Feature Article

Going Mobile: The Emergence of the M-Health Market


Posted in Mobile Health by Camilla Andersson on February 29, 2012

The mobile health market is surging, and competition will be intense in the coming years. Companies that embrace interoperability, generate actionable intelligence and design devices that delight users are the most likely to succeed.


Wireless connectivity amongst medical devices is on the rise, as is the use of mobile phones for healthcare applications. The latter has led to the emergence of a new and rapidly growing market segment for mobile health, or m-health, as it is more widely known. In the first half of 2011 alone, m-health start-ups raised US$93 million in venture funds. The iPhone with its simple user interface and open programming platform catalysed the use of smartphones for health applications. More than 6000 health-related applications (or apps) have been developed in the short time since its arrival. The iPad has also made an impact in clinical environments: 30% of US physicians now own an iPad and are using it to simplify their daily routines, according to a survey conducted by Manhattan Research in 2011.

Mobile devices in the hands of physicians provide reference and patient information, but mobile devices in the hands of other caregivers and patients themselves have far greater potential for improving quality of care and reducing healthcare costs. Innovators are seeking ways in which these devices can provide the proverbial ounce of prevention that avoids a pound of cure. Mobile phones and tablets, with their significant computing power and ubiquitous connectivity, can enable real-time, bidirectional data transfer between patients and healthcare providers. They can be used to disseminate messages, gather and store data, and track patient compliance on a continuous basis with minimal disruption in the daily life of the user.

Potential beneficiaries of m-health span from underserved areas in emerging economies to developed countries with a significant medical infrastructure. Mobile phones have proliferated in emerging economies, in many cases well ahead of medical care, so m-health could provide a means for deployment of care to remote areas. In developed countries, m-health could be the catalyst to move from expensive, reactive care toward preventive care, focusing on patient outcomes rather than medical services rendered. Such a change in focus would be nothing short of revolutionary.

The m-health ecosystem
Traditionally, medical devices have been stand-alone or perhaps worked with a couple of other products. m-health, by its nature, is a broad ecosystem and can constitute several devices and client and server software as well as a communications infrastructure.

A mobile hub and tablet application
A mobile hub and tablet application.

The home health ecosystem consists of one or more diagnostic/therapeutic devices that are required for a particular condition and a hub or data manager to collect data locally and upload it to a central server, where a dedicated database or electronic medical record (EMR) may reside. The hub may serve as a focal point for delivering telehealth/telemedicine services, or it may simply be a data aggregator. In clinical settings, various devices and monitors hook up to the central hospital network and will be required to send and receive data from the EMR.

When designing m-health solutions, the biggest challenge facing most developers is determining what the hub should be. Options include off-the-shelf mobile phones running an app as well as dedicated devices. A half-way solution that starts with a commercial mobile platform that is then customised is also feasible. The decision must be made based on the particular application, its regulatory path and expected volumes while balancing cost, complexity and scalability.

For m-health solutions that require other hardware such as diagnostic devices and sensors, the choice of a mobile platform becomes critical, as they are not all equally endowed. Operating systems (OS) widely used on mobile phones include Windows Mobile or CE, Android, Symbian and, of course, the iOS on the iPhone. Each OS provides different levels of support for local area wireless communications and, thus, dictates the development effort and timeline to integrate third-party hardware.

As all hardware, software and communications infrastructure will not be provided by a single commercial entity, the m-health ecosystem naturally mandates relationships between various vendors. The obvious ones are between medical device manufacturers and mobile software providers. However, other players such as mobile handset and chip makers, cellular network carriers and enterprise infrastructure providers all have key roles to play if m-health is to be successful. New players such as Big Pharma also have entered the market and are looking for ways to engage consumers. As these players attempt to expand their reach, we are bound to see interesting acquisitions and partnerships begin to form. Such partnerships can help bring together the strengths of different organisations and, more importantly, provide new channels to access the market.

As the m-health ecosystem develops, a number of key factors are likely to shape the market. They are as follows.
Consumerisation of healthcare. As people get more involved in their own care, and especially if they are required to pay for treatment, the focus on user experience will increase. Given a choice, consumers will choose devices and solutions that are easier to use, have a more intuitive interface and are more engaging. Such behaviour is well established in the consumer market; thus, we call this trend the consumerisation of healthcare. Recently, Cambridge Consultants undertook a study to understand factors affecting device choice amongst diabetes patients and found that three-quarters of the survey respondents were willing to pay a small premium for devices that are easier to use.

To gain and maintain a competitive advantage, medical device manufacturers will have to pay attention to the usability of their devices, improving the ergonomics and the overall interface. Over the last few years, both US and European regulatory bodies have increased their demand for human factors validation, especially in drug-delivery devices, where efficacy is dependent on the proper usage of the device. It will not be a surprise to see this expand to other types of devices where proper use affects the end result.

Standards and interoperability. So far, not much attention has been paid to standards or communication protocols to which wireless health devices must adhere. However, as the m-health ecosystem grows, interoperability will become critical to efficiency, and the standardisation of protocols and data formats will be required. In the last five years, the Continua Health Alliance has attempted to build consensus and facilitate development of interoperable systems. They have chosen the IEEE 11073 standard to specify data formats and the Bluetooth Health Device Profile (HDP) as the Personal Area Network transport protocol. They have chosen to use existing standards rather than attempt to develop new standards or set up protected spectra. A separate effort is underway in the United States to have the FCC dedicate a frequency band for Medical Body Area Network (MBAN) similar to what it did with the MedRadio service (MICS) for implantable devices.

When selecting a connectivity option and protocol, every design team is faced with the primary question of whether to choose standards-based solutions or develop a custom proprietary protocol. There are pros and cons to both approaches and the decision must be made bearing in mind the nature of the device being designed. If the device is expected to be part of a larger system that includes other devices, the standards approach can ensure plug-and-play capability. Often, standards-compliant devices take longer to deploy, especially if certification processes are involved. However, there is much good that can come about (for manufacturers and consumers alike) from building interoperable systems rather than silos.

Communications technology. Wireless technology continues to improve and become available at lower cost points. For m-health, both local and wide area communication is required.

Bluetooth has been the most prominent technology for local area communication amongst wireless medical devices, and it promises to continue its leadership. Most mobile phone operating systems provide native Bluetooth stacks, thus making it a convenient technology for m-health. It should be noted that Apple uses its own variant operating system on the iPhone; thus, customised Bluetooth accessories can be developed for the iPhone, iPad and iPod Touch only in cooperation with Apple. Moreover, this involves a nontrivial specialised development unless further support is made available by Apple.

In recent months, the launch of Bluetooth Low Energy (BLE) has created a buzz in the market. BLE was introduced in version 4.0 of the Bluetooth standard. This version allows dual- and single-mode implementation. In dual-mode, BLE functionality is integrated into an existing Classic Bluetooth controller, resulting in a minimal cost increase and the ability to communicate with both Classic Bluetooth (Bluetooth v2.1 + EDR or Bluetooth v3.0 + HS) chips and the new low-energy chips. Single-mode chips feature a lightweight Link Layer providing ultralow-power idle-mode operation, simple device discovery and reliable point-to-multipoint data transfer. Moreover, advanced power-save modes and secure encrypted connections enable highly integrated and compact devices. BLE technology is designed for low peak current consumption, and consequently permits device operation via standard coin-cell batteries and enables battery life lasting up to one year.

BLE is a relatively new standard that was introduced in 2010. Chips have been announced by all major Bluetooth manufacturers and some dual-mode chips have already made it into mobile handsets. It is expected that this market will develop ahead of the accessory market, which is what will drive down cost of the single-mode chipset. Even so, introductory pricing by the major vendors is fairly attractive, thus making single-mode chips better suited for handheld point-of-care or home-use medical devices. While there is every indication that BLE will achieve global uptake similar to Bluetooth, it remains unproven in the market and the risk around new technology should not be ignored.

The other short-range wireless technologies on the market are ZigBee and ANT/ANT+.

ANT is a proprietary 2.4-GHz radio protocol. The upper layers of the stack (ANT+) have been opened up in an attempt to build an ecosystem of interoperable devices; several fitness products based on this protocol recently have been launched. However, the future of ANT for clinical applications remains uncertain. The Continua Health Alliance considered ANT for the low power link before choosing BLE.

ZigBee is another low-data-rate transmission protocol that has been around for some years and also supports a specialised healthcare profile. Unlike Bluetooth, however, ZigBee has not proliferated widely. There are no ZigBee hubs on the medical market yet, and attachment to mobile phones is absent.

In the wide area network space, recent months have seen single-chip cellular modules starting to make their appearance. Qualcomm’s Wearable Mobile Device, which is available in both GSM and CDMA versions, was first to market but several others are due to hit soon. While the price point of these modules remains high at the moment, increased competition will drive down cost. Bandwidth availability and carrier costs notwithstanding, direct data push from medical devices to the cloud thus becomes feasible without the need for an actual mobile phone in the communication chain.

Wi-Fi technology is a strong alternative to cellular networks, and has been gaining popularity. Given its seemingly ubiquitous presence in homes, offices, hospitals and even city blocks, as well as the range of chipsets available at a reasonable price, Wi-Fi can be built into devices relatively easily. A recent report by ABI research suggests that the market for Wi-Fi healthcare services is likely to reach US$1.34 billion by 2016.

Sensors. Sensing technology has advanced significantly in the past few years. Sensors are becoming smaller, cheaper and smarter at the same time. Measuring activity, temperature, impedance and even electrical signals such as ECG is becoming possible in small form factor devices that can run for a reasonable period of time on disposable batteries. Appropriate application of such sensors can enable collection of highly relevant data. Combine that with wireless connectivity and you have a complete toolkit that enables continuous, real-time monitoring of various physiological and environmental parameters essential to diagnose and treat chronic diseases.

Regulatory environment. The other challenge faced by m-health today is an evolving regulatory environment. Until US FDA released draft guidance in July 2011 describing its approach toward m-health regulation, there was no clarity around what might be regulated. Everyone wondered whether a smartphone could be considered a medical device. US FDA guidance clearly differentiates between applications that use built-in or attached sensors on a smartphone, thus turning it into a medical device, from those that simply use the phone to collect, transfer and display data. This risk-based approach is quite sensible and will create the necessary framework to ensure that smartphone-based health applications go through the appropriate level of scrutiny. Many expect the EU to take a similar approach. Regardless of the regulation, m-health players are advised to pay attention to the end use (and risk profile) of their application and follow proper development and verification and validation processes to ensure the safety of their systems.

The road ahead for m-health
As the m-health market continues to grow, competition will be fierce amongst device makers and solution providers alike. Three elements likely will separate the winners from the losers:

  • Interoperable, not siloed, devices. As healthcare migrates from being disconnected to collaborative, stand-alone devices that do not share data will be left behind. The need for pooling data from several devices into central databases, such as EMRs, will only grow as the market expands.
  • Actionable information. Simply accumulating reams of data will do more harm than good to the healthcare system. Clinicians will be overloaded with numbers, and consumers will have nothing to aid continued compliance, thereby failing to achieve the goal of improving outcomes. When designing solutions, device makers must pay attention to generating actionable information from the gathered data. Data analysis tools and algorithms will be key as monitoring devices and mobile apps are scaled to a wide audience. They could provide the competitive edge to companies that recognise this and move fast.
  • User-centred design. The success of mobile medical devices, especially those that rely on user acceptance and adoption, will depend greatly on the user interface. Personalised and context-sensitive solutions will have a greater chance of success. The level of engagement that devices build will determine their long-term success.

CTIA, the association for the wireless telecommunications industry, recently estimated that the wireless home health market, which represented about US$304 million in 2009, will grow to US$4.4 billion by 2013. M-health based solutions will continue to rise and become increasingly vital to care delivery. The initial uptake is likely to be driven by conscientious individuals interested in taking care of loved ones or themselves as well as by large employers facing the burden of rising healthcare costs. However, critical mass will be reached only when payers recognise the benefits of deploying mobile applications for monitoring chronic diseases and promoting healthy living habits.

Vaishali Kamat
is Group Manager, Medical Technology, at Cambridge Consultants, 101 Main Street, Cambridge, MA 02142, USA
tel. +1 617 532 4700
e-mail: info@cambridgeconsultants.com
www.cambridgeconsultants.com



Find more content on:
Your rating: None Average: 4 (2 votes)


Login to post comments

Comment viewing options

Select your preferred way to display the comments and click "Save settings" to activate your changes.

An fascinating discussion is

An fascinating discussion is value comment. I think that it is best to write extra on this matter, it won’t be a taboo topic however generally people are not enough to talk on such topics. To the next. Cheers
AntoniaPearceRomance

good post

Such a very useful article. Very interesting to read this article.I would like to thank you for the efforts you had made for writing this awesome article.
american home protection

starofservice.co.uk

A very awesome blog post. We are really grateful for your blog post. You will find a lot of approaches after visiting your post.
starofservice

I found your this post while

I found your this post while searching for some related information on blog search...Its a good post..keep posting and update the information.
2012 memorial day

Thank you again for all the

Thank you again for all the knowledge you distribute,Good post. I was very interested in the article, it's quite inspiring I should admit. I like visiting you site since I always come across interesting articles like this one.Great Job, I greatly appreciate that.Do Keep sharing! Regards,
www.kptv.com/

m-health start-ups raised

m-health start-ups raised US$93 million in venture funds. The iPhone with its simple user interface and open programming platform catalysed the use of smartphones Potluck Wording

Bismillah... Ayo dituntut

Bismillah...
Ayo dituntut ulah ngagugu kana hoream wae
sok gera alus toko obat herbal jelly gamat
Mugia diridhoi, piduana ti dulu2 sakabehnya...
kesehatan wajah, cara wajah putih, cara wajah awet muda, cara wajah putih alami, cara wajah bersih, agar wajah, wajah berjerawat, wajah berminyak

Positive site, where did u

Positive site, where did u come up with the information on this posting? I'm pleased I discovered it though, ill be checking back soon to find out what additional posts you include.
Schuhe online kaufen

Pretty good post. I just

Pretty good post. I just stumbled upon your blog and wanted to say that I have really enjoyed reading your blog posts. Any way I'll be subscribing to your feed and I hope you post again soon. Big thanks for the useful info.
installateur zonnepanelen

I recently came across your

I recently came across your article and have been reading along. I want to express my admiration of your writing skill and ability to make readers read from the beginning to the end. I would like to read newer posts and to share my thoughts with you.kettlebell workout

I feel strongly about it and

I feel strongly about it and love learning more on this topic. If possible, as you gain expertise, would you mind updating your Hemorrhoid No More Review

You have a real ability for

You have a real ability for writing unique content. I like how you think and the way you represent your views in this article. I agree with your way of thinking. Thank you for sharing.

obat kuat herbal

been reading along. I want to

been reading along. I want to express my admiration of your writing skill and ability to make readers read from the beginning to the end.. rodents

Thanks For sharing this

Thanks For sharing this Superb article.I use this Article to show my assignment in college.it is useful For me Great Work.
are there natural ways to make your breasts bigger

I must say, I thought this

I must say, I thought this was a pretty interesting read when it comes to this topic. Liked the material. . .
http://numerologyreview.com

This article gives the light

This article gives the light in which we can observe the reality. This is very nice one and gives indepth information. Thanks for this nice article.
by clicking here

ZigBee is another

ZigBee is another low-data-rate transmission protocol that has been around for some years and also supports a specialised healthcare profile. Unlike Bluetooth, however, ZigBee has not proliferated widely.
http://www.travellerscity.com/best-lightweight-carry-on-luggage/

When selecting a connectivity

When selecting a connectivity option and protocol, every design team is faced with the primary question of whether to choose standards-based solutions or develop a custom proprietary protocol.
best electric pressure washer

This article gives the light

This article gives the light in which we can observe the reality. This is very nice one and gives indepth information. Thanks for this nice article.
агентства недвижимости в Монако

I think this is an

I think this is an informative post and it is very useful and knowledgeable. therefore, I would like to thank you for the efforts you have made in writing this article.

rebelmouse.com

This is very educational

This is very educational content and written well for a change. It's nice to see that some people still understand how to write a quality post.!
doTERRA Lotus Essential Oil Diffuser

I just couldn't leave your

I just couldn't leave your website before telling you that I truly enjoyed the top quality info you present to your visitors? Will be back again frequently to check up on new posts.
weblink

track patient compliance on a

track patient compliance on a continuous basis with minimal disruption in the daily life of the user. Text Mate 2

Hey what a brilliant post I

Hey what a brilliant post I have come across and believe me I have been searching out for this similar kind of post for past a week and hardly came across this. Thank you very much and will look for more postings from you.
http://www.twitter.com

I think this is an

I think this is an informative post and it is very useful and knowledgeable. therefore, I would like to thank you for the efforts you have made in writing this article.
twitter.com/newspaper_cat/status/583015267229265920

I have been searching the

I have been searching the Internet for fun and came upon your website. Fabulous post. Thanks a ton for sharing your knowledge! It is great to see that some people still put in an effort into managing their websites. I'll be sure to check back again real soon. mannequins heads

I can see that you are an

I can see that you are an expert at your field! I am launching a website soon, and your information will be very useful for me.. Thanks for all your help and wishing you all the success in your business.
Denton TX Web Design

i was just browsing along and

i was just browsing along and came upon your blog. just wanted to say good blog and this article really helped me.
Victorino Noval Los Angeles

So far, not much attention

So far, not much attention has been paid to standards or communication protocols to which wireless health devices must adhere.
http://chaturbatetokengenerator.org

Someone Sometimes with visits

Someone Sometimes with visits your blog regularly and recommended it in my experience to read as well. The way of writing is excellent and also the content is top-notch. Thanks for that insight you provide the readers!
education news

I love this blog!! The flash

I love this blog!! The flash up the top is awesome!!

about

I can see that you are an

I can see that you are an expert at your field! I am launching a website soon, and your information will be very useful for me.. Thanks for all your help and wishing you all the success in.. cab service jaipur to delhi

i was just browsing along and

i was just browsing along and came upon your blog. just wanted to say good blog and this article really helped me.. car accident attorney Detroit

Mmm.. good to be here in your

Mmm.. good to be here in your article or post, whatever, I think I should also work hard for my own website like I see some good and updated working in your site.
mercedes rims for sale

it's really nice and meanful.

it's really nice and meanful. it's really cool blog. Linking is very useful thing.you have really helped lots of people who visit blog and provide them usefull information.
Ai wei wei

I would love to stop by. But,

I would love to stop by. But, I think it might have to wait until this summer. I did not know that Serlkay had ever expanded its size. I must say that a succesful family owned business in this day and age is a very refreshing sight! As well as this is a very refreshing site!
Tourism in China

The website is looking bit

The website is looking bit flashy and it catches the visitors eyes. Design is pretty simple and a good user friendly interface.
http://www.theofficialwebsite.co

Positive site, where did u

Positive site, where did u come up with the information on this posting? I'm pleased I discovered it though, ill be checking back soon to find out what additional posts you include.
king game tips girlfriend activation system

I thought this was a pretty

I thought this was a pretty interesting read when it comes to this topic. Liked the material drug rehab treatment

I haven’t any word to

I haven’t any word to appreciate this post.....Really i am impressed from this post....the person who create this post it was a great human..thanks for shared this with us.

metallic epoxy flooring nh

Mobile phones have

Mobile phones have proliferated in emerging economies, in many cases well ahead of medical care, so m-health could provide a means for deployment of care to remote areas
Warren

I admire this article for the

I admire this article for the well-researched content and excellent wording. I got so involved in this material that I couldn’t stop reading. I am impressed with your work and skill. Thank you so much.
latest mobiles

Easily, the article is

Easily, the article is actually the best topic on this registry related issue. I fit in with your conclusions and will eagerly look forward to your next update. http://www.stockbroker-career.com/

The website is looking bit

The website is looking bit flashy and it catches the visitors eyes. Design is pretty simple and a good user friendly interface.
www.dating-journal.com

Thanks for another wonderful

Thanks for another wonderful post. Where else could anybody get that type of info in such an ideal way of writing?

bipolarism

Thanks for another wonderful

Thanks for another wonderful post. Where else could anybody get that type of info in such an ideal way of writing? plumbing business for sale

Excellent .. Amazing .. I’ll

Excellent .. Amazing .. I’ll bookmark your blog and take the feeds also…I’m happy to find so many useful info here in the post, we need work out more techniques in this regard, thanks for sharing.
cap barbell rswb review

When you need a legal

When you need a legal professional, it can be is suggested that you just get a Texas Legal professional. highlander plumbing

I’ll bookmark your blog and

I’ll bookmark your blog and take the feeds also…I’m happy to find so many useful info here in the post, we need work out more techniques in this regard, thanks for sharing. Youtube

I am very enjoyed for this

I am very enjoyed for this blog. Its an informative topic. It help me very much to solve some problems. Its opportunity are so fantastic and working style so speedy.
Edward Bass Producer