I think it’s a very positive step forward for the mHealth industry and great to see such open knowledge sharing and thought leadership. To contribute to the effort I thought I’d share some some of the things I the report had me thinking about:
I’m very confident that we’ve gone beyond the technical barriers and now the biggest challenge is awareness of the mHealth opportunity. A report produced by a leading research organisation and freely shared by a leading US mobile operator is very welcome for everyone in this industry and the positive patient outcomes we’re all looking to achieve.
The reports goal (which I’m not convinced it achieved – maybe there’s a part 2?) identifies a very important knowledge gap in the market eg. “summarizes the current weaknesses and strengths of these device types, predicts best fit, and reminds the reader that there is more to selecting the right device than just running price comparisons”.
Skips the lecture
Unlike a lot of other telco focused mHealth reports this one goes light on all the demographic trends that I think anyone who has ever read a newspaper is fully aware of and accepts (Rises in Obesity, Aging, Diabetes, healthcare spend, etc, etc).
The report is littered with the typical oversights that you find when you have technologists writing about healthcare:
“Water resistance is another necessity in hospital settings (while not as applicable in individual doctors’ offices or in patients’ homes). Devices at the point of care are going to be wiped down with strong disinfectants on a frequent basis. Can your device withstand this treatment over time?”
Of course I’m a big proponent of device makers who go the extra mile to manufacture devices that are washable but this problem and the urgent need for solutions is most definitely not confined to hospital settings.
Widespread ignorance of community acquired and other healthcare associated infections are a massive opportunity for mHealth education in patient and carer markets but clearly this reports author could also benefit greatly from a crash course.
Unreliable mobile market analysis
I’m not sure if this report benefited from a discussion of smartphone OS’s and it looks like a cut and paste from one of Frost & Sullivan’s telco market reports. I think with awareness initiatives we’ve got to be careful to be very accurate in the information we present and it’s for this reason I’m forever pointing people to the excellently referenced work of mobile statistics guru Tomi Ahonen. Unfortunately I found the data presented to be inaccurate and potentially misleading:
The term “smartphone” is widely accepted to refer to a mobile that has a programmable OS and it’s useful to be mindful that todays smartphone is tomorrows featurephone. One thing is for certain: the future of mobiles are ever faster processors, increased device convergence and more innovative form factors. With the increasing rate of change be prepared to accept in 4 years time for the leading smartphones of today (eg. the iPhone 4 or Samsung Galaxy SII) to be considered “feature phones”.
I’m surprised that the report claims “Doctors report being even higher adopters” of smartphones as there are lots of reliable stats emerging that show that the adoption of smartphones by Doctors ALREADY far exceeds even the Foster and Sullivan 67.1% prediction for 2015 eg. last year Manhattan Research claimed 72% of US physicians were using smartphones and an Amptilon survey in April claimed 84% will be using one by the end of 2011).
There’s also plenty of evidence that they’re using them (eg. by the end of 2009 the Epocrates smartphone app had been downloaded & used by 20% of US Physicians) and that’s before you even begin to count smartphone based tablet adoption (John Moore at Chilmark Research estimated that at the end of 2010 22% of US Doctors already had an iPad and another Aptilon survey showed 80% planned to buy one in 2011 which sounds about right when you look at the sales volumes Apple have achieved in 2011!).
Being very picky I found the perceived quality of the report to also be reduced by some small smartphone OS technical errors eg. “RIM’s BlackBerry®” isn’t the name of its OS, complete ignorance of Samsungs BADA (which has a much larger smartphone market share than WP7), etc.
Lone Worker opportunity
The report suggests “Worker monitoring — Home healthcare aide location and workflow can be monitored via GPS to ensure timely arrivals and departures and optimal productivity” but omits the massive opportunity to enable these workers to be more effective (see digital pen solution from BlackBerry), more informed (educational resources) and safer (lone worker services).
I think it’s important that we should be mindful of mentioning these benefits when talking about this opportunity – otherwise we risk alienating the key professionals we seek to drive adoption amongst (by just focusing on tracking their where/when).
Inaccurate sweeping generalisations about security and ease of use
This type of thing annoys me as it really comes down to design. Most of these issues can/have been designed out:
“Limited displays and lower processing power can result in incomplete or unclear information, time-consuming paging through multiple screens… …Potential security vulnerabilities”
Watch the BlackBerry Digital Pen solution from PaperIQ (more on my thoughts about this solution here) outlined in the following video and tell me where this is more time consuming than the paper based system it replaced:
Security vulnerabilities are everywhere in life but smartphones supported by readily available remote device management tools are widely available. Unfortunately the same can’t be said for the alternatives eg. individuals mislaying sensitive patient documents.
Smartphone market assessment
I was really surprised that this didn’t mention the benefits of the device being “already carried”. Lots of healthcare professionals are already using and familiar with smartphones and this lowers the adoption barriers associated with new hardware significantly.
Tablet market assessment
Maybe I’ve heard about and been involved in too many hospital tablet projects but I get the feeling this section of the report is massively underestimating the Hospital appetite for tablets and I’m surprised that there is no mention of patient use of tablets eg. as clipboard replacement in waiting room, as a bedside patient terminal, etc.
Push to Talk
Okay so I’m very biased on this one (I’ve debated since the start of the Nokia Decade with American colleagues who were convinced that SMS would never take off in the USA because of PTT) but even though I rather like smartphone based alternatives (eg. Hullomail) I really can’t get my head around the application of PTT in Healthcare that this report is recommending:
“Push-to-talk devices are often marketed for field service workers; however, they can also be ideal in the healthcare industry, especially for hospital support staff in patient transport, campus security and facilities management. Push-to-talk handhelds can provide needed functionality in the emergency room and in natural disaster situations, where temporary care locations have to be created and stressed communications networks need to be maintained. In many medical settings, push-to-talk devices are also positioned as an ideal replacement for the ubiquitous pager”
To be suggesting that a modern healthcare practice replaces it’s pager system with Push to Talk is to my mind as counterproductive as suggesting that you replace a horse and cart with dogs and a sled.
In complete disagreement with the analysis I think PTT combined with speech transcription presents large homecare opportunities eg. natural language data entry to medical record:
Misrepresentation of M2M
This section of the report has got to include the poorest and most limiting explanation of the M2M opportunity I’ve ever read:
“Often, geography, expense or health conditions make it difficult for patients and healthcare providers to be in direct, in-person contact as often as they would prefer. Machine-tomachine (M2M) medical monitoring devices have been developed to bridge this gap”
I could not imagine the author of this report discounting the hospital M2M opportunity like they have had they ever spoken to a bed manager (“Go and check if a patient is still in that bed”) or facilities manager (“I have no idea where my $300k ultrasound machine is or for that matter when it was last used/serviced”) at a large hospital, but surely everyone’s read at least one story about a patient who’s had a foreign body accidentally left inside them during a procedure?
Lack of appreciation of what can be achieved with mHealth even when there is no network connectivity
“The backbone for running any sort of wireless applications within a healthcare facility is the wireless network. If there’s no connectivity, then wireless communication is not possible. Whether caregivers are trying to access patient data on a tablet or just need a reliable voice capability, dependable wireless connectivity is mission-critical”
Whilst it’s clear this statement is reinforcing the value proposition of the client (a wireless network provider) I think it’s counter intuitive to dismiss store and forward (eg. data is uploaded when the device next sees a network) or other convergent uses for the mobile terminals (eg. “your caregivers can have a library of clinical resources stored on these pocketable devices – on hand anywhere and at anytime even if there isn’t network coverage”) as everyone appreciates that even with the best network coverage there will be times and places where coverage might not be available.
Missed Video Opportunity
It would have been great to have more mention of the mobile video educational opportunity but I also think this entire report could have been better presented as a video. Could have been much more engaging and would have further pushed the interests of a broadband wireless provider.
Lack of confidence in the mHealth opportunity
“YES, MOBILE DEVICES CAN TRANSFORM THE HEALTHCARE EXPERIENCE”
Shouldn’t that read “Mobile Devices HAVE transformed the healthcare experience”?
I don’t know a single Doctor who doesn’t have at least one mobile phone on at all times. 80% of 999 calls in the UK originate from mobile phones (and the proportion of mobile originating 999 medical calls is even higher). It’s worth mentioning that as I post to this blog I’m working with a Doctor on an OOH shift and we’re working exclusively on mobile around the clock.
Lack of awareness of the Healthcare industry adoption of IT
“The healthcare sector has never been known for being an early adopter of information technology”
This is a nonsense that I see continually being perpetuated by people who don’t understand the need for healthcare to continue to evolve rather than start again every 3-5 years (like modern IT companies can do). In my opinion the Healthcare sector is all too often the first to adopt new information technology.
Many of the earliest large scale IT deployments were for gathering, sorting and analysing personal health information and it amazes me how many people are unaware that Doctors practically financed the launch of mobile networks when they en masse adopted pagers (which in modern countries then evolved into the foundations of the cellular networks).
“For some hospitals, the computer on wheels (COW) is as mobile as it gets—simply because no one is motivated to search for better alternatives”
If this were true then somewhere there must be hospitals out there that are running a fleet of unconnected ambulances, where staff don’t use mobiles or pagers, etc, etc.
Patient focus was way off target
“Delivering high-quality, easily accessible patient care—on both an in-patient and out-patient basis—is an ongoing balancing act. Consumers are looking for quality and value. They have done their homework, think they know the answers, and are frustrated with insurance plans that impose increased limits on their access to providers and care. In the face of this educated customer, the healthcare industry has to compete and survive by demonstrating real value-add. The new healthcare value proposition to patients is equal parts high-quality medicine, affordability and convenient accessibility. Multiple expert providers are expected to work together to deliver seamless, coordinated medical services. And those services can more often be provided right in the patient’s home or in a nearby satellite facility”
I think this completely misses much bigger and more readily available mHealth opportunities. Educating seniors so that they are comfortable using mobile services (such as SMS) provides an enormous opportunity to contain future healthcare expenditure by simply making basic communication more efficient and accessible.
Biggest failing of this report
It’s all too common to find techies getting wrapped up in the “what’s possible” rather than the “here and now” opportunities for monetization and this report typifies this by completely ignoring the $100 Billion mobile opportunity.
If I were writing this report for Sprint there would be a whole section dedicated to the enormously profitable, revolutionary opportunity for healthcare providers and patients to engage via SMS. I’m astounded to find that this report doesn’t even mention SMS.
If you too don’t understand SMS please please please read this introduction to the most used data application on the planet.
What I would have liked to have seen more of
It would have been fascinating if Sprint had given the market some statistical insights into how their 52 million customers are already using mobiles for health. Imagine the additional awareness of mHealth if Sprint shared:
> What percentage of Sprint subscribers had conducted a healthcare related search from their mobile browser
> How many patients register their mobile number as “primary contact” at one of their big hospital clients
> How many of the inpatients at the hospitals they work with use a mobile phone
> How many “Did Not Shows” their leading Healthcare clients have saved by introducing SMS appointment reminders (and the financial and productivity savings this has created)
To end on a very positive note it’s great to see in the report that Sprint conclude by listing their “Healthcare Software Application Solution” partners including CellTrak, TeleNav, Xora®, mVisum, AirStrip Technologies and Calgary Scientific.
Whilst the dedicated MySprintHealthcare website includes some details on these I think some case studies detailing market experiences would have added enormous “what’s happening already” value to the report.