From commercialisation of health apps, to reaching an increasingly wideraudience, connectivity is now driving various innovative models in healthcare.A sneak peek into the world of dynamics of connectivity By Shally Makin, ENN.
Vishal Gupta, Vice President and GM, Global
Healthcare Solutions, Cisco
The booming mHealth marketwill grow to USD 26 billion by2017, reaching a worldwidemarket of 1.7 billion userslooking to use their smart phones andtablets to take care of their health. Currently,there are about 97,000 mobilehealth applications available from anumber of different application stores,with 15 percent of them dedicated tomedical professionals instead of patientsand popular consumers as predictedby a new study by Research-2Guidance.
With more and more traditionalhealthcare providers joining the mobileapplications market, the business modelswill broaden to include healthcareservices, sensor and advertising anddrug sales revenues. However, as smartphones become ever more powerful andtablets saturate the landscape, revenuefrom the mobile market will continue toincrease. The study predicts that up to84 percent of revenue will not come frompaid downloads, but from extra equipmentsuch as sensors and monitoringdevices that patients and providers willlink to their phones and tablets. Developersare already exploring wearabledevices such as wristbands and sensorsthat use bluetooth to upload data suchas heart rate, temperature, and bloodglucose to a cloud repository.
In richer countries, meanwhile,money is pouring into mobile health.The main aim is to let people with chronicillnesses better manage their conditionsday-to-day and reduce time spentin hospital. According to PwC, by 2017mobile health services could save USD400 billion a year out of a total annualhealth expenditure of USD six trillionin the leading industrialised nations ofthe OECD. Several smartphones now offerapplications that link with diagnostictools, for example to perform urineanalysis or check the blood sugar levelsof people with diabetes. GlucoDock,which connects to an iPhone, allows diabeticsto check their blood sugar levelsbefore and after eating.
Latest solutions introducedMobility is here to stay and accordingto economists, the number of mobilesubscriptions exceeded the number offixed line connections for the first timeand there is estimated to be over sixbillion mobile subscriptions today forvoice and data services. Given the veryadoption of mobile devices like tabletsand smart phones, it is natural thatthey will play a key role when it comesto mhealth since they are ubiquitous.At Cisco, we are looking to supportmobility across all our key solutions sothat we give more choices to our customersand users. There are three keymobile health solutions from Cisco:
Mobile Tele-health which we supportvia Cisco Health Presence. Here,Cisco has a unique technology calledJabber which can run on Iphone, IPADs,and in a couple of months also onandroid phones and android tablets inaddition to running on desktops andvarious operating systems.
Work Your Way via BYOD Aspart of our suite of offerings for asmart hospital; Cisco has releasedvery exciting technology called CiscoBYOD (Bring Your Own Device). Thisallows a healthcare company to givechoices to their patients and clinicianson any phone to use and anylaptop or desktop to use while stillmaintaining control of what informationand application can be accessedby whom and enable the enforcementof policies without actually the devicesbeing supplied by the company.
Healthcare Service ExchangePlatform (SxP) will be released inJune 2013 and is in pilots today. Thisplatform will enable any processwithin healthcare to be supported viaa cloud and here again, the cliniciansand patients can access the data totheir work on any device which willbe supported via advanced security,role based access, and supportinghealthcare standards like IHE.
Accountability is crucial
There were 30 billion applicationsdownloaded on mobile devices lastyear alone and we believe at least5fivepercent of those were for healthcareand so you are looking at oneand a half billion mobile healthcareapplications downloaded. In healthcare,it can be sometimes harder toget objective information on providersto enable the decisions from consumersand hospital administratorsto be more objective. In all our threemhealth offerings, we support deepanalytics and reporting for easier determinationof metrics at individualdoctor level which can in turn driveaccountability. We have thus doneover 28,000 speciality consultationsin one year alone just for 20 primaryhealth centers though our target wasonly 1000 speciality consults.
mHEALTHA Mammoth Just Born!
Dr Pankaj Gupta,
Partner, Taurus Glocal Consulting
I think we are at an inflection pointwhere the large HIS/EMR/RIS/PACSclient-server products could just die
out and be replaced by apps on thecloud. We are entering an era of appsto capture small data which collectivelybecomes big data on the cloud!Lots of apps are being offered onthe mobile/tablet for – appointments,EMR, CDM etc. As for now, mHealth isfledgling with maybe under 10 percentshare of the total Healthcare-IT marketin India (~ USD 500M per year).
New technology is heading towardsa connected healthcare ecosystemwhere all stakeholders can monitoreach other based on published keyperformance indicators and dashboard.Soon there will be a rating enginefor doctors and patients will haveoptions to go to 3 star or 5 star rateddoctor. Old guard has to adapt to newtechnology or quit the bastion. Onlyproviders who adopt cloud technologywill survive this onslought. We are enteringan era of connected healthcareecosystem that will be connected byapps and cloud.
BV Natesh,
Director Emerging Market Services at Nokia
Since launch, the service has beenexperienced by more than 50 millionpeople across India. With the rapidgrowth of mobile penetration, campaignssuch as mDiabetes havethe potential to reach millions ofpeople, helping build awareness
There are applications, whichworks with android-powered phonesand links via a wireless bluetoothconnection to a device that can checkblood pressure, pulse, cholesterol levelsand a patients weight, all of whichcan be relayed to medical staff. Forthose who want to lose weight, thereare applications that allow users tocount calories by selecting photos ofvarious foods and discover how mucheffort it would take to lose them.
Novartis has added two more mobileapps to its existing constellationof digital offerings. This time, cancerpatients are the beneficiaries. TheSwiss drugmaker rolled out an app tohelp oncology patients find appropriateclinical trials and an app specifically
for patients with neuroendocrinetumors (NET).
The app for NET patients is a sortof disease-management app thats increasinglycommon in the diabetes fieldbut less so in cancer. NET Manager isa full-fledged app that allows patientsto log their symptoms, set remindersfor treatment appointments and drugrefills, and track their test results. Sanofirecently launched a text-basedprogram for men with prostate cancerto push lifestyle tips and coping techniquesto patients on chemo.
Arogya World and Nokia Indiahave enrolled one million people intomDiabetes, the groundbreaking dia-betes prevention mHealth initiativestarted in January 2012, in India. Aspart of mDiabetes, an ongoing ClintonGlobal Initiative (CGI) send alertsin 12 regional languages, informingNokia mobile phone users in Indiaabout diabetes and its prevention withlifestyle changes. It is also estimatedthat more than 70,000 consumershave completed the six-month program,having received free-of-chargemDiabetes alerts twice a week. Todate,Nokia Life services coveringtopics such as health, education andagriculture have been experienced bymore than 95 million people across India,China, Indonesia and Nigeria.
Dr Sandhya Ramalingam,
Head, Program uation, Arogya World
We are encouraged by the positiveconsumer feedback we have received forour alerts to date. If effective, mDiabetes willadd to the evidence base for mHealth andbecome the cornerstone of a chronic diseaseprevention model for the developing world
To cater to the growing numberof elderly people living alone in urbancities, a personalised telecare servicewhich helps senior citizens to managetheir health and safety while stayingconnected with family is also launchedin the market. HelpSOS offers serviceslike medication and doctor appointmentreminders as well as informingthe family of an elderly living alone in
case of an emergency through automatedcalls, SMS or email on a daily basis.Once you have registered with HelpSOSwith the details, an exclusive numberwould be provided to the person whichhe can use to avail the service. Thisservice is present across India in 11
regional languages as well as English.The services are offered under three categories, health reminders; whichinclude medication, vaccination anddoctor appointment reminders.
Carecalls, under which the elderly remainconnected with their family members,offer an automated call, daily requestsconfirmation of the seniors well-beingand notifying the family if the person isunwell or does not respond to the calls.The third is the emergency notification,which allows a senior to notify multiplefamily members when an unexpectedevent occurs anywhere, anytime. Accordingto HelpAge India, an estimated100 million elderly live in India and by2025, 40 percent of the population, over75, is likely to live alone and thereforethere is need to focus on the needs ofthe urban elderly.
Its often the only device they canaccess; an SMS text information campaigncan significantly improve theimpact and efficiency of organisationsdisease prevention programmes. Inmaternal, newborn and child health,we are witnessing the game-changingeffects that mobile technology has tooffer through services such as pregnancyand birth registries, immunisationand nutrition tracking. Theseservices could prove useful in sub-SaharanAfrica for instance, where morethan 1.2 million newborns die eachyear and one in nine children do notreach the age of five, according to thereport by GSMA and PwC.But the financing of mobilehealth in the developing world is stilluncertain.The question of financialsustainability and ultimately whopays? poses persistent challenges in
this sector.
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