In a remarkable achievement, CareFirst, the innovative healthcare web app developed by First Care Solutions, has secured 1st place in the Health Section at the 2024 Stuff Awards. Held annually by Stuff Magazine, these prestigious awards recognise excellence in digital innovation and technological advancement.
CareFirst has quickly emerged as a game-changer in South Africa’s healthcare landscape, offering users:
Instant medical consultations with qualified doctors, available 24/7 – 365
AI-powered Vital Scanning: Advanced technology to monitor key health metrics including blood pressure, respiratory rate, and heart rate.
Comprehensive Medical Services: Convenient access to doctors’ consultations, prescriptions, sick notes, and referrals.
‘’I’m really proud of what our team has created. CareFirst is a platform that can really transform the way people access healthcare,’’ says Dr Steve Holt, Chief Executive Officer – at First Care Solutions.
CareFirst represents a shift towards more accessible, efficient and personalised care, promising a future where quality care is available to everyone, regardless of their location or time constraint and this award is a testament to that.
Researchers at the University of Pittsburgh are pioneering a new approach to blood pressure monitoring, using the devices we carry with us every day. Ramakrishna Mukkamala, professor of bioengineering at Pitt’s Swanson School of Engineering, is passionate about developing accessible blood pressure (BP) detection tools. Instead of designing a new medical device to monitor BP, Mukkamala decided to take advantage of the sensors readily available in smartphones and figure out how to detect blood pressure with them.
“The most significant thing you can do to reduce your risk of cardiovascular disease is to lower high blood pressure through lifestyle changes, but in underserved populations, many people don’t have access to blood pressure cuffs, regular doctor’s appointments, or even know it’s a problem,” Mukkamala said. “But they do have smartphones.”
Mukkamala’s team harnessed tools already built into most smartphones, like motion-sensing accelerometers, front cameras, and touch sensors to build an Android smartphone application that can measure an individual’s pulse pressure.The user performs a hand-raising motion while holding the smartphone to make a measurement. The results of the project, published in Scientific Reports, demonstrate a promising new technology that could uniquely help reduce the burden of systolic hypertension globally, particularly in underserved populations.
Designing blood pressure technology for a touchscreen
Turning a smartphone into a monitoring device is no easy task, as Vishaal Dhamotharan, graduate student in the Cardiovascular Health Tech Laboratory, found out through multiple iterations of app development. Because smartphones don’t have force sensing tools, a crucial element of the project was figuring out how to replicate the effects of a traditional blood pressure exam using only a cell phone, which the team solved by using a familiar force – gravity.
“Because of gravity, there’s a hydrostatic pressure change in your thumb when you raise your hands up above your heart, and using the phone’s accelerometer, you’re able to convert that into the relative change in pressure.” Dhamotharan said.
By pairing this hand-raising motion with guided thumb maneuvers on the smartphone, the team was able to calculate each participant’s pulse pressure, the difference between systolic and diastolic numbers. For example, an individual with a BP measurement of 120/80 has a pulse pressure of 40. For Sanjeev Shroff, collaborator and bioengineering department chair, this publication is a promising advancement for blood pressure measurement devices.
“Development of a cuffless blood pressure measurement device that does not require any external calibration is the holy grail – such a device currently does not exist,” Shroff said. “The research work reported in this publication is an important step in the right direction, and is also encouraging for additional work aimed at obtaining systolic, diastolic, and mean pressures.”
Although pulse pressure isn’t typically used in cardiovascular disease monitoring, the study revealed its significance as a metric for detecting hypertension, according to Céderick Landry, assistant professor at the University of Sherbrooke and former postdoctoral researcher in the lab.
“Guidelines typically require doctors to measure both systolic and diastolic blood pressure, and pulse pressure is just the difference between the two.” Landry said. “We showed that if you only have access to pulse pressure, it’s still very correlated with hypertension, so part of our challenge now is changing the mentality on how to best measure things.”
Hypertension management within reach
This app could bring blood pressure monitoring software to any smartphone owner, enabling consistent self-monitoring and easy sharing of results with healthcare providers. This innovation is especially promising for managing hypertension, which can often be lowered through lifestyle changes such as reducing salt intake, quitting smoking and exercising regularly.
“This app would be really useful in low-income settings where people may not even have existing access to blood pressure tools.” Dhamotharan said. “Being able to measure blood pressure more frequently would allow an individual to track any significant changes in blood pressure, monitor for hypertension, and be able to manage their conditions with that knowledge.”
“The research is here – we just need some help making the technology better.” Landry said. “This is the first method of its kind, and even better, it’s something that we can start implementing right now.”
Allmed Healthcare Professionals, a leading healthcare agency, has launched its innovative Pay Slip App, designed to provide convenience and efficiency to its valued staff. The app, available for both Android and iPhone devices, revolutionises the pay slip distribution process, eliminating the need for staff to physically visit the office.
The development of the Pay Slip App began in January 2022 with the vision of addressing the challenges staff faced while collecting their pay slips. “We saw that our staff were spending time and money to come to our offices, which led to inefficiencies and unnecessary expenses,” explained Zukisani Sirwaxa, Operations Manager at Allmed. “Our goal was to save costs, improve accessibility, and streamline the entire process for our staff.”
The user-friendly app allows staff to access all their pay slips since they started working for Allmed, aiding them in financial planning and loan applications. Staff can easily check their pay details, including overtime, leaves, and earnings for specific shifts. This real-time access empowers staff to proactively manage their finances.
Karishma Dayaram, Business Unit Manager at Allmed, highlighted the app’s broader benefits, saying, “The Pay Slip App not only saves costs in printing and delivery but also frees up valuable staff time that was previously spent on manual processes. It enhances transparency and empowers our staff with immediate access to their essential pay information.”
Donald McMillan, Managing Director of Allmed, shared his excitement about the app’s unique features, stating, “As one of the first agencies to introduce such a dedicated Pay Slip App, we have been at the forefront of technology adoption in the industry. We are continuously exploring ways to improve the app’s functionality to meet our staff’s evolving needs.”
The Pay Slip App, developed in collaboration with a third-party developer, underwent a rigorous testing phase to ensure its efficiency and reliability. Since its launch, the app has received several thousand downloads, and Allmed has been proactive in addressing any technical challenges to ensure a seamless user experience.
Looking towards the future, Allmed envisions expanding the app’s functionalities to provide enhanced communication with our staff. “We are exploring the possibility of using the platform to share important updates, memos, and notices directly with our staff,” said Zukisani Sirwaxa. “This will further streamline our communication and foster a dynamic and connected community.”
As a forward-thinking company, Allmed recognises the importance of environmental responsibility. “We are also proud to align ourselves with the green initiative,” stated Donald McMillan. “By embracing digital solutions like the Pay Slip App, we are reducing paper usage and contributing to a sustainable future.”
A smartwatch ECG can accurately detect heart failure (HF) in nonclinical environments, according to a study published in Nature Medicine. Researchers analysed Apple Watch ECG recordings with AI to identify patients with ventricular dysfunction. Study participants were able to remotely record their smartwatch ECGs at any time, with the data automatically and securely uploaded to their electronic health records via a smartphone app.
“Currently, we diagnose ventricular dysfunction – a weak heart pump – through an echocardiogram, CT scan or an MRI, but these are expensive, time consuming and at times inaccessible. The ability to diagnose a weak heart pump remotely, from an ECG that a person records using a consumer device, such as a smartwatch, allows a timely identification of this potentially life-threatening disease at massive scale,” says senior study author Paul Friedman, MD, chair of the Department of Cardiovascular Medicine at Mayo Clinic.
Ventricular dysfunction might not cause symptoms, but affects about 2% of the population and 9% of people over 60. Symptoms may develop with a low ejection fraction, including shortness of breath, a rapid heart rate and swelling in the legs. Early diagnosis is important because once identified, there are numerous treatments to improve quality of life and decrease the risks of heart failure and death.
Mayo researchers interpreted Apple Watch single-lead ECGs by modifying an earlier algorithm developed for 12-lead ECGs that is proven to detect a low ejection fraction.
While the data are early, the modified AI algorithm using single-lead ECG data had an area under the curve of 0.88 to detect low ejection fraction. By comparison, this measure of accuracy is as good as or slightly better than a medical treadmill diagnostic test.
“These data are encouraging because they show that digital tools allow convenient, inexpensive, scalable screening for important conditions. Through technology, we can remotely gather useful information about a patient’s heart in an accessible way that can meet the needs of people where they are,” says first author Zachi Attia, PhD, the lead AI scientist in the Department of Cardiovascular Medicine at Mayo Clinic.
“Building the capability to ingest data from wearable consumer electronics and provide analytic capabilities to prevent disease or improve health remotely in the manner demonstrated by this study can revolutionize health care. Solutions like this not only enable prediction and prevention of problems, but also will eventually help diminish health disparities and the burden on health systems and clinicians,” says co-author Bradley Leibovich, MD, the medical director for the Mayo Clinic Center for Digital Health.
Approximately 420 of the 2454 participants had an echocardiogram within 30 days of logging an Apple Watch ECG in the app. Of those, 16 patients had low ejection fraction confirmed by the echocardiogram, which provided a comparison for accuracy.
After 20 years searching for a cure for tinnitus, for which there is no pharmacological treatment, there are ‘encouraging results’ from a clinical trial of a smartphone app therapy, the results of which have been published in Frontiers in Neurology.
The study randomised 61 patients to one of two treatments, the prototype of the new ‘digital polytherapeutic’ or a popular self-help app producing white noise. On average, the group with the polytherapeutic (31 people) showed clinically significant improvements at 12 weeks, while the other group (30 people) did not.
“This is more significant than some of our earlier work and is likely to have a direct impact on future treatment of tinnitus,” said Associate Professor in Audiology at the Universirt of Auckland, Dr Grant Searchfield.
Key to the new treatment is an initial assessment by an audiologist who develops the personalised treatment plan, combining a range of digital tools, based on the individual’s experience of tinnitus.
“Earlier trials have found white noise, goal-based counselling, goal-oriented games and other technology-based therapies are effective for some people some of the time,” says Dr Searchfield.
“This is quicker and more effective, taking 12 weeks rather than 12 months for more individuals to gain some control.”
“What this therapy does is essentially rewire the brain in a way that de-emphasises the sound of the tinnitus to a background noise that has no meaning or relevance to the listener,” Dr Searchfield says.
Audiology research fellow Dr Phil Sanders says the results are exciting and he found running the trial personally rewarding.
“Sixty-five percent of participants reported an improvement. For some people, it was life-changing – where tinnitus was taking over their lives and attention.”
Some people didn’t notice an improvement and their feedback will inform further personalisation, Dr Sanders noted.
Tinnitus is a phantom noise and its causes are complex. It has so far defied successful treatment.
While most people experience tinnitus, or ringing in the ears at least on occasions, around five percent experience it to a distressing degree. Impacts can include trouble sleeping, difficulty carrying out daily tasks and depression.
Dr Searchfield says seeing his patients’ distress and having no effective treatment to offer inspired his research. “I wanted to make a difference.”
The next step will be to refine the prototype and proceed to larger local and international trials with a view to FDA approval.
The researchers hope the app will be clinically available in around six months.
Instead of causing people to become lazy or forgetful, the use of smartphones and other digital devices could help improve memory skills, report the authors of a new study published in Journal of Experimental Psychology: General.
The research, showed that digital devices serve to aid people storing and recalling crucial information. This, in turn, frees up their memory to remember additional, less important, things.
Neuroscientists have previously expressed concerns that the overuse of technology could result in the breakdown of cognitive abilities and cause ‘digital dementia’.
The findings show that, on the contrary, using a digital device as external memory not only helps people to remember the information saved into the device, but it also helps them to remember unsaved information too.
To demonstrate this, researchers developed a memory task to be played on a touchscreen digital tablet or computer. The test was undertaken by 158 volunteers aged between 18 and 71.
Participants were shown up to 12 numbered circles on the screen, and had to remember to drag some of these to the left and some to the right. The number of circles that they remembered to drag to the correct side determined their pay at the end of the experiment. One side was designated “high value,” meaning that remembering to drag a circle to this side was worth 10 times as much money as remembering to drag a circle to the other “low value” side.
Participants performed this task 16 times. They had to use their own memory to remember on half of the trials and they were allowed to set reminders on the digital device for the other half.
The results found that participants tended to use the digital devices to store the details of the high-value circles. And, when they did so, their memory for those circles was improved by 18%. Their memory for low-value circles was also improved by 27%, even in people who had never set any reminders for low-value circles.
However, results also showed a potential cost to using reminders. When they were taken away, the participants remembered the low-value circles better than the high-value ones, showing that they had entrusted the high-value circles to their devices and then forgotten about them.
Senior author Dr Sam Gilbert said, “We wanted to explore how storing information in a digital device could influence memory abilities.
“We found that when people were allowed to use an external memory, the device helped them to remember the information they had saved into it. This was hardly surprising, but we also found that the device improved people’s memory for unsaved information as well.
“This was because using the device shifted the way that people used their memory to store high-importance versus low-importance information. When people had to remember by themselves, they used their memory capacity to remember the most important information. But when they could use the device, they saved high-importance information into the device and used their own memory for less important information instead.
“The results show that external memory tools work. Far from causing ‘digital dementia,’ using an external memory device can even improve our memory for information that we never saved. But we need to be careful that we back up the most important information. Otherwise, if a memory tool fails, we could be left with nothing but lower-importance information in our own memory.”
A New Zealand trial of a smartphone combining virtual reality (VR) with cognitive behavioural therapy (CBT) showed a 75% reduction in phobia symptoms after six weeks of the treatment programme. The results, published in the Australian and New Zealand Journal of Psychiatry, suggests an easily available treatment for the nearly one in 12 people who suffer common phobias such as that of heights or spiders.
The trial, led by Associate Professor Cameron Lacey, from the Department of Psychological Medicine, involved phobia patients using a smartphone app treatment programme called ‘oVRcome‘, which combines VR 360-degree video exposure therapy using headset alongside more traditional CBT. The company provides a simple headset into which users insert their own smartphone, turning it into a display.
“The improvements they reported suggests there’s great potential for the use of VR and mobile phone apps as a means of self-guided treatment for people struggling with often-crippling phobias,” Associate Professor Lacey says.
“Participants demonstrated a strong acceptability of the app, highlighting its potential for delivering easily accessible, cost-effective treatment at scale, of particular use for those unable to access in-person exposure therapy to treat their phobias.”
A total of 129 people took part in the six-week randomised, controlled trial, over May–December 2021, with a 12-week follow-up. Participants needed to be aged between 18–64 years, have a fear of either flying, heights, needles, spiders and dogs. Weekly questionnaires were emailed to record their progress, with access made available to a psychologist for any adverse effects.
For all phobias, participants showed comparable improvements in the Severity Measures for Specific Phobia scale. The average severity score decreased from 28/40 (moderate to severe symptoms) to 7/40 (minimal symptoms) after six weeks. There were no participant withdrawals due to intervention-related adverse events.
“The oVRcome app involves what’s called ‘exposure therapy’, a form of CBT exposing participants to their specific phobias in short bursts, to build up their tolerance to the phobia in a clinically-approved and controlled way,” Assoc Professor Lacey explained.
“Some participants reported significant progress in overcoming their phobias after the trial period, with one feeling confident enough to now book an overseas family holiday, another lining up for a COVID vaccine and another reporting they now felt confident not only knowing there was a spider in the house but that they could possibly remove it themselves.”
The programme used standard CBT components including psychoeducation, relaxation, mindfulness, cognitive techniques, exposure through VR, and a relapse prevention model. Participants were able to select their own exposure levels to their particular phobia from a large library of VR videos.
“This means the levels of exposure therapy could be tailored to an individual’s needs which is a particular strength. The more traditional in-person exposure treatment for specific phobias have a notoriously high dropout rate due to discomfort, inconvenience and a lack of motivation in people seeking out fears to expose themselves to. With this VR app treatment, triallists had increased control in exposure to their fears, as well as control over when and where exposure occurs,” said Assoc Professor Lacey.
The cost-effective availability of the app and headsets and the fact that multiple phobias were tested at once made this a novel trial, the researchers said. Most comparative VR studies to date have investigated high-end VR devices which are only available in research and limited clinical settings. One Dutch study examined a low-cost VR Dutch-language program using animated imagery that demonstrated improvement in fear-of-height symptoms, however this study only examined a single type of specific phobia.
Associate Professor Lacey says public demand to take part in the trial was unprecedented, demonstrating the increasing need and desire for phobia treatment in the community.
Infected cell covered with SARS-CoV-2 viruses. Source: NIAID
Findings from a new study reported in The Lancet has found the risks of developing long COVID are greatly reduced (by ~50% to 75%) as a result of Omicron infection compared to Delta infection.
The study, the first of its kind to report on long COVID risk associated with Omicron, highlights the speed with which app-based health surveillance can provide insights. These have further been shown to be consistent and replicable.
A major strength of the study was the ability to log a wide range of symptoms with the app. Limitations of the self-reported data include no direct testing of infectious variants (here assumed from national data) and no objective measures of illness duration. There was insufficient data to estimate the odds of long COVID in unvaccinated individuals. Finally, to enable swift reporting, the period of assessment of omicron cases was slightly shorter than for the delta variant, and assessment of longer durations of long COVID (eg, >12 weeks) was not possible.
In this case-control observational study, the researchers took self-reported data from the COVID Symptom Study app.
Participants were selected on a positive COVID test after SARS-CoV-2 after vaccination, at least one log per week in the app for at least 28 days after testing positive, and no previous SARS-CoV-2 infections before vaccination. The researchers identified 56 003 UK adults first testing positive between Dec 20, 2021, and March 9, 2022, when the Omicron variant became dominant. Similarly, researchers identified 41 361 UK adult cases first testing positive between June 1, 2021, and Nov 27, 2021, during the period of Delta dominance.
Both symptomatic and asymptomatic infections were considered, and, for the Omicron period, only participants testing positive before Feb 10, 2022, were included, to ensure all participants had at least 28 days for symptom reporting after testing positive. The researchers adjusted for socioeconomic deprivation and other factors.
In both periods, female participation was higher than male participation (55% for Omicron and 59% for Delta cases). Delta and Omicron cases had similar age (mean age 53 years) and prevalence of comorbidities (around 19%). Among Omicron cases, 2501 (4.5%) of 56 003 people experienced long COVID and, among Delta cases, 4469 (10.8%) of 41 361 people experienced long COVID. Cases were stratified by time from vaccination to first infection. They found that, for all vaccine timings, Omicron cases were less likely to experience long COVID, with an odds ratio ranging from 0.24 to 0.50.
However, the researchers noted that the the absolute number of people with long COVID at a certain time depends on the pandemic curve. Considering the UK Omicron peak of more than 350 000 new symptomatic COVID cases per day estimated on March 26, 2022, by the ZOE app model, with 4% of cases being long COVID, future numbers with long COVID will inevitably rise.
A new study published in the Journal of Sleep Research found a complicated relationship between media use and bedtime and sleep quality and duration, with short, simple media use resulting in earlier bedtime and longer sleep duration.
Many factors contribute to sleep disturbance among young adults. Use of media is increasing rapidly, and little is known regarding its association with sleep disturbance. Previous research showed that social media use before bedtime in young adults resulted in reduced and poorer quality sleep.
The study examined how sleep might be impacted by media use – such as watching movies, television, or YouTube videos; browsing the Internet; or listening to music – before bed.
In the study, 58 adults kept a diary that recorded information related to time spent with media before bed, location of use, and multitasking. Electroencephalography captured parameters such as bedtime, total sleep time, and sleep quality.
Media use in the hour before sleep was associated with an earlier bedtime. If the before-bed use did not involve multitasking and was conducted in bed, it was also associated with more total sleep time. A long use of media associated with later bedtime and less total sleep time.
Sleep quality, operationalised as the percent of total sleep time spent in N3 and REM sleep, was unaffected by media use before bed.
“If you are going to use media, like watching TV or listening to music, before bed, keep it a short, focused session and you are unlikely to experience any negative outcomes in your sleep that night,” said lead author Morgan Ellithorpe, PhD, of the University of Delaware.
Researchers have shown that smartphone pictures of post-surgical wounds taken by patients and then assessed by clinicians help spot infections early on.
These ‘surgery selfies’ were associated with a reduced number of GP visits and improved access to advice among patients who took them. This practice could help manage surgical patients’ care while they recover.
Death within 30 days of surgery is the third largest cause of mortality globally. More than a third of postoperative deaths are associated with surgical wound infections.
In the study, published in NPJ Digital Medicine, University of Edinburgh researchers conducted a randomised clinical trial involving 492 emergency abdominal surgery patients to determine if photos from smartphones and questions on symptoms of infection could be used to diagnose wound infections early.
One group of 223 patients were contacted on days three, seven and 15 after surgery and directed to an online survey, where they were asked about their wound and any symptoms they were experiencing. Then they were asked to take a picture of their wound and upload it.
A surgical team member assessed the photographs and patients’ responses were assessed for signs of wound infection. They followed up with patients 30 days after surgery to find out if they had been subsequently diagnosed with an infection.
A second group of 269 received standard care and were contacted 30 days after surgery to find out if they had been diagnosed with an infection.
No significant difference between groups was seen in the overall time it took to diagnose wound infections in the 30-days after surgery.
However, the smartphone group was nearly four times more likely to have their wound infection diagnosed within seven days of their surgery compared to the routine care group. They also had fewer GP visits and reported a better experience of trying to access post-operative care.
The research team is now conducting a follow-up study to determine how this can be best put into practice for surgical patients around the country. Artificial intelligence will also be used to help the clinical team in assessing the possibility of wound infection.
Professor Ewen Harrison, Professor of Surgery and Data Science, who led the research said: “Our study shows the benefits of using mobile technology for follow-up after surgery. Recovery can be an anxious time for everybody. These approaches provide reassurance – after all, most of us don’t know what a normally healing wound looks like a few weeks after surgery. We hope that picking up wound problems early can result in treatments that limit complications.”
Dr. Kenneth McLean, who co-led the research said: “Since the COVID-19 pandemic started, there have been big changes in how care after surgery is delivered. Patients and staff have become used to having remote consultations, and we’ve shown we can effectively and safely monitor wounds after surgery while patients recover at home – this is likely to become the new normal.”
