GSMA / PwC Connected Health Predictions

GSMA, a global representative body of the mobile carriers, and PwC (India offices) releases a new report outlining the potential impact of our increasing connectivity. The report is broken down into education, automotive (transport), and health. The report is global in focus, so not everything is relevant for US or European markets, but it’s quite a good read nonetheless.

The report is not just talking about mobile phones, but all connected devices (TVs, glucometers, etc.) It predicts that those connected devices will outnumber mobile phones in the coming years with an expected 10 billion devices by 2017. Just think, 10 billion potential sources of gobs of big data. It’s also a wonderful thing for carriers as they will have more active, revenue-generating devices than the total number of people on the planet.

The report’s main findings for the potential of mHealth are deaths prevented and costs saved. For deaths prevented, the focus is all on global health, mostly in Africa. The report states that mHealth has the potential to save 1 million lives over the next five years.

How does mHealth have such a tremendous impact, according to GSMA? Simple — mHealth programs should be created that target specific conditions and events such as TB, HIV, and pregnancy-related conditions with SMS reminders, targeted educational messaging, mobile clinical decision support to front-line workers, and proactive monitoring of medication stock levels using mobile devices.

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These things seem simple enough to do, and I bet most of the mobile carrier members of GSMA agree. And the motivation of saving 1 million lives seems clear as well. I’ve written about global mHealth and hope some of what the report outlines comes to bear. The carriers — and GSMA by extension — have lots of motivation, as mHealth program funders pay carriers for the messages and data used, though I imagine there are discounts for health programs and public funders like the Clinton Foundation.

Scaling health system capacity in places like Africa is really what technology and mHealth are meant to do. Carriers are probably the best organizations to help health systems scale in Africa as mobile connectivity is one of the few things that can be counted on in that region. Additionally, trained medical professionals are not available in many parts of these countries, though some new novel models of training community health volunteers and rural retail health franchises are emerging.

That said, technology remains essential to scaling health. Bolting on SMS reminders for HIV patients or text education to new and expectant moms aren’t a panacea, but they do have the potential for huge impact. Just like in the US, these programs are dependent on integration with existing health services (HIV and TB treatment programs, pre-natal programs, health workers, rural retail health clinics). And just like in the US, there are layers between the health delivery organizations and the funders, though my impression is that these layers are better aligned internationally than in the US. Ideally connected health models would emerge that would be self-sustaining, but as in the US, some degree of pubic funding in health is essential and is here to stay.

The second major argument in the report about connected health, the cost argument, applies to OECD countries. The OECD is made up of most or maybe all of what are considered developed countries, the US included. The report predicts that OECD counties could save $400 billion (with a "b") in healthcare costs by 2017 with the widespread application of connected and mobile health. The report is only stating the potential of mobile health as a best case and not necessarily what is likely to happen.

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That savings in the report come from several areas:

  • Remote consultation to curb the costs of acute care for chronic disease patients.
  • Acute care triage.
  • SMS appointment reminders.
  • Mobile access to EHR data. I’m not sure I buy this one, that finds that organizations can reduce admin burden by 20-30 percent with mobile EHR access.
  • Remote monitoring, and I assume aging in place technologies.

The pilots that the report cites are international in nature (European) and my bet is the programs are part of integrated systems that are rewarded for reducing cost (i.e. minimizing episodic, acute care). Incentives are a little different in the US, at least if you’re talking about system-wide incentives and not pockets. SMS appointment reminders as an exception seem to offer ROI for providers as fewer no-shows mean more revenue.

Suspending reality and assuming you could align incentives, what do you think of the findings? I have no idea about the specific savings, but I’m sure they’re significant if you can prevent acute visits, remotely monitor patients, and conduct virtual visits.

The next question is, what it would take to actually create some of these solutions at scale? It’s not a simple matter of technology. It’s about acceptance and adoption by both the providers and the patients. It’s about fitting connected health into a broader health delivery system. I think those challenges are closely aligned with incentives, and once the proper incentives are in place, connected and virtual health will find its place with both patients and providers.

TGphoto 

Travis Good is an MD/MBA involved with health IT startups. More about me.

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