Overlap's Blog – We make healthcare better for everyone

By David Haddad on August 10, 2018

Introducing 8 new mental health survey instruments

overlap survey writing mobile phone

Today we’re excited to introduce the addition of 8 new mental health survey instruments towards the goal of making it easier to get patient reported outcomes into the clinical workflow.

Which surveys?

PC-PTSD
1. a 5-item survey for identifying probable PTSD that was designed for use in primary care (PC) settings
GAD-2
1. a brief 2-item survey for screening and monitoring generalized anxiety disorder (GAD)
GAD-7
1. a 7-item survey for screening and monitoring generalized anxiety disorder
WEMWBS
1. a 14-item survey for monitoring mental wellbeing, an acronym for the Warwick-Edinburgh Mental Wellbeing Scale
SWEMWBS
1. a shortened 7-item and RASCH compatible version of WEMWBS for monitoring mental wellbeing
PHQ-2
1. a brief 2-item survey for screening and monitoring depression, an acronym for the Patient Health Questionnaire
PHQ-9
1. a 9-item survey for screening and monitoring depression, which includes a question about suicide ideation
PHQ-8
1. an 8-item version of PHQ-9 without the suicide ideation question

These surveys are available on the Overlap iOS and Android applications, and responses can be visualized and exported in our provider dashboard.

Why does this matter?

Patient-reported outcomes (PROs) are a key ingredient to making sense of a patient’s health and driving towards value-based care.

Overlap is committed to offering a remote patient monitoring solution that’s both device AND disease agnostic. Yes, we do make it easy to add customized survey instruments to your workflow. But we also think that by offering lots of measurements out of the box (we’re up to 28 now!), you’ll be able to realize results faster.

Get mental health measurements into your clinical practice or research today with Overlap.

Start here

By David Haddad on August 9, 2018

Hiring: UI/UX Designer

Overlap makes healthcare better for patients and their providers. We work with some of the world’s best healthcare institutions to help them get data from wearables and mobile apps into the clinical environment so they can manage disease more effectively. The Overlap product line spans iOS, Android and Web and has deep data visualization components.

As our part-time UI/UX Designer, we want your experience to help turn ideas into engaging experiences that are implementable.

About you:

You are self-managed, know how to prioritize, meet deadlines and define deliverables.
You can effectively communicate and present your design thinking to teams and stakeholders
You can take a design from high-level concept to Sketch and Invision and static assets easily and quickly
You write and speak English clearly
Your are up-to-date on industry trends in UI and UX
You are honest – You know what you don’t know and you have no problem raising your hand and asking for help.
You’re obsessed with simplicity and consistency
You’re okay working across the organization (product leadership, engineering, marketing and the CEO)
You have knowledge of design trends in mobile and how to adapt designs across platforms
You have experience working with visualizing large sets of data
You have previous remote working experience

You will be:

Collaborating with Overlap’s CTO, product lead engineers and CEO to align partner needs with company goals
Augmenting UI and UX across our iOS, Android and Web application
Working-off of our existing design UI on iOS, Android and Web
Designing some marketing collateral and new features for the overlaphealth.com website
Participating in project planning and project review (QA and post-mortems)
Designing everything from logos to icons to QA’ing final work and assist with acceptance testing
Focusing on shipping a beautiful product you’re proud of

Role requirements:

3+ years of experience
Most recent portfolio demonstrating both design skill and process across mobile and web
Design experience with data visualization
Experience in creating easy-to-use designs that display holistic thinking
Acute attention to detail
Experience with and proficiency in design and prototyping software (Sketch, Invision)
Stellar presentation skills
Strong communication (verbal and written) skills

Software skills

Sketch software
Prototyping & wireframing software
Invision

How to apply

Send along a cover letter explaining why you’d be a good fit for Overlap and a resume. Email everything to jointheteam@overlaphealth.com, including “UI/UX Designer” in the subject line. We look forward to hear from you!

By Alexa Hornbeck on August 8, 2018

4 Steps To Designing Better Healthcare Experiences

How many times have you gotten lost in a hospital?

So often, unmarked hallways and white-washed walls lead us astray. But for UX design researcher Katie McCurdy, the solution might simply involve painting a wall blue to lead patients and providers to the main reception desk, or redesigning the look of a medical bill.

“Often the reaction we get in these medical facilities is that “it’s just the way it is around here,” McCurdy tells a crowd of onlookers at a talk at the University of Vermont Medical Center in 2016.

McCurdy’s work is focused on strengthening relationships between doctors and patients — such as creating an information pamphlet for parents to be more aware of activities and resources at a children’s hospital, or designing a map with rivers and forests to help navigate a patient through a healthcare facility.

“Pretty much every staff member gets stopped every day by someone asking for directions,” said McCurdy. She is currently working to get hard numbers on how the implementation of her wayfinding project has changed things for staff members.

“The design of a facility/structure with its fixed and moveable components can have a significant impact on human performance, especially on the health and safety of employees, patients, and families.”

This finding is from a study titled “The Impact of Facility Design on Patient Safety” published by members of the Agency for Health Care Research and Quality and Synergy Health in 2008. The study reviews “more than 600 articles and finds links between the physical environment (i.e., single-bed or multiple-bed patient rooms) and patient (e.g., fewer adverse events and better health care quality) and staff outcomes (e.g., reduced stress and fatigue and increased effectiveness in delivering care).”

McCurdy has designed a problem-solving model to solving issues providers and patients often face. For instance, the invention of an analog tool called Pictal Health, which allows patients to express their symptoms to physicians by creating detailed visual timelines.

McCurdy’s process is one that allows her to achieve a simple solution to complex issues. Here are her four steps to designing better healthcare experiences:

1. Visualize the Problem

McCurdy uses a lot of drawings, whether it be maps, notes, pictures. In fact, McCurdy’s Pictal stemmed from a personal visit to a physician in which she felt she was unable to communicate the problem, and decided to draw out a timeline of her symptoms while in the waiting room. Or for McCurdy’s wayfinding project she drew old maps of the hospital and placed new designs overtop. If there’s a way to visualize the situation, she will find it.

2. Observe and Ask Questions

After implementing new prototypes into the environment, whether its a zoning system or orientation guide, McCurdy inspires patients and providers to think of a clear memorable experience at the hospital and map it out. She will spend a great deal of time walking around and attempting to understand the experience for herself. Solving the right problem begins with asking the right questions. Tools such as tip and comment boards, help change the conversation around the patient and provider experience, and develop solutions which meet their specific needs.

3. Always Be Testing (ABT)

Do the orientation pamphlets or maps make things less confusing or more confusing for physicians, patients, families? If something doesn’t work, she’ll try something new. Because the users are co-creators in developing the solution, they feel confident to provide feedback. McCurdy encourages her colleagues to “be like water,” and amenable to trying new avenues to solve a problem in a clinical setting.

4. Document Progress

The process is one that is constantly evolving in McCurdy’s work, and for all designers. UX design has proven to save hospitals hundreds of thousands of dollars, and made the relationships between providers and patients stronger. But the work is hardly over, and only time will tell if McCurdy’s work will remain an effective solution, or if changes over time, such as new technology on the market, will lead to new problems in need of new solutions.

In many ways, the health concerns McCurdy takes on in her projects is similar to that of start-ups, but she admits industries aimed at creating a new app or gadget aren’t necessarily “selling their vision” in a way which necessarily takes into “the concerns of the users.”

McCurdy said tech industries “do not always have the ability to be useable across multiple platforms,” and that “not every facility has streamlined the process” of new products.

“I hope wearable and digital health data will become more embedded into the culture of healthcare,” McCurdy said.

A recent op-ed published in healthcare design magazine by Kara Freihoefer shares McCurdy’s passion, but for what Freihoefer calls “empathetic design,” a way “for designers to truly see and experience the healthcare environment as patients see and experience it.”

And McCurdy does believe that “new technology, like devices and apps, are reimagining what healthcare might look like, and bringing healthcare out of the hospital, and into the community,” she said.

Given the obstacles providers and patients face, McCurdy said designers should primarily focus their efforts on, “building stronger doctor and patient communication and relationships.”

And designers have their work cut out for them. The global mobile health market an estimated $28 billion is expected to be generated on sales in 2018.

Wearables, and other health and fitness devices can be helpful at tackling a multitude of health issues. There are devices which assist with things such as tracking exercise and calorie intake for those with obesity, a hybrid closed-loop insulin delivery system for those diabetes, or a pacemaker is a for someone with sleep apnea. Mobile health devices can even assist with post-surgery recovery as reported in the Cleveland Clinic’s predictions on medical innovations in 2018.

For McCurdy — the success of her work — and that of many other designers is fueled by a personal motive to make healthcare an easier maze to navigate.

“I was struggling with a bunch of symptoms, and a light turned on to use the skill set I bring to design work — there is so much potential in making things better for other patients,” McCurdy said.

By Dan Sung on August 6, 2018

Collapse or consolidation? The wearables market and what you need to do next

There’s no hiding it. The wearables market is looking shaky right now. In the fourth quarter of 2017, two major players, Fitbit and Xiaomi, shipped 17 percent and 5 percent fewer devices worldwide than the equivalent period in the previous year.

In fact, the wearables market only grew by 8 percent thanks to the Apple Watch topping the charts with 8 million sales, up from 5.1 million.

The outlook for 2018, so far, isn’t much rosier. While wearable shipments increased by 12 percent in Q1, that represents a slow down compared to the 18 percent year-on-year growth managed in 2017. Plus, with Fitbit’s stock price bombing; Misfit’s sale to Fossil; Jawbone and Moves dead, along with a host of other names you never even got to hear about; and Withings wobbling since getting sold to Nokia and then sold back again, the picture looks even worse.

Is this collapse or consolidation, and for consumers looking to sign up to a healthier lifestyle and for hospitals wondering how and when to invest in wearable devices for their patients, what are we supposed to do next?

Race to the bottom

“From a health and fitness wearables perspective, we’re at an interesting crossroads,” says James Stables, co-founder and Director of leading wearable technology website, Wareable.

“We’ve had a race to the bottom in terms of the functionality of fitness trackers and people are fed up with the standard features which you can get pretty cheap now. Fitbit has eaten up that market bar Xiaomi who are operating at the other end.”

Little wonder then that the smaller fitness band players somewhere in the middle have all but disappeared but there isn’t much more heterogeneity in the smartwatch market just beyond, which itself is picking up in popularity. Dominated by the Apple Watch, these smartwatches have integrated those same features which were once unique to the simpler fitness trackers. The end result is a bigger squeeze at the bottom.

“If you look at the two biggest wearable markets,” continues Stables considering the trackers and the smartwatches, “each has become dominated by one major player and one of them has started to cannibalise the other. So, I think we’re in a holding position where there’s no no new sensor data coming through, people have got their fitness trackers and are replacing them when they break or they’re losing interest. That’s why we’re seeing fewer companies and higher profile companies struggling because they’re not cut out to compete with Apple and Fitbit.”

The Apple effect

“The Apple Watch is one device that seems to be immensely popular despite wearables faltering elsewhere but part of that popularity means that it’s also sucking in every feature of everyone else’s device. It’s taken a big chunk out of Fitbit and now it’s taking a chunk out of Garmin because it’s a pretty good running watch too. It really is the one singular device that everyone needs so long as they’re willing to use an iPhone.”

So says Stables, and therein lies hope that this period of consolidation will perhaps cause few more casualties because Apple will always give competitors room on price. Apple hogs the mainstream but not everyone can afford a $330 smartwatch and not everyone can afford the even more expensive iPhone you need to get it to work. And hospitals certainly can’t be dishing this kind of luxury kit out to their patients willy-nilly.

After a false start with the Ionic smartwatch, which performed worse than expected for sales due to its similar pricing to Apple, the $200 Fitbit Versa is filling that more affordable space very nicely while focusing on the more health side of wearables as opposed to fitness. Its Female Health tracker feature is a case in point.

The other natural challenger to Apple is, so far, sadly all but absent, according to Stables.

Where’s Google?

“Google has really dropped the ball. Bear in mind that the iPhone is only around 30 percent of the smartphone market at the moment. There’s no cohesion around the Android Wear OS experience. All they’ve managed to do in the last two years is change the name of the OS. They’re not bringing in any new features. They’re not helping the likes of Fossil. Fossil is actually doing a really good job but it would be doing a lot better job if Google could create an OS that got people really hyped up.”

Google’s attempts at a quality smartwatch operating system have been disorganized, as usually happens when you don’t have control over the hardware on which your software is supposed to run. While Google has been stumbling, in the same time frame, Apple has become a wearable super-power, as Stables attests.

“The Apple Watch started off quite poor but has grown into a really, really great device. If you look at what it was with no GPS, a crap battery, no third-party access to the device sensors compared to now, the difference is staggering. Now, with watchOS 5 launching in September, there’s cadence sensing for running, advanced heart rate, the breathing training, VO2 max, exercise detection, resting heart rate measurements and that’s just the sports side. Then there’s all the fitness, wellness, walkie-talkie features and smartwatch features. It can tell you’re going to have a heart attack before you have one, and they’re the only smartwatch manufacturer to have LTE connectivity and sign up working really smoothly.”

Medical wearables and other specialists

While the Apple Watch is fantastic running watch, it’s not got the battery life to get you through a 48-hour ultramarathon. Garmin has. Now, while slogging it out over two-days on rough terrain is not everybody’s idea of fun, what we’re saying here is, that just with price, Apple leaves room for specialist wearables too. Even if Garmin itself took out everyone else in the sports wearable space, most notably the very worthy TomTom range, Garmin is still the choice for triathletes of all persuasions and it’s not likely that Apple will try to snatch the hardcore end of that.

Similarly, the medical wearables space is under no threat from Apple either. Johnson & Johnson, iHealth and Omron are in no danger of clinical-grade blood glucose trackers or blood pressure monitors arriving from Fitbit any time soon; certainly not for the moment.

Even if one did turn up in the consumer stream, the process of getting medically certified is slow, expensive and probably too much so for a fundamentally consumer focused company to bother with.

Either way, for the time being, the global market for medical wearables is on the up. Valued at $6.22 billion in 2017, it’s predicted to have a compound growth of 18.3% to take it up to a healthy $14.4 billion by 2022 with sales in the US set to rise from 2.5 billion units to 8.7 billion.

Also, unlike fitness trackers, the medical wearables space is far from saturated. There is no one big market hog threatening to suck up all the sales and, with new and specialised sensors in development, there’s every reason to think that it will be a sector able to support itself and stave off cannibalisation by the mainstream.

Of course, if not correct, we do at least appear to have a vision of the future by looking at the consumer device space which the medical market could be shadowing a few years behind that same curve.

So, which wearable should you buy next?

The key situation to avoid – whether you’re a patient looking to get on a health and fitness kick or a hospital investing in a remote patient monitoring program – is the one where you end up buying into an ecosystem that goes out of business.

What’s left in the fitness tracker space with Xiaomi and Fitbit seems safe enough, despite the recent downturn, given Apple’s pricing structure.

Apple Watch is, of course, headed nowhere but up. So, it’s a safe call for those that can afford it and it’s a device that’s only going to get better.

As for the dedicated medical wearable space, it looks safe to buy into one of the major players but judging by what we’ve seen both in the mainstream and in sports, you need to back the right horse.

Omron or Johnson & Johnson would make a sensible choice and have enough at stake in terms of reputation to make them accurate and trustworthy as well. They should see you gathering quality data and prevent any need to port all your information over to another platform with these players unlikely to go bust. They’ve also been making these devices before anyone was calling them wearables, and are set up to integrate with technology companies to help move that data into the EHR. Beyond that, what you need to look for before nailing your colors to the mast is signs of life. There’s no one key marker but it’s about recent news and announcements from the wearable divisions of these companies.

Are they releasing new APIs?
Are they updating device firmware?
Are they updating their software platforms regularly?
Is there news about new sensor developments?
Any new products in the pipeline?

Of course, if the answers to these are ‘yes’ then it’s all going well. As well as the negative responses possible warning signals would include:

Price structure changes on services; eg: features that used to be free becoming freemium
Consistently poor product reviews
Product recalls
Company mergers

None on their own necessarily spell doom but they’re all pointers. Read the news, if too many lights start flashing, then that’s a wearable company best avoided, and if you’re tempted by the early adoption of a brand new wearable, you might want to think again unless it’s got a revolutionary and validated new sensor inside it, and, even if it does, it’s only a matter of time before one of the big players moves over to eat it up.

By Mike Plunkett on August 1, 2018

Conduct better mHealth research with these 5 best practices

The realm and possibilities of mHealth have grown substantially in a short period of time. Last year, 325,000 mHealth apps were available for use on mobile devices. Of those, 158,000 were on Google Play, a 50% increase from 2016.

Researchers are finding mHealth and the opportunities it provides for better healthcare to be a fertile ground for study. Yet in a rapidly changing technological environment, it’s a challenge to collect and analyze data that withstands clinical scrutiny but also can apply “in the wild.”

As top researcher Dror Ben-Zeev, Ph.D. and his colleagues noted in their seminal 2015 study on mHealth research:

“Without realistic expectations and planning, integration of complementary sets of expertise in the research team, and an ability to remotely monitor, detect, and flexibly resolve obstacles as they arise, researchers will find mHealth projects to be daunting and difficult.”

Three years later, these guidelines still apply, said Beth Jaworski, Ph.D., a researcher at the National Center for PTSD, part of the U.S. Department of Veterans Affairs. Researchers, she said, are learning best practices and ideals, often as they go along.

Here are five best practices and tips that can guide your mHealth research campaigns in a fully digital — and mobile — world.

1. As with most research, good mHealth research comes down to definitions

It was only a decade ago that “mobile health” meant remote health clinics set up in rural or underserved populations. Now, mHealth could mean telehealth, remote monitoring with an app or measuring data from a fitness device. Jaworski said researchers have to define what specifically they are accessing and the research questions they hope to answer.

“Be clear about the definitions of what you’re researching so that you know what the scope and bounds of the claims you can make so people can understand it,” she said.

That also goes with communicating constantly with your technological partner in the study. The same words can have different connotations among researchers, engineers and designers. A strong partnership can help steer the ship the way the study should go, as to not get caught in ambiguity.

**2. Think carefully about who you’re studying and under what conditions**

It can be easy to target research toward well-served communities and those with the means to get quality healthcare. But the promise of mHealth is in reaching underserved communities and those who lack the means or the motivation to seek healthcare through a provider or clinic.

“How can we work for folks that don’t have a primary care provider or have difficulty and feel ashamed to seek mental health care and making sure we’re building products and tools and resources that meet the needs of those folks?” Jaworski said.

Jaworski also issues a call to research on the social determinants of health, as well as including strong qualitative research to complement the often data-centric approach of research campaigns. It helps tell the full story of healthcare and technology.

3. Allow for creativity as well as validity

The gold standard for clinical research — randomized control trials — are useful for peer and industry efficacy and validity. But often in the case of mHealth research, it may be too difficult to accomplish.

Jaworski said that having a good sense of the traditional research outcomes you want as well as thinking through other possibilities mHealth can provide will guide your thinking into what will and what won’t work.

In 2015, Jaworski and her colleagues assessed the scope of “PTSD Coach,” an app created by the VA to help track PTSD symptoms. In their assessment of research, they relied upon tracking the app’s ratings in the Apple App Store and Google Play, as well as measuring the user experience with Flurry Analytics. That gave them the data they were looking for, while following IRB protocol.

She is also partnering with Overlap to conduct the Aware Study, which is looking into the relationship between mood and PTSD, researching the use of the Aware app in myriad ways.

In short, mHealth researchers must account for variety (and even some creativity) to assess the efficacy of a particular mHealth intervention.

4. A thoughtful design of the research is key

With the promise of the field, there are ways to design a study to get good data for analysis. Researchers with the National Cancer Institute posited incorporating “SMART design” processes for study that takes into account the dynamic engagement with a subject and the technology. Allowing for different research design methods can help the study overcome the often slow nature of a trial, as well as the iterative nature of mobile technology.

In another context, mHealth researchers are using gamification and VR to treat mental health disorders. This is a nascent field that is integrating both RCT and new tools for analysis and application.

That also means staying on top of the academic literature as well as the technological update. Also, Jaworski said that the technology cannot be an afterthought. “It’s not like you come with the entire research protocol and say, ‘Let’s slap that into an app and run with it.’ I think those pieces have to come together,” she said.

5. Be mindful of the pros and cons of collaborations

The main players in the mHealth research field: academia, the government, the private sector and tech startups, offer advantages and disadvantages in conducting research.

Academia, for example, may offer more freedom to conduct different aspects of research but the long-term guarantee of funding often isn’t present.
The private sector does have funding but the main goal is monetization.
The federal government may not have funding constraints but the time and patience required to meet regulations and proposal guidelines can loom large.

Also, being open to other collaborators can ease the process. Jaworski said it’s not worth reinventing the wheel and making the same mistakes others have made in the past. She suggests establishing a team across disciplines, having engineers, designers and researchers that are in the space.

With these best practices, mHealth researchers who conduct this important work will add to the dynamic growth of technology and healthcare.

By Dan Sung on July 30, 2018

6 ways to get wearable data into your clinical workflow

Nearly one in five adults in the US currently owns a wearable device. Whether that’s an activity tracker or a smartwatch, it doesn’t really matter. What follows is that there’s a lot of health data out there ripe for the picking. Estimates from Soreon Research suggest that 1.3 million lives will be saved using healthcare wearables by 2020. Almost half of all patients are prepared to to use them and hospitals are already prescribing them. Getting any meaningful data to the physician at the other end, though, is where the process can break down.

The problem is that, traditionally, there has been something of a disconnect between the Fitbits of this world, who make the devices, and hospitals looking after the patient EHRs. So, how are clinicians supposed to make use of all this? How do you get that wearable data into your workflow and in front the right person when they need it? Here are six ways. N.B. Some are better than others.

Why doesn’t Fitbit do it?

First, a little note on the problem. After all, why don’t the wearable manufactures do the leg work for the patients? Isn’t improving health what they’re selling to the customers? To a degree, it is but really they’re in the business of selling hardware and then often selling the anonymized data that those devices send to their servers for some healthy bonus revenue.

Making it possible for their apps to feed into patients’ EHR is less lucrative or, indeed, not lucrative at all for the wearable manufacturers. There’s licensing, medical certification of the hardware, responsibility for the measuring and the accuracy of the data and it’s all a bit beyond the remit of a company who just wanted everyone to wear its cool new bangle.

As it stands, it’s only really Apple who is making any inroads towards direct EHR compatibility with FHIR (Fast Healthcare Interoperability Resources) although that’s more about taking data from a patient’s record and pushing it to their mobile Health app and not the other way round. More on FHIR another time.

Without any quick and direct wearable data access, then, these are the options left open to hospitals and their clinicians.

Data synchronization of health book between smartwatch and smartphone in male hands

1. Get patients to show their apps

It doesn’t give much information on how and when data was gathered but the non-technical and obvious solution is for a patient simply to show their physician the wearable app on their mobile phone when they go to their next appointment. For tracking in-between visits, then they could always exchange screengrabs via email or SMS. It’s cheap and simple but it’s also a big fistful of sand into the gears of a clinician’s workflow. How is all this supposed to integrate with a health record and what about being able to consistently monitor a patient whenever needed?

There’s also issues of data trust because screengrabs and a quick flick at an app don’t offer much in the way of provenance, so it’s understandable if a doctor takes what they’re shown with a rather large grain of salt and the patient themself then becomes rather demotivated at the dismissive attitude they’re received.

While it’s easy to ignore, though, it should be noted that even this rudimentary approach has value. Data about steps taken or even weight loss isn’t so complicated that a patient would make a mess of recording it and, even if the wearable in question is not endorsed by the hospital, it may still show a useful trend.

So, patients, don’t be put off if this is your only option and, doctors, do make more than a show of taking a look at the screen.

2. Head to the source – ask the wearable manufacturer

Once a wearable makes its measurements, that information is stored on the servers of the company that made it. You want information gathered on a Garmin Vivofit, you ask Garmin.

As it stands, the patients can access that data through their mobile apps but, as discussed, there’s no other pre-built conduits for that data to slide along. Instead the likes of Garmin, Fitbit, Facebook, Apple and all these big companies create an API – an application processing interface – which is a set of tools that a developer can use to build something to get the information they need from those servers. In the context of wearables, what we’re talking about is Samsung or Nokia effectively saying that they’re not going to waste their time and money making their wearables all nice and compatible with your EHR but they are going to leave out the bits and bobs for the hospital system and EHR developers to make those connections if they want to. So, yes, head to the source but it’s only part of the solution.

3. Get the hospital software technicians to work with Fitbit et al’s APIs

It’s a good idea but it’s very, very big ask of the developer teams within the healthcare system. Hospitals just aren’t really set up to do this themselves. They’ve bought and integrated EHR platforms from external providers at great expense and, even if the hospitals want to, they’re very short on the right kind of staff, with the right kinds of skillsets. There’s already enough work for the technical team in keeping their current EHR from falling over. It’s possible you’ll find a dev with a big heart, a can-do attitude and some time in their schedule but you might want to have a plan B up your sleeve.

4. Get the EHR companies to build in wearable compatibility

Pulling information from one database and integrating it into another is typically complicated and the kind of operation performed by workers developing complex systems more akin to banking and other kinds of enterprise technology. EHR systems currently aren’t as sophisticated as that. The teams that create and manage them don’t really have the resources to be the vanguard of this charge and the companies behind them might well see such attempts at integrating wearable data into the workflow as not really worth their time.

Again, it’s not in the EHR vendor’s business model to make money from wearable integration and, even if the hospitals are crying out for it, their EHR contracts have them over a barrel. Some have spent into the billions to get their systems up and running. They’re not about to switch which is why other companies with all the right software architecture skills have popped up to help bridge the gap. It’s a good idea and maybe something that will become part of the EHR buying decision in the future but it’s a dead end for now.

5. Wearable data aggregators

Spotting the obvious gap in the system, there are companies who specialize in aggregating the wearable information from all the various device manufacturer sources into a single data type. They then pipe that stream over to the hospitals who still have to figure out how to integrate it all into their systems. That still means getting the hospital’s developers at their to do the work but they only have a single API to deal with instead of the whole spectrum.

Using an aggregator is certainly one of the more realistic options on this list. There are aggregator companies out there offering this service and the hospitals have the resources to make use of them but you get what you pay for and there’s something of the cheap and dirty about this solution. It will get that wearable info in but the aggregators don’t do anything much to make tangible sense of that data. It doesn’t offer much at the patient end either but, sure, job done.

6. Dedicated remote monitoring software

The more sophisticated solution to all of this is a company that will not only pull that data into an EHR but one that will provide an end-to-end solution from a dedicated app on the patient’s phone all the way over to a meaningfully presented set of measurements at the clinician’s monitor screen and, yes, of course, this is what we do at Overlap and there are other good companies that offer similar software. By all means, go and investigate.

As far as we’re concerned, an overarching approach is going to be far better for getting patient-generated data into the clinician’s workflow. Rather than pulling from a single device – and plenty of patients will have multiple sensors on them at any one moment – dedicated remote monitoring software gives the opportunity to take multiple kinds of data from a patient and create a more detailed picture of their health. So, it’s not just ‘how much are you walking’ but ‘how much are you walking and how are you feeling’.

That’s all gathered together on the patient’s mobile app via Bluetooth, Wi-Fi and from the patient’s own manual inputs too and then is sent up into the remote monitoring software provider’s servers from where it’s pushed out to hospital EHRs. The data arrives at the EHR most usually within a separate remote monitoring tab of the record. Clinicians can then track their patients during their time away from hospital and, once it’s time for their appointment again, it’s all there together on-screen.

The other key benefit is that an end-to-end solution is more secure with one platform protecting the data all the way from the patient to the physician.

So, some choices; not many, we’ll grant you, but choices.

Which way will you go?

Overlap Blog