The Webinar organized by Endeavour - The Mobility Company, held on July 28, 2010 explored the increasing use in healthcare and its future. For more information on mHealth, visit: www.techendeavour.com

1. Mobility in Healthcare
A Webinar
By Endeavour Software Technologies
Presenters : Jayaraman Raghuraman (Raghu)
Ajay Gabale
www.techendeavour.com
Image Credits: Gasshead, LLC, WellDoc, Inc

2. Copyrights and Ownership - Disclaimer
All ownership of ideas, products and solutions referenced in this presentation belong
to the people and companies who have created and have the rights and copyrights to
the solutions and ideas. This session is educational and the speaker and Endeavour
does not own rights to this incredible work being done across the world. Material has
been derived from the internet, articles and journals as well as experiences of
Endeavour in Healthcare

3. Vision and Agenda
• Vision
– Explore the immense increase of mobile
technologies and it’s increasing use in
healthcare
• Agenda
– Growth in Mobile Technologies and Devices
– Leveraging Mobility in Healthcare –
Advances and Opportunities
– Examples of Innovations in Healthcare
using Mobile Solutions
– About Endeavour
• Value to You as Participants
– Help in generating ideas of use of mobile
solutions in your domain in healthcare
– Evaluate Endeavour’s work in mobility and
it’s applicability to your organization as
partners or vendors

4. Section 1:
The Tremendous Global Growth in
Mobile Technologies and Devices

5. Incredible Growth of Mobile Users and Phones
• 4.6 billion mobile phones
worldwide (3.6 billion users)
• Will Grow by another 2 billion
within next 6 years!!
• 45.5 million people in the United
States own Smartphones - 90% of
households
• 91% of Americans keep their
handset near them 24 hours a day

6. Growth is Global and not just here in the USA!
• Exploding growth in developing countries
– 128m new subscribers in India (660 mln users
in 2010)
– 89m in China
– 96m in Africa in 1 year
– Adding 9 mm subscribers monthly in India,
China
• Worldwide penetration – 60% in 2009 to
grow to 74% in 2013
• 500 mm PC, 4 billion cell phones, 50+ billion
devices with data ports
• Smartphones : 500 million in use globally by
2012
• 10% increase in mobile phone adoption
results in 0.8% increase in GDP per person

7. Growth in Internet, SMS, Broadband and Data
• Portables (Laptops, Netbooks, Tablets)
account for 60% of sales
– More than 3.7 mln iPADs sold in 3 months
• Total Mobile Broadband users : 200 million
(2009) to grow to 2 billion by 2014.
• Broadband Households: 429 million (2009).
88 million (China), 84 million (USA)
• Text Messaging exploding
– 4.1 billion messages sent daily in USA
– 2.1 trillion messages from AP in 2010
• Mobile data including SMS contribute 25%
of mobile revenue

8. Growth in Internet, SMS, Broadband and Data (cont’d)
• 62% of US subscribers used some form
of mobile data services in 2009
• There are more than 257 million data-
capable devices
• In January, Gartner Research predicted
that more people will access the Web
by phone than PC by 2013
• 5000% data increase in 5 yrs

9. Growth of mobile devices in Healthcare
• 72 percent of U.S. physicians use Smartphones
– Up from 50 percent in 2007
• The number of physicians using Smartphones in
2009 doubled
• Physicians access some medical apps 15 to 20
times a day
• 53% of chronic disease patients have cell phone
access
• 60 million people to be benefited using remote
Patient Monitoring devices by 2013
• 75-80% of adult internet users seek medical data
online

10. Growth in Mobile Device Usage
48.8 80% 75%
50
44.3 70%
66%
45 70% 64% 62%
60%
40
48%
50%
35
40%
30
30%
25 20.6 1Q 09
19.4 20% Age
20 1Q 10
15.4
10%
15 10.5 9.6 10.2 0%
8.2
10 6.8
4.4
5 1.6
0
Symbian Blackberry iPhone OS Android WinMob Others
35.0 45.9 112.2 806.3 -0.9
Data source: Gartner Data source: Forrester Research
Figure. 1 Figure . 2
Worldwide Smartphone market share by OS Age Wise Cell Phone Ownership

11. Technology Adaption by Chronic Condition People
89%
90%
81%
76%
80%
70%
68%
70%
60%
60% 52%
50% No Condition
1 Condition
40% 32% 2+ Conditions
30% 23%
20%
10%
0%
Go Online Have a Cell Phone Send/ Receive text messages
Source: Chronic diseases and the Internet, Few Internet and American Life Project, March 2010

12. Section 2:
Leveraging Mobility in Healthcare –
Advances and Opportunities

13. Mobile Solutions for Healthcare – Changing Environment
Until Now Progressing To
• Independent Medical Devices for • Better Connectivity and communication
each function – Between healthcare providers and their
• Not fully integrated with hospital patients
and healthcare information – As well as their devices
systems to share data • Seamless Device Integration,
Interoperable with consumer devices
• Manual Data collection and
Analysis • Platform enabling
• Transition of care beyond hospitals and
• Care limited to hospitals, clinics
doctors’ care to patient’s home and
and healthcare providers beyond
• Limited wireless availability in • Leverage 3G and 4G network
hospitals but growing • Disease Management and Monitoring
• Lifestyle management
• mHealth and Telemedicine
Fact : 8 in 10 Americans expressed interest in • Analytical Tools for Healthcare
mHealth Solutions (CTIA Survey – Oct 09)

14. Adoption of Mobility in Healthcare
Biometric
Data
Monitoring
Education Chronic
and Disease and
Reference Wellness
Health and Areas Home
Epidemic
Telecare for
data
the elderly
collection
Provider Hospital
and Patient and Clinical
Apps Solutions

15. Mobility in Health Care – Hospitals and Clinics
Medical Event Alerts
Calendars and Appointments
Patient History
Metabolic Standards
Up-to-date Medical Reference
Tests/Medication Alerts
Tests/Medication Alerts Physician Patient History
Patient History
Job Schedule
Physician Instructions
Raise Drug Requisition
Real time Coaching
Metabolic Standards
Appointments
Patient Caregiver
HIS
Asset Tracking
Physician Instructions Demand & Capacity Management
Ready Reckoner Job Scheduling & Tracking
Real time Coaching People Tracking
Business Analytics
Lab Admin Integration with Insurance providers
Technicians
Pharmacist
Stock Check
Stock Level Alerts
Fulfill Drug Requisition

16. Mobile Health (mHealth) Defined
mHealth (n) – the delivery of health care services
via mobile communication devices
Health Electronic Health
mHealth Services
Services
Slide Owner and Courtesy : Vital Wave Consulting Photo: UN and UN Foundation
16

17. Solutions Across the Healthcare Spectrum
Data Collection and Monitoring and
Education and Awareness Record Access Medication Compliance
SMS/Text Messaging in Applications to enter and Maintain care-giver
support of health programs access patient data appointments, Medication
regime
Analysis, Diagnosis and
Disease and Emergency Health and
Consultation
Tracking Administrative Systems
Access to staff or
Use mobile devices to send Allow access to mHealth
information via mobile
and receive disease incidence and public health systems
devices for diagnosis
Credits: UN Foundation, Vital Wave Consulting

18. The Application Store – Healthcare Applications
• iPhone has simplified the discovery of
applications for variety of uses, to help
developers bring them to consumers
– Fitness and Wellness
– Healthcare
– Education
• Growing trend of healthcare business
applications by new breed of organizations as
well as established companies such as Abbott,
Johnson & Johnson, etc
• Cross Platform –
- Blackberry, Google Android, Windows,
Symbian
• Use Of Features
– Location, Camera, Video
– Voice and phone
• Top Healthcare Applications include Fitness and
Diet
• Trend towards Hospital applications and then
Home

19. Section 3:
Examples of Innovations in
Healthcare Using Mobile Solutions

20. MedApps – Health Anywhere Using
Personal Health Devices (PHD)
Credits : MedApps – www.medapps.net

21. Smartphone Healthcare Application Examples
Epocrates for Medical New England Medical Journal
Reference for Education and Research
Credits : Epocrates,Inc , Massachusetts Medical Society

22. Smartphone Healthcare Application Examples
Airstrip OB for Diagnosis Allscripts for PHR
Credits : Airstrip Technologies, AllScripts Solutions

23. Applications – Medical Record Capture
Digipen technology manipulates and converts the handwritten medical
records into any digital format, bringing in control and efficiency to
“daily” on the move reporting for medical staff.
Once the form is handwritten and
completed, it only takes a few minutes for
the information to be converted and sent
to medical servers securely while mobile
user is on move.
Digipen technology reduces operating
cost, speeds up processes, prevents
valuable data being lost or altered giving
medical records as a true reflection of what
is being captured at the site.
Credits : Digipen Benelux BV

24. Case Study - Project Masiluleke
Disease Awareness Health Objective
Build awareness of HIV status, encourage
HIV/AIDS testing and treatment and halt the
disease’s spread
Country
South Africa
Techniques Used
‘Please Call Me’ service - free text messages
Impact Partners
• 365 Million text messages – one MM per Praekelt Foundation, iTeach, National
day – being sent (2008-2009) Geographic, Nokia Siemens
• Encourage people to be tested and treated Networks, MTN, Ghetto Ruff, Children of South
for HIV/AIDS and TB African Legacies, Aricent, PopTech!, frog design
and National AIDS Helpline
Photo: Praekelt Foundation
Slides Owner and Courtesy : Vital Wave Consulting 24

25. Case Study - Data Gathering
Data Gathering Health Objective
Containing the spread of the Dengue virus
Country
Brazil
Impact Techniques Used
• Data collection times dramatically reduced Customized questionnaires distributed to field
(from months to days) health agents’ mobile phones. Health data and
GPS location information are integrated to enable
• 400 test results gathered by 20 field immediate analysis and identification of areas
professionals in two days, all with GPS with high infection levels.
information (paper-based system
would have taken 2-3 months for
lesser information)
Partners
• End-user acceptance very high Nokia, Amazonas State Health Ministry
Photo: Wikimedia Commons
Slides Owner and Courtesy : Vital Wave Consulting 25

26. Endeavour Case Study:
ACOMS – Hospital Management System
Business Imperative
Endeavour’s mandate was to develop a BlackBerry based mobile application to assist
healthcare service providers in real time resource planning and scheduling using sophisticated
demand and capacity management procedures.
Solution Features
Complete mobile solution for demand and capacity
management Reports
Alerts and notifications on BlackBerry
Alerts based on census, staffing, acuity
Actions based on workflow defined in the system
Integration with Enterprise database
User Benefits
The BlackBerry enabled solution provided
healthcare unit real-time access to demand and
capacity information of the facility / department in
the hospital.
Credits : Vistaar Health Solutions

27. Endeavour Case Study:
Anesthesia Clinical Tutor and Calculator (AcTC)
This application was developed to bridge the gap between clinical anesthesia & reference books &
practical functioning. This guides anesthetists by assembling easy to use interactive tools, performs all
complex calculations & gives instant results with guided explanations.
Credits : Gasshead LLC.

28. Endeavour Case Study: Orthopedics' Hyperguide
The CME Mobile Application for doctors and healthcare providers. Audio, Video, White
papers of relevant Orthopaedic field along with quiz taking ability on the iPhone and
BlackBerry.
Credits : Vindico Medical Education

29. Endeavour Case Study: Surgical Equipment
Supply Chain
The application was created for Windows Mobile handheld devices for
meeting the needs of the sales agents for both Inventory assignment / Order
Capture as well as Marketing / Merchandizing / Sales activities.
Credits : Surgisoft Inc.

30. Regulatory Practices and Requirements for the Mobile
Healthcare Industry
• Specific Compliance Needs for Healthcare Applications
– HIPPA Compliance
– CIA, HITECH Compliance
– GXP
• FDA Approval for medical applications
– Disease Management
– Patient Care
– eHealth and mHealth applications
• Accessibility to disabled, visually impaired, other users
– Section 508 compatibility
– Using Device Settings (iPhone Voiceover, Blackberry)
– Text phones for the deaf
– Over 100 Voiceover iPhone applications
• Servers, web sites and mobile devices are in compliance
with HIPPA regulations.
• All employees/ developers are required to be certified in
HIPPA regulations.

31. Regulatory Practices and Requirements for the Mobile
Healthcare Industry
• Personal information protected using Secure
Sockets Layer (SSL) technology.
– SSL is an industry standard that encrypts information
provided, to avoid decoding of that information by
anyone.
• Messaging Center Contents.
– The company will not read or disclose to third parties
private messaging center communications that are
transmitted using Application Services.
• Application Services
– Except as required to operate the service or as
otherwise authorized by law.

32. Healthcare Mobile Solutions – Emerging Trends
• West Wireless Institute • Investments by large wireless and
– Dr. Eric Topol, Gary and Mary West semiconductor organizations
– Qualcomm, Scripps Health – Healthcare Mobility Devices
– Mission - advance health and wellbeing around the world – Healthcare Mobile Solution – driving growth of data
by identifying, validating and accelerating the use of services
innovative and cost-effective wireless solutions to critical,
unmet medical and community needs • Healthcare Investments for Productivity
– Disease Management and Chronic Care
– www.westwirelesshealth.org
– Clincial Trials for new drugs
• Opportunities for Healthcare Technology
• Bringing Healthcare to the masses in
Professionals
developing world
– Extend enterprise healthcare solutions to leverage the
power of mobility – UN Foundation
– Connect HIS with eHealth and mHealth solutions – mHealth initiatives – Government, NGO, Private
– Measurement is the Key – What is the VALUE ADDITION? – Huge Opportunities for Software Applications

33. Section 4:
About Endeavour

34. Who We Are
Enterprise Mobility Strategic Consulting. Product Delivery
We are a specialist Mobility company since 2002
We Analyze, Recommend and Execute Mobility Roadmaps
“What would be the best mobile platform to launch our latest software product.
What should be our Enterprise-wide Mobile strategy for the next 2 years.
Should we plan on re-developing our Mobile Applications? Can you help us develop those.”
“We have 250 senior deal makers traveling world wide.
How can we get them to access their corporate data systems securely on the mobile.
How do we secure mobile data. Data in transit.”

35. Our Offerings
We undertake mobile test
strategy, device and application
porting, test planning, design and
execution via a dedicated QA Lab
– EQuAL**
We
analyze, recomme
Mobile Quality
nd and execute Assurance
Mobility Roadmaps Opportunity
Assessment
(MOA)
We architect, design, develop
and deploy mobile enterprise
solutions through dedicated
RDE* teams
*RDE – Research and Development Centre
**EQuAL – Endeavour Quality Assurance Lab

36. Marquee Clients

37. Thank You
• Contact Information
– Jayaraman Raghuraman (Raghu), VP – North America
– Email: Raghu@techendeavour.com
– Phone : (512) 275-6105
– Company: www.techendeavour.com (Endeavour Software Technologies, Inc –
THE MOBILITY COMPANY)
– Follow us on Twitter : @EndeavourTech, @mobilitycompany

38. Thank You
+91 80 4288 5500 (IND)
+44 20 7193 0986 (UK)
+1 214 306 6848 (US)
info@techendeavour.com
www.techendeavour.com

39. Endeavour Case Study:
Anesthesia Clinical Tutor and Calculator (AcTC)
Area Features
• Education • Patient Data Entry and Vital Statistics
• Business Case • Different Anesthetic setups
• Learning the art of Anesthesia requires a solid – Fluid needs, medication and patient specific
understanding of the science of Anesthesia and blood requirements based on scenarios
mastery of details – Standard GA, RSI ED Dept, Neurology,
• Need for a handheld tool Vascular, MAC cases
– MH (Malignant Hyperthermia) Guides
– to perform complex calculations
– Interactive Tutor and Help Screens
– give instant results with guided – Drug Screen
explanations to ensure coverage of critical
points • Analgesic, Emergency, Paralytics,
Sedatives, Reversals, Anti-etnetics, and
Solution more
• ACTc is designed to teach interactively, on – Labs
modern PDAs, the everyday calculations and • Common lab values used in Anesthesia
clinical flow involved in Anesthesia Practice. • New additions of a PH/ETCO2/K
• Mobile Application on Windows Mobile, Palm – Regional
and soon on iPhone • Anatomical 3D images
• Bridges Gap between clinical anesthesia, • Spiral and Epidural Guides ( Opiates
reference books and practical functioning Duration, Side Effects, 2 level
• Easy to use suite of tools with instant results Regression, Age/Pregnancy Dosing,
Updated Dermatome and Peripheral
Developed by nerve charts)
Gasshead, LLC – Dr. Anthony Young – Updated Blood Screens and Resuscitation
Information
– Inhalation Agent Guides

40. Orthopedics Hyperguide
CME Mobile Application for doctors and healthcare providers. Audio, Video, White
papers of relevant Orthopaedic field along with quiz taking ability on the iPhone and
BlackBerry
Key Features Benefits
 Secured login & registration.  Accessing Orthopaedics' Hyperguide
 View/play the orthopedic Hyperguide’s educational content anytime, anywhere is
contents. easier than ever
 Contents can be video, podcasts, tutorials or  Earn CME while reading engaging
lectures. tutorials, viewing online lectures or
 User can filter the contents of their interest listening to expert podcasts
through modules, category and custom  Stream or download content at your
search. convenience
 User can download the contents to view/play  Bookmark content that is most relevant to
during his downtime. your clinical needs
 User can participate in quiz and certificate  CME certificate will be e-mailed to you
will be emailed at successful completion. within minutes
 User can manage the in-progress, fail and
passed quizzes through quizzes screen.
 Application supports offline mode to
view/play the downloaded contents.

41. Endeavour Case Study:
ACOMS – Hospital Management System
Area Features
• Hospital Service Management • ACOMS Operational Control Center – Enterprise
Visibility System-wide view of demand and
Business Case capacity
• Next generation of Hospital Service • Resource Management (e.g. Beds, Xray, MRI
Management Solution to streamline line scanners, etc)
functions of a hospital
• Real-time facility dashboard
• Enable mobile hospital administrators and
caregivers to manage resources effectively • Alerts and Ticker
• Based on staffing, census, acuity
Solution • Highly scalable and Highly available
• A Mobile and Web Solution that streamlines
functions of a Hospital including • ACOMS “on-the-go” Portable version of ACOMS
designed for Mobile Devices
– Resource Demand and Capacity
Management • Small memory and display utilization,
– Patient Registration, Medical Services, • Minimal input and No storage required
Appointment scheduling to Billing and • ACOMStracker - Real-time Resource Tracking
Accounting • Appointments scheduling and tracking
• Operations Center - Real time Dashboard and • Available on Blackberry mobile devices
Alerts
• Used by Hospital staff as well as doctors and
nurses
Developed by
• Vistaar Healthcare Solutions, NJ

42. Endeavour Case Study:
Anesthesia Clinical Tutor and Calculator (AcTC)
Area Features
• Education • Patient Data Entry and Vital Statistics
• Business Case • Different Anesthetic setups
• Learning the art of Anesthesia requires a solid – Fluid needs, medication and patient specific
understanding of the science of Anesthesia and blood requirements based on scenarios
mastery of details – Standard GA, RSI ED Dept, Neurology,
• Need for a handheld tool Vascular, MAC cases
– MH (Malignant Hyperthermia) Guides
– to perform complex calculations
– Interactive Tutor and Help Screens
– give instant results with guided – Drug Screen
explanations to ensure coverage of critical
points • Analgesic, Emergency, Paralytics,
Sedatives, Reversals, Anti-etnetics, and
Solution more
• ACTc is designed to teach interactively, on – Labs
modern PDAs, the everyday calculations and • Common lab values used in Anesthesia
clinical flow involved in Anesthesia Practice. • New additions of a PH/ETCO2/K
• Mobile Application on Windows Mobile, Palm – Regional
and soon on iPhone • Anatomical 3D images
• Bridges Gap between clinical anesthesia, • Spiral and Epidural Guides ( Opiates
reference books and practical functioning Duration, Side Effects, 2 level
• Easy to use suite of tools with instant results Regression, Age/Pregnancy Dosing,
Updated Dermatome and Peripheral
Developed by nerve charts)
Gasshead, LLC – Dr. Anthony Young – Updated Blood Screens and Resuscitation
Information
– Inhalation Agent Guides

43. Applications – Fitness and Wellness
Lost It! for Fitness iFitness for Exercise
Credits : Lose It, iFitness