From the mHealth Summit 11/10/10

The mHealth Summit finished up today. Today was all large-group sessions, the final one being a debate, with some keynotes mixed in. 

As with most conferences, attendee numbers were down and the air seemed to have been let out of the group. The last three days have shown clearly that this is a fast-moving, fragmented industry which, depending on your perspective, is either on the brink of a tipping point or bubble burst.

The difficulty in putting mHealth into one of these buckets is that mHealth is so many different things, to so many different people, in so many different place and health systems. The talk this week has included such far-reaching subjects as mobile money, decision support, integrated health information systems, SMS for patients and providers, data security and integrity, remote monitoring, business models, open source, wellness programs, and clinical trials.

This conference has been globally focused, with lots of talk of mHealth as a means of “leapfrogging” health systems forward in developing and middle-income countries in Africa, Asia, and South America. On a global level, in both the least-developed and missing-middle countries, the consensus here is that mHealth is essential to overcome the shortfall of over 2 million health workers worldwide. 

The other side of the equation for mHealth is its application in economically developed countries. In this context, the area of focus this week has been on remote monitoring and more broadly remote data collection, which is distinct from the global goal of making mobile phones into remote healthcare facilities. The problem that needs to be solved in the US is figuring out how mHealth augments and integrates into the current delivery paradigm, empowering consumers to make more informed health and wellness decisions.   

As I mentioned in yesterday’s post, every session at the summit seems to come back to some common themes which I think are reflective of the stage of mHealth as a industry. These include:

  • Open Standards / Architecture / Source.  As with most technology debates, the issue of open source, or at least open platforms, came up time and time again. As the moderator from The Economist pointed out to the academics on his panel, successful open source is more the exception than the rule. But good examples of open source in e-health, such as Jembi, OpenMRS, and FrontlineSMS Medic do exist. My opinion is that open source will continue to win in the mHealth space until viable business models emerge, at which time we’ll see the proprietary platforms from the big players take over. 
  • Ability / Readiness to Scale. People seemed to disagree on this point. mHealth pilots, numbering in the thousands based on estimates given this week, are fragmented. Those who said it was time to scale were countered by others that felt we needed to better define the purpose and place of mHealth before thinking about scaling. I think the answer lies somewhere in the middle, as it does seem to be the time to start growing pilots, collecting better evaluation data, and integrating into the larger health system; but, it is also time to better define, and inform decision makers about, mHealth as a viable mode of providing health services. 
  • Sustainable Business Models for mHealth. As I said, this was a hotly contested area at the summit with no good examples given other than Nike Plus. This is an evolving space with the only area of consensus being that there is no one business model for mHealth. Vijay V. Vaitheeswaran at The Economist is supposed to be running a report at the end of this week on the various mHealth business models attempted, with outcomes. 
  • Develop with Customer Needs in Mind. Saying solutions have to be built to meet real needs of customers guaranteed an applause this week and the point is well taken. Let’s start building mobile solutions people (both providers and patients) need to improve performance and health.  
  • Integrate mHealth Solutions into Health Systems. This was a good point that seems obvious, but is not always realized in a market driven by grants and pilot projects. mHealth solutions need to be built to be a part of larger health systems and health information systems if they are going to deliver on their large scale promise.  

No matter where you stand on the hype of mHealth, the one thing that is clear is that mHealth is moving at an extremely fast pace in many different directions. I can’t wait for the 2011 summit to compare notes to see what a difference 12 months makes. Llet’s hope at that time we have some hands go up when the question of “who is actually making money” is posed.

  • Deja Vu All Over Again

    For anyone who attended Web or Internet conferences in the mid-90s, your description of the market is a flashback. mHealth as a separate model does not make a lot of sense, which is why they are having a hard time trying to figure it out.

    Like in the late 90s for eHealth, all those new mHealth corporate groups will be integrated back into the main lines of business. Mobility is just a different (and exciting) way to deliver much more interactive and innovative value for core health care processes. The dot-com bubble experience will keep the fervor in check this time around.

    Having said that, mHealth will have profound changes in US health care over the next five years for the following reasons:

    Our 5-10 year industry technology lag sets up a great deal of potential disruption for mobile components as the current brittle systems start to move towards loosely coupled modular application platforms like in other industries. Many large HIT vendors are about to enter the SAP enterprise model death spiral.

    Historically institutions and “back channel” processes have been the focus, not mobile savvy consumer / patients who are rapidly becoming financially forced to be more engaged in their health.
    Care delivery transformation from payment reform and skill shortages will require fluid care approaches that require mobility, and

    Most care is now done in the home, but will move from routine to chronic disease management due to aging and the obesity explosion.

    Note to bright-eyed entrepreneurs who have not been in the health care industry a long time: the existing HIT vendor mafia has always been much more effective in squashing innovation from disruptive outsiders to maintain the status quo than competitively innovating against each other. If you fashion yourself as David vs. Goliath, make darn sure that God is on your side before you start hurling rocks.

    Therefore, there will be a great deal of opportunity for those niche companies that focus on meeting the needs above by complimenting the old guard entrenched HIT vendor systems, but with an eye towards explosive disruption when they are embedded, delivering value, and the market timing is right.

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