“Don’t immediately believe the mhealth hype – Dave Clifford”

In reply to the publishing of the Pew Internet Mobile Health 2012 report author Susannah Fox has shared an interesting point of view from Dave Clifford, a strategy consultant in Health IT and Science and Tech Policy, who having read the report challenged the conclusions many readers are making.

Of course this isn’t the first time someone’s suggested there’s too much hype in the mHealth app world but it’s well worth a read and gave me several further thoughts I thought it might be worth expanding on (in addition to my shared thoughts on Pew’s 2010 and 2012 Mobile Health reports):

Since 2010, Susannah’s reporting has shown that the number of people downloading health apps onto their smartphones has remained roughly constant

For me this highlights the importance of us understanding what is mHealth. Obviously I disagree with Pew’s definition (eg. that it’s a “health application you download to a smartphone” or a “health related search you make on a mobile browser”) and the speed with which this has run into problems hasn’t surprised me because so many mHealth activities don’t look like healthcare but rather social interactions – which is something I am expecting to see more of eg. when mobile and health truly converge it won’t be called mHealth it will be referred to as Mobile (something I’ve tried to explain in this post: Why we’re more likely to drop the “Health” than the “m” in mHealth).

To give you an example of what I mean consider a healthy citizen looking up “Alzheimer” on their mobile phone because they heard an Auntie or colleague at work has developed this. Now ask yourself do you think it’s likely that they’d even recognise that this was a health related search when called up by a researcher a few weeks later?

In 9 out of 10 instances they probably won’t even recall that they did it, and if reminded that they did they’d probably respond that they “just wanted to know what it might be so it was hardly a health search as they’re not their aunties carer or anything”.

If however you look at in from a Healthcare point of view you’ve managed to achieve access in moments to data that only a few years ago you would of had to go to a Medical School library to discover. Perhaps I’m just too sensitive to the impact of this because I remember how hard it used to be for citizens to get information in those good old days (eg. in 1995 I vividly recall the day an anxious parent begged me at the door of my medical school to help them access our medical library and research a condition that her child was being treated for in the adjacent hospital).

To give you an idea of the impact that I see from low health literacy I recently shared a long haul flight next to a group of non-medical professionals who were travelling with a close friend that they told me had been diagnosed with dementia – and yet they had so little idea what this meant that they had taken to thinking it was funny to tease him about his increasingly frequent memory lapses.

If you want to take the counter argument (that Health searching behaviour isn’t increasing) consider how quickly mobile web search activity is growing and the increasing growth of smartphone ownership amongst seniors (eg. more than half – 53% – of Apple iPhone customers in the USA are aged 35+) as I can’t think of one good reason why health searches would be an exception on a device that’s unshared and always with us.

"Since 2010, Susannah’s reporting has shown that the vast majority of what are considered “health apps” are diet, exercise, and weight loss apps. Of the remainder, there are limited cases of disease management apps, drug adherence apps, or personal health record apps being used. We’re talking about handfuls of people out of thousands of people

This probably explains the confusion. The vast majority of health apps that are used by patients are native apps not ones they have to discover and download. To get an idea of these think of things like SMS appointment reminders (eg. your Doctor or Hospital implements a SMS service and 100% of their patients start using it), pill reminders (eg. you program your calendar/alarm to tell you to take a pill at 8am everyday), a mobile phone you bought for your grandmother to help her stay in touch (please consider doing this – connectivity not only has a massive direct relation to health but it’s key to mHealth reaching it’s potential), etc.

If you must have data to show that the smartphone is being used by patients to find healthcare information look to Kaiser who have taken a mobile first strategy that is setting new benchmarks for patient engagement (is it any surprise they’re already talking with the Pew Research report’s author?).

And that’s without touching things like “frequency of app use.” I can only speak from my inclinations, but the most used “Health App” on my phone is called “Zombies, Run” and it’s a fantastic app that says “Oh no, zombies! Run!” when I’m listening to music on my phone while I’m running. It’s great and it’s the best thing that I use on my phone when I’m running and I think I’ve used it six times. Six times is a lot of times for a user of any given health app, since most people download a “health” app and don’t use it, and very few people use “health” apps more than once. This is even in the broadest category

When it comes to mobile we have to realise that “use” doesn’t mean actively doing something. Most people don’t actually use their mobile any more than a few hours a week but the rest of the time they benefit from being reachable. Being reachable is key to mobile adoption but it’s value is hard to appreciate because we quickly forget we’ve got it (something Tomi Ahonen explained in his “3G Marketing: Communities and Strategic Partnerships” book way back in 2005) and in the healthcare world it is often even more valuable than 2 way communication eg. I can walk to the landline to place a call but I can’t find out my mum’s fallen or even just needs something from the stores if I’m not reachable.

On the flip side, Susannah showed that a large number of people use their smartphone in their healthcare. The majority of smartphone users indicated that they have used their smartphone to search for health information. To me, this seems totally logical. My smartphone has become a secondary brain for me that I can offload factual memory into. It tells me what streets connect where if I’m in a different city, or who that guy was that sang that song that I like, or what time the football game starts and what time the proper football (soccer) game starts. For the most part, it answers these questions via Google, although some people might use Siri to accomplish the same tasks. I use a very, very powerful app for this called ‘Browser’

Great point, after the Nokia Decade most people just uses native apps without thinking. In many cases we don’t even consider them to be software as when an App is native and simply works out of the box we quickly presume it to be “just something a mobile phone does”.

In my opinion it is wrong to discount an app that is used for a health purpose because it is a native app and here are a few examples of this to give you the general idea: the camera you snapped your screensaver image with (remember this is the one that shows you wearing your skinny jeans!), the calender/alarm that reminds you to take your pills, the SMS you send to your daughter on a night out (reminding her to stay safe and let you know if running late), the GPS details that you share with a 911 operator when you make a distress call in an emergency, the Navigation app that you use to find the quickest/safest way home or to map a jog, etc… …these are ALL now native software apps and they are ALL being used routinely for healthcare uses.

On the other side, there are hundreds of health and medical apps that seek to use things that only a smartphone could do in order to advance care. For example, there are a set of apps that claim to cure disease via sound, light, or vibration from a cell phone. These have not been demonstrated to have any benefit at all. There’s also some health apps that tell you if you’re ready for exercise by counting the number of squats a user can do in a minute via the phone’s accelerometer and then asking the user to measure a resting health rate. These are slightly ambitious in their functional claims

Isn’t it obvious this is what happens? Have we forgotten already that when the online health revolution started over a decade ago that it was all very spammy and low value? (largely because the business model back then was created by millions of illegal adverts that do-no-evil capitalised on).

Fast forward to today and no one’s going around saying “stay off the interwebs is full of misleading information”, instead we’ve got well known patient leaders explaining why we need to have the right to access our health information and highlighting the importance that we can turn whoever we want to in order to share and discuss this information.

In 5 years time it will be laughable to suggest that we should have hesitated with mHealth strategies because of the existence of obscure Health Apps on app stores that are practically impossible to find or generate a livelihood from. Instead we’ll see that the creative early adopters will be some of the major victors as the cannibal of cannibals takes chunks out of major medical device, pharma and healthcare brands (just like the carnage we saw the camera phone and Facebook inflict on Kodak).

One of the other interesting findings is the number of users with chronic disease that used a health app on their smartphone. This was only slightly higher among those with chronic disease than those without (21 percent v. 19 percent), but the number of people with chronic disease that went online to look for medical information was lower than those with no chronic conditions (26 percent v. 34 percent.) My guess, if I had to venture one (and without seeing the cross-tabs) is that people with chronic conditions are less likely to have a smart phone to be able to look up health information online (thus the 8 percent gap) but more likely to use a smart phone to manage their wellness (thus the increased use of apps.)

First up I think these stats are likely to be so off the mark it’s hardly worth commenting on them. Unfortunately you can’t determine the existence of a chronic disease by calling a patient up and asking them if they do.

Let’s ignore the statistical reasons why someone with a chronic disease is less likely to be answering the phone in the first place, or to tell an interviewer, and instead look to the clear fact that there are tens of millions of people in the USA who have chronic conditions who don’t think they have got a chronic condition – the sources of good stats for this claim would include the CDC’s National Diabetes Education Program (these indicate that about 10 million citizens in the USA have Diabetes and don’t know it).

Before you make an app, ask yourself “Is the app I want to make essentially a mobile web page? Is the purpose of it to serve information to a consumer on the go?” If yes, there are ways to code your landing page(s) so that they detect the sort of browser being used and provide an optimized experience for a mobile user

I agree that mobile web design is critically important – click here for a good source of information on this. If you really need an app I think you should also think of some ways you can leverage the 8 already discovered attributes of mobile as the newest mass media – as the more of these you can incorporate the richer experience it could offer.

What side of the “Digital Divide” do the consumers you want to target live on? The gap is narrowing but it’s still there. Many individuals with chronic disease are older and have lower incomes, both of which are unfortunately correlated with lower digital literacy and lower smartphone adoption

There is no technology on the planet that’s getting anywhere close to the capacity the mobile has shown itself to have to cross the digital divide. The fact that the world’s biggest mobile brand is going to be bringing mHealth Apps to us as native out-of-the-box experiences should assure anyone that there is no longer a contest – especially when you look back at the history of basic mobile hardware being extended and popular apps going native.

If you want to be the partner for them I’d suggest you get out there and work out how you can create an app and get paid for it because it’s these successful developers who’ll be getting their doors knocked on by Apple and Samsung… (here are some solid stats that support the fact that the most successful smartphone brands are talent scouting in exactly this way).

Does your app take advantage of a feature of the smartphone in a compelling way? Does it use the camera or the microphone or GPS? Could your app be an API that runs off a separate, common media (Twitter, email, SMS)? Would it be simpler to integrate it with a separate “workstream” of day-to-day life than force a separate “workstream” on to a consumer?

Instead of “twitter, email” I’d suggest HealthVault, Patientsknowbest, a bricks and mortar healthcare provider, or remote consulting healthcare professionals (like the service we offer here in the UK/Ireland at 3GDoctor or you can find in the US market through firms like ConsultaDr.com or TelaDoc).

Last, if you’re selling an app that cures a disease or diagnoses a condition from user-entered data that is a very difficult thing to do and seldom supported by rigorous science and the FDA is probably going to scrutinize what it is that you say your app does

I find it odd to hear IT consultants sound paternalistic when they talk of patients incapacity to differentiate the good from the bad so that they come to harm because of some obscure information that you could find on the interwebs, but it’s particularly surprising when you realise that Dave works with PatientsLikeMe – a firm that pledges to patients that it’s a community made up of patients just like them despite it’s full and frank acceptance that many of the patients …aren’t even human.

I don’t personally think low quality content is actually the big challenge as people are more likely to believe/take the advice of a friend (who has no medical training) than that of an obscure health app that has poor/zero ratings and no affiliations with registered Doctors or healthcare brands.

I also think many people underestimate the work the app stores are doing to ensure quality control, the fear developers have of being banned (eg. the AppStore is not like the world wide web you’ve got to play by Apple’s rules), and must be unaware of the many much more significant challenges patients are encountering already as a result of digital advertising techniques that are being used to covertly profile them so they can be set up for some other -seemingly unlinked – scam.

My take away

If you’re concerned about the fact that some 12 year old hackers might be creating bizarre mHealth apps for smartphones that can “tell you if you’re ready for exercise by counting the number of squats a user can do in a minute via the phone’s accelerometer” take comfort in the fact that this is what digital innovation often looks like eg. it’s not totally incomparable to the clumsy FaceMash website made by a Harvard sophomore in 2003.

Instead of worrying get yourself networked with the key leaders in this industry, partner with talent so that you can help them fill gaps (eg. you might find that the kid who has an app monitoring squats has worked out how to accurately identify when a user falls) and learn by doing (launch, measure, improve, rinse, repeat…) and if you’re in any doubt about the direction this is heading reflect on how:

> Seniors are the future of smartphones and the mobile industry and despite their affluence (citizens aged 50+ in western markets own 80% of global wealth) they still represent one of the lowest spending mobile user groups.

> Just as we saw camera technology converge with the Mobile (thanks of course to the mHealth genius that is Philippe Kahn), mHealth apps are going to increasingly converge medical technology and services with the cannibal of cannibals. If you need to see where this is happening read Digital Korea or take a trip to Japan where the majority of senior citizens have smartphones, use mobile data services and millions use native pedometer apps.

15 Responses to “Don’t immediately believe the mhealth hype – Dave Clifford”

  1. Editor says:

    Reblogged this on Health Care Social Media Monitor and commented:
    some interesting points raised in this post

  2. mHealth in the US has become overwhelmingly corporate (especially apps). How do we keep public health as an important piece of the picture and move away from just exercise apps?

    • @Awesomemausam

      In my opinion public health remains a pioneer in the mHealth space and in the USA it’s off to some good starts eg. the work the CTIA, FCC and FEMA have done to put in place the wireless emergency alert system, the recall of the Jitterbugs, etc.

      Of course there’s still a lot to be done but awareness and invested interests in legacy operations are in my opinion the biggest challenges we have – so let’s me sure we do our best to keep the spotlight on what can be achieved.

      • Dave Clifford says:

        I think one of the continued possibilities of using mobile for public health is in the GPS/location-enabled areas. Google has done some interesting proof of principle work on IP addresses attached to searches on flu-like symptoms used to identify “hot spots” or potential outbreak area. Adding location data from mobile phones to that improves the granularity even further.

        Additionally, there’s been some work done by SAMHSA (I believe) about identifying service providing locations through passive alert. Another mHealth tool that’s been raised in the public health sector was a means for a user that had challenges maintaining sobriety to be alerted when they came too close to a bar. Not sure what adoption rates are like here, but again, I think there are interesting inflection points.

  3. Dave Clifford says:

    HI,

    Thanks for your thoughtful reply. I’d like to address a few of the points that you made because I think dialogue is important and I think because our disagreements are mainly differences in perspective.

    From the bottom to the top:

    1) I’m not sure what’s paternalistic about noting that the FDA may scrutinize an app developed that makes a claim. If your takeaway is that my perspective here is one where patients cannot distinguish good science from bad science and therefore they need regulators to shield them from predatory practices I’d like to apologize. My broader point was that investigators and entrepreneurs who do make claims regarding their apps should conduct controlled experiments before they say “My app does X” in health and medicine. Not only because it is the right thing to do, to my mind, but also because the FDA has repeatedly indicated a desire to move in to this space.

    I also bristle at the notion that I’m an “IT Consultant.” Additionally, the claim that PatientsLikeMe admits that many of their members aren’t real people is specious.

    2) HealthVault and PatientsKnowBest are both workstreams that are shared between patients and clinicians. It’s great to integrate them where consumers are using them, but to my experience users that are accessing secondary services are more likely to be activated and engaged patients. I think that we’re talking past each other a bit here though, which I’ll get to above.

    3) I think that you’re misreading the statistics when you’re pointing out that Apple is selling products into Healthcare corporations because the apps on them are good. Apple is not the salesforce for the app developer. As far as I can tell from the link you provisioned, the app developer are still the salesforce for the app in your example. Unless I’m misreading your point.

    4) Your point about mobile breaching the Digital Divide is absolutely spot on, but if, as a business, I were to have a business plan that said “I’m going to get this functionality out to 90% of the Diabetes Mellitus patients in the United States and get them to use it every day and they’re going to use it appropriately,” you would have a set of headaches regarding deployment of devices (And I would say that the cost of avoiding dialysis is infinitely more valuable than a smartphone), health literacy appropriateness, etc., that auto-correlate with the condition you’re dealing with. In 5-10 years this will be diminished, but I believe still true. Maybe we disagree here.

    5) We agree on mobile web design! Great! You’re also more useful than I am there by far.

    6) When you say “You can’t determine the existence of a chronic condition by calling them up and asking them if they do,” you’re making an argument that quantitative polling research has minimal value because people don’t understand the question being asked. The latter can be true in some cases, but that doesn’t minimize the value of the data. Without conducting quantitative survey research we know much less about the universe and are left with guess work or gut feeling as a guiding light and to me that’s simply not enough. I appreciate your point that many people have an undiagnosed or unrecognized chronic condition and I think that definitely comes into play, but the next step, in my mind, is to say “I think people with an undiagnosed chronic condition are more likely to X than Y,” rather than imply that therefore doing research isn’t worthwhile.

    Additionally, the Pew Researchers ask a series of questions about specific, common, chronic health conditions that are binary (do you have asthma, do you have cancer,) etc. Before asking a catch-all bin “do you have any other chronic condition.) This assures that they’re capturing more of populations that may be considered to have a chronic condition by a public health professional but which the layperson may inaccurately say, e.g. “I don’t have a chronic condition, just high blood pressure.”

    7) My point is that software has limitations. In the UK, you’re fortunate enough to have Ben Goldacre writing for the Guardian to make snake oil salesmen a bit of a laughing stock. We are without such a national treasure so sometimes must spend more time pointing out the obvious. The extract for that bit of the article on snake-oil salesmanship in the Apple App Store was in the Washington Post and used the existence of those sorts of apps to lambast “Health Apps” more broadly in a less restrained way.

    8) A native app used for health purposes shouldn’t be discounted, but the language of “appification” in mHealth in the US is rarely around using a native app and frequently around raising Series A funding to build out something new and shiny and placed in the Android Market that does a narrow thing with a Field of Dreams like assumption that “if you build it, they will come.”

    9) Being reachable by phone, alarm, or sms is absolutely critical in both mobile health and telehealth more broadly – If my use of language didn’t convey that these are the sorts of things that make mobile powerful and are lower hanging fruit than opening up a “health app” then I apologize.

    10) I don’t think I was confused. I think there’s a difference in use of language between what you’re calling an app and what I’m calling an app that should have been clear. Additionally, I think that the broad definition of “app” to include “native app” dilutes the usefulness of the term “app” – Yes a browser is technically an application and yes camera is technically an application but in the vernacular neither of those are referred to as “apps” with common usage.

    The technical question regarding adoption of apps is:

    “What kind of health apps do you currently have on your (cell) phone? (If Necessary, clarify:) What health issue or topic do your apps deal with?”

    Additionally, questions are asked about the remainder of cell phone applications but -not specifically for health-. I would imagine that if you asked users if they ever used their camera for a medical or healthcare purpose the numbers would be low. Similarly (currently) with SMS – but again, this is where I think better design can more appropriately integrate with native apps without being burdensome on the user.

    11) The takeaway from my notes should have been that integration with native behaviors and not selling a custom bit app is more likely to lead to adoption of mHealth uses. I absolutely, and this was my error, should have more strongly referenced the numbers in the following paragraph: “On the flip side, Susannah showed that a large number of people use their smartphone in their healthcare. The majority of smartphone users indicated that they have used their smartphone to search for health information. To me, this seems totally logical,” and brought it up higher in the lede. I think that would have indicated that, functionally, we have more in common than we have differences.

    My belief is that mobile can be transformative in healthcare. My belief is that raising capital to build and sell an “app” independent from consumer workstreams is not a short-term “winning” strategy in many cases.

    I look forward to keeping the conversation going.

    Thanks,

    Dave

    P.S. If it wouldn’t be a bother, I’d appreciate it if you removed the photo of me from your website as it’s one of the absolutely most dreadful photographs of me that’s ever been taken.

  4. Hi Dave,

    Thanks for your comments.

    P.S. If it wouldn’t be a bother, I’d appreciate it if you removed the photo of me from your website as it’s one of the absolutely most dreadful photographs of me that’s ever been taken

    I of course don’t agree with you but I have no problem removing it at all. FYI here’s the public location of it on the PatientsLikeMe.com website as you might want to have it removed from there too.

    Best wishes,

    David Doherty

  5. Matthew Holt says:

    Dave–you can stick a photo of me up anytime–I’m always beautiful….but as you might guess much as I love Susannah, her definition of mobile health is so limited as to be virtually useless AND of course your wrong as it’s not the of the 2 words in the term “moblie health” it aint “health” that is going to vanish!

    See you at the misnamed conference in 2 weeks!

    • Thanks Matthew,

      It’s a problem I’ve never had – can’t pay people enough to post shots of my boat race ;)

      Despite some pretty persistent efforts to thwart the uptake of mHealth the record attendance levels, 300+ speaker program and the 270+ exhibitors that will be joining us in Washington DC will once again highlight that some people might just be wrong.

      Tomi Ahonen explains the “Mobile + Anything = Mobile” much better than I ever could:

      So initially it was a ‘musicphone’ now all mobile phones have music. So originally Mobile + Music became just Mobile. Or the camera. Early on it was a curiosity and not all phones, not even all premium phones (remember early Blackberries) did not have cameras. Mobile + Camera became just Mobile. Today almost every phone has an inbuilt camera of some sorts, most have two. And so forth. Mobile plus anything becomes soon just mobile

      The casualties amongst those who fail to see these earlier trends are easy to spot eg. SONY didn’t see Mobile + Music happening until it was too late, Kodak didn’t see Mobile + Camera happening until it was too late, etc.

      Fortunately those of us who appreciate the change that’s happening in Healthcare are in the minority (eg. Kaiser who have adopted a “Mobile First” strategy) and we’ve got some time to spot the innovations and key innovators with whom to partner to lead the change.

      Think of it like the opportunity Steve Jobs took when he realised the future of music was mobile and made moves despite the revenues Apple was making from the iPod (“If you don’t cannibalize yourself, someone else will“) or conversely the opportunity that Kodak failed to take eg recognising in 1999 that Philippe Kahn should be heading up their new product line… IMO if they’d done that right they’d have dwarfed the success at Apple eg. dominating the market created by Facebook and MMS – the 2nd most used data service on the planet.

      Please join us at this mHealth group meet up as I’m quite sure you’ll meet with some members who are much more convincing than I could ever be!

    • Susannah Fox says:

      I love you too, Matthew, and I tend to agree with you that the term “mobile health” is an artifact of this moment in time.

      Please don’t give me more credit than I deserve regarding a definition of mhealth. This report represents the few questions directly related to mobile that we were able to squeeze onto a much-bigger survey about many other topics related to the social impact of the internet on health & health care. “Mobile Health 2012″ is just a report title, guys!! I personally wanted to slice them out and present them in a short report, as we did in 2010, because mobile adoption is the one area of my field of study that is changing monthly, even weekly, and I didn’t want the data to grow stale while we analyzed the rest of the survey results.

      I don’t think I’m giving much away to say that Pew Internet’s next health report, the big enchilada, will fold these mobile findings in to the rest of the analysis. Maybe that’s where they should have stayed this year.

      Prediction: there will not be a Mobile Health 2014 study published by Pew Internet. It will truly be integrated and even inseparable from our other findings.

      • Hi Susannah,

        Let me assure you the impact of the newest mass media (and the hungry tech companies with billions of subscribers that make up this trillion dollar industry with their insatiable appetites for cannibalising other profitable industry verticals) is only an “artifact of this moment in time” in as much as the term mHealth has been created with a view to communicating coherently why and how the most radical change in the history of healthcare is happening (whether we want it to or not).

        I think by 2014 you’ll have accepted that your 2012 report missed out on the big mHealth story, that most people (eg. hundreds of millions of Americans and billions of citizens around the world) are already using their mobile phones for health, don’t always appear obvious or even get recognised (even by those who are using them) and don’t always involve healthcare professionals.

        In my opinion very few firms that make their money in the sickcare industry have any interest in being integrated with the open transparency needed for preventative low cost public health solutions and relationships with empowered patients that mHealth can and will increasingly support. By 2014 rather than being focused on integration I think we’ll be witnessing the last gasps as healthcare brands (who didn’t see it coming) cling onto what they thought was their primary business (ownership and control of patients, their data and how their disease is managed) while those who see the opportunity and are adopting a mobile first strategy will find themselves much closer to their patients, winning trust, brand loyalty and market share.

        I’m confident that we’re not going to have established sickcare brands step aside without a fight so by 2014 we’ll be far from deciding the winners/losers but one thing that will be abundantly clear: if your primary means of communication with your patients is not mobile your days will be numbered.

        To wrap up I’ll also put my neck on the block with a-little-bit-more-realistic prediction: By 2014 you will be dictating your report on your mobile and the majority of your readers will be reading and discussing it on their mobiles.

      • Matthew Holt says:

        Ha! I win!! And Susannah also explains why surveys are such a pain in the arse and why the sensible people gave them up in 1999!

  6. Susannah Fox says:

    Oh my, I feared that my comment would be interpreted as a diss of some sort and it was not meant to be.

    My work is to talk with regular people about how the internet (defined broadly) is having an impact on their lives, then report back to policymakers, industry leaders, developers, etc. If you listened in on our surveys, you’d hear a growing annoyance in the voices of respondents when they answer questions about how they access the internet. They don’t much care about their devices, their broadband speed, etc. They care about getting a question answered or a transaction completed or a connection made. To many, the technology is becoming wallpaper — they don’t see it. It’s like fish in water, not aware of the water.

    So, I agree that mobile is sweeping the world. In fact, I’m saying it’s going to sweep so majestically that we won’t even need to differentiate it as a platform in 2014!

    You see, I think we agree. Or maybe I’ve had too much coffee and am feeling overly optimistic about our collegial discussion.

  7. Matthew Holt says:

    Dave–multi-screens on multiple different unplafforms. It’s not a prediction, It’s here already.

    You’re still trying to cook the thanksgiving turkey using only the fridge!.

    • Hi Matthew,

      Please appreciate that not for a minute am I saying “ignore all the other mass media, only do mobile” in fact some of the very best mHealth strategies will also include some/all of the other mass media (I don’t call them “screens” as there are also important contributions made by radio and print for example). Here are a few obvious ones:

      > A SMS reminding you to tune into a radio program about a health topic

      > A TV ad encouraging audiences to make a SMS donation to a charity like the Red Cross

      > An print ad or a bill board encouraging you to download a Health app to your smartphone

      What I try to do on this blog is help people see the opportunity that mobile (the newest and least understood mass media) offers and the potential that it has to transform and create new opportunities for healthcare.

      I’m interested more by this as mobile is the only mass media that is personal, permanently carried, always on, with a built-in payment channel, available at the point of creative impulse, most accurate at measuring its audience, can capture the social context of consumption, etc.

      As for the multiscreen bit – isn’t it interesting how mobile brands are innovating all over the other screens in our lives?

      > PC/Laptop: The iPad (a mobile derived device) has in less than 3 years transformed Personal Computing.

      > TV: Simon Cowell has shown the world what can be acheived when you combine TV and Mobile, next up Apple and Samsung will show us what a TV is like when you take a mobile first strategy.

      > Other Screens: Look at how leading motor companies (like the VW group) are letting a mobile company (Apple) control the digital user interface on their $200k+ (Bentley) cars.

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