On the 9th August I was in Toronto, Canada, as guest of the leading Canadian mobile operator and Healthcare brand TELUS where it was a great honour to be invited to present at their inaugural mHealth event.
TELUS have a very open approach to innovation and sharing ideas and have kindly given me permission to share with readers a copy of the slide deck from the meeting:
In the remainder of this rather (too) long post (you have been warned!) is a summary of my reflections on the presentations from the day and I’d welcome you to feel encouraged to use the comments section at the bottom to share your thoughts, feedback and opinions.
The event began with a keynote from TELUS Vice President Terry Nemeth in which he outlined the objectives for TELUS in mHealth – outlining how this isn’t just an effort to create new technology solutions that people will want but rather to understand the market opportunity isn’t about technology but about cooperation and being well placed to help their partners introduce and support new healthcare services.
It’s fascinating that although TELUS have already invested $1 billion in their healthcare business and employ 1300 Healthcare professionals they’ve decided on a very different approach than that taken by the other mobile operators whose mHealth strategies I watch closely. Rather than trying to claim that it has the answer to everything TELUS is positioning itself as a reputed partner that is continually working on large-scale implementations, understands what needs to happen, is invested in the subject matter and engaged with the industry experts.
Whilst I think it’s the most promising strategy for a telco that wants to benefit from the increasingly patient empowered care experiences and healthcare industry reform that further adoption of mHealth will create. It’s a very different approach to that being taken by other mobile operators (eg. Vodafone and O2/Telefonica’s O2 Health) who have assumed roles where they are positioned more as one stop shop solution providers.
I feel TELUS will achieve more as an enabler and understanding collaboration partner for projects as there have already been lots of expensive failures amongst telcos when they’ve misread market acceptance and began marketing themselves as the Healthcare brand eg. despite confidence in 2007 from Orange/France Telecom that they’d have a €500m turnover from the launch of a series of new solutions we heard in 2010 from the Head of Healthcare that “Customers didn’t value Orange Brand when associated with a Healthcare offering”.
Following Terry’s introduction I gave a “mHealth in Action” talk in which I introduced myself, my experiences with 3G Doctor and outlined some of the major mHealth success stories we’ve seen and been involved with from around the world.
Key to this was an explanation of the definition of mHealth. Obviously this relies on an appreciation of the fact that mobile is the newest mass media:
I followed this up with an explanation of the 8 (already discovered) unique attributes of Mobile as the Newest Mass Media (an appreciation that was expertly defined by Tomi Ahonen) with an outline of 8 mHealth examples that leverage these.
I then explained 3 hallmarks that I find are common to every successful mHealth service:
The 3rd of these is for me a really helpful barometer or “sniff test” for mHealth success. If you’re starting out with a new mobile innovation but cannot identify the same technology being successfully deployed within another industry already take a rain check.
Try and find analogies because not only will you learn a lot from seeing how similar tech has been deployed but if you can’t find it you’ll realise that either you don’t know the mobile industry well enough OR it’s probably not going to be something that will be successfully adopted for a very good reason.
I then gave an mHealth overview of the importance of the most used data application on the planet: SMS communications. Outlining how it is the “here and now” mHealth opportunity that everyone must understand because it represents the biggest opportunity to effectively connect patients.
Wrapping up I stressed the importance that we teach patients on the use and benefits of SMS and explained why I feel it represents the biggest opportunity to contain wasteful healthcare expenditures going forward.
Thankfully it was easy to point out the analogous SMS success stories – they’re abundant in a $100 billion market!
Next up was an introduction to the opportunity to engage seniors with mobile were I referenced the exhibition demo area where we had the latest 3G EasyPhones and services from the worlds leading senior mobile manufacturer (Doro) being showcased.
The key take away here was to ensure that engineers weren’t left alone to design mHealth devices or experiences:
I then expanded on how inclusive design will always find analogies outside the sickness industry and gave the example of how Doro’s easy to use mobiles are proving popular not only with elderly audiences but also with a much wider audience eg. professionals in the industrial and building industrys who appreciate the extra loud ringtone because it not only means workers don’t miss incoming sales calls due to workplace noise but also affords workers more enjoyment at work because they can have their workplace radio playing.
I also stressed the importance of device design to encourage SMS and data services with patients and discussed how this is disruptive and opens up a whole host of new opportunities that cannot be acheived using dedicated single purpose devices that don’t have accessible developer networks.
Next up I discussed what’s happening in Europes leading Medical Schools as a result of the expansion of mobile medical library content from companies like Medhand. This was a rather informed discussion as the audience included representatives from the Ottawa Hospital – a group who have already (in partnership with TELUS) deployed 1800 iPad’s to staff. In the exhibition session that followed delegates had the opportunity to get hands on with a demo of the latest solution running on an iPad 2.
Key here was a discussion of what it means for medical education and healthcare delivery going forward if the future means we can rely on every carer being able to leverage an exhaustive clinical library whenever they are patient side. The takeaway was that the time is now for us to begin to understand how to leverage this new capability as there are massive gains to be had in terms of patient outcomes through increases in the quality, efficiency, access to and consistency of the information we use to provide care.
Next up I discussed the mobile video opportunity for education for both patients and carers with an explanation of how leading clinicians are already leveraging this content and the new care experience they are delivering as a result.
Referring to efforts to replace clipboards with touch screen devices I outlined the work being conducted by our partners at HealthSmart (Community Health Checks) and IMH UK (in clinic/waiting room experience) and the massive opportunity I believe this represents once you take a mobile first approach to interactive digital healthcare experiences and are prepared to accept that “patient documentation doesn’t have to be done by a healthcare professional and it doesn’t have to involve a pen and paper”.
And an outline of the research we’ve been involved in studying the use of tablets mounted on Hospital Beds and in patient homes.
During the talk I also discussed some models that failed, the lessons learnt from these and the potential for these business models to be adapted to be successful. Examples included LG’s blood sugar monitoring clamshell mobile in Korea and PearlMedical’s advertiser funded BlackBerry service in the UK that provided a doctor with a subsidised smartphone/data plan on the basis that they would complete surveys.
With a nod to the future I then explained the augmented reality opportunity, the type of patient experiences it will enable and an outline of a prototype solution that I’ve collaborated with a leading pharma brands R&D department to create.
Of course it has analogies in successful mobile content offerings eg. Shazam the music discovery, purchase and sharing app that has been used by 100 million customers.
I also referred to how hospital technologies making their way to the home often make no sense at all without the support of mHealth services. As an example I talked about the trial we’ve conducted with the Biancamed home sleep monitoring technologies. This product is designed to be used with babies at risk of SIDS yet can you imagine if a mother was woken up by this device? The minimum you would want is a live recorded 3G video call with an informed paediatrician who can advise and manage a emergency service response.
It was also interesting to outline the opportunities these technologies have for much wider application outside of the sickness industry eg. as part of diet programs, smart alarm clock, etc. The popularity of alarm clock functionality (most mobiles have this integrated) and download prices/volumes indicate the demand for differentiated offerings.
In wrap up I introduced and discussed the use case of the transformational mHealth technologies that were being showcased in the exhibition space which included the following:
The tablet based Community Health Check product developed by our partners at Health Smart and the BlackBerry Digital Pen solution from PaperIQ that’s deployed at Portsmouth NHS Hospital Trust and explained so neatly in this BlackBerry enterprise video (more on my thoughts about this solution here):
Following my presentation Heidi Wilson, TELUS’s resident mHealth Expert, gave a fascinating overview of the tools that her clients are going to need to be change agents with a focus on commercialisation lessons that I think every mobile operator in the world needs to be mindful of as they expand to support the mHealth market.
Instead of the sales focus that I see at their mobile operator counterparts (such as Vodafone, O2, and Orange) this talk was about inspiring and helping build confidence that this is all within reach. Setting out the challenge with a great story that started with the “Way Back Time Machine” showing how Google looked 10 years ago when it was still just a “good idea”:
Heidi expanded on the need for the “Why use Google?” button and the important lessons this provides for us as we look to face the challenges of commercialisation.
Next up was a discussion of a 1999 Wired article on eTickets that listed all of these intractable problems. Just like we hear from mHealth critics today, eTickets “weren’t sustainable”, “complete”, “not how we’ll be doing things going forward”…
This was continued with some great insights into the way things are changing as basic things like books get connected. I’m sure a mBook publisher would be able to make any of the throw away lines here into a marketing campaign eg. “Do you ever get the feeling that you want to search for something in a book? Or search online for something you see in a book?”
Next up Facebook was held up as an example of the rate of change that is happening and how this is now affecting diverse cross sections of society – writing off claims that suggest seniors don’t want to use technology – and assisting lots of other technologies to cross the chasm and get into mainstream.
Next up Heidi shared a little secret to her presentations – Google Images. Searching terms “just to see what Google is trying to tell me” obviously worked because this was an excellent way to address the issues originating from Supply > Demand challenge that is faced the world over by the Healthcare industry and the challenges the healthcare industry faces with acceptance of efficiency drives:
Yes it’s true you only have a few choices: 1) You slow down the conveyor belt 2) You fall behind and just get okay with the chocolates just falling on the floor – an untenable option for Healthcare 3) You introduce efficiency to your processes
Instead of looking at efficiencies as being cold and unwelcome Heidi helped reframe them by pointing to the work of Henry Ford whose assembly lines allowed people to get cars who otherwise would never have had access to a car. Yes assembly lines have a bad rap but they can provide an invaluable service to community by increasing access to sections of society who would otherwise not benefit.
Proceeding to frame the new possibilities for care through mobility that recognised that some things are harder to do (due to more complex regulatory and payment models) but that these also coincided with more transformational things that will have more impact.
Within an overview of 1 to Many Care Models Heidi outlined the opportunities to strip out the “doesn’t need to be done in person” activities, before outlining the Self Care opportunity with a powerful reminder that patients are already doing this (Dr Google) and that most of it now seems so natural that consumers are now expecting it. Demanding it will come next!
Heidi then explained the need for clients to understand change by asking why this isn’t mainstream already?
Before reminding us that misunderstandings and resistance surrounding the need for change isn’t a new problem with the story of the Thomas W Lawson – a steel hulled schooner that was built and sunk over a hundred years ago this was the largest ever pure sailing vessel to be built. While it proved to be the last unsuccessful bid to keep sailing ships competitive with the rise of auxillary powered ships it makes for a great example of why the winners are rarely those who think the answer lies in just doing more and straight line thinking.
“Ready, aim, fire” was a great overview of the change management and restructuring issues that I see the world over preventing adoption of mHealth so it was very encouraging to hear of the abilities of the TELUS team to help clients take an operationally effective approach to making this happen.
Next was an outline of the need for progress through a evolutionary revolutionary approach that appreciates where clients are today and plays to talents TELUS have from working with similar challenges in other industries that have already added the mobility component.
The key lessons on avoiding the analysis paralysis that so often mires new projects were well recieved by clients especially where Heidi discussed TELUS’ experience making change happen with appreciation of need to “train off the field” but with a very honest acknowledgement of the massive lessons you’ll get only by doing:
“Before we launched MobileCare (a mHealth service now used by 7000 carers across Canada) I thought I was 60% there with respect to the knowledge base. Now I realise I knew maybe just 5% of what I needed to and that it was only when the product was out there that we figured most of it out”
…and the need to ensure you are setting yourself up to succeed:
Within an overview of mobile application best practice Heidi outlined the massive SMS opportunity with an appreciation of the ability for change to be embraced if we build on existing acceptance:
“If you all introduce SMS appointment reminders you’re not going to get patients saying “Whoah!!! You’re rocking my world” …because they already get status and booking updates from Taxi firms”
I’m sure a lot of people will find this readiness checklist useful:
Useful takeaways: The importance of defining the problem, what is it? For who? Optimise a situation – only then automate. Don’t take a broken workflow and put into an electronic form because you’re wasting your energy and won’t get a ROI. Change the way you work to get efficiencies that will then pay for the change. Fundamental to understand the business problem that you’re trying to solve first, 1 = Problem, 2 = Solution.
Saving Staff Time for Higher Value Activities
Useful takeaways: Is data entry and high value activity? Eliminate processes that can free time to care – if a team member isn’t super skilled could they add value by being a really great receptionist?
Useful takeaways: What determines success? What will you measure? Change is a constant so automate measurement processes because it’s your only hope of staying up-to-date.
Useful takeaways: Be ready to absorb changes into your organisation. This isn’t a departmental initiative – slow work at the beginning will pay off at the end. Recognise the support needed from the beginning, so you’re prepared for it and have HR policies etc in place before roll outs. Get the right people for the job. This isn’t going to work if someones working off the corner of their desk – create a position.
Understand the other challenges as you scale a pilot from 50 to 5000 users – consider the device management issues.
Gave a great example of the TELUS experience here working with the remote device management specialist VoxMobile: staging managing and integrating updates.
Acceptability, Usability and Engagement
Useful takeaways: don’t start with the device, four follows function. Make sure you know where they use it, how to get on their Phone. Understand the benefits of introducing things that are training lite. Avoid 50 page manuals!
Useful takeaways: Can we do this cheaper in a non technology way? Does this have an impact that it promised? Spend time to build a detailed ROI process.
Data Vs Information
Key takeaways: Move on from an engineer focused output. Leverage expertise and algorithyms to create valuable experiences.
Predictive Modelling and Scenario Building and use of Change Management Formula
Wrapping up Heidi summed up how TELUS wishes to work with healthcare providers to implement mHealth services:
“This is a service. Here’s the value. Oh and here’s how the technology will let us do this”
Before sharing a key lesson on commercialisation from GE’s Change Acceleration Process training that is very useful for us to consider when trying to encourage mHealth adoption:
Q = Quality A = Acceptance E = Effectiveness
While a lot of our energies are spent on product quality because it’s tangible, we can ratchet up our effectiveness by shifting effort to the “acceptance” part of the equation, which tends to be the part most ignored when introducing new initiatives. We naturally tend to ignore it because it’s about influencing people (which is hard!), but even a small increase in accptance makes a big difference (do the math).
Following the event there was time for some fascinating meetings with TELUS clients and it was abundantly clear that taking the initiative to build awareness and acceptance of mHealth is a strategy that has delivered results.
Tablets installed with a feedback app were circulated amongst delegates to encourage audiences to share their opinions and I asked one of the participants if I could quote his opinion because I think it highlights much better than I could ever describe the success TELUS have had with their approach:
“With 3,000 staff serving more than 15,000 clients in 800 communities across Canada, mobility will be critical to our ability to get our clients the help they need no matter where they are and spend our time caring for patients. The transition to mHealth isn’t always straightforward so it’s essential to have a partner like TELUS. They’re not afraid to innovate, and understand what it takes to make things happen. mHealth is a game-changer for us”
Anthony Milonas, COO, We Care Health Services LP
The next event takes place on the 14th November 2011. If this has whet your appetite and you’d like to attend or get involved please add your name/email/telephone number in the comments below and I’ll ensure we try and get you involved. Alternatively reach out to Heidi Wilson, mHealth Expert at TELUS on Linkedin or via email at heidiDOTwilsonATtelusDOTcom.
PS. A very big thank you to Jasmine Campbell, Public Sector Marketing TELUS, who applied tireless attention to detail handling the promotion, registration, organisation and feedback to what was an exceptionally professional well produced event.