10/31/11 Mobile Health Apps Computer Science and Engineering - University of Notre Dame Smartphones Embedded and pervasive compudng plaeorm Embedded 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 Mobile CompuDng PlaEorm Wireless Sensor PlaEorm 1
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 2
Smartphone OS Smartphone OS Market 3
Smartphone OS Trends Smartphone Manufacturers 4
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-healthcarefitness/id6013?mt=8 Next best question how many are free 5
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 Walled Garden 12 6
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. 13 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 14 7
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 15 iphone Revenue Q2:07 $5M Q1:10 $5.5B 16 8
Apple iphone 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/ 18 9
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 19 Android 20 10
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. 11
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. 12
Selected Apps Learn to Dance Salsa two hours of instructional videos designed to teach the salsa in a step-bystep 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. 13
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. 14
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) 15
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 16
Modularity: Dis- IntegraDon of the Computer Industry EMR 1.0 17
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 18
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? 19
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. 20
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 21
iphone- Based EMR 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. 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 22
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 23