Over the last few weeks there has been a lot of hype regarding mHealth. In late August Deloitte published an Issue Brief: The Mobile Personal Health Record (mPHR) that led to the conclusion that an mPHR will become the “killer app” healthcare app for the consumer. Then we have PWC who released their own report: Healthcare Unwired at the beginning of this week which stated that some 40% of consumers were willing to pay for wireless health solutions. Jane Sarasohn-Kahn did a nice write-up on the PWC report, though Paul McNamara may be closer to the truth on what consumers are really willing to pay for when it comes to mHealth-type solutions. And last, but cettainly not least is the plethora of mHealth conferences. As the fall conference season heats up, seems like one could go to some form of mHealth event every other week from now till Christmas.
As Eric Dishman of Intel points out in an excellent post, part of the problem may be one of definition, part of it al ack of truly trying to understand th market, its needs, the technology currently available to meet those needs and how does that technology become a part of the workflow of traditional care processes, or augment if not disrupt that workflow. Many questions that remain unanswered or poorly answered.
So is there really any justification for all this hype?
Yes and No.
Quite awhile back, when Chilmark first started looking into the mHealth market, we felt that indeed, there truly is something here and that provided the tools were simple enough, the value big enough that mHealth. It was at that time that we coined the term: Health is Mobile. Health does not happen when you are in-front of your laptop or desktop computer, it happens when you are on the move, going to an appointment, picking up a sick child from school, etc. Chilmark agrees with Deloitte that an mPHR like app has incredible potential, however, the lack of personal health information (PHI) in a common, computable digital format, (eg CCD or CCR) is a significant hurdle. There are also the issues of the need for a well-defined, simple to grasp value proposition for the consumer (see previous post) and subsequent business model(s) and a go to market/commercialization strategy that will make mHealth a sustainable success in the market. Not easy hurdles to overcome.
But there is significant change occurring and the rapid acceleration in adoption of smartphones is staggering. Recently, the market research firm IDC upped its 2010 smartphone growth projections from 44% growth to 55%. Then take a look at app sales on Apple’s iTunes. On September 1st Apple stated that 6.5B, yes, that’s BILLION, apps have been downloaded and 120M iOS devices (iTouch, iPhone, iPad) had been sold. This equates to 54apps/device. While many of these apps are for games and productivity tools, there are literally thousands of apps for medical, health and wellness purposes. What is particularly interesting about app download growth is that it is overtaking downloads of music. Maybe Apple needs to start calling iTunes iApps instead.
And then there is the story from Stanford Medical School where new med students this year have been issued an iPad in the hopes of replacing mounds of paper that are typically distributed to students for a course over a semester. The students seem to like it and even one of the doctors is quoted as saying towards the end of the article that the iPad is in an ideal form/function factor for a busy physician.
This may truly be key, for as the PWC report points out, most consumers would prefer to get their mHealth solution from their physician. Thus, if physicians get on-board in using something like the iPad, this could become a virtuous circle. First, the doctor will be able to easily create and update a patient’s record, digitally creating the content (PHI) that a consumer/patient could then use to populate their own mPHR. The physician’s familiarity and use of such technology will also drive a higher comfort level with using such in the process of care coordination and engagement with the consumer, including reviewing data in the consumer’s mPHR that may not have originated from their practice. Likewise, the consumer trusting in their physician and possibly with physician encouragement, will more readily adopt and use such a technology to better monitor and track their health or the health of a loved one.
As Dishman points out in his post, too much is being put under the general rubric of mHealth. A clearer set of definitions are required to make sense of this market for today it is simply a mish-mash of terms extending from telehealth monitoring, which has been around for years, to novel apps on smartphones and the iPad to small, self-monitoring devices such as fitbit or even those devices that are embedded for say cardiovascular monitoring (defibrillator implants). Even PWC in its report, decided against the term mHealth, instead going with Healthcare Unwired to express a more encompassing view of the technology advances/capabilities arriving in the market.
But are we really doing anything breath-takingly new? On the technology front, not really, though the hype will have you think otherwise. Where the new really comes into play is in how will these mHealth/Health Unwired technologies affect the practice of medicine and the the delivery of care?This is where the real revolution will occur. This is where it gets interesting. So let’s not get so ga-ga over the technology, let us cool the hype-cycle and get down to the real business of understanding how these technologies will impact the delivery of care, the cost of care and the models of reimbursement, be it to the consumer, the physician, or the hospital. Now that is something to get hyped up about.
Giving Credit: Thanks to asymco for the great figure charting music vs app sales on iTunes.