Heart rate variability (HRV) data collection can now be done in any setting thanks to a new app designed by HRV Fit Ltd and PhD candidate James Heathers.
The app, combined with a heart rate sensor for a finger, is based on iThlete: an HRF Fit Ltd app that is already used by professional sports teams and athletes. iThlete is used to monitor the health of athletes and improve efficacy of training methods.
“The idea struck me because I’m by nature impatient and my area is psychophysiology,” explained Heathers. “I realized the problem was how to get this very useful data more quickly and cheaply.”
HRV data is necessary for psychophysiologic research in areas including emotion, stress and self-control. Currently, HRV data collection is done at universities with chest electrodes connected to a computer. With Heathers’ new app, it can now be done anywhere and it can be done by the patient unsupervised. The sensor is small enough that it can be mailed to the patient.
To address the issue of data contamination from untrained patients, Heathers intends to use quality controls already accepted by the psychophysiologic community including evaluating data consistency.
“This new device will be a huge help in my own research but also has fantastic potential for the research area in general, and I want everyone to have access to it to pursue their own work.”
Heathers presented the concept for his app at the Australasian Society for Psychophysiology conference. The iMedicalApps team has previously reported on the potential use for data collection to aid in their diagnosis and treatment.
Malnutrition is a byword in the forested hills of the Melghat region inhabited mostly by Korku Adivasis. Every year 400-500 children between the ages of 0 and 6 die in the region, comprising Chikhaldhara and Dharni taluks, according to official figures from 2005.
The Problem: Thousands of kids die every year in the tribal area of Melghat (Maharashtra, India) due to lack of medical attention and nutritional support. Increased incidence and rapid spread of infectious diseases such as pneumonia, typhoid, and dysentery are primary cause of high child mortality. Situation worsens during monsoon when the food supplies are low and the communicable diseases are at their peak.
Melghat is also a place known for high infant mortality rate. Some reasons for the health crisis in Melghat include lack of infrastructure, under-equipped and under-staffed public health and ICDS centres, the tradition of early marriages and early motherhood, lack of sanitation and clean drinking water facilities and the tribals' blind faith in bhumkas (quacks).
Failed Operations of the past: When the Maharashtra government first recorded the figures of child deaths due to endemic malnutrition in the remote villages of Melghat, shocking numbers were revealed.Almost two decades later, even though the government figures show a substantial drop in the number of malnutrition deaths, social activists and health-coordinators working in the impoverished area say that the authorities pass off such deaths as still-births.
The reality continues to bite with the data recorded just before monsoon this year, indicating 509 malnutrition induced deaths during past year, until March 2011. Every year, hundreds of children of Korku tribe in the tehsils of Melghat in the Satpura ranges fall prey to starvation and malnutrition. While the government records indicate figures ranging from 400-525 in the last five years, health activists working among the tribals tell a different story.
Madhukar Mane, Health Coordinator with NGO Maitri, which organises monsoon campaigns to prevent deaths in the precarious season, says: "The figures are certainly better than the late 90s but the numbers are still very high in the tehsils of Dharni and Chikhaldhara. Government records child deaths under two categories: still birth and neonatal. What happens is that they write off several deaths as still births so that the infant mortality rate (IMR) could be kept under check.
Ray of Hope: mhealth is now bringing about a change in India. My two adopted ones- Bongu and Priti along with several others are now fighting malnutrition in their region..I adopted these two angels with the help of World vision India.
The community health workers in Melghat are given the latest weapon to fight against the silent killer – malnutrition. It's a mobile phone pre-loaded with an application called CommCare. "Whenever a pregnancy is reported, I register the women's name and other details via the phone," a community health worker explains.
Once the registration is done, the software gives her the woman’s expected delivery, check-up and immunisation dates. The phone also has pre-recorded messages on maternal and child health that can be played for the women.
Once data is collected, it is saved on a central server of World Vision India, a non-profit organisation that works closely with the government, which distributed these phones. The information then helps in monitoring the health of pregnant women, lactating mothers and young children. The government is now toying with the idea of expanding this successful service to other districts of the state.
Recommendations: Government need to provide access to basic healthcare using mHealth/Telemedicine. About 50 per cent families in Melghat are below poverty line with a high rate of unemployment. Weak mothers often deliver children in grade 1 malnutrition.
It almost instantly deteriorates to grade 2, and then 3 & 4. The nearest emergency health care is about 120 km away that too without a child specialist or medical equipment. About 39 children are suffering from grade 4 malnutrition while 442 fall under grade 3 here.
Here are some of the basic needs of the people in Melghat:
· Proper Scientific Nutrition, including Micronutrients. · Preventive Health · Mother and Child Care · Reactivating Comprehensive Education system . Transportation & Roads · Availability of permanent Employment Guarantee during the non-agricultural season.
The health of Melghat cannot change overnight. But tough monitoring and creative solutions along with the State-led ones, the primary being the crucial Right to Food law, can hopefully nurse it back to good health in future.
Wolters Kluwer Health has partnered with the Altos Group for a sepsis mortality reduction program. The pilot will put mobile technology, actionable clinical content and change management programs to work in the hopes of early sepsis identification and intervention.
The Reston, Va.-based Altos Group is a consulting firm that works with providers to implement change management programs aimed at improving patient outcomes. Headed by Julie A. Kliger, its methodology and services have proven effective at impacting sepsis rates. In one case, which was profiled recently by the Agency for Healthcare Research and Quality (AHRQ), a 54.5 percent reduction in average mortality rates was achieved within three years across nine California hospitals.
“Sepsis is the top preventable cause of death in hospitals. And while hospitals have been proactive in their efforts to reduce its devastating and often fatal consequences, sepsis rates remain unacceptably high because traditional approaches fail to address the human factors involved in early detection and proper treatment,” said Kliger. “By combining The Altos Group’s change management expertise with Wolters Kluwer Health’s advanced decision support technologies and superior clinical content, we are closing the gaps that have hampered hospitals’ efforts to intervene before sepsis becomes life-threatening.”
The sepsis mortality reduction program focuses on early detection and applying best practices to treating the septic patient. In addition to reducing overall patient mortality, costs and lengths of stay, the goal of the program is to identify and address the top healthcare-associated infections (HAI) that drive sepsis mortality, officials say. This will be accomplished through a three-pronged approach that couples mobile software with actionable content, driven by Wolters Kluwer Health tools supplemented by change management consulting services.
“A sepsis crisis is gripping the U.S. healthcare system, claiming 215,000 lives and burdening the system with $16.7 billion in unnecessary healthcare expenditures," said Linda R. Peitzman, MD, chief medical officer, Wolters Kluwer Health Clinical Solutions. "Software and clinical content alone are not enough to change that. Sepsis can only be eliminated if we also pay attention to workflow and human factors."
Independa announced this week the launch of Angela, an integrated tablet and software offering for the independent elderly. The company plans to offer a 10-inch and a 22-inch tablet running the software. Chances are the tablets are running Android.
Independa launched its first services in January at CES: Independa “Smart Reminders,” which is a Web-based platform that includes smart calendaring, medication reminders, and “life stories” all managed for its elderly users by their caregivers.
Angela marks the company’s first move to a dedicated, mobile device-based offering.
According to Independa, Angela is a “social interaction solution tailor-made for the non-technical elderly.” The software features one-touch shortcuts to video chats, email, the Internet, Facebook, games and puzzles, and other interactive content. The interface offers large screen fonts, higher contrast and bright colors for those with poor eyesight. Angela can also remind users to take medications; keep medical and personal appointments; and remember birthdays and anniversaries.
“User-friendly technology solutions that encourage social engagement are essential in preserving independence for older adults,” stated Dr. Richard Della Penna, Chief Medical Officer of Independa, in a press release. “While often overlooked, isolation is the Number One issue for the elderly, as it commonly triggers depression and physical illnesses, which can hasten the move to less-independent living and shorten life.”
Angela began beta testing July 1 and will be released in September. After the beta period, the software will be available for a monthly subscription, with tablet pricing to be determined.
This new addition to Independa‟s integrated telecare suite provides the all-important social engagement that helps the elderly continue living healthy, safe, rewarding lives in their own residences. Knowing their loved ones or patients are thriving also gives remote caregivers peace of mind.
“Angela is unique, powerful and inviting – truly angel-like,” said Independa CEO Kian Saneii. “We see it as the next Wii or iPad for the golden generation. It‟s especially designed to entertain and engage while being convenient for those who care for the elderly. Imagine being able to see Mom or your patient right away, or engage them through emails, Facebook or even video chat. Now imagine them doing all this plus a whole lot more, like playing games and surfing the Internet, without any prior computer knowledge.”
Independa‟s new social interaction solution is tailor-made for the non-technical elderly. Running on an off-the-shelf touch-screen tablet, Angela provides an intuitive interface with secure, one-touch access to video chats, email, the Internet, Facebook, games and puzzles, and other interactive content. The preconfigured Angela tablet comes ready to use. Those being cared for do not need to learn to use a general-purpose computer, navigate with a mouse or type on a keypad.
Meticulously designed for aging adults, Angela offers larger screen fonts, higher contrast and brighter colors. Users don‟t need to worry about repeated software updates, blue screens or virus scans.
“Angela is the latest building block in the integrated suite of solutions Independa is rolling out to help family members and home-care professionals stay in touch with and watch over care recipients when they can‟t be with them,” Saneii said. “Elderly care recipients can use simple, fun tools, and those looking after them need practical solutions that are easy to use and don‟t require their own care. Angela meets all those needs, and adds essential social elements.”
How can Angela enrich an elderly person‟s life? In a myriad of ways. Mom can have a “video-chat breakfast” with her granddaughter. Dad can finally use email. A patient alone at home can reconnect on Facebook with friends who have moved away and play interactive games. Angela also can remind users to take medications; keep medical and personal appointments; and remember birthdays and anniversaries.
“At LivHOME, we believe that technology is going to play a key role in providing consistent high-level senior in-home care at an affordable price,” said Mike Nicholson, Chief Executive Officer of LivHOME. “We feel that Independa has the best-in-class solution to date. Over the two years we have followed their development of care monitoring, medication reminders and other technology solutions, LivHOME has been excited about the prospect of offering the Independa solution to our established national locations and our growing franchise markets. With the launch of Angela, we are proud to be able to offer it as a component of the LivHOME solution to our thousands of clients across the country.”
Angela is an antidote to the critical problem of social isolation and loneliness among the elderly.
Laurie Orlov, founder of the market research firm Aging in Place Technology Watch, commented: “Traditional telehealth boxes and computers are last-decade clumsy approaches to helping older adults, providers, and caregivers. Twenty-first century solutions will look more like the integrated engagement and wellness platforms of new firms like Independa and its “Angela”.
The Independa Angela solution builds and enhances upon Independa‟s Smart RemindersTM. Launched in January, Smart Reminders uses patent-pending technology to enable caregivers to set up automatic reminders for care receivers to take their medications, keep medical and social appointments, and record “Life Stories.” Angela adds visual notifications to existing telephone alerts as options for receiving reminders, as well as confirmation to a family member or professional caregiver that a reminder was acknowledged and confirmed, closing an important daily communication loop for medication compliance.
Angela will be available for beta testing July 1 and generally available in September. After the beta period, the software will be available for monthly subscription, with tablet pricing to be determined. Care recipients will only need Internet access to their homes to stay connected to the service.
Plans call for an option of a 10-inch or 22-inch tablet screen with the commercial offer and a 10-inch screen for the beta phase.
Smartphones already have been used to help dress wounds in a disaster situation, remotely diagnose and self-diagnose acute appendicitis, detect melanoma, pinpoint outbreaks of malaria, substitute for microscopes and track heart rhythms.
Now, researchers at the Massachusetts Institute of Technology have developed a method to detect cataracts on a smartphone, significantly lowering two of the barriers to testing for the condition in remote and low-income parts of the world. With the system, called Catra, no longer does the test require a $5,000 device known as a slit lamp, nor does there need to be a physician present to interpret the results, according to the MIT Media Lab.
Catra is a small device that clips on to various brands of smartphones or other “smart” gadgets such as an iPod. Hold it up to the eye and Catra beams light across the eye to search for cloudiness that could indicate cataracts.
The device then goes beyond the simple score of 1 to 4 that ophthalmologists traditionally assign to the degree of blocked vision. It “scans the lens of the eye and creates a map showing position, size, shape and density of cataracts,” Media Lab graduate student Vitor Pamplona, says in an MIT-produced news story.
This may someday help physicians determine whether cataract treatment—which currently involves the surgical removal of the eye’s lens—could target specific areas of cloudy vision. For now, though, the researchers see the technology as a low-cost way of diagnosing cataracts in underserved parts of the world. It also could help spot cataracts earlier than with traditional testing because the Catra sensor can detect changes in parts of the lens that may not have turned cloudy yet.
With Catra, patients report whether a point of light beamed at their eye stays steady, appears dimmer or completely disappear, instead of relying on a physician to interpret light reflected by the lens. “We turned the problem around,” according to Ramesh Raskar, director of MIT Media Lab’s Camera Culture group. “Instead of asking the doctor, we ask the patient.”
Cataracts are said to be the number one preventable cause of blindness worldwide, but the condition isn’t always detected in time, particularly in developing nations. “Since the blindness can be treated by surgically removing the cataract, the diagnosis is important, and patients may not know that they have a treatable condition. If they can be accurately diagnosed, then they are more likely to seek treatment,” Massachusetts Eye and Ear Infirmary ophthalmologist Dr. Joseph Ciolino says.
The MIT Camera Culture team will present the Catra device next month at the annual SIGGRAPH computer-graphics conference in Vancouver, British Columbia.
Last week the US Food and Drug Administration (FDA) granted 510(k) clearance for UK-based Monica Healthcare’s AN24 wireless fetal monitor for use during labor and delivery. The clearance allows AN24 to be used for intrapartum term monitoring for all singleton births in the US, according to the company.
“The Monica AN24 uses innovative wireless, non-invasive technology to collect real-time electrical signals from the abdomen of a pregnant mother,” the company stated in a press release. “The device uses complex algorithms to correctly identify signals related to the fetal heart rate and uterine muscle (contraction signals) on the abdomen of singleton pregnant women using ECG-style electrodes. This method of using electrophysiological signals differs from current external monitoring devices that collect FHR and uterine activity data based on physical changes (e.g. change in reflected sound waves and changes on strain gauge) that may cause problems in data interpretation such as discerning FHR vs. MHR data.”
Interestingly, Monica points out that clinical trials in the US demonstrated that Monica performs well for obese pregnant women.
“We found the Monica AN24 performed excellently in very obese women (BMI >35) when compared with available Doppler ultrasound/tocodynamometer techniques,” Professor W. Cohen of Albert Einstein College of Medicine, New York stated in the press release. Conventional external monitoring is sometimes challenging with obese women, according to the company, and obesity in pregnancy is becoming more prevalent as the obesity rate in general continues to surge in the US.
For hospital use cases, Monica’s AN24 device will be sold exclusively through Glenveigh Medical and its distribution partner Norgenix in the US.
The Monica AN24 uses innovative wireless, non-invasive technology to collect real-time electrical signals from the abdomen of a pregnant mother. The device uses complex algorithms to correctly identify signals related to the fetal heart rate and uterine muscle (contraction signals) on the abdomen of singleton pregnant women using ECG-style electrodes. This method of using electrophysiological signals differs from current external monitoring devices that collect FHR and uterine activity data based on physical changes (e.g. change in reflected sound waves and changes on strain gauge) that may cause problems in data interpretation such as discerning FHR vs. MHR data .
The Monica AN24 is simple to use, beltless, requires no wires to connect to the display or printer, and will provide high levels of patient satisfaction. There is also no need for the constant re-positioning of transducers, which is required with the current technology, especially during an epidural when the patient is on her side. Clinical trials in the US also have demonstrated that Monica performs well in obese women. Professor W. Cohen from Albert Einstein College of Medicine, New York, stated: “We found the Monica AN24 performed excellently in very obese women (BMI >35) when compared with available Doppler ultrasound/tocodynamometer techniques.” Obesity in pregnancy is becoming more prevalent and acquiring accurate FHR and uterine activity signals in obese patients using conventional external monitoring is sometimes challenging.
Carl Barratt, CEO of Monica Healthcare, explained ”the introduction of Monica AN24 to the US market is a significant milestone for Monica Healthcare, an endorsement of the team here, and represents an exciting opportunity for this advanced technology to positively impact the care of pregnant women during the critical stages of labour.” Monica hopes that its technology will lead to improved patient care, raise efficiency, and ultimately reduce the cost of pregnancy care in the hospital
In the hospital, the Monica AN24 will be available exclusively in the USA through Glenveigh Medical. Glenveigh and its sales and distribution partner, Norgenix , will be promoting the device to pregnancy clinicians. It was formally introduced at the 31st meeting of the Society of Maternal-Fetal Medicine in San Francisco February 9-11.
For more information on Monica Healthcare, please visit www.monicahealthcare.com or contact firstname.lastname@example.org In the USA please contact Glenveigh Medical (www.glenveigh.com) or Norgenix (www.norgenixpharma.com).