The reasons why the Health app isn’t available for the iPad aren’t clear. The iPad lacks the M7 and M8 activity tracking chip, but the utility of Apple’s Health app isn’t in actively tracking your health. Rather, using the Healthkit platform, it enables your wearable devices to streamline their data, such as blood pressure readings, efficiently into the Health app.
What Dr. Husain doesn’t grasp is that the core of HealthKit is based on security. Data stored in Apple’s Health app are locked down. Apps can only read or write Health data after being granted specific permission from the user. Developers aren’t allowed to sell the data. Apple has gone even further and made sure the data aren’t backed up into iCloud. All this in the name of security and HIPAA compliance.
All these security features aren’t good for usability. In my experience as both a physician and app developer, patients and app users aren’t yet familiar with using the Health app. Most people haven’t figured out how to use the Dashboard-feature. This is Apple’s fault.
Another ground for confusion is the lack of iCloud integration. Since data aren't stored in iCloud, they won't be synced between devices. This results in partial data for people on several devices. Introducing iPads into the mix would only compound the confusion.
In my opinion, the Health app needs a lot of improvements, and I find it wise to let the platform mature on the widely used iPhone before releasing it on the iPad. Especially as even Apple doesn’t know what the iPad is best at. That being said, I believe the HealthKit platform has immense potential.
At first, the seniors were horrible at it. After a month of training, they were better than untrained 20-year-olds. More important, though: their scores on untrained skills, such as sustained attention and working memory, went way up — and remained strong for at least six months. By using scalp electrodes to measure participants’ brain waves, the researchers also showed that NeuroRacer training altered participants’ wave patterns: the older brains looked decidedly younger.
The part about “making older brains look younger” seems superfluous to me—I don’t see these games being that good. Still, must be interesting since Big Pharma invests in these games and they are seeking FDA approval.
Yet Another Flawed Telehealth Study
A recent research paper on telehealth follow-up of heart failure patients, is being cited on Twitter and media sites as yet another case for telehealth preventing hospital admissions. As in other cases, the researchers reach this false logic due to a flaw in their thinking or their material.
In this case, the researchers state:
The research team exploited the within-person variation in each member’s heart failure telemonitoring program enrollment over time to examine whether there were any statistically significant associations between the program enrollment and the dependent variables. More specifically, member fixed effects were used in the multivariate regression models to remove variation across members in the sample by including a dummy variable for every member (ie, each member served as his or her own comparison). This approach removes all confounding related to any time-invariant factors, such as sex and race, as well as any underlying health conditions not directly observed from the data.
They are correct to assume that most confounders are removed by this method. As they did not include a control group, they haven’t accounted for the regression towards the mean which is inherent to following a population over time. They falsely conclude that the telegraph intervention resulted in the reduction in admissions. It is more plausible that with every re-admission, the population’s condition improved because of better medication, behavior change, and physical therapy during the hospital admission.
We can therefore not conclude that telehealth follow-up reduces admissions. I’m not entirely sure this study can even conclude that telehealth follow-up was cost-effective. Researchers should focus on whether telehealth is efficient in regards to the number of healthcare professionals needed per patients. Future healthcare is immediately threatened by the relative sparsity of doctors and nurses - not by the ever increasing economic expenses.
The hospital had prepared for the possibility that Ebola would arrive in its emergency room. It had adopted a Centers for Disease Control screening checklist to identify patients with fever who had travelled from the region of West Africa beset by Ebola. (Full disclosure: my research center and I advised the C.D.C. on the design of its checklists.) The staff had rehearsed the event. And, on September 24th, when just such a traveller arrived, the triage nurse who saw him actually asked the proper questions and flagged in the medical chart that he was a potential concern for Ebola.
Then how could the physician miss the risk of Ebola and discharge the patient with a diagnosis of a low-grade viral gastroenteritis?
Simply because hospital EHRs are not designed for the massive data we currently aggregate an every patient:
For instance, staff routinely put flags about concerns in medical charts and computer systems and then are surprised when doctors fail to notice them buried among all the other information.
