Christine Porter is hooked on the My Fitness Pal app. In October, after deciding to lose 50 pounds, Porter started typing in everything she eats, drinks and any exercise she gets.

“This is like my main page here,” says Porter, who lost 42 pounds in nine months. “It’s telling me I have about 1,200 calories remaining for the day. When I want to record something I just click the ‘add to diary’ button. I’m on it all day either through my phone or through the computer.”

Health apps such as My Fitness Pal are turning smartphones and tablets into exercise aides, blood pressure monitors and devices that transmit an EKG. And the day is not far off when doctors may be suggesting apps along with prescribing drugs to help patients manage their health. But the explosion of apps is way ahead of tests to determine which ones work.

Porter heard about the app from Ryan Sherman, her health coach at a clinic for employees of Massachusetts General Hospital. Sherman helps clients turn a doctor’s orders into a user friendly action plan for keeping high blood pressure or sugar levels in check.

Increasingly, says Sherman, patients with diabetes or heart problems are coming in, pulling out their phones, and saying hey, have you seen this app?

“There’s a new one every day, so it’s trying to keep up with that,” Sherman says.

Which is one reason why many doctors are suggesting, but not prescribing apps. Doctors aren’t sure which of the roughly 40,000 available apps do what they claim to do. The U.S. Food and Drug Administration divides health apps into two categories: those that help with healthy lifestyles and those that turn your phone into a medical device to, say, record blood pressure or an EKG, and then send those readings to a doctor.

The FDA is revising regulations for apps in the medical device category. It does not plan to regulate diet or exercise apps. A few private companies are stepping in to do that task. Ben Chodor started Happtique, a company that reviews apps and gives those are at least perform correctly, a seal of approval.

“It’s the Wild West and someone needs to come in and at least help the consumers and the clinicians and the payers sort through the 40,000-plus apps that are already out there,” says Chodor.

Happtique will not say which apps work better than others or guarantee their safety. Still, some doctors say apps that work are transforming medicine. Dr. Eric Topol, the chief academic officer at Scripps Health in San Diego, says apps that monitor blood pressure or glucose rates can be more valuable than prescriptions to keep these conditions in check.

“When we use a medication we don’t know if it’s going to work or not.  It’s much better when a person’s taking their blood pressure on a frequent basis,” says Topol.

Some apps work with another device, such as when a person wears a blood pressure monitor that transmits the data to the person’s phone. “The average person looks at their smart phone 150 times a day,” says Topol. “All of a sudden, they’re able to diagnose if their blood pressure’s adequately controlled and what are the circumstances when it’s not.”

Topol says apps that control blood pressure will help prevent strokes and heart attacks and may mean doctors should prescribe phones and tablets in addition to apps. But Dr. Laura Ferris at the University of Pittsburgh, urges patients to use apps cautiously.

“It does make sense that people who download these apps and use them really understand that they are doing so at their own risk,” says Ferris.

Ferris ran a study of apps that claim to detect cancer based on a picture of a mole. Only one of the apps sends the  picture of your suspicious mole to a dermatologist. It was right 98 percent of the time.

Three others, says Ferris, could be dangerously wrong: “The best of them missed melanoma 30 percent of the time. The worst of them missed melanoma over 90 percent of the time.”

Despite the growing interest in medical apps, there are many unresolved questions about their use: Should all the information patients collect become part of their medical record and how? Who in the doctor’s office analyzes patients’ numbers? Will insurers cover the cost of apps?

Dr. Ben Crocker, at the Mass General clinic that is testing a few apps, says those are questions doctors will have to answer.

“This is what’s engaging patients,” says Crocker. “Patients are coming to their doc for the first time saying, ‘I’ve been collecting some information or I’ve been using this application.’  And that, I think we can’t ignore no matter where this is taking us, no matter how Wild West it feels.”

This story is part of a partnership that includes WBUR, NPR, and Kaiser Health News.

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Toni Lewis-Bennett remembers hesitating when she was asked to be an organ donor while applying for her driver’s license.

But years later, when a friend at work became sick, she got tested to see if she could donate her kidney to save his life. And with a green light from doctors, there was no question in her mind that she would go through with the transplant.

“I felt honored to be able to do it,” Lewis-Bennett said. “I don’t think many people in their lives get the opportunity to make a significant change in someone else’s.”

She said not enough people are part of the organ donor dialogue, which doesn’t always come up in normal conversation. But a social  media campaign might be changing that culture.

In May 2012, Facebook introduced an option that lets users add “Organ Donor” to their profiles, just as someone would add their favorite movies or marital status. It also provided users a quick link to sign up for the national registry of organ, eye and tissue donors through Donate Life. The Facebook project was a partnership with a team from the Johns Hopkins Medical Center, the Living Legacy Foundation of Baltimore and Donate Life America.

The results, as chronicled in a report released on Tuesday, were immediate. On the first day alone, more than 57,000 people added the label to their profiles, and 13,054 people registered to be donors online. A year later, 30,818 people had registered to be donors, about five times more than pre-Facebook rates.

For the authors of the report, published in The American Journal of Transplantation, the surge in awareness was one step toward resolving the chronic shortage of organs available for transplants.

“Eighteen people die every day waiting for an organ,” said Dr. Andrew Cameron, the Hopkins surgeon who helped spur the Facebook effort and the lead author of the report. “But it’s not a medical crisis, it’s a social crisis.”

Cameron said his team’s collaboration with Facebook was meant to address a disconnect between donors and recipients.

In a 2005 Gallup poll, for example, 95 percent of respondents said they support organ donation. But that doesn’t always translate to action: in 2009 there were about 14,600 donors for a waitlist of 105,567 people needing organs, according to federal report on organ and tissue transplants.

With social media like Facebook and Twitter, Cameron said, the steps to consider donations, and register, become a little more accessible.

Karan Chabbra, a medical student and health care blogger, said he chose to display the Organ Donor option on his profile the first day he saw it on Facebook.

Although he had earlier registered as an organ donor when he received his driver’s license, the 23-year-old said including the decision in a profile was as much a part of an online identity as education or language skills. He also said noting the decision to be a donor can have broad effect on a serious public health problem.

“I think with this, and other similar issues, this can be a social tipping point,” he said. “If I can show that I’m doing it, it could subtly encourage others.”

And it’s Chabbra’s generation that could make the largest impact. According to the results, those who displayed their organ donor status were largely 25- to 35-years-old and included more women than men. The highest response was in the state of New York.

Cameron said he and his team are hoping to study and apply the results to make the campaign more effective.

“It’s frustrating when we see patients dying who we know we can help,” he said. “We have to rededicate ourselves and see how we can change that.”

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It’s one of those unhappy holiday surprises — a visiting family member gets sick. That happened to Dr. Farzad Mostashari last Thanksgiving.

“My dad comes downstairs and he has acute pain in his eye where he had cataract surgery. And I said, ‘What’s the matter, what’s the story?’” recalled Mostashari, who lives in Bethesda, Md. “And he said, ‘Well, I think they put the wrong lens in my eye, I’d gone back to the doctor and…’” His father didn’t remember exactly what had happened at his last doctor’s appointment and the office was closed anyway.

How could a local doctor in Maryland access his dad’s medical record in Boston? Through Medicare Blue Button, a computer program that allows patients to download their medical history into a simple text file on their smartphones and personal computers. Then third-party applications that you download help organize this information.

See also: Could That Star Trek Device Soon Be Diagnosing You?

Mostashari certainly knew how to handle his dad’s problem. After all, he’s the coordinator for health information technology at the U.S. Department of Health and Human Services, and it’s his passion and profession to promote electronic health records.

And, he had signed his dad up for Blue Button, which downloads three years of a patient’s medical history, as well as the Humetrix iBlueButton, a smartphone app that translates and displays the information in a simple-to-understand way. The file includes names, phone numbers and addresses of physicians as well as diagnoses, lab tests, imaging studies, and medications.

So when Mostashari took his father to a local doctor, his dad was able to hand over his iPhone and say, “Here’s my history.”

Mostashari predicts that soon everyone will have that kind of information at their fingertips: “Within the next 12 months if people want to, they will be able to get the same data that your doctors would send to each other to have it come to you.”

The Blue Button service is available from the federal government for veterans as well as Medicare beneficiaries.

Before a patient can download medical information to a computer or a smartphone, the files must first be stored electronically. And while electronic health record advocates note that there has been a sharp increase in the number of hospitals and doctors using EHRs, they acknowledge that a complete electronic system is a long way off. According to a 2012 CDC survey, while 72 percent of office-based physicians are using some sort of electronic system in their practice, only 40 percent of practices meet the definition of a “basic” system.

Power In The Hands Of The Patients?

The federal health law is designed to encourage patients to be more involved in managing their own health. Making medical records and test results accessible to smartphones is in line with those policy goals.

The floodgates have opened for patients to use technology to manage their own care particularly those that have chronic, and expensive, diseases, said Jennifer Lundblad, CEO of Stratis Health, a nonprofit organization based in Minnesota, which aims to improve health care by translating research into practice.

Lundblad said smartphones and health-related applications can become powerful tools to help people monitor and improve their health.

“Some parts of health care are so complex that we need complex solutions,” she said. “But some parts of health care can be simplified and with the prevalence of smartphones, let’s use the smartphone tool that that patient already has.”

But there are also risks that Lundblad and others worry about, among them the possibility that a company storing the health data could go out of business or that some patients may lose smartphones containing their medical information.

Protecting Your Data

To address privacy concerns, in February the Federal Trade Commission released recommendations to companies that build and sell mobile apps, not just those related to health care. Those recommendations followed a major report the FTC released about best practices for consumer privacy in 2012.

But even its most recent report noted that “many questions remain” about the applications. Among them: What information should be included in application developer’s privacy policies? What might a model short privacy notice look like? Can a single system of icons be developed to avoid consumer confusion?

Deven McGraw, director of the Health Privacy Project at the Center for Democracy and Technology, notes that when doctors and health plans store electronic medical information, that information is covered by federal privacy and security rules. But those rules don’t extend to medical information on a smartphone.

“When you take possession of it and share it, stick it in an app, share it on the web, a social networking site, it’s not going to be protected beyond what’s in the privacy policy for the app or what’s the privacy policy for the social networking site. And you need to read that,” McGraw said. “Be aware before you share.”

McGraw provides some tips for consumers who want to protect themselves:

• Determine if cellphone app makers claim rights to patients’ data for marketing purposes.

• Look for very clear statements about how the data is used. Language such as “from time to time we will use your data…in order to improve the services we provide for you” may warrant further investigation.

• Look for who owns the data, if the company will disclose it. Do you own your data? Or do you merely have the right to use the service, but that is the extent of your rights?

• Look for commitments on security of the data. Is the data stored on your phone or on a server?

• What are your rights to retrieve data if they cancel service? Are you permitted to have a copy of the data? What is the app provider’s right to use the data after service is canceled? Ideally, McGraw said, companies should return all your data and not have the right to subsequently use it.

• You should use unusual passwords that employ varied symbols and numbers.

• If possible, you should be able to remotely delete data from the device if it is stolen.

And Medicare Blue Button has these security recommendations:

• Download your data to a secure location. You may want to download your information to a CD or flash drive. Consider purchasing an encrypted flash drive for your information. You may also encrypt or require a password to access a CD.

• If you want to send your information via email, you should encrypt the message.

• Keep paper copies in a safe and secure place that you can control.

Another problem with smartphone medical records – not related to security – is that some physicians may not know whether the records stored there are complete, said Scott Edelstein, co-chair of Squire Sanders’ Healthcare & Life Sciences Industry Group in Washington, D.C.

“There may be some data that the patient doesn’t want to keep on their smartphone,” said Edelstein, who specializes in mobile health applications. “Maybe there’s very sensitive health information. Maybe there’s information that they don’t want other providers to know but it could be very important information for a provider to know, for example, in the event of an emergency.”

Edelstein said errors or omissions could be disastrous.

But in the case of Dr. Farzad Mostashari’s father, the records on the phone had pointed to the problem: “He had dry eye; that was the diagnosis.”

Then, it was an easy treatment that salvaged the Thanksgiving weekend.

This story is part of a collaboration that includes MPR News, NPR and Kaiser Health News.

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Only a small percentage of legislation makes it to the Senate and House floors, where insomniacs can stay glued to the proceedings on C-SPAN.

But these days, it’s a lot easier than it used to be to track bills of interest through the legislative process.

The granddaddy of legislative access is named, fittingly, after the guy who created the Library of Congress. The library’s THOMAS system (as in Thomas Jefferson) allows users to research by topic or bill number and find a mostly readable summary of the legislation along with every step in the how-a-bill-becomes-law process, including final votes.

But the Library of Congress is now beta-testing a new website, Congress.gov, that aims to serve up a much more comprehensive platter of legislative information (including profiles of congressional lawmakers) in a format that’s considerably more user-friendly than its old standby. It will eventually incorporate all the information that’s now on THOMAS.gov.

Meanwhile, House Majority Leader Eric Cantor (R-Va.) has unveiled a new website that allows the public to follow legislation in the House of Representatives and even sign on as a “citizen cosponsor” of bills and resolutions. “Whether you want to support new legislation like the Kids First Research Act or show support for legislation that has already passed the House, like the Working Families Flexibility Act, you can do so here,” Cantor said.

Moving off of Capitol Hill, there are lots of choices when it comes to figuring out what Congress is up to.

If Vegas is your style, for example, you can get a bill’s odds of passage from GovTrack. The site is run by “civic hacker” Joshua Tauberer, who started it as a hobby and has since written a book called Open Government Data. GovTrack points out that only about 4 percent of the 10,000 measures introduced in each session of Congress make it into law. The odds of passage, based on things like whether a bill’s sponsor chairs a powerful committee, are designed to help people focus on the bills most likely to succeed. With Govtrack you can choose a bill to follow and be emailed updates on its progress.

OpenCongress, funded by the Sunlight Foundation, has the bill information along with news coverage and public comments.

Want to dive even deeper? Here’s a WikiHow primer on how to track legislation and keep tabs on what Congress is doing.

So if you want to know whether the Older Americans Act is headed toward renewal, whether Social Security’s cost-of-living formula is likely to be changed or what resolution is being offered to honor the obscure organization of your choice, it’s all only a few keystrokes away. Thomas Jefferson would love it.

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The news? A majority (56 percent) of Americans now own a smartphone, according to Pew. You may think it’s been that way forever, but Pew says we’ve just passed a tipping point. This is the first time that a majority of people surveyed have said they own a phone that’s not dumb.

Still, some people are getting left behind. Among those 50-64 with income under $30,000, people are more than three times less likely to own a smartphone as their peers with incomes above $75,000. And for those over 65, the digital divide is even wider, with only 8 percent of those in the lowest-income group owning smartphones vs. 43 percent of those earning the most.

What are those without smartphones missing? They don’t have access to hundreds of thousands of apps for staying connected with other people and with the world at large. That includes innovative ways to help monitor health and apps that aid caregiving.

Overall, as you might suspect, the 65+ group lags with just 18 percent owning smartphones, while those 55-64, with 39 percent ownership, are second from the bottom. And the kids? The 18-24 group is in second place overall with 79 percent, just slightly under the 25-34 cohort.

A while back we marveled at Samsung’s campaign to paint iPhone owners as geezers. Here’s some data. In the 18-24 and 25-34 groups, Android phones beat iPhones by 12 and 6 points respectively. Android also has an edge among those 55-64, though not by much. And yes, Samsung, the very oldest smartphone users prefer iPhones … by a whisker.

Graph above courtesy of Pew Research Center’s Internet & American Life Project. Phone image courtesy Samsung.

At least eight foreign-sponsored organizations have hacked into computer networks at the Veterans Affairs Department in recent years or were actively trying to do so, a former VA computer security chief told Congress on Tuesday.

Pretty amazing, huh? Wouldn’t it be cool to actually have a gizmo like that to monitor your vital signs? Well, there’s a good chance that a real-life version of the Star Trek device will be available to consumers in the near future.

Click here to view the embedded video.

One of the most promising contenders is the Scout, a digital health monitoring device that’s being developed by medical technology startup Scanadu. Mashable reports that when you hold the gadget to your forehead for just 10 seconds,  it checks your temperature, heart rate, blood oxygen level, and other important measures, and then relays the information to an app in your smartphone.

Scanadu’s founder and chief executive, Belgian-born internet entrepreneur Walter De Brouwer, got the idea for developing a tricorder not from watching Bones on TV, but from spending a lot of time in the intensive care unit after his then-six-year-old son sustained a traumatic brain injury in 2006. As this Fast Company article details, De Brouwer spent three months by his son’s bedside, and learned to read and log the monitoring machines that watched for trends and abnormalities in his son’s condition, so that he could ask his doctors better-informed questions. After his son, who remains partially paralyzed on the right side of his body, was released from the hospital, De Brouwer wished that he still had that continuous stream of information. That led him to launch the project that led to the Scout.

“With your smart phone, you can find information about anything, anywhere,” explains Scanadu’s chief medical officer, Dr. Alan Greene. “But what you can’t find is information about your own body.”

Scanadu is raising money through the crowdsourcing site indiegogo. It’s offering investors a chance to help test the device, which it needs to do before it can obtain the approval of the U.S. Food and Drug Administration to market its product to the public. The company is also one of multiple contenders for the X Prize Foundation’s medical tricorder contest, which is offering $10 million to the first party that develops a clone of the Star Trek device that’s capable of capturing health metrics and diagnosing 15 different diseases.

The foundation has a pretty good track record on stimulating technological advances; it’s the same group that sponsored the $10 million competition to develop and fly a privately built reusable spacecraft in the early 2000s.

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The technology news website ZDNet reports that a surviving Apple-1, the computer giant’s first product, fetched a breathtaking $671,400 at a German auction. Other Apple-1s have fetched six-figure prices in the past, but this particular one was especially sought after because it reportedly is one of just the half-dozen or so surviving Apple 1s still capable of booting up. It was snapped up by an unidentified collector from somewhere in the Middle East. According to an unofficial registry of Apple-1s maintained by an antique-computing aficionado, there are at least 48 of the computers still in existence.

Related: Wendell D. Garrett: An Antique Expert’s 5 Most Interesting Appraisals 

Here are some fascinating facts about the machine that helped launch Apple, which has grown since the 1970s into one of the world’s biggest and most successful companies.

• Apple co-founder Steve Wozniak got the inspiration to build the Apple-1, also commonly known as Apple I, when he attended a meeting of the Homebrew Computer Club (in the garage of computer enthusiast Gordon French) in Menlo Park, Calif., in March 1975. At the meeting, Wozniak saw a spec sheet for a microprocessor — a chip with an entire central processing unit on it. Wozniak had gone to the meeting with the ambition of designing a terminal that would access a remote mainframe computer, but the spec sheet put in his head the idea of building a full-fledged, standalone home computer that could sit on a desktop.
• According to Walter Isaacson, biographer of Wozniak’s partner Steve Jobs, it took Wozniak, who was working for HP at the time, about four months to design the Apple-1 in his spare time. He first got the prototype to display a line of type on a screen on June 29, 1975. Here’s a 1984 speech in which Wozniak described the Apple-1′s origins:

  Click here to view the embedded video.

• According to Technology Review, Wozniak and his nascent partner, Steve Jobs, decided to price the Apple-1 at $666.66, not just to be affordable, but because Wozniak liked repeating numbers.
• Unlike Apple’s later products, which became popular with computer newbies because of their works-out-of-the-box ease of use, the Apple-1 was basically just a circuit board. Purchasers had to find their own case, and hook up a monitor — usually a television — and a keyboard.
• It actually was Jobs who picked the name Apple for the new computer company. He chose it because he had dabbled in an all-fruit diet, and because he thought that apples sounded friendly and non-threatening.
• The initial Apple-1 was first used in a math class at Windsor Junior High School in Windsor, Calif., in 1976.
• The Apple-1 was replaced in 1977 by the Apple II, which had a case with a built-in keyboard and was capable of displaying color.

Click here to view the embedded video.

Photo: Auction Team Breker

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Everyone expects a hospital to be ready to jump into action when disaster strikes. But what about when the disaster devastates the hospital itself?

Turns out, it helps a lot to have an electronic medical record system in place.

At least that was the case at Moore Medical Center in Oklahoma, a small hospital right in the path of the tornado that ripped through the suburbs of Oklahoma City on Monday (see photo, right). Three-hundred people — staff, patients and community members — hunkered down in the cafeteria, stairwells and chapel as 200-miles-per-hour winds demolished the building around them.

One patient in labor stayed on the second floor with two nurses, where they could continue to monitor the fetal heartbeat.

Amazingly, everyone survived. Within an hour, 30 patients had been transferred to the two other hospitals that are part of the Norman Regional Health System. And every one of them arrived with their medical histories fully intact. The woman in labor even delivered a healthy baby later that evening.

“The transfer was totally seamless,” says John Meharg, director of health information technology at Norman, which has had an electronic health record system for the past five years. “We’re very fortunate that we’re a little ahead of the game,” he said.

If the hospital system had still been using paper, Norman explains, “the first thing we would have had to do was find their records. And with all of the hustle and bustle of a disaster, they can easily get lost.” As for any records left behind in files, he continues, “if the tornado doesn’t get them, the subsequent rain would ruin them. The roof’s gone, the walls are gone, and the windows are gone.”

Instead, physicians at the two transfer hospitals were able to pick up care for the Moore patients where their home physicians left off. Even if the patients had been taken to hospitals outside of the Norman system, their records would still have gone along with them. That’s because Oklahoma City has a regional health information exchange that allows the various hospital systems in the area to access all patient records, says Meharg.

“I’m very happy,” he adds, breathing a sigh of relief. “The systems never missed a beat. It would really have been a mess if we weren’t electronic.”

Photo: Norman Regional Health System (hospital)

Photo: Gene Chutka/Getty Images (doctors)

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Click here to view the embedded video.

Sponsored by the Senate Special Committee on Aging, the fair brought together about two dozen groups — ranging from the Alzheimer’s Foundation to the SilverSneakers (you can seen them at work in the video above, promoting healthy and appropriate exercise) — for a three hour demonstration of their wares. AARP and the AARP Foundation were among those presenting.

Dr. Stephen Axelrod demonstrated his tabsafe medication dispenser (at left). You load the gizmo with pills, and it makes sure you take them on schedule. It has a lot of ways to remind you, and your loved ones, if medications are missed or if you don’t respond in a predictable way to its electronic signals. Microsoft and its Kinect were in the house; so was Wii. The National Institutes of Health promoted a major summit, scheduled for October, where they’ll bring together 50 top researchers to explore the connections between aging and chronic disease. And Christy Carter, an assistant professor at the University of Florida, described an ongoing project coordinated by its Institute on Aging, involving 1,600 older adults to determine whether physical activity or health education can prevent or delay major physical and cognitive  problems among those at risk. Listen to an interview with Carter below:

The National Association of Area Agencies on Aging presented its policy priorities, appropriately for a Capitol Hill event. “Tight budgets,” they write in their brochure, “demand wise investment.” Their plea? “Deficit reduction must not be used as an excuse to undermine the very programs that keep our nation’s older adults from falling into poverty, suffering ill health or otherwise struggling to live independently and with dignity.”

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