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Mobile Health is the Top Health Industry Issue for 2015

Mobile Health is the Top Health Industry Issue for 2015 | Healthcare and Technology news | Scoop.it

A recent report from leading consulting and professional services firm PriceWaterhouseCoopers on key challenges in healthcare highlights digital health as one of the biggest.

In their report, Top 10 health industry issues of 2015, the PwC Health Research Institute (HRI) labelled “do-it-yourself healthcare” and “making the leap from mobile app to medical devices” as the number one and two issues on their list. These two issues are reflective of two parallel streams in digital health – one a generally unregulated activity and the other being potentially highly regulated.

The first issue is connected to underlying changes in the healthcare insurance industry that incentivize preventive services more than ever before. A greater focus on preventive services inevitably requires that consumers focus on their own health behaviors. Many employers are incentivized by the federal health reform law (Patient Protection and Affordable Care Act) and state law changes to encourage their employees to either improve their health behaviors or pay more in premiums than their colleagues who do improve their behaviors. This is where the increasing focus on do-it-yourself health care comes in.

Wearable devices linked to apps help people gather data that is useful in guiding their behavior changes and maintaining healthy behaviors they have already begun. These devices, while significant for individuals and potentially important to lowering health care costs for private insurers and state/federal governments, are ironically not the focus of FDA. They are not perceived as medical devices although some might be perceived by consumers as making medical claims of helping a person to improve their diet and increase their physical activity so that they lose weight. This unregulated realm of innovation will likely continue its growth in 2015, according to HRI, encouraged by the continued flow of investment funds and attention-grabbing contests like the $10 million Qualcomm Tricorder XPRIZE. This prize will go to the development team that creates a personal device able to diagnose 16 conditions and measure five real time vital signs in a non-invasive manner.

The second issue represents the use of medical apps for more than general wellness; instead, connected to medical devices or used to manage specific diseases. Apps being used as medical devices or tied directly to medical devices are not accessible to consumers without a doctor’s order. While that likely makes them safe, it does imply a number of regulatory hurdles that can make this area less appealing to innovators. As we’ve now seen, these regulatory hurdles have been overcome as the FDA has approved or cleared nearly 100 medical apps. In 2015, HRI sees the FDA reviewing a record number of mobile health apps in order to meet the growing industry demand for this technology. According to HRI, over the next 5 years, 86% of clinicians believe that mobile apps will play a major role in a physician’s practice.

As the PwC HRI indicates, 2015 is likely to be a significant year for mobile health and a driving force in the ever changing environment of healthcare in the US.


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Moving Mobile Health Past The Hype

Moving Mobile Health Past The Hype | Healthcare and Technology news | Scoop.it

Imagine if the iPod could only play Frank Sinatra songs, or if the latest iPhone version was a not-so-smart-phone with just text, email and a weather app. It’s not just the existence of mobile computers we call smart phones that has changed our lives in profound ways, but the content delivered by them. It’s also why the “mobile health” or “wearable technology” movement is dramatically over-hyped.

The belief that new technology like body monitoring and data tracking is the key to a healthier and happier world ignores the huge role that content plays in converting data and analytics into emotion that engages people in new health behaviors by humanizing our experience with technology. It’s one thing to get fitness fanatics who already take care of themselves to adopt cool new devices. It’s an entirely different challenge to attack major health issues like diabetes among large populations historically resistant to engaging in their own care.

Ultimately what will successfully complete the virtuous cycle back to the user is not simply data. Nor is it a text, a call, a reminder or a lecture upon the next visit to a physician who is now armed with yet more data.  We need personalized, compelling and imaginative content that makes the user want to engage in self-care.  People aren’t moved to action by “data dumps,” but by emotion and narrative.

Mobile health devices could become a biological information superhighway that transfer data from our bodies or brains to the cloud for analysis and action, so long as the right content returns to the user to complete the cycle.  Here is a prescription for success.

1. Overcome Innovator Arrogance. Only in the rarified air of Silicon Valley, where revolutionary trends, rebellious billionaires and the fastest-growing companies are created, would a movement emerge apparently tone deaf to the audience it most needs to serve. The current fascination with making disease management quantitative has less to do with mass population health need and more to do with the often narrow perspective of technology “innovators” who (1) believe that data is the answer to every problem and (2) build things for who and what they know, which tends not to be the mass population of chronic disease sufferers. Aging Americans have little access or interest in a quantified life, but rather are just trying to have a normalized life.

2. Get Beyond a Self-Selected Consumer Base. There are multiple markets and consumers to serve for this new generation of mobile health tools, but so far adoption is from those raising their hands. Whether it’s activity trackers like Fitbit or a new family of interactive glucose monitors for people with diabetes, users opting in early aren’t the ultimate target. Most consumers aren’t even asking for this gadgetry. Despite the over 100,000 health and fitness apps now available, the number of Americans using technology to track their health has not changed since 2010, according to the Pew Internet & American Life Project.  And when asked, “What would you like to do more of with your smartphone?” only 12 percent of consumers told a recent Zogby survey they would like to “monitor their health.”

3. Serve Patients, Not Their Proxies. Crossing the divide from cool consumer devices to integrated healthcare tools for the chronically health-disengaged requires penetrating the powerful forces that pay for it (employers, insurers and government) or entrenched providers that deliver the service (physicians and hospital systems). These consumer proxies are focused on the macro and thus love data and the potential efficiencies and cost savings it can deliver, fueling interest from start-ups but not necessarily from the ultimate user who lives in the micro and may not care much about this data collecting gadgetry – even if their doctors and insurers do. Commercialization is a great deal more challenging as innovators bump up against embedded and siloed systems not prone to quickly adopt or integrate new paradigms and where consumers tend be treated like they’re not in the room. We must put products in front of patients they will actually want to use, not the ones its proxies want them to use.

4. Recognize That Medical Problems Have Tough Behavioral Roots. Diabetes consumes almost 25% of total healthcare system spending and is growing at epidemic rates. By 2050 a third of Americans will be challenged by diabetes which requires strict adherence to diet, exercise, medication and more. The onus always falls to the patient, which is why it is so critical for new digital health solutions to be “humanized” to attract the panoply of potential users. Start-ups like Telcare and Livongo claim they can make diabetes management better or easier with a “connected” blood glucose meter that sends data all over the place – your doctor, your insurer, your caregiver and so on, but it still depends on a base level of compliance by the patient.

This is fine for the young, intensely self-managed, tech savvy Type 1 patient or parents of kids with diabetes, who are motivated and open to leveraging this kind of technology and may even have a physician with the time and interest in using the data. But unfortunately, the vast majority of the devastation and cost of diabetes is concentrated in higher-risk groups who are less informed or resistant to behavior change, and managed by a harried primary care doctor inside a fossilized system. 65% of people with diabetes are over 50 and almost 60% don’t even test their blood sugar at all. These folks don’t look or act like “quantified selfers”.

5. Think Like Marketers and Storytellers. Fundamentally these chronic “lifestyle diseases” such as diabetes, obesity and hypertension are behaviorally driven. Digital health must shift to a more consumer-centric mentality to achieve user relevancy and embrace the very real psychosocial and emotional challenges that limit self-care behaviors.  Numerous studies refer to the “narrative” as a more effective way to get individuals to do what you want them to do, no longer clinging to outdated strategies of authorities lecturing overwhelmed patients with data and facts.  Current data-driven algorithms that use basic information like blood sugar readings, medication, food intake or heart rate as inputs could come to life if enveloped by compelling branding, content and storytelling to command attention and sustain behavior change regardless of age, ethnicity, disease progression or tech-savviness.

Integrating the biological with the behavioral is as much a creative process as it is an engineering or clinical challenge. Doctors and engineers must collaborate with behaviorists, content creators and marketers to pioneer new ways to engage not just with data, but with emotion.  Even in a HIPAA-dominated world with appropriate sensitivity around data security, knowing more about each user by not just monitoring physiological variables, but assessing subtle psychosocial and behavioral influences as well, can facilitate delivery of a more personally tailored, relevant, involving and even entertaining experience.

For example, a diabetes management system enabled with individual “likes” could deliver videos from Oprah encouraging me to test my blood sugar for the sake of my grandchildren, instead of a generic text reminder to test my blood sugar. Which one do you think would resonate with an Oprah fan and sustain some behavior change? This is where the content creators – storytellers, filmmakers, game developers and advertisers – can play a major role in product development by integrating the narrative elements that attract the disengaged into their story because it is personal, involving, compelling and real.

We now have a pipeline of hardware and the highway; we just need the content for digital health to start changing the game for a mass population compromised by chronic lifestyle diseases like diabetes.

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Allan Pedersen's curator insight, February 9, 2015 7:05 PM

Pretty much right on the money.

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How One Man Brought Health Care to India's Poorest Populations

How One Man Brought Health Care to India's Poorest Populations | Healthcare and Technology news | Scoop.it

Shelley Saxena, a mobile technology entrepreneur in Atlanta, had a head start when he launched Sevamob, a distribution system for low-cost preventive health services across India. But that didn’t save him from having to make a few strategic pivots as his new business grew.

Shelley used capital and intellectual property from his earlier startup, Saasmob -- which provides tools for mobile-app developers -- to launch the health service in his original hometown of Lucknow in the Indian state of Uttar Pradesh. The Cornell MBA and his founding partners scraped together $46,000.

SaasMob, his U.S. company, developed a platform to provide information to farmers. But to fulfill the need for primary healthcare in mostly poor, mostly rural regions in India, Shelley knew the model had to be adapted for communities where literacy rates and smartphone use are low.

Sevamob is now providing services -- basic primary healthcare, diagnostics, medicines and insurance -- to more than 7,000 subscribers in Uttar Pradesh and four other states including Karnatka and the National Capital Region around New Delhi.


Last year, he raised a bridge round of $227,500 as a step toward expected Series A financing to help it expand to three more states and test a model in sub-Saharan Africa.

Sevamob’s model “is innovative, scalable and replicable,” said Andy Lower, founder of ADAP Capital LLC, which led the bridge financing. “We believe in the massive potential of Sevamob’s disruptive primary healthcare model.”

Honing that model was tricky, however. The company dropped door-to-door checkups and policy enrollment because the approach proved too costly and time-intensive. It also scrapped some of its lowest-cost policies, like its $2.50-a-month student plans.

Sevamob now partners with local institutions as well as governmental and non-governmental organizations to enroll groups of employees, students and others in insurance plans costing as little as $2 to $3 per month. The plans cover semi-annual, on-site health checkups from homeopathic and other well-trained but low-cost professionals who provide primary care, dental checkups and prescription medications. These professionals log patient data in an online healthcare platform that can be accessed by patients and partnering emergency care and specialist providers. Patients can also tap into the system by phone.


Shelley knew the data repository could become Sevamob’s ultimate value-proposition. “We know [every patient’s] medical history and can splice the data in a number of ways,” he says. Sevamob can tell a pharmaceutical company where to launch a new product, for example.

Last year, Sevamob introduced Seva360, an online health exchange that connects patients and healthcare providers. Sevamob collects transaction fees from the growing base of 400 providers who use the site to expand their services and patient reach. Patients with computer access or smartphones can schedule video and in-person appointments or check personal health data. Through a partnership with Alere, Sevamob can provide rapid diagnoses at the point of care.

Families and individuals with monthly income of between 6,000 and 25,000 rupees per month (about $95 to $400) now make up Sevamob’s key demographic. The majority of its plans cost between $4 and $9 a month, depending on the coverage package.


Sevamob still looks for opportunities to serve the true base of India’s pyramid, through partnerships with government, non-profits and foundations. With Texas-based Firdous Foundation, Sevamob provides healthcare for 2,000 orphans in Bangalore, Delhi and Lucknow. It has a partnership in Bangalore to provide HIV screening to more than 12,000 sex workers.

Sevamob got a lift from Village Capital, the startup accelerator, when it was selected by other entrepreneurs in its cohort for a $50,000 convertible note. Last year’s bridge round of $227,000 included ImpactAssetsArtha Venture Challenge and D3 Jubilee as well as ADAP. The company is not yet profitable, but has reached a break-even point in two states.

“Right now, we’re focused on growth,” Shelley says. “That’s where our investor targets are focused.”


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