A new report from Datacomm Research Company (which I co-authored along with David Strom) details how restaurant chains are using consumer-facing connected technology to promote their brands, engage customers, and provide superior customer experiences. In recent years, virtually all major restaurant chains have added nutrition information to their websites. Some simply provide tables with entries for each of their menu items. Others provide ingredients used in specific products and additional information for those with allergies or diabetes.

Several restaurant chains (such as McDonald’s, Chick-fil-A, and KFC) provide meal nutrition calculators. This is very helpful, because it often allows consumers with dietary restrictions to identify acceptable combinations of menu items. And chains including McDonald's, Wendy's Chick-fil-A, Red Robin, and Steak n Shake also provide nutrition information in handy mobile apps that consumers can consult in the restaurants' stores.

Though the report (Good Food and Drink and Connected Technology, 2014-2019) focuses on restaurant chains' use of consumer-facing connected technology, it predicts that the technology will increasingly play a major role in other retail segments, and suggests that the other segments would do well to study the restaurant chains' experiences. Though there is already quite a bit of effort going into the development and marketing of consumer-facing connected technology for health and fitness, the use of this technology by restaurant chains provides important lessons regarding what does and doesn't work, how to optimize its use, and how to avoid common pitfalls.

Another new resource that may be of interest to readers of this blog is MIMO World. This site provides news, analysis, and resources regarding 4G and coming 5G wireless technologies.

Almost everyone says that you must have health insurance. Here is why that isn't necessarily true:

• If you have a family to insure or are over age 50, you can buy quite a bit of health care for the same amount you will pay for premiums, deductibles, and copays under Obamacare.

• If people paid directly for their own health care, prices would plummet. About 50% of the prices you are charged are for overhead—much of it the office staff and systems needed to track insurance claims. Hospitals and doctors would be forced to publish and guarantee their prices. Competition—the only genuine means of driving down prices without sacrificing performance and quality—would ensue.

• Hospitals set highly inflated prices because that gives them negotiating leverage with insurance carriers. No one—not even the wealthiest—really pays those prices. Many hospitals will give you an automatic 25% discount just for being a self-pay patient. Many doctors will negotiate a 50% discount if you pay directly. Depending on your income and outstanding bills, you may be able to obtain even higher discounts. Demand an itemized bill.

• Hospitals and physicians groups are happy to accept monthly payments. Those who pay for their own health care establish personal credit with local hospitals and doctors. People who pay for their own health care receive better service. These things could come in handy if the government begins denying expensive health care services to older or sicker patients insured under Obamacare.

• You may be able to enhance your standing with your preferred hospital by doing volunteer work, fundraising, and/or making regular donations.

• Yes, there are risks associated with being uninsured. Uninsured patients are usually disqualified from receiving organ transplants. Long hospital stays are rare these days—less expensive home care is usually, but not always, an option. Be sure you fully understand the risks before choosing to be a self-pay patient.

While there are legitimate roles for government in health care, denying life-saving drugs to seriously ill patients, discouraging innovation, and driving up costs are not appropriate functions. The Food and Drug Administration (FDA) in particular is often an obstacle to new technologies and consumer empowerment.

Please stay tuned for the three part series: Reform the FDA!

Part 1: How the FDA Amassed Tremendous Power.
Part 2: How the FDA Harms Patients, Physicians, and the Health Care Industry.
Part 3: It’s Not Too Late to Fix the FDA.

There is a fascinating article in today's Wall Street Journal about Theranos, a company that is automating and miniaturizing laboratory tests. Founded by Elizabeth Holmes, Theranos uses a fingerstick to draw a large drop of blood from the skin rather than poking a vein to fill one or more vials.

The basic concept is not entirely new. The fingerstick method is routinely used by diabetes sufferers and people on anticoagulants. What's unique about Theranos is that they have or are developing fingerstick versions of a long list of blood tests. The fingerstick method is less expensive, safer, faster, and less error prone. For example, sticking a vein can cause a bruise. The blood must be put into vials and the vials sent to a lab that does the analysis. As Ms. Holmes points out, more people are involved when the traditional method is used, so there are more opportunities for error.

While Theranos does not currently support self-testing, a strategic alliance with Walgreens promises to bring testing closer to the consumer. Going to a hospital outpatient lab typically means driving to the hospital, parking a distance from the closest entrance, registering for the test, and sitting in a waiting room. Hopefully, Walgreens will offer testing in the evenings and on weekends when many hospital labs are closed.

The article ends with the suggestion that Theranos' technology could lead to wearable diagnostic devices using silicon microneedles. See my previous article about Gentag.

The Personal Health Tech Blog was cited as one of the Top Ten Health Technology Blogs:

2. Personal Health Tech Blog – Ira Brodsky blogs about health technology from a personal perspective in an easy-to-understand format. While this blog is relatively new, we’ve included it in this list thanks to the easily digestible news on health technology that’s relevant to patients and caregivers. Definitely one to watch.

French pharmaceutical firm Sanofi SA says it has received FDA approval for a device that gives users step-by-step directions (both audible and visible) for handling potentially fatal allergic reactions. The Auvi-Q is smaller than a mobile phone and features a retractable needle for injecting epinephrine (adrenaline) in the patient's thigh. A light indicates when the injection has been completed. The device comes in two versions (with different size doses for people with different body weights). The product is targeted at people who are susceptoble to life-threatening allergic reactions--particularly those who live or travel far from a major hospital.

An article in today's Wall Street Journal, New Medical Devices Get Smart, discusses several companies that are using wireless technology to deliver innovative solutions for patients.

Orthocare Innovations is leveraging the insight that observing a patient in the clinic is not the same as observing a patient in their natural environment engaging in normal activities. The company's Magellan Microprocessor Foot Ankle System, expected to be introduced later this year, employs mesofluidics (miniaturized hydraulic systems) to achieve better comfort and performance for lower limb prostheses. Magellan uses wireless technology (most likely Bluetooth) to enable patients to adjust their prostheses via a smartphone app.

Rest Devices, founded by three MIT graduates, is developing a wearable product for sleep apnea patients. The firm's SleepShirt contains wireless sensors that monitor respiration.

Scanadu, a company we mentioned earlier that is competing for the Qualcomm tricorder X PRIZE, makes a handheld diagnostic tool that works together with smartphones to enable patients and their families to identify illnesses such as strep throat--a serious infection that may require immediate intervention.

The article also mentions that the cost of sensor technology has come down significantly in recent years. This is important not only to personal health technology but the larger "Internet of things" market. Growth in other areas could benefit personal health technology--both by driving down sensor costs and spurring development of related tools.

A study published this week in Science Translational Medicine cast doubt on the value of gene mapping for the average consumer. As an article in the Wall Street Journal observes:

Sequencing can be very useful in assessing the risk of rare diseases triggered by a single faulty gene, such as the brain disorder known as Huntington's disease. With more common and more complex ailments affected by many genes and the interactions between them, the picture gets fuzzier. The study suggests, for instance, that whole-genome tests aren't especially helpful in predicting cancer in most people who don't have a strong family history of the disease.

This is more or less what I said in an earlier post. The study examined "data from thousands of twins in five countries" for 24 diseases. It found that for 23 of those diseases, gene mapping produced negative results, providing a false sense of security.

This week MIM Software Inc. introduced VueMe, a medical imaging application for patients. The application enables consumers to view diagnostic images on their Apple iPad, iPhone, and iPOD Touch devices. Patients can share the images with specialists and family members using VueMe’s secure image transfer feature.

VueMe is available for free from Apple’s App Store. MIM Software makes money by charging clinicians for uploading and viewing FDA-approved diagnostic images stored in its MIMcloud. Presumably, MIM Software believes VueMe will spur additional paid use of MIMcloud by health care professionals.

Some health care professionals will no doubt complain that consumers are not qualified to interpret medical images. However, that misses the point. VueMe empowers consumers to track and share their medical images. Some images may be self-explanatory. Consumers also have the right to ask their physicians to explain what they are seeing.

My only concern is that MIMcloud runs on the Google App Engine™ platform. MIM Software understands the importance of protecting users’ privacy. The images are encrypted and the company spells out in detail the information that is collected and stored and the involvement of third parties. However, as evidence of Google’s “high standards for reliability and security” the company points to this statement on the Google App Engine Web page:

Google has a reputation for highly reliable, high performance infrastructure. With App Engine you can take advantage of the 10 years of knowledge Google has in running massively scalable, performance driven systems. The same security, privacy and data protection policies we have for Google's applications applies [sic] to all App Engine applications. We take security very seriously and have measures in place to protect your code and application data.

Some may find this classic Google formulation soothing but it contains no guarantees or even concrete statements. As Scott Cleland explains in Search & Destroy, Why You Can’t Trust Google Inc., Google claims to care about users’ privacy but tracks everything you do and resists anything that might limit the practice.

I applaud MIM Software for releasing a medical imaging application for patients. And I commend the company for the steps it has taken to protect patients’ privacy. But MIM Software could do even better by only working with third parties that share its commitment to privacy and security.

Companies such as Life Line Screening offer a cost-effective and convenient way for you to get tested for a number of health risks. These tests bridge what Life Line describes as a “gap” in our health care system: doctors prescribe and insurance companies pay for tests related to symptoms you are experiencing but not tests for common risks that increase as you grow older.

You can choose different packages of tests from a menu. For example, packages of three, five, or eight tests are currently offered in my area for prices ranging from $119 to $219. The available tests include “Stroke/Carotid Artery Disease,” “Peripheral Arterial Disease,” “Abdominal Aortic Aneurysm,” “Osteoporosis,” “Atrial Fibrillation,” “6 for Life Health Assessment,” “Complete Lipid Panel,” and “Glucose (blood sugar).” Based on my experience, most doctors’ offices charge more for the blood tests alone.

The screenings are not intended to provide definitive diagnoses. As a Life Line spokesperson told me, the tests are a form of triage: they are designed to flag potential problems that you should consult your physician about.

A few doctors say the screenings are a waste of money and possibly even harmful. For example, Dr. Davis Liu says that according to United States Preventive Services Task Force (USPSTF) guidelines only men between the ages of 65 and 75 who are or were smokers should be screened for abdominal aortic aneurysms. Dr. Kenneth Lin complains that the benefits of some of the tests are unproven; he also worries about “increasing rates of false positive tests.”

It’s always wise to consider the arguments against specific health care tests and treatments. The rate of false positive results is a valid concern. However, Dr. Lin and Dr. Liu are being rather elitist. They accept the notion that only men between the ages of 65 and 75 who are or were smokers should be screened for abdominal aneurysms. Surely others over the age of 50 have some risk and their lives are also valuable. Doctors Lin and Liu rely on USPSTF recommendations but insist that others supply proof. And it's rather presumptuous of Dr. Liu to say that instead of spending your money on Life Line's preventive health screenings you should (among other things) stop smoking and drink less alcohol.

Preventive health screenings may not be proven beneficial for everyone. But that misses the point. Many people are willing to pay for these tests with their own money because they value their lives and good health more than they trust statistics.