E Health 2008 Apple

Making money with mHealth Apps

Target audience is THE MOST AFFLUENT

Patients make THE MOST LOYAL customers

Legacy industry is very expensive – lots of opportunity as services are cut back to
get paid directly out of the patients pocket

Business Model doesn’t have to be BASED ON ADVERTISING

Patients WANT PRODUCT RECOMMENDATIONS and REFERRALS

Patients are very active contributors to online communities (even MySpace!)

Be careful with your customers Personal Data and Privacy
> Storage
> Third Party Access
> Location sensitivity

eHealth 2008, City University London © 3G Doctor Ltd

TURN ON BLUETOOTH TO RECEIVE MY VCARD

Connected Care:
Adding Value to the
David Doherty
Electronic Health Record Business Development


Connected Care: Adding Value to the EHR

> Why a disconnect in care is holding back EHR adoption

> The Mobile Phone – the optimal device for Connecting your Health

> Why health information and devices will converge to the Mobile

> Unique benefits of Mobile for personalized delivery of connected care

> Some examples of how the Mobile is Connecting Care

> How 3G Doctor is Connecting Care

> How a mobile connected care would enhance care services today

> Summary


Why is EHR adoption languishing?



Financial

Security & Privacy

Legal Liabilities



Financial

Ubiquitous
Mobile
Security & Privacy Connectivity

Legal Liabilities



Financial
Consumer owned
Mass produced
Ubiquitous
Mobile

Legal Liabilities



Financial
Consumer owned
Mass produced
Ubiquitous
Mobile
Personal & unshared
Always on & connected
Biometric authentication

Legal Liabilities



Financial
Consumer owned
Mass produced
Ubiquitous
Mobile
Personal & unshared
Always on & connected
Biometric authentication

Legal Liabilities
Patient Owned & Managed
Up-to-the-minute


How should Patients carry their Health Information?


Convergence to the Mobile Device
we have already seen
Video Player
Camera
/Recorder
Calculator/
Answer machine
Converter

Internet Calendar/
Browser Diary

GPS/Altimeter/ NFC/ Barcode
Navigator Reader

Clock/Alarm Pager

Games Music recorder
Console /player
Office Software


The inevitable convergence of personalised
Connected Care to the Mobile
Temperature/
Weighing Scales
Touch
Exercise Coach
Sleep Monitors
/trainer

Food
Holter Monitor
Diary

Connected
Medication
Point of Care
Reminders
Testing
Games &
Cognitive BioSensors
Monitoring
Blood Pressure
Blood Sugar
Monitors Carer-Ping


Unique benefits of the Mobile Phone for
Personalized Delivery of Connected Care

> Completely personal device

Facilitates highly personal health services
Can help to ensure fidelity of patient
> Always turned on and carried or within arms reach

Facilitates Wireless Body Area Networks
Facilitates the gathering of contextual info
Ensures it's there in unexpected emergency scenarios
Provides assurance that care is at hand
Facilitates push services as well as pull

> Built in micropayment means

Enables lower costs to deliver services
Supports low cost pay-as-you-use health services


Early successes in Mobile Healthcare…

> In 2004 London Ambulance service began locating callers following EC
Directive 2002/22/EC requiring MNOs to provide data to EMS

> Today 80% of the 30 million UK Emergency 999 calls are made from a Mobile
Phone - up from only 25% in 2004.

> 8 million NHS Direct calls - again most were made from Mobile

Inevitably a lot of these are happening within the vicinity of a fixed-line phone.



Case of Emergencyquot;
quot;In

Number programmed into your phone memory under the name “ICE”

In case of emergency the 24/7 service will provide Medics with information
and inform family and friends

Annual subscription based service



Mobile Health Promotion for over 36 NHS Primary Care Trusts (Islington CS)

Fully automated appointment reminders and targeted group messaging.

Started by using SMS to reduce GP missed appointments the services are now
used to support:

Smoking cessation
Child immunization
CVD
Breast Screening
Obesity
Flu-Jab
Hypertension



BLOOD BANK



Nokia Wellness Diary

Free to download
application for
Symbian S60 Mobile
Phones

Enables the collecting,
Storage & analysis of
Wellness-related data
collected from everyday
life.

Over 150,000 downloads
per month from Nokia website



Samsung MiCoach

Partnership between Samsung &
Addidas

Provides an on-the-go real time
coaching system comprised of a
connected stride sensor & heart
rate monitor.

MiCoach.com
By fusing music, sports, fashion &
mobile technology the service
connects through the website to
enable fitness planing, tracking
and analysis.

Compare to NR’s Nike+ (size/pc/designed/cost)



Medical Intelligence – Columba bracelet

Safety Device for those with advanced stages
of cognitive impairments & for peace of mind
for their families and caregivers.

Permanently wrist worn, waterproof, shock
resistant and requires a special key to be
removed.

24/7 accurate GSM & GPS location & exit
detector.



Interactive health management & remote patient
monitoring for populations with conditions
including asthma, diabetes, COPD, cardiovascular
disease, obesity as well as general wellness.



Integrated Technology and Service

Ambulatory Cardiac Monitoring with realtime
beat-to-beat analysis, automatic arrhythmia
detection & wireless ECG transmission.

Benefits over 24-48 hour Holter Monitoring
or event recorders include the fact that
some arrhythmias may occur too infrequently
or be asymptomatic presenting difficulties
triggering the alarm.



LifeCOMM

US Based Mobile Virtual Network Operator
(MVNO) set to launch 2008

quot;Targeting women aged 40-65 because they
are influencers when it comes to healthquot;

quot;15 million U.S. women look after 2 sets of
parents - an unserved marketquot;

quot;Today we primarily use our phones for
communication, information gathering
& entertainment, but LifeCOMM wants to
transform our phones into 'in-the-hand'
tools that can help us maintain our good
health or manage a condition we may
already havequot;



Tuvi orbach screenshots


How we're Connecting Care at 3G Doctor

Ability to Create, Manage and Share
your important health information.

Questions & Answers handled by remotely
Distinct servers and SSL encryption

Data stored remotely and not on the
Device so no issues with loss/theft.

Can be referred to when Video Consulting
with 3G Doctor from registered mobile

Can be electronically transmitted to
official authority with Name, Mobile
Number, IMEI, Address, Photo, NHS
Number etc.


How we're Connecting Care at 3G Doctor

24hr x 365 day 3G Video access to an informed
General Medical Council registered Doctor for
non-urgent help and advice.

Video Call is made to the patient after the
completion of an interactive Medical History
Questionnaire and the review of this by the
consulting Doctor.

Following the Video Consultation the Patient
receives a 3G Doctor Consult Report including
their Medical History and the Doctors advice.

Charged at £35 per consultation inclusive.


3G Doctor Future Developments

Medication management program using low cost NFC
sensory technologies

Connection of Point of Care Testing to Video Education
and 1-2-1 Advice
Support of secure Mobile Care Communities
International multilingual 3G Video Advice

Informed Doctor triage of Emergency calls


What can happen when we Connect Care
to the EHR through the Mobile…

Community Critical


d
ge
na ily
ma m nt ce
ly & fa
rge Advi
al s ral
orm iend nu l fer
No iona
N fr Re s
al sult
ss
by n
ofe sio Re
Pr fes Test y
nc
Pro eg. e
erg
Em

Community Critical


d
ge
na ily
ma m nt ce
ly & fa
rge Advi
al s ral
orm iend nu l fer
No iona
N fr Re s
al sult
ss
by n
ofe sio Re
Pr fes Test y
nc
Pro eg. e
erg
Em

Community Critical

Emergency
Telephone/online Dermatology On scene at
Home Help Telephone
advice referral emergency


Home Help

80% of all care is delivered by unqualified friends and family

Growth of ever more sophisticated home health technologies will continue
to impact on this particularly as 9 in 10 of US 60+ claim that they want to
stay in their home & community as they age*.

The need for remote access to informed care is increasing and the ability
to access anytime anywhere care means that patients aren't discouraged
from leading out going lives by fixed systems. And can benefit from
physical and social benefits of this additional mobility.

* American Association of Retired Persons


Telephone/online
advice

Authenticated Connected Care would:

> Enhance the Continuity of Care and reduce repetition
> Improve the speed and quality of decision making
> Prevent misuse and privacy breaches
> Enable the international support of patients.
> Increase access to quality care and ensure it is current
> Better support new medical technologies and POC tests

The NHS itself is leading by example in this area with Healthspace

Push instead of pull… eg. Drug recalls and seasonal advice

Epidemic awareness: by knowing who is reporting we can make more informed
decisions. Eg. Profiling of diseases and patients

Strengthening the carer' ability by giving them more information and better tools
which will lead to better decisions and less burden.


Dermatology
referral

Mobile Connected Care Current Store & Forward Practice


Dermatology
referral


Book appointment & attend Clinic
Questions asked by Mobile Device Questions asked by Nurse
Images uploaded by patient Images taken by Nurse


Dermatology
referral



Consultant Reviews Case


Dermatology
referral




Patient receives report Nurse receives Report

Clinic arranges for patient to
attend
Patient attends appointment


Dermatology
referral




Patient receives report Nurse receives Report

Clinic arranges for patient to
attend

Referral / Treatment


Dermatology
referral




Patient contacted by Consultant Nurse receives Query
Nurse Queries patient
Consultant Review case
Nurse receives report
Patient attends appoint


Emergency
Telephone

Which service would you like, Police, Ambulance, Fire or Coastgaurd?

3G Video Connected Care would offer the Who, Where, Next of Kin, Doctors
Name, Condition(s) and Identity enabling more appropriate
and timely referral to staff with appropriate skills

Future enabled eg. quot;I understand you have a device called an ABC that is
reporting XYZquot;.

75% of the 30 million UK annual 999 calls are hoax & more than 17,000 per
day originate from inadvertent key pressing.


On scene at
emergency

As the device that is always with us, always connected.

In the event that it is not data and informed care can be retrieved using
any other means of connectivity

Identification uses every patients unique mobile phone number but can be
extended to IMEI number, SIM Card Number, Name, Address, Biometric
Recognition.

Ultimately the provision by the patient of important information in a timely
and electronic way will let us start to utilise the most underutilised person
in todays healthcare system.


Summary

EHR and Connected Care present a classic chicken and egg scenario:
because the value of either is dependent on the other.

The value in health records cannot be realised until they are connected.

The value of remote care cannot be realised until it is connected to information.

Advanced consumer Mobile devices and networks are placed uniquely to be
the means by which this can be delivered.

3G Mobiles provide additional ubiquity, future proofing, location data, higher
speed data transfers (both up and down link) and multimedia abilities.

The healthcare industry should build to exploit consumer 3G technologies and
Always Best Connected principles


mHealth App Business Model

The free Medzio iPhone app does more than just connect consumers to health
information. It’s a fast and easy way to bring together consumers, world-class
health content, medical resources and expert advice for an improved healthcare
experience. We’re connecting a network of forward-thinking companies with
fresh, new ideas about healthcare and people who want better access to health
information and services. Because we believe that when you bring together the
best healthcare providers with motivated consumers good things will happen.

Download and Update Prices

Partner Referral Fees

Advertising

Make something useful, promote it,
build a community & stay ahead of the pack…


Let’s think of some mHealth Apps…


E Health 2008 Apple

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Editor's Notes