To help medical providers save more of their limited time, we’ve found five of the best medical apps that doctors can download to get ahead on the go.

1. PEPID

The Chicago-based medical information company, PEPID, has a data-rich mobile app that offers evidence-based conclusions for paramedics and doctors. This app is specifically aimed at helping emergency room paramedics and doctors diagnose their patients as quickly as possible. It’s also a great learning tool for nurses, students, residents, and interns during simulations and training and in time-sensitive situations.

The PEPID mobile app is available for Android and Apple devices, and it allows providers to filter by conditions, symptoms, and prescriptions. It even takes care to include possible multi-drug interactions during the patient’s treatment. With PEPID, doctors can diagnose patients based on several factors: lab results, symptoms, and exam results. The app also offers videos that show clinical exams and procedures. And to help providers stay current on cutting-edge treatments, it has an option to turn on push notifications for the latest medical news, research, and tools.

2. Epocrates

Epocrates is a wildly popular mobile app with medical professionals. It’s been downloaded millions of times, and providers use it to look up and reference drug information, find peers for consults and referrals, interact with patients, and even perform quick calculations like BMI during patient exams. This app offers a freemium model, where the free version is good enough to be used on its own, but upgrading to premium will unlock even more value.

For example, the premium version helps providers interpret lab results, find more information on diseases, or look for medication alternatives. This app is available for Android and Apple mobile devices.

3. Lexicomp

The Lexicomp app is a hospital system app that comes equipped with a large database of diseases, including oral diseases, toxicology, and infectious diseases. It’s an intuitive app that also includes information about drugs, their uses, and their effects on patients. Lexicomp comes with several medical dictionaries, and similar to the Epocrates app, it offers calculators for quick computations.

This app is available for Android and Apple users, but there is no free version, unlike Epocrates. It offers several subscription plans for providers to choose from, allowing them to pick a paid tier that fits their needs and budget.

4. Medscape

The Medscape mobile app is great for specialist providers because it allows them to choose their specialty and customize the information they want to see in the app. Choices include the latest news, treatments, research, drugs, and procedures. This app prevents information overload for providers by subjecting them to what they actually want to read about.

It also provides opportunities for medical providers to earn continuing education credits, which is an ongoing requirement for all medical professionals. Medscape is available for Android and Apple mobile devices, and it’s completely free to use.

5. DynaMed

The DynaMed app is highly rated for what it provides to healthcare professionals. It includes disease information, graphics, and images for learning, drug recommendations, an excellent search engine, content for specific specialties, information from accredited experts, and verified medical content. With this level of value, it’s not surprising that DynaMed is a paid app.

The app offers different pricing levels depending on if you’re registering with an institution (free), as a student ($99.95/year), or as a professional with no institutional affiliation ($395/year). It does offer a free trial so that providers can check if it works for them before taking the plunge with their credit card. Users on Android and Apple devices can download this app that’s been reviewed as intuitive, easy-to-use, and easy to search through.

The Future of Healthcare Is Mobile

For our medical providers, getting the best education and continuing education directly benefits patients and healthcare systems. These five apps promise the latest guidance on drug recommendations and interactions, procedure protocols, patient exam calculators, and even continuing education. With these apps, even the smartest and most up-to-date providers will find something new to learn.

Digital vaccine passports have become a contentious topic over the past few months. Whether you agree with their necessity or not, one thing’s become readily apparent: They are coming. But these passports may not take on the shape or format you imagined.

The U.S. government will not be implementing a vaccine passport. Instead, it is handing off the responsibilities of building and enforcing one to private enterprise. The reasoning behind this decision? Private organizations can solve this problem, faster, better, and more efficiently. The U.S. Department of Health and Human Services will be releasing guidelines for how to develop a vaccine passport in the coming weeks. But if you’re eager to get started on developing yours, we’ve got you covered.

In this blog post, we’ll give you a glimpse into our future with digital vaccine passports. We’ll also examine some of the common pitfalls that this paradigm is susceptible to. Lastly, we’ll round up this piece with a checklist that health tech developers should try their best to meet when creating a digital vaccine passport. Let’s get started!

Our (Near) Future With Digital Vaccine Passports

Whether you want to visit a certain country, partake in events like attending a concert, or work in a particular sector, it’s likely that you’ll have to demonstrate that you’ve received your COVID-19 vaccine in the near future. For example, unless they have very good reason to abstain from it, healthcare employees will need to be vaccinated to keep their jobs. This also goes for frontline workers across industries. Companies have the right to fire an employee or forgo renewing their contract if they have not been vaccinated.

Across the world, many organizations and countries are already taking action to implement vaccine passports and regulations of some kind. For instance, E.U. legislators recently proposed rules for a certificate system to verify the vaccine status of people moving between this union of 27 member countries. While those who pass these checkpoints can travel without the need for quarantine restrictions or additional tests, anyone who fails to comply with these regulations could be denied admittance or forced into quarantine.

While the concept of vaccine passports may seem stringent to some, its success is readily apparent in Israel. The country has issued “green passes” to citizens who are fully vaccinated. With this pass, people are free to eat at restaurants, socialize at bars, and attend concerts or sporting events. Public health experts believe that the country’s vaccine passport implementation has helped tremendously in keeping its COVID-19 numbers down and allowing its economy to reopen safely.

The arrival of vaccine passports will cause a big shift in society. After all, how do you really prove you’ve been vaccinated? In the U.S., people receive flimsy cards as proof. But these can potentially be forged and possibly lost. Well, that’s why vaccine passports are going digital. But there are still myriad pitfalls to address for this concept to be a success.

Potential Pitfalls of Digital Vaccine Passports

As we’ve alluded to with forgery, security is a prime concern when it comes to vaccine passports. But there’s also the potential issue of non-compliance. People as well as private and even public organizations may not follow the regulations that come with these passports. There’s also the question of fragmentation — as we witnessed during the COVID-19 pandemic, each state took different measures to stave off this illness from spreading. If you were in Los Angeles, California, you probably had a drastically different experience than a citizen of Miami, Florida.

The problem of non-uniformity in vaccine passports only becomes magnified when you examine the entire world. Different vaccines are being distributed and used around the globe, and what’s permitted in one country may not be allowed in another. For example, China does not accept travelers who received the Moderna COVID-19 vaccine. Such fragmentation between countries, along with the fact that digital vaccine passports will be developed by different organizations, could make things quite confusing.

Then there’s the question of time. Currently, there isn’t much data to go off of to see how long the COVID-19 vaccines are effective for. A quick Google search shows that there’s conflicting information regarding each specific vaccine’s efficacy against the COVID-19 variants circulating throughout the world. It’s likely that we’ll need to receive annual booster shots to ensure proper protection against this virus, so we’ll also need to factor in proof of these into passport iterations.

Clearly, several questions must be answered. While digital vaccine passports may differ from one another, there are a few key factors that all of them should possess.

Best Practices for Building a Digital Vaccine Passport

Here are some elements that every digital vaccine passport should have:

An Intuitive User Experience

A digital vaccine passport should be seamless to access and use. It should also enable the passport holder to easily disclose the minimum amount of information needed for verification. This can be difficult since the information required to be disclosed is dependent on the use case.

Privacy Protection Must Be Prioritized

Obviously, digital vaccine passports should be forgery-proof. But that’s only one segment of security in a long list of many. Be prudent and examine each component of your digital vaccine passport and every step required in a verification process. Identify any weak areas and ask yourself how you can strengthen them to ensure complete end-to-end privacy.

Build Trust Through Credibility and Transparency

Digital vaccine passports must strike a fine balance between information security and transparency. They must also work and be recognized across organizational and jurisdictional boundaries. Your solution should not only be multi-lingual but also credible enough that it’s recognized by various organizations such as airline companies and foreign governments. It should also be transparent enough to pass stringent requirements set forth by these organizations in a timely manner.

Data Portability

At the end of the day, digital vaccine passports are all about data. And developers of these passports must prioritize data portability. Passport holders should have complete control over the data they choose to share. Create your solution with granular data-sharing in mind so that users can easily compartmentalize and choose what information is displayed for various use cases.

Factoring In the Future

We believe that digital vaccine passports will become an essential part of humanity’s future. With that said, it’s vital for developers of these solutions to plan with the future in mind. This can be difficult to do since nobody knows what the future holds as far as health crises like the pandemic go. But it can help to examine the potential benefits that emerging technologies offer.

For instance, blockchain is a strong candidate for a tech stack that supports vaccine passports. it’s transparent, encrypted, and private. Not only does it store information securely, but you can choose who you share it with. And if you end up needing booster shots in the future to protect against COVID-19 variants, it can easily log that.

We hope you’ve enjoyed this overview of digital vaccine passports. What components would you like to see in these health tech solutions. As always, let us know your thoughts in the comments below!

COVID-19 brought many changes to our world over the past year, and healthcare and medicine were hit hardest by the pandemic as hospitals constantly scrambled to find enough personal protective equipment, hospital beds, and space to house infected patients during each surge. While hospitals were barely staying above water, providers and patients who weren’t infected were able to continue their appointments using telehealth technology. This technology is relatively new for most people, and it offers a variety of benefits.

Here are five changes caused by the pandemic for telehealth technology that you should know about.

1. Mass Usage of Telehealth Was Possible Only Because CMS Paid For It

The Centers for Medicare & Medicaid Services (CMS) acted swiftly to enable all patients and providers to use telehealth technology during the pandemic. They covered the unknown costs of payment parity, allowed payment for codes that were previously non-payable, and they worked with the Office for Civil Rights to waive HIPAA guidelines, allowing providers and patients to meet over Zoom and FaceTime for the first time ever. These regulatory flexibilities were invaluable and instrumental in helping telehealth get off the ground faster at the beginning of the pandemic.

While telehealth existed in several hospital systems before the pandemic, it was confined to specific areas like larger Easy Coast medical systems. Telehealth had a difficult time expanding “due to the lack of reimbursement and payment parity when there was reimbursement all,” according to Iris Berman. Berman is the vice president of telehealth services at Northwell Health, a New York City-based 23-hospital healthcare system. But CMS fixed this issue by directing much of the reimbursement to rural communities, allowing nationwide access to telehealth technologies.

2. Telehealth Offers A Safe Alternative to In-Person Care During the Pandemic

With telehealth, doctors are still able to attend to their patients who need medical attention at home. But telehealth technology has played an important role in inpatient care as well. Dr. Natalie Pageler is the chief medical information officer at Stanford Children’s Health and clinical professor of pediatric critical care at Stanford University.

Pageler says, “During [the pandemic], we also found ways to implement telehealth among our inpatients in the hospital. This allowed physicians to care for patients in isolation while minimizing the spread of infection and conserving personal protective equipment, such as masks and gowns.”

Many hospitals have also had to conference in specialists from other parts of the country that were experiencing fewer COVID-19 cases. This helped prevent hospitals from becoming even more overwhelmed with patients who did not truly need emergency care.

At Northwell Health, two telehealth platforms are being used to take care of inpatient care. These include eICU, which communicates with hardwired ICU beds that come with cameras, a monitor, speakers, and a button that alerts a remote critical care team. The other platform is DTC (direct to consumer), which is used for ER consultations, home televisits, and hospital floor care.

3. Telehealth Can Be More Convenient for Children and Pediatric Care

Childhood requires a higher-than-normal amount of medical care, and many of these visits can be conducted with telehealth. If a child isn’t in need of a vaccine, chronic condition check-ups, or regular testing, telehealth can save everyone some time and money. Pageler says that telehealth for pediatric services also enables children to see a doctor without missing school, sports, or extracurricular activities. Telehealth is also a great alternative to in-person follow-up appointments when possible.

4. Telehealth Is Now a Necessity

Dr. Peter Antall is the chief medical officer of Amwell, a telemedicine platform based in Boston. He says that Amwell’s monthly visit volume went up by 300% between April and June when compared to visitor counts from January to March. Antall says that telehealth is now a necessity and no longer a nice-to-have tool in the healthcare journey.

He added, “We expect this momentum to largely continue post-pandemic. … You can’t put the toothpaste back in the tube. Now that both patients and providers have experienced the convenience of telehealth, we don’t anticipate healthcare to ever go back to how it was.”

Pageler agrees that “we won’t return to the baseline we were at before the pandemic” because providers and patients now “see the value and incentive to continue using virtual visits.” Telehealth offers benefits like cutting travel time, reduced scheduling, and better access to specialists, among others. According to research conducted by McKinsey & Co., 74% of telehealth users were “highly satisfied”, 64% of providers are more comfortable using it than before the pandemic, and 57% of providers saw telehealth more favorably than they did before the pandemic.

5. There’s Still a Growing Digital Divide

As a medical application, experts argue, nuanced information and the human connection are missing from telehealth appointments. They also worry that telehealth is creating a deeper digital divide between patient populations. For patients who have regular, stable access to Wi-Fi and updated devices, telehealth is just a new technology in their toolbelt.

But, according to the Federal Trade Commission, 19 million Americans don’t have access to fixed broadband service at minimum threshold speeds. This encompasses many rural patients. Additionally, Pew Research estimated that 19% of Americans don’t have a smartphone. Many patients who most desperately need telehealth technology are boxed out of it due to having unstable or slow Internet connections and a lack of suitable devices.

Telehealth Isn’t Going Anywhere

Telehealth has proven itself to be an indispensable technology for patients and providers alike. Although it shines a light on ongoing problems, like rural populations’ lack of access to care, technology, and stable Internet, it brings about many more benefits by far. The pandemic may have negatively impacted the world in more than one way, but it also brought us the normalization of widespread telehealth usage. Telehealth technology has enabled patients around the world to stay safe and healthy during the pandemic.

Have you used telehealth technology to speak to your doctor during the pandemic? Share your telehealth experience with us in the comments below!

The COVID-19 pandemic has necessitated a change in patient care, from simple check-ups to psychiatric help. As a result, patients, practitioners, and providers have had to quickly pivot and adapt to the changing times. And although most medical needs were met adequately with the technology we have already, some parts of medical care have not remained accessible and helpful for patients as in-office care.

These areas of concern include mental health care and support, like the delivery of group-based therapies, education, and psychotherapy. Because they are reliant on the patient and provider sitting down together, communicating via body language and other non-verbal cues, and interacting without any outside distraction, mental health aspects of healthcare are more difficult to outfit with the right technology.

In short, our current technologies (like telehealth video conferencing and telephone) don’t work as well as they should for patients requiring mental health and support. But new strides in virtual reality (VR) could change the landscape of medical applications and healthcare delivery for the foreseeable future.

Extending Virtual Reality

VR has been most recently associated with gaming, seeing real estate without stepping foot inside a new building, and even medical training. But in order to extend the closeness of real-life human interaction into VR, we need to extend the reality. We need to enhance our virtual interactions with new tools and close the gap in virtual therapy so that it remains effective and high-quality even as a remote service.

Extended reality is a real technology term that encompasses VR, mixed reality, and augmented reality in a spectrum of various levels of immersion. These three technologies themselves offer various levels of immersion, from mixed and augmented reality allowing the user to see their real-world surroundings with an overlay on a screen to VR which creates a new reality using headphones and body-tracking sensors. VR is the most advanced, mature, studied, and available technology of the three.

VR’s early days included use in applications for medical care and education in the 1990s, which brings us back full circle to today. Since the 90s, VR has been used in healthcare settings for pain control, education, anxiety, exposure therapy, and even to manage the fear of death. Studies show that VR creates a literal change in perspective, creates neural correlates to manage and numb pain, and reduces pain-related brain activity in several parts of the brain.

Additionally, research shows that exposure therapy using VR has had direct, measurable effects on the prefrontal cortex, which plays a major role in cognitive and behavioral activities. These changes are similar to the effect of in-person exposure therapy on the patient.

A Perfect Companion for Telehealth?

When VR was still a young technology, it required expensive, immobile setups using computers, headphones, cameras, and sensors. But these days, consumer-ready headsets are widely available, and they remove the need for cameras and computers. The current state of VR is perfect for studying VR’s potential in telehealth and telepsychiatry.

The Adolescent and Young Adult (AYA) Oncology department at the Yale-New Haven Hospital has begun researching how VR engages AYA patients in support groups. New York City-based VR firm Foretell Reality designed and developed software for the AYA project, and it runs on readily-available $400 Oculus Quest headsets. Four patients attend each support group session using their Oculus headsets.

The patients can attend from anywhere that has Wi-Fi or a cellular data connection. They virtually enter a therapeutically-curated space and sit in a circle with a moderator and the other participants. Each session lasts for 45 to 60 minutes, and each patient must attend six total sessions. The study consisted of five support groups, making it a total of 20 patients. The research team says that the initial results are very promising.

Overcoming Longstanding Obstacles

But there are some challenges to overcome. For example, the team had to ensure physical and emotional safety for all of the patients. Things like motion sickness or triggers could lead to further care or even suicidal thoughts. Headsets had to be sterilized between uses. And the tech industry part of the team clashed with the academic part of the team on timelines and urgency.

Metrics were designed before the study took place to measure depression, resilience, and anxiety before and after the VR experience. Early results show that patients performed well with lower anxiety levels and higher resilience. Attendance to the virtual group support meetings has been steady.

Patients have been encouraged to share their thoughts and ideas with the team, and the team has been grateful for the user feedback. Many patients have stated that they feel more comfortable meeting with the rest of the group when they’re feeling ill. Some patients have noted the need to take a break when their headset starts to feel heavy. Others have asked for more robust and dynamic avatars to represent themselves. And quite a few patients have expressed interest in meeting their support group in-person after their six sessions are completed.

Finding Patients

When the team is done analyzing the AYA group’s findings, they plan to expand their research with a larger, multi-institutional Phase 2 trial. In the second trial, the team hopes to assess risk, dig into the benefits of VR-based mental health support groups, and work with a larger and more diverse patient population. The AYA group was a great starting point because the patients were young, technologically-savvy, and willing to learn a new technology.

But research from other studies shows that elderly patients have performed well in virtual grief counseling, even with their propensity to not pick up new technology as fast or as enthusiastically. VR has the potential to change the lives of patients who live with rare diseases and away from adequate medical care. But the research team at Yale-New Haven worries about rural and lower socioeconomic populations that lack access to a stable, high-speed internet connection.

Coming Soon to VR Goggles Near You

The team hopes that emerging technologies like 5G and Space X’s Starlink system will provide better internet access to underserved populations, allowing VR to be a realistic therapeutic option for anyone who is interested in trying it out.

Would you attend a support group meeting with a VR headset? Why or why not? Let us know in the comments below!

The pandemic has changed many industries, but the field most affected by the coronavirus has been healthcare and medicine. As hospitals scrambled to accommodate the high numbers of emergency room and intensive care unit visits, telehealth grew extremely quickly to complement physical contact with hospitals and doctors. In fact, telemedicine grew so rapidly that The Mayo Clinic estimates the field grew ten years of progress within six to eight weeks.

As a result, things have moved too fast for insurance companies to organize their billing claims appropriately, creating a lack of transparency in how medical services are billed and reimbursed. Although telemedicine provides tremendous value for both patients and providers, doubt and confusion are rampant in the state of healthcare today. And for providers who were already opportunistic and predatory, the relaxation, elimination, and suspension of rules during the pandemic have created a massive playing ground for large-scale fraud.

Before the Pandemic

Fraud related to telemedicine before the pandemic was a sign of what could happen if we implemented telehealth on a much bigger scale. Whether it was one-off fraud or constant scheming, the most hurt groups were single-payer systems like Medicare and Tricare which consistently were victimized by telemedicine scams. Marketers would get together insurance beneficiaries and market them as telemedicine companies, giving them access to providers over the phone.

The “telemedicine company” would then recommend expensive drugs, medical equipment, and diagnostics to the physician. The cost of these scams? Just one nationwide scam before the pandemic, which involved free or low-cost orthotic braces, created $1.2 billion in false billing claims.

Before the pandemic, medical applications like telehealth technology were used to help under-served rural patients get in touch with their doctors. It was also used to “store and forward” important medical information, like radiological images. HIPAA rules regarding the technology were strict, and a HIPAA-secure connection was required. If you were a patient who was going to meet with your provider, you had to be at a pre-approved origination site, and your provider had to be at a pre-approved distant site. You also were required to speak on an audio-visual connection. But it’s well-known that American healthcare rules and regulations change daily, and it changed much more drastically when the pandemic arrived.

After the Pandemic

There’s been no question about extending telemedicine technology to everyone during the pandemic. Because of the fast timing, HIPAA and privacy concerns on telehealth platforms were largely relaxed to accommodate the massive influx of patients and providers. Today, video isn’t even required during telehealth appointments.

You can speak to your provider over the phone or over the computer. Patients now send private clinical and medical data directly to their providers. But this has created confusion and uncertainty about how to bill for medical services.

Before the pandemic, the Centers for Medicare and Medicaid Services (CMS) allowed only 101 telehealth services. On March 30, 2020, an additional 85 services were added. A month later, 51 new services were added. This brought up the total from 101 to 241 within a month.

No one knows how long the lax rules of telehealth will last after the pandemic is over. And no one has information about if telehealth will be shrunken down again as a service offered to a select group of patients. The Chicago-based American Medical Association also added to the confusion and chaos by releasing new billing codes and descriptors for telehealth services. But one thing is clear: there was likely massive fraud committed in 2020, and many schemes are still active.

Chaotic, Confusing, and Challenging

Because of the relationship of the American government with states, there are no two states that have the same healthcare guidelines and delivery regulations. State regulation depends on a variety of factors, like if the telehealth technology uses live video or just email/fax/phone or if it offers store-and-forward services, remote patient monitoring, or originating/remote site restrictions. It also depends on whether online prescribing and coding is happening, what geographic locations are offered, and what the form of consent looks like. 35 states have parity laws that require telehealth billing to be reimbursed at the same rate as in-office visits.

Identifying and analyzing telehealth claims doesn’t usually result in any actionable insights. Workers’ compensation, disability carriers, and union welfare trusts are particularly at risk for being bamboozled. When you look at the fraudulent claims singularly, they look legitimate and payable, which provides more fuel for the scam and involved fraudsters. In fact, fraudulent claims and legitimate claims are difficult to distinguish because the scammer won’t disclose that the service was provided through telehealth technology.

What’s worse is that advanced automation technology, like fraud detection algorithms, sophisticated analytics software, and previously-trained billing and clinical data applications, cannot catch the hundreds of physicians that scammers pay under the table. Bills are spread out over hundreds of payers, resulting in even more chaos and confusion, and this negatively affects any analysis because the volume is too low to analyze.

The Future of Medicine

Medical fraud has always been a part of healthcare in the U.S., especially because of the obfuscation created by adding more complexity into an already complicated system. Insurance companies must help sort out these scams moving forward, rather than remaining passive and reactive bystanders. If we don’t prepare now, we’ll have to pay much more later on.

Telehealth has changed how we treat and care for those who have medical maladies and are vulnerable. The latest innovations in this field are enabling people to live safer, fuller lives without the need for constant human supervision. The COVID-19 pandemic has made this abundantly clear; more healthcare facilities than ever before are embracing telemedicine in an effort to keep patients from in-person appointments that risk exposure to the deadly virus.

Recent telehealth innovations such as wearables heavily rely on the Internet of Things. With this technological paradigm, we can securely transmit and analyze data in order to unearth life-improving care plans. These capabilities allow aging populations to continue to live in their own homes while reducing the burden that many care facilities are experiencing at the moment. In this post, we’ll examine the benefits of furthering telehealth connectivity innovation and the factors needed to make it happen.

Enabling Patient Independence

Good connectivity is essential for three types of telehealth monitoring: passive, active, and condition.

Passive monitoring deals with medical applications and technologies in the patient’s home that quietly monitor his or her behavior. These devices usually only initiate action if they notice something concerning. For instance, the Alcuris Memo Hub connects a variety of smart devices around a patient’s home, like a tea kettle, TV, and lighting. If this platform notices a change in the patient’s typical pattern of behavior, it will issue an alert. It can also observe and trigger an alert for gradual changes that may indicate a revision to a health regimen is required.

Active monitoring entails devices such as panic buttons and two-way intercoms. In summation, these devices require proactive action, either from the patient or a caretaker.

Lastly, as its name implies, condition monitoring involves the monitoring of specific health conditions. It combines aspects of the first two approaches we’ve discussed with detailed health data, like blood pressure, heart rate, and movement.

Simplicity Is Essential

Digital health innovations help improve the quality of life for aging populations as well as patients living with chronic conditions and disabilities. They also help lower the costs and resources needed for adequate healthcare delivery for these cases.

Ensuring that telehealth devices have enough connectivity to reliably capture, share, and analyze data is absolutely necessary. Without proper connectivity, wrong conclusions (and consequently, outcomes) could be reached. But these connected devices need one more feature to take telehealth to the next level: the ability to work right out of the box.

Telehealth device manufacturers should configure their devices to seamlessly connect to a healthcare provider’s system seamlessly without any complexities. They should also be able to work anywhere, whether that’s Beijing or Los Angeles. Making telehealth devices and platforms plug-and-play is imperative since a large portion of their audience may not be tech-savvy or have the time to set up complicated systems.

Overcoming Connectivity Obstacles

Unless you’ve been living under a rock for the past decade, chances are good that you have some experience with mobile phones. This means you’re also painfully familiar with the occurrence of black spots where your mobile device can’t receive a strong, reliable signal. Can you imagine this conundrum for a device that your life depends on?

When a patient’s life is on the line, we cannot compromise on connectivity. To mitigate this issue, telehealth devices should be capable of selecting the best network based on its location and even change between networks to minimize drop-out time. During a critical moment, a dropped connection can mean the difference between life and death. So any device in the telehealth market should offer strong, reliable, and continuous connectivity.

To ensure optimal connectivity, medical device makers must consider its importance from the start of the design process. This often translates to a few common factors for the device. For example, it must be lightweight, easy to operate, robust, and unobtrusive. Often, these elements restrict the design of these devices, which is something that manufacturers may have not dealt with before if they previously focused on larger or fixed devices.

On top of this, manufacturers must also think through what occurs at the back end of their telehealth devices. Do they connect to a cloud service through which analyses are run? Or is the data being transmitted to another human who needs convenient access to it? In this case, how should the information be presented? Alongside connectivity, this focus on communication must also be considered at the beginning of the design stage.

Don’t Forget Security

End-to-end security is always crucial for anything that handles sensitive data such as telehealth devices. Whether it’s your hardware or software, all of your connectivity platforms must be secured properly in order for your device to work effectively.

Unfortunately, several consumer SIMs lack advanced security protocols. They actually send data over standard internet channels, which increases the risk of this information being stolen or lost. To mitigate this, prioritize security early on in the device design phase.

Numerous IoT manufacturers treat device security as an afterthought. As we know from the IoT industry’s track record with data breaches, this has not worked out well. The same mistakes cannot be made when it comes to the personal data of patients.

Dedicated end-to-end security solutions are usually the best for telehealth devices. This involves measures such as data encryption at the device level, communication through trusted private networks and secure gateways, authentication, and authorization.

If you want to take things a step further (which is never a bad idea), add in data flow monitoring tools to detect any unusual activity. These could be your first indicators of a malicious attack taking place. Lastly, consider consulting a third-party pen tester before deployment.

Are You Ready for the Future of Telehealth?

We hope you’ve enjoyed this overview of how connectivity can help accelerate telehealth innovation. It may not be the first topic that comes to mind when you think of new capabilities in digital medicine, but it’s certainly among the most important. By emphasizing connectivity during the design of a telehealth device, you’re able to give patients and providers more peace of mind and unlock better outcomes for both parties.

Have you had any unusual experiences with telehealth connectivity? As always, let us know your thoughts in the comments below!

The research sounds like it can be expanded by introducing more social media platforms and more types of user-generated content, but these findings are not without criticism. Experts not involved with the research say that this medical application of AI may seem promising, but that it does not and should not replace clinicians in diagnosing illness.

The Algorithm’s Skeleton

Using an AI algorithm, the researchers extracted specific details from messages and photos that each volunteer posted. For example, swear words in messages indicate mental illness in general, while words related to negative emotions and words of perception (see, touch, listen) were linked to schizophrenia. And blue tones in photos were indicative of mood disorders. Using these existing traits, the researchers grouped each person into a prediction category: schizophrenia, mood disorder (like depression or bipolar), or no mental health issues.

To test the algorithm’s efficacy, the team used a metric that calculates a trade-off between false negatives and false positives. An algorithm with no false positives and no false negatives (a perfect algorithm) gets a score of 1. On the other hand, an algorithm that guesses randomly gets a score of 0.5. The researchers’ algorithm performed in the range of 0.65 and 0.77, which indicates that the algorithm is on the right track.

When the research team restricted the algorithm from looking at content unless it was posted in the past year, the performance was still better than randomly diagnosing users. H. Andrew Schwartz is a computer science professor at Stony Brook University who did not help with the study. He says that the results of the researchers’ algorithm are similar to those you would get from taking the PHQ-9, which is a 10-question survey used to screen for depression.

The research team was led by Michael Birnbaum, a professor at the Feinstein Institutes for Medical Research located just outside of New York City. Birnbaum says that this type of AI algorithm can have a huge positive impact on the treatment of psychiatric illnesses. According to Birnbaum, psychiatrists have the tendency to work with patients after they’re diagnosed, but the research could help find people who are feeling symptoms much earlier, allowing them to get help before things get worse.

Mining Social Media

Although Birnbaum’s team isn’t the first to use an AI application to detect mental illnesses, they’re the first to work directly with the users as patients. Other studies asked their patients to take the PHQ-9 survey, self-diagnose, or take their word for their diagnosis, but Birnbaum’s team worked with patients who had an official diagnosis from a clinician. Using the date of the professional diagnosis, the team worked backward to find indications of mental illness before the patient had a confirmed diagnosis.

Although Sharath Guntuku, a computer science professor at the University of Pennsylvania, doesn’t think that we’ll be using social media to mine for clues of mental illness as a professional diagnosis any time soon, he says that the algorithm designed by Birnbaum’s team could be a crucial tool in the mental health field. And “what we are increasingly looking at is using these as a complementary data source to flag people at risk and to see if they need additional care or additional contact from the clinician,” he says.

Schwartz agrees with this sentiment, adding that diagnosing mental illness isn’t an exact science, but that more data could definitely improve the accuracy of each diagnosis. “The idea is, you’re triangulating mental health. Assessing mental health is an exercise that can’t just rely on one single tool,” Schwartz says. Adding social media data into the mix can help clinicians bolster the hour per week they spend with their patients, allowing them to get a better (and maybe even clearer) look at their patient’s thoughts and feelings.

And according to Guntuku, some social media platforms are already taking it upon themselves to help catch users who may be feeling symptoms. For example, if someone searches for suicide-related keywords on Google, the search engine will show the phone number for the National Suicide Prevention Lifeline before the search results. Facebook is constantly watching for posts that indicate suicide risk and flagging them for human moderation. If the moderator agrees that the user may be at risk, Facebook can contact law enforcement while sending the user resources for suicide prevention. Either way, Guntuku says, “Any sort of public, large-scale mental health detection, at the level of individuals, is very tricky and very ethically risky.”

Digitalizing Mental Health Awareness

Birnbaum is a clinician, and he sees social media as an impactful data source for therapists to hone in on a diagnosis. After the diagnosis, social media data can be used to monitor and follow patients while they engage in long-term treatment plans. In psychiatry, Birnbaum says, clinicians are lucky to get a snapshot of the patient’s progress once a month, so “incorporating this type of information really allows us to get a more comprehensive, more contextual understanding of somebody’s life.”

Birnbaum has hope that social media will become a part of psychiatry in the next five to ten years. He envisions a day when “digital data and mental health will really combine, and this will be our X-ray into somebody’s mind.”

But there’s more in store for 2021, namely all kinds of interesting new technologies being added to the hardware and software of wearables devices. Here’s what features and devices we’re looking forward to seeing launch this upcoming year.

1. SpO2 Monitoring

Because of the pandemic, the SpO2 sensor has become one of the in-demand features of any smartwatch. Almost every new smartwatch that shipped in 2020 had a SpO2 sensor. But the efficacy of the data has repeatedly come into question by medical professionals, device wearers, and the companies themselves.

Watches with SpO2 sensors often come with a disclaimer that the sensor is only for fitness and wellness. In other words, these sensors don’t offer medical advice, although you can monitor your SpO2 levels to figure out if a doctor’s appointment is warranted. One issue that the SpO2 sensors can alert a user to is the possibility of sleep apnea. However, some wearables don’t use the SpO2 sensor automatically, making it a nearly useless feature.

In 2021, SpO2 data is expected to start being utilized more deeply, especially for health monitoring, early COVID-19 detection, and other respiratory illnesses. In fact, San Francisco-based Fitbit recently released a study that links data from devices’ SpO2 sensors to early signs of respiratory infection, including COVID-19.

2. Sleep Tracking

Sleep tracking has been a major hit for all wearables devices. In Apple Watch devices, sleep tracking involved downloading a third-party app. In watchOS 7, the major added feature was native sleep tracking, which more closely aligns the wearable with Fitbit’s offering.

With the new sleep tracking feature, Apple Watch users can check sleep consistency, set sleep schedules, and focus on time spent asleep and awake in bed. Since the feature just launched, the visualizations are lacking compared to Fitbit and Garmin. Although it’s not known what improvements watchOS 8 will bring, experts are certain that watchOS 8 will be released sometime this year.

One thing is for sure: Apple is going to put its own spin on sleep tracking, whether that means a sleep ring, goals for sleep consistency, or more cognizant sleep schedule tracking. These small changes can help users prioritize sleep as an aspect of health and fitness, rather than viewing sleep as a necessity that doesn’t need any optimization.

3. Body Temperature TrackingBody temperature is a difficult vital to measure, but Fitbit managed to accomplish it. Temperature tracking will remain important in 2021 since it’s an early COVID-19 symptom, so the other wearables manufacturers are expected to follow suit this year. Changes in basal temperature hold a lot of value: they can indicate the start of menstruation, signs of illness, or the beginning of a fever.

Huami’s Amazfit GTR 2e and GTS 2e watches have temperature tracking already, leaving Apple and Samsung behind in offering this feature. This is one feature that users will never ignore, empowering them to get help earlier than they normally would.

4. Your Personal Trainer In a Watch

One of the most utilized features in smartwatches is exercising tracking. The sports watch manufacturers, like Polar and Garmin, work for swimming, bike riding, running, and indoor workouts. With the amount of data collected during each workout, making that data accessible and actionable is the next step for wearables in 2021.

Garmin and Polar are also monitoring sleep and heart rate, tying daily activity levels to other aspects of health and wellness. In addition to Garmin’s acquisition of heart analytics company Firstbeat, Polar’s FitSpark feature dives deep into looking at training data to give insights about how to train moving forward as well as give recommendations about what trainings to incorporate into your next workout.

The notion that a smartwatch can be a digital personal trainer has been an ultimate goal of wearables developers, and we’re inching closer to it every day.

5. ECG and Blood Pressure

Apple led the way when it introduced ECG examining in its Apple Watches. To remain competitive, Samsung also added ECG sensors to its Samsung Galaxy Watch Active 2 and Galaxy Watch 3. One of the hurdles these companies had to overcome is regulatory approval. Additionally, this feature is incredibly complex, so development time is extended for the company. ECG support has been approved in South Korea and the U.S., but other countries are expected to grant approval in 2021 as well.

Blood pressure support is still a unique selling point for smartwatches, and Samsung is leading the way. The company approaches blood pressure monitoring by inserting a dedicated blood pressure monitor that requires some calibration before use. This feature has only been approved in South Korea, but as demand for this feature grows from Samsung users around the world, we expect that more countries will approve blood pressure monitoring in 2021.

The Year of Wearables

Wearables are staying strong in market presence and user engagement. As more people purchase smartwatches in 2021, we expect wearables manufacturers to add more features to stay competitive with each other. This may be the year that wearables go from being nice-to-have devices to becoming need-to-have tools for your health and fitness tracking.

Do you have a wearable that you use for fitness and health monitoring? Do you think the current features are enough or do you want to see more measurements on your wrist in 2021?

So where do we draw the line on how deep we let the AI technology go in our healthcare system? And can we fully trust the results that come out of an AI’s calculations, especially since those calculations are black-boxed (hidden) from those who are interested in learning the reasons behind the AI’s final decision? A few months ago, academics debated these questions against developers from Google Health.

The Root Problem

AI-enabled medical applications, like those we mentioned earlier, span a variety of fields and disciplines, from academia to industry enterprises like Amazon, Google, and Apple. Everyone involved has different incentives, ideas for the future, and thoughts about where the technology stands today. The two sides engaged in a heated discussion in Nature, one of the most well-known science journals. The two sides included AI researchers from the University of Toronto, Stanford, Johns Hopkins, MIT, Harvard, and the Princess Margaret Cancer Centre (PMCC), as well as researchers from Google Health.

It began when Google Health published a study about their AI’s phenomenal results in screening for breast cancer. The company said that its AI vastly outperformed professional radiologists in finding and diagnosing breast cancer. It also added that this technology could be generalized beyond training populations, which is a very confident statement, given that large datasets of high-quality medical images are incredibly rare.

The academics argued that the study was non-replicable, which is a must for published studies so that other researchers can help bolster the claim or warn others that the authors are just blowing hot air. Google Health didn’t include sufficient descriptions about its model and code, requiring readers to blindly trust the results and model’s performance. Google Health’s rebuttal stated that they couldn’t release that information in order to protect patients and the AI.

In science, discourse like this is necessary to push the boundaries of ethics, morality, and regulations surrounding emerging technologies. When big-name companies and schools argue, even the public takes notice.

Academics’ Arguments

Without a replicable method and enough details, published scientific studies are at risk of losing credibility and trustworthiness. Anyone could publish something, make up stellar results, and get praise and credit from the media. But science is formed in replicated experiments that return the same results, follow-up experiments that explore a slightly different question, and novel ideas on how to apply the study. Thus, in all published studies, you’ll read about the exact number of people used in the research, how they were split up, what technologies and tools were used, what experimental procedures were carried out and when, and much more.

But with AI mixed in, it’s difficult to publish replicable studies. Dr. Benjamin Haibe-Kains is a senior scientist at the Toronto-based PMCC. He explains, “In computational research, it’s not yet a widespread criterion for the details of an AI study to be fully accessible. This is detrimental to our progress.” As any developer knows, asking five developers to write code to solve one problem will likely result in five different programs. So without having the exact program, a developer might have a different way of accomplishing the same thing using the very few details he or she knows, which in turn could impact the performance of the AI.

The academics said Google Health’s study is just an example of a major, far-reaching problem. The study lacked transparency and not just for the AI algorithm’s code but for the dataset used for training the algorithm as well. Many medical datasets are under license and can cause patient privacy problems, but that’s not an excuse as datasets can be anonymized. Ultimately, the authors wrote, “such resources can considerably accelerate model development, validation and transition into production and clinical [implementation].”

Google Health’s Rebuttal

Google Health’s team, led by Dr. Scott McKinney, centered around protecting patients and the AI’s code. They also mentioned that regulations require that the AI algorithm remain private, for example, because it could be classified as “medical device software”. Without the proper permissions and regulatory body overseeing the release, developers, patients, and providers can be at risk. Google Health also mentioned that the largest dataset they used is accessibly online by putting in an application to Google. But the other datasets cannot be shared at all.

The Next Big Debate

This is just the start of a series of debates that multiple stakeholders will have over new AI algorithms, their performance, their underlying black box calculations, and the effects on patients and providers. These arguments could rage on for decades, as the line between “right” and “wrong” is still unclear and can vary from stakeholder to stakeholder. One thing is for sure: because this debate was held publicly, it opened up the possibility of hosting these discussions with input from patients. If nothing else, the researchers on both sides piqued the public’s interest in the pitfalls of AI, publishing AI research, and medical experimentation.

Would you trust an AI to diagnose you from your medical scans, or do you prefer a physician to make a decision before looking at what the AI thinks? Let us know in the comments below!

In our last Amazon post about its medical and healthcare strategy, we covered the successes and potential improvements of PillPack and Amazon Care. If you missed it, you can check it out here. In this second and final post of the Amazon healthcare series, we’ll dive into Comprehend Medical, Alexa, Haven, and the ramifications of data and privacy.

Amazon’s Comprehend Medical

Comprehend Medical is an extension of Amazon Web Services, and it’s just as much an artificial intelligence (AI) application as it is a MedTech one. The technology focuses on the comprehension of electronic medical records, which are notoriously complex, rich with years of patient history, and more focused on insurance billing than clinical analysis and data capture. Not only does Amazon offer transcription services that map the patient’s data into the appropriate field, but it also standardizes the healthcare data along the way so that medical clients can easily access and use the data.

The technology also uses AI to study imaging files and find possible abnormalities. However, because the AI algorithms are being developed for specific cases and diseases, the imaging portion of the technology is slower-moving.

Amazon’s Haven Collaboration

As opposed to Amazon Care’s potential to become the newest trend of corporate healthcare offerings, Haven is a little more elevated in potential and theory. The Haven service was launched in early 2018 as a collaboration between Amazon, Berkshire Hathaway, and JPMorgan Chase. The companies named Oxford- and Stanford-educated Atul Gawande, M.D., which further elevated expectations of the venture.

But, in May, Gawande stepped down as CEO, dealing a big blow to the Haven collaboration. Haven’s self-proclaimed goal on its website is to undertake “commonsense fixes as well as innovative approaches” to healthcare access for patients, easier-to-understand insurance benefits, and more affordable prescription drugs. The company’s strategy is to use technology and data to improve the “overall healthcare system”. It’s unclear what exact technologies the company is using, what exactly they’re tackling, and what changes they want to exact upon the healthcare system. Recently, Haven partnered with Cigna and Aetna to offer employees at JPMorgan healthcare plans with increased transparency in pricing.

Alexa’s Medical Skills

Amazon partnered with Anthem Blue Cross and Blue Shield to create a program in 12 states for members to use Amazon Alexa smart assistants to refill prescriptions, answer insurance-related questions about deductibles and claims, and schedule appointments. Rajeev Ronanki is Anthem’s chief digital officer. Ronanki says the goal is to “simplify the experience for our members.”

The service was first introduced in 2018 by Anthem for informational questions, like giving the user the nearest doctor’s or pharmacy’s information without collecting identifying data about the user. When Amazon became HIPAA-certified in 2019, however, Anthem became interested in further pushing the boundaries of what Alexa can do for its members. Across the Atlantic, Britain’s National Health Service signed up with Amazon to use Alexa to provide general health information and guidance in 2019.

Privacy and Data Concerns

Amazon’s an enormous company with a lot of data about our browsing habits, shopping behavior, and likes and dislikes. By dipping its hands into healthcare, we encounter an unspoken understanding that one company will have more varied information and diverse data points about us than ever before. How is Amazon using the data they’ve accumulated? For patients using Alexa through the National Health Service, the company said they were not creating health profiles or using the health information about each patient to recommend products.

However, the devices have been shown to send recordings to Amazon without the user’s consent. Amazon also keeps the recordings to use for training its AI algorithm. According to Ronanki, however, Alexa isn’t retaining any member information, and that caveat is in “our contract.” Alexa does verify the user’s voice for authentication purposes.

Without the healthcare data, Amazon can still use the learnings from these ventures to develop customized medical applications for other organizations. For example, Amazon can use information about British patients as learnings to apply to another partnership. Some experts, on the other hand, worry about using healthcare data for marketing purposes, especially for patients who have Medicare Advantage.

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Amazon’s Ongoing Healthcare Strategy

To become a big player in healthcare, Amazon has to work with the entrenched companies, and this becomes increasingly challenging as insurance and healthcare companies are consolidating to build bigger market shares. Adding the pandemic into the mix, healthcare innovation has accelerated particularly for patient experience and convenience. And more concerningly, the federal government has relaxed its rules and regulations on healthcare and insurance companies during the pandemic to allow patients to get faster and cheaper care at their convenience.

But it’s this loosening of regulations that has opened up the floor for Amazon to jump in, whether with an idea that increases patient convenience, like its new digital pharmacy, or an idea that revolves around the acquisition of a major telehealth or healthcare company. It’s still not certain what Amazon’s healthcare strategy is, at least not at first glance. The company will need to work hard to find a way to fit all of its health ventures into a neat little package.

One thing is for sure: Amazon is definitely interested in healthcare and medicine, and we can’t stop the company from becoming a healthcare juggernaut in the next decade or so. Would you use Alexa to find a nearby doctor? Are you open to purchasing prescriptions from Amazon Pharmacy? And how concerned are you about your data being used or sold for marketing purposes? Let us know in the comments below!