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David Doherty, Business Development, 3G Doctor
mHealth will begin to supersede eHealth



eHealth is a term used to cover a wide plethora of digitalization of health. However the vast majority of eHealth
initiatives to date have involved basic administration tasks eg. converting paper written records and communications
into digital communications. Whilst there is no doubt these conversions of our antique health information systems
will continue to deliver enormous cost savings (as much as $30 Billion annually in the U.S. healthcare system1) in
2009 this will become seen to be expected as efficient business practice and not eHealth.
When a 2008 Kings Fund Report2 reveals that unhealthy behavior is costing the UK’s NHS £6 Billion a year it’s time to
identify what digital technologies can and can’t do to drive health benefits and begin to target patients who can
benefit. The pervasive ownership levels3 and the power of mobiles to engage patients4 will propel the growth of
connected healthcare faster than any economic or policy decisions, and whilst Chronic Care makes up the majority
of healthcare spend5 it may not be the safest area in which to deploy transformative technologies or to make
healthcare cost savings.

In 2009 the medical industry will begin to realize that patients can benefiting from mHealth in ways not possible with
eHealth because;
> Mobiles can offer unrivaled levels of ownership, accessibility and secure identity management.
> the type of Healthcare problems that can benefit most from digital intervention are those that require brief
engagement, are unplanned, may take place at anytime or anywhere, are long term and can benefit from persuasion
& motivation. Only a mobile device has the potential to serve these needs with the necessary privacy, discretion and
personalization.
> Because mHealth doesn’t have the confines of episodical event based interaction it can throw aside legacy
healthcare applications from the desktop era and deliver magic through use of Smartphone technologies such as
Video, 24/7 Feedback, games & applications, Bluetooth, NFC, QR codes, GPS etc.



                                    1) ushealthcareindex.com/howitworks.php           2) kingsfund.org.uk/publications            3) themda.org/
                                    4) 3gdoctor.wordpress.com/2008/12/18/mhealth-the-only-way-of-garunteeing-reachability/
                                    5) There are 860 million chronic disease patients and Chronic care = 75-85% of healthcare spending (WHO; McKinsey)
the Personal mHR will begin to replace eHR



With X% of US adults thinking about creating a Health Record the opportunity for personal Mobile Health Records to
take a small slice of this will be the start of something big, particularly now that Nokia has become the worlds
largest computer manufacturer1.

The take up will languish until the healthcare industry becomes aware that a mHR is not just an eHR contained on
a small and convenient mobile phone but an eHR that has enhanced features that include:

> Ownership – enabling patients to be in charge of their own care which also leads to more active role management
and maintenance. A one stop shop through which they can create, manage and update (automatically in some
instances) and retrievable even in the event of loss/theft.

> Privacy in the event of loss (as it can be remotely stored and retrieved only via secure processes).

> always carried (fundamental to digital identity management best practice)

> Personalization – and engagement

> as the only platform that can empower efficient health monitoring

> as the only platform that can include community as an innate ability.

> micro payment which facilitates patient friendly non-advertiser funded business models

> Mobilizing patient access control via accurate location identifiable and digital identities and authorities

> Reduction of the age/economic access barriers that have hampered eHealth initiatives as a result of the
requirement for PC/Internet access

> The unshared personal nature of the mobile meets the needs of the user-centric healthcare model.

                                                                  1) communities-dominate.blogs.com/brands/2008/12/so-nokia-is-wor.html
the Health Web Bubble won’t happen



Unlike bookstores or videostores most of the work done in the Healthcare industry can’t be done through a content-
specific site on the internet... in 2009 this will be obvious and startups will stop trying to be the Amazon or YouTube
of Healthcare.

Hyperbolic overnight success won’t happen in 2009 as consumers are too well connected to fall for the hype of
unproven healthcare ideas that don’t have a clear and sustainable business model. Marketing hype will not motivate
patients to share their private information and nor will it address the complex pain points they face, as a result it
will be seen for what it is – a tactic used to confuse and distract the listener from questioning the viability of their
decision to entrust their health with an unknown. Instead of setting expectations too high and using buzzword
crutches – Healthcare innovators will need to do the hard work of proving they can help patients.

The need for Health Information will continue to grow and Medical Search Engines will continue to prosper if they
can understand the need for privacy and combine Health Record information to personalize the results. In 2009 the
vast majority of patients will continue to begin Health information searches at Google.

Adoption of Electronic Health Records will continue to flounder until they are patient owned, non-proprietary, easy
to use and access. The step change won’t happen until they become more than an information-only experience and
begin to bundle information with a connection to care experience1 that is tangible and can be understood and
appreciated by patients.

Hyping internet plays may have worked but this can’t be done in Healthcare where behind the marketing hype what
we really need are more gradual evolutions of existing ideas and technologies, organic traffic and recommendation.




                                                       1) slideshare.net/3GDR/ehealth-2008-3g-doctor-connecting-care-and-ehealth-records-presentation/
OLPC interest will shift to OMPC (One Mobile Per Child).



Just as 2008 saw Nokia become the worlds largest computer maker and the Apple 3G iPhone brought smartphones to
under $200, 2009 will see wider appreciation of the computing & educational benefits of mobile and this will start to
shift the interest in the very successful OLPC into wider global appreciation of the much more achievable potential
for One Mobile Per Child to bridge the digital divide.

In retrospect this won’t seem surprising since much of the initial growth of the PC industry was as a result of the
parallel development of the video gaming console. The OMPC project will be competitively driven by entrepreneurs
and will not only benefit from bundling games but also digital communities, communication and mCommerce.

Oxfam used to use a catchy slogan, give a man a fish he will eat for a day, teach a man to fish he will eat forever.
Giving a child a laptop is like giving a child a fishing boat. There is no doubting the usefulness of a fishing boat, but it
needs more than 1 child to operate and has a resale value, giving a child a mobile is like giving them a fishing rod
because it puts them in the driving seat for their own destiny.

Yes there will no doubt be downsides to small screens and keypads but the new digital migrants that mobiles can
reach will thrive by throwing aside the confines of PC legacy applications and seizing transformative mobile
opportunities.




                   laptop.org
SmartHome and Body Area Network initiatives will disappoint
                         and focus will shift to mHome and Pervasive mTechnologies.


   2009 will be another year when the reality of the talking/computing appliances and homes won’t materialise.
   Despite the continued hype and enthusiasm of Industry statements such as “Your Robot Will See You Now”1 and the
   proof from providers2. But the tide will turn as the worlds largest maker of computers (Nokia3) launches the first
   commercial mHome offering4 and the lower costs, tech neutrality, economies of scale and personalisation potential
   that is possible by twinning with upgradeable mobile phone based technologies will future proof ongoing efforts
   towards mHomes rather than Smarthomes.

   Despite this demand for mHomes will remain restricted to small scale and pilots due to economic pressures and
   replacement cycles and mainstream adoption will have to wait until these can prove mass market end user benefits –
   which will probably only be achievable for economic/environment, safety (smoke detection etc) or mHealth
   functionality.

   For 2009 “Body Area Networks”5 will continue to not
   happen for a reason. Most of these still represent the legacy
   way of doing things: “the job we have is to measure something
   and record it”. The ability for Mobiles to support continual
   always on sensory monitoring and the computing to process
   Biometric data to drive feedback and engagement will lead
   to new insights. mHealth technologies won’t go mass market
   until designers build specific mobile solutions where the
   technology is low cost, invisible and automated.




1) Intels Digital Home Group at CES  2) aberdeenshire.gov.uk/news/release.asp?newsID=981
3) communities-dominate.blogs.com/brands/2008/12/so-nokia-is-wor.html
4) smarthomepartnering.com            5) en.wikipedia.org/wiki/Body_area_network
A scientific paper will prove a mFitness application can offer
                     greater Health benefits than regular gym use.


 A scientific paper will be published that will prove a mFitness application involving mobile persuasion and
 motivation can exceed the physical health benefits of gym membership. This will open the flood gates for mFitness
 applications that produce smarter exercising options, more flexibility and better feedback by integrating smartphone
 sensing technologies like GPS and accelerometers1.

 Early examples of commercial success in this field can be seen
 with Addidas/Samsung’ MiCoach2 and Apple/Nike’ Nike+3, and
 next generations will build on the Fitness Gaming phenomenon
 that has risen from the success of Nintendo’ Wii4 through the
 introduction of community and competitive aspects. A simple
 example could be a Wii fitness game that gives coded scores
 which can be submitted (via SMS) to a community site.

 mFitness gaming will be able to address unmet youth fitness
 targets – the levels of obesity are continuing to rise as academic
 pressures are making PE mandates harder to meet, and this is
 largely underserved by the limitations of conventional gyms
 (eg. need for accompaniment by an adult or inconvenient
 opening hours).

 A motivational mFitness application can drive better fitness
 levels by helping persuade participants in a discrete and highly
 personalised way to reach their self selected nutritional and
 fitness targets and goals.


1) news.cnet.com/Motion-sensing-comes-to-mobile-phones/2100-1039_3-6169697.html
2) micoach.com 3) nike.com/nikeplus 4) nintendo.com/wii
Mobile Network Operators will start promoting Healthcare
                        uses for Smartphones


The success of Apple’s App Store in 2008 with over 5,000 applications and 200 million downloads in the first 100 days
has proven that the mass market is interested in doing things with their mobile asides from voice calling and texting
once the user experience is improved, the discovery challenge is met (through open access and unlimited data) and
the mobile operators stop forcing customers towards their own proprietary services.

Several Mobile Operators are set to launch mHealth
initiatives in 2009 including LifeComm1, Orange Health2
and Vodafone/t+3. Whilst these will push the boundaries
of what is possible none will scale as quickly as open
health applications that can run on multiple devices
such as social gaming (eg. Mental game Sukodu) or
mfitness applications that get around the need for
patients to use the Mobile Internet Browser (a legacy
application from the PC days).

By the end of 2009 Health uses for Smartphones will have
proven to be key drivers for Smartphone adoption and use,
and all 3G operators will have begun to promote them in
a bid to chase the profits that can be generated from
increased use of Smartphones (the most profitable mobile
user group4)




                                                                                             »
                                                                                                 Nokia Wellness Diary
 1)   qualcomm.com/innovation/stories/lifecomm.html
                                                                                              ^ Brain Games
 2)   slideshare.net/3GDR/orange-health-strategy-presentation

                                                                                              < Secure Health Records
 3)   3gdoctor.wordpress.com/2008/12/18/vodafone-invests-in-mhealth-firm/
 4)   dw2-0.com/2008/09/beyond-smartphones.html
A 3G Video Calling service will be launched to serve patients
                in need of Medical Emergency Assistance.


A 3G Mobile Video service offering live 2-way connection
with an informed Health professional will transform
consumer appreciation of the benefits of 3G Video
Calling technology.


The benefits of 3G Video Calling for emergency medical
advice will include:

1) More effective and informed advice
2) New opportunities for continuity of care
3) New training opportunities
4) Better deployment of emergency response resources
mHealth will drive the next phase of hardware convergence



Convergence to the mobile has already happened with Smartphones now featuring Calculator, Calendar, Camera,
Clock, Diary, Email, Games Console, GPS, Gyroscope, IM, Office, Pager, Phonebook, PTT, Radio, RSS Feeds,
Stopwatch, Thermometer, Timer, TV, Video and Web browser.

In 2009 this will continue with Control of our SmartHomes, Google Maps, mBanking, Mobile Communities, mPayment
authorisation, mTicketing, mWallet, SatNav and VOIP.

mHealth technologies/solutions will provide substantial &sustainable mobile ARPU increases and in 2009 will become
appreciated as the first convergent technology that will compel consumers to pay significantly more for advanced 3G
Smartphones.




 Patient using a Healthphone to perform a diagnostic heart test          Low power wireless medication reminder application

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mHealth Industry Predictions for 2009 by David Doherty, Business Development at 3G Doctor

  • 1. David Doherty, Business Development, 3G Doctor
  • 2. mHealth will begin to supersede eHealth eHealth is a term used to cover a wide plethora of digitalization of health. However the vast majority of eHealth initiatives to date have involved basic administration tasks eg. converting paper written records and communications into digital communications. Whilst there is no doubt these conversions of our antique health information systems will continue to deliver enormous cost savings (as much as $30 Billion annually in the U.S. healthcare system1) in 2009 this will become seen to be expected as efficient business practice and not eHealth. When a 2008 Kings Fund Report2 reveals that unhealthy behavior is costing the UK’s NHS £6 Billion a year it’s time to identify what digital technologies can and can’t do to drive health benefits and begin to target patients who can benefit. The pervasive ownership levels3 and the power of mobiles to engage patients4 will propel the growth of connected healthcare faster than any economic or policy decisions, and whilst Chronic Care makes up the majority of healthcare spend5 it may not be the safest area in which to deploy transformative technologies or to make healthcare cost savings. In 2009 the medical industry will begin to realize that patients can benefiting from mHealth in ways not possible with eHealth because; > Mobiles can offer unrivaled levels of ownership, accessibility and secure identity management. > the type of Healthcare problems that can benefit most from digital intervention are those that require brief engagement, are unplanned, may take place at anytime or anywhere, are long term and can benefit from persuasion & motivation. Only a mobile device has the potential to serve these needs with the necessary privacy, discretion and personalization. > Because mHealth doesn’t have the confines of episodical event based interaction it can throw aside legacy healthcare applications from the desktop era and deliver magic through use of Smartphone technologies such as Video, 24/7 Feedback, games & applications, Bluetooth, NFC, QR codes, GPS etc. 1) ushealthcareindex.com/howitworks.php 2) kingsfund.org.uk/publications 3) themda.org/ 4) 3gdoctor.wordpress.com/2008/12/18/mhealth-the-only-way-of-garunteeing-reachability/ 5) There are 860 million chronic disease patients and Chronic care = 75-85% of healthcare spending (WHO; McKinsey)
  • 3. the Personal mHR will begin to replace eHR With X% of US adults thinking about creating a Health Record the opportunity for personal Mobile Health Records to take a small slice of this will be the start of something big, particularly now that Nokia has become the worlds largest computer manufacturer1. The take up will languish until the healthcare industry becomes aware that a mHR is not just an eHR contained on a small and convenient mobile phone but an eHR that has enhanced features that include: > Ownership – enabling patients to be in charge of their own care which also leads to more active role management and maintenance. A one stop shop through which they can create, manage and update (automatically in some instances) and retrievable even in the event of loss/theft. > Privacy in the event of loss (as it can be remotely stored and retrieved only via secure processes). > always carried (fundamental to digital identity management best practice) > Personalization – and engagement > as the only platform that can empower efficient health monitoring > as the only platform that can include community as an innate ability. > micro payment which facilitates patient friendly non-advertiser funded business models > Mobilizing patient access control via accurate location identifiable and digital identities and authorities > Reduction of the age/economic access barriers that have hampered eHealth initiatives as a result of the requirement for PC/Internet access > The unshared personal nature of the mobile meets the needs of the user-centric healthcare model. 1) communities-dominate.blogs.com/brands/2008/12/so-nokia-is-wor.html
  • 4. the Health Web Bubble won’t happen Unlike bookstores or videostores most of the work done in the Healthcare industry can’t be done through a content- specific site on the internet... in 2009 this will be obvious and startups will stop trying to be the Amazon or YouTube of Healthcare. Hyperbolic overnight success won’t happen in 2009 as consumers are too well connected to fall for the hype of unproven healthcare ideas that don’t have a clear and sustainable business model. Marketing hype will not motivate patients to share their private information and nor will it address the complex pain points they face, as a result it will be seen for what it is – a tactic used to confuse and distract the listener from questioning the viability of their decision to entrust their health with an unknown. Instead of setting expectations too high and using buzzword crutches – Healthcare innovators will need to do the hard work of proving they can help patients. The need for Health Information will continue to grow and Medical Search Engines will continue to prosper if they can understand the need for privacy and combine Health Record information to personalize the results. In 2009 the vast majority of patients will continue to begin Health information searches at Google. Adoption of Electronic Health Records will continue to flounder until they are patient owned, non-proprietary, easy to use and access. The step change won’t happen until they become more than an information-only experience and begin to bundle information with a connection to care experience1 that is tangible and can be understood and appreciated by patients. Hyping internet plays may have worked but this can’t be done in Healthcare where behind the marketing hype what we really need are more gradual evolutions of existing ideas and technologies, organic traffic and recommendation. 1) slideshare.net/3GDR/ehealth-2008-3g-doctor-connecting-care-and-ehealth-records-presentation/
  • 5. OLPC interest will shift to OMPC (One Mobile Per Child). Just as 2008 saw Nokia become the worlds largest computer maker and the Apple 3G iPhone brought smartphones to under $200, 2009 will see wider appreciation of the computing & educational benefits of mobile and this will start to shift the interest in the very successful OLPC into wider global appreciation of the much more achievable potential for One Mobile Per Child to bridge the digital divide. In retrospect this won’t seem surprising since much of the initial growth of the PC industry was as a result of the parallel development of the video gaming console. The OMPC project will be competitively driven by entrepreneurs and will not only benefit from bundling games but also digital communities, communication and mCommerce. Oxfam used to use a catchy slogan, give a man a fish he will eat for a day, teach a man to fish he will eat forever. Giving a child a laptop is like giving a child a fishing boat. There is no doubting the usefulness of a fishing boat, but it needs more than 1 child to operate and has a resale value, giving a child a mobile is like giving them a fishing rod because it puts them in the driving seat for their own destiny. Yes there will no doubt be downsides to small screens and keypads but the new digital migrants that mobiles can reach will thrive by throwing aside the confines of PC legacy applications and seizing transformative mobile opportunities. laptop.org
  • 6. SmartHome and Body Area Network initiatives will disappoint and focus will shift to mHome and Pervasive mTechnologies. 2009 will be another year when the reality of the talking/computing appliances and homes won’t materialise. Despite the continued hype and enthusiasm of Industry statements such as “Your Robot Will See You Now”1 and the proof from providers2. But the tide will turn as the worlds largest maker of computers (Nokia3) launches the first commercial mHome offering4 and the lower costs, tech neutrality, economies of scale and personalisation potential that is possible by twinning with upgradeable mobile phone based technologies will future proof ongoing efforts towards mHomes rather than Smarthomes. Despite this demand for mHomes will remain restricted to small scale and pilots due to economic pressures and replacement cycles and mainstream adoption will have to wait until these can prove mass market end user benefits – which will probably only be achievable for economic/environment, safety (smoke detection etc) or mHealth functionality. For 2009 “Body Area Networks”5 will continue to not happen for a reason. Most of these still represent the legacy way of doing things: “the job we have is to measure something and record it”. The ability for Mobiles to support continual always on sensory monitoring and the computing to process Biometric data to drive feedback and engagement will lead to new insights. mHealth technologies won’t go mass market until designers build specific mobile solutions where the technology is low cost, invisible and automated. 1) Intels Digital Home Group at CES 2) aberdeenshire.gov.uk/news/release.asp?newsID=981 3) communities-dominate.blogs.com/brands/2008/12/so-nokia-is-wor.html 4) smarthomepartnering.com 5) en.wikipedia.org/wiki/Body_area_network
  • 7. A scientific paper will prove a mFitness application can offer greater Health benefits than regular gym use. A scientific paper will be published that will prove a mFitness application involving mobile persuasion and motivation can exceed the physical health benefits of gym membership. This will open the flood gates for mFitness applications that produce smarter exercising options, more flexibility and better feedback by integrating smartphone sensing technologies like GPS and accelerometers1. Early examples of commercial success in this field can be seen with Addidas/Samsung’ MiCoach2 and Apple/Nike’ Nike+3, and next generations will build on the Fitness Gaming phenomenon that has risen from the success of Nintendo’ Wii4 through the introduction of community and competitive aspects. A simple example could be a Wii fitness game that gives coded scores which can be submitted (via SMS) to a community site. mFitness gaming will be able to address unmet youth fitness targets – the levels of obesity are continuing to rise as academic pressures are making PE mandates harder to meet, and this is largely underserved by the limitations of conventional gyms (eg. need for accompaniment by an adult or inconvenient opening hours). A motivational mFitness application can drive better fitness levels by helping persuade participants in a discrete and highly personalised way to reach their self selected nutritional and fitness targets and goals. 1) news.cnet.com/Motion-sensing-comes-to-mobile-phones/2100-1039_3-6169697.html 2) micoach.com 3) nike.com/nikeplus 4) nintendo.com/wii
  • 8. Mobile Network Operators will start promoting Healthcare uses for Smartphones The success of Apple’s App Store in 2008 with over 5,000 applications and 200 million downloads in the first 100 days has proven that the mass market is interested in doing things with their mobile asides from voice calling and texting once the user experience is improved, the discovery challenge is met (through open access and unlimited data) and the mobile operators stop forcing customers towards their own proprietary services. Several Mobile Operators are set to launch mHealth initiatives in 2009 including LifeComm1, Orange Health2 and Vodafone/t+3. Whilst these will push the boundaries of what is possible none will scale as quickly as open health applications that can run on multiple devices such as social gaming (eg. Mental game Sukodu) or mfitness applications that get around the need for patients to use the Mobile Internet Browser (a legacy application from the PC days). By the end of 2009 Health uses for Smartphones will have proven to be key drivers for Smartphone adoption and use, and all 3G operators will have begun to promote them in a bid to chase the profits that can be generated from increased use of Smartphones (the most profitable mobile user group4) » Nokia Wellness Diary 1) qualcomm.com/innovation/stories/lifecomm.html ^ Brain Games 2) slideshare.net/3GDR/orange-health-strategy-presentation < Secure Health Records 3) 3gdoctor.wordpress.com/2008/12/18/vodafone-invests-in-mhealth-firm/ 4) dw2-0.com/2008/09/beyond-smartphones.html
  • 9. A 3G Video Calling service will be launched to serve patients in need of Medical Emergency Assistance. A 3G Mobile Video service offering live 2-way connection with an informed Health professional will transform consumer appreciation of the benefits of 3G Video Calling technology. The benefits of 3G Video Calling for emergency medical advice will include: 1) More effective and informed advice 2) New opportunities for continuity of care 3) New training opportunities 4) Better deployment of emergency response resources
  • 10. mHealth will drive the next phase of hardware convergence Convergence to the mobile has already happened with Smartphones now featuring Calculator, Calendar, Camera, Clock, Diary, Email, Games Console, GPS, Gyroscope, IM, Office, Pager, Phonebook, PTT, Radio, RSS Feeds, Stopwatch, Thermometer, Timer, TV, Video and Web browser. In 2009 this will continue with Control of our SmartHomes, Google Maps, mBanking, Mobile Communities, mPayment authorisation, mTicketing, mWallet, SatNav and VOIP. mHealth technologies/solutions will provide substantial &sustainable mobile ARPU increases and in 2009 will become appreciated as the first convergent technology that will compel consumers to pay significantly more for advanced 3G Smartphones. Patient using a Healthphone to perform a diagnostic heart test Low power wireless medication reminder application