Ryan Slipakoff of PharmaConnect at Digital Pharma East 2011. Here he speaks with host Alice An on doctor-centric technology.

By DJ Edgerton (@wiltonbound)

If you could go to the one place where 58% of your customers are…would you go?

Well, you’re here reading Pixels & Pills, so clearly you’re of above-average intelligence, and therefore, your answer is “yes.”

Right now, 30% of doctors in the United States have iPads, and another 28% plan to get one soon, according to data released last month. Moreover, that same data showed that 75 percent of U.S. physicians own an Apple iOS device (iPhone, iPad or iPod). When you consider that apps frequently work across devices, the penetration becomes astounding. And in case you were skeptical, this isn’t an American epidemic. There are nearly 30 million iOS users in the five major EU countries, as well.

It’s become very simple: We must be focusing on the iPad in our digital plans. It is no longer optional. It is no longer a niche, it is no longer trendy or cutting-edge. iPads are simply where people are – and, in this case, where physicians are.

Here’s a short list of things that must work on iPads:

1. Electronic medical records
2. Detail aids and other educational and promotional materials
3. Patient-assistance websites
4. Diagnostic databases
5. Therapeutic databases
6. Specialty-pharmacy websites
7. And: you.

It’s simple. How can you create something that will help a doctor do their work better with their favorite device, if you’re not intimately familiar with what works best on that device?

Here at Pixels & Pills, we’ve been hard at work developing some pretty innovative apps for our healthcare clients. From apps that help people continue group therapy in an online setting to keeping patients constantly connected to their circle of care, we recognized the power of the iPad early on and its limitless possibilities to optimize the way we manage our health.

We’re enamored of these odd little hybrids that aren’t phones and aren’t laptops. We’re watching our clients – and their physicians – figure out where they fit in their lives, as we’re doing the same in our own, and we’re keeping pace with their discovery with our own products.

The iPad has stopped becoming a frontier, and it’s rapidly becoming home. Is your information part of that home?

By Philip Reynolds (@boylanblazes)

“The robot will see you now…”

Even in our advanced technology era, it seems farfetched to think that medical encounters will be led by robots, but that reality may be here sooner than you think. Robotics are being used in a variety of clinical and surgical settings, increasing surgical accuracy, decreasing operating times and often creating better health care outcomes than standard current approaches.

New technologies may soon make robots part of our everyday lives. However, in a health care setting, they likely won’t work alone; rather than replace humans in providing care, robots are expected to augment traditional treatment, resulting in humans and robots working side by side.

Robotic technology will have a tremendous social and culture impact on the future of health care – and there’s a strong argument to be made that it’s needed.

With aging Baby Boomers, the need for care is greater than ever as incidence of heart disease, diabetes, and cancer continues to rise. At the same time, the number of primary care health professionals is on the decline, creating a gap that will continue widening as the population ages. How can medical facilities fill the gap without raising costs? Some think the answer may lie in robotics.

If this is going to work, patients will need to learn to trust these new “medical professionals” and have some guidance in how to best interact with them. Twenty years ago this all would have seemed incredibly foreign, but in today’s world forming relationships with technology is becoming the norm. We have virtual pets, navigation systems that speak directions or offer restaurant recommendations, and I know I’m not the only person who brings my iPhone to bed.

On the other hand, while I’m okay with people having pet rocks and maybe even talking to them once in a while, I’m not sure I’d trust one to help me decide whether to get my prostate operated on.

On the third hand, these days I’m not sure how much I trust the advice of some doctors either.

Just like the doctor-patient relationship is central to quality care, people will need to develop a similar level of comfort with robots if they are going to be effective in improving health care outcomes. Dr. Joe Kvedar stresses the need to think about our human-robot interactions and help patients develop trusting relationships with technology. In some cases, patients may realize even better relationships with robotic advisors because they can share details of their illness without the feeling of stigma or embarrassment, or feeling that they are being rushed by a doctor with a waiting room full of patients. At the same time, an overworked, rushed, and emotionally drained human is not much of a standard. Couldn’t we aim a little higher?

Using robots instead of people to deliver care is one way, and maybe it’s an inevitable one, to find cost savings in the healthcare system, but it will certainly be helpful to look at others.

Fear of new technologies is usually a precursor to engagement; as people become comfortable interacting with robots, they will enable health care to scale and meet the needs of an aging population. It will be interesting to see if it’s possible for patients to feel cared for by their physician while interacting with software or robots.

By Russ Ward (@russcward)

One of the great ongoing achievements of the human race is the ability to measure our world with ever-increasing precision. In centuries past, inventions such as compasses and minute hands helped cartographers and astronomers map out the edges of what we knew, and microscopes and x-rays helped us go in the opposite direction and learn more about what was within us.

Today, digital technology makes measurement precise to degrees that the learned men and women of the past would never have dreamed possible: satellite maps accurate to the centimeter and clocks accurate to one second every three billion years are accepted realities today.

Part of the amazing repercussions of these abilities are that they pass the abilities on from the professional to the everyday person. It’s not just the military who can see incredibily detailed topography of faraway regions: I can do the same thing sitting barefoot in my living room.

Of course, these abilities translate brilliantly into healthcare, and the capabilities that healthcare professionals and patients now have. Our doctors, PAs and nurses can now see this information – but what I find particularly fascinating is that either we can too, or at least the technology they’re using is common to most consumers.

Here’s one recent example that’s blowing my mind.

Most all of us have broken a bone in our lives, and we’re all familiar with the movie cliche of the white-coated physician pacing concernedly in front of a wall with x-ray flims clipped to them and backlit, as they scrutinize the images to determine the cause of their patient’s malady.

But a couple of months ago, the FDA approved an app to help physicians view scans from anywhere, and do it so thoroughly as to provide a diagnosis. It’s not a complex piece of machinery; not something that has to be installed in a professional facility. It’s just simply a downloadable app from the iTunes App Store that can be used on an iPhone or iPad.

Using it, the physician can wirelessly receive images sent from CT, MRI and PT scans, view them, manipulate them, and use them to diagnose. Think about the implications for telemedicine, and the ability for expert physicians to offer second opinions with speed.

It’s not a new app – it was two years ago that it won an Apple Design Award – but it is the first one to get FDA approval. Think about the implications of THAT.

The ground has been broken. What are the rest of us waiting for?

Rishi Shah, CEO of Context Media, talks about the high ROI of Point of Care and the unique challenges in the diabetes sector to reach and enhance the lives of busy patients and doctors.

By Sven Larsen (@zemoga)

In the weeks following ad:tech New York, the song above was stuck in my head. Why? In between sessions, I was reading my free copy of Fast Company from the attendee gift bag, which included a feature about the popular Disney Channel cartoon, Phineas & Ferb. I had combed through most of the issue, but that article stayed with me for a while. The song played in my head round the clock, even as I tried to write posts for Pixels & Pills…until I decided that it was there for a reason: the compelling story of Phineas & Ferb has a really important lesson to teach the pharma industry about letting go.

My argument has less to do with the plot surrounding the triangular Phineas Flynn and his rectangular stepbrother, Ferb Fletcher, and more to do with how they ended up winning over the hearts and minds of Disney execs – and viewers all around the world. If I had to guess, I’d put Phineas and Ferb somewhere in the middle school age group (this is never disclosed in the show), but the reality of the situation is that Phineas & Ferb are almost 20 years old. The road from sketchbook to screen has been a long one for the duo-behind-the-duo, namely, the show’s creators Dan Povenmire and Jeff “Swampy” Marsh.

Povenmire and Marsh were both layout artists for the hit Fox TV show The Simpsons. Their friendship continued as they both joined the writing team for Nickelodeon’s Rocko’s Modern Life. After Rocko’s, the two careers diverged, but Povenmire continued to carry around his Phineas & Ferb portfolio, even when he joined the team of another blockbuster animated comedy, Family Guy.

Finally, 16 years after they first started pitching the cartoon, Povenmire and Marsh got the chance to put Phineas & Ferb in front of Disney execs. The pitch was shelved. Povenmire and Marsh received feedback that the show was “outside the company mold.” By this, they meant that the angular aesthetic of the characters may turn viewers off, and the jokes were too sophisticated for the target demographic of 6- to 14-year-old boys. As Fast Company put it: “In other words, too smart for Disney.” Much to the creators’ surprise, Disney green-lighted Phineas & Ferb, with a challenge to woo their audience in under 11 minutes. After a wildly successful pilot airing, Disney picked up the show in 2006.

No one knows the formula for success better than Disney – those guys have marketing to children & teens down to a science. They built their powerhouse media empire on the right combination of programming and merchandising. They’ve started crazes around franchises like High School Musical and Hannah Montana. But when it came to Phineas & Ferb, all those rules had to get tossed out the window. Disney had faith in Povenmire and Marsh’s vision, and took a chance with them. Now let’s take a look at what made the investment so risky.

Part of Disney’s “mold” was its script-driven model for animated series. The writers write. The execs tweak. The animators animate. Phineas & Ferb required a storyboard-driven approach “that begins with a detailed outline, bypasses the traditional script stage, and turns things over to a team of storyboard artists to produce a scene-by-scene visual break-down accompanied by key dialogue.” In other words, the outcome is less predictable. The show takes on an organic life of its own, the plot grows and develops right before everyone’s eyes. This invites a level of artistic freedom that is crucial to the show’s effectiveness.

Phineas & Ferb continues to top the ratings charts, and even took home a few Emmys for its original music (the creators compose a differnt song for each episode). Disney also found tremendous merchandising opportunities in the show’s 3 simultaneous plotlines – doubling the number of licensees that the highly lucrative Spongebob Squarepants has.

We’ve been seeing a lot of blog posts and tweets from the Pharma community about FDA regulations. Some inform, some criticize, and others poke fun at the whole situation. At the ePharma Summit this past February, we got a preview from DDMAC’s Thomas Abrams of what to expect when we finally get that social media guidance we’ve all been waiting for. These were promised to us over a year ago – but think about what we’ve accomplished in that year, without the guidance. Could pharma continue innovating in this space running on faith, like Phineas & Ferb, instead of regulations?

That’s a scary thought for some people, not just the ones in Washington. Over the last year-and-a-half of Pixels & Pills’ lifetime, we’ve enjoyed the pleasure of meeting and creating strong friendships with some really, really intelligent marketers. You’re not only uber creative, but you’re experienced. You constantly watch the industry, and observe both the good and the bad. We’re fortunate to be in a community that constantly criticizes itself. We almost self-regulate. And this has led to some flops, but more importantly, it’s led to us breaking some crucial ground. This whole ecosystem, what we’ve been able to accomplish together – pharma marketers, empowered patients, and doctors alike – has been impressive.

There’s still a long road ahead of us, and the tools and technology are evolving by the minute. I think our continued success lies on a foundation of faith and fearlessness. What do you think?

By Kimberly Reyes (@CommDuCoeur)

Shame on you, Christopher Thomas Aber.

If you don’t know who Christopher Aber is, he’s married to Christina Aber, daughter of Emmy Award-winning actor Mickey Rooney. Aber is accused of verbally, emotionally, and financially abusing his 90-year-old stepfather. Rather than allow himself to be a victim, Rooney went before the Senate Special Committee on Aging to ask for help.

“I am here today because it is so important that I share my story with others, especially those who may be watching at home, suffering silently as I was,” he said, “If elder abuse happened to me, Mickey Rooney, it can happen to anyone.”

Sadly, it is estimated that 14 percent of non-institutionalized older adults had experienced some form of abuse in 2009, according to a report by the Government Accountability Office published on Bloomberg.com. And a recent article in the New York Times points out that elderly patients often drop hints about their private suffering to their doctors. In addition to finding signs of physical abuse, doctors hear their elderly patients fret over missing valuable items, signing forms that haven’t been properly explained to them, and more. Some doctors mistake these anecdotes for signs of memory loss associated with aging. Some are confused about the proper procedure for handling such a situation.

The healthcare system is crucial in defending elderly patients against abuse. Recognizing this fact, the Montefiore Medical Center launched a program in 2008 that trained doctors in identifying signs of abuse so that the cases can be reported to social services. In that same year, the New York City Council passed a law that requires “employees of agencies that contract with the Department for the Aging” and who have “significant and direct contact with senior citizens” to attend training on elder abuse.

Believe it or not, there’s an opportunity here for Pharma and healthcare companies to be champions for people whose voices are often underheard. Last week, Jason Brandt suggested different ways that technology can help our senior citizens live fuller, more independent lives – from finding the best retirement facilities to installing motion sensors that alert officials of an in-home accident. What we did not discuss was implementing plans for emergency response in instances of abuse.

Social media and mobile training

While many of today’s seniors are tech-savvy, not enough of them understand the benefits of social media and mobile technology. The key objective here is constant contact – regular tweets and status updates can keep a moderator abreast of the goings-on in an elderly community. If a community member seems particularly depressed or continuously mentions losing things, the moderator can request an investigation into the situation from local authorities.

Patient education and empowerment

One of the obstacles we have to consider is that victims of abuse are often ashamed of reporting their situation. In cases of elderly abuse, the abuser is often a loved one that the victim does not want to betray. It’s important not just for doctors to recognize the signs of abuse, but even the patient needs to be educated on the key criteria for abuse. The Internet gives us access to more information than ever before – some would argue information overload. For the elderly, accessing the resources that they need can sometimes be overwhelming. Creating a reservoir that delivers the latest news and information to seniors about their health and well-being empowers seniors in desperate situations to make the right decisions for themselves.

Preventing Financial Abuse

A secure financial application may have prevented Mickey Rooney’s unfortunate situation. Seniors are easy prey for scam artists, who exploit their generosity. There are many personal banking apps on the market, but few with the kind of built-in security needed for elderly use. Some criteria for building such an app would be a list of “approved vendors,” or institutions that the person makes regular payments to, such as a grocery chain or movie theater. Another feature of the app is that every expenditure must be listed under a category, while miscellaneous expenses require personal authorization from the user.

Since Mickey Rooney went public with his story, he was granted court protection from his abusive stepchildren and has raised awareness for elderly victims of abuse nationwide.

“All I want to do is live a peaceful life, to regain my life and be happy,” Rooney wrote in a statement to his fans. “I pray to God each day to protect us, help us endure and guide those other senior citizens who are also suffering.”

By Russ Ward (@russcward)

They’ve been happening for over a hundred years, and millions of people around the world need them. What are they? Today we’re talking about organ transplants, one of the triumphs of medical technology over disease and injury.

It takes incredibly complex networks of communications and transportation involving databases, private jets, and volunteers to make organ and tissue transplants possible. Already newsworthy simply for their miraculous-seeming ability to renew life, transplants have been getting additional publicity in recent years as hospitals live-tweet the procedures, something becoming increasingly commonplace since Children’s Medical Center of Dallas tweeted during the kidney transplant of a firefighter in 2009. While some argue that it’s a gimmick, it demystifies the experience and raises awareness of the need for transplant donors.

Through telemedicine, videoconferencing helps help doctors around the world learn how to execute transplant procedures and discuss their cases with each other, while giving patients the opportunity to consult with doctors anywhere. But communication wizardries are far from the only types of technology helping human organ and tissue transplantation evolve.

Stem-cell transplants, which can cure some types of cancer, such as leukemia and lymphoma, were once thought of as being for healthy patients who could stand up to the rigors of chemotherapy and radiation. The assumption was, it wasn’t for senior citizens. But today, the combination of new technology in cord-blood harvesting (as well as the wealth of healthcare technologies that help us live better, longer, and healthier) have made it possible for patients in their 60s and 70s to receive transplants.

Patients awaiting bone-marrow transplants have had face long wait times, which bring with them the chances of getting so sick they become ineligible for the transplant. That risk is lessened now with technology that takes some of the steps out of the process. Think of it as hi-def: instead of several procedures to home in on the right match, a new higher-resolution typing process can tell which patient will match faster than ever before.

Technology can help address many of the concerns of transplants: How long will it take? Will the patient be able to withstand the procedure? And now, technology may even help in the limbo stages of transplantation.

The Freedom driver, made by a company called SynCardia, is being tested now in the United States. Patients who are awaiting heart transplants may not have to wait for months in the hospital – instead, they can use this combination of an artificial heart with an external “motor” that they wear in a backpack. It truly looks like cyborg science fiction – until you see the news stories of the actual patients. Charles Okeke and Marcella Padilla aren’t robots. They’re regular everyday people who look as healthy as anybody you’d see in your day – and, they’re people with the time and the ability, now, to be living life with their families, because of technology like this.

The reverse of this is a robot – an actual robot – scooting around the halls of a high school in Texas, bearing a video hookup with a teenage boy whose immune system is too compromised for him to attend school. He will need a kidney transplant eventually, if his fail completely, but until then, he can participate in class and see his friends, even if it is virtually.

Whether the technology is as obvious as a four-foot-tall videoconferencing robot, or a 13-pound machine connected by tubes to your chest, or as subtle as the @GiveAndLetLive Twitter promoting signing up to be a donor, technology has revolutionized transplant medicine – whether connecting patients with donor organs more efficiently, allowing doctors to help each other with the technique, or giving people another chance at life.

Ben Wolin, Co-Founder and Chief Executive Officer of Everyday Health, advocates cause marketing – the practice of raising awareness for a condition – and emphasizes the importance of delivering information to doctors.

Today’s guest blog post comes from Carmen R. Gonzalez. Carmen is the Manager of Strategy and Communications at Healthcare Communications Group, a leading clinical trial recruitment and retention firm, where she spearheads new technology in clinical trial recruitment and business development initiatives.

By Carmen R. Gonzalez (@crgonzalez)

Digital applications are taking the lead in the clinical trial recruitment arena, while their social media brethren lag behind. At the time of this writing, the U.S. Food and Drug Administration still had not issued its first set of rules on social media—a reason frequently cited by drug companies and clinical sites in delaying or avoiding use of this platform for patient recruitment. While social media is slowly being adopted in some quarters, the marketplace is teeming with e-tools directed at patients and doctors which support patient enrollment. This article offers a brief overview of this new technology. Full disclosure: my employer has developed an iPhone/iPad app mentioned in the article.

SMS Services: Reaching Out to Patients and Doctors One Text at a Time

Texting is widespread among youth and has gained traction among general society. Already, many companies are tapping into SMS to affordably and efficiently target patients for study enrollment. Early entrants, such as Exco In Touch, have applied phone technology to send HIPAA-compliant SMS text blasts among client databases to promote study awareness. Others, like In Touch Recruit, have offered SMS text messages embedded into clinical trial ads which allow responders the opportunity to reply and consent for further follow up and screening. The latest entrant into the field, Doximity, supports doctor-to-doctor SMS messaging, integrated with privacy controls, while allowing physicians to locate each other and incorporate them into their social network—an ideal framework for physician referral of patients for clinical studies.

Expect the use of SMS to continue to rise in this field. Many racial and ethnic groups are already digitally connected, creating new opportunities for study promotion. Earlier this year, Sparxoo.com reported that 76% of African-Americans use their cell phone to access the Internet, and a recent Pew Internet report in September confirmed that texting has reached the mainstream, with the movement being led by African-Americans, Latinos and teens. As the FDA increases its focus on diversity recruitment for clinical trials, it will become crucial to harness SMS to attract more ethnic and racial minorities.

Clinical Trial Recruitment? Yep, There’s An App For That

iPhone/iPad applications in clinical trial enrollment are growing in number, with most providing identification of local research studies, though a few offer information concerning the clinical trial process or clinical site-oriented support. The majority of apps are free. For the few that are fee-based, most tap freely available government sources (e.g. clinicaltrials.gov), providing no clear advantage over their pro bono cousins. Here’s an overview of a few of them:

Cancer Trials by MedTrust Online, LLC
This free app allows a user to locate nearby oncology studies within 150 miles of their location/zip code and to contact clinical trial managers directly by email or phone. It includes search features to locate specific types of trials (phase, status, type, and distance from location). Integrated into this is a share feature, allowing users to pass along their search results with friends and family.

Clinical Trials by StopWatch Media
Tapping into the National Library of Medicine and National Institutes of Heath database, this app touts access to over 78,000 registered clinical trials. It includes advanced search features by clinical trial type, location, phase, open or closed status and other options. Featured trials from the American Diabetes Scientific Sessions and the American Society of Clinical Oncology conferences are included, with abstract numbers for ease of reference. Search results may be forwarded to friends and colleagues via email. Polls exist to vote on the “most important clinical trials of the week, month and all-time periods.” This app is $3.99.

TrialX by Applied Informatics, Inc.
Locating nearby studies relies on the user’s location or zip, where this free app provides matching trials according to the user’s health condition, age, gender and other traits. Search results appear on a map or list, sorted by proximity to the user. Clinical study team members may be contacted via email or phone. An additional feature allows physicians to refer patients directly to study investigators. This app claims a database of more than 17,000 recruiting clinical studies accessed from clinicaltrial.gov, CenterWatch and registered sites and principal investigators on TrialX.com.

cTrials by Visual Soft Inc.
With this no-fee app, the user may search clinical study listings in clinicaltrials.gov, using advanced search features (e.g. country, state, refined terms). A time filter is available to limit results to more recent postings and search histories may be saved. Study teams can be contacted email or phone, and study listings may be shared with friends and family through email.

A Guide to Clinical Trials by CISCRP
De-mystifying the clinical study process, this free application explains the research trial process and provides instructive resources. Ongoing educational support is offered through educational programs, newsletters on real world clinical volunteer stories, advice on how to navigate the trial process and current updates in the clinical research field.

MyOutreach by Healthcare Communications Group
Aimed to help clinical sites perform patient recruitment efforts, this free permission-based application maps nearby support organizations and disease-based associations by proximity to the clinical site, so staff is guided to the closest community outreach opportunities. Details include group name, address, phone, primary contact, meeting times/dates/location, along with any unique details. The current version presents diabetes-related organization information among a dozen U.S. metropolitan cities.

As the technology grows in popularity among the medical community and patients alike, the app market will likely continue to heat up for clinical study recruitment well into the future.