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Sandeep Kishore

mHealth – for the healthier world

Sandeep KishoreSandeep Kishore

Earlier this month, a patent application was filed by Google with the US Patent & Trademark office for “Reader communication with contact lens sensors and display device”. As is well known, Google and Novartis are working on the smart contact lens to track glucose levels through sensors on the contact lens. The new patent now takes this to a new level by allowing communication to external display devices. The ability to connect, monitor and communicate critical glucose related information with an external device such as a smart phone or smart mobile device opens great possibilities to the 285+ million people around the world who currently live with diabetes. Welcome to the future of mHealth!

Currently, 90% of the world’s adults have mobile phones and everyday, smart phone adoption is increasing globally and replacing the old feature phones. It is creating a unique opportunity in the healthcare industry to disrupt the traditional expensive value chain with a new, much more agile value chain. One where everyone is empowered to control one’s health through mHealth; where personalized experience, monitoring and prevention take center stage; where spend correlates to outcome; where healthcare moves from the hospital to the patient’s site; and where the flow of health information is seamless and on-demand. mHealth provides the platform which must be leveraged to deliver effective healthcare.

As per World Bank, one billion people globally lack basic access to healthcare and 100 million people face poverty each year due to out-of-pocket healthcare expenses. Most often, these people live in countries with severe healthcare challenges such as epidemic diseases, severe shortage of healthcare personnel, lack of adequate information for prevention, and lack of resources for basic healthcare.

Given the proliferation and adoption of mobile phones even in these countries, mHealth must take center stage in addressing universal healthcare. The world simply cannot wait till 2030 to deliver healthcare coverage to all. There are several examples of leveraging mHealth in emerging economies, and these should become an effective way forward for others to follow, improve and improvise as per local healthcare requirements. ChildCount+ in Kenya noticed that many children in rural Sauri, Kenya were dying from easily treatable diseases. It secured technology and financing from Zain, Sony Ericsson, UNICEF, the Millennium Villages Project and endorsement from the Kenyan government, and created an mHealth service that tracks health and monitors risks among local children. It registered more than 9,000 children in its pilot year and is expected to support continuous reductions in child and maternal mortality.

Several governments and NGOs around the world are now advancing mHealth benefits to remote areas by making basic health information easily accessible via mobile phones, availing doctors over text, email or video conference, and sending out health alerts – often free of cost.

mHealth can also benefit from native mobile payment applications and reduce the overall cost of care, including health system costs associated with chronic conditions such as HIV/AIDS, etc. Kenya‘s Changamka allows users to deposit funds into health savings accounts, using services such as M-PESA, to pay for health services.

The availability of content in local languages will be key to drive the massive adoption of mHealth. As new mHealth applications are developed, innovations at the grassroots level increase with higher adoption of mobile and wearable technology in native languages – the impact will be massive.

The National Health Portal in India has a list of its mHealth initiatives. In its infancy, it may be useful to have all the information in one central location. However, mHealth is a massive transformational opportunity to fundamentally change the way healthcare is delivered in countries such as India. Compared to the world average of 10.5% of GDP spend on Healthcare, as per World Bank, India currently spends less than 4% of its GDP on Healthcare. It must significantly increase investment in healthcare to harness its social and economic potential in the 21st century and mHealth is one of the most effective way forward for such investment.

mHealth in the developed world is of a very different shape. The proliferation of powerful smartphones along with wearables and other connected devices are increasingly empowering patients with more control over their health. Prevention and wellness are becoming more important and constant data collection is facilitating better outcomes as well as compliance. Providers are now increasingly suggesting apps to their patients. The FDA has established a separate approval process for critical mHealth apps. Data capture and reminders through apps are improving compliance among patients. Fitness and wellness are preventing many chronic diseases. Social media is giving rise to virtual communities of people with similar health conditions and objectives.

Some challenges, however, have to be overcome to realize the true potential of mHealth. 2/3 of current mHealth applications focus solely on fitness, lifestyle, stress, diet and nutrition, underscoring the lack of focus on diseases and treatment. Only 10% of these apps have the ability to connect to a device, and only 2% have the ability to connect to a provider system. HIPAA compliance of medical records, especially for connected apps, is a key concern, as is a lack of existing processes and protocols to incorporate mHealth into enterprise systems. At the same time, data security and data ownership are two significant concerns for patients, providers and payers alike. Moreover, while more than 50% of providers use and often suggest mHealth apps to their patients, the apps universe is largely unaudited – creating the risk of harm in unpredictable behavior or incorrect data capture. The absence of a structured way for providers to use captured data further reduces their utility. As wearables become more integrated into our lives, i.e. the diabetes monitoring contact lens, the ecosystem of regulators, technologists and healthcare experts must address these challenges for the world to leverage mHealth in the most effective way.

At the end, significantly improved quality of life and lowest cost of care is the common goal for everyone in the world, and mHealth is one of the most effective platforms available to achieve this.

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