Overview of the mHealth market and players perspective, with focus on telecom operators

1. Research Study
How mobile technology is transforming
health care
November 2013
By Gisela Vendrell
es.linkedin.com/in/giselavendrellhernandez/
@giselebcn

2. How mobile technology is transforming health care
Contents
1.
Overview of the mHealth market
2.
Players perspective
3.
Conclusions
2

3. How mobile technology is transforming health care
The global healthcare industry is facing major challenges
Figure 1: Major challenges in the global healthcare industry [Source: own elaboration]
 Shortage of health professionals- likely to worsen
Access
and
coverage
further- thus leading to low coverage in certain areas
 Increasing demand for more available access to
healthcare in developing countries
Outcomes
Outcomes
 Patients
are
increasingly
demanding
better
outcomes in terms of quality, velocity and safety
Key
challenges
 Health spending as part of GDP is expected to
Access
and
coverage
Cost
Cost
reach 15% in larger developed countries in 2015*
 Cost escalation due to chronic diseases increase
- costly to manage and time-consuming
* McKinsey estimate
3

4. How mobile technology is transforming health care
Technology innovations have the potential to overcome them, enabling more
accessible, faster, better and cheaper services
Figure 2: Technology innovation impact on healthcare provision [Source: Ernst & Young analysis, 2013]
Technology enabler
Impact
Applications
Smart mobility
 Wireless and user-friendly devices (eg: senior
phones)
 Increased access to health information and
delivery through mobile devices and apps
 Remote treatment and real-time interactive
communications
 Prescription of smartphone apps to patients
Social networking
 Increased access to critical health insights
collection and sharing trough social networks
 Disease
progress
tracking
(eg:
PatientsLikeMe.com-150m users)
 Understanding of patients care experience and
findings sharing
Big data analytics
 Ever-growing information processing
transformation into valuable data
and
 Use of insights to build treatment practices
predictive modeling
Cloud computing
 Large scale, flexible and secure data storage
in a public or private cloud
 Remote access via cloud applications and
microsites designed for mobile devices
 Mobile access to health personalized data and
services - anywhere and anytime
 Networking with healthcare providers and
connection with patients
4

5. How mobile technology is transforming health care
Smartphones expansion is driving mHealth growth- healthcare delivery supported
by mobile devices
Figure 3: Smartphone (SP) connections split by region [Source: Informa
telecoms & media, 2013]
m-Health
technology platforms on cellular or wireless
networks …
− Such as cell phones, tablets, mobile-enabled
Connections (millions)
 Delivery of health-related services through mobile
3.000
Western Europe
North America
Middle East
Latin America
3.500
Eastern Europe
Asia Pacific Developing
Asia Pacific Developed
Africa
2.500
2.000
1.500
1.000
diagnostic and monitoring devices
500
 …anytime and anywhere…
− Real-time information access and monitoring
0
2011
outside of physicians’ offices and patients’
home
 …thus driving a significant change in the
Global
smartphone
penetration
2012
2013
2014
2015
2016
2017
12%
16%
21%
26%
31%
36%
42%
healthcare traditional delivery system
− Patients are actively engaged in delivery and
assist to real-time experiences
 44M health-related apps downloaded in 2011- 142M downloads by
2016 (CAGR of 26%)
 3B of SP connections by 2017 with exclusive functionalities
(expanded memory, location tracking, touch-screen technology, …)
5

6. How mobile technology is transforming health care
The global mHealth market is expected to reach $ 23 billion by 2017 –growing at a
compound annual growth rate (CAGR) of 50%
Figure 4: global mHealth market evolution [Source: PwC, 2013]
Key highlights
($ in billions)
CAGR ‘13-’17:
50%
23
 Health call centers creation and SMS for reminders
among the most common initiatives
15
1
5
2012
2013
7
10
 Key drivers of mHealth might differ per country
and stakeholder
2014
2015
2016
2017
− Convenience of access and desire to take greater
control of own health are the leading drivers of
mHealth in developed countries…
Figure 5: global mHealth market per region [Source: PwC, 2013]
− …while cost reduction is the biggest attraction in
emerging countries, such as India
5%
7%
Europe
30%
28%
Asia Pacific
 52.7M m-health connections worldwide by 2021,
growing at a GAGR of 43% between 2011 and 2021
North America
30%
LatAm
Africa
6

7. How mobile technology is transforming health care
Remote monitoring is supposed to account for 65% of global market, mainly to
manage chronic disease
Figure 6: global mHealth market distribution per type of
service [Source: PwC, 2013]
5%
0%
1% 0%
3%
Monitoring
Diagnosis
11%
Threatments
Support to medical personnel
15%
65%
Key highlights
Wellness
Prevention
Administration
Surveillance support
 Chronic diseases represent by far the leading
cause of mortality in the world…
− Eg: Diabetes, hypertension, heart failure, many
cancers, and Alzheimer’s
 …and are increasing in number in both developed
and emerging countries
 Remote monitoring technologies are likely to
prevent and treat chronic disease, as they provide
real-time and continuous management …
 …and are expected to lead significant cost
Figure 7: global mHealth monitoring services per type of
patients [Source: PwC, 2013]
Remote
mobile
monitoring
savings, improved disease evolution and patient
lifestyle
Chronic Disease Management
71%
29%
Older patients management
7

8. How mobile technology is transforming health care
Remote monitoring devices enable patients to record, send and access their own
health measures
Figure: healthPal capabilities, a wireless mobile handheld system [Source: MedApps]
 Automated data collection from
peripheral monitoring devices…
− Pulse oximeters
Data
collection
− Glucose meters
− Blood pressure monitors
− Weight scales
 … through a wireless mobile
handheld device (healthPal)
Data
Transmission
Data
Management
 Data
communication
through
servers and IVR to an electronic
health record or the user’s account
(HealthVault)
 Access for patients and families to
data stored on user’s account or
electronic health records…
 … and for health professionnals
using
a
web-based
patient
management portal (healthCOM)
8

9. How mobile technology is transforming health care
Contents
1.
Overview of the mHealth market
2.
Players perspective
3.
Conclusions
9

10. How mobile technology is transforming health care
The mHealth market is a complex ecosystem, with a broad variety of
stakeholders...
Figure 8: The complex mHealth ecosystem [Source: own elaboration]
Biopharma
companies
…
Medical
device
companies
Technology
companies
Health care
providers
Patients
Healthcare
professionals
Telecom
operators
Pharmacies
Entrepreneurs
and retailers
Governments
NGO’s
Regulators
There is a shift trend towards a patient-centered model
10

11. How mobile technology is transforming health care
... with different incentives to adopt mHealth
Figure 9: Key stakeholders incentives to adopt mHealth [Source: own
elaboration]
Patients
Figure 10: Opportunities for mobile operators
[Source: own elaboration]
 Better care and lower costs
 Increased quality of life
 Ability to create a cost and capability
Health care
providers and
professionals
 Efficiency (greater time for patients, processes...)
 Improved quality (better health outcomes)
Cost and
capability
advantage
advantage, based on core capabilities
of connectivity, networking and large
scale information management
 Lower costs (fewer admissions and emergency
Governments
room visits, avoidable over use of medications and
increased use of self-care)
 Increased access and coverage
Life science
companies
 Platform for demonstrating value of therapeutics
and diagnostics
Integration
and access
 Integration solutions based on mobile
operators core capabilities, accessible
by a large user base
 Increased incremental revenue on top of existing
voice and data revenue streams
Telecom
operators
 Opportunity
to
expand
into
infrastructure
services, managed services, cloud computing
and professional services
 Opportunity to own/dominate and take first
mover advantage
11

12. How mobile technology is transforming health care
Patients expect significant changes in terms of health data access, management
and communication, thus enhancing convenience, quality and cost
Figure I: Technology enabler’s impact on patients [Source: Ernst & Young analysis,
2013]
Technology
enabler
Smart
mobility
Expected patient impact
 Ability to…
− Communicate with doctors and hospitals
− Access health-related information
− Obtain care from remote and underserved
communities
− Monitor and manage chronic disease
− Fitness and wellness programs monitoring
 …from anywhere at any time
Social
networking
 Cost comparison of different providers
 Outcome performance comparison
 Peer advice on treatment and living with chronic
conditions
Cloud
computing
 Delivery of “heavyweight” healthcare services and
information to “lightweight” mobile devices
 Secure storage of patient information
Figure II: mHealth expected benefits by patients
[Source: Economist Intelligence Unit, 2012]
(% of patients agreeing with mHealth
improvements, in the next three years)
Convenience
52%
Quality
48%
Cost of
health
care
46%
12

13. How mobile technology is transforming health care
Efficiency and quality are considered as top incentives among doctors
Figure III : Top incentives to adopt mHealth among doctors [Source: Economist Intelligence Unit, 2012]
Improved quality of care/better health outcomes
36%
Reduction in administrative time for medical personnel, allowing
greater time for patients
32%
Ability to reach previously unreachable patients
32%
More efficient internal processes/communication
29%
Patient expectations/demand
26%
Lower overall cost of care for patients
25%
Easier access to care for existing patients
24%
Opportunity to provide new services/tap into new markets
Ubiquity of smartphones and applications in all areas of life
Encouragement by regulations
Expectation/demand of medical personnel or employees
17%
16%
14%
13%
Efficiency incentives
Quality incentives
13

14. How mobile technology is transforming health care
mHealth can also benefit developing countries by spreading information and
bringing health care to underserved populations
Figure IV: Key applications for mHealth in developing countries [Source: UN Foundation and Vodafone Foundation, 2013]
mHealth
key applications
Description
Education and
awareness
 Spreading of mass information about various subjects through SMS…
− Including testing/treatment methods, availability of services, disease management
 … to strengthen education and awareness and healthy habits adoption
Remote data
collection
 Collection and transmission of real-time data quickly, cheaply and efficiently…
− Eg: location and levels of specific diseases, areas of greatest needs within a country
 …. thus leading to disease and epidemic outbreak tracking
Remote
treatment
 Automated care delivery and advice about diagnosis and treatment of patients through mobile devices…
− Eg.: SMS, mobile applications, …
 …specially useful to mitigate cost and time of travel for patients located in remote areas
Remote
monitoring
 Automated monitoring to patients situated in different location to healthcare professionals leading to:
− Better tracking of patient conditions, medication regimen adherence and follow-up within environments of limited
resources
14

15. How mobile technology is transforming health care
Telecom operators have three potential options to monetize mHealth
Figure: Potential options to monetize mHealth for Telcos [Source: McKinsey]
1
 No relationship between mHealth providers and MNO’s
Pure
connectivity
2
 Data transmission through MNO’s
 Mobile charges as part of data plan or charged as additional usage via mobile bill
 MNO’s as the primary face to the consumer, providing an integrated solution
Operator
end-to-end
− Transmission, Devices, Software apps, Deployment & integration services
 Benefits for Telcos: larger revenue share in the value chain
 Challenges for Telcos : lack of healthcare knowledge; patients may hesitate
3
 Interaction with mhealth providers
Joint
service
− Providers are not required to develop a large tech infrastructure
 Transmission and other services subcontracted to MNO’s
15

16. How mobile technology is transforming health care
However there are several factors that may affect mHealth initiatives success and
Players should bear in mind...
Figure 12: Key factors in mHealth models success and level of contribution [Source: own elaboration from PWC data,
2012]
Impact
Outcomes
 Provide a return on investment in terms of cost, access, and quality of care...
 ... by defining a suitable business model, taking into account patients
willingness to pay and technology costs
Interoperability
 Interoperability with sensors and other devices that enable information
sharing (when authorized)
Integration
 Integration into existing activities and workflows of providers and patients
Intelligence
 Provision of real-time and qualitative solutions based on existing data
Socialisation
 Share information across a broad community to provide support, coaching and
recommendations
Engagement
 Enable patient involvement and provision of instant feedback in order to improve
services orientation
... thus requiring an in-depth analysis of the ecosystem, key challenges and success factors
Impact level
-
+
16

17. How mobile technology is transforming health care
Contents
1.
Overview of the mHealth market
2.
Players perspective
3.
Conclusions
17

18. How mobile technology is transforming health care
Key findings
 Mobile technology is enabling a new era in health care
− Shift towards a patient-centric model, delivering health care anytime and everywhere
− Smartphones expansion as key accelerator of mHealth adoption
 The global mHealth market is expected to show strong growth-reaching $ 23 billion by 2017
− Remote monitoring is supposed to account for 65% of global market, mainly to manage chronic disease
 The mHealth ecosystem involves a broad variety of stakeholders with different perspectives and levels of
involvement
− MNOs have an opportunity to play a big role in mHealth and develop new revenue streams
 There are key challenges that may affect mHealth adoption and need to be deeply analyzed
− In terms of technology, business models, policy and regulatory barriers
18