Orange Health: Thierry Zylberberg

The 2010 Mobile Healthcare Industry Summit saw two speakers representing Orange. First up was Thierry Zylberberg is the Executive Vice President, Head of Orange Healthcare.

Customers didn’t value Orange Brand when associated with a Healthcare offering

Thierry has been busy since his “mHealth by Orange Healthcare” presentation at last years inaugural Mobile Healthcare Industry Summit and the direction seems to have changed considerably. I assume this has happened as a result of the disappearance of the UK brand (which was rebranded as “Everything Everywhere” following the announcement of a joint venture with T-Mobile – which was obviously sprung on employees quite dramtically as Orange only just managed to drop their sponsorship of the BMJ Awards in March) but also no doubt as a result of the lack of demand from the market (which the company are putting down to a “brand lesson” while openly admitting that customers didn’t value the Orange brand being associated with a healthcare offering).

In 2010, I sense that Orange have inherited a much better sense of the realism of the market and my conclusion is that “mHealth by Orange Healthcare” has very much been replaced by “sold by Orange” (although I’m sure Orange are hoping they’ll succeed with the much more important sounding “Powered by Orange” slogan that they are now using). Instead of developing competitive solutions Orange is now focused on partnering with smaller providers who already offer solutions.

“there are more things in mhealth, than are dreamt of by any sound marketer”

Thierry’s presentation started by stating that “there are more things in mhealth, than are dreamt of by any sound marketer”. Exactly what this meant I have no idea – I’m guessing it’s something that’s been lost in translation. All the same he went on to describe mhealth as “a fuzzy concept, covering many different kind of services”. Yes even mHealth industry execs still seem to be trying to grasp the basic concept of mHealth.

Thierry went on to highlight the GE V-Scan device and presented it as though it was an example of a “Mobile Device for Caregivers”:

Mobile devices for caregivers

Lets get this cleared up: Whilst this may look like a flip/clamshell mobile, this is not a mobile phone. It does not ring. You can’t text on it. You can’t make calls with it. It needs to be used by a highly experienced medical specialist who has spent years being trained and tested to use and make any valuable sense from it’s output. It offers no wireless connectivity. It is not going to be something that any mobile operator will be retailing.

Visiting Veterinarian’s and special interest GP’s I know have been using laptop sized ultrasound equipment for years and there are several advantages over non portable devices but no one is clamoring for something that is pocketable eg. the large screen aids the clinician/patient when viewing the images being produced, clinician can upgrade the probe and/or the laptop, the clinician can use the laptop for other uses, the laptop can enable the clinician to also manage the patients EHR, the laptop can enable the images to be uploaded to the patients electronic record, etc etc

Yes there has been a prototype produced by twinning a probe with a Windows Smartphone:

But again this has a very limited screen size/resolution making it rather impractical for any serious work. This is functionality that >90% of clinicians would not pay extra for and the additional cost for a set up that can be used in insured medical practice will remain very high for a long time (Ultrasound equipment is highly regulated and requires extensive approval processes).

Mobile Operator thinks Device Manufacturers are set to own the mHealth market

Despite the fact that there wasn’t a single handset manufacturer talking at the conference (fortunately there where plenty in the audience), I found this point of view very surprising given Thierry’s position. Who would have thought we’d have a Director of mHealth for a large mobile operator extolling the virtues that device manufacturers have for owning the mhealth market eg. “It always starts with a device”,” they build vertical strategies”, the “classical device business model (one-shot revenues)”, “Moore’s Law is working for them”, “soon mass-market” and “huge scale effects”.

Thierry went on to explain that “apart from mobile devices for pros, the mhealth ecosystem consists of four layers and is a classic value chain for telcos but the value is moving inside the value chain on mHealth, and device manufacturers are on the sunny side”.

Such open admission confirms my faith in the next decade seeing convergence of medical devices to the mobile and should be music to the ears of the big mobile device manufacturers (or at the very least the research guys I know who still need to muster wider support from the board in order to get their ideas and concepts into production devices).

Personally I disagree with Thierry’s assumption that it’ll be about one-shot revenues as there will almost certainly be micropayments (eg. provider to patient SMS communications), disposable components and the increasing cost of devices at the very least will encourage the creation of imaginative payment/leasing/insurance plans in order to make services affordable.

iTunes App Store

Thierry went on to talk about the rise of apps in the “iTunes App Store” (yes, I think it’s safe to assume he isn’t too familiar with the Apple iPhone user experience) that are categorised as “medical, health and fitness” (something that MobiHealthNews’ Brian Dolan talked about in more detail). Maybe I’m a bit weary of these numbers or is it that without more detail they are almost meaningless?

New Orange Services for Health Professionals: Smart Numbers

Last year Thierry proposed that they would be launching “advanced voice call management services”, it appears these are now being branded as “Smart Numbers“. This service seems to be a late stab at what’s already happening with numerous VOIP players eg Google Voice, Skype’s SkypeIn etc.

I’ll have to find more detail but it doesn’t seem to offer the most elegant VoIP solution I’ve seen eg no voice recognition features (eg. Voice to text messaging, transcription etc), no replacement of inbound number with a local rate number (would have been surprised to find an operator actively trying to avoid generating inbound call revenues), etc.

I’m also not entirely confident that effectiveness of health care professionals will be dramatically improved via a voice message service that currently doesn’t offer voice to text. Orange need to publish research that shows this otherwise I get the impression it’ll face slow adoption as carers just regard it as a solution looking for a problem.

The website also seems to ignore security/privacy which is one of the biggest concerns that healthcare providers will face when considering trial/adoption.

Surely this is one of the biggest differentiators that the service could offer potential customers (over and above what is offered by VOIP providers)?

In my opinion Orange would do well to take a leaf out of BlackBerry’s book and begin understanding their healthcare partners key needs much better.

New Orange Services for Health Professionals: Health Gateway

When Thierry announced plans for this last year I commented on how this might be a new entrant to the increasingly crowded UK healthcare SMS provider market, from details revealed in the talk it appears that they’ve taken the sensible approach and partnered with existing UK provider iPlato.

The Orange Health Gateway provides a web interface for clinics to manage text message communications with their patients. Although for the small/medium clinical practice I’m not so sure this can’t be just as effectively done with the free software tools that can link a SIM card with a PC interface (eg. FrontlineSMS) particularly as the set up fee is so small and some of these can work even in the absence of internet connectivity.

eWellness becomes mWellness: Chronic Disease

At last years conference Thierry explained that there were trials being conducted into the use of RFID, Telemetry, lone worker protection and Chronic Disease Monitoring. Whilst the Diabeo service that was mentioned last year wasn’t mentioned, a check of their website shows that they no longer feature any Orange branding so maybe that partnership didn’t work out:

Thierry then talked of how Orange is working with the Sorin Group (an Italian Cardiovascular device Company) in the area of chronic disease, prevention and wellness where “partnerships and new distribution models” have been mandatory. In describing the “coach forme” mobile application Thierry suggested that eWellness has now become mWellness which to my mind is really bizarre bit of terminology particularly as there is so little evidence supporting the possibility that web apps are helping anyone stay well.

Similarly to the presentation on O2 Health by Mike Short, Thierry also expressed an interest in the use of second-life style avatar based coaching applications:

Insurance players and Orange to build B2B2C mHealth Strategy

Thierry also revealed some more details on the partnerships Orange is making with “insurance players” to build “B2B2C strategy”. I guess this is building on their initiative in France with the Mondial “Care and Assistance” service and the Doro EasyPhones.

Senior Mobile Success Story: an extra €22 million/year anyone?

It was fascinating to hear Thierry reveal that in H1 2010 orange shops in France sold 40,000 units of DORO mobiles. This is an impressive record as it suggests a >80,000 per year new device opportunity. As I said in my review of the senior mobile devices on show at Mobile World Congress the design and branding (eg. “it’s an easyphone”) of these devices is well thought out – so I see this is a good example of the success that well thought out design can deliver.

So what’s this worth? 80,000 devices at €9 each on monthly ARPU’s of €12. Total ~ €12.24 million in additional revenues for what are largely uncompetitive devices (ie. many of the users of Doro mobiles are currently not using mobiles, once with a Doro Mobile they’re likely to be making/recieving calls and sending/recieving texts) and that’s before we even start on incoming/outgoing call/text revenues.

If these devices were all sold with a €10/month subscription to the Mondial Assistance plan that would make for an additional €9.6 million per annum in revenues, which is definitely another case of an operator mHealth service showing us the money… and makes me wonder what’s making Thierry so confident that the money is on the Mobile Device opportunity. Maybe the likes of Doro are building so much brand loyalty they could launch a successful MVNO (like we’ve seen in the USA with the JitterBug or with a familiar healthcare brand such as a health insurer).

Emerging Market efforts

In AMEA Thierry revealed how Orange is working with NGOs and foundations to help in able data collection and remote monitoring, and Thierry revealed partners here including: Text to Change, the mHealth Alliance and the Agence de Medecine Preventive. Although I find it hard to read much into the commitment behind these partnerships as when I checked the mHealth Alliance agreement was nothing more than just a temporary agreement to “plan something” and involved no financial commitment whatsoever.

Project Masiluleke

Masiluleke (meaning “give wise counsel” and “lend a helping hand” in Zulu) sounded like the first spam effort I’ve seen conducted in the field of mHealth. Apparently it’s using the unused space of “please call me” SMS messages to connect mobile phone users with a government funded HIV call center.

Maybe I’m wrong but I can’t imagine how expensive call centres are going to be able to tackle the deep rooted problems of HIV amongst a population so disadvantaged that they’re friends can’t even afford SMS rates. Surely the resources spent on the call centre could be better spent on making educational resources freely available on the mobile operator portal (which would have the added commercial benefit for the operator of increasing awareness of the mobile web).

I also can’t help but wonder if recipients have been upset or offended by these HIV messages? I wonder if something like this (eg. free webtext service with such advertising) was happening in a country where people had more legal representation whether we’d have heard of some customers getting vocal about it eg. “I broke up with my husband after finding a message about HIV on his phone from a girl who works for him” (something similar happened as a result of suggestive preset messages on a Virgin USA Mobile)

“mHealth is mainly about health management”

Thierry continued by suggesting that “mHealth is about efficiency but also access to health. In any case, it’s mainly about health management”. According to Thierry: “more than 50% of mHealth revenues” are spent on health management which he described as “teleassessment and remote monitoring”. In emerging countries the role is to “help reduce the economic and health divide” in which he illustrated the business would evolve from a profit maximising business that distributed profits to shareholders to a profit maximising business that share the profits. If that makes any sense, please help me because it’s lost on me.

Summing up

All in all it’s great to hear about a mobile operator rolling it’s sleeves up and talking candidly about it’s mHealth initiatives and sharing some numbers on the success they are having with senior mobile adoption. It would be great to get some more accurate data on the related financial success and service adoption levels and I look forward to reporting more as and when details emerge.

This blog post is part of a series of mHealth reviews from the 2nd Mobile Healthcare Industry Summit 2010. Click here to get the full review.

About 3G Doctor

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