Health care sector has always been at the forefront of any technology adoption. In the recent past, there has been considerable interest in utilizing the mobile phones to provide health care services to the billions of people across the world. Mobile phones are a great leveler and have democratized the access to health care. Increasing mobile penetration especially in the rural areas means that even the poorest of the poor can potential benefit from mHealth. The need for use of mobile technology in health care transcends across geographies and income levels. It is myth that mobile health or telemedicine is a need for emerging markets where the health infrastructure is poor. mHealth is equally important in developed nations which are struggling with rising health care costs.
What is mHealth?
mHealth is a term used for the practice of medical and public health, supported by mobile devices. mHealth applications include the use of mobile devices in collecting community and clinical health data, delivery of health care information to practitioners, researchers, and patients, real-time monitoring of patient vital signs, and direct provision of care (via mobile telemedicine).
How large is the opportunity?
Opportunities in the global mobile healthcare market are estimated to be worth between $50bn and $60bn in 2010, prompting operators to step up their initiatives in this emerging sector. The figures come from a global market survey from management consultancy McKinsey & Company, and suggest that mHealth opportunities in 2010 could be worth $20bn in the US alone.
To test consumer demand for mhealth services, McKinsey conducted a global market research survey of 3,000 consumers in six countries (500 each in Brazil, USA, Germany, South Africa, India and China). The findings indicate that a large proportion of the four billion people using mobile phones today struggle to gain access to good quality and affordable health care, both in emerging markets and more developed societies.
What is working in favor of mHealth?
1. Mobile phones are the only ubiquitous devices: There are over 4 billion mobile owners across the world which means that around 70% people own phones and over 90% of world’s population is covered by mobile network. The mobile phone is always carried by an individual making it an ubiquitous device and hence best suited for providing health care. There is no other personal gadget apart from a wrist watch that comes even close to mobile penetration. Even wrist watch is losing its relevance to mobile phones !!!
2. Increasing data speeds: Most of the countries across the world have rolled out the 3G networks and some are rolling out HSPA and 4G networks. The high speed networks facilitates telemedicine and remote diagnosis.
3. Lowering tariffs for voice and data: Lower tariffs leads to higher penetration and usage which is good for mHealth. Lower data tariffs are particularly encouraging. As networks upgrade from 3G to HSPA to 4G, the bandwidth costs are going to come down significantly leading to even lower costs in future. However, operators may take time in taking the high speed networks to rural and smaller towns.
4. Better handsets: Over the last few years, the smart phones are getting better and now provide the same computing power as computers used to provide just 3-4 years back. This means that the remote diagnostics, access to web based patient information system and telemedicine via video conferencing are now possible on the mobile phones. Though the smartphones are not very prevalent, but the medical centers in far flung areas can have a few smartphones catering to hundreds of patients.
Emerging opportunities in mHealth
1. Information/ Awareness: In health care, it is very important to be able to inform the vast majority of the population about a medical campaign. The Polio awareness campaign in India which has been supported by mobile operators is a very good example of how awareness can help eradicate the dreaded disease like polio. SMS messages can be sent out to millions of people as part of awareness program. Voxiva in Mexico gives people living with HIV the ability to register to receive messages to help improve their adherence to their specific treatment.
2. Medicine Reminder Service: Some people need to take medicine at regular intervals on a long term basis. Many patients, especially seniors forget to take their medicines on time. It is not practical to set alarms on the phone as it would require multiple alarms. In my opinion, a service that can send out alert messages or calls to remind people to take their medicines would be extremely successful. Imagine a situation where somebody’s parents are living in a different city and are required to take multiple medicines. Any son or daughter would like to take care of their parents but cannot always be physically present. If there is a service where the entire prescription can be uploaded on the cloud and the alerts are sent out basis the prescription, it would give a lot of mental peace to everybody in the family. The alerts can be in the form of SMS or auto-dialers. There are a few services like medication-reminder, ePill, OnTimeRx, etc. but there is scope for many more such or improved services.
3. Remote Consultation: Remote consultation is consultation between patients and doctors when they are not physically present at the same place. It is very useful when:
- The patient lives in a remote region where travel would be financially difficult
- The patient is hospitalized or otherwise too ill to travel
- The history and examination are well-established: there is simply a need for more diagnostic or therapeutic suggestions
- The diagnosis is known and specific treatment options are requested
In such situations, remote consultation can be done with the help of health workers or junior doctors. A big opportunity is in facilitating remote consultation with expert doctors across the world. A person sitting in Nigeria can get expert advice from a doctor in New York at a faction of the cost of physical visit. A pilot program is being run in Southern Ghana to bridge the gap between doctors in under served regions with local shortages of medical expertise and medical specialists worldwide. This pilot is being run on computers but similar services can now be piloted on mobile phones as well. McKinsey estimates that remote consultation on mobiles itself can be a $10 billion opportunity.
4. Remote Monitoring: Recently, I came across a blood sugar monitoring service by the name of MyGlucoHealth which has an app that enables users to transmit blood glucose testing results from a MyGlucoHealth Wireless meter through the user’s mobile phone (using bluetooth) to a personal health record. Patients can also review their most recent blood sugar test results, view line charts, pie charts and histograms, as well as enter, fitness, weight, exercise and nutritional data. The beauty of the product is that any family member can monitor the progress of the patient. This application is again attempting to not only provide the health record but also giving the opportunity to family members to view the report and monitor the progress. Most of the downloads of this application are from US, India, Saudi Arabia and Latin America. There are similar opportunities waiting for entrepreneurs to take benefit of the $50 billion opportunity.
5. Diagnostics: Mobile phone is a good example of integrating features from other industries e.g. camera, radio, torch, etc. However, no widespread attempt has been made to convert the mobile phone itself into a diagnostic instrument. Recently, I read about researchers in Uppsala, Sweden, who are developing a portable laboratory that enables mobile phone users to conduct a quick and accurate analysis of blood samples. A disposable microfluidic chip that is able to analyse blood samples and thereby identify inflammatory conditions, the need for antibiotics and the risk of heart disease. If true, this coupled with remote consultation can be a real boon for people living in remote areas. Even people in urban areas and developed countries can benefit from cheaper and convenient method of diagnostics.
Health Monitoring services may include a SIM embedded biosensor watch that monitors vitals, and is connected to the emergency services. Such services can send automatic alerts if there is something wrong in any of the key vitals.
6. Emergency Services: Communication and alerts are the best tools to fight any disaster or emergency. Mobile phones have proved to be handy in disasters such as Tsunami in South Asia or earthquake in Haiti. US and now Europe are attempting to use location based services for emergency services and response. Mobile towers are used to provide the location of the emergency. In Haiti, over $1.5 million were collected by using mobile donations and immediately after the earthquake, Ushahidi helped prioritize the locations which were in need of help. Ushahidi is an open source project that allows users to share information during crises. People can share information over the web or using mobile phones.
7. Helplines: Helpline typically consists of a specific phone number which any individual is able to call to gain access to a range of medical services. These include phone consultations, counseling, service complaints, and information on facilities, drugs, equipment, and/or available mobile health clinics. Helplines are available in many countries though the scope varies a lot. In many countries, the helplines are run by governments and NGOs but now even the private companies and operators are waking up to the potential of helplines.
The mHealth opportunity is huge but it would need close cooperation between mobile operators, handset vendors, hospitals, medical device manufacturers, health insurance companies and the Government authorities. Many operators like Vodafone, O2, Bharti, etc. have already formed health verticals within their organizations to exploit the mHealth opportunity. However, I would caution the operators against treating mHealth as another value added services as this would require a lot of support from doctors and health workers. There needs to an ecosystem that needs to be created for mHealth which would be distinct from the mobile ecosystem. With opportunities like mHealth, I am sure that there is a lot of steam still left in the telecom space and we have only scratched the surface of the opportunities.
Alison Bloch, m-Health Advisor at GSM Association, Talks About m-Health Alliance
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