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Computer  Science  and  Engineering  -­‐  University  of  Notre  Dame  

Mobile  Health  Apps  

Smartphones  

•  Embedded  and  pervasive  compuDng  plaEorm  –  Does  not  run  general-­‐

purpose  programs  –  Does  not  have  

convenDonal  interface  •  Mobile  CompuDng  

plaEorm  –  Operates  on  the  go  –  Adapts  to  available  

resources  •  Wireless  sensor  plaEorm  

–  It  contains  an  array  of  sensors  

–  Context-­‐aware  

Embedded  CompuDng  PlaEorm  

Wireless  Sensor  

PlaEorm  

Mobile  CompuDng  PlaEorm  

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Growth in Smartphones

Background Info

•  Smartphones v. feature phones •  Manufacturers (Samsung, HTC, Motorola, etc.) are

less important than operating systems because apps are aligned with the OS. What operating systems exist? –  Apple iOS, Google Android, RIM Blackberry OS, Palm

OS, Windows Phone 7, Nokia Symbian OS

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Smartphone OS

Smartphone  OS  Market  

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Smartphone  OS  Trends  

Smartphone  Manufacturers  

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Smartphone Apps

•  What are apps? –  Mini-programs specific to an OS –  How many are available:

•  Apple App Store: 500,000+ •  Android Marketplace: 250,000+

Guess

•  How many apps are there on the Apple App Store related to health and physical activity –  Any guesses? –  Answer: 10,000+ –  http://itunes.apple.com/us/genre/ios-healthcare-

fitness/id6013?mt=8

•  Next best question – how many are free

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Development Strategies

•  “Native app” –  Specific to OS –  Can use all features of OS/phone

•  Use Internet based version of apps – can be used on a website or downloaded to a smartphone –  Advantage – anyone, anywhere can use the “app” –  Can be used for any OS with browser –  May not take advantage of all features of OS/phone

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Walled  Garden  

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What’s  a  Walled  Garden  (WG)?  

•  Controls  users’  access  to  content  and  services  •  Restricts  the  user’s  navigaDon  within  parDcular  areas  (applicaDons)      

•  Not  all  alike:  differing  heights  and  levels  of  permeability  to  the  walls.    

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Walled  Garden  (WG):  Apple  iPhone  

•  Chronology  – March  7,  2007:  Apple  introduces  iPhone  – March  2,  2008:  Apple  opens  API  to  developers  – March  6,  2008:    

•  100,000  downloads  of  SDK  •  Kleiner  Perkins  announces  $100  M  investment  fund  

–  November  4,  2009:    100  K  apps  –  July  2010:    225  K  apps  

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Apple  App  Store  

•  Business  model  –  Open  API    –  Virtually  every  other  aspect  closed  

•  Integrated  hardware/sodware  plaEorm  •  Non-­‐swappable  applicaDons    •  Exclusive  distribuDon  of  apps.    •  RestricDon  on  carrier  choice    •  RestricDons  and  controls  on  developers    

– MulDple  revenue  sources  -­‐-­‐  HW  $$,  developer  $$,  app  store  

–  Highly  controlled  user  experience  

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iPhone  Revenue  Q2:07  $5M                      Q1:10  $5.5B  

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Apple  iPhone  

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Google  Android  OperaDng  System-­‐-­‐  Open  PlaEorm  

•  Open  Handset  Alliance:  30+  companies  –  Google  Android  open  source  SW  – MulDple  handset  developers  bring  hardware  

•  Open  API  •  40+  smartphones  on  the  market  use  Android  OS  

•  500K+  Android  apps  •  Google  maintains  “control  points”,  e.g.,  see  hgp://www.visionmobile.com/blog/2010/04/is-­‐android-­‐evil/  

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Google  can  give  away  Android  because...  

  “...we  make  money,  and  lots  of  it,  it  turns  out,  from  adverDsing  on  mobile  phones.”    

  Eric  Schmidt,  CEO,  Google  

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Android  

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Selected Apps - free unless indicated

•  Walk n' Play – allows users to track their PA and compete with other users; can create customized profiles and compete online against other users or computer simulations.

•  Fitness Free - 300 exercises grouped according to body parts, muscles and equipment. Includes three prepared routines as well as ability to track weights, sets and repetitions.

Selected Apps

•  Daily Butt Workout Free – five minute video of exercises.

•  Ballroom Dancing Basics 1 ($0.99) – teaches the steps for 10 major ballroom dances, includes color pictures, step placement indicators, and directional arrows.

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Selected Apps

•  Bench Press Lite – strength measure that uses a one repetition max bench press while adjusting for age, sex and weight – strength is relative.

•  Playback – users capture video of self performing a skill and compare to a checklist. This can be done individually or in groups.

Selected Apps

•  Heart Rate – Free – measures heart rate via built in camera. Detects changes in finger skin color corresponding to heartbeats

•  Heart Rate Training Zone Calculator – calculates training zone with ability to adjust upper and lower limits depending on activity. Includes charts and a pulse oximeter.

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Selected Apps

•  Learn to Dance Salsa – two hours of instructional videos designed to teach the salsa in a step-by-step fashion.

•  THI Personal Trainer Lite – includes full workouts, 3D demonstrations, and a virtual personal trainer.

•  Fitness Pro - has over 450 exercises with pictures, the ability to create routines, log results, and graphs.

Selected Apps

•  Pedometer FREE (Dr. Oz) – Calculates steps while walking, running or jogging. Measures distance, time, calories burned, speed and pace. Creates logs, calculates BMI and can export results to a spreadsheet file.

•  The North Face Trailhead – locates hiking trails/bike routes based upon user’s location, over 300,000 available.

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Selected Apps

•  Nike Women Training Club – addresses five areas of fitness (cardio, core, strength, balance and flexibility) through videos, drills and a workout schedule. Friends can work towards common goals or compete for most improved.

•  Stopwatch – basic functions of stop, start and reset.

Selected Apps

•  Pace Yourself Lite – calculates pace, distance and time based upon the other two variables.

•  RightBrain Golf Lite – view swing demonstrations by a PGA tour player overlaid with audio cues. Focuses on mental training and visualization.

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Selected Apps

•  Virtual Tennis Coach – learn from Lleyton Hewitt’s former coach how to serve and volley from videos.

•  CPR Hero – can be used for training purposes or in the event of an emergency. Includes pacing, counts, breaths, verbal guidance and an in-app 911 calling feature.

Selected Apps

•  Attendance ($3.99) – record class attendance and schedule meetings. Student information can be uploaded from a spreadsheet file or address book. Photographs of students may be displayed next to their name.

•  QRS Reader (free local if under 100)– similar to geocaching (have students text location and you reply with next location)

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Q&A

•  Does anyone presently use smart-phone apps for related to health and/or physical activity not discussed? If so, which one(s)?

Healthcare  Facts  

•  Healthcare  industry  spent  $7B  in  wireless  technology  in  2010  

•  5.5%  of  IT  budgets  were  devoted  to  wireless  applicaDons  in  2004  

•  80%  of  hospitals  surveyed  have  or  plan  to  launch  a  wireless  soluDon  

•  85%  said  IT  is  crucial  in  improving  the  process  of  treaDng  and  handling  paDents  

•  50%  of  medical  professionals  say  mobile  computers  reduce  their  errors    

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Modularity:  Dis-­‐IntegraDon  of  the  Computer  Industry  

EMR  1.0  

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EHR  2.0  &    Clinical  Groupware  

Future  of  EMR/EHR  Technology  

1)  Yesterday:  Closed/Monolithic    2)  Today:  Walled  Garden  EHR  PlaEorms  3)  Tomorrow?:  Open  EHR  Technology  PlaEorm(s)  with  

Plug-­‐and-­‐Play  Modular  Apps  

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“Walled  Garden  EHR  Systems”  

1)  AMA/Dell  AMA  to  team  with  Dell  for  EHR  info  plaEorm    3/10  2)  AT&T  AT&T  Expands  Healthcare  Community  Online  to  Improve  PaDent  Care    2/10  3)  Axolotl  Axolotl  Corp  Showcases  New  SOA  Technology  at  HIMSS  2010  3/10  4)  Covisint  Covisint  Jumps  onto  PaaS  Bandwagon  11/09  5)  Eclipsys  

Eclipsys  Introduces  Open  PlaEorm  to  Transform  Health  IT  and  Drive  Electronic  Health  Record  AdopDon  3/10  

6)  GE  GE  IT  CEO  touts  debut  of  next-­‐gen  clinical  knowledge  plaEorm,  eHealth  PlaEorm  3/10  

7)  Henry  Schein  Henry  Schein  Announces  the  Launch  of  InnovaDve  Henry  Schein  ConnectHealth  (TM)  CollaboraDve  3/10  

8)  Medecision  MEDecision  Webinar  Will  Introduce  New  InFrame  CollaboraDve  Health  InformaDon  Service  Technology  3/10  

9)  Medicity  Medicity  Opens  Its  Health  InformaDon  Exchange  PlaEorm  to  Third-­‐party  ApplicaDon  Development  11/09  

10)  Microsod/Eclipsys  Microsod  and  Eclipsys  Announce  Health  Care  IT  Alliance  2/10  11)  Navinet  NaviNet  Offers  End-­‐to-­‐End  Healthcare  CommunicaDons  PlaEorm    2/10  12)  Quest  DiagnosDcs  Quest  DiagnosDcs  Unveils  Care360  EHR    3/10  13)  Verizon

Verizon  Launches  IT  PlaEorm  to  Help  Accelerate  AdopDon  of  Electronic  Health  Care  Records  3/10    

Developer’s  PerspecDve  

•  13+  plaEorms!  –  Cost/Dme  to  get  up  learning  curve  with  each  plaEorm?  –  How  easy  is  the  API  to  learn/use?  –  How  are  revenues  split?  – Which  plaEorm(s)  have  market  viability?  

•  Likely  winners  unclear  •  High  transacDon  costs  of  exploring  opDons  •  Wait  and  see?  

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Future  Open  EHR  Technology?    

•  Open  at  many  levels  (not  necessarily  all)  –  API  –  PaDent  ownership  of  data  –  Data  portability  –  Open  standards  –  Open  source    –  Cross-­‐plaEorm  apps  –  Low  barriers  to  entry/restricDons  for  developers  –  etc.  

1)  Technology  plaEorms  that  support  subsDtutable  applicaDons  should  be  promoted.  

2)  Messages  and  protocols  for  data  exchange  should  be  allowed  to  emerge  on  demand  in  a  market-­‐driven  approach,  and  specified  transparently  at  every  level.      

3)  Protocols  and  applicaDon  programming  interfaces  should  allow  the  possibility  of  mulDple  plaEorms  co-­‐exisDng.      

4)  ApplicaDon  programming  interfaces  should  be  open.    5)  SubsDtutable  applicaDon  or  plaEorm  vendors  should  not  have  control  over  

what  is  installed  on  the  plaEorm    6)  ApplicaDon  installaDon  should  be  turnkey.    7)  The  intellectual  property  of  plaEorms  and  applicaDons  should  be  kept  

separate.  8)  All  applicaDons  should  be  removable  and  none  should  be  required  to  run  a  

plaEorm.  9)  The  plaEorm  should  have  a  highly  efficient  delivery  mechanism  for  

applicaDons.      10) CerDficaDon  requirements  for  plaEorms  and  applicaDons  should  be  kept  

minimal  to  maximize  subsDtutability.    

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Future  Healthcare  

•  By  2014  complete  implementaDon  of  electronic  health  records  

•  Electronic  health  records  will  save  “hundreds  of  billions  of  dollars”  

•  In  U.S.  today  99%  of  physicians  use  the  Internet  •  Fewer  than  25%  of  physicians  have  electronic  medical  records  

 

Smartphone  Technology  

64%  physicians  

use  Smartphone  

36%  physicians  use  iPhones,  Blackberry’s  and  Treos  

100%  mobile  technology  

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“First stand-alone EMR for the iPhone was launched in September

of 2008.”

The  popularity,  convenience,  and  technology  of  Smartphones  will  allow  professionals  to  access  Electronic  Medical  Records  at  any  ?me  or  place;  changing  the  face  of  healthcare  forever.  

iPhone-­‐Based  EMR  

CareTools:  iChart  for  iPhone  

•  iPrescribing  –  PrescripDons  can  be  sent  directly  and  securely  to  paDents’  pharmacy  

•  iBilling  –  A  tool  for  organizing  diagnosis  and  procedure  codes    using  ICD9  codes    

•  iLab  Reports  –  A  lab  and  study  organizer,  labs  can  be  reviewed  and  signed  

•  iNotes  –  Create  and  review  clinical  notes  

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iNotes  Usability  

•  Quick  paDent  data  entry  •  Document  paDent  photos  •  Automated  note  integraDon  •  Automated  dictaDon  •  Customize  documentaDon  templates  •  Sharing  of  paDent  informaDon  

Another  Video  

•  hgp://www.youtube.com/watch?v=a6cNdhOKwi0&feature=channel_video_Dtle