PediDoser features include :

• All common outpatient pediatric drugs
• Find your drug fast by generic or brand name or by class
• Use weight in pounds, weight in kilograms, or age to find the right dose.  No need to convert weight.
• Scrolling pick lists are faster than typing in weight or age
• Bookmark your favorite medications to get to them even faster

PediDoser comes in two flavors: the iPhone/iPod touch version (available from the App Store) and the iSilo version for everyone with PalmOS, Android,PocketPC, Blackberry and other devices (available from MeisterMed’s online store).

For more details about the features and medications list, visit http://www.pedidoser.com/isilo/features.html

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PricewaterhouseCoopers’ research reveals that universal coverage could swamp the health system unless simultaneous steps are taken to create innovative, new care delivery models that will expand access to care without adding costs to the system. Research conclusions and survey findings are in a new PricewaterhouseCoopers’ Health Research Institute (HRI) paper entitled “Jammed access: Widening the front door to healthcare.”

Other interesting finds in the report:

• Electronic interaction with providers and payers: One-half (50%) of consumers surveyed said they’d be willing to seek healthcare through the Internet or other computer technology as a substitute for a face-to-face, non-emergency visit. Of those, e-mail consultations was the preferred method of interaction (76%),  followed by telehealth, question/answer fee-based consults and an online forum/chat room monitored by a doctor.
•  Retail and worksite clinics for patients: Of consumers surveyed,   37 percent said they’d be likely to use a worksite clinic, and 36 percent would use a retail health clinic. Ten percent of large employers surveyed in PricewaterhouseCoopers’ 2009 Annual Employer Barometer Survey said they are now providing worksite clinics, up from one percent in 2008.
• Use of  telehealth technologies: Telehealth, the use of medical   information exchanged from one site to another via electronic   communications, such as video conferencing or bio-metric remote monitoring, is expanding access, particularly to specialty   physicians for patients in remote and underserved areas. Nearly   three-quarters (73%) of consumers said they would use biometric   electronic remote monitoring services to track their condition and vital signs.
• Shared medical appointments: One in four (28%) of consumers  surveyed said they would be willing to participate in a shared   medical appointment, typically a 60- to 90-minute session that  includes a private or personal exam integrated with patient   education and discussion with a group of 10 to 15 people. Providers currently offering shared medical appointments have   found both patient and physician satisfaction has soared.  Instituting one shared medical appointment can increase patient access and a physician’s productivity by an additional six patients during a four-hour clinic session.

Another few reasons to look into developing Android medical mobile applications……………..

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The features include:

• Over 350 laboratory and diagnostic tests
• Evidence-based information
• Convenient tables and algorithms
• Expanded coverage of molecular and genetic testing
• Intuitive navigation, optimized for your device
• Personalized favorites
• Quick links to the medical literature

For more details, refer to Unbound Medicine’s product page.

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The Merck Manual for Mobile and Web lets you take the world’s most widely used medical reference wherever you go. The new companion website,  The Merck Manual for Mobile and Web, allows you to access disease information while at your computer or via your mobile device.

Written by more than 300 expert clinicians, this proven resource now features expanded clinical focus on each disorder along with more specific guidance on patient evaluations than ever before. Intuitive built-in navigation helps you quickly retrieve and review diagnostic and treatment information.

Regular updates are delivered automatically. With Unbound Medicine’s unique mobile platform you can refer to the latest information from The Merck Manual anywhere!

Features:

• Reliable: Trusted content written by more than 300 medical experts
• Essential: Clinically focused topics with quick disease overviews
• Easy to use: Handy navigational tools to retrieve the right information, right away
• Comprehensive: 34 new chapters, including Dietary Supplements, Exercise and Sports Injuries, Principles of Radiologic Imaging, Care of the Surgical Patient, and more!

Requirements: 10 Mb (Memory card supported ), Carrier Data Plan or on-device WiFi

The demo is available here.

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One of the challenges usually doctors/physicians face , is that  whether patients have  taken their medications or not. This is even more challenging in case if the patient has to taken medicine for longer periods( e.g. couple of months).

Mobile applications could come in handy to ensure if the patients have taken their medicines or not. The application could be a simple reminder service which could be installed on patient’s phone (with patient’s consent) with reminders set for medication dosage and times. Another option could be a reminder sms sent to the patient’s phone(  In most of countries except US, incoming Sms is free).

In developing countries, where doctor/physician to population ratio is very low, these applications could be more helpful. Incentives could also be added for patients to take their medicines with the help of sponsor(e.g.  local mobile company or local grocer ).

I found an interesting article in The Economist titled  ” Taken your medicine? “, where patients were given incentives to take medicine and report back. The trial done in Nicaragua involving 30 people with tuberculosis was a success and a second is about to be carried out in Pakistan, where a batch of 400 XoutTB patches is arriving this month.  The details regarding the project in Pakistan from the article are below:-
” Conditions in Karachi, the Pakistani city in which the trial is being conducted, could politely be described as “challenging”. According to Rachel Glennerster, a member of the XoutTB team who has worked as an economist at the IMF and the British Treasury, the local medical clinics are closed about 60% of the time and doctors or nurses are often absent during the 40% when the doors are nominally open. Such absences—and the associated lack of compliance-monitoring—are some of the problems for which XoutTB is designed to compensate.

Pakistan, though, presents a second difficulty. Aamir Khan, the director of XoutTB’s operations in the country, quickly discovered that one of the neediest groups of people there are 15- to 25-year-old women. Unfortunately, they are often under the thumbs of their parents or husbands and are not allowed mobile phones of their own. Dr Khan is therefore considering the idea of a different reward—high-energy food supplements to combat malnutrition. The system would not supply food directly, but would instead top up credit at the patient’s grocer using an automatic link.

If XoutTB does work, the team has ambitions to extend it. Other drugs can also be a nuisance to remember. The anti-retrovirals used to combat AIDS, for example, have to be taken for the rest of a patient’s life. And taking medicines for non-infectious conditions such as diabetes and high blood pressure is also a chore. Find the right “litmus test”, though, and what is now being done with TB drugs could succeed with any of these as well. Taking your medicine could, at last, become a truly rewarding experience. “

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The document “Ten Principles for Fostering Development of an “iPhone-like” Platform for Healthcare Information Technology“, details the Ten core principles.

Below are those core principles along with Android platform features that support those principles:-

1. Technology platforms that support substitutable applications should be promoted.
   Android Platform source  is open source and open to modifications. The core components of the platform are substitutable and custom platform image can be created to suit one’s needs and promote the creation of, and enable the incremental adoption of, useful task-specific applications with low switching costs.
2. Messages and protocols for data exchange should be allowed to emerge on demand in a market-driven approach, and specified transparently at every level.
   Android Platform source being open source it is easy to add unique protocols for creation of a suite of wellness applications linked to everyday activities. Currently (as of Android 1.5- Cupcake edition) , bluetooth is not fully supported, but one can enhance the bluetooth source code to communicate with medical devices with bluetooth support (ex. glucose monitors with bluetooth support). Google has also released NDK(Native Development Kit) which provides tools that allow Android application developers to embed components that make use of native code in their Android applications. The NDK allows developers to implement parts of their applications using native-code languages such as C and C++. This can provide benefits to certain classes of applications, in the form of reuse of existing code and in some cases increased speed.
3. Protocols and application programming interfaces should allow the possibility of multiple platforms co-existing.
   The Android platform is open platform with open source. It is part of OHA(Open Handset Alliance), so it enjoys support of various mobile operators, handset manufacturers,semi-conductor companies, software companies and many more …. For more details on Open Handset Alliance, please visit http://www.openhandsetalliance.com.
4. Application programming interfaces should be open.
   Android Platform allows the development of plug-and-play applications and developers can reuse their knowledge of Java( most commonly used open source development language)
5. Substitutable application or platform vendors should not have control over what is installed on the platform.
   Even though Android platform is available from Google, it does not control what gets installed on the platform. It has removed its Google Maps API from Android platform and is available as separate API.
6. Application installation should be turnkey.
   Installation of Android Applications is easy and can be done without any knowledge of software programming. Currently, the applications can be installed using Android Market. The mobile phones with root access can install applications without Android Market.
7. The intellectual property of platforms and applications should be kept separate.
   Even though Android Platform source is open source, the applications developed by third party does not need to be open source and is not governed by open source agreement.
8. All applications should be removable and none should be required to run a platform.
   Android Platform is not vendor locked,  the core components can be substituted easily.
9. The platform should have a highly efficient delivery mechanism for applications.
   Android platform is not limited to mobile phones. The various netbook manufacturers are planning to release Android based netbooks by end of year and early next year.
10. Certification requirements for platforms and applications should be kept minimal to maximize substitutability.
    

Though the document’s title includes Iphone and the authors mention Iphone within their document,  Android platform is better suited for being the platform for Healthcare Information Technology.

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From the press release:

Today, Unbound Medicine, a leader in knowledge management solutions for healthcare, and the American Academy of Pediatrics (AAP), the professional organization representing over 60,000 pediatricians, announced the launch of Red Book® for Mobile + Web. Now, the latest findings and clinical guidelines contained in the new 28th edition of Red Book are available on any of today’s popular phone or handheld platforms.

Up-to-date information about vaccines, emerging infectious diseases, and new methods of diagnosis and treatment is essential for clinicians who encounter childhood infectious diseases. Red Book for Mobile + Web, powered by the Unbound™ Platform, is designed to make this critical information accessible whenever and wherever it’s needed. From any location, clinicians can refer to Red Book via the Web or download to iPhone™/iPod® touch, BlackBerry®, Android™, Windows Mobile®, or Palm®

The AAP Committee on Infectious Diseases with Larry K. Pickering, MD, FAAP, editor, and associate editors Carol J. Baker, MD, FAAP; David W. Kimberlin, MD, FAAP; and Sarah S. Long, MD, FAAP, develops Red Book in conjunction with liaisons from the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the National Institutes of Health, The National Vaccine Program Office, the Canadian Paediatric Society, and hundreds of individual contributors.

Press Release: Unbound Medicine and American Academy of Pediatrics Release Mobile Edition of Red Book®

Red Book®: 2009 Report of the Committee on Infectious Diseases presents the most current AAP recommendations for diagnosing, treating, and preventing infectious diseases in infants, children and adolescents. Full Web access included for 1- year. It is available for USD 99.95

For more details about Red Book , click here

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What should the applications do to ease the daily work of Nurse practitioners along with efficient and error-free results. What kind of devices would they prefer?

A study titled “ Human Factors Evaluation of PDAs and Smartphones in Nursing Practice” was performed by Healthcare Human Factors Group based in Ontario, Canada . The objective was to determine which design features of popular mobile devices are supportive of various nursing tasks. Device usability was determined through metrics such as performance and user perceptions using various mobile devices.

The following observations were made by the study:-

• Nurses expect lightweight devices with physical keyboards, advanced rendering capabilities, intuitive menu structure and data access speeds that are comparable to desktop applications
• Devices need to be portable and compact; ideally weigh less than 180g
• Larger screen sizes are preferred, so long as page rendering is advanced
• System speed perception was also an important indicator of device acceptance; in addition, Wi-Fi compatible devices are recommended
• Be mindful of the types of applications and tasks the nurses will be using most; if text entry is required for the majority of tasks, a device with a physical keyboard is recommended
• From an infection prevention and control standpoint, devices that can easily be used with a protective cover that can be easily wiped with a disinfectant are recommended. Those devices with the fewest buttons, connectors, and crevices that could trap microbes are considered best.

The key points to take-away from the study are:

• Nursing application should support large screen
• Nursing application should have advanced rendering capabilities
• Nursing application should make text entry easy and intuitive
• Nursing application should have intuitive navigation
• Nursing application should be responsive and quick

The above study results, suggests that netbook would be preferred instead of mobile phones where majority of daily nursing tasks include typing. This could be good news for Android developers , as seen lately, almost all netbook manufacturers are planning to have Android based netbook within a year’s time. With Android capability to allow developers to create device independent code, the same application could potentially run on mobile phone as well as netbook. This provides an advantage compared to other mobile platforms available.

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According to masshightech,  Ben Sawyer, co-founder of Portland, Maine-based serious game development studio Digitalmill Inc. predicted that eventually mobile fitness tracking applications and video games like Electronic Arts Inc.’s (Nasdaq: ERTS) EA Sports Active will integrate with electronic medical records. Ben predicted at fifth annual Games for Health Conference on fitness-based “XRgames” in Boston, last week. He is also conference organizer. He also commented that Boston was right place, as it has capital, game developers and health experts in one place.

It would be really interesting, if this happens. The doctor will know why you have back pain or painful thumbs. Too much gaming are we?

Another future Android medical application in the making ………………………….

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Read on for the entire section related to regulatory compliance for health and medical apps.

Regulatory Compliance for Health, Medical and Related Apps:

3.3.19 You will fulfill any applicable regulatory requirements, including full compliance with all applicable laws, regulations, and policies related to the manufacturing, marketing, sale and distribution of Your Application in the United States, and in particular the requirements of the U.S. Food and Drug Administration (”FDA”), and the laws, regulations and policies of any other applicable regulatory bodies in any countries or territories where You use or make Your Application available. However, You agree that You will not seek any regulatory marketing permissions or make any determinations that may result in any Apple products being deemed regulated or that may impose any obligations or limitations on Apple. By submitting Your Application to Apple for selection for distribution via the App Store, You represent and warrant that You are in full compliance with any applicable laws, regulations, and policies, including but not limited to all FDA laws, regulations and policies, related to the manufacturing, marketing, sale and distribution of Your Application in the United States, as well as in other countries or territories where You plan to make Your Application available via the App Store. You also represent and warrant that You will market Your Application only for its cleared or approved intended use/indication for use, and only in strict compliance with applicable regulatory requirements. You agree to promptly notify Apple in accordance with the procedures set forth in Section 15.6 of any complaints or threats of complaints regarding Your Application in relation to any such regulatory requirements, in which case Apple may remove Your Application from the App Store.

There is no mention of FDA approval on Android Market agreement  as of today (15th June 2009).

So, Will Android Medical Applications require FDA approval too?

We will have to wait and see ……………..

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