I spent a good part of the last week at the mHealth Summit in Washington learning how mobile technologies (cell phones and the like) are reshaping healthcare. If you have a smartphone, this won’t be news to you. I feel like there is an app for most everything health-related now. You can be sure that every pound lost, mile run, and health question asked can be recorded, tracked, and answered through your cell phone. The wave of health apps isn’t just for consumers though; clinicians are also part of this trend and are changing the way they practice medicine. For example, the app MIM allows a radiologist the ability to use an iPhone to take, store, and share an x-ray in any environment.
Some of the most exciting innovations are happening at organizational and system levels. In conjunction with the Summit, the trade association HIMSS provided a roadmap for the industry (one of our own HealthFlock’s own blogger Marcus Gordon was a contributor). When looking at the care models being developed today as result of the Affordable Care Act and other industry trends, mobile technologies are helping us drive to a more integrated and accessible health system. For example, more and more hospitals are using cell phones and other devices to monitor and track their patients, particularly those with chronic diseases. At the same time, they are collecting rich data from those patients to mine for trends and opportunities to advance evidence-based medicine and reduce overall costs.
Even though so much of the “mHealth” conversation has centered on the U.S. market, compelling work in mobile health is also transforming global markets, particularly for the poor. While the Intels and Verizons of the world are publicizing their advances in the U.S., there is a quiet revolution occurring in the poorest countries. Today, three of four people in the world have access to mobile phones. In fact, approximately 1 billion women in low and middle income countries own mobile phones. From my experience in the field and running a nonprofit focused on mobile health, I highlighted three major trends that I thought would shape the industry, particularly outside the U.S., in 2013:
1. Cheap technology can provide a higher return on investment than the latest innovation: Most of the buzz (and capital) is typically given to the latest and greatest technology. However, cheap technology can sometimes provide a similar, if not greater, impact on local communities. In an ongoing pilot in Kenya, for example, two nonprofits Kilifi Kids and Medic Mobile have outfitted hospital staff with “dumb” phones to improve communication with local health facilities using text messages to fight malnutrition and decrease child mortality rates. By focusing on simple and cheap technologies, adoption rates have soured and local communities have become more invested in solving difficult problems rather than showcasing their new tools to their neighbors.
2. A one-size-fits-all mHealth solution is not likely the best answer: With the emergence of any new industry, there is uncertainty on how its actors will function and collaborate to advance the field. In the US, we have seen a few industry leaders in the electronic health records (EHR) space capture significant market share through a comprehensive solution. Outside the US in the mHealth space, we have seen the reverse: a specialization of services. For example, D-Tree has focused its services on care protocols, DataDyne on disaster response, and Dimagi on communication. Next year, expect further specialization of products and services. Data though needs to be interoperable and for any system to deposit and exchange it.
3. Scale can’t be achieved without some kind of viable financial model: The technology already exists today that could halve child mortality rates. Why it hasn’t happened in the world yet? An inability to scale and, more specifically, a lack of financing for these innovative trials. What’s promising though is that we have seen some dramatic steps forward around positive returns. For example, the nonprofit Switchboard negotiates with African telecoms to provide free provider calling and then shares in incremental revenues generated from non-clinical calls by the same providers. Expect additional pressure in 2013 from donors and funders to achieve real profits in order to finance mHealth pilots.
It is refreshing to see that so much is happening in the mobile health community not only in the United States but also globally. Advancements in mHealth have equated to gains in universal access and a more integrated care delivery model here and abroad. Expect 2013 to be a banner year for mHealth and the tools that allow us to continually reshape how patients consume health services.