Mobile Health Symposium #HIMSS15 Session Mh1

DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

The Convergence of mHealth:A Consumer and Clinical

PerspectiveApril 12, 2015Ahmed Albaiti CEO, Medullan

Conflict of Interest

Ahmed Albaiti, CEO, Medullan Inc.

Has no real or apparent conflicts of interest to report.

© HIMSS 2015

Learning Objectives

• Assess the current landscape of mHealth

• Illustrate the roles of consumers and patients

• Define the current issues

What is mHealth?

“I am Baymax, your personal healthcare companion”

The “formal” definition…

“Medical and Public Health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices.

mHealth involves the use of voice and short messaging service (SMS) as well as more complex functionalities such as 3G systems, global positioning systems (GPS), and Bluetooth technology”

Source: The Global Observatory for eHealth within the World Health Organization (WHO)

mHealth breaks down into…

Mobile Health Apps

Wearables Connected Devices

Mobile Health Apps - Functionality

46,389Healthcare & Fitness or Medical

23,682“Genuine” Healthcare & Medical

Multi-FunctionalityIndividual Functionality

Source: IMS Institute Patient Apps for Improved Healthcare October 2013

Mobile Health Apps – Therapy Areas

8.786Prevention / Healthy Living

304Symptomatic / Self-Diagnosis

931Finding a Physician

562Education Post-Diagnosis

200Filling Prescription

225Compliance

Source: IMS Institute Patient Apps for Improved Healthcare October 2013

Mobile Health Apps – Audiences

8.786Prevention / Healthy Living

304Symptomatic / Self-Diagnosis

931Finding a Physician

562Education Post-Diagnosis

200Filling Prescription

225Compliance

Source: IMS Institute Patient Apps for Improved Healthcare October 2013

37:06

35:40

33:57

25:26

21:21

Source: Nielsen, Statista Q42013

Mobile Health Apps - Hurdles

• Dizzying choice of apps without an easy way to navigate

• Demographic skew of smartphone users: patient populations most in need aren’t serviced

• Lower potential ROI

• FDA approval process lengthens gestation period of app launch > e.g. WellDoc and AgaMatrix

• Physicians wary of prescribing apps• Lack of efficacy data to filter apps• Lack of infrastructure to prescribe• Patient Privacy concerns• Legal and reimbursement incentives

Mobile Health Apps – managing the explosion

Managed app storese.g. VA App Store, NHS

App Library

Most tightly managed, least “open” and slowest to grow

Commercial app “catalog” products

e.g. HealthTap, Happtique

Self-certification process with self-

reported test results

Most growth potential, least

trusted presently

Darkest horse, most potential

Wearables – devices to ingestibles

Source: The Future of Biosensing Wearables, by RockHealth

The world's first wireless wearable heart rate monitor, the Polar Sport Tester PE 2000, was launched in 1982!

Wearables – engagement curveSource: The Future of Biosensing Wearables, by RockHealth

Wearables - Hurdles

• Confusion of choices with no easy way to navigate

• Utility over time: here today, gone tomorrow

• Few wearables have the functionality and the reliability expected by the healthcare business and clinical communities

• Even fewer have the convenience and smart feedback loops (software, clinician engagement) to impact behavior change and outcomes

Connected devices – applications for all settings

At the Hospitale.g. Capsule Tech

In the Homee.g. CliniColud

On the Goe.g. AliveCor

Connected devices – more momentum?

• More clinical (vs. lifestyle) focus

• Biosensor cost structure dropping precipitously

• More clinically mature incumbents and start ups - lots of experience with existing, non-connected devices is transferring

• Already targeting all contexts : in the hospital, in the home and on the go

We are going from mHealth to Health IoT

“I have some concerns”

What can we expect from Health IoT?

From:

App computing Cloud computing

Biosensors Smart, connected devices

Predictive analytics Prescriptive analytics

IoT : explosive growth expected

Source: Harvard Business Review, Digital Ubiquity

Health IoT : Prescriptive analytics

“in context” prediction that includes evidence, and

interpretation and recommended actions for each predicted outcome

linked to clinical priorities and measurable events, such as cost effectiveness, clinical

protocols, or patient outcomes

Health IoT : still a lot of hype…

Source: Gartner

What about the patients?

“Does Karate make me a better healthcare companion?”

What are patients’ needs and wants?

Sources: McKinsey Digital Patient Survey, Manhattan Research, ComScore, MaKovsky Health

86%of the general population is

online for health information 75%

of patients would like to use digital

healthcare services

20%of all patients

state that mobile is essential for managing their

care

39%of MS patients

state that mobile is essential for managing their

care

32%of diabetes patients state that mobile is

essential for managing their

care

What’s most important to patients?

Core features patients expect from their health system are surprisingly mundane: efficiency, better access to information, integration with other channels, and the availability of a real

person if the digital service doesn’t give them what they need”

Sources: McKinsey Digital Patient Survey, Manhattan Research, ComScore, MaKovsky Health

Mobile versus the demographics

Sources: McKinsey Digital Patient Survey, Manhattan Research, ComScore, MaKovsky Health

70%of patients (50 years or older)

want to use digital healthcare

services 2xmore millenials (vs. those 66 years or older) are likely to use a mobile app to manage their

health

51%of baby boomers

have never downloaded an

app

Mobile vs wearables adoptionWearable awareness is high, adoption is low

If Pebble smartwatch, a relatively unknown brand funded on Kickstarter, already holds the #2 ownership spot after FitBit …

Sources: Manhattan Research, ComScore, MaKovsky Health

72%of consumers own

a smartphone

79%are willing to

use a wearable

…imagine what the Apple Watch will do?

Smartphones are no threat to wearables

Smartphones won’t cannibalize wearables. It’s simple – they are too big. Average screen size has gone from 2.59” to 4.86” in the last 7 years

Sources: Manhattan Research, ComScore, MaKovsky Health

23%don’t see the

benefit

48%not interested

54%too expensive

The real barriers to wearable adoption are utility, price, and convenience

What about the clinicians?

“I will add fist bump to my caregiving matrix”

What will get traction with clinicians?

Sources: Chilmark Research, Manhattan Research, HIMSS Analytics

• Communication capabilities

• Voice, video, text, and e-mail

• Informational resources• Guidelines, Literature,

References• Hospital information

systems• EHRs, EMRs, CDSSs,

and PACSs, LIMs• Clinical software

applications• Disease Diagnosis

Aids, Medical Calculators

Anecdotal evidence reveals gaps

Source: Medullan Research

63%don’t use apps as part of their work

35%use their own personal

mobile device

60%don’t have or not aware

of mobile EH/MR

Consumers vs. vendors are driving adoption

Sources: Medullan Research, Chilmark Research

HCOs are still doing the bare minimum when it comes to digital interactions with patients.

Most [vendor] deployed patient portals today have limited or no mobile-friendly patient tools (beyond mobile-optimized browsers) or advanced care planning applications.

75%find the data that

wearablesprovide to be

useful

9%have patients that bring wearables

with them to consults

What are the Health IoTheadwinds?

“I am not fast”

Health IoT : headwinds for adoption

• Ownership, privacy and portability of patient data • Serious ramifications described by the New Deal on data

• Lack of certification and measurement of outcomes for heath mobile apps in any consistent manner

• Clinician cost and incentives/reimbursement for use of apps, connected devices, or wearables

• Supplier middling on delivering clinical software that drives patient engagement

Fast forward : can Health IoT change the future of Health Care?

“Flying makes me a better healthcare companion!”

Other industry disruptors have emerged

By focusing relentlessly on

customer satisfaction, not margins, Amazon is turning retail into a

subscription-likerelationship…

By connecting riders with transport (and other

riders), Uber redefines what personal transport should cost – everyday, every hour, everywhere

(soon)...

By connecting consumers, home

devices, and energy companies – Nest is

driving a focus on energy usage outcomes…

We don’t just need the Internet of Things.We need the Internet of the Right Things!”

- John Driscoll, CEO, CareCentrix‘‘

Where will Health IoT disruption emerge?

Knowing who patients really are…

Knowing when + where your patients are…

Knowing what really matters…

Prescriptive Analytics: Interventions, Decision Support,

Mobility: Phones, Tablets, Watches, TVs, etc etc.

Data: Connected Devices, ODLs, Genomics

Empowered patient self-

management

Informed shared-decision moments

Questions?

Let’s continue the conversation! [email protected]