With rising healthcare costs and aging populations, mobile health has been looked to as the panacea to our healthcare challenges. Mobile health offers the promise of increasing efficiency in healthcare while also mitigating the costs.
Many aspects of our life are “on demand” in a digitally connected world. However, healthcare has been a real laggard. It’s a topic that often floods our Twitter feed but has had slow penetration in the marketplace.
No country has taken to the use of mobile as quickly as China. From FinTech to the IoT, China is moving towards a cashless society. China is certainly a mobile first country where beyond the office, the majority of people use smart phones or tablets instead of laptop or desktop computers. Naturally, tech leaders have been bullish on the uptake of mobile health. Yet, healthcare in China has been slow to embrace digital health. Many tech leaders in China placed big bets on mobile health in 2016, bets that have been slow to see returns.
Despite mHealth’s relatively slow penetration in the market place, it is an industry that is expected to increase rapidly from its already considerable size. In 2016, the global market for advanced patient monitoring reached approximately US$35 billion. Patient monitoring is expected to reach US$49 billion by 2021.
MHealth offers the ability for people to have more control over their health while increasing the efficiency of the healthcare system as a whole. However, how we deal with hurdles currently facing it will determine if it lives up to the hype.
Adoption: Too Many Specific Apps, Too Few “WeChats” of Mobile Health
MHealth has an adoption problem. In order for mHealth to be truly effective, it needs to be frictionless. The vast majority of people will not engage with health apps that require them to be active. The ones who are willing to engage generally encompass the health-conscious demographic in peak physical condition.
Doctors believe optimizing one’s health should be the top priority for a patient so he or she should be willing to actively use the app. However, in a patient’s eyes, mHealth usually is just seen as creating more work for him or her. The user experience needs to be greatly improved. Open APIs so multiple organizations can share data from a given app is one way to significantly improve functionality. If an app is not multifaceted or has the perception of being too niche, adoption of the app will be limited. WeChat is such a powerful app because it has a plethora of functions. An app that analyzers many different data points with very little effort on the patient’s behalf is where mobile health is heading. The current state is much more fragmented, and this current fragmentation is one reason why 80% of health apps are abandoned in 2 weeks.
Many people consider the fact that in 2016 there were approximately 8.0 billion global mobile devices and connections would automatically lead to increased uptake in mHealth. Although many people are looking at a mobile screen for a significant portion of the day, the ability to hold onto a person’s attention is more difficult than ever. This is mobile health’s greatest challenge. Let’s imagine a scenario a typical, adult mobile user. We will call him Jeff.
Jeff has a chronic heart condition. The doctor and Jeff both intellectually understand the value of regular monitoring of Jeff’s blood pressure and heart rate. The doctor feels he is doing Jeff a service by prescribing an app to Jeff. Jeff sees this as more work. For up until last year, Jeff was completely unaware of his heart condition. He believes that he is living with no symptoms, and that his health is presently not in any critical danger. The variety of tasks Jeff completes on his phone throughout the day (whether for work or social purposes) take priority over his healthcare app. Jeff’s brain focuses on the app that requires the most immediate attention, pushing his health app to the bottom of the list.
Furthermore, people don’t utilize health apps the same way they utilize social apps. The human need to share has allowed for apps like WeChat, Pinterest, Instagram or Snapchat to become wildly popular. Yet, the desire to share information about your health is not there. When people look at their cell phones, there is a small shot of dopamine released. Responding to a chime from a text message taps into the human reward system. Health apps are different. For people involved in healthcare, there is this ideology that if an app can help you be healthier, then people will want to actively use it. This is not the case.
Moreover, the need for mHealth is greater than ever since chronic diseases are on the rise. According to a recent study conducted at the Boston University School of Public Health, researchers argue that diabetes is responsible for 12% of deaths in the U.S. rather than the 3.3% indicated from death certificates. Chronic diseases pose a risk to society because of the fact that cures are usually not attained. Therefore, prevention and proper monitoring are critical for successful outcomes.
A good doctor is one who is experienced yet also up-to-date with the latest clinical trials. Patients are willing to spend a greater amount on a well-known physician due to the trust factor. MHealth has the opportunity for doctors to monitor patients from afar. MHealth is designed to strengthen the patient-doctor relationship, not replace it. However, it is a relationship that doctors must acknowledge is evolving. Historically, the relationship has almost been a patriarchal one as the doctor had all of the data and knowledge. MHealth gives the patient the ability to control his or her data. A new, stronger relationship is evolving.
Patient monitoring is one area that is eyeing significant growth. It allows for physicians or nurses to be able to see beyond the 15-minute checkup in the clinic. Prevention is one of the most effective strategies for living a long, healthy life.
Notifications that indicate outlying value points or points of concern could be clues for an underlying disease that is developed, a clue that may otherwise go unchecked in traditional physicals. Physicals offer very limited insight since the data the doctor traditionally records is only a snapshot at that specific time when the patient is present. Being able to visualize the trends in a patient’s data over several months provide powerful data for a physician.
Policies and Regulations
Reimbursement for mHealth products has been an issue that has been slowing the uptake of mHealth, particularly in China. For the most part, mHealth companies in China rely upon private insurers for reimbursement. Public insurance policies mostly do not cover mHealth services. Despite Beijing pushing for public insurance to ease the burden for the public sector in funding healthcare, citizens have been slow to trust private insurance providers or hospitals.
Policy and lawmakers can create the incentives for doctors and hospitals to be mobile friendly.
Access to Data
Hospitals aren’t always keen to sharing data with companies due to protection of their patient’s privacy while also having the fear of being exposed to liability. In order for A.I. to be effective in healthcare, companies must have access to a vast amount of data. Robin Li, Baidu’s chairman, said that a dearth of medical data was hindering their ability to develop algorithms for the basis of artificial intelligence.
One way of overcoming this issue is giving patients more options about what healthcare providers can do with patients’ data. Special insurance rates can be given to those who participate in sharing certain data. Additionally, as blockchain evolves into healthcare, patients can have more confidence that they are anonymously and safely sharing their data.
MHealth is still in its infancy. When investing or looking to enter the mHealth sector, it’s important to understand the policies and goals of the country in which one is operating. When value is added that aligns with the goals set for by policymakers, companies can experience a plethora of opportunities.