More Users in More Places Able to Do More Things

I really enjoy Benedict Evans’ research on technology, especially mobile technology. Evans is up there with Mary Meeker in terms of the quality of the analysis and the breadth of coverage and he posts content regularly on his site.

I was listening to his most recent mobile podcast yesterday. He’s does them from time to time. This one was sponsored by mega-VC Andreessen Horowitz. It’s 16 interesting minutes, or you can read this post that covers the most relevant information in text.

Evans has a way of putting things that click for me. His basic premise goes beyond the numbers for mobile vs. computer. Today there are more smartphones than computers and the number of smartphones will double in the next year, while the number of computers will remain about the same. Those are data points everybody knows.

But the impact of more smartphones than computers is greater the those numbers. Smartphones are always with their user, are more sophisticated (think unique hardware like cameras and sensors), and are easier to use than computers. Those differences compound the effect of mobile on the adoption of new technologies. Evans predicts they will result in 5-10x more Internet use. The best quote from the podcast sums up the power of mobile technology: "More users in more places able to do more things."

That statement sums up the hype of mHealth, or mobile health, or connected health, or whatever you want to call it. It’s the reason many of us have been focused on mobile health.

It’s also the reason flocks of investors, developers, and enterprises are developing mobile strategies and/or products. Mobile devices create more 24/7 connected users with the ability to track, transmit, and receive more information in ways not possible before. In healthcare, the potential of mobile falls largely into two broad buckets – consumer health and provider tools.

Reducing healthcare costs means consumers must take ownership of their health. Khosla may be hyperbolic in some of his statements about tech replacing physicians, but his stance that consumers should be the CEO of their health is a good way to sum up this trend.

Some uniquely mobile capabilities for consumer health:

  • Sending messages to users at all times of day and night. These can be one-way messages, two-way messages, and even intelligent messaging based on some criteria (medication schedule, appointment, or location). They can be custom or generic. They can be motivation or education. But they can reach people 24/7, assuming the user gave you permission.
  • Collecting patient-generated data. This includes manual data entry (pain level, intake form) and passive data collection (steps, mobile activity like, Smartphones have unique capabilities including the camera (derm-specific apps like Goderma) and even sensors for movement (Sway Medical). These capabilities are getting better all the time.
  • Acting as hubs for aggregating data and connectivity. Smartphones can easily aggregate data from multiple devices via direct connections as well as over wireless.

On the provider side, there are the obvious use cases enabled or enhanced by mobile:

  • Provider access to data at the point of care. I don’t care what the data is, it’s easier for a mobile workforce to carry around mobile instead of a cart.
  • Securely messaging other providers. This can be for specialty curbsides or for specific tasks. This is also where pager replacement comes in.
  • Capturing more and higher quality data at the point of care. Cameras and sensors expand what providers can capture and can automate the entry of data, assuming the platforms accepting the data allow it.

The other area where I think mobile will have a huge impact on provider care deliver relates to who is delivering the care. The training and privileges of non-physician providers (RNs, PAs, LNPs, med techs, home care) are expanding all the time. My wife and friends talk about more than most areas of practice, so it’s certainly top of mind. There are good reasons for it — cost and availability as well as political lobbies for each camp (the strongest lobbies are winning). The term “physician extender” is often thrown around, and there are practice models that leverage non-physicians in a pyramid-like model.

Non-physician providers are already doing a lot of direct patient care in the US health system. Mobile devices have the power to help them do more and to be in more places. They can collect and easily transmit more data in real time or batched, expanding reach well beyond the office walls. This is already happening with some forms of telemedicine.

But the more powerful mobile devices get and the more medical devices that utilize mobile devices for data storage and transmission, the more direct patient care non-physician providers will be able to do. This is the area of most immediate impact in health related to what Benedict Evans was discussing in his podcast.

All of these use cases, on both sides, will scale. It’s a matter of time. The timing question is an interesting one, especially from an investor standpoint. Healthcare moves slowly on both the consumer and the provider side and it’s heavily regulated by large public agencies.


Travis Good, MD/MBA, is co-founder of Catalyze. More about me.

  • Mobile Man

    I’ll borrow a phrase from a compadre that’s relevant – “Stop working for the computer and make the computer work for you…” I think that means even more when you put it in the perspective of the above. Great post!

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