Chilmark Research: mHealth Adoption for Provider–Patient Engagement

The announcement of the latest report from John Moore at Chilmark Research states “the market is abuzz about all things mHealth” and that there is a potential market valued at more than “$1.1B by 2017″ (which is a nice update from John’s 2010 “is it a market” judgement but conflicts with my opinion that it exceeded this many moons ago due to the important contribution it’s made to adoption of the newest Trillion $ industry).

I had some thoughts on the post announcing the availability of the report:

a lot of the current hype will overinflate expectations of impatient technology investors foraying into this unfamiliar space, greatly increasing the potential for high rates of failure as these investors pull the plug on their young prospects

This is something I hear a lot of undue concern about. If you believed it you’d think there are naive investors out there jostling shoulders to fund the next bit of code with a mHealth tag that a Silicon Valley app developer can punch out. I think the reality is very different and that it’s just a natural outcome of an aging tech investor community that there’s an increasing interest in opportunities that leverage the newest mass media to radically transform the bloated reactive sickcare industry.

Is it a recipe for disaster? Probably not because every one of us is actually very good and experienced at being customers of healthcare services (aka patients). John himself proves this in the post where he states:

We even wrote a piece recently about a personal experience using the iTriage app to self-diagnose E. Coli poisoning

As you can see in John’s glowing write up of the iTriage service (to save you the jump this free app possibly saved his fathers life) we’re much better at evaluating the value of this type of innovation than we are at say appraising the opportunity in a new medical device, technique or pharmaceutical target which will be bought initially by people who have very different objectives and needs from us (eg. will this enable me to bill an insurer for more?).

For the report, we started with the definition of mHealth from the WHO report mHealth, New Horizons for Health Through Mobile Technologies, published in 2011: “…mHealth or mobile health is medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants and other wireless devices”. We then narrowed the scope to those offerings that went beyond mere monitoring and are truly engaging care providers in more continuous, patient-centered care

It always amazes me that people can be so accepting of a definition that is so obviously wrong just because there is some assumed authority of its author. When did you last see/use a PDA? I get that Americans sometimes call the “mobile industry” the “wireless industry” but what’s a wireless device in 2012? Is my reflex hammer a wireless device?

To me the healthcare world needs to quickly realise that mobile is not a device but a completely new mass media. As we go forward to the time frames that this report projects to (2017) we’ll increasingly see many of the healthcare opportunities aren’t even going to originate from the device in our hands but from the analysis of the data that is already being created by the smart networks that continually track and monitor these devices.

Limiting it to medical and public health practice is already futile as in many cases the really exciting bits don’t even look like healthcare eg. the inbox screen protector AT&T supply on their texter focused devices:

What we found should surprise no one that follows this market: there is almost no current market demand for such solutions, and offerings today remain in perpetual pilot stage

In my opinion this statement is a natural consequence of not having an adequate definition of mHealth. If Johns’ right and there is “no current market demand” imagine there was a car crash outside your window right now and then ask yourself the following question:

What would be the first thing you’d think of grabbing?

If you don’t think calling 911 = mHealth then go and talk to a Emergency Service Call Handler because across the world they and the response teams they manage will be using a wide variety of mobile technology to enable the delivery of this life saving service including caller ID, LBS’s, wireless data, video calling, digital pen/paper, etc to manage and deliver the services they offer.

Unfortunately for readers of the report “offerings today remain in perpetual pilot stage” probably suggests there’s not going to be a mention of the massive mHealth success stories that are already being shared widely eg. the million plus patients in the USA that have used KP’s mHealth service in it’s first month of availability.

I fail to see how anyone could consider a million patients using a new digital service on their mobile phone to be a pilot and KP obviously don’t think so either – they recently announced that they would be the worlds first major healthcare brand to adopt a Mobile First approach going forward.

Would I buy the report?

Despite all the above, I’m a very big fan of Chilmark Research and it has a great reputation for quality insights into the US healthcare IT market and I have no doubt this presents lots of value to anyone considering targeting this market. US Telcos (eg. AT&T mHealth) are directly targeting this market and have great appetite of mHealth start ups that can show they add value (eg. their multimillion $ deal with WellDoc Inc) so it’s not hard to see how you’ll get value for money for your $’s by gaining these indepth market insights and knowledge of potential customers.

3 Responses to Chilmark Research: mHealth Adoption for Provider–Patient Engagement

  1. John says:

    Thanks for providing a brief review of our announcement re the mHealth Rpt. Now for some clarification:
    The use of mHealth Apps for care provisioning is in perpetual pilot stage. Apps such as KPs, mPHR, MyChart are seeing wide adoption and are being driven by marketing initiatives. There has not been a broad roll-out anywhere in the US of an mHealth App for care provisioning/care mgmt purposes.
    We use the WHO definition as it is arguably the most clear cut we have seen for we did not want to go down the road of sensors, eg fitbit, etc., that every other analyst seems to have gone down to rpt big numbers. As to your comment re PDAs, is not an Apple Touch with a data plan a PDA? This is why we left that in there.
    We still find many an investor in healthcare IT not fully cognizant of the challenges to adoption in this market. Therefore, we caution that there may indeed be a backlash. Yes, there are some savvy investors as well, but right now there is also a tremendous amount of overblown hype. We don’t like hype.

    Thanks again for giving your perspective and hopefully the clarificiations above provide a clearer picture of this rpt.

    Cheers,
    John

  2. Hi John,

    Thanks for the feedback:

    “There has not been a broad roll-out anywhere in the US of an mHealth App for care provisioning/care mgmt purposes”

    OK I’m not for the “App” term as I think in terms of “Services”. In healthcare this is important as we don’t want siloed apps we want coordinated services.

    Broad roll out can be found at KP where they:

    a) are now prioritising mobile and rolling upgrades out to their mobile website FIRST:

    http://mhealthinsight.com/2012/05/31/kaiser-permanente-now-operating-on-the-mobile-first-strategy-thats-put-google-in-pole-position/

    b) have had more than 11% of patients engaging with their mobile service in it’s first month of operation:

    http://mhealthinsight.com/2012/02/24/zero-to-one-million-in-one-month-is-kps-mhealth-initiative-the-fastest-ever-adoption-of-digital-health-services-in-history/

    For perspective compare this to the colossal failure of the NHS’s expensive and now shelved HealthSpace (a “free, secure online personal health organiser”) that was designed to be used via a PC (it was used by only 0.13% of ELIGIBLE – not total – patients over 3 years):

    http://www.bmj.com/content/341/bmj.c5814

    “We use the WHO definition as it is arguably the most clear cut we have seen for we did not want to go down the road of sensors, eg fitbit, etc., that every other analyst seems to have gone down to rpt big numbers”

    I’ve written yet another post criticising the use of this definition just today:

    http://mhealthinsight.com/2012/06/07/mhealth-is-not-a-subset-of-ehealth-even-if-wikipedia-the-who-and-gsma-claim-it-is/

    “As to your comment re PDAs, is not an Apple Touch with a data plan a PDA? This is why we left that in there”

    Definitely not. The Apple Touch device would not exist or have any market success if there wasn’t a mobile counterpart. Apple have been smart to expand their mobile device to create this new device but Apple is now a mobile company and the device and service it offers (including apps) only exist because of Apples mobile R&D/Investments/ecosystem.

    Don’t worry too much about this grey area even Facebook’s Mark Zuckerberg initially failed to see the mobile opportunity in these new devices from Apple:

    http://mashable.com/2010/11/03/mark-zuckerberg-the-ipad-isnt-mobile/

    “We still find many an investor in healthcare IT not fully cognizant of the challenges to adoption in this market. Therefore, we caution that there may indeed be a backlash. Yes, there are some savvy investors as well, but right now there is also a tremendous amount of overblown hype. We don’t like hype”

    I don’t think it’s going to happen as the speed of connectivity and discussion we have today will act to quickly dampen hype and inflated claims while empowering the voices of patients and providers.

    “Thanks again for giving your perspective and hopefully the clarificiations above provide a clearer picture of this rpt.”

    Thanks for your visit and sharing these different points of view, I only wish I could justify the expenditure for the report (perhaps I’ll convince a client to buy it) so I could consider your analysis in more depth.

  3. [...] followed a classic “Is mHealth a Market?, Is there too much hype?, If we can’t beat them let’s join them!” realisation process that I’m [...]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

Follow

Get every new post delivered to your Inbox.

Join 129 other followers

%d bloggers like this: