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Can be misused to self diagnose or delay seeking professional care
Possibility of causing unnessasary anxiety in patients
Not being accurate
Platform dependent(Iphone vs Galaxy)
Cost and learning issues
Privacy and cyber safety

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Available technology
Individuals become more involved in their own care
Flexible in development
Widely accepted tools
Visually appealing

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The Top Medication Reminder Apps for Patients

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Nonadherence impacts health outcomes, health care costs, and quality measures. Are mobile apps the way to increase adherence rates?

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he next blockbuster therapy is probably already in your pocket or purse.

The FDA recently approved the first prescription digital therapy, Pear's Reset app and program, which is focused on substance abuse. Others are likely to follow. That means your next trip to the doctor could include a prescription for a mobile app in addition to, or instead of, medicine.

Digital therapy represents a powerful yet provocative new idea in health care. Software brings a precision to therapy and with it an ability to personalize treatment. This gives digital therapy a big role to play as we transition to value-based care.

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But can software be a therapy all by itself? Or, as MIT's Technology Review recently asked, "Can 'digital therapeutics' be as good as drugs?"

These aren't purely academic or technological questions. They are ones we need to take seriously as we look to curb our country's dependence on prescription drugs and find better, more effective options for treatment. At the same time, the health care industry continues to embrace a focus on prevention. The emphasis on wellness and health management has driven new thinking about how to engage people well before they become patients.

Where we are today

Several companies are playing out this argument. Omada and Virta are often cited, along with Ginger.io, Triggr, Propeller, Livongo, AbleTo, and my company, Vida Health.

The solutions they offer are now emerging from pilots and testing, and we're beginning to see enormously positive outcomes from digital therapy.

As the Wall Street Journal reported, "the emerging field of digital medicine - a combination of remote monitoring, behavior modification and personalized intervention overseen by the patients' own doctors - can improve outcomes in some of the most costly and tough-to-manage categories such as diabetes, heart disease, and lung disease."

In one recent study, digital therapy and tailored health programs helped drive down body weight and blood pressure. Such tools can be especially effective for diabetes prevention and management. Doctors prescribing digital therapies are seeing increased patient activation, medication adherence, and reduced hospital readmissions.

A growing body of research on digital therapies is validating what physicians have long known: that environment and behavior play substantial roles in most preventable diseases, and that software-based digital therapy can consistently and positively influence both.

Focus on chronic disease

Most digital therapies today focus on complex chronic conditions, like obesity, diabetes, and mental illness. Chronic care is a good fit for digital therapies for several reasons.

Money. Chronic disease accounts for a disproportionate share of health care costs in the United States - more than $2 trillion dollars year and 86 percent of all health care costs. Elevated glucose levels associated with prediabetes and diabetes alone cost our country more than $322 billion annually. Payers, self-insured companies, accountable care organizations, and patients themselves are all highly motivated to reduce costs. By reducing the burden of chronic diseases, digital therapies can help create a rare win-win in health care.

No cure. Although most chronic diseases have no "cure" in the classic sense, the majority of cases are preventable. But the active day-to-day management, continuous care model, and data required to prevent these diseases elude us today. As a result, patients (and their doctors) are often willing to try new things.

Daily behaviors matter. For most chronic diseases, lifestyle changes can beneficially affect biology in both small and large ways. From migraine to obesity, high blood pressure, depression, anxiety, sleep apnea, or diabetes, success is often achieved when a patient can control the condition by developing new routines. That's where digital therapy comes in. Software-based interventions provide a continuous feedback loop that is necessary when building the small daily habits that can have an outsized impact on health and quality of life.

Overcoming disease should be our indicator of success

There are two main categories of digital therapy today.

Single disease focus. Some digital therapies focus on a single chronic disease, like diabetes, high blood pressure, obesity, or depression. Companies in this space include Omada (pre-diabetes), Livongo (diabetes), Hello Heart (hypertension) and Ginger.io (mental health).

Wellness. Others are designed for general health and wellness. These help individuals live healthier lifestyles by getting into an exercise routine or shifting to a plant-based diet. They aim to help individuals reduce their overall risk of developing a chronic disease. Users of apps in this category tend to be comparatively healthy. Companies in this space include MyFitnessPal, Noom, Farewell, and Weight Watchers.

Both types of digital therapy are useful, but there needs to be a bridge between the two. Let me explain what I mean.

General health and wellness apps are great, but they only work for a relatively small, self-motivated group of people. These apps often don't sustain long-term behavior change and there's little evidence that they can, on their own, drive measurable outcomes for people who need them most.

Digital therapies focused on single diseases, on the other hand, can be quite effective at addressing the chronic condition they were built to treat in certain "cookie cutter" cases. But they miss an important fact about chronic diseases: most of them are the product of more than one underlying condition. Physical and mental health are entwined along a continuum that makes it difficult to effectively treat one without at least acknowledging the other. For instance, 43 percent of people with depression are obese; obese people are 55 percent more likely to depressed. Factors of one disease can feed into the other, creating a vicious cycle.

If we treat just the mind or just the body, we're failing people in a profound way.

Why you should care

My friend Daphne Kis, whose Litmus Health startup employs machine learning to make sense of behavioral data in clinical trials, uses the phrase "good days and bad days" to describe the opportunity in front of us all, both inside and out of the lab.

If digital therapy can meaningfully create for users many more good days than bad ones, then software can convincingly improve the daily quality of life for millions of people, not to mention drive billions of dollars in system-wide savings.

Digital therapies aren't yet seeing SoulCycle and Orangetheory numbers, but they are getting there. We are seeing larger and larger numbers of individuals voluntarily enlisting in and paying for outcomes made possible by software.

If it's true that the average American taps, types, swipes, or or otherwise engages with his or her smartphone an astonishing 2,617 times per day, we ought to be able to leverage our national obsession with pocket computers for dramatically better health. It's amazing to think that the path to a fundamentally healthier digestive system is no harder to use than Facebook and no more expensive than a respectable coffee habit, but it's entirely possible.
Stephanie Tilenius is the founder and CEO of Updated to correct Americans' engagement with their smartphones Vida Health.

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Your smartphone as medicine: Digital therapy is here to stay

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he next blockbuster therapy is probably already in your pocket or purse. The FDA recently approved the first prescription digital therapy, Pear's Reset app and program, which is focused on substance abuse. Others are likely to follow. That means your next trip to the doctor could include a prescription for a mobile app in addition to, or instead of, medicine.

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February 18, 2017 by Jean-Louis Santini

Researchers are finding new benefits to smartphone features such as camera and flash, which can help examine and diagnose patients

Smartphones are revolutionizing the diagnosis and treatment of illnesses, thanks to add-ons and apps that make their ubiquitous small screens into medical devices, researchers say.

"If you look at the camera, the flash, the microphone... they all are getting better and better," said Shwetak Patel, engineering professor at the University of Washington.

"In fact the capabilities on those phones are as great as some of the specialized devices," he told the American Association for the Advancement of Science (AAAS) annual meeting this week.

Smartphones can already act as pedometers, count calories and measure heartbeats.

But mobile devices and tablets can also become tools for diagnosing illness.

"You can use the microphone to diagnose asthma, COPD (chronic obstructive pulmonary disorder)," Patel said.

"With these enabling technologies you can manage chronic diseases outside of the clinic and with a non-invasive clinical tool."

It is also possible to use the camera and flash on a mobile phone to diagnose blood disorders, including iron and hemoglobin deficiency.

"You put your finger over the camera flash and it gives you a result that shows the level of hemoglobin in the blood," Patel said.

An app called HemaApp was shown to perform comparably well as a non- smartphone device for measuring hemoglobin without a needle. Researchers are seeking approval from the US Food and Drug Administration for its wider use.

Smartphones can also be used to diagnose osteoporosis, a bone disorder common in the elderly.

Just hold a smartphone, turn on the right app in hand and tap on your elbow.

"Your phone's motion picture sensor picks up the resonances that are generated," Patel said.

"If there is a reduction in density of the bone, the frequency changes, which is the same as you will have in an osteoporosis bone."

Such advances can empower patients to better manage their own care, Patel said.

"You can imagine the broader impact of this in developing countries where screening tools like this in the primary care offices are non-existent," he told reporters.

"So it really changes the way we diagnose, treat and manage chronic diseases."
Lower costs
Mobile smartphone devices are already helping patients manage cancer and diabetes, says Elizabeth Mynatt, professor at the Georgia Institute of Technology.

"Someone who is newly diagnosed with diabetes really needs to become their own detectives," she said.

"They need to learn the changes they need to make in their daily lifestyle."

For women newly diagnosed with breast cancer, researchers provided a tablet that allows them real-time access to information on the diagnosis, management of their treatment and side effects.

The technique also helps patients who may not be able to travel to a medical office for regular care, reducing their costs.

"Our tool becomes a personal support system," Mynatt said. "They can interact to get day-to-day advice."

Research has shown this approach "changes dramatically their behavior," she added.

"The pervasiveness of the adoption of mobile platform is quite encouraging for grappling with pervasive socio-economic determinants in terms of healthcare disparities."

A growing number of doctors and researchers are turning to smartphones for use in their daily work, seeing them as a useful tool for managing electronic health data and figuring out the most effective clinical trials, said Gregory Hager, professor of computer science at Johns Hopkins University.

Clinical trials currently cost around $12 million to run from start to finish, he said.

"The new idea is micro-randomized trials, which should be far more effective, with more natural data," he said.

Although the costs could be dramatically lower, too, the field is still new and more work needs to be done to figure out how to fully assess the quality and the effectiveness of such trials.

© 2017 AFP

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February 18, 2017 by Jean-Louis Santini Smartphones are revolutionizing the diagnosis and treatment of illnesses, thanks to add-ons and apps that make their ubiquitous small screens into medical devices, researchers say. "If you look at the camera, the flash, the microphone... they all are getting better and better," said Shwetak Patel, engineering professor at the University of Washington.

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HealthRhythms uses mobile phone data to monitor symptoms of anxiety and depression, giving doctors valuable insight into their patient's mental health and offering new interventions and treatments.

When you're depressed, it isn't all in your head. Depression can disrupt sleep, instigate irregular eating and make you less active and social. It can completely disrupt your internal body clock.

The good news: we can monitor these behavioral changes to more effectively diagnose depression. Digital health company HealthRhythms is working to do just that. Using data passively collected from smartphones with privacy sensitive and HIPAA compliant sensing and processing, the New York-based company can assess daily behaviors to paint a comprehensive picture of an individual's mental health. Soon it plans to go even further: last fall, the company received a $2.1 million grant from the National Institutes of Health to develop an automated recommendation engine capable of delivering personalized, real-time health interventions and behavioral change suggestions for people with mental health conditions. And while HealthRhythms currently provides software directly to healthcare clients to support their patients, it plans to make a version of their system available to the general public soon.

Here, co-founder and CEO of HealthRhythms Tanzeem Choudhury, a TED Fellow and Director of the People-Aware Computing Lab at Cornell University, walks us through how HealthRhythms works, how it fits into the broader personalized-medicine movement and how she thinks we'll treat mental health in the future.

How does HealthRhythms work?
Currently, the best way to measure mental health outside the doctor's office is to ask patients questions and let them report their own experiences. These questions look at a person's overall behavioral patterns: Has your sleep been disrupted? Do you eat regularly? Are you moving too slow or too fast? Have you lost interest in socializing? Most screening tools simply combine answers to such questions to form assessments.

The core idea behind these assessments is that when someone's mental health is declining, there's a disruption in their normal behavior. If that disruption persists for two or three weeks, or even longer, it's often seen as an indication that someone's emotional well-being is compromised.

At HealthRhythms, we use the sensors on smartphones to sense many of these behaviors, and the way a person typically uses their phone provides a baseline of behavior and routines. We monitor a user's speech and sleep, as well as how they use their device, which can tell us about cognitive changes. What apps do they use? How many texts do they send? What are their typing habits, including typing speed and word length?

The app also tracks movement and mobility: Where do they typically go? How much time do they spend at home? Are they walking faster or more slowly? With such data, HealthRhythms detects when routines get disrupted, which can indicate that the person is depressed. For instance, when someone gets depressed, their walking rate slows down, and in the manic phase of bipolar disorder their pace of activity speeds up. We can look at sociability too - based on app usage, SMS and voice patterns - to determine whether someone is becoming more isolated.
Who is using HealthRhythms?
The app focuses on depression and anxiety across all age groups due to their high prevalence across the human lifespan, so we address everything from youth anxiety to geriatric depression. Some behavioral symptoms related to sleep, mobility, activity and sociability are relevant for a range of mental illnesses at more specific times of life. In our research, for example, we have looked at schizophrenia, bipolar disorder, mood disorder and depression. However, depression and anxiety are the most common disorders across all ages.
How does HealthRhythms suggest behavioral changes?
The key here is knowing the habits and timing of a person's routine when they are well, so that if the person begins to experience a mental health condition, we can make suggestions that are meaningful and seem doable to the user.

For instance, the app can suggest engaging in social behavior if it senses growing social isolation in the user. If someone is spending more and more time at home, the system might say "It's a nice sunny day today, a great day to get a coffee from your favorite café down the block." For activity, we generate suggestions that could change behavior but won't cause disruption in lifestyle. By looking at the times a person typically takes a walk, the routes they normally take and the weather conditions, for instance, we can suggest a walk that fits with their basic routine.

For sleep, it's important to align bedtimes with specific body types. HealthRhythms can estimate someone's body clock type based on sleep habits - such as the difference between sleep habits on work days versus free days, and the types of app used when they wake up. The app then automatically suggests a sleep pattern aligned to that person's body clock.
How might these interventions evolve over time?
Lots of apps out there try to engage and motivate alternate behaviors, and offer lots of feedback. But this can overwhelm the user. How many things can you actively keep track of, and how many changes in behavior can you realistically make on a conscious level? Our long-term vision is to make the interventions disappear into the background, modifying a person's behavior with minimal effort by the user, because we think it will make treatment more effective.

Our long-term vision is to make the interventions disappear into the background, modifying a person's behavior with minimal effort.

Here's an example of an almost undetectable intervention: Often, when a person gets stressed or anxious, their heart rate will increase measurably. So we designed a piece of wearable technology called Emotion Check. When Emotion Check senses that a user's pulse is beginning to race, which suggests anxiety, it will provide very subtle tactile feedback that mimics a slower heartbeat. This feedback can actually slow the heart rate down and reduce anxiety levels.

In this vein, we're thinking about how to leverage the brain and body's automatic reactions, and how to design technology that intervenes in minimal ways. Instead of shouting instructions, we're nudging the user's behaviors with biofeedback.
How does HealthRhythms work with doctors, nurses and other health care professionals?
When our app identifies behavioral changes in patients that could be unhealthy, we raise alerts for their doctors. In working with those doctors, the key is not to overwhelm them with data but to deliver timely indicators of mental health changes in their patients, and provide a succinct summary of the behavioral changes that could raise red flags.

We also speak the language of clinicians rather than expecting them to learn our tracking lingo. Our behavioral-health API easily integrates with health systems applications and electronic health records, making it easy to incorporate our behavioral health measures into existing systems.
How does HealthRhythms fit into the broader movement to personalize medicine?
Precision medicine is a big initiative. We're getting more and more information about the biological makeup of unique individuals, how disease manifests in individuals and how treatments work at the level of the individual. Traditionally, the obstacle to personalized medicine has been easy access to such data and measurements as genomics, hormone levels and various other physical manifestations of illness. These standard measurements do exist; the question is really how you use this information to personalize treatment.

But in the context of current mental health practice, such objective measurements don't exist - it's typically self-reported. Yes, within certain populations of mental health patients, neural changes do occur, but some of these factors are still not very well understood. Meanwhile, there is no physical test for diagnosing mental illness. By gathering personalized measurements, HealthRhythms will enable mental health care to be on more equal footing when it comes to gathering data to create personalized care.
What is your long-term vision for HealthRhythms?
Mental health is not an isolated condition; it affects all of health. About one half of chronically ill patients have co-occurring depression or anxiety. Research shows that if a patient has one of these conditions along with another disease, their chances of a second heart attack goes up, for example, or their cancer relapse rate rises. The cost of treating someone with co-morbid depression is at least double or triple the cost of treating someone without depression. That's why we say we deliver mental health as a service - we want to add a layer of mental health care across all of health care.

The TED Fellows program supports extraordinary individuals at work on world-changing projects, helping to raise international awareness of their work and maximize their impact.

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How we can use smartphones to diagnose and treat depression

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When you're depressed, it isn't all in your head. Depression can disrupt sleep, instigate irregular eating and make you less active and social. It can completely disrupt your internal body clock. The good news: we can monitor these behavioral changes to more effectively diagnose depression. Digital health company HealthRhythms is working to do just that.

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[1]: Smartphones are revolutionizing medicine. February 18, 2017 by Jean-Louis Santini.  https://phys.org/news/2017-02-smartphones-revolutionizing-medicine.html

[2] HemaApp screens for anemia, blood conditions without needle sticks (Jennifer Langston) September 7, 2016

[3] The Top Medication Reminder Apps for Patients DECEMBER 10, 2017
https://www.pharmacytimes.com/contributor/christina-tarantola/2017/12/the-top-medication-reminder-apps-for-patients

[4] How we can use smartphones to diagnose and treat depression.  Feb 14, 2018

https://fellowsblog.ted.com/how-we-can-use-smartphones-to-diagnose-and-treat-depression-adc4cf9ede8a

[5] Your smartphone as medicine: Digital therapy is here to stay By STEPHANIE TILENIUS DECEMBER 11, 2017

https://www.statnews.com/2017/12/11/your-smartphone-as-medicine-digital-therapy-is-here-to-stay/

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There are many different kinds of apps available for fitness purposes. Apps such as Samsung health and Apple Fit are used as pedometers to record and track activity. Smart devices can sense and measure heartbeats and help individuals track their fitness goals.

These device not only come with powerful cameras, flashlights and sensors, they are also capable of connecting to other wired or Bluetooth ready devices for measurements such as sleep cycle, blood oxygen, and body weight. Built-in or attached microphone can be used to detect asthma or COPD. It is also possible to use the camera and flash on a mobile phone to diagnose blood disorders, including iron and hemoglobin deficiency.  HemaApp screens for anemia, blood conditions without needle stick. BP sense, an app from the University of Washington can measure and record the blood pressure and heartbeat throughout the day. BiliCam uses the smartphone's camera and flashes together to measure the amount of bilirubin in the newborn babies.

Smartphones can also help patients stay adherent to their medication. Mango Health, MyMeds Medication Management and MediSafe Meds and Pills Reminder are just examples of many apps that can be used to remind patients about their medications.
In the mental health field, an app called HealthRhythms, monitors the symptoms of anxiety and depression and helps individuals seek professional medical care in a timely manner. Pear’s Reset is the first FDA approved prescription digital therapy app used to treat substance abuse.

In conclusion, smartphones are opening a large field of opportunities for prevention, diagnostic and treatment of deceases, and can be used to have patients be more involved and invested in their care and well being.

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This research discusses the possibility of using smartphones and mobile devices by individuals in order to become more involved in their own care. Smartphones are being utilized in many areas of healthcare, from preventive to diagnostic and managing different alignments.

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Phone Applications in Patient Care

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Daisy– Developer
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I have choose a team base on my own weaknesses. We compliment each other, and all bases are covered by someone in the team. We can be more successful in obtaining public's interest in what we are offering.