Timeline: The iPhone as medical tool

By Brian Dolan
01:00 am

MiM iPhone App

Ever since Apple's AppStore created a dedicated category for medical applications for the iPhone and iTouch, it seems that "the medical community is flocking to the iPhone," as an Apple executive put it last summer.

Back then we cobbled together the first half of the timeline featured below. At the time the launch of the iPhone 3.0 operating system, was the talk of the mHealth town square, especially since Johnson & Johnson company LifeScan was featured onstage. The timeline included a number of the major milestones and interesting developments that related to the medical community and the iPhone.

Even though Apple announced this month the latest version of its operating system, iPhone 4.0, with no mention of medical or health apps, a few readers' requests to update this Apple iPhone timeline. It now spans 18 months of health-related iPhone news.

Be sure to let us know what we missed in the comments. While extensive this list is far from exhaustive:

November 29, 2008: A medical student successfully lobbies Apple to create a "medical" category for applications in the AppStore that would include mostly applications for physicians, nurses and other healthcare workers. The new category took 82 applications from the still existing Health & Fitness category and marked the first spin-off category Apple has created. More

January 22, 2009: Epocrates Essentials becomes available in Apple's AppStore for iPhone and iTouch users. More

February 12, 2009: During a question and answer period at a medical records event in Palm Springs, CA, the Food and Drug Administration's Don Witters says that there may be circumstances where the iPhone should be considered a medical device and regulated as one. More

March 17, 2009: At Apple's special sneak preview of iPhone OS 3.0, Scott Forstall, SVP of iPhone Software at Apple gushed: "Now here's a class [of services] that we think will be really interesting: medical devices." Forstall explained that the new iPhone OS will allow application developers to sync medical devices like BP monitors via both Bluetooth and USB. "So imagine the possibilities," Forstall continued. "We think this is profound." Apple then invited a rep from LifeScan, a Johnson & Johnson company onstage to demonstrate how a Bluetooth-enabled blood glucose monitor synchs up to a diabetes management application running on the iPhone. More and More

March 31, 2009: An iPhone developer uses Google Health's API to create Health Cloud, which allows Google Health users to view their personal health record from their iPhone. Google has yet to take the PHR mobile itself. More

April 8, 2009: AirStrip Technologies announced that the FDA had granted the company's iPhone application, AirStrip OB, clearance to market the app to physicians via Apple's App Store. AirStrip OB enables obstetricians to use their iPhones to remotely access real-time and historical waveform data for both the mother and the baby. The data set includes heart tracings, contraction patterns, nursing notes and exam status. The app pulls the data from the hospitals' labor and delivery units. AirStrip has been planning its iPhone launch since July of 2008. More

April 9, 2009: By many accounts, Sarasota-based start-up Voalte steals the show at the HIMSS event in Chicago with its iPhone-based voice, alarm, text service for physicians, nurses and other hospital workers. More

April 15, 2009: Manhattan Research finds that twice as many doctors are using iPhones in 2009 than were in 2008. More

April 17, 2009: A pediatrician in New York is the first to access Allscripts' popular electronic medical record using the company's new iPhone application. More

April 21, 2009: The "medical" category in Apple's iPhone AppStore becomes the third fastest growing category of applications for the first quarter of 2009, according to O'Reilly Radar.

April 30, 2009: Doylestown Hospital, located outside of Philadelphia, PA, recently outfitted its 360 independent physicians and hospital staff with 3G iPhones in an effort to help them save time, be more productive and provide better care for their patients. More

May 1, 2009: Winner of the $10,000 DiabetesMine Challenge effectively turns the iPhone into the controller for a combined glucose meter + insulin pump. More

May 5, 2009: At the height of the "swine flu" or H1N1 media frenzy, a number of quick coding developers created apps that helped people track swine flu cases' locations, determine if their symptoms were signs of swine flu and more. The rush to create swine flu apps demonstrated the platform's ability to offer timely applications to the market when needed, which could come in handy for future public health events. More

May 29, 2009: Dr. Natalie Hodge emerges as "The First iPhone Doctor" by running a pediatrics concierge service called Personal Pediatrics almost entirely from her iPhone. More

May 31, 2009: Scott Eising, director of product management for Mayo Clinic Internet Services, said the launch of the iPhone and the success of its AppStore convinced him and his colleagues that the time to figure out a mobile strategy is now. More

June 8, 2009: At Apple's World Wide Developer Conference AirStrip's Dr. Cameron Powell takes the stage to demonstrate how the new iPhone 3.0 operating system lets "push" notifications from its remote wireless monitoring device transmit EKG systems to a doctor's or clinician's mobile phone. Apple's Mark Wilson reportedly said that "The medical community is flocking to the iPhone" at the WWDC event during his introductory remarks for AirStrip. More

June 9, 2010: Apple puts FDA regulatory onus on developers. Under the iPhone developer agreement section labeled “Regulatory Compliance for Health, Medical and Related Apps,” Apple writes: “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….” More

June 15, 2009: Audi Lucas and Tim Gee debate whether Apple's regulatory policy for its apps developers is reasonable. More

June 19, 2009: Dr. John Halamka dubs mHealth the "Cool Technology" of the week: “The iPhone is quickly turning into a major resource for accessing mobile health applications. Although I find the iPhone a challenging device for data entry, it’s a great device for data viewing. Realtime viewing of waveform, imaging and text data via a handheld mobile device. That’s cool!” More

June 19, 2009: Boston’s Children’s Hospital’s Informatics Program published a group of principles to guide the creation of a new health information infrastructure for the U.S. The piece was a follow-up on an article published in The New England Journal of Medicine in March. The latest article argued for the development of a platform model, very much like Apple iPhone’s setup, to encourage the development of “substitutable” health care applications. More

June 24, 2009: Dr. David Kibbe predicted that successful EMR vendors should look to the iPhone for inspiration. Once EMR vendors begin to open up their APIs, the industry will begin to see thousands of new applications built on the EHR platform just like Apple’s AppStore, Kibbe predicted. More

June 25, 2009: The USPTO grants Apple an iPhone-related patent that covers wireless remote monitoring of vital signs. More

July 1, 2009: Apple’s senior director of worldwide product development for the iPhone recently left the company to join venture capital firm Opus Capital as a general partner. Bob Borchers, 43, previously worked at Nokia and Nike before joining Apple in 2004. Borchers told VentureWire he won’t be leaving the wireless industry: his focus at Opus will include wireless and medicine as well as mobile marketing technologies. More

August 7, 2009: Aetna’s head of eHealth Product Management, Dan Greden: “The opportunity [with the iPhone] is we don’t have to ask [iPhone users] to wear another device to do this we can tap into their existing device they are already wearing,” Greden said. “Just add an app to it. Last I checked there were half a dozen iPhone apps that we are working on integrating now.”

August 11, 2009: Zepherella has added an iPhone app pilot to its online service, which aims to give physicians and patients an efficient and stress-free way to complete payment transactions online or through the iPhone. More

August 25, 2009: Matthew Connor, a rising junior at Princeton University received a $100,000 grant from Center for Integration of Medicine and Innovative Technology (CIMIT) to build a more in-depth online portal for his diabetes management iPhone app, Islet, which Connor and his brother launched last September. More

August 25, 2009: A survey of 1,000 medical students conducted by Epocrates found that 45 percent of the students that had a smartphone owned an iPhone -- far more than any other type of smartphone. What's more, nearly 60 percent of those medical students who did not have a smartphone planned on buying either an iPhone or an iPod Touch within the next year. More

September 11, 2009: “The iPhone can be an integral part in advancing the fundamental science — the very complexities of biology and understanding of the human genome can be made accessible through tools like the iPhone,” Consumer genomics company Illumina’s CEO and President, Jay Flatley told Apple in a recent interview. “I think it is the convergence of the science and IT technology that today creates a unique possibility to manage our human health in new ways,” Flatley said. “It’s an incredibly exciting time.” More

September 16, 2009: It was a hard fight to get insurance companies to cover dedicated text-to-speech devices for speech-impaired patients, but it finally happened in 2001, according to a report in The New York Times. Kara Lynn, an ALS, or Lou Gehrig’s disease patient, used to use a PC with text-to-speech software loaded on it because that’s what her insurance would cover. The computer had to be stripped down of all other capabilities to be eligible for coverage — no web browsing, email — nothing. As you might imagine, however, Lynn wanted to “take her voice with her” where ever she went, which wasn’t possible with a PC. Instead she bought an iPhone and an iPhone application that she believes works better. Insurers, of course, won't cover it. More

September 28, 2009: The US federal government's first Chief Technology Officer Aneesh Chopra explains how he uses his iPhone to track his eating habits: “Everyday today when I visit a certain coffee shop, I enter into my iPhone — I click, click, click — and it tells me exactly what my sugar consumption patterns were from that grande vanilla nonfat latte, and it becomes very clear to me what this has done to my nutrition habits." More

October 8, 2009: Voalte announced this week a collaboration agreement with Sarasota Memorial Hospital that sees the care facility’s nurses using Voalte’s iPhone-based voice, alarm and text offering. The service allows Sarasota Memorial’s nurses to send and receive text messages, make voice calls, and receive critical care alarms through their iPhones in an effort to provide faster response times for their patients. The hospital began piloting the Voalte service in June. More

October 14, 2009: “Last month, Stanford Hospital & Clinics, in Palo Alto, Calif., started a trial with Apple and Epic Systems … to test software that will let medical staff access patient charts on Apple’s iPhone,” the WSJ reported. More

October 23, 2009: Earlier this month at the Body Computing Conference in Los Angeles, Boston Scientific showed off a concept iPhone app, called Latitude Connected, that is currently focused on cardiac rhythm care management, but its full range of functions enable physicians to access patient records, monitor implanted devices, tap into patient support networks and schedule follow-up care, according to a report from Fast Company. More

November 4, 2009: During its third quarter conference call this week, WebMD announced that its Medscape Mobile iPhone application, which it launched in July, has already been downloaded more than 200,000 times. Medscape Mobile is an app the company created for physicians, but WebMD said the total number of downloads for its consumer iPhone apps now tops 1 million downloads — and its first consumer iPhone app was launched less than a year ago. More

November 18, 2009: RidRx’s new iPhone peripheral, iStetho Adapter enables users to connect old stethoscopes to an iPhone or iPod Touch. The company also developed an iPhone app, iStethoscope Pro, and suggests that users look to iPhone apps iMurmur or iAuscultate to analyze the sounds from the stethoscope better. More

November 30, 2009: Asim Choudhri, MD, a physician in the neuroradiology division at Johns Hopkins University in Baltimore presented a study 15 of the 25 patients were correctly identified as having acute appendicitis. These diagnoses proved accurate for 74 out of 75 interpretations, which is about 99 percent of the time. There was only one false negative — and no false positives. More

December 1, 2009: Bradley Merrill Thompson explains how to get the FDA to clear a mobile health app. More

December 11, 2009: Apple announced the top selling apps, songs, games and podcasts from 2009 in an iTunes feature it called iTunes Rewind 2009. Perhaps surprisingly, one medical iPhone app made the list of the top 30 selling iPhone applications in 2009: Proloquo2Go. The app, which costs $189.999, appears among apps that generated the most revenue in 2009, which seems to be how Apple created a list of the Top Selling apps for the year. “Proloquo2Go is a new product from AssistiveWare that provides a full-featured communication solution for people who have difficulty speaking." More

December 14, 2009: While Apple supports the Nike+ activity monitor and has demonstrated a connected blood glucometer made by Lifescan at its iPhone 3G unveiling, its movement toward championing peripheral health devices for the iPhone has been decidedly limited to date. However, a recent patent application points to the a lot of activity on the connected health front inside the company’s research and development teams: An Apple patent describes a couple of methods for using a wireless earbud to track a user’s blood oxygen level, body temperature, heat flux and heart rate. The patent application notes that the earbud could use infrared photodetectors to monitor the user’s biometrics. More

January 6, 2010: Mayo Clinic has partnered with smartphone application developer DoApps to form a new start-up, called mRemedy, which is focused on creating health apps for smartphones. mRemedy’s apps will be based on Mayo Clinic’s research and services. The first mRemedy app, Mayo Clinic Meditation, launched last week for Apple’s iPhone and iPod touch. More

January 13, 2010: After three months of rumors, details surrounding Epic Systems’ partnership with Apple for a mobile phone-based electronic health record (EHR) application have come to light: Just a few days ago, Epic System’s iPhone application, called Haiku, became available on Apple’s AppStore: “Haiku provides authorized clinical users of Epic’s Electronic Health Record with secure access to clinic schedules, hospital patient lists, health summaries, test results and notes. Haiku also supports dictation and In Basket access." More

January 20, 2010: American film producer, Dan Woolley, was trapped in the ruins of a hotel in Port-Au-Prince, Haiti during last week’s earthquake. Woolley used the light from his digital camera to examine his broken foot and head wound. He then used a medical application on his iPhone to look up how to dress his wounds, which included a broken foot and a head wound, according to the report. Woolley said that during the 65 hours that he spent in the ruined hotel’s elevator shaft, he also looked up symptoms for shock using his iPhone medical app. More

January 27, 2010: Apple confirmed the rumors today and unveiled a tablet device, which looks like a giant iPhone, called iPad. While Apple CEO Steve Jobs and his team of presenters at Apple’s iPad launch event this morning did not mention the healthcare vertical as a key market for the iPad: It looks to be just that. More

February 8, 2010: Epocrates surveyed 350 clinicians to gauge their interest in buying the iPad for use at work: "Nine percent of survey respondents plan to buy the iPad when it was immediately available, another 13 percent plan to buy it within the year, thirty-eight percent of respondents expressed interest in the iPad with the request of more information to solidify their purchase decision." More

March 15, 2010: MIMvista, the iPhone app the FDA asked to be taken out of the AppStore: In August of 2008, we submitted our first 510(k). We knew that the iPhone software raised new issues as compared to workstation software, specifically in terms of its intended use. On the iPhone, the images would be viewed under different circumstances than are typical for radiologists (reading rooms). This difference did raise new issues of safety and effectiveness. To be honest, this dramatically new direction for our company, and the speed at which it occurred, left us ill-prepared for the scope of the regulatory process that would unfold. Within only a few weeks of submitting, we were contacted by the FDA and told that our app could not be on the app store (despite the fact that it was both free and labeled as “not intended for diagnostic use”) because it served as marketing for a device that was not cleared for marketing. We promptly removed it. More

April 8, 2010: The HHS and the Office of the National Coordinator for Health Information Technology (ONC) have awarded Harvard Medical School and Children’s Hospital a $15 million grant for a four year research project to “investigate, evaluate, and prototype approaches to achieving an ‘iPhone-like’ health information technology platform model.” More

April 8, 2010: Apple announces the iPhone OS 4.0, which includes 1500 news APIs for developers and new features, including multi-tasking. iPhone users with the OS 4.0 installed will be able to keep more than one app running at the same time, sort of. More

April 23, 2010: Nick Volosin, director of technical services, at Visali, California-based Kaweah Delta Health Care, has been piloting three Apple iPads for X-ray images, EKG results and other patient monitoring programs, according to a report from Network World. Volosin now plans to buy 100 more iPads for use by the care group’s home health and hospice care workers, nurses, dietitians and pharmacists. More


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