Workshop building baseline mobile health landscape, scenario description, and development workshop given by Mike Kirkwood in Oakland California on 11/17/2010.

1. Center for Health Leadership
New Media Training Series
UC Berkeley SPH
Mobile workshop
11/17/2010
Mike Kirkwood
mike@eek.com

2. Introduction – Mike Kirkwood
• Mobile
– An early innovator in mobile apps (day one Apple apps, over 1
million apps downloaded)
– Developed core technology for text reminders with AHA
(American Heart Association) and HealthVault
• Health
– Serial speaker at Health 2.0 (tools panel), mHealth conference,
and Quantified Self
– Health claims management (large and small payers)
– Developer of first iPhone emergency app & PHR (using CCR)
• Technology
– Analyst / Author, cloud computing for ReadWriteWeb
– Large enterprise technology leader (Sony, Cisco, Intuit)
specializing in real-time agile enterprise (6 patents in enterprise
content, data, and metadata)

3. Workshop objective
• Today, we will survey the mobile health
technology landscape, review a real app
development project, and kick off the
design of our own personal mobile health
project
• Participants will:
– Understand mobile health landscape
– Be able to take a mobile project idea to peers
or technology advisors

4. Agenda
• Introductions
• Landscape of M-Health
• Examples of mobile phone tools in public health and healthcare
– overview with open Q & A
LUNCH
• How mobile phones can be used for health applications
– sharing and group discussion
BREAK
• Workshop
– mobile tool and app design
• Design statement
• Wireframes
• Brainstorm
• Feasibility analysis
• Closing and evaluation

5. Introductions
• Name
• Your role in your
organization
• What you are
doing with
M-Health
• One reason you
are here today

6. The Survey
• What are some ways to kick-start a
project?
• Is HIPAA important?
• How is the web connect to mobile
strategy?
• What if I have a smart phone, but I don’t
use apps?

7. Activity
• Set a reminder message to your phone

8. LANDSCAPE

9. Why use mobile platform instead of
web?
• Graphics engine
support (games)
• Maps using location
services
• Sales through app
store (1 click to buy)
• Push notification to
deliver free
notifications that can
pull open apps

10. Examples of projects in mHealth
• Text4Baby – Over 100,000
members. First “free send and
receive”
• Apps and mHealth challenge,
Todd Park @ #mHealth
• Heart 360 releases text
reminders for Heart health
patients
• Norwegian Government
Announces $1 Million for
Initiative Using Mobile
Technology to Support
Maternal Health...Supports
Use of Wireless Networks and
Devices to Reduce Maternal
and Newborn Mortality

11. Tsunami of activity
• Neilsen Report: Teens Text
3,339 Times Per Month! Voice
Calling on Phones Going
Extinct?
• Mobile phone health apps
could improve care in
developing countries
• Why your phone is now the
doctor in your pocket
• Mobile Health Apps See Weak
Adoption Rates
• Innovative strategies and high-
tech solutions for sexual health
education and STD/HIV
prevention
• IT chief sees mHealth moving
faster than expected
• Bill Gates keynotes mHealth
Summit, focuses on saving
children
• Text messages used to reach
expectant, new moms
• The Power of Mobile by
Susannah Fox | Pew Research
Center's Internet ...
• New app zaps auto texting,
tracks teens

12. Tsunami of activity
• For Many, Health Apps Are
Just Not Part Of The Routine
• Dear Google: please make a
medical category for apps in
the Android Marketplace
• Emotional Automation:
Bonding with Technology to
Improve Health
• Chip-in-a-pill may be approved
in 2012
• Busting the paradigm about
mobile for health: it’s not just
phones and browsers. (Morgan
Stanley, April 2010)
• Cleveland Clinic calls wireless
telemonitoring of heart disease
#6 most important medical
innovation of today
• Formation of mHealth
Regulatory Coalition: Singular
purpose is to create & submit a
guidance document to FDA
clarifying mHealth hardware...
• Healthcare sector among top
adopters of iPad
• Health Insurer Humana's
mHealth Program for 60,000
w/Chronic Disease
• Mobile Phone Apps Being
Created To Test For STDs

13. What do you think?

14. A few videos
http://www.youtube.com/wat
ch?v=OextYih4Z28
mHealth - Infectious
Disease in a Mobile Age
(MWV34)
http://www.youtube.com/wat
ch?v=PEza09P7bDo
Med Apps: It's the Future-
Just Right Now

15. Some key #mhealth terms
• Smart phone
• Phone with OS that
includes full keyboard,
applications, and other
core services (email,
maps, apps)
• SMS
• short messaging service,
a commonly supported
standard for sending and
receiving messages on
mobile networks
• Web services
• protocols for delivering
data services over the
web
• Cloud computing
• infrastructure and
computing resources via
the Internet
• HIPAA
• U.S. law governing
health insurance
portability & accounting
• EHR
• electronic health record
• Meaningful use
• standard for determining
health stimulus incentive
qualification over stages
of time

16. Landscape: Longevity planning

17. Landscape: Self admin tools

18. Landscape: Wellness

19. Landscape: Augmenting reality

20. Landscape: Some challenges
• Fragmentation
– Touch-screen apps, no apps, some apps
– SMS / MMS
– Push notification
• Infrastructure assumptions
– Web and services support
– Network quality and reliability
– SMS fire and forget
• Information management
– HIPAA
– Tokens, credentials

21. Landscape: Development
• Building a goal
• Developers are closest to canvas
• Template for app scope
• Scripting a story with tools
• “not pretending” rapid wire-frames – Balsamiq
• “reality” wireframe templates - Mockapp
• Development technologies
• Web (HTML 5)
• SDK (Apple, Android)
• Libraries & languages (Unity, Flash)
• SMS / Voice (Twilio)

22. Landscape
• Topics
– Mobile trajectory
– Health reform
– Location is social
– Apps in the market
– Connecting the
dots

23. Landscape - Mobile
• Mobile
– Messaging
is network
– Texting is
the medium
– iPhone
offers
baseline
• SMS
• Email

24. Landscape - Social
• Social
– Games
– Our story is
in memory
– Location
has a story
to tell
• People
• Places
• Things

25. Landscape - Health
• Health
– EHR
stimulus =
outcomes
– Measure
– Mobile
enterprise
• Sensors
drive
workflow

26. Landscape: Connecting the dots
• Health cloud
– SMS,
Email,
sharing
connect
– Apps with
sensors log
behavior
– Measuring
outcomes
becomes
baseline

27. SCENARIO
Review of a recent real-world mobile health app construction

28. Scenario – Mobile reminder log
• Scenario overview
– Connecting patients who need to take action to
achieve good heart health, working with doctors
that observe and react to patient outcomes
• Goal
• Wireframe example
• Application example
• Scenario brainstorm
– What could we do next?
• For patient, family, friends
• For doctor, nurse
• With location, web, games, content, social, AI, …

29. Scenario: What is the goal?
• Allow people with
heart conditions to
easily keep track of
their risk factors
when working with
their doctor to
monitor their
progress
• Conversation
guideposts to help
modify behaviors

30. Scenario: How does it work?
• Embedded
into web
applications,
e.g. provider
portals
• Joins web
account with
mobile
reminder
system

31. Scenario: Provider workflow
• Trigger new
dialog or
knowledge
sharing
• Brings
mobile and
web view
together

32. Scenario: Questions or reminders?

33. Scenario: Medications are tricky

34. Scenario: Simplify medications

35. Scenario: Daily expectations

36. Scenario: Simple user thread

37. Scenario: Complex user thread

38. Scenario: Missed reminder action

39. Scenario: Ask, Log, Confirm
• Proactive
SMS
reminder
• Smart
listener
• Share
through
web
services

40. Scenario: Anticipated outcomes
• Simple reminders become
baseline (like an alarm
clock)
• Story telling increases
length of use and
commitment to action
• Noisy and random is good
(frequency dialog vs.
numbers and form fields)

41. Scenario: Community design
• Some steps
– Convert
achievable
actions into
shared currency
– Organize delivery
systems
• geography
• closeness
• situational
– Silence is golden

42. Scenario: Embedded app

43. Scenario: Question!

44. Scenario: Conversation threading

45. Scenario: Confirm dialog

46. App elaboration: What else?
Should it do? Should it not do?

47. WORKSHOP

48. Workshop: Agenda
• Activities
– App definition
• What will your mobile service do?
• Wire-frame workshop
• Feasibility review
• Work in teams, or alone
• Ask questions, review similar, invent new
– App review
• Peer review (time permitting)

49. What does your app do?
___________ (name) enables
____________ (group of people)
to accomplish _____________
______________________
(a specific task), while…
______________________ (optional:
specific conditions)
[ ] app [ ] sms [ ] service [ ] device

50. Sample (simple) use case
Actors
• Doctor
• Person
• Mobile #
• HealthVault
• AHA 360 application
• Log web service
• SMS gateway
• Reminder engine
• Conversation engine
• Actions
• Message
Use case steps
• Person accepts invitation from
Provider to join HealthVault
AHA 360 application
• Person signs up for reminder
engine by validating mobile #
• Reminder engine sends
reminder message to person
• Person responds to message
• Conversation manager
inspects action in message
– If understood, log action
– If not understood, exit
• Provider requests action log
from conversation engine web
service
• Provider confirms review and
updates person web service

51. Use case
Actors Use case steps
1. -
2. -
3. -
4. -
5. -
6. -
7. -

52. Application name:
On this screen, the user if able to…

53. Application workflow:
The user…

54. Application name:

55. Application name:

56. Application name:

57. Application name

58. Application name:

59. Application name:

60. Application name:

61. Application name:

62. Application name:

63. Application name:

64. Application name:

65. Closing and Evaluation
• One thing you are
taking away from
today that will be
useful for you
• One thing you are
going to do to move
forward with your M-
health project