Healthcare Technology Insights for May 15th — June 1st, 2021
Here are the most-read articles from our Digital Health Blogs and Curated Newsletters over the past 2 weeks. Insights by
Amazon and the Coming Rise of Personal Healthcare
The pandemic has accelerated some trends here, notably telemedicine. That’s given a healthy push to an emerging field — remote diagnostics. Your phone is gradually — with some extensions — turning into a remote diagnostic tool to replace doctor visits and expensive tests. That’s fairly well known, even if it is extraordinary: blood oxygen levels are captured by a device costing less than $20, while an always-on cardiac monitor tracks heart activity, for example.
But that’s just the very tip of the iceberg. Remote diagnosis can transform the entire scientific basis of modern medicine. Currently, the gold standard for testing the safety and efficacy of treatments is the randomized control trial (RCT), in which some part of the trial group is treated while another part is not. Both are tracked to see whether the treatment worked, and to look for adverse events like additional illness or even deaths. Outcomes are assessed using standard statistical tools to compare the two groups.
This is the gold standard. But it is based on a single core assumption: that humans by and large react similarly to treatments, and hence that the best way to address disease is to identify treatments that work effectively for large numbers of patients. Ideally, treatments work for everyone, although sometimes RCTs and subsequent tracking find groups for which a treatment doesn’t work, or another for which it works especially well — maybe the old (or young), men (or women), or people with specific pre-existing conditions. Still, this is definitely mass-oriented medicine: it’s based on the impact of treatments on what might be called the median patient.
Amazon is about to enter healthcare in a big way. It is already planning to offer Amazon Care (its primary care system organized around telehealth) not just to its 1.2 million employees, but to other employers as a service, much like it offered Amazon Web Services 15 years ago (and AWS is now the leading provider of internet infrastructure in the world). It also purchased Pillpack and set up Amazon Pharmacy to deliver medications and other health products online for delivery. But the real revolution is coming inside the home. The Amazon Halo is a new health monitoring device (with some admittedly creepy privacy-related features). It is designed to apply the capabilities of AI to the needs of individual patients. And then there is Alexa, which is clearly going to be Amazon’s device of choice for wellness in the home. It’s already partnered with Sharecare to provide automated advice on 80,000 wellness and health questions, as a first line response to health concerns. Alexa will likely expand, gaining the capacity to integrate remote diagnostics and escalation into Amazon’s wider telehealth network.
Still, this mostly sounds like more of the same: using telehealth and the telemedicine capabilities, but mainly just extending what we do now, making it all a bit more convenient — possibly, a lot more convenient. But all these new tools, and especially diagnostics tools, make truly personal medicine possible — like Amazon, all this will be individual-specific: a market segment of you.
read the entire unedited article at https://www.healthitanswers.net/into-the-future-amazon-and-the-coming-rise-of-personal-healthcare/
Our insights:
True. Remote diagnosis can transform the entire scientific basis of modern medicine.
The accuracy with which remote diagnosis services operate helps define how evolved the future of digital medicine will be. Initially when the accuracy is low, prematurely scaling the solutions may lead to an environment of distrust, so one will have to tread carefully.
Capturing COVID-19–Like Symptoms at Scale Using Banner Ads on an Online News Platform
Identifying new COVID-19 cases is challenging. Not every suspected case undergoes testing, because testing kits and other equipment are limited in many parts of the world. Yet populations increasingly use the internet to manage both home and work life during the pandemic, giving researchers mediated connections to millions of people sheltering in place.
Objective: The goal of this study was to assess the feasibility of using an online news platform to recruit volunteers willing to report COVID-19–like symptoms and behaviors.
Methods: An online epidemiologic survey captured COVID-19–related symptoms and behaviors from individuals recruited through banner ads offered through Microsoft News. Respondents indicated whether they were experiencing symptoms, whether they received COVID-19 testing, and whether they traveled outside of their local area.
Results: A total of 87,322 respondents completed the survey across a 3-week span at the end of April 2020, with 54.3% of the responses from the United States and 32.0% from Japan. Of the total respondents, 19,631 (22.3%) reported at least one symptom associated with COVID-19. Nearly two-fifths of these respondents (39.1%) reported more than one COVID-19–like symptom. Individuals who reported being tested for COVID-19 were significantly more likely to report symptoms (47.7% vs 21.5%; P<.001). Symptom reporting rates positively correlated with per capita COVID-19 testing rates (R2=0.26; P<.001). Respondents were geographically diverse, with all states and most ZIP Codes represented. More than half of the respondents from both countries were older than 50 years of age.
Conclusions: News platforms can be used to quickly recruit study participants, enabling collection of infectious disease symptoms at scale and with populations that are older than those found through social media platforms. Such platforms could enable epidemiologists and researchers to quickly assess trends in emerging infections potentially before at-risk populations present to clinics and hospitals for testing and/or treatment.
source: Credit to Regenstrief Institute
read the entire study here : https://www.jmir.org/2021/5/e24742
Our insight:
Wow! Online news tools can be a useful strategy to reach a broad and diverse population during emerging outbreaks. This provides a quick and easy way to capture data on what is happening in the community at large rather than people hospitalized with the disease.
The beauty of this approach is that it offers access to a wide audience, many of whom might not be captured in other data gathering methods. Make no mistake, this is not useful when used in a silo. Its amazing if this is used as a step one tool to bring in participation to more involved mHealth tools for surveying.
Can a smartphone be used to reliably detect early symptoms of autism spectrum disorder?
A typical eye gaze is an early-emerging symptom of autism spectrum disorder (ASD) and holds promise for autism screening.
Current eye-tracking methods are expensive and require special equipment and calibration. There is a need for scalable, feasible methods for measuring eye gaze.
This case-control study examines whether a mobile app that displays strategically designed brief movies can elicit and quantify differences in eye-gaze patterns of toddlers with autism spectrum disorder (ASD) vs those with typical development.
In effect, using computational methods based on computer vision analysis, can a smartphone or tablet be used in real-world settings to reliably detect early symptoms of autism spectrum disorder?
Findings : In this study, a mobile device application deployed on a smartphone or tablet and used during a pediatric visit detected distinctive eye-gaze patterns in toddlers with autism spectrum disorder compared with typically developing toddlers, which were characterized by reduced attention to social stimuli and deficits in coordinating gaze with speech sounds.
What this means : These methods may have potential for developing scalable autism screening tools, exportable to natural settings, and enabling data sets amenable to machine learning.
Conclusions and Relevance
The app reliably measured both known and new gaze biomarkers that distinguished toddlers with ASD vs typical development. These novel results may have potential for developing scalable autism screening tools, exportable to natural settings, and enabling data sets amenable to machine learning.
read the study at https://jamanetwork.com/journals/jamapediatrics/fullarticle/2779395
Our insight:
Identifying autism in toddlers is helpful to starting care for it early. This study’s results demonstrate that with an app based approach coupled with an algorithmic approach, it is certainly possible to get possibly affected children in for detailed clinical evaluations earlier and fairly cheaply.
Thus, doctors will be able to install an app on their smartphone/tablet, one that is capable of analyzing the visual gaze of a toddler in order to determine if they may be on the autism spectrum.
And, in time, parents and family members will be able to download it onto their own smartphones/tablets carry out the screening themselves.
A Novel Remote Follow-Up Tool Based on an Instant Messaging/Social Media App for the Management of Patients With Low Anterior Resection Syndrome
Low anterior resection syndrome (LARS) is a common functional disorder that develops after patients with rectal cancer undergo anal preservation surgery. Common approaches to assess the symptoms of patients with LARS are often complex and time-consuming.
Instant messaging/social media has great application potential in LARS follow-up, but has been underdeveloped.
Objective: The aim of this study was to compare data between a novel instant messaging/social media follow-up system and a telephone interview in patients with LARS and to analyze the consistency of the instant messaging/social media platform.
Methods: Patients with R0 resectable rectal cancer who accepted several defecation function visits via the instant messaging/social media platform and agreed to a telephone interview after the operation using the same questionnaire including subjective questions and LARS scores were included. Differences between the 2 methods were analyzed in pairs and the diagnostic consistency of instant messaging/social media was calculated based on telephone interview results.
Conclusions
The instant messaging/social media system provides a promising solution to accommodate the primary follow-up needs of patients with LARS by integrating complex functional follow-up tools into smartphone apps. Although it is currently not a substitute for manual follow-up, it has the potential of becoming a major LARS screening method. However, further research on response rate, information accuracy, and user acceptance is needed before an advanced system can be implemented
read the study at https://mhealth.jmir.org/2021/3/e22647
Our insights:
Common approaches to assess the symptoms of patients in long term treatments, currently in practice, include
- face-to-face clinic interviews,
- post or email questionnaires,
- and telephone interviews,
These are time-consuming and often complex.
With the popularity of smartphones and mobile internet, remote network technology is changing traditional medical behavior
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