The World of Mobile Health

pMDsoft Offers Native Mobile Charge Capture App to be Used on iPad and Smartphone Simultaneously

pMDsoft continues to lead innovation in mobile charge capture by allowing doctors to use the software natively on an iPad in addition to an iPhone, iPod Touch or BlackBerry.
The software company creates easy-to-use mobile applications to capture billing charges, manage patient information and facilitate communication between physicians. It released the first-to-market native charge capture app for the iPad last year.

"iPad usage in the hospital is growing exponentially," said Dr. Travis Rutland, a gastroenterologist in Alabama. "It's definitely changing medicine in a good way."

As doctors move between their offices, hospitals and clinics, they still need immediate access to patient information. The iPad, which offers more screen real estate than a smartphone and is more portable and battery efficient than a laptop, puts this information literally at physicians' fingertips.

"It's great for doctors to enter notes and access the hospital system while they're walking down the hall," said Dr. Maria Nguyen, an infectious disease physician in Texas. "They're walking, and they're working."

Dr. Rutland has found that the iPad gives him more leverage. "I'll use it when I'm with patients to draw something on my chalkboard app rather than using paper, and I show videos of procedures," he said. "And when you're on at the hospital and rounding on every patient, it's helpful to have the iPad to access the hospital EMR, pull up labs and use pMDsoft."

"We suspected that the iPad would be a big success, but it was unrealistic to think that it would replace smartphones," Philippe d'Offay, CEO of pMDsoft said. "All doctors are mobile, so they need a charge capture solution that works wherever they are."

After receiving overwhelmingly positive feedback from doctors using the pMDsoft app on the iPad, the company re-engineered its software to give doctors the option of using their account natively on an iPad and smartphone simultaneously. Information is transferred automatically in the background, so if physicians switch from one device to another, they are able to pick up exactly where they left off in pMDsoft.

The companion device upgrade enhances the capabilities of native applications, which unlike web-based applications, can be used when a device is offline and with minimal battery usage. Physicians can continue using pMDsoft as they come in and out of the notoriously unreliable data service at hospitals and clinics.

"With an app as complex as ours where information is flowing bi-directionally, it seemed almost impossible to run as a native app simultaneously on the iPad and a smartphone," d'Offay said. "Because of our obsession with usability, we knew that we had to develop it even though it would be difficult.

Although the companion device upgrade was ambitious, it gave physicians the flexibility to use their iPad with their smartphone at any time.

"There are times when you're just going into the hospital to do a couple of outpatient procedures and consults," Dr. Rutland said. "You don't want to lug around the iPad, so it's nice to just be able to use a smaller device like the iPhone to use pMDsoft."

Dr. Nguyen agreed that the devices aren't mutually exclusive. "I don't always carry my iPad around with me because it can be cumbersome," she said. "I still like to use my iPhone to enter charges when I'm in the hospital. But when I'm outside of the hospital, I'll use pMDsoft on the iPad."

Dr. Rutland, who is now using pMDsoft on his iPad as a companion device to his iPhone, said that his practice loves the software. "pMDsoft is easy to use, intuitive and fast," he said.

pMDsoft's mobile charge capture software supports today's physician by allowing them to enter their patient charges into their iPads and smartphones at the point of patient care. The patient visit is then visible to other doctors within the practice and can be billed immediately. Doctors using charge capture are increasing their ROI in a time where Medicare cuts and other costs are significantly impacting profitability. pMDsoft increases efficiencies in a practice through automation, and it provides free interfaces with almost every major electronic medical record and medical billing system, including athenaCollector by athenahealth (Athena), Centricity, Medicity, NextGen and Sage Intergy. For more information, visit http://www.pmdsoft.com/.

http://www.sfgate.com/cgi-bin/article.cgi?f=/g/a/2011/02/03/prweb5032604.DTL

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World of iPhone Medical Health

FDA clears first diagnostic radiology app, Mobile MIM

Mobile MIM was one of the very first medical applications to debut in Apple’s AppStore when it first launched in 2008, but the application also has the distinction of being the first medical application pulled from the store because of regulatory concerns.

Today those concerns are over: The US Food and Drug Administration has officially granted the mobile radiology application a 510(k) clearance.

“The application is the first cleared by the FDA for viewing images and making medical diagnoses based on computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine technology, such as positron emission tomography (PET),” the FDA stated in a press release this morning. “It is not intended to replace full workstations and is indicated for use only when there is no access to a workstation.”

The app enables clinicians to measure distance, intensity values, display measurement lines, annotations and regions of interest. The images are securely transferred to the app from a hospital or physician’s office through a secure network transfer facilitated by MIM.

“The display performance of mobile devices can experience significant variations in luminance levels even between mobile devices of the same model,” the FDA wrote in its press release. “The Mobile MIM application includes sufficient labeling and safety features to mitigate the risk of poor image display due to improper screen luminance or lighting conditions. The device includes an interactive contrast test in which a small part of the screen is a slightly different shade than the rest of the screen. If the physician can identify and tap this portion of the screen, then the lighting conditions are not interfering with the physician’s ability to discern subtle differences in contrast. In addition, a safety guide is included within the application.”

Mobile MIM was one of the only iPhone apps demonstrated during Apple’s keynote presentation that launched the Apple AppStore back in the summer of 2008.

“Of course, we were thrilled,” MIM Software CTO Mark Cain told MobiHealthNews in an interview last year. “We were one of eleven developers that presented during the keynote. That week we won an Apple Design Award for Best iPhone Healthcare & Fitness Application.”

That August MIM submitted their 501(k) for Mobile MIM and after some discussions with the FDA decided they had to remove Mobile MIM from Apple’s AppStore: “Then, over the next few months, we discovered that our proposed device raised more questions than we had anticipated. In order to make their determination, the FDA wanted more information than we had provided,” Cain explained to MobiHealthNews last March. “The process stalled out as we reviewed what we would have to do next. This 510(k) was declared not substantially equivalent (NSE) because of insufficient data.”

In June 2009 MIM resubmitted a 510(k) with more data from trials. After 221 days the FDA again deemed the app NSE: The FDA’s official position was that “displaying medical images for diagnostic use on a mobile/portable device” is a new intended use without predicate, and as such is a class III (premarket approval) medical device, according to Cain.

Luckily for MIM, the FDA’s opinion on that matter must have changed in the intervening months because today Mobile MIM has a 510(k) clearance. MIM’s experience is one of the few public accounts of the nuances of FDA regulation of mobile health services. The clearance some two and a half years later of an app that originally launched with Apple’s AppStore is surely a milestone for mobile health.

The industry — and the FDA — have come a long way since 2008. Read the FDA’s full press release below:

FDA clears first diagnostic radiology application for mobile devices

Provides wireless access to medical images for iPhone, iPad users

A new mobile radiology application cleared today by the U.S. Food and Drug Administration will allow physicians to view medical images on the iPhone and iPad manufactured by Apple Inc.

The application is the first cleared by the FDA for viewing images and making medical diagnoses based on computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine technology, such as positron emission tomography (PET). It is not intended to replace full workstations and is indicated for use only when there is no access to a workstation.

“This important mobile technology provides physicians with the ability to immediately view images and make diagnoses without having to be back at the workstation or wait for film,” said William Maisel, M.D., M.P.H., chief scientist and deputy director for science in the FDA’s Center for Devices and Radiological Health.

Radiology images taken in the hospital or physician’s office are compressed for secure network transfer then sent to the appropriate portable wireless device via software called Mobile MIM. Mobile MIM, manufactured by Cleveland-based MIM Software Inc., allows the physician to measure distance on the image and image intensity values and display measurement lines, annotations and regions of interest.

In its evaluation, the FDA reviewed performance test results on various portable devices. These tests measured luminance, image quality (resolution), and noise in accordance with international standards and guidelines. The FDA also reviewed results from demonstration studies with qualified radiologists under different lighting conditions. All participants agreed that the device was sufficient for diagnostic image interpretation under the recommended lighting conditions.

The display performance of mobile devices can experience significant variations in luminance levels even between mobile devices of the same model. The Mobile MIM application includes sufficient labeling and safety features to mitigate the risk of poor image display due to improper screen luminance or lighting conditions. The device includes an interactive contrast test in which a small part of the screen is a slightly different shade than the rest of the screen. If the physician can identify and tap this portion of the screen, then the lighting conditions are not interfering with the physician’s ability to discern subtle differences in contrast. In addition, a safety guide is included within the application.

http://mobihealthnews.com/10173/fda-clears-first-diagnostic-radiology-app-mobile-mim/

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What's Crohn's Diary; Mobile Health

10 iPhone apps created by pharma companies

Johnson & Johnson — Crohn’s Diary:

Doctors know that Crohn’s disease is not caused by stress or sensitivity to certain foods or food products. However, both can aggravate symptoms in some people. The more you know about how Crohn’s disease affects you, the more you can do to help manage your Crohn’s disease symptoms

http://mobihealthnews.com/9989/10-iphone-apps-created-by-pharma-companies/5/

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10 iPhone apps created by pharma companies

Boehringer Ingelheim — NIHSS:

An intuitive, user friendly tool for clinicians to efficiently evaluate Stroke patients with the NIHSS scale. 1.19 British Pounds

http://mobihealthnews.com/9989/10-iphone-apps-created-by-pharma-companies/3/

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MedApps’ road to AT&T ForHealth

AT&T continued to reveal the constituents of its ForHealth portfolio of mHealth and telehealth solutions that aim to improve disease management. MedApps’ offerings include a remote care monitoring hub called HealthPAL and a Web-based application called HealthCOM. AT&T will provide 3G connectivity to MedApps’ hub and will co-market and distribute MedApps products along with other remote care applications, peripherals and devices in AT&T’s new ForHealth portfolio.

“Instead of having to adapt to every new platform that comes out, we use a single purpose device or personal health device (PHD) that sends personal health information (PHI) into the personal health record (PHR),” MedApps CEO Kent Dicks told MobiHealthNews in an interview in 2009. “That’s what we are doing at MedApps: We are creating a platform that is dedicated solely to collecting personal health information, behavioral information and biometric information to send it to a central server in an invisible way so that the user doesn’t have to press any buttons. If the user misses any data, HealthPAL will alert them to send the data or it will alert a caregiver.”

“MedApps’ focus on cloud computing and open platform architecture, allowing connection of multiple clinical devices to a single plug-and-play hub, is highly aligned with AT&T’s vision,” Randall Porter, assistant vice president, AT&T ForHealth Solutions stated in the press release. “It will help AT&T offer mHealth solutions that are user agnostic and universally accessible, despite carrier, device type and operating-system. AT&T is excited to work with MedApps to provide a comprehensive remote care monitoring solution suite to our healthcare customers.”
ForHealth already includes WellDoc’s mobile and Web-based DiabetesManager program.

MedApps received 510(k) clearance from the FDA for its HealthPAL device in June 2009, while it secured a CE Mark for Europe and approval by Health Canada this time last year.
One of MedApps’ biggest partnerships to date was with New Jersey-based hospital group Meridian Health, which uses MedApps’ wireless remote monitoring technology to keep an eye on patients who were recently discharged from acute care settings with Congestive Heart Failure (CHF). According to the two companies, the aim was to monitor the patients on a daily “near real-time” basis in an effort to improve patient outcomes and decrease re-admissions to the hospitals.

CardioNet also inked a deal with MedApps late last year to co-market MedApps’ solutions bundled along with its own mobile cardiac outpatient telemetry (MCOT) services. The companies positioned the partnership as a “strategic alliance” to “deploy new and innovative wireless monitoring solutions that benefit patients in a cost-effective, meaningful manner.”

MedApps navigated the early years of wireless health, first as a mobile phone-based solution, which the FDA approved in 2007, before switching to a connected, dedicated device, called HealthPAL. It’s a bit smaller than a mobile phone, but unlike a phone based solution MedApps does not require the user to push any buttons to function. Although HealthPAL has buttons to access simple menu options, users are not required to even touch the HealthPAL device in order to transmit data for review and online storage. The goal was to maximize usability to improve compliance. Read more about the origins of MedApps in this interview with company CEO Kent Dicks from back in September 2009.

http://mobihealthnews.com/9902/medapps-road-to-att-forhealth/#more-9902

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What New: Mobile Health

Prediction: 14 percent to use mobile health apps

In 2011, some 14 percent of adult Americans will use a mobile health app to manage their health, wellness, and chronic conditions, according to IDC. Why? “Demographics are accelerating this trend. Health reform will make these approaches even more important as the industry shifts to new delivery and reimbursement models,” IDC writes in its 2011 predictions report. The estimate is not at all outlandish, especially given that a recent Pew survey showed that already 9 percent of adult Americans are using mobile health apps to track or manage their health. (For more on mobile health apps, be sure to check out our latest apps report on the fastest growing and most successful smartphone health apps.)

Another analyst increasingly sees HIPAA as a challenge for mobile devices in medical environments.

“Formerly a toothless tiger,” Info-Tech’s Director of Research Mark Tauschek told Processor.com in a recent interview, “HIPAA now has some teeth, thanks to the HITECH (Health Information Technology for Economic and Clinical Health) act.” The Processor.com article notes that “it is one thing to protect sensitive medical data in a data center which can only be accessed through onsite desktop computers or terminals… quite another to do so when doctors who travel daily among multiple hospitals and/or clinics carry personal mobile devices with them everywhere they go.”

Awareness about security issues with mobile devices is another issue, according to Lisa Gallagher, senior director for privacy and security at the Healthcare Information and Management Systems Society (HIMSS):

“Medical personnel often assume that if they’re handed a device, it’s OK. At the highest level, like doctors, they’re not aware. They just want the devices.”

According to Chilmark Research analyst Cora Sharma physicians do indeed want devices:

“By the end of this year, 22 percent of physicians will have iPads, and half of doctors will have them within two years,” Sharma said. “As of early November, 18 percent of the 700,000 physicians in the United States were using iPads.”

http://mobihealthnews.com/

http://www.processor.com/editorial/article.asp?article=articles%2Fp3225%2F37p25%2F37p25.asp&guid=&searchtype=&WordList=&bJumpTo=True

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