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Is the New Clinic, Forward, Only Reasonable for the Silicon Valley Elite?

A new clinic has been opened in San Francisco called Forward which is an attempt to reinvent the doctor’s office by several dozen former employees of Google, Facebook, Uber, and Palantir. On the one hand, this new clinic is an amalgamation of all the innovation that’s been happening in the digital health space. On the other hand, it seems to illustrate Silicon Valley excess and culture. Let’s take a look at each perspective.

Forward starts the patient experience with an iPad sign in that’s setup looks a lot like the Apple Store. It sounds like they’ve built all new software for their clinic, but tablet check in or other kiosk check in options have been in healthcare for quite a while. After checking in on the iPad, the patient then goes to a body scanner that identifies you using 2 fingers and then gathers your height, weight, body temperature, heart rate and the amount of oxygen in your blood. All of this data is available to doctors today, but this is a novel way to collect the data that likely saves time for patients and the clinic staff.

The exam rooms look like a really well designed exam room, but still feel like an exam room you might go to in most doctor’s offices. However, one notable feature of the exam room is a massive touch-screen display on the wall.

What makes the exam room and this touch screen unique is that the exam room listens to what’s being said in the room and pulls out information for the medical record and displays that information on the screen in real time. This sounds a lot like what I described in my Video EHR idea. The screen will also show the patient’s health history including sensor data and suggests diagnoses and treatment plans. How well it does at this is a good question, but in true Silicon Valley fashion I’m sure it’s an MVP (Minimum Viable Product) that will improve over time.

Many are touting Forward’s unique approach to Urine Sample collection, but this has been done in many other offices for years. Is this really an issue? I don’t think so. Forward also has essentially a health store as well that sells everything from wearable sensors to vitamins and supplements to skin care products. This has a kind of Apple Store feel as well. This can be a great revenue stream for clinics. Eventually you can imagine all of these items being ordered at the doctor’s office and delivered to your house or office by drone. Until then, UPS/FedEx/USPS will have to do.

As you can imagine, all of the biometric data that’s collected at check in, lab results, etc syncs up with a mobile app that the patient can use to access their health data. Looks like they have plans for genomic data as well. Forward has also committed to responding to messages from it’s members (yes, they call you members, not patients) within 1 minute day or night. I wonder if that response is a real human or an AI bot.

As I mentioned, this feels like an amalgamation of everything that’s been happening with digital health. If you’ve followed the digital health space, then you’ve seen almost all of these things done individually somewhere already. This isn’t necessarily a knock on Forward. The iPhone largely was an incorporation of a bunch of innovations that were available elsewhere. However, Apple packaged it nicely into an extremely usable package. Is that what Forward’s done here? I personally think that’s overstating things since they haven’t completely transformed the model (yet?), but it has made a high end medical office experience.

That leads to my second observation about Forward. In many ways, Forward just looks like Silicon Valley excess in the same vein as the over engineered $1500 Smart Oven. How many of the things mentioned above actually improve your care or inspire you to be healthier and how many of them are just for show?

I guess you could make the case that the whole package makes for a better experience that makes you want to go to the doctor, but that’s butting up against a massive desire we all have of not going to the doctor that’s been built into our DNA for years. Plus, the package doesn’t seem like it’s reached the nirvana of treating healthy patients, but instead is just a high end doctor visit experience.

I’m not suggesting that there’s anything wrong with creating a high end doctor visit experience. That very well could work in wealthy areas like Silicon Valley and other areas of the country like New York and LA. That very well could be a good business (although, my guess is they raised too much money for that to be their only business), but it’s not going to transform healthcare as we know it. I don’t see how Forward scales down to the lower end of the market. They should go and talk with ZDoggMD about his experience with Turntable Health which he just had to shut down. They could learn a lot from his experiences.

I’m not saying that no good will come from the Forward experience. It’s quite possible that the Forward clinic is used as an incubation lab for new ideas which the company can then commercialize and sell to the rest of the medical world at a reasonable price. Their excess could produce learnings that could benefit the rest of healthcare if they package it the right way and don’t just try to build a new health care system themselves. That would be an incredible outcome for healthcare.

I know every doctor would rejoice at the idea of a smart patient wall that listened to their interaction with the patient and did the proper documentation for them. That’s the face to face interaction for which doctors and patients now yearn. The big challenge here is that Forward doesn’t have to worry about things like insurance reimbursement, meaningful use, and MACRA. So, will their technology apply to the rest of healthcare? Or does it just enable the high end unlimited primary care model that they’re executing today?

Also, Forward is only working on primary care, wellness, and men’s and women’s health. That still leaves specialists in the regular insurance controlled world (Yes, you still need insurance and the $149/month membership to Forward). Can high quality primary care change healthcare? I think it could, but it’s going to take a shift in mindset (payers, employers, patients, doctors) by many for it to happen.

I know another medical practice in San Francisco that built their practice on the back of cash patients who got a great, fast customer experience. Employers in San Francisco were happy to pay cash for the visit because they knew their employee would be off work at the doctor’s office for less time then traditional healthcare paid for largely by insurance. The cash cost of a visit was much less than having that employee away from work. San Francisco is a unique culture and so that worked for this medical practice and Forward could work in San Francisco as well. I just don’t see the path for them to scale the clinic model across the country. I hope they don’t try, but instead focus on spreading their innovations across the country. If all that fails, at least the Silicon Valley elite now have an opportunity to network with other Silicon Valley elite at the doctor’s office.

January 19, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Apple’s October 22nd Mac and iPad Event – What’s Coming?

I was excited to read this Techcrunch article on the next Apple event that is scheduled for Tuesday, October 22nd in San Francisco. Of course, Apple always tries to keep their announcements private, but the tech press has done a good job getting the leaks just the same. So, I was interested to see what might be coming out of Apple.

The unfortunate part of the Techcrunch post is that there was no game changers listed in the post. Basically, a little bit faster, a nicer screen, better resolution, and a small change in weight. None of those really impact how you use the device. Sure, they’re all nice and in aggregate we gain some benefit, but it’s nothing that will change how we’re using the devices today.

Of course, Techcrunch was just trying to guess what Apple’s going to announce. So, I hope that they’re totally wrong. I hope that Apple comes out with a cool wristband technology that changes the way we consider the battle for the wrist. Something new and different. Sure, there are some apps that are limited by the processing power of a phone or by the screen resolution, but all of that will come.

Anyone else have predictions on what Apple could announce that would provide an amazing opportunity for healthcare?

October 16, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The iWatch and Apple’s Role in Healthcare

Christina Farr at MedCityNews has a great article up about the rumors circling around Apple’s entrance into the digital health space. The article circles around the possible announcement of the Apple iWatch. Of course, right now it’s mostly just rumor that Apple is going to start selling an iWatch. Although, there are some strong suggestions that this is a possibility.

In some ways I can see how the iWatch is an interesting next step for Apple. However, unlike most other smart watches, I’m pretty sure that if Apple does release the iWatch it will do much more than just digital health. Sure, digital health will play a role in any watch based sensor device. I just don’t see Apple putting all their iWatch eggs in the digital health basket. In fact, I’d go so far as to say that if the iWatch can’t do more than digital health, then we’ll never see an iWatch on the market.

This will be a drastic change in the battle for the wrist. Would you rather wear a smart watch that only does digital health or something that does so much more? The answer is simple and if Apple is able to create a multi function smart watch, then they’ll destroy much of the other smart watch market.

Regardless of the iWatch, Apple is going to play a major role in healthcare thanks to the iPad and iPhone. Although, much like those devices, I think it’s very unlikely that Apple will make the decision to create a digital health specific product.

July 24, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Top Medical Apps

 

It’s almost boring to look at a list of top medical apps these days. Mostly because you know that the top medical app is going to be Epocrates. If Epocrates isn’t at the top of the list, then you know that something is wrong with the list. However, I also can’t help looking at who else is on the list. Epocrates can’t hold down the top spot forever. So, I like to look at the rest of the list and see what other up and coming apps might displace them.

Here’s the list of top medical apps for iPhone:

  • Epocrates
  • Medical Encyclopedia
  • Medscape
  • Pill Identifier by Drugs.com
  • My Chart

Here’s the list of top medical apps for Android:

  • Test Your Hearing
  • ICE
  • Diagnosaurus DDx
  • Speed Bones MD
  • Home Remedies (Lite)

Are these your top medical apps? What other apps would you like to see on the list?

July 10, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Pain Squad App Helps Adolescent Cancer Patients

I can’t even imagine what a scary experience it would be to have cancer, let along as a child. One of the ways to treat the symptoms of cancer is to understand the pain level, and what the patient is feeling. However, that can be difficult to get a full grasp on, especially in children. If they aren’t tracking it daily, then information collected can be flawed.

Last year, an app was released in beta testing at a Canadian hospital in Toronto to help doctors understand more fully what their younger patients were feeling as they underwent cancer treatment. The app, called Pain Squad, was developed using the feedback from children and teenagers who had cancer. It involves pain surveys that have to be filled out twice daily, but involves the child and engages them.

The app features videos of celebrities from popular law enforcement shows, Rookie Blue and Flashpoint, giving motivation to kids as they do a certain amount of journals in a row, and they can be promoted to different ranks. This video does a great job of explaining the app, and shows some of the videos. They are so motivating!

I really liked this quote, from the parents of a little girl named Olivia, who was a study participant:

Filling out a paper pain journal was like homework. The Pain Squad app is interactive and the more Olivia used it, the more rewards she got. It only takes a few minutes to complete but it gave Olivia a better understanding of and more control over her pain.”

Last year, this was in some of the final stages of testing, and because of it’s success, it was set to be released in other areas in Canada, as well as outside of Canada. I’m not sure if it’s officially been released since then, but I love the idea of this. There’s only so much you can determine from asking someone to point at a smiley face on a poster board to describe their pain level (I personally never really know what to say when I’m confronted with that sign!)

This app is designed for the iPhone.

June 26, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

BlueStar By WellDoc To Be First Mobile Prescription Therapy

You may be familiar with WellDoc already. They are distributors of a mobile app that was created to help manage diabetes, which has been very successful. And just a few days ago, they released something else that appears to be rather monumental.

The service is called BlueStar, and is the mobile version of the diabetes management program. What’s so monumental about this, is that it is the first disease therapy to be prescribed through an app. In addition to that, it is also the first that can be eligible for reimbursement through insurance. Not all insurance companies will cover it, but self-insured companies like Ford, Rite Aid, and DexCom have said BlueStar will become a part of their pharmacy coverage.

BlueStar features many of the same features that Diabetes Manager, the first WellDoc program, did which include getting alerts when their blood sugar level is too low or high and charts to detect trends. It suggests tips for getting blood sugar higher. However, what’s new is that BlueStar can provide feedback concerning medication dosage, give better coaching, and even recommendations to a doctor.

Just like any prescription, a doctor can prescibe BlueStar for a certain period of time in addition to medications. When a pharmacy receives that prescription, they will forward it on to WellDoc, who will have someone help the patient setup BlueStar on their device. BlueStar will calculate how much insulin a patient should take, depending on the attending physician’s recommendations, blood sugar levels, and how many carbs were eaten at a certain time. If a treatment regimen is deemed to be ineffective for a patient, a report will be sent to the doctor recommendation a new regimen.

Because diabetes truly affects so many across the country, this could mean a lot to many people. Of course, there are questions about how effective it can be, since many people may become unmotivated after using the app for a certain period of time. Time will only tell.

June 19, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Lumosity: An Exercise Program For Your Brain

So often, we focus on our physical health, but neglect our mental health. All forms of dementia are devastating. Many people complain of brain fog. Thousands of people suffer from attention disorders. While I don’t claim to know the cure for any of these things (or even the cause) I do think that exercising the mind is just as important as exercising your body. I mean, if your brain fails, then your life ceases to exist. It’s a pretty important thing to take care of!

I saw a commercial today for a website called Lumosity.com. It sparked my interest, so I decided to check it out. The website says that it “turns neuroscience breakthroughs into fun, effective games” and it’s a way to “harness your brains neuroplasticity [the brain’s ability to grow and expand] and train your way into a brighter life.”

To be honest, it seems like it is set up a bit like an exercise website. When you sign up, you answer some questions about where you want changes to be made. Changes can be made in any of five categories, all of which have subcategories. These categories are memory, attention, speed, flexibility, and problem solving. You can select as many or as few of these categories as you want. After doing this, you can create an account and view your free and personalized training program, and you can personalize your training even further.

The program changes with you — as you get better at the challenges, you get newer ones. Each of the “sessions” include a variety of games to help you improve in the areas you initially selected. You get points very every game you do, to help you track your progress. The games are actually pretty fun, and challenging, and scientifically developed to help increase your brain function.

The basic version of Lumosity is free, but if you really want to get into the program, there are paid options. This gives you more games each day, more personalized training, and more. People spend hundreds, maybe even thousands, on personal training at a gym, as well as countless hours…so why not spend some of those valuable resources on making sure your brain is in tip-top shape? I thought this was a cool idea, and I think it could be a great resources for anyone wanting to exercise their mind. Apparently, 97% of Lumosity users improve after just 10 hours of training (which can be seen in the personalized tracking portion of the website.)_

Lumosity Brain Trainer is also available as a free download for iOS devices.

June 10, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

Discover The Best Health Apps With AppRx by Health Tap

Well, Health Tap has once again come out with a new and useful way to help people find legitimate healthcare information. In an effort to help people sift through the 40,000 health and exercise apps available, AppRx was created.

AppRx is a directory of apps that have been recommended and reviewed by some of the world’s leading physicians. If you’ve ever tried looking through apps, it can be hard to figure out which ones should be trusted. Because, not all health apps should be regarded as so.

It’s a simple idea, but one that I think is long overdue. I just checked it out, and it looks like it is very easy to navigate. You can search for specific apps, or select from a variety of categories. There are 23 different categories, that cover everything from ab workouts to mental health to pregnancy. You can even set it to show just iOS compatible apps or Android compatible apps. To be honest, I think that’s one of my favorite features! Back when I only had an Android device, I got so frustrated when I was searching for a certain kind of app, and only iOS apps would show up.

You can also sign up for a newsletter, which sends you an app of the week — this weekly publication highlights a certain app that comes highly recommended from physicians. So if you want to try out new apps that already have the seal of approval from a physician, this might be a good newsletter to subscribe to!

I am excited to use this website — not only for my personal use, but to help find apps to write about on here! There are already some app certification programs in the works, such as Happtique, but until apps start getting the mark of approval from that, AppRx is a great alternative. I use Health Tap a decent amount, and I do trust that information I get from there, so it will be nice to have this additional resource.

June 3, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

“Instagram” for Heart Attacks Could Save Lives

What do you think of when you think about Instagram? Probably not a life-saving device, right? Turns out, the popular social media platform is the inspiration for ECG Capture, an iPhone app that is being lauded as the “Instagram for Heart Attacks.” 

Students and faculty from the University of Virginia created an Instagram-like app for the iPhone to assist in helping heart attack victims get treatment quicker. With the app, the user taks a photo of the ECG and sends the image, via a cell phone network, to a secure server at a hospital. At the hospital the heart attack victim is being sent to, physicians are able to see the ECG before they arrive and determine the best course of action.

It appears to work faster than the traditional way of sending ECGs. In more than 1,500 tests, it was found to transmit images in less than 6 seconds — the traditional method took up to 114 seconds to send. These few seconds difference could change, and possibly save, a person’s life.

This sounds like a great way to increase efficiency. Obviously, there’s always the concern of being in an area where there’s no cell service, or something else malfunctioning, but it seems like a pretty reliable method so far, after the 1,500 tests that were conducted. It’s nice to see that people are taking note of successful social media, and finding a way to adapt it toward health care.

May 22, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.

11 Great iPhone Apps for Nurses — According to Apple

It seems like every day, I read another article about nurses using tablets and smartphones in the workplace. I was just thinking the other day that I should do a round-up of great apps for nurses, but it looks like Apple beat me to it. This list was compiled by Apple last year, and they are their top 11 iPhone apps for nurses. While I still plan to make a list of apps for both the iPhone and Android devices that nurses can use, I thought I’d share these apps as well.

Most of these apps are free (though they may involve a paid subscription), though some cost less than $10. After reading about them, I can definitely see how they could be helpful. So, nursing friends, if you have an iPhone or an iPad that you use at work — these might be something you want to look into. Here’s a brief description, and cost, of each app that made Apple’s top apps for nurses list:

1.  Voalte OneBefore you get too attached to this one, your hospital must be equipped with the Voalté Server. And if it is, then great! Because this app allows for phone calls through a hospital’s VoIP system, secure text messaging using a user directory, and alarm management. Medical professionals are able to receive alarms, and respond quickly, which helps with overall workflow.

Cost: Free 

2Nursing CentralThis is a comprehensive database designed to help nurses find answers to just about any question they might have.There is detail information on diseases, tests, drugs, and more, and a medical dictionary with more than 60,000 entries.

Cost: Free

3. NurseTabs: FundamentalsThere are a couple of NurseTabs apps, which are specifically designed for new nurses. This one covers the basic skills and procedures nurses need to know. After selecting a specific procedure, the nurse will be given step-by-step information, including what kind of equipment should be used.

Cost: 9.99

4. PatientTouchThis app was created to help improve workflow, and help nurses spend more time with their patients.  It assists in specimen collection, infant care, communications, and more. PatientTouch is completely HIPAA compliant, and hopefully will help increase quality of care, while decrease costs. 

Cost: Free

5. MedigramMedigram is a simple way to securely send messages containing medical information. This makes it possible to collaborate with other medical professionals in a secure and quick manner.

Cost: Free

6. NurseTabs: MedsurgeAnother app by NurseTabs that was created specifically for new nurses, or nursing students. It contains over 300 diseases and disorders, organized in an easily searchable way. After selecting a certain ailment, the user can access tons of information about it, including a nursing process approach on how to handle the situation. It’s also a great place to review for the NCLEX exam.

Cost: 9.99

7. Lab Values ReferenceIf you are working with lab results a lot, this could be very helpful. I actually might download this myself (access to my lab results immediately makes me constantly look things up until I hear from my doctor.) It has coverage of the 375 most commonly performed lab results, which includes the normal ranges or findings, results, explanations of abnormalities, and more.

Cost: .99

8. NCSBN Learning Extension Medication FlashcardsStressing out about the NCLEX? No need to worry anymore. This app is a great resource for memorizing drug information, as you can sort cards into different categories, learn interesting facts, and more.

Cost: Free

9. The Merck Manuals for Mobile + WebMerck Manuals are one of the most widely used and accepted medical reference guides. And now, you can have it at your fingertips. The app is free, but you have to pay for the subscription. There are three different manuals that can be downloaded — the 19th edition for mobile and web, patient symptoms guide, and Davis’ drug guide.

Cost: Free

10. Shots by STFM: Does anyone like getting shots? I sure don’t think so. And I imagine nurses don’t get any joy out of administering them. This app helps making the process a little easier when trying to determine the correct dosages, especially for unique situations. It contains the CDC recommended course for vaccines, information on ingredients, side effects, and more.

Cost: Free

11. Lexicomp: Lexicomp is a great resource with trusted information about drug and clinical information. There are quite a few databases available with information, pictures, videos, and more. These can be accessed with or without a data/WiFi connection.

Cost: Free to download, but you will need a subscription to Lexicomp as well

May 13, 2013 I Written By

Katie Clark is originally from Colorado and currently lives in Utah with her husband and son. She writes primarily for Smart Phone Health Care, but contributes to several Health Care Scene blogs, including EMR Thoughts, EMR and EHR, and EMR and HIPAA. She enjoys learning about Health IT and mHealth, and finding ways to improve her own health along the way.