Recap of frog design’s Healthcare Twitter Experiment - #froghealth

On Tuesday (5/5/09), frog design hosted a live one-hour conversation on twitter about mobile health. It was our first time using Twitter for what was dubbed "curated crowdsourcing" by an event participant. Since it was an experiment, we didn't promote the event but we were happy to see we had just as many outside participants as frogs in the conversation. The debate was lively, and it generated some very interesting insights, which we've recapped below.

Based on the positive feedback we’ve received, we’re planning to do another healthcare session soon. The experiment also yielded some important insights about how to improve this kind of event. So please stay tuned to this blog and follow frogdesign on Twitter for more details.

Thanks to everyone who participated in our first Twitter chat experiment exploring the theme of mobile health!

A recap/summary of #froghealth Chat First Edition-5.5.09:

How would you define "mobile health"?

• frogdesign: Mobile health: "healthcare engagements enabled by portable devices and wireless connectivity" What do you think? #froghealth
• laurasgt: i think that's a good starting defintion, but it also applies to our mobility, not merely the devices. environments as well. #froghealth
• laurasgt: if my world is on the go, it's more than me and my phone, it's interaction with everything around me. services for my health. #froghealth
• videofred: @frogdesign That's more "Mobile healthcare" than "mobile health" Are they the same? #froghealth
• ATX: to me, 'mobile health' means having all the pertinent and critical medial data and history in my mobile device at all times. #froghealth
• mcrate_s: @laurasgt agreed. health including sickness and wellness, nutrition, exercise, smog alerts, you name it #froghealth
• jfreach: Real opportunities exist to connect appt info with hospital wayfinding systems. #frogHealth
• soosixty: mobile health - can be used by individual #froghealth
• babjopa: may just be semantics, but to me, healthcare implies relationship with healthcare providers (ppl, devices,) vs. health lifestyle #froghealth
• DeannaLawrence: mhealth-continuous well care apps mhealthcare-sick patient monitoring with urgent response direction #froghealth

Q1: What are the major trends going on right now in mobile tech that can really impact how we engage with healthcare?

• laurasgt: data usage is higher than voice, so healthcare data delivery will continue to surge #froghealth
• frogdesign: Good point fast data is critical to mobile healthcare. 3G and 4G are key. #froghealth
• laurasgt: healthcare IT is making proliferation of iphone apps into hospitals and for the benefit of healthcare providers more difficult #froghealth
• bryanhammer: apps for mobile devices big and getting bigger. could be used to track patience health and auto report to doctors #froghealth  #froghealth
• mcrate_s: @frogdesign http://tinyurl.com/cccyra (expand) is an attempt by Lifescan to bridge devices and ease data entry...or double data entry #froghealth
• ewilmot: well, in the future tense, much medical technology is heading toward nano diagnostics. this info will need controlling/mgmt #froghealth
• emmazure: GPS based mobile apps can help people find out relevant healthcare resources on-the-go. and Geo-tracking can help with report. #froghealth
• jfreach: Cloud solutions for personal productivity apps/services are becoming more robust. #frogHealth
• laurasgt: This comes from my relative who works in a VA based hospital. She told me with HIPPA and JCAHO requirements, IT is scaling back #froghealth
• bryanhammer: could see heart rate, distance, calorie monitors used to track and report health status and improvements #froghealth #froghealth
• babjopa: telehealth, or remote patient monitoring is a huge trend that is improving information sharing between patient & hcps #froghealth
• mcrate_s: @frogdesign all phones will be smartphones soon enough. #froghealth
• mebajason: can you sidestep healthcare IT? #frogHealth
• kaleemux: Major mobile tech trends that can change how we engage with healthcare? Ubiquitous mobile networks, smartphones, falling costs #frogHealth
• jfgrossen: not sure when 'soon enough' is...feature phones / pre-paid phones are still all the rage #froghealth
• frogdesign: @mcrate_s What about in the third world? What about senior citizens? #froghealth
• bryanhammer: exactly. rt @mcrate_s @frogdesign all phones will be smartphones soon enough. #froghealth #froghealth
• laurasgt: Healthcare IT policies and procedures are not in place for mobile devices, which is also the reason for some resistance #froghealth
• gerwitz: @frogdesign #froghealth - The personal context and ubiquity of mobile devices enables the tight feedback loops needed for self-management.
• laurasgt: community based phones - one phone for all is a trend, so this gets me excited about group health "plans" through one phone #froghealth
• mcrate_s: @laurasgt perhaps there may be a bottom up approach which sidesteps IT #froghealth
• emmazure: speaking of telehealth, mobile devices and svc have many advantages in this area, and esp. home health monitoring #froghealth
• frogdesign: @mebajason 3rd world has an advantage there...they can leapfrog like they did with phones because they have no infrastructure #froghealth
• babjopa: Third world - SMS marketing is playing a big role in health education and service #froghealth
• tr5000: In Case of Emergency (ICE) cards alert first responders to your allergies and medical conditions #froghealth
• hupajoob_chat: i wish medical records were easier for people to obtain and manage. Visual mobile devices would be the perfect portal for this #froghealth
• gerwitz: @laurasgt Healthcare is more than professional records; tech will evolve personal fitness into self-doctoring (good or bad). #froghealth
• videofred: Data is key. and how that data is sorted then accessed. Companies will specialize in organizing data then delivering it. #froghealth
• jfgrossen: @videofred what about making data friendly, not just accessible and sorted #froghealth
• kaleemux: Major mobile tech trends & healthcare engagement (cont'd) Location-based services & eg. GPS, proximity; SMSGupShup-like networks

Q2. How can a mobile device be used by a doctor in a doctor's office?

• hupajoob_chat: Q2) to receive notices of patients who are waiting and the severity of their needs. #froghealth
• jfgrossen: A2 - instant notices of availability of prescribed medicines at local pharmacies #froghealth
• mcrate_s: @frogdesign specifically for doctors offices, a mobile device with as much smarts as desktop machine can be a good space saver #froghealth
• mebajason: what if "Patients Like Me" got so big they bought an insurance company and became the intermediary btwn patient/provider #frogHealth
• emmazure: Q2- i think mobile devices should be used not only in the doctor's office #froghealth
• hplug: Apple is definitely trying to push the envelope - http://moourl.com/uem8z - perhaps chart integration? Additional Patient data #froghealth
• mcrate_s: @mebajason i like this idea and have been a big fan of Patients Like Me since I first heard of them #froghealth
• tr5000: Q2- Most hospitals already have PC's is the exam rooms #froghealth
• laurasgt: Q2: Wellness Wireless, glucometer embedded in a phone, auto tracks blood sugar, sent back to nurse at office #froghealth
• DeannaLawrence: #froghealth Personalized monitoring/alerts Preventative simple app-UV protection/allergies-advanced monitoring chronic health conditions
• hplug: Perhaps patient education - using Epocrates on a smartphone to show patients pill color and size, Seniors care about this. #froghealth
• tr5000: Q2- doctors could receive test results and patient scheduling info #froghealth
• jfreach: The transfer of scripts to patient and pharmacy. #frogHealth
• frogdesign: I know doctors who still carry Palm PDA's because of the medical software to help make a diagnosis #froghealth
• babjopa: Q2 - portable access to records, patient education, drug interaction db access, wireless connectivity to med equip/devices #froghealth
• videofred: Q2 Using a tablet PC a doctor can have access to all records of a patient, write Rx, send them to the pharm. #froghealth
• laurasgt: Q2: the idea of "glow caps" (see URL), could be an app: http://tinyurl.com/ahgt3n (expand) #froghealth
• paligoy: Q2: scan (photograph) skin conditions and send them to colleagues or mechanical turk for identification.
• kaleemux: Q2 Mobile device use by doctor in office: Medical record access, diagnostic information, expert network, hospital patient alerts #frogHealth
• babjopa: @hplug yes, and animations/visuals to explain condition - with ability to send that information to patients via their mobile #froghealth
• laurasgt: Q2: I REALLY want doctor "signatures" through my phone for ease in getting scrips on the fly.
• babjopa: capitalize on trend of info Rx (prescribing not just pills, but also education) via sending links from mobile device #froghealth
• kaleemux: Q2 Mobile device use by doctor in office (cont'd): Office = anywhere mobile/wireless exists. Housecalls by necessity: Aging pop. #frogHealth
• frogdesign: @kaleemux Great point! Completely changes the "doctor's office". With good mobile health much care can be delivered anywhere #froghealth

Q3 - What are the barriers to using mobile devices in a doctor's office?

• hupajoob_chat: Q3) They have been banned for so long that there is a current stigma to overcome. #froghealth
• videofred: Q3 security for one. #froghealth
• emmazure: Q3 - potential radiation and noises to medical devices in the hospital #froghealth
• mcrate_s: @frogdesign barriers include the ability for the doctor to not have to use both hands, be able to put on and take off gloves...
• frogdesign: For one, I think being sterile is important, but mobile devices need not be shared among multiple individuals. #froghealth
• laurasgt: Q3:barriers are privacy, hospitals often have leaded walls so poor data connection #froghealth
• hplug: Q3- Biggest barrier to my mind - implementation...can you teach an older doc new tricks? Better yet is a patient ready for this? #froghealth
• gerwitz: @frogdesign Q3: fear of doctor's diagnosis role being diluted. #froghealth
• babjopa: Q3 - system integration (or lack thereof) is huge barrier in HCP offices/hospitals #froghealth
• ChrisR_here: Formatting of information - records are often kept in a manner that is specific to the physician or hosp system #froghealth #froghealth
• videofred: No reason the device has to be a current brick. Can be a heads up display worn like glasses hooked up to pack #froghealth
• videofred: Q3 biggest problem is data being in so many different formats. Agree with @Babjopa. Need to give individuals control over data #froghealth
• kaleemux: Q3 Barriers to mobile device use in doctor's office: Systemic & cultural issues (not technical) barriers. Training & procedures. #frogHealth
• emmazure: @frogdesign probably building the first mobile-friendly clinic environment :) #froghealth
• babjopa: also depends on how we define mobile - future may not even mean handheld - check out this from MIT http://bit.ly/LdXlr (expand) #froghealth
• paligoy: @emmazure This is a big one - at least in ICU you have to turn off your phone when you visit. #froghealth
• kaleemux: Q3 Barriers to mobile device use (cont'd): Legacy systems in old hospitals: huge barrier. Redesigning process to include mobile. #frogHealth

Q4- How would an individual use a mobile device differently for health/wellness vs. for healthcare (i.e., in the hospital)?

• tr5000: Q4- Health/wellness is motivational. Healthcare seems more like management/records/appts #froghealth
• hupajoob_chat: Q4) i want to be able to scan 'what hurts' with my phone and email it to my doctor #froghealth
• deremer: But health requires more frequency of use. Healthcare is once in a while only. Different usage pattern. #froghealth
• hplug: Q4 - I am not sure the average individual would take part in mobile health but if it was initiated by a professional they might? #froghealth
• videofred: Q4 Individuals use devices all the time. Nike armbands hooked up to iPod captures running data. Doesn't have to be phone. #froghealth

Q5- What are the ways that a mobile health app can keep a user actively engaged over time?

• hupajoob_chat: Q5) FEEDBACK! integrating personal data, tracking exercise, heart rate, food intake, and graphing all of it. #froghealth
• deremer: Q5- A rewards system or some sort of status indicator...competition works wonders for engagement. Look at playfoursquare.com/ #froghealth
• videofred: Q5 Apple/Nike built a community of people charting their running. And they all stay engaged. http://is.gd/i1NC (expand) #froghealth
• jeff_bare: @frogdesign #froghealth Q5- a personal connection, providing info specific to me and my health. suggested activities/recipes
• laurasgt: MedTracker – just saw a journal of a guy who keeps track of all his meds and notes how they are interacting together. Every day #froghealth

Q6- From all this, what is the best idea you can think of for a mobile health application?

• laurasgt: One Slide Project extended to mobile: http://www.engagewithgrace.org/ #froghealth
• deremer: Q6- I want to see my doctor notes, prescriptions, CT scans, everything about my health on my iPhone. Then I own it, not my DR's. #frogHealth
• jfreach: I want the big binder of my daughter's health history in a widget or iPhone app that speaks to her physician. #froghealth
• aurasgt: Project M, but for Obama's Aids Awareness Campaign. See: http://tinyurl.com/c8jmg2 (expand) #froghealth
• peterhorvath: @frogdesign A medical diary with core location to track various symptoms in real-time. #froghealth
• videofred: Q6 Just a quick medic alert for iPhone. You press the Medical symbol and get Emergency info for the person #froghealth
• deremer: Q6- Not to open a can of worms, but it'd be nice if I could buy healthcare like I can buy stuff on amazon or ebay. #froghealth
• babjopa: a well done PHR app allowing easy access and input and many linkages(my health plan, fitness, nutrition trackr, family linkages) #froghealth
• kaleemux: Q6 idea for mobile health app? SMS-based service to give low socio-economic status folks access, extended outreach & aftercare. #froghealth
• laurasgt: @kaleemux yes, this reminds me of the Gates Foundation focus on India. http://www.gatesfoundation.org/avahan/Pages/overview.aspx #froghealth