2010 mHealth Summit, Washington DC, Day Two

The big day today – Mr Bill Gates is going to pop along for lunch at the summit. Any former bleats of Apple and the iphone within the industry mysteriously go out the window: with the NHS as Microsoft’s 3rd biggest client in the world, the standing of Mr Gates in health still rings true….

David Aylward, Executive Director, mHealth Alliance again opened up the morning – first by showcasing software company Zephyr-Technology’s remote heart sensor bravely on screen so that the mhealth influencers could ruminate on his cardiovascular situ in detail. He re-iterated the need for health change:

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• 360,000 women die every year on the reference of ‘bad data’
• 4 million children die before they reach 30 years old

The Millenium Development Goals are going some way towards rectifying this – we heard in September of how the Nigerian Government are working with Intel to realise some of the goals though wireless healthcare. But as Aylward said we now rightly demand ‘more health for the money’; mobile healthcare can start to deliver some of the breadth of service and cost savings necessary.

Ted Turner, Chairman, United Nations Foundation

Truly, A LEGEND

 

One of the keynote guests of the day was former husband of Jane Fonda, Founder of CNN Network, Cartoon Network, Turner Broadcasting, and Chairman, United Nations Foundation, Ted Turner. I was not previously aware of the gravitas of Mr Turner’s standing – he was a brilliant asset to showcase the arrival of mhealth.

Much though moderator Tom Wheeler tried to get back Ted onto ‘Health’ the main advice was on stopping war – ‘shooting someone or bombing them is not good for their health’!

 Other Ted Turner Advice for Those in M-Health:

• How to get on as a start-up …‘Early to bed, early to rise, work like hell and advertise.’
• Challenges? ‘Whenever I hit an obstacle, I tried to get around it, around it, under it or over it!’
• He personally doesn’t watch more than 1/2 hour of television a day, doesn’t read novels only books of industry focus and The Economist from cover to cover.
• Customer Service ‘You always do better if your customer likes you,… and your wife and your husband. Be nice! Be nice!’

Lessons Learned Around the Globe

 Thierry Zylberberg, Executive Vice President, Orange –

speaking in 2010 at the MHIS, London

 

Thierry stated how mobile health in mature markets meant efficiences; mobile health in growth or developing markets means pure access to services and these different perspectives must be respected -Note: you cannot apply a mature market model to a regionally specific market. FACT: A recent Price Waterhouse Cooper report stated that 42% of Americans would pay for a remote monitoring service

Alex Ibasco, CIO, Smart Communications, Phillipines agreed –

his multi millions network subscribers suffer 20 typhoons a year, but only spend 4$ a month on airtime – the Government however is keen to divert TB, Malaria and Dengue Fever and manage cases so the care-givers or Government pay for m-health, creating a sustainable business model outside of the 4$month subscriber.

‘We are the electronic glue connecting the value systems in the m-health ecosystem’ With 50% of filippinos born without a doctor or midwife and the nation spread across 7,000 islands, mhealth is working in the same way as the existing m payments infrastructure to allow payments to go direct to the patient via the NGO or micro-financier.’

Thierry, Orange seemed to agree with this enabler model of the operator: [the operator] ‘takes information from here and puts it there and maybe stores it in the middle’; end-to-end services are destined to failure as you can’t be all things.’

FACTS AND MYTHS in mHEALTH

Lisa DeJong Ellis, Principal, McKinsey and Company,  provided an astute m-health Myth busting list to follow in commercial mature markets:

 

1. LEADERSHIP – for mHealth to scale strong leadership is needed to forge robust PPPs

2. THERE IS NOT A KILLER APP – there are multiple solutions for multiple scenarios

3. RECYCLE, RE-USE, RE-PURPOSE – share with others, don’t re-invent the wheel. Collaboration is much more fun than competition.

4. SYSTEMS  – leverage a systems thinking approach throughout. What is the impact further down the chain?

5. DEVELOP WITH LOCALS

6. PARTICIPATORY DESIGN PROCESS – make sure the end user is involved in design and change management

7. BE REALISTIC

8. ACCOUNTABILITY – set targets and benchmarks, lives are involved and accountability is key.

9. LOCALLY GENERATED CONTENT – make it local!

10. EVALUATE – you must unlock pathways to change that have been reasoned.

• NOT A FAD – 30% of consumers in McKinsey study would pay $2 for a 10 minute consultation. That’s 10x rev. of base telecoms minutes.
• NOT A GAME – this will have disruptive impacts to standard business models and impacts on lives
• NOT JUST ABOUT CARE DELIVERY – will also change insurer communication with consumers over mobile
• NOT A NICHE BUSINESS – ‘mobility’ is transforming a number of business’ – energy, retail, and banking (good news for our smart cities event in Dubai then – ask me if you are interested!)…
• ABOUT REACH OF CARE – but dollars are certainly in the mature markets which have massive spend in this area.
• 1:50 doctor to patient ration in developing markets
• 1:2 mobile penetration in same markets

I briefly was distracted by this moustached young gentleman:

Spiffing!

 

 

and then it was time for the BILL GATES LUNCHEON!!

Ask: 'What is the key metric you are trying to improve.'?

 

Comfortably sat, and apparently oblivious to the geeky scramble to get to the front, Bill Gates espounded a view of mobile healthcare as a tool to bring down some of the key health issue metrics in the world: ‘It is our mission to bring computer technology to some of the global issues’ He referenced how pharma antiviral drugs and vaccines had helped cancel out small pox and reduce the ravages of other diseases but ‘in the case of the cell phone, there is a chance to go beyond that, and to be with the patient.’

What we must ask ourselves is ‘What is the key metric you are trying to improve.’?

He asked while vaccines are doing so well, how do cell phones fit in? By registering every person at birth the following was enabled:

• 1. Patient Reminders – take TB drugs regularly
• 2. Supply Chain – what’s available and taking fraudulent drugs out of the chain
• 3. EHR and birth registration

‘We should let 1000 ideas blossom, but work to key metrics – can we drop diarrhoea by 1/2? etc etc’

With more Bill and Melinda Gates grants of $2m upwards towards this area he was particularly encouraged by movements in diagnostics: ‘we are seeing a lot of great things’ coming through’.

Though he praised the beauties of capitalism he said that its downfall was research, which had a systemic failure only to be met by Government intervention. With Capitalism ‘the means of the poorest are not met by human guise’; The Gates’ Foundation went some way to fill this research gap.

The 6bn-9bn population growth will not be in urban cities but in urban slums, putting new pressures on housing, education, sanitation – ironically, the countries with high population are unhealthy, but those with a healthy population have low population growth and plateau out – disproving the idea that helping the under 5s who may otherwise die will lead to further resource depletion and stress, but will actually enact the opposite.

‘There will be no trees,animals, jobs, or schools at 3% population growth -no one can handle that.’

He mentioned that with Economic recession aid had lessened and his role was now international beggar of monies. The most sentient point I found was his approach to different regions, not developing and developed but

• Low Income
• Middle Income
• Rich Income

with China, Brazil and South Africa among the Middle Income countries who are now leading technology and innovation. Whilst the rich countries’ approach to healthcare is conservative, regulated, and without a reimbursement model. He stated that for best health global improvements we should go for the middle income countries, as there are some potential end-users of the US who will not exercise whatever incentive is laid out, and he warned against going after this super narrow market but instead attacking the wide breadth of new middle income countries.

Asked about the future he said ‘it’s got to be robots’!

Whilst dexterity technology is 5 years out, ambulatory connected services had far advanced and robotic c-sections might be a possibility. Robotic aids could help the elderly to the toilet, which led me to question if this fitted in with a patient-centric model of health innovation or one of metallic misunderstanding and loneliness??

Finally, he wrapped up by suggesting that mobile and computing may help stem the dip in drug discovery by computing this process and that what ever health innovation occurs,

‘if we’re smart about it , it will benefit the poor as well as the rich.’

Aneesh Chopra, US CTO, White House

Another great techy from the White House – I’m pretty sure he said dude a number of times and he was buzzing with excitement/delerium having come back the night previously from Obama’s world tour. He spoke about Barack Obama’s own personal belief in using technology to gain better health outcomes and used the example of a Maternal Health application in a ‘wired village’ in India. He stressed the importance of a new RESULTS DRIVEN ECOSYSTEM won by adding public participation to achieve:

• CONSENSUS DRIVEN STANDARDS
• ACCOUNTABLE GOVERNMENT
• OPEN DATA
• CLOUD COMPUTING ‘i believe you can’t talk about mobility without talking about cloud computing’
• CONNECTIVITY

The US Government should act as ‘convener’ to open up opportunities for innovators who can scale – and show

• QUALITY, SAFETY AND EFFICIENCY
• PATIENT AND FAMILY ENGAGEMENT
• COORDINATED CARE
• IMPROVED PUBLIC AND POPULATION HEALTH
• PRIVACY AND SECURITY

All to play for!