summit - the keynotes

This is a live blog post from the mHealth Summit. The summit is taking place from December 5-7th at the Gaylord National Convention Center, National Harbor, MD.

This is a live blog post, as such the notes are made in real time and posted with minimal editing. I am sharing these via Facebook, Twitter and my blog to help others get a snapshot of the activities at the conference. You can follow the tweet stream at #MHS11 or follow the mHealth Summit's twitter account @mhealthsummit.

Monday, December 5, 2011

9:45–10:15 AM — Opening Keynote

 

	Kathleen Sebelius Secretary U.S. Department of Health and Human Services
	Eric J. Topol, M.D. Vice Chairman West Wireless Health Institute

First the introductions:

Scott Campbell - Exec Director & CEO - Foundation for the National Institutes of Health kicks off the Summit.

Around 3,000 attendees in 2011 growing 25% from last year.

We need to learn from the mFinance community - they are further along in developing solutions than Health Care.

Rosemary Nelson - mHIMSS Taskforce Chair of HIMSS.  mHIMSS is the mobile offshoot of HIMSS.

Patricia Mecheal, Ph D. - Executive Director - mHealth Alliance -- focusing internationally on the poor, disadvantaged and vulnerable communities.

Robert Kaplan, Director - OBSSR - National Institutes of Health

Now on to the key notes….

Kathleen Sibelius - Secretary, US Dept of Health and Human Services (who has her talk on her iPad)

Almost every American has a cell phone and smartphones represent more than 50% of cell phones. The iTunes store alone has 12,000 apps related to health.

What is exciting is the rate of innovation in an area (Health Care) which has been traditionally sedentary.

When innovation is slow so is improvement.

Rapidly rising health care costs are imposing increasing burdens on families, employers and Government. 

We need information. Incomplete information about patients. Information Deficit is being addressed through the push for Health IT.

Office based doctors have grown in EMR use from 17% to 34% in less than two years. 

Mobile Health is the next logical extension. Cellphones are an incredible tool for engaging consumers in our own health.

iTriage and Pillbox gets a shout out as innovative solutions to help patients and providers.

What can the Administration do to promote innovation. The Government role is to provide research. Act as a catalyst.

Adoption of EMRs had not changed in many years to the Recovery Act set out to - set Standards for interoperable systems, Create Regional Extension Centers help small practices adopt, Health Information Exchanges to help interoperability. 

Recognized that it wasn't good enough to just dump paper in to electronic form. Meaningful Use emerged from this. We can now measure progress.

Government data was locked up and difficult to obtain. HealthData.gov was created to make the data accessible. 

Shining a spotlight on health problems. 1 in 5 students in college report some sexual assault during their college years. Why not use technology to protect themselves. Apps Against Abuse: Circle of 6 and onWatch were the winners.

TXT4Health from InfieldHealth also got a shout out.

Innovations are being per sued around Care Transitions to reduce hospital readmissions. 

Challenge 1: Support all innovations in Health Care - not just mhealth solutions.

Challenge 2: Help consumers understand that applications and data for consumers are safe and privacy is maintained.

We are heading for a future where we each take care of our health.

There are major opportunities to  export technology as developing countries grow.

Scott Ratzan, MD, MPA - VP - Global Health - Johnson & Johnson

TXT4BABY - 71% of people getting text messages are seeking advice from physicians.

TXT4BABY is expanding to Russia.

0.5M babies die in first year of life. We need to change that.

Only 10 years ago less then half the wor;d's population had ever made a phone call. Today over 5B people in a 7B world population now own a cellphone.

Eric Topol, MD - West Wireless Health - The Creative Destruction of Medicine 

@EricTopol

Kairos - The supreme - most opportune moment in history.

Digital World and the Medical Cocoon. They are starting to converge. 

 We are now talking about "Digitizing Man".

We have a new species - Homo Distractus

Joseph Schumpeter - Creative Destruction - now being applied to medicine. 

Johns Hopkins has announced it is closing it's medical library and going digital. This is the harbinger of change.

Eric gave a number of examples from FitBit 

AliveCor was demoed with the new Credit Card reader that can do ECG on your iPhone.

Skin Scan can snap a skin lesion and have it diagnosed remotely.

CellScope converts a cellphone to a microscope.

We are moving to a lab on a chip. 

EyeNetra.com for Refractive Assessment in eye tests. 

Sensimed - Triggerfish monitors eye pressure.

Qualcomm has announced 2net - a wireless health ecosystem

The Steve Jobs Autobiography looking at the future thought the biggest innovation of 21st century will be the intersection of medicine and technology.

We are entering the era of genomics sequencing. Eric demonstrated a handheld DNA Sequencer that could assess whether a patient would respond to Plavix.

The stethoscope is an icon of medicine. Why listen to a heart when you can see an ultrasound image using a portable scanner

There is now a technology to detect cracks in an artery. Using nano technology. Embedded nano sensors 

Eric has an ebook on "The Creative Destruction of Medicine"

((tag: mHealth, mHealth Summit, Mobile))

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#MHS11 At the mHealth Summit at the National Harbor outside Washington DC

This week is the mHealth Summit which is being held at the Gaylord National Convention Center, National Harbor, MD. Around 3,000 people are expected to descend on National Harbor to attend the mHealth Summit. I am joining the throngs to catch up on the latest developments in mHealth

The pre-conference meetup last night brought together a sizable crowd. Many old faces and a lot of new people - all doing interesting things in the mHealth field.

I will be blogging from the conference and visiting the exhibition floor and reporting over the next couple of days.  Watch out for a stream of blog posts and tweets over the next few days.

((tag: mhealth, mhealth summit))

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GooglePlus Frustrations

Google Plus has improved their error messages when adding people to circles. Now I am told I have reached my daily limit for adding to circles.

http://www.google.com/support/plus/bin/answer.py?hl=en&answer=1733011&p=circl...

It appears I am allowed to add <1 people to my circles each day. I will have to try again tomorrow.....

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Is @klout losing credibility? Their scores are all over the place. 51 is the new 49!

A few months ago Klout revamped their scoring. Some people were winners, others losers. I admit. ! was one of the losers with my Klout score dropping by more than 17 points.

Over the past two days my Klout score had been rising. This could easily be explained by my increased activity in Social Media. I have been through a quiet spell as I have been doing some development work and learning Python/Django for work on RainbowButton.com.

Today I logged in to Klout and got a warning message that my Klout Score had dropped by two points in the past day - back to 49 from a recent high of 51. Yet my score still showed as 51 (in the chart it shows as 50.70 but the chart shows it back down to 48 point something.

We understand that Klout is still in beta but credibility is an important factor to be maintained. If Klout is tweaking their algorithms they should let us know. If they have dropped or added data feeds that might be the cause - in which case let us know.

The more Klout scores bounce around the less credibility they have.

I understand that Klout needs to keep secret how they calculate their score, otherwise people will game the system but there is also a need to balance that with enabling Klout's user base to identify a level of cause and effect for the actions they take in Social Media.

((tag: klout, social media))

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@TechCrunch article - Internet Bandwidth a time-based issue and not a capacity issue

TechCrunch has a great post about the impact of bandwidth caps for Internet use. The post, which links to an expensive report is available here: 

Another Study Shows Data Caps Are Likely Ineffective, Address Wrong Problem

The Internet Capacity problem is just like the electric energy problem. In the UK customers could install a meter for cheap rate power to charge up storage radiators. 

These ran overnight when there was plenty of power available and then gave out heat during the day. As pointed out in the Techcrunch article, we need to deal with the peak capacity issue and simple bandwidth caps exacerbate rather than alleviate the problem. 

If "cheap rate" bandwidth became popular it might trigger some interesting developments. Imagine an "Internet Storage Radiator" that could go on to the Internet each evening when bandwidth was plentiful and download and cache popular content. This could be based on the browsing patterns of the people typically using the family or small business network. Then with some intelligent proxy serving the pre-loaded content could be served from the "Storage Radiator" with the live Internet connection only being used for real-time content.

With the falling cost of compute power and storage this type of service could be an affordable option. Imagine if the storage radiator would refresh your video queue amd download and store likely new content which would then be available on demand - without taxing the your network connection. This could be an interesting proposition for Netflix since they currently represent probably around 30% of peak time Internet usage. 

Netflix could turn the tide of bad sentiment for their brand through caching

Imagine if Netflix offered a low cost storage hub that you could attach to your network router that cached popular content and offered this in conjunction with a low cost "cached movie plan". This could be refreshed overnight based upon a member's queue selections. This could reduce/redistribute network demand and reduce peak demand on their architecture and content delivery network. They might even negotiate more favorable transmission charges with ISPs for this off-peak content transmission.

I can see how Netflix could easily implement the use of this cached content.

There are plenty of opportunities for innovation in this space. We can come up with better solutions that address the real problem - peak hour demand versus network capacity. 

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