Health and Wellness Panel

October 30, 2013, NFC and Proximity Solutions, WIMA, San Francisco—Clint McClellan from Qualcomm and the Continua Organization brought on a panel of providers. The panelists were George Karidis from Hotech in Greece, Suke Jawanda from the Bluetooth SIG, Koichi Tagawa from Sony, and Horst Merkle from Roche Diagnostics.

Karidis opened with comments about integrating NFC into their solution devices. The value of standards and guidelines helps the client approve the technologies. The implementations included various tests including sleep and movement. NFC enables their whole home care and elderly care programs.

Jawanda noted that the Bluetooth SIG has over 20k members and is still growing. The latest version, Bluetooth Smart is one way they ar addressing new markets by enabling medical-grade technologies on a consumer scale and set of platforms. This version is cloud friendly towards data and provides a low power link. The major difference in the versions is that the first function for standard Bluetooth is for streaming audio, which requires steady high-quality data, while BT Smart is optimized for very low power by sending bursts of data. The short-term nature of the bursts allows the devices and apps to reduce power while sending data to the hub.

Tagawa stated that NFC is growing and now supports multiple apps and devices. One issue for the technology is the lack of promotion and education that exacerbated the weak services. The latest SIGs in the NFC Forum are looking at the transportation, consumer, healthcare, and payment markets for retail. These groups will address deployment in their areas.

Apps?
Karidis specified the care at home apps are their priority. The devices provide a check-in data function to provide a proof of presence and a “clock-in, clock-out” function. The readings per person are updated in their database and special needs per person are checked. Other records on the person’s health are available to the monitors as well as advice from the doctors if needed. Emergency alerts are through the phones to a central call center, which notifies the local providers and emergency people if needed.

The technology and infrastructure are modular and scalable. The insurance pays for the services, so the costs are built into the plan costs. They replaced all the insurance cards with NFC cards to make the whole system interoperable.

Exciting developments?
Jawanda responded the segments with the greatest growth potential are health and wellness, followed by sports and fitness, which is an unregulated market unlike the health and wellness segments. Because medical care is regulated, the design constraints and documentation requirements are more stringent.
Lots of products are coming on to the market for the sports segments, but the consumerization of the devices is bringing the prices of the medical products down very fast. Now many medical products are accessories to a smart phone and a medical-grade appliance is under $100. The ability to add more sensors and move data to a common repository enables the health dashboard.

Japan is going for more quantified self functions and wellness is not opposed to clinical functions?
Tagawa agreed that NFC is emerging in the consumer devices and the mobile operators are working to take advantage of the trends. The carriers are also interested in other verticals and the emergence of BT-Smart and NFC are opening a lot of new functions. the two technologies have common specifications and a symbiotic pair enhancement capability.
Some special cases allow for BT-ultra low energy to change to high power through a NFC control and power transfer for the reader. Studies show that users want to tap to transfer data, so the users need an infrastructure that assists interoperability and allows for a range of use cases. The good thing is that NFC and Bluetooth have data commonality.
Continua helps with the data exchange. In Japan, the first products were pedometers, and now this has expanded to thermometers, and blood pressure with dynamic tags. Data is uploaded with a tap and is automatically transferred to the cloud services.
One example of changing environments is a smart phone step counter app. It emails a specified contact the number of steps the user took. But most people don’t carry their phones with them in the house, so the devices changed to be a small activity sensor which emails the contact person about the activity levels of the user.
The carriers are adding services like body temperature and temperature changes for about $5-10 per month extra. The healthcare system is not private, but is a nation-wide government function. Large companies have separate systems for insurance. Now all entities are focusing on wellness through activity monitors, blood pressure, etc. to have a constant check on the person’s health. There are annual promotions and subsidies for the monitoring devices because the health outcomes result in lower costs for the companies and government.

Regional differences in standards, mandatory increases in activity lead to increased wellness? A health dashboard?
Jawanda commented that the industry is still in the early stages. Some companies like Nike, Fitbit, etc. are making other monitors to collect more data. The devices are generating diverse data and calling for new apps to use those data. People want an integrated service for their health dashboard, so non-standard formats across multiple devices will not fly in the long term. The current database formats deter data exchange.

App developers use standards to improve data integration. Separate apps need to improve their integration to reduce data friction?
Jawanda offered the example of a smart phone attachment to an asthma inhaler that identified the time and location of use. The aggregated data are then used to identify spaces and events that induce attacks. Getting app to app communications creates better overall functions.

Hospitals and other medical providers are moving to other areas?
Karidis declared that it is not only medical functions and services that are changing. Now just making a new software tool can create new solutions. The healthcare industry is moving towards more equipment, but most of this new equipment is manual. As the devices evolve, more Bluetooth Smart and NFC capabilities will increase the functionality and reduce integration issues. Developers need to work with the people monitoring users to evaluate and promote the devices.
Jawanda added that the NFC specifications and global platforms like smart phones are changing the landscape. Current NFC and Continua tag interfaces for transferring health data. If the app needs security, then other specifications are invoked and added to the platform or device.

Differences in regulations by region? NFC improvements in the user experience versus policy?
McClellan responded that there probably is no data violation. The back end shares the changes in the electronic health records and personal health records. You need HIPPA compliance for the US, but there is no other issues for local rules.

So data sharing is ok, but diagnosis and recommendations are under FDA?
McClellan noted that the data depends upon the market. For example, a blood pressure and weight scale can share the data it collects. If a doctor prescribes this device, then it falls under the medical device classification, so these are different markets even if it is the same device. It is best to identify the potential issues so you can be a consumer or direct function.
Jawanda added that everything is going for more consumerization of data. The regulating bodies like FDA can certify the apps, but this is not part of their basic DNA. The agencies always trail the technologies and consumer expectations. Companies also need to understand the business issues and changes in business models. Doctors do not get money, but there is a need to change the insurance and MD business models.

Developer education on competitive technologies?
Jawanda stated that the organizations will be announcing more collaboration. BT is complementary to WiFi and cellular for connecting sensors to a hub or phone, which will transfer the data to the cloud. NFC can assist in a touch and pair transfer.
Tagawa comes from a consumer electronics background, and has always had to work with human interaction and physical limits. Bluetooth gives connectivity with your appearance in the area, while NFC offers contact with an activity point. An app developer could note an approach and subsequent contact.

McClellan cautioned that developers must understand use cases. Location with a hub is not easy for NFC, so BT is better for distance. For tablet or phone apps, NFC might be better and provides flexibility for the user.

Security?
Tagawa declared that NFC transactions use a common data interface with security on top. Author and authorization are through digital signatures and a separate signature authority.
Karidis considered that NFC is the most secure of all the interfaces because it is very short range, < 5 cm with normal transmitter power. Developers have to balance the cost of additional security with the value of the data.

Pre-certification compliance of the hardware, where does NFC fit?
Jawanda noted that is NFC in health functions. all the sports and fitness devices are certified for interoperability. The health apps are cross certified with Continua. The clinical devices use Continua guidelines.