Why does Orange choose to see uncertainty in things that are already being done by others?

Mobile World Live reports from the GSMA-mHA Mobile Health Summit in Cape Town (an event that we’ll be reporting from) with some take aways from Orange/France Telecom Healthcare General Manager Thierry Zylberberg’s keynote presentation:

Orange and Sorin, a medical device vendor, are set to launch a wireless-enabled cardiac implant in mid-June, said Thierry Zylberberg, Orange EVP and general manager of its healthcare business, during his keynote today at the Mobile Health Summit. The launch with Sorin shows the value of collaboration, according to Zylberberg, but also demonstrated some unresolved issues in the mobile health business model. The cardiac implant, which will be available in six countries at its launch, will send data to a bedside monitor which in turn regularly uploads its memory to doctors over the cellular network. Orange has previously talked about this product but is now about to launch the result of its co-operation with Sorin. However Zylberberg cautioned there are still questions about how such mobile health services work. For instance he pointed to how the two partners were going to be reimbursed. Given the ongoing monitoring involved in the service (which obviously carries a cost), a one-off purchase of the cardiac implant by a healthcare provider might not cover costs. Another reimbursement model is needed, he suggested. “This is a major issue in this new world”.

Another unclear area is around medical data compliance. This can vary in different parts of the arrangement between the two companies. For instance the physical implant is Sorin’s responsibility and the cellular network in Orange’s. There are probably other areas which are not so obvious. Overall it is a new model for mobile operators to contend with. “It is not clearcut where are the divisions of responsibility,” he said.

In his presentation Zylberberg also talked about possible frameworks for mobile operators so they can progress in the mobile health market. In one slide he segmented the market into B2B type services (services provided by mobile operators to healthcare providers such as hospitals), B2C services which are health or wellness services delivered by operators direct to end-users. He indicated B2C markets for health are more problematic for operators than B2B ones. In the middle are more complex services such as the one mentioned above with Sorin which do not fall so easily into either category.

In a second slide he contrasted on one arm of a graph health efficiency and on the other, health access. Some services such as connected hospitals and remote monitoring already have distinct positions on one arm of the graph or the other

Wow. A lot to take it. My thoughts:

This isn’t something new

I can’t see what’s with all the uncertainty? Whilst Thierry may be cautioning that “there are still questions about how such mobile health services work” the proposed work with Sorin is merely following the lead taken that’s already been taken by other medical device makers eg. Biotronik have already deployed such a solution in more than 3500 clinics across 55 different countries.

FYI This isn’t obscure data this Biotronik device was actually being showcased by Cinterion back in 2010 at the Mobile Healthcare Industry Summit that I helped to organise in London and at which Thierry presented.

“The launch with Sorin shows the value of collaboration”

I think Thierry has slipped up here and inadvertently made the case for Medical Device makers to avoid working in collaboration with telcos and instead take an Over the Top (OTT) approach to mHealth. Surely any developer can see that if Biotronik have already deployed the same by working with M2M specialists Cinterion (a company formed from a management buyout of Siemens’ M2M unit and was recently acquired by mobile security/SIM card giant Gemalto – the combination of which now enables a single company to provision embedded connectivity solutions) and they aren’t reporting “unresolved issues” with regard to their business model (Biotronik are expanding rapidly taking market share from rivals).

I get the feeling that unless Thierry can start sharing more specific information (Cinterion do a very good job of this) all it seems that a telco like Orange/France Telecom can offer the medical device manufacturer community is additional uncertainty and delays.

“Unresolved issues in the mobile health business model… …a one-off purchase of the cardiac implant by a healthcare provider might not cover costs”

As this is something that’s already being done by competitors I think it would be more accurate to say Orange/FT Group can’t work out how to add enough value to sell Sorin on the need and include them in the pricing, after all what’s to stop Sorin skipping the middle man and using exactly the same over the top (OTT) approach as their competition have already taken?

The demand for cardiac device monitoring hasn’t originated to help extend Orange’s business goals and unless they’re adding value why should a device maker include profits for a telco into the sale price of devices they sell? To my mind this shouldn’t be hard the data volumes for cardiac device monitoring are worth £xx’s, an implanted device costs in the £x-xx,000 price range and the care costs are in the £xx-xxx,000 price range.

Connectivity would add at least 10% of incremental value to a device even if it just helped the manufacturer get repeat sales (eg. by driving brand awareness and preference amongst patients) as not only is repeat devices where the implanted device market is growing but at the moment there is almost 0% awareness of the brand amongst patients (although this is changing rapidly as the first mover advantage has now woken up device makers to a range of strategic digital opportunities eg. the support of device registries etc).

“Another unclear area is around medical data compliance… …There are probably other areas which are not so obvious”

What would a telco exec unduly want to highlight concerns about this for? Not only can concerns be designed out but this problem was solved years ago by M2M pioneers for a variety of other critical applications in other industries eg. the mobile connected SOS emergency system that’s been fitted in BMW motor cars for years.

Thierry’s claims that “It is not clearcut where are the divisions of responsibility” has got to be the most poorly considered statement from a mHealth exec. What is the legal team at a device maker going to make of that?

No more spin?

Orange Health have recently been heard making some big promises to revolutionise the global healthcare industry but it comes at a time when even it’s home mobile customer base isn’t steady (in Q1 2012 615,000 of their customers migrated to a completely new MVNO – hitting operating profit by as much as 8%), similarly it has failed to properly support the mixed bag of mHealth services it has already launched across the world eg. in Egypt (a Dermatology service), Austria (a remote monitoring service with the Red Cross) and the UK (where it’s brand has pretty much made an exit following the formation of “Everything Everywhere” with T Mobile).

With more than 170,000 employees and some massive increasing healthcare liabilities perhaps Orange should look closer to home, stop trying to trade it’s uncertainties but show the world that what’s good for the goose is also good for the gander?

The Future might be Bright but what would it look like?

Imagine the power and influence Orange would earn if it stopped treating mHealth as some CSR opportunity and radically embraced the change in culture that’s needed to seize the opportunity. Imagine if Thierry could announce something like:

“At Orange our mHealth initiative …gave every single employee, retired worker and member of their family a mobile accessible EHR with 24×7 access to informed Doctors …saved 10% of our total healthcare costs on the previous year …improved patient ratings of their healthcare experience by 30% …reduced employee sick days by 30% saving us €X million …improved workflow at our staff clinics by 400% and created savings of €X million. Now here’s how we achieved this proven success story. We’ll be starting off by expanding the provision of these services to our millions of mobile subscribers and any companies who are also interested in bringing these technological advances to their health plans”

Imagine the quality and size of customer base an approach like this could engage them with?

About David Doherty

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