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Doctors, Not Patients, May Be Holding Back mHealth Adoption

Posted on June 24, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Clearly, mHealth technology has achieved impressive momentum among a certain breed of health-conscious, self-monitoring consumer. Still, aside from wearable health bands, few mHealth technologies or apps have achieved a critical level of adoption.

The reason for this, according to a new survey, may lie in doctors’ attitudes toward these tools. According to the study, by market research firm MedPanel, only 15% of physicians are suggesting wearables or health apps as approaches for growing healthier.

It’s not that the tools themselves aren’t useful. According to a separate study by Research Now summarized by HealthData Management, 86% of 500 medical professionals said mHealth apps gave them a better understanding of a patient’s medical condition, and 76% said that they felt that apps were helping patients manage chronic illnesses. Also, HDM reported that 46% believed that apps could make patient transitions from hospital to home care simpler.

While doctors could do more to promote the use of mHealth technology — and patients might benefit if they did — the onus is not completely on doctors. MedPanel president Jason LaBonte told HDM that vendors are positioning wearables and apps as “a fad” by seeing them as solely consumer-driven markets. (Not only does this turn doctors off, it also makes it less likely that consumers would think of asking their doctor about mHealth tool usage, I’d submit.)

But doctors aren’t just concerned about mHealth’s image. They also aren’t satisfied with current products, though that would change rapidly if there were a way to integrate mobile health data into EMR platforms directly. Sure, platforms like HealthKit exist, but it seems like doctors want something more immediate and simple.

Doctors also told MedPanel that mHealth devices need to be easier to use and generate data that has greater use in clinical practice.  Moreover, physicians wanted to see these products generate data that could help them meet practice manager and payer requirements, something that few if any of the current roster of mHealth tools can do (to my knowledge).

When it comes to physician awareness of specific products, only a few seem to have stood out from the crowd. MedPanel found that while 82% of doctors surveyed were aware of the Apple Watch, even more were familiar with Fitbit.

Meanwhile, the Microsoft Band scored highest of all wearables for satisfaction with ease of use and generating useful data. Given the fluid state of physicians’ loyalties in this area, Microsoft may not be able to maintain its lead, but it is interesting that it won out this time over usability champ Apple.

Wearables Trendsetters Don’t Offer Much Value

Posted on June 1, 2015 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Today I was looking over my Twitter feed and this tweet popped up:

The referenced article appeared on the corporate site of Qmed, a supplier to the medical device industry. I found this interesting, as it’s pretty obvious that wearables and other mHealth toys will evolve into medical-grade devices over time.

But the choices the article made for hottest wearable firms, while worth a look, demonstrate pretty clearly that few wearables makers can point to any real, meaningful healthcare benefit they offer. (That’s obviously not Qmed’s fault — none of this is aimed at the editor who pulled this piece together — but it’s still a significant point.)

Some of the wearables listed are half-hearted medical device plays, others are fashionable eye candy for upscale geeks, and still others are tadpoles evolving from some other industry into a healthcare mode. Here’s some examples from the list, and why I’m skeptical that they deserve a high five:

* The list includes Apple courtesy of  its Apple Watch.  Right now nobody seems to know quite how the Apple Watch, or any smartwatch for that matter, serves anyone except gadget geeks with extra cash. How, exactly, will having a smartwatch improve your health or life, other than giving you bragging rights over non-owners?

* There’s Fitbit, which is undeniably the wearables success story to beat all others. But just because something is cool doesn’t mean it’s accomplishing anything meaningful. At least where healthcare is concerned, I fail to see how its cursory monitoring add-ons (such as automatic sleep monitoring and heart rate tracking) move the healthcare puck down the ice.

* The list also includes Misfit, whose $850K success on Indiegogo has vaulted it into the ranks of hipster coolness. Admittedly, its Shine is a lovely piece of wearables jewelry, and the Flash is cool, but again, should healthcare leaders really care?

* I admit to a certain interest in Caeden, a Rock Health wearables firm which apparently started out making headphones. The Qmed article reports that the company, which got $1.6M in funding this year, is creating a screenless leather wristband which does health monitoring. But I’m critical of the “screenless” aspect of this product; after all, isn’t one of the main goals of monitoring to engage patients in the process?

I could go on, but you probably get the point I’m trying to make. While the devices listed above might have their place in the consumer health device food chain, it’s not clear how they can actually make patients do better or feel better.

I do have to offer kudos to one company on the list, however. Chrono Therapeutics has an intriguing product to offer which could actually save lungs and lives. The company, which took in $32M in financing last year, has created a slick-looking wearable device that delivers doses of nicotine when a smoker’s cravings hit, and tracks the doses administrated. Now that could be a game change for consumers trying to beat nicotine addiction. (Heck, maybe it could help with other types of addiction too.)

I only hope other wearables manufacturers pick a spot, as Chrono Therapeutics has, and figure out how to do more than be cool, look good or sell to trendies.

By Supporting Digital Health, EMRs To Create Collective Savings of $78B Over Next Five Years

Posted on December 1, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Here’s the news EMR proponents have been insisting would emerge someday, justifying their long-suffering faith in the value of such systems.  A new study from Juniper Research has concluded that EMRs will save $78 billion cumulatively across the globe over the next five years, largely by connecting digital health technologies together.

While I’m tempted to get cynical about this — my poor heart has been broken by so many unsupportable or conflicting claims regarding EMR savings over the years — I think the study definitely bears examination. If digital health technologies like smart watches, fitness trackers, sensor-laden clothing, smart mobile health apps, remote monitoring and telemedicine share a common backbone that serves clinicians, the study’s conclusions look reasonable on first glance.

According to Juniper, the growth of ACOs is pushing providers to think on a population health level and that, in turn, is propelling them to adopt digital health tech.  And it’s not just top healthcare leaders that are getting excited about digital health. Juniper found that over the last 18 months, healthcare workers have become significantly more engaged in digital healthcare.

But how will providers come to grips with the floods of data generated by these emerging technologies? Why, EMRs will do the job. “Advanced EHRs will provide the ‘glue’ to bring together the devices, stakeholders and medical records in the future connected healthcare environment,” according to Juniper report author Anthony Cox.

But it’s important to note that at present, EMRs aren’t likely to have the capacity sort out the growing flood of connected health data on their own. Instead, it appears that healthcare providers will have to rely on data intermediary platforms like Apple’s HealthKit, Samsung’s SAMI (Samsung Architecture for Multimodal Interactions) and Microsoft Health. In reality, it’s platforms like these, not EMRs, that are truly serving as the glue for far-flung digital health data.

I guess what I’m trying to say is that on reflection, my cynical take on the study is somewhat justified. While they’ll play a very important role, I believe that it’s disingenuous to suggest that EMRs themselves will create huge healthcare savings.

Sure, EMRs are ultimately where the buck stops, and unless digital health data can be consumed by doctors at an EMR console, they’re unlikely to use it. But even though using EMRs as the backbone for digital health collection and population health management sounds peachy, the truth is that EMR vendors are nowhere near ready to offer robust support for these efforts.

Yes, I believe that the combination of EMRs and digital health data will prove to be very powerful over time. And I also believe that platforms like HealthKit will help us get there. I even believe that the huge savings projected by Juniper is possible. I just think getting there will be a lot more awkward than the study makes it sound.

Microsoft Joins Battle for Wearables Market

Posted on November 4, 2014 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Following the lead of several other companies big and small, Microsoft has jumped into the wearables healthcare market with a watch, a fitness tracker and a cloud-based platform that condenses and shares data.

It’s little wonder. After a few years of uncertainty, it seems pretty clear that the wearables market is taking off like a rocket. In fact, 21% of US consumers own such a device, according to research by PricewaterhouseCoopers. That’s slightly higher that the number of consumers who bought tablets during the first two years after they launched, PwC reports. Not only Microsoft, but Apple and Samsung, as well as smaller players with a high profile — such as Fitbit — are poised to take the sector by storm.

Microsoft’s new entry is called Microsoft Health, a platform letting users store health and fitness data. The date in question is collected by a Microsoft Health app, available on Android, iOS and Windows Phone. The platform also gathers data generated from the Microsoft Band, a smart and designed to work with Microsoft’s new platform.

The idea behind pulling all of this data into a single platform is to integrate data from different devices and services in a smart way that allows consumers to generate insights into their health. The next step for Microsoft Health, execs say, is to connect all of that data in the platform to the tech giant’s HealthVault, a Web-based PHR, making it easier for people to share data with their healthcare providers.

Other tech giants are making their own wearables plays, of course. Google, for example, has released Google Fit, a fitness-based app designed to help users track physical activity. Google’s approach is  Android smart phones, relying on sensors built into the smart phones to detect if the user is walking, running or biking. Users can also connect to devices and apps like Noom Coach and Withings.

Apple, for its part, has launched HealthKit, its competing platform for collecting data from various health and fitness apps.  The data can then be accessed easily by Apple users through the company’s Health app (which comes installed on the iPhone 6.) HealthKit is designed to send data directly to hospital and doctor charts as well. It also plans to launch a smart watch early next year.

While there’s little doubt consumers are interested in the wearables themselves, it’s still not clear how enthusiastic they are about pulling all of their activity onto a single platform. Providers might be more excited about taming this gusher of data, which has proved pretty intimidating to doctors already overwhelmed with standard EMR information, but it remains to be seen whether they’ll find fitness information to be helpful.

All told, it looks like there will be a rollicking battle for the hearts and minds of wearables consumers, as well as the loyalty of providers.  As for me, I think it will be a year or two, at minimum, before we get a real sense of what consumers and providers really want from these devices.

Apple’s Security Issues and Their Move into Healthcare

Posted on September 3, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m on the record as being skeptical of Apple’s entrance into healthcare with Apple Health and HealthKit. I just don’t think they’ll dive deep enough into the intricacies of healthcare to really make a difference. They underestimate the complexity.

With that disclosure, I found a number of recent tweets about Apple and healthcare quite interesting. We’ll start first with this tweet that ties the recent nude celebrity photos that were made public after someone hacked the celebrities’ iCloud account together with Apple’s HealthKit release.

For those who don’t follow Apple, they have a big announcement planned for September 9, 2014. Rumors have the new sizes of the iPhone 6 could be announced and the new iWatch (or whatever they finally call it) will be announced alongside the iPhone 6. We’ll see if the announcement also brings more details on Apple Health and HealthKit which has been short on concrete details.

Even if Apple Health and HealthKit aren’t involved in the announcement, every smartwatch I’ve seen has had some health element to it. Plus, we shouldn’t be surprised if the iPhone 6 incorporates health and wellness elements as well. Samsung has already embedded health sensors in the S5. I imagine iPhone will follow suit.

With Apple doing more and more in healthcare, it does bring up some new security and privacy issues for them. In fact, this next tweet highlights one healthcare reaction by Apple that is likely connected with the iCloud security issues mentioned above.

This reminds me of a recent business associate policy I saw from a backup software vendor. They were willing to sign a business associate agreement with a healthcare organization, but only if it was their most expensive product and only if it was used to backup your data to your own cloud or devices. Basically, they just wanted to provide the software and not have to be responsible for the storage and security of the data. Apple is taking a similar approach by not allowing private health data to be stored in iCloud. Makes you wonder if Apple will sign a business associate agreement.

We’ll continue to keep an eye on Apple’s entrance into healthcare. They have a lot to learn about healthcare if they want their work in healthcare to be a success. Security and privacy is just one of those areas.

Is Epic the “Microsoft” of Healthcare?

Posted on July 1, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Iltifat Husain, MD from iMedicalApps has penned an interesting article about Apple’s partnership with Epic being a game changer for patients. For those keeping track at home, I’ve predicted something very different with the Apple – Epic partnership. I’m quite skeptical that anything will come from it. Although, I was even more struck by Iltifat’s description of Epic:

If your hospital is currently changing its EMR, more than likely, it’s going to Epic. Epic has essentially become the Microsoft for EMRs.

While there’s no arguing that Epic has done very well and has a large portion of the EHR market, I think it’s far from fair to say that Epic is the de facto choice for hospitals. In fact, many hospitals don’t even get that choice because of Epic’s business practices.

One thing I keep learning more and more is that healthcare is very regional. Maybe where Dr. Husain practices medicine Epic is the Microsoft of that community. However, there are other communities where this just isn’t the case. In fact, I have a story waiting in the hopper for my site Hospital EMR and EHR that talks about the Nashville EHR community. I think we have to be really careful generalizing our regional biases.

We’ll see how this plays out over time, but I don’t think Epic has quite reached Microsoft like dominance in the EHR industry. What do you think? Should I be giving Epic more credit than I’m giving them? Also, let me be clear. Epic has done amazing. Although, Microsoft created a relative monopoly in multiple product lines.

NFL EMR and Patient Generated Data

Posted on February 2, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


We wrote previously about the NFL using eCW, but this tweet seemed appropriate on the day of the super bowl. It was interesting to think that they have multiple video angles available of the injury. I wonder how/if that changes the assessment of the injury by the doctor.


This is a great image and does show the partial disconnect between those using smart devices to track themselves and the sick patients who could really benefit from them. Word on the street is that the latest iOS8 from Apple will have a bunch of health and fitness tracking built in along with a new app called Healthbook. I’ve been waiting for the smartphone to basically do what all these other external tracking devices are doing. If Apple hops in, then we’ll see that happen.

Android’s Advantage Over iPhone in Mobile Health Applications

Posted on February 7, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The reports are all over the web comparing the Android market share to iPhone’s market share (see one example here). These numbers are important for anyone in the mobile health space that’s considering their strategy for developing a mobile health application. The same goes for EHR vendors that are working on their mobile EHR strategy.

The reality as I see the mobile phone market share numbers is that Android is taking the lead when it comes to market share. No doubt, iPhone still has an incredibly compelling offering and many loyal fans. This is particularly true in healthcare where a doctor having an iPhone is in many ways a bit of a cool “status” symbol for the doctor. However, in the long term I think that even healthcare will see a similar market share shift to the Android over the iPhone as well.

Why am I so bullish on the Android in healthcare despite healthcare’s current love affair with the iPhone?

The core reason that I think the Android phones (and much of this could apply to tablets as well) will do very well as mobile health applications is because of how much customization is possible with Android devices. In fact, pretty much anything is possible on an Android phone because of the open source nature of the software. I expect many mobile health applications will need and want to exploit the flexibility and openness of Android over the iPhone.

One concern I do have about this idea is that Android does pose its own challenges for developers. In the case of the iPhone, you basically only have to code your application to work across a small handful of iOS versions and handsets. In fact, Apple has smartly made sure that many things remained the same across every iPhone. This makes developers lives much easier. In the case of Android, you have hundreds of possible handset combinations you have to consider when developing your application. This can be really hard to test and can often lead to a bad user experience for some Android devices.

In some ways, the current Android environment reminds me of the challenges we use to face (and still do today in some ways) in creating a webpage that worked across all the various web browsers. A lot of effort went into making sure your website worked everywhere. However, over time the standards have developed and this is much less of an issue today than it was when the internet first started. I believe the same will be true for Android.

The reality is that Android and iPhones are both here to stay for the foreseeable future. Most mobile health applications are going to have to be able to support both platforms. Some might say that we should just be glad that it’s only two platforms we have to worry about. We had a lot more than two to think about back during the internet browser wars.

drChrono EHR Featured on Apple’s iPad Website

Posted on August 6, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Carl Bergman recently sent me a link to a video on the Apple iPad website that profiles an urgent care center in St. Louis using the DrChrono EHR software. Here’s the intro about the urgent care facility using the iPad:

iPad makes the rounds with physicians.
Trained to handle any medical condition that comes in the door, emergency room physician Dr. Sonny Saggar treats everything from life-threatening issues to small cuts that need a few stitches. Dr. Saggar is also the medical director at Downtown Urgent Care in St. Louis, MO — and its sister location, Eureka Urgent Care in West St. Louis County. He and his staff rely on iPad to help them deliver efficient, high-quality health care. “We can often get patients precisely the care they need in less than 20 minutes,” he says.

I think it’s brave for any doctor to put a time on how long it takes to give care. Does DrChrono have a module that tells you average patient times. Did Dr. Saggar get those times from the EHR? Plus, he says that they often can which I guess could mean that they often can not? Of course, the above copy was probably written by some intern at Apple.

The page also offers these benefits to using an iPad EHR:
-Health records go paperless
-Better communication at the point of care
-Smooth operation
-More personalized care

Are these the benefits you see of using an EHR with the iPad?

We’ve written a lot about ipad EMR software on EMR and EHR. In fact, we were writing about the iPad together with EMR well before the iPad even was officially released. While doctors love the iPad, I’m still not seeing very many doctors use the iPad for their daily documentation needs. The challenge has and still is that the iPad is a great consumption device, but has yet to be a great documentation tool. I’ll be interested to see if someone will be able to crack that second nut.

Reasons to Not Use Virtual Desktop Access to Your EMR on an Ipad

Posted on December 8, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I found this great article which highlights a number of the reasons I’ve been saying that the iPad needs its own native EMR interface and not just some Virtual Desktop solution to access your EMR.

First it offers two reasons why the Virtual Desktop solution is a good option:
-Security
-Cost

The first benefit of security is a good once since as long as your virtual desktop and access to your virtual desktop are secured, then you don’t have to worry about healthcare related data on the iPad. The second benefit is mostly a benefit to the EMR software vendor. Sure, they could make the argument that the price to develop a native iPad app is passed on to the end user. However, most doctors won’t feel that cost. In most cases it just means that other features on the EMR development roadmap will just get pushed back. Although, even this can be a bad strategy if your developers are good at developing EMR software on your current platform, but aren’t familiar with developing a native iPad app. Then, it’s worth spending some money on an iOS developer who knows which features of the iPad they can really leverage.

Now on to the reasons the article suggests that you develop a native iPad app and not just do the virtual desktop solution:
-Doesn’t Make Use of Native iPad Functionality
-Requires Constant Connectivity
-Virtualized Apps are Not Optimized for the iPad

The first and third in the list are very much related and are the biggest reasons why a native iPad EMR app makes so much sense if you’re going to do something on the iPad. The second item actually doesn’t apply very well to an iPad EMR app which even when created as a native app will likely need to have internet connectivity to have any value. An EMR iPad app could be made that didn’t need connectivity, but I have yet to see one that’s done that.