The Next Frontier, Attaching Health Sensors Directly To Your Smartphone

by Timothy Aungst, PharmD

physician using iPad

A month ago I saw a video on YouTube about creating modular smartphones, created by Phonebloks. Phoneblok puts forth their idea that such a product could reduce waste, and allow highly customizable products for smartphone users who utilize their phone for different purposes. In essence, this platform moves beyond a modifiable user interface that focuses on apps, and focuses on a system with modifiable hardware to supplement those apps.

While the premise was interesting, I did not give it much thought due to the fact I could not envision any smartphone developer investing into such a product. Needless to say, I was wrong since Motorola has announced it will be creating modular smartphones with its Project Ara. Motorola’s idea is to create an endoskeleton that will provide the key components of a phone with modules that may be attached.

Such a modifiable phone would allow users to create a phone that will be tailored to their primary user preferences. For instance, someone who may like to take pictures with their phone could invest into a better camera module and more storage to keep the pictures.

However, I see such a development as the next step in creating a smartphone that can serve patients and the medical community to a greater extent than currently available. While many have recognized that smartphones are changing healthcare, it has–until this point–relied on the ingrained apps available or peripheral accessories that work with a phone.

A modular phone could, in essence, make it possible to completely remove those peripheral devices reliance on indirect connections and be directly incorporated into the phone itself. For example, I have created a mockup of a modular piece that could measure EKG’s. Taking, for example, the currently available product AliveCor, it could be transformed into a module that could directly connect to the phone, therefore bypassing the need of an external battery source and feeding data directlyinto the phone itself.

Continue reading The Next Frontier, Attaching Health Sensors Directly To Your Smartphone

Why The Annual Physical Still Has Value

 | PHYSICIAN | NOVEMBER 14, 2013

teddy bear with stethoscopeEver since the days of William Osler, annual physical examinations with one’s doctor have been an accepted and expected part of health care.  But recently the practice has come under some criticism.  Given the dearth of studies showing that physicals lower the risk of death and hospitalization, some experts and organizations state that the annual physical should be abandoned.

I appreciate the effort here to question tradition and to consider if a commonly accepted practice truly has value.  Nonetheless, I believe that in the appropriate patient population, annual physicals serve important functions.  First, they ensure that people are up to date on health maintenance measures.  Screening for colon, breast, and cervical cancer is proven to save lives.

In my work in hospice and primary care, I have seen the tragedy of unnecessary suffering and premature deaths caused by a failure to do appropriate cancer-screening tests.  In my physicals, I also review patients’ immunization records to make sure they have been appropriately vaccinated against tetanus, diphtheria, pertussis, shingles, pneumonia, flu, and hepatitis A and B.  Doing so decreases their chance of suffering from these diseases and helps protect the surrounding community.  By screening for sexually transmitted infections I have detected HIV and syphilis, thereby enabling people to be treated at an early stage of the illnesses and preventing their spread into our local population.

Continue reading Why The Annual Physical Still Has Value

The Latest Scoop on AEDs in the Workplace

Posted October 31st, 2013 by SCAFoundation   

[If you have any questions about AED’s for your business or organization, our colleague, John Fowler, represents the leading manufacturer in the U.S.  Check HRRE .]

Sudden Cardiac Arrest Foundation logoAutomated external defibrillators (AEDs) have become a familiar sight in many workplaces across America, yet these life-saving devices are still not present in the majority of them. Organizations without AED programs cite various concerns, range from liability issues to costs, as reasons to withhold a sudden cardiac arrest safety net.There are many compelling reasons to have an AED program. Leading this list, of course, is having the ability to save the life of a co-worker stricken by sudden cardiac arrest. Let’s take a look at the latest research, best practices, and results to see how they apply to your workplace.

1. Research shows speed to shock is the most important lifesaving factor. Of the countless studies about AEDs, the one making perhaps the most important point is the Johns Hopkins study by Myron Weisfeldt and colleagues published in the Journal of the American College of Cardiology. This study demonstrated that training lay (non-medical) volunteers to use AEDs doubled the survival of cardiac arrest victims.

Most interestingly, laypersons using a defibrillator achieved the highest survival rate (40 percent)—higher than health care workers, police, and EMS. The overall survival rate among 13,769 victims eventually reached by EMS personnel was 7 percent. The 33 percentage point difference between laypersons and EMS is attributable simply to speed. The laypersons were on the scene with an AED and were able to treat the victim more quickly than EMS responders. The study’s authors even went so far as to state that “speed is more important than training” and encouraged early defibrillation programs in communities, including workplaces.

2. AEDs are extremely reliable, but maintaining them to ensure they are ready for a rescue is important. AEDs have proven very reliable at the scene of sudden cardiac arrest. AED program expert Richard A. Lazar is the founder and president of Readiness Systems, which helps organizations create and maintain operationally ready and risk-managed AED programs. He examined data the FDA used recently to support proposed rules that would tighten AED regulations.

Writing on his blog, Lazar said the data shows that AEDs work as intended more than 99.5 percent of the time. When they don’t work, the reason is often related to faulty inspection and maintenance. He cited a recent University of Alabama at Birmingham study that evaluated five years of data from Alabama communities involved in the National Institutes of Health Public Access Defibrillation (PAD) trial. The data showed high percentages of AEDs with expired batteries, expired defibrillation pads, and unresolved maintenance alerts. “These are people problems, not device problems,” he wrote.

If AEDs are inspected and maintained regularly, the chances of an AED failing when needed are virtually nil. Recent technological advances are making AEDs even more reliable and easier to maintain and use through features such as automated daily self-tests, status screens showing the readiness of defibrillation pads and the AED’s battery, and embedded help videos that can be used during training to review the critical steps of a rescue.

3. You can’t argue with results. Virtually every day somewhere in America, an organization with an AED program saves the life of a worker, customer, or community member. A quick Google search finds these organizations mentioned in news stories about co-workers saving an employee’s life: American Airlines, ARTCO/ADM, Bennett International Group, Delta Air Lines, Honeywell, Indiana University-Purdue University Fort Wayne, Maryland National Capitol Park Planning Commission, New Jersey Transit, Northern Virginia Electric Cooperative, O’Hare International Airport, Penn State University, Pentair, SANBlaze Technology, Schick, State Farm, Systemax Manufacturing, Trans International, WebMD, Wells Enterprises, and more.

The list of organizations saving customers or community members would go on just as long. LA Fitness, for example, has saved 50 lives since instituting its AED program. Lives saved on airlines and in airports, schools, athletic facilities, and casinos are well documented, with thousands of saves occurring in these locations. The Sudden Cardiac Arrest Foundation’s You Can Save a Life at School (www.sca-aware.org/schools) and You Can Save a Life on Campus (www.sca-aware.org/campus) programs provide many examples of students and school employees saved by AEDs.

In addition, certain U.S. communities have achieved exemplary results by combining access to AEDs with innovative EMS services. For example, King County, Washington, has a sudden cardiac arrest survival rate of 57 percent, according to Seattle and King County Public Health. Through its “Shockingly Simple” campaign, the county has encouraged the purchase and registration of AEDs while improving the speed of EMS response and the training of paramedics. A new initiative has EMS dispatchers providing CPR instruction over the phone while EMS is en route. The basic elements of King County’s approach can be replicated in any workplace by having AEDs readily available and employee response teams trained in CPR and AED use.

Yet the vast majority of workplaces have not yet implemented AED programs. Citing concerns about legal liability, the time involved, and costs, these workplaces are basically betting that no employee, customer, or visitor suffers sudden cardiac arrest on their premises. Or these organizations are falsely assuming that EMS will arrive to save the day, despite the evidence showing that EMS saves of sudden cardiac arrest victims are quite rare in most communities, the King County example notwithstanding. Of about 380,000 annual, nationwide incidences of sudden cardiac arrest that occur outside the hospital, only about 8 percent of victims survive. That’s nearly 1,000 people dying each day.

4. Reliable, regularly inspected, and well-maintained AEDs are the best answer. Having one or more AEDs at your workplace is simply the least risky approach to managing the possibility of sudden cardiac arrest, assuming the AEDs are a reliable brand, regularly inspected, and well-maintained. An employee response team with an AED and training will typically “do the right thing” in response to sudden cardiac arrest, Lazar said, and often the team members are able to save a life. And despite the warnings from naysayers, well-intentioned and reasonable responses by trained and prepared workplace teams rarely result in adverse legal consequences. Most importantly, correctly maintained AEDs rarely malfunction–and they’re easier to use than ever.

All AEDs provide real-time audio instructions for rescuers, and some have video and text instructions. For example, when the audio says and text reads, “Place pads on patient’s chest,” the video shows exactly where to place the pads. When it comes to simplicity, AEDs have reached a tipping point similar to when the iPhone was introduced to cell phone users. The iPhone made smartphones easy. Before the iPhone, relatively few Americans used their mobile phones to text, use the Internet, and keep track of important personal information. Now, many people use their phones to manage virtually every aspect of their lives.

Simply put, new AED technology makes it easier to save a life while giving workplaces the opportunity to send a strong message about health, safety, and well-being to employees, Lazar explained. “If you want to have an AED program,” he said, “you can do it and you can do it well.”

SOURCE: Greg Slusser, Occupational Health and Safety

Risk: It’s Not Just a Board Game

Risk, is not just a board game in Workers' Comp

I always go for Australia.

The fear of death is the most unjustified of all fears, for there’s no risk of accident for someone who’s dead.
–Albert Einstein

When I was a kid, I used to read Choose Your Own Adventure books. For those of you who are unfamiliar with the genre, you were the main character in a story. The first few pages were an initial vignette, and then you had to make a decision. If, for example, you went into the cave, you’d turn to page 33, but if you went to the lagoon, you’d go to page 52.

Occasionally, these choices spelled doom and gloom for your hero character. You’d step into a pit of monsters and that would be the end.

Except, of course, you could always go back to the previous spot and make a different decision.

Life rarely offers these opportunities to turn the page back and make different decisions. Once we’ve chosen, we’re forced to live with the consequences of our actions.

Most of the time, bad outcomes from our decisions aren’t truly that bad. We go to a restaurant where the waiter was surly. We buy cable packages with channels we never watch. The TripAdvisor reviews about the hotel we chose for our vacation were overly flattering.

Those are inconvenient outcomes, but we can shrug them off and move on with our lives.

Some outcomes, though, aren’t as easy to move on from.

Therefore, when we’re faced with risk and potential bad outcomes, we have three choices for how to deal with that risk:

  • Reduce the risk. Driving around on bald tires? Change the tires and reduce the risk of a blowout on the Interstate.
  • Accept the risk. Each time you step on a plane, you’re taking a risk that the plane is going to fall out of the sky. The chances are very low (though our limbic systems tell us that the risks are much higher), and it’s not like you can fly the plane better than the pilot, so you accept the risk and take that flight.
  • Insure the risk. When a bad outcome would be devastating to you or your family, you can pay someone else a small amount of money to pay up in the event that the bad outcome happens. It’s why we have health insurance, life insurance, auto insurance, homeowners’ insurance, long-term care insurance, and disability insurance. Continue reading Risk: It’s Not Just a Board Game