I wrote about Proactive Sleep a while back and wondered how it would be to combine a sensor to automatically record sleep pattern. Well, Zeo gets one step closer to that.

Zeo system consists of a wearable headband that measure brain’s natural electrical activity. Although their blog has a high-level explanation of how it works, my understanding is that its a single-channel EEG, which seems to be a reasonable way to do sleep analysis in healthy individuals. That data is wirelessly transmitted to a bedside display and stored on an SD card.

Algorithms based on proprietary logic churn out a personal sleep score (called ZQ) to quantify the type of sleep you get. The display unit looks like a bedside alarm clock and shows current and past 2 weeks worth of sleep analysis. Also has some smart alarm clock features like SmartWake alarm that wakes you up at the most suitable time within half-hour of set time. You could upload the data to an online sleep journal through the SD card. The website gives graphs, trends and the ability log other supplementary lifestyle data that can affect your sleep. All that for $249. An additional $100 would get lifetime access to a personal sleep coaching program, which includes regular assessments, goal tracking, email tips etc.

There is no question that Sleep Science is a serious, mature field. Zeo can find its place as a useful adjunct for plenty of sleep-related disorders that affect people who are otherwise healthy. It’s not an FDA approved 11 channel medical grade polysomnogram, and it’d be a mistake to compare it to one. It’s perhaps a closer analog to Actigraphy where a wearable sensor measures overall motor activity during sleep. An actigraph unit is an accelerometer based device like the FitBit, WakeMate or Axbo.

Accurate or not, Zeo is yet another proof that healthcare is slowly being transformed by sensor-based, portable devices that are capable of analyzing data in a consumer-oriented way to enable individual patient to manage their conditions better.

Around 1989, Steven Schueler started working on a computer program that could perform symptom triage. The intent was to create something that patients could use to safely decide what to do when they were sick. In 1990, his company DSHI Systems released “Home Medical Advisor” on a floppy disk. Later it was issued on CD-ROM’s, and claims to have sold over 2 million copies over the years. A major win for DSHI since 1999 has been its adoption by the Veterans Health Administration (VHA) as the Veterans Health Gateway (VHG). VHG provides over 300 symptom/condition-based triage algorithms and related patient education information and is used by VHA nurses to provide health advice via the telephone.

FreeMD is the free online version of the same underlying triage application. It  uses video to conduct the interview, ask questions and then generates a custom web page that contains care instructions and suggested next steps. I tested it with a few hypothetical cases (from benign nose bleed to serious UTI) and it seemed to do fine for basic diagnosis. With vague complaints like diffuse abdominal pain and vomiting, it stayed roughly in the right categories at a high-level (appendicitis, pancreatitis, kidney stones, gallbladder disease, intestinal obstruction).

Is the underlying logic based on hierarchical structured programming or a more sophisticated expert system with forward and backward chaining algorithms? I don’t know. My interest in FreeMD spiked when I saw the 100K+ unique visitors/month statistic. They are consistently generating a lot of traffic, so there’s got to be fairly comprehensive content and at least some utility in the service. My personal impression is that as a patient-oriented triage tool, it does well. Of course, provider-oriented decision support is tougher and I don’t expect it to hold up like Mcyin or DXplain.

I’m also intrigued why DSHI systems chose to make their application available for free, when the revenue model seems to be based on licensing/co-branding with partners. I was half-expecting to see a feedback loop on FreeMD (like “Was this the right diagnosis? Let us know”) since one of the major reasons for open-sourcing anything is to leverage wisdom of crowds. But there isn’t anything like that, so maybe its all about gaining awareness and marketing the application.

Update: Connected with Dr. Steven Schueler after writing this post. He correctly identified that FreeMD is a triage system, so its a bit unfair to compare it with diagnostic decision support systems like Mycin/DXplain.

Another vital-sensing hardware with integrated service to keep you healthy. miCoach from Addias helps users create a custom workout plan and track progress with real-time feedback and audio coaching.

I was fortunate to see a demo last month. At the core of the offering is a set of remote sensors- a heart rate monitor (worn as a strap around torso) and a stride sensor (clips on to shoes, and measures stride pattern, distance and speed). These communicate wirelessly to a central unit called ‘Pacer’ (MSRP $139.99) which connects with your mp3 player and gives audio feedback about things like calories burned, distance, workout progress etc. Another peripheral that communicates with both sensors is the ‘Zone’ (MSRP $69.99) which is worn on wrist, and gives constant visual feedback (using colors) about your heart rate zone. Pacer connects and syncs to the personalized website, zone doesn’t. Coupled with all that hardware are workout ‘plans’ for your goals like run faster, get fit, loose weight, learn to run or to reduce stress.

My initial impression is that it all sounds too complex and too expensive. But maybe this is legit functionality for people who are serious about running. For the novice consumer who wants to track daily physical activity, I like the simple approach of FitBit. For those who run regularly, the Nike+ Ipod offering is another (much) cheaper competitor. Either way, miCoach is yet another sign that consumer-oriented wellness monitoring solutions are becoming mainstream. Next logical phase would be moving similar technologies and frameworks to tackle real disease management and prevention.

Royal Philips International seems to be placing its bets on some innovative healthcare IT markets. Here are some that I’ve noticed in the past couple of years:

• VISICU (a remote ICU monitoring technology company acquired in 2007)
• Digital Pathology (commercial offering in 2009)
• Motiva (Remote patient management and education delivered through television)
• TeleStation (In-home hub for two-way communication between provider and patients with chronic diseases, integrated with wireless measurement devices)

The list above is not comprehensive by any means, it’s just what I could recall right away. Without making this a post about Philips’ strategy, here is the latest addition to my personal list of innovative Philips Healthcare IT offerings- DirectLife activity monitor. It tracks your physical activity (through a triple axis accelerometer) to calculate calories burned. Results show up on a personal webpage (detailed) and on the device (simple indicator lights).

It’s like FitBit, but with some design differences – DirectLife is waterproof and needs USB-based sync (FitBit is wireless through a hub). Most importantly, DirectLife comes with a coach- a real person to provide inspiration and assistance to meet your target weight or activity level. The device (hardware) is $99, but coaching is a monthly subscription of $12.95 (first four months free).

The entry of Philips in this lifestyle-tracking arena makes the proposition more legit for mass adoption- now the HR departments of large enterprises  can think of offering it as a health benefit, maybe health insurance companies will pay attention too. FitBit is a great device in itself, but what’s needed is a “wellness service”, much like what DirectLife is starting to sound like. My prediction is that we’ll see proliferation of such services in the next few years- maybe even a lower premium option in your medical insurance if you choose an integrated activity tracking service.

Here is a half-baked idea that adds another data point to my rant about how keeping a record of health-related activities is useful, and how web 2.0 technologies can help enable such a record. Bedpost is a web application (currently in private beta) that helps in keeping track of user’s sex life. I’ve not used the site myself, but they claim simple functionality- log in after the fact and fill in some fields about it. Thankfully, they also claim ‘zero social networking’ functionality to keep things private.

Sure all this can be a simple iPhone app (maybe there is already one out there) or even a one-line cryptic entry in your google calendar. My point is not to critique the utility of an independent website to track one’s sex life. I’m reflecting on the overall trend of niche health and wellness ‘trackers’ (read my previous posts about FitBit, Proactive Sleep, ZeaLog, Qwitter). Given the myriad sexual disorders (e.g. Erectile Dysfunction) and their probable causes, an application like this could provide rich history for clinicians. Overall, it underscores the importance of web 2.0 technologies in enabling consumers to keep granular, accurate health records.

NLM may not be known for Health 2.0 efforts, but this one surely qualifies for one. Pillbox.nlm.nih.gov is a fantastic tool that lets users identify medications by the way they look. A beautiful Adobe Flex powered interface enables selection of various physical characteristics like shape, color, size etc. and comes up with matches.

The website is not currently recommended for clinical use- mainly because the images have not yet been verified by pill manufacturers. Still, it’s a smart tool that can benefit multiple care settings. Many seniors coming through the emergency room and clinics don’t remember the name of their pills, but can recall its visual characteristics. A tool like this can be a great addition to EMRs and even PHRs.

In their own words ‘Psych Central is the Internet’s largest and oldest independent mental health social network’. From what I can find, it seems to be true. They have been online since 1995, and last year got close to half a million unique visitors.

So consider it as the social network that started before the age of social networking. It now offers blogs, forums, reviews, news, feeds, tweets and other community features to people interested in mental health. Seems like they are making a decent revenue with it too.

Always good to see focused, pragmatic and simple solutions being successful. Proves the point that social networking has more potential when done in a niche way.

Usually I’m wary of putting time into big-budget health portals, but San Francisco based Healthline deserves a mention. They have a portfolio of healthcare search, navigation and content that is syndicated through a growing network of big web properties like AARP, Health.com, iVillage, AOL etc.

Healthline was founded in 1999 as YourDoctor.com and was re-launched as Healthline Networks in 2005. It’s got some deep-pocket investors behind it (Aetna, NBCU, Kaiser Permanente, Reed Elsevier, US News & World Report to name a few) so I’m not surprised that they have managed to create (what they call as) ‘Consumer Healthcare Taxonomy’ of >1 million terms and 250K medical concepts. That is what powers their proprietary ability to organize and present contextually-relevant health information to a viewer. Personally I dont think much of it, given that there are plenty of precursors in the medical ontology area (SNOMED, UMLS…) that match this feat.

So Healthline can power health search in multiple ways (symptom, treatment, doctor, drug) and help consumers navigate to the right information. They have also branched out into health-specific ad network, PHR etc. Regardless, I’m interested in mentioning Healthline because of their excellent 3D Body Maps. They have a neat library of 3D animations that lets you partially control and understand body structure and function. Much like CareFlash. Development of these consumer-oriented educational health content repositories is a positive trend, although it’d be much nicer if all these individual attempts were cataloged in one place, giving a complete guide to educational 3D health and wellness content on the web. Like what Clicker does for Internet television.