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Examining a variety of alternatives to Apple's Healthkit

7/15/2014

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I was referred to examine the following related technologies by Dr. Atreja.  


Qualcommlife
(click on the word above to visit their site)

I wasn't quite clear on exactly what they did from their site, so I watched a video on youtube where their CEO talks about his organization and project.

It seems that QualcommLife is focused on making it easier for 3rd party hardware developers to make it so that their devices can communicate wirelessly with primary devices such as perhaps ipads used to collect data, or perhaps even updating directly to online servers.

Aetna's Carepass
(click on the word above to visit their site)
Aetna is primarily a health insurance company, but it seems like they are getting in on this too.  This puts them in a unique position because they already have access to a good amount of information from their own health care subscribers.

This reminds me of a story told to me by a friend who vehemently argued that Vonage would fail.  Vonage was and still is a voice over IP telephone service that achieved a good amount of press and recognition around 2001, after which their stock price and subscriber base dropped.  My friend argued that no business could succed when they did not control their own infrastructure.  

Vonage can provide low price calls between different callers, however all of these users need high speed internet connection.  Sure enough every single high speed internet provider aggressively has continued to sell phone package deals which use voice over IP.  Furthermore the advent of free VOIP phone services like Skype have created a lot of problems for Vonage, and they definitely had a period of struggle.  However it seems that they have found a niche where they can offer superior value, namely international calling and also they've used their name brand recognition to create apps that while still using other's networks, have been, when combined with their core business model of VoIP telephony, enough to help Vonage bounce back from bankruptcy.  (Now their website focuses on selling to small businesses.)
Sources I used to make the claims made in the above paragraph were made after reading Vonage's wikipedia entry and a review of their product placed on PCMAG.com.

So while it seems that owning one's own infrastructure isn't a death knell, it seems that the way to succeed in a business venture where one does not control the infrastructure is to focus on providing superior value in a niche.

Aetna will theoretically have an advantage in their installed user base, but their product line does not as of yet seem to have enough to differentiate from the other products I have had opportunity to review, or the proposed products that are to be released including Apple's Healthkit, Google's Fit, or Samsung's already active health/fitness tracker.

Here's an article by Forbes that supports Apple's Healthkit over their competitors.  (it mainly focuses on privacy issues and how Apple is doing a better job of protecting patients privacy.  However this is completely odd because the article itself admits that Apple hasn't even revealed how they will use the information.  In fact this following article from Tech Advisor  titled  Why Apple's HealthKit isn't good for your health makes the exact opposite claim.
The only thing clear here, is that no one's really sure exactly how ANY of these organization will use the data that they collect.

Microsoft's Healthvault

Probably the best option that I've seen as of yet that addresses the possibilities of what this technology can and should do is found at Microsoft's Healthvault site..  The site has a list of devices that their software already works with, and also have a list of apps that their system works with.  However they are missing the elephant in the room, WebMD who apparently may be working exclusively with Apple's Healthkit.  (This is not certain though and I'll have to research this further.)
Out of all the sites I've visted I like the presentation of this organization the best.  However I have yet to see implementation of any of this.  I'll try to sign up next week and examine this more in depth.

Applying these lessons to our own work

So as I start to investigate deeper into the possibilities... I realize that the relationship of these programs to our gastroenterology unit and specifically tracking of Crohn's disease leads to it's own set of unique problems.  What device has the most relevance to Crohn's disease care?

How about the camera pill?  The following is a video of the camera pill technology at work.
The Role of Capsule Endoscopy in the Diagnosis and Management of Patients with Crohn's Disease

Perhaps these pictures can be examined using detection of certain light wavelengths or patterns that can generate auto diagnosis.  The pictures and or video can be stored in the patient's database (hopefully the patient database will be large enough to handle a large number of high resolution photos)

Also the app can lead to better tracking of how medications have impact on disease aka # of ulcers, etc.

I'm also thinking that perhaps we can use google glass/ and or phone cameras to capture pictures of the food we eat and use algorithms perhaps to estimate the volume and then predict quantity of food eaten.  I'm thinking that if two pictures are taken from slightly different angles an algorithm can predict the volume of the image.  This would make things like food diaries easier to track.  Also wearables even just a wrist band may be able to detect the clenching of core muscles used in the Valsalva maneuver associated with bowel movements.  (However it is possible that flatulence or even certain core exercises may trigger false positives.)

I spoke recently to a friend named Slav who is interning in Mt. Sinai's Genomics lab, and apparently Harvard Medical School has a genomics program where they track certain patients who's genome have been identified.  Data such as medications they are taking are apparently tracked and since Crohn's disease has a genetic correlation perhaps we can look at testing our app with such a population.



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    Ed Lee is an aspiring medical student and a man driven by his passion to care for and advocate for others. 

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