DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
The Convergence of mHealth:A Consumer and Clinical
PerspectiveApril 12, 2015Ahmed Albaiti CEO, Medullan
Conflict of Interest
Ahmed Albaiti, CEO, Medullan Inc.
Has no real or apparent conflicts of interest to report.
© HIMSS 2015
Learning Objectives
• Assess the current landscape of mHealth
• Illustrate the roles of consumers and patients
• Define the current issues
The “formal” definition…
“Medical and Public Health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices.
mHealth involves the use of voice and short messaging service (SMS) as well as more complex functionalities such as 3G systems, global positioning systems (GPS), and Bluetooth technology”
Source: The Global Observatory for eHealth within the World Health Organization (WHO)
Mobile Health Apps - Functionality
46,389Healthcare & Fitness or Medical
23,682“Genuine” Healthcare & Medical
Multi-FunctionalityIndividual Functionality
Source: IMS Institute Patient Apps for Improved Healthcare October 2013
Mobile Health Apps – Therapy Areas
8.786Prevention / Healthy Living
304Symptomatic / Self-Diagnosis
931Finding a Physician
562Education Post-Diagnosis
200Filling Prescription
225Compliance
Source: IMS Institute Patient Apps for Improved Healthcare October 2013
Mobile Health Apps – Audiences
8.786Prevention / Healthy Living
304Symptomatic / Self-Diagnosis
931Finding a Physician
562Education Post-Diagnosis
200Filling Prescription
225Compliance
Source: IMS Institute Patient Apps for Improved Healthcare October 2013
37:06
35:40
33:57
25:26
21:21
Source: Nielsen, Statista Q42013
Mobile Health Apps - Hurdles
• Dizzying choice of apps without an easy way to navigate
• Demographic skew of smartphone users: patient populations most in need aren’t serviced
• Lower potential ROI
• FDA approval process lengthens gestation period of app launch > e.g. WellDoc and AgaMatrix
• Physicians wary of prescribing apps• Lack of efficacy data to filter apps• Lack of infrastructure to prescribe• Patient Privacy concerns• Legal and reimbursement incentives
Mobile Health Apps – managing the explosion
Managed app storese.g. VA App Store, NHS
App Library
Most tightly managed, least “open” and slowest to grow
Commercial app “catalog” products
e.g. HealthTap, Happtique
Self-certification process with self-
reported test results
Most growth potential, least
trusted presently
Darkest horse, most potential
Wearables – devices to ingestibles
Source: The Future of Biosensing Wearables, by RockHealth
The world's first wireless wearable heart rate monitor, the Polar Sport Tester PE 2000, was launched in 1982!
Wearables - Hurdles
• Confusion of choices with no easy way to navigate
• Utility over time: here today, gone tomorrow
• Few wearables have the functionality and the reliability expected by the healthcare business and clinical communities
• Even fewer have the convenience and smart feedback loops (software, clinician engagement) to impact behavior change and outcomes
Connected devices – applications for all settings
At the Hospitale.g. Capsule Tech
In the Homee.g. CliniColud
On the Goe.g. AliveCor
Connected devices – more momentum?
• More clinical (vs. lifestyle) focus
• Biosensor cost structure dropping precipitously
• More clinically mature incumbents and start ups - lots of experience with existing, non-connected devices is transferring
• Already targeting all contexts : in the hospital, in the home and on the go
What can we expect from Health IoT?
From:
App computing Cloud computing
Biosensors Smart, connected devices
Predictive analytics Prescriptive analytics
Health IoT : Prescriptive analytics
“in context” prediction that includes evidence, and
interpretation and recommended actions for each predicted outcome
linked to clinical priorities and measurable events, such as cost effectiveness, clinical
protocols, or patient outcomes
What are patients’ needs and wants?
Sources: McKinsey Digital Patient Survey, Manhattan Research, ComScore, MaKovsky Health
86%of the general population is
online for health information 75%
of patients would like to use digital
healthcare services
20%of all patients
state that mobile is essential for managing their
care
39%of MS patients
state that mobile is essential for managing their
care
32%of diabetes patients state that mobile is
essential for managing their
care
What’s most important to patients?
Core features patients expect from their health system are surprisingly mundane: efficiency, better access to information, integration with other channels, and the availability of a real
person if the digital service doesn’t give them what they need”
Sources: McKinsey Digital Patient Survey, Manhattan Research, ComScore, MaKovsky Health
Mobile versus the demographics
Sources: McKinsey Digital Patient Survey, Manhattan Research, ComScore, MaKovsky Health
70%of patients (50 years or older)
want to use digital healthcare
services 2xmore millenials (vs. those 66 years or older) are likely to use a mobile app to manage their
health
51%of baby boomers
have never downloaded an
app
Mobile vs wearables adoptionWearable awareness is high, adoption is low
If Pebble smartwatch, a relatively unknown brand funded on Kickstarter, already holds the #2 ownership spot after FitBit …
Sources: Manhattan Research, ComScore, MaKovsky Health
72%of consumers own
a smartphone
79%are willing to
use a wearable
…imagine what the Apple Watch will do?
Smartphones are no threat to wearables
Smartphones won’t cannibalize wearables. It’s simple – they are too big. Average screen size has gone from 2.59” to 4.86” in the last 7 years
Sources: Manhattan Research, ComScore, MaKovsky Health
23%don’t see the
benefit
48%not interested
54%too expensive
The real barriers to wearable adoption are utility, price, and convenience
What will get traction with clinicians?
Sources: Chilmark Research, Manhattan Research, HIMSS Analytics
• Communication capabilities
• Voice, video, text, and e-mail
• Informational resources• Guidelines, Literature,
References• Hospital information
systems• EHRs, EMRs, CDSSs,
and PACSs, LIMs• Clinical software
applications• Disease Diagnosis
Aids, Medical Calculators
Anecdotal evidence reveals gaps
Source: Medullan Research
63%don’t use apps as part of their work
35%use their own personal
mobile device
60%don’t have or not aware
of mobile EH/MR
Consumers vs. vendors are driving adoption
Sources: Medullan Research, Chilmark Research
HCOs are still doing the bare minimum when it comes to digital interactions with patients.
Most [vendor] deployed patient portals today have limited or no mobile-friendly patient tools (beyond mobile-optimized browsers) or advanced care planning applications.
75%find the data that
wearablesprovide to be
useful
9%have patients that bring wearables
with them to consults
Health IoT : headwinds for adoption
• Ownership, privacy and portability of patient data • Serious ramifications described by the New Deal on data
• Lack of certification and measurement of outcomes for heath mobile apps in any consistent manner
• Clinician cost and incentives/reimbursement for use of apps, connected devices, or wearables
• Supplier middling on delivering clinical software that drives patient engagement
Fast forward : can Health IoT change the future of Health Care?
“Flying makes me a better healthcare companion!”
Other industry disruptors have emerged
By focusing relentlessly on
customer satisfaction, not margins, Amazon is turning retail into a
subscription-likerelationship…
By connecting riders with transport (and other
riders), Uber redefines what personal transport should cost – everyday, every hour, everywhere
(soon)...
By connecting consumers, home
devices, and energy companies – Nest is
driving a focus on energy usage outcomes…
We don’t just need the Internet of Things.We need the Internet of the Right Things!”
- John Driscoll, CEO, CareCentrix‘‘
Where will Health IoT disruption emerge?
Knowing who patients really are…
Knowing when + where your patients are…
Knowing what really matters…
Prescriptive Analytics: Interventions, Decision Support,
Mobility: Phones, Tablets, Watches, TVs, etc etc.
Data: Connected Devices, ODLs, Genomics
Empowered patient self-
management
Informed shared-decision moments
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