“Where is there mHealth, really?”

Matthew Holt, Co-Founder Health 2.0, shares an interesting point of view over at The Health Care Blog (reproduced at the WSJ) outlining how he’s been “railing against the term “mobile health” or “mHealth” for about three years“.

As the first person to introduce/explain the mHealth opportunity (even though I was well aware of his feelings) at one of Matthews very well organised events (Health 2.0 Europe) and a confirmed speaker at this years Doctors 2.0 in Paris I find it very interesting to read more about Matthew’s reasons for such dismissal of the mHealth opportunity.

Here’s the point of view Matthew puts forward:

Health 2.0 aficionados will know that I’ve been railing against the term “mobile health” or “mHealth” for about three years. I think this is Health 2.0 is simply the next thing in health technology, and will remain so (whatever that might be). Sure we have a definition, but it’s about what’s happening not how it happens. Calling something mHealth traps it to a device, in particular a cell phone, and ignores the rest of the ecosystem of the technology and culture that the cell phone is but one part of–that’s the concept we call “unplatforms.” mHealth is like talking about cooking in the kitchen and only talking about the fridge. It’s damn important but you need a stove, a sink and more to make it all work.So if you have a mHealth strategy, as Susannah Fox might quote LOLcats, “URDoin it Rong”.

However, the place where it makes sense to talk abut mHealth is where there are only cell phones, and that place is large tranches of the rural developing world. This came up for me twice yesterday. once in a long chat with DataDyne’s Joel Selanikio who has a really cool product called EpiSurveyor that works not via SMS but via an app on simple phones and enables very cheap and easy data collection. The other was in a high profile announcement by Johnson & Johnson (a major funder of text4baby btw), which via its Babycenter subsidiary is introducing–with USAID, State Department & the mHealth Alliance– $10m program supporting the use of cell phones for maternal health in developing countries. So for the health worker in the rural Bangladeshi village, lets have an mHealth strategy. For those of us in the developed world, we need an overall strategy to deal with data and applications–whatever devices they are using

My thoughts:

> I’m not at all surprised that Matthew believes “Health 2.0” is simply “the next thing in health technology, and will remain so” after all he’s a cofounder of the company that owns the trademarked term and has been producing very popular, enjoyable and well organised Health 2.0 events that have clearly had their format copied by several US mHealth event organisers.

> Stating that “calling something mHealth traps it to a device, in particular a cell phone” really highlights how important it is that we appreciate mobile as “the newest mass media” and not just a cellphone.

> Matthew continues with an analogy: “mHealth is like talking about cooking in the kitchen and only talking about the fridge. It’s damn important but you need a stove, a sink and more to make it all work“. Of course we can’t and shouldn’t just talk about healthcare involving “mobile” but couldn’t the same be said about Health 2.0?

But let’s say you invented a converged fridge (or SmartFridge) that featured a stove sink and more. Then within a few years a billion people each went out and bought one and as it fitted in their pocket they began to take it everywhere with them. Would it then be reasonable to start talking about the SmartFridge cooking opportunity that we have on the road, at the beach, inflight? I think this is somewhat analogous to what’s happening with the convergence of consumer electronics to mobile that defined the last decade… …and in the next decade I have no doubt we’ll continue to see the convergence of healthcare technologies to this personal device we’re already carrying.

> Quoting Susannah Fox to say that you’re just doing it wrong if you “have a mHealth strategy” is obviously just a misquote and/or very bad advice – particularly when you appreciate the mobile first strategy being taken on by the likes of Google or the Albanian Ministry of Health. As I’ve mentioned before (here and here) despite Susannah’s incredible research credentials in online patient behaviour I’m not sure that her recent work in mobile appreciates the more significant mHealth opportunities eg. her reports dismiss the importance of patients use of native apps such as P2P voice & SMS, mobile web, etc

> The mention that “large tranches of the rural developing world” are the places “where it makes sense to talk abut mHealth” because there they “only” have cell phones really just highlights a common misunderstanding of what’s happening in in emerging markets:

Of course the “rural developing world” actually contains lots of other technologies eg. radios, cinema screens, newspapers, internet cafes but none of them can even begin to offer the eight (already identified) unique attributes of mobile.

But just because we have alternative ways of doing things that already have their own business models don’t dismiss the opportunities for innovators to apply the unique attributes of mHealth to improve everyday lifestyle choices and help achieve better outcomes in western modern urban communities too (after all we’re not doing great on areas such as engaging patients with their records, medication adherence, giving patients enough consult time, managing waiting lists, capping costs, etc etc)

> Matthew’s conclusion: “So for the health worker in the rural Bangladeshi village, lets have an mHealth strategy. For those of us in the developed world, we need an overall strategy to deal with data and applications – whatever devices they are using” makes an assumption that I think is dismissive of some of the major mHealth opportunities.

If we can accept it or not, all over the developed world there are healthcare systems that have reached or gone beyond breaking point. Higher health expectations, rising levels of childhood obesity, increasingly aging populations, rising levels of chronic disease, etc, etc all mean change is in store for us.

In less developed markets I firmly believe mHealth innovations will continue to thrive by delivering improved outcomes and experiences for patients but in developed markets there is still a massive disruptive opportunity that mHealth holds over more generic “overall strategies” that all too often have to compensate for and manage the needs of the increasingly redundant incumbents such as insurers, administrators and the various brands who will fight tooth and nail to just maintain their profitable status quo.

Update: 13 May 2011

For unexplained reason(s) the original post has disappeared off The Healthcare Blog website.

About 3G Doctor

The Corporate Blog of 3G Doctor
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