Notes & Links: November 1, 2013

IMS: Half of Android health apps have fewer than 500 downloads
The report by IMS ends with the following:

The report also identifies a number of barriers that need to be addressed to increase app adoption and improve the quality of apps, including a curation platform of some kind, app integration with other parts of care, better safety and security, and more robust efficacy measures to prove the value of apps to all stakeholders in the ecosystem.

Pair that with the following from the same report and what we have is, let’s throw some poop against the wall and see what sticks. I am not sure that any consideration of strategies, objectives, etc. are made when launching these apps. And it is not as if there is not seasoned smart healthcare executives available to help. Oh wait we are old and can’t code. Gee look how well you’re doing.

Analysis of the widely available consumer healthcare apps on the iTunes app store shows that at present there are 159 apps which link to sensors,” IMS writes in the report. “However these are dominated by fitness and weight apps which monitor pulse rates when exercising and measure weight and body mass index (BMI). Fewer than 50 of these 159 apps relate to actual condition management or provide tools and calculators for users to measure their vitals. There is therefore considerable room for growth in this sector.

Sociotechnical Challenges and Progress in Using Social Media for Health
Munson, Cavusoglu, Frish, et. al out of the University of Washington shared their view on social media in healthcare and how these tools that hold so much promise are not meeting their established goals. This is a long well referenced piece that has many nuggets of knowledge. I must say it is hard to read. Damn near turgid. Of course it may be my modest IQ but I shared the work with colleagues and they felt the same.

At a recent Peter Wall Institute for Advanced Studies workshop, our group was tasked with reflecting on contemporary and coming technical challenges for using social media to promote healthy behaviors, communicate health information, and to gather information on current health behaviors or events. We hope to see a continuation and extension of recent technical developments in sensing, connectivity, and large-scale data aggregation and analysis. There are clear areas for improvement—for example, activity inference can be unreliable and drains battery life, and Google Flu is still poor at detecting atypical flu trends, as the most severe often are. We believe, however, that these challenges are being fairly well addressed by current research and market forces, and thus we do not dwell on them here.

Grab a coffee, print this out, and explore all it has to offer. The next step will be assigning sets of goals and strategies to what is presented here in clear simple language.

An Epidemic Out of Control: Poor Children and Psychiatric Drugs
Howard Brody, MD, PhD writing on Hooked: Ethics, Medicine, and Pharma reports from the American Society for Bioethics and Humanities a presentation by Dr. Melody J. Slashinski of the Center for Medical Ethics and Health Policy at Baylor College of Medicine.

Slashinski’s presentation was based on discussion with mothers and their ‘folk-knowledge network’ linking them and information about drugs commonly prescribed for children today.

That might sound easy to do, but the data went on to show that it’s extremely difficult in this population especially. The mothers also feared, quite realistically, that any evidence of “medical noncompliance” on their part would end up with a report to Protective Services and eventually losing custody of their children. So the stories Dr. Slashinski told generally depicted a delicate balancing act—moms on the one hand certain that they would not give these medicines to their children, and on the other hand going through as many hoops as they could to appearcompliant and submissive to the medical system so as not to set off alarms.

There is a long passage where Dr. Slashinski speaks to a pediatrician’s office check-up for a 9 year-old son and 8-year old daughter she witnessed. You must read the entire description but here is part of it.

The doctor then examined the daughter and said something at one point about her “boobies.” The daughter apparently became offended by this comment and stopped cooperating with the exam. The doctor immediately asked the mother how often the daughter had these “tantrums” and started talking about the possibility of bipolar disorder.

Brody’s post and his comments speaks to the massive level of drugs that are being prescribed to poor children and to the reality that parents of these children find the only way parents can protect them is by not taking them to the physician.

Can Everybody Please Just Calm Down?
Ann Mond Johnson writing on the Healthcare Blog gives another perspective on Obamacare and the whirling Dervishes surrounding its failed launch. Johnson asks that the private sector to step up to the plate and “counteract what much of the media refers to as a complete debacle”. 

  • First, just calm down and focus on helping clear up the confusion
  • Help people shop remind people of their options under this healthcare plan
  • Provide perspective Americans must have healthcare by law and now that is easier

There are voices out there who are rational, not shrill, that speak to the need for the ACA to be successful for the health of America. We all should try and find these voices and listen if for no other reason but to calm the !*#@ down.

What Would Darwin Think Of Obama’s Health Insurance Exchanges?
Ian Shepherdson a contributor at Forbes gives us another step away from that epic disaster of a launch called Obamacare and its Insurance Exchanges breach birth. 

Amid the chaos, it is easy to overlook the key point, which is that the insurance exchanges are here to stay.  Despite their difficult birth, they will evolve over time as lessons are learned, bad technology is fixed, and operational difficulties are overcome.  They will persist, even if a future Republican administration succeeds in unravelling some elements of Obamacare.

Shepherdson goes on to point to the fact the idea which was originally a Republican concept in the 80’s. But the primary message is this is not easy task making a sea change to a nations healthcare and a change that hopefully will manage costs and improve outcomes. Those are huge targets sitting on the back of anyone trying to make Obamacare work. 

Good ideas spread, unless something really powerful gets in their way. Next time you swat away a mosquito, remember how it got to be buzzing around your ear in the first place.  Insects were the first flying creatures on earth, but they didn’t always have wings.  They didn’t really fly, either.  Instead, a random mutation in the genetic code of a non-flying insect affected the shape of its body, helping it hop or jump a bit further than its siblings, or ensuring it was blown a bit further by the wind.

Another rational voice. Perhaps I am looking for hope for America’s healthcare crisis.