The first day was rather disappointing but by the end of the second day I had achieved my goal and had networked with some people who have done, are doing, and plan to be doing, some remarkable things around mHealth – and that was priceless.
Presentations from Robin Miller (Dalberg Global Development Advisers) and Dr Ruchi Dass at the pre-workshop explained the term ‘ecosystem’ in the context of mHealth from the perspective of consultants working in the developing world, while Ahmed Jubbawey give an entrepreneurial slant from his work in New Zealand via Vensa Health.
(An ecosystem is a system whose members benefit from each other’s participation via symbiotic relationships (positive sum relationships). The intention being that the relationships established across different industries become mutually beneficial. The mHealth ecosystem requires clinician input, patient buy in, devices, telephony, technologies and the need for policies and standards for communication between patients and providers, design and integration of applications.)
The audience at the event was a mix of the potential stakeholders you’d expect to be within a mHealth ecosystem.
The audience was reminded by Dr Nosa Orobaton – Deputy Executive Secretary Health Metrics Network (a partnership administered by WHO) – to ensure that its ‘value added’ notion is well defined and that the basic principles of information management (confidentiality, integrity and access) are embedded within any solutions.
All agreed that definitions of mHealth (m-Mobile) are varied and there was a debate as to the value of separating mHealth from eHealth (e- Electronic).
However, it was useful to see mHealth definitions placed in categories by Thierry Zylberberg, Executive Vice President, Strategic Partnerships and General Manager, Health Business, Orange-France Telecom, France
1. Health Awareness and Prevention e.g. text messaging
2. Healthcare Management e.g. disease monitoring
3. Healthy Lifestyle e.g. promotion of fitness and wellness
Evident from the presentations was the difference in mHealth requirements between the global north – developed world, and global south – developing world, with the developed world being driven by the need for efficiency savings and the developing world by access to healthcare.
There was much talk about moving away from pilots with the coining of the term ‘Pilotitis’ and the undue focus on technologies and the need to ensure that clinicians are onboard and that solutions are patient centric.
However, I agree with those who stressed that we need pilots to establish proof of concept especially as mHealth is a nascent field. So in response to questions around business and revenue models – there is no universal mHealth model!
Nuggets of advice given/suggested included:
1. Complexity of healthcare as a system must be understood and managed as does the time it takes for agreement by clinicians who expect to see evidence-based justification for use of solutions.
2. Not involving ALL stakeholders initially as gaining consensus can be tedious.
3. Potential business models within the mHealth ecosystem are B2B, B2C and B2B2C.
4. Solutions need to be low tech and free to end users if they are to be used.
5. Revenue from use tends to be small initially but with the potential for large volumes of activity this will eventually bring in revenue.
6. For some operators currently in the market it’s about added value to their telephony service in a bid to engender customer loyalty and attract new customers.
7. From the potentially diverse stakeholder groups in the mHealth value chain the main question of who should lead/drive an mHealth solutions implementation was agreed to be dependent on the solution’s focus.
8. Experiential advice was given regarding the need to:
• Partner with local or International Non Governmental Organisations where possible
• Consider 2G or 3G depending on what you want to achieve with your Solution
• Involve Social Networks in designing solutions
• Not necessarily work with one Telephony Operator.
From the developing world’s perspective the issues of interoperability, FDA approval and the need for polices and standards were also discussed.
The Continua Alliance has been set up to establish an eco-system of interoperable personal health systems that empower people and organizations to manage their health and wellness better It’s worth having look at their membership list and the work they have been able to achieve in pulling together design guidelines, and the list of certified products at their website.
There were some amazing examples of different members of the ecosystem taking the lead. The notable ones from telecoms operators were presented by Shainoor Khoja, Director of Corporate Affairs, Roshan, Afghanistan and Juergen Pillinger, New Business Development, Orange Austria. But what stuck in my mind most was the presentation from Mobile Healthcare Inc – James Nakagawa on their anytime, anywhere, always-on disease remote monitoring mHealth solution called Life Watcher.
My main take away from the conference was just to get on with it… Not necessarily involving all the stakeholders initially and to learn from mistakes. As one of the attendees stated, one needs to be daring – indeed he who dares wins!
Yvonne Odegbami is a Healthcare Management Solutions Implementation Consultant living and working in the UK and is Consulting Director of DEA Consulting Solutions. She holds degrees in Physiology and Medical Informatics. Recent research has focused on the nuances of mHealth and gaining insight into viable business models and the tradeoff of different options of managing mHealth alliances. She is currently working on a remote disease monitoring offering for Nigeria. For more information contact firstname.lastname@example.org