Seems like there are three components of the overall offering:

1. A hardware device called “Spiroscout” – a small add-on that mounts the inhaler canister. Every time it is pushed, the location and time-stamp data is recorded.
2. Mobile app – a ‘diary’ to keep track of symptoms, triggers, medications, etc. Can also be used to view map of data received from Spiroscout, and to get sms reminders for taking medication.
3. Online website – a ‘dashboard’ of sorts. Can help summarize submitted data to figure out disease patterns and trends.

The hardware device is not out yet (website says it’ll be out this summer), and the mobile app is currently in private beta. So there is not much of real world testing that has happened. But I’m still positive about Asthmapolis, for a number of reasons.

First, it’s the right kind of ‘focused’ monitoring solution that can potentially be transformative for managing a specific disease (kinda like Regina Herzlinger‘s argument about ‘Focused Factories‘ as one of the ways to salvage the entire healthcare system). It’s better than trying to find a solution that can monitor multiple conditions (example 1, example 2). I think the mobile diary and online dashboard would be key engagement tools in this regard. The more focused and customizable, the better.

Second, it helps in medication adherence which is a big issue irrespective of the medical condition. I think that knowing whether you took your medications and getting reminders if you didn’t,  is more powerful than knowing when/where you took it. The mobile app reminders would be a great resource there (automated calls to landlines may be good too…for seniors).

Third, it helps understand the individual triggers and community impact of asthma. For successful asthma management, a patient should know his/her triggers and avoid getting exposed to them. That is not an easy task for a number of reasons. My initial reaction was that GPS may be a bit of an overkill. But with rapidly decreasing cost of location-aware technology, why not? Much better than using it to check-in to nearby McDonalds.

The Life Pebble hardware includes a single lead ECG, skin thermometer, and an accelerometer. The data collected by the system is streamed wirelessly to a USB Network Adapter over short distances. According to MobiHealthNews, the device is currently in clinical trials are few US hospitals and Toumaz has declared an intention to submit for FDA clearance in 2011. This continuous physiological monitoring capability is currently marketed for assisted living, rehabilitation and professional sports applications by the company.

If we can put aside the “who will pay for this?” question for a minute, this kind of technology has myriad applications in both consumer and provider space. What is chunky hardware today, will almost surely be a disposable, thin patch tomorrow. If we can have a reliable way to do real-time monitoring of key vitals, disease management is no longer confined to interactions in the healthcare setting.

What intrigues me is how the trend of medical-grade remote monitoring (which is moving outside of hospital setting with technologies like Sensium) will interact with the trend of consumer-oriented remote monitoring (FitBit, DirectLife, BodyMedia, Zeo, etc.). There will be a shakeout, obviously. My guess is that the winners then will be not be defined by which way and how much data they gather, but what they do with that data. Analytics and interpretation will be the differentiators.

With that background, Corventis becomes an interesting entrant to the MCOT space. Their technology platform consists of a bandaid-size wireless sensor patch called (“PiiX”) that detects, records and transmits physiological data to a portable hub (called “zLink”). zLink is a cellphone-size device that sends the data over wireless network to ‘Corventis Monitoring Center’, which is a staffed to do preliminary interpretation and urgent physician notification. They offer these capabilities in two forms: NUVANT (ECG based continuous arrhythmia monitoring) and AVIVO (non-ECG physiological paramters monitoring). Corventis has some big venture names behind it: KPCB, Mohr Davidow, DAG ventures. They recently got FDA clearance for NUVANT in January 2010.

Cardiac diseases are certainly the prime target for any wireless remote monitoring startup. Corventis is not alone. iRhythm’s Zio Patch is designed to diagnose cardiac arrhythmia by providing  up to 14 days of continuous recording. Once done, the Zio Patch can be mailed back to the company for analysis. Unfortunately, the Achilles heel for all of these companies is reimbursement. So far, private insurance companies and CMS are not convinced that such services are worth paying for. MobiHealthNews has an interesting post about this trend here.

I’ve written about a number of consumer-oriented ‘wellness’ services by startups that are using wireless sensors to detect simple metrics like activity and help you achieve a healthy lifestyle. Corventis, iRhythm are good examples of medical-grade services utilizing the same basic technical framework and abilities for managing life-threatening conditions. Once we get over the barrier for reimbursement, you can bet on the remote monitoring market for serious medical conditions exploding. We can wait for that to happen, but I’m personally convinced that as consumers take more charge in managing their conditions (and health insurance continues to spiral the drain from a cost and outcome perspective), there is a growing scope for remote monitoring services that consumers will pay for themselves.

PS: I had a discussion with Corventis founder, Darryl Drinan a few weeks ago. He had three insightful comments for anyone thinking about getting into the remote monitoring space:

• If you have a choice, focus on therapeutic service, not diagnostic
• Product alone is not enough, always tie it to a service
• Patient education is a big problem (if you need to do it for them to use your device, you are hosed)

In an effort to understand what is unique about Zumi Life, I stumbled upon this interview with its CEO. Crunchbase tells me that they started with $700k seed funding in 2007 and got a Series A infusion of $1M in April 2008. With that context, several questions come to mind. Zume Life needs manual input for all the data it needs from the user- and that assumes the user to be reliable enough to put it in. If Zuri had a sensor to automatically capture the critical vitals (like Zeo, Bodymedia, DirectLife, FitBit, LifeShirt and scores of other devices), that would make it infinitely more useful. But I understand that there is no automatic sensor for your mood or for what you just ate, so somethings need to be captured manually. Which is why there are services like RememberItNow, Reqall, Zealog, Polka etc. Still, why not get the medication list for Zuri from PHR platforms like Google Heath? If we assume that the chronically ill and overworked individual remembers to input their care regimen in one place, why wouldn’t they use a simple paper sticky note or a smartphone reminder app? Even a simple Google Calendar or 30Boxes event can be configured to deliver reminder emails that show up as audible, sms alerts on your phone. So is there really a need for a dedicated hardware device in a world that is slowly converging mobile computing platforms? Zuri reminds me of the device that is made to do twitter only.

The price tag was also a bit of surprise. Although there is no official mention of pricing on the Zume Life website, I found a PCmag article from Sept’09 that quotes $35/month or $300/year for the service, and $4.99 for the iPhone app. That sounds way too much money for a basic alerting and journal-keeping service that is 100% manual entry based.

Of course, it’s easy to criticize others idea. I don’t have the complete facts on the service, its utilization and its founder’s vision. The overall trend of using patient-oriented hardware devices integrated with web and mobile dashboard/analytics to manage chronic conditions is for real. I just think sensors are a key aspect of such devices and that pricing can be Achilles heel for adoption.

In general, I really like the idea of using personal mobile computing devices in treating/preventing chronic conditions. As devices and sensors get smarter and cheaper, it’s logical that they start playing role in helping individuals deal with chronic, lifestyle affecting conditions like migraines, sleep disorders, allergies, dysmenorrhea, depression etc.

Proactive Sleep provides a ‘smart alarm clock’ for iPhone/iPod Touch. Some features: customize what music to fall asleep to, and to wake up with, a dynamic ‘vigilance game’ that you need to complete to turn the alarm off, and a sleep diary to note your observations and sleeping habits. Nothing earth-shattering there. The features may be simple, and its not my intention to critique Proactive Sleep per se. What I want to emphasize is that applications like these are a step in the right direction overall.

For a number of chronic disorders with no established cause (like migraines, insomnia), keeping an accurate log (diary) can be extremely useful for prevention and treatment. Integrating such ‘digital diary’ into daily lifestyle can be much more convenient and smart way of keeping track of such conditions. Proactive Sleep is a bit too manual, in my opinion (e.g. you need to document everything in your sleep diary yourself). What would be awesome is to combine it with a smart sensor (like the FitBit) to automatically record your sleep habits. That way its even more Health 2.0.

It’s not focused on healthcare issues, but I see potential for something like this in chronic conditions that affect an individual’s lifestyle. A good example is migraines. Those who have these terrible headaches would benefit from knowing exactly how many did they have this month vs. past 6 months and what were they doing when it started. So If one could log the onset/end of a migraine attack and the preceding activity conveniently, it’d be easy to spot a pattern (e.g. higher chance of migraine after cold shower).

Why not keep a simple diary bedside? or spreadsheet? Yeah, you can. But how many people do? And how many diaries can remind you to enter latest information in them and chart/graph your progress? It’d be a good idea to add some social networking features to ZeaLOG- finding comparative stats or just connecting with others in the same state as you are powerful motivators for using such tools (for example- Qwitter). ZeaLOG has twitter integration, but it’d be neat to have a mobile app too, especially one that syncs up intelligently with online data.

There is a paid service idea in this concept somewhere. I’m sure we’ll see one soon in healthcare.

Remote Patient Monitoring (RPM) is a subset of telemedicine that includes devices and software that enable healthcare providers and educators to diagnose, monitor and follow up patients remotely. There is a lot of potential in smart fabrics to enable RPM, especially for chronic diseases like Asthma, CHF, Hypertension, etc. I’m personally very excited to see companies enter this space and solutions becoming more and more mainstream.

Currently VivoMetrics is focusing on clinical research and sleep apnea study market. Their next generation product is supposed to be lighter, more comfortable and with the ability to transmit data wirelessly. Also in the works is a partnership with OBS Medical to incorporate their Visensia® software as a predictive tool.