Mobile services speed up timeframe of ‘mHealth’ development

By Accenture

Mobile health care or “mHealth” has gained significant investment and traction from many participants, as pilots and trials evolve to substantively funded business ventures aimed at reaching broad consumer segments. Early results suggest that mHealth products and services can help meet two goals; providing high-quality care and reducing costs, especially in managing chronic diseases.

New health care funding, the pervasiveness of mobile technologies and the current state of the pharmaceutical market make this an interesting time for life science companies. Whether pharmaceutical companies should choose to wait and see how policies, technologies and stakeholders’ strategies evolve or establish leadership and make significant investments to create new value streams is a difficult decision to make.

Pharmaceutical companies should target specific tiers of mHealth opportunities based on several strategic considerations, including their relationship with payers, alignment, with disease focus, extent to which services will support targeted therapeutics and likely adoption rates in selected markets.

mHealth’s pervasiveness and relevance to virtually all consumers suggests significant health care benefits and opportunities for all key stakeholders across the health care value chain. Over the last few years there was media coverage on investment and product development; regulatory approval of solutions that support remote monitoring; pilots and projects to demonstrate effectiveness; clinical trials including mHealth components; and investments by leading technology and health care firms to build initiatives.

Several factors are converging to move mHealth into mainstream health care. First, a rapidly aging population needs options for care delivery, especially for chronic diseases such as diabetes, cardiovascular disease, chronic obstructive pulmonary disease, cancer and arthritis.

Second, the shortcomings of episodic treatment and event-driven reimbursement are well known: patients delay seeing a health care professional until symptoms severely impact their quality of life and limit treatment options making more costly treatment necessary.

Also, relying on patients with chronic diseases to assess whether treatment adjustment is necessary can be unproductive. Recent articles on diabetes treatment summarized significant improvements in glycemic control in adults and children who used devices or were given text message reminders to take medications versus patients who used traditional home monitoring and reporting.
The evidence that mHealth makes a positive impact is compelling.

Global and domestic mobile health care trends

There are key steps of biopharmaceutical companies to bring mHealth forward in their business: 1) Determining which products have the most issues with adherence; 2) determining which methods and technologies best support various patient segments; and 3) implementing a program and monitoring the results, adjusting as needed.

Moving to a level two or three approach, companies should assess if they have the technological competency, the ability to influence providers to adopt new platforms, and the credibility in providing mHealth services.
In pursuing a level two approach, biopharmaceutical companies serve as catalysts in bringing together a community of providers, and payers who will be able to influence care delivery and achieve targeted patient outcomes.

Companies opting for a level three approach will effectively enter a new business area that involves risks/rewards and compete with existing providers of these services including payers that are extending their footprint in this space in developed markets.
Still there is the fourth option that is to wait until these systems reach maturity levels and then incorporate them into trial design and health outcomes studies, but the risk of waiting is high, leaving the market open for others to develop.

Each market will require different approaches. For example in Europe, most people are simply not going to pay for additional mHealth services out of their own pocket. In Western Europe, payers are the only potential buyers of these services. However in Eastern and Southeastern Europe, some corporations could be additional targets as many cover the health care costs of their employees and would benefit from health care cost reductions from improved prevention and health outcomes.

On the other hand, some countries such as France, the United Kingdom and the Netherlands have started to change their reimbursement and are beginning to recognize Telehealth and mHealth services as part of their regular health care provisions making them obvious targets for a level 3 approach.

In countries like United States where private payer dynamics, political agendas and health care economic factors work as key factors to speed up the timeframe of mHealth evolution, immediate adoption and rapid growth of narrowly focused mHealth solutions are expected. Through web and mobile-enabled adherence solutions, mHealth products and services will mostly develop in two categories: 1) stand-alone products as smart pills that track medication compliance or 2) comprehensive solutions as delivery applications.

Mobility, as a key component of biopharmaceuticals overall digital strategy, will play a critical role in connecting multiple, currently disparate stakeholders in the health care industry including patients, payers, providers, medical device companies, governments and regulators. As these entities come together mHealth will go through a maturation process from stand-alone initiatives to the point where mHealth is pervasive throughout the industry.

Recently innovation and investment in mHealth relates to stand-along solutions because it is easier to bring a discreet product for an identifiable target segment to the market. The value and benefits can be easier to explain and implementation can be streamlined.

Current examples of stand-alone mHealth products or services include: 1) portable ECG heart monitoring device for at-home use 2) smart shirt with embedded sensors that continuously monitors more than 30 physiological signs 3)armband that gathers detailed data about body movements from which inferences are made about important lifestyle patterns 4)“Home cams” or smart environmental sensors that monitor and calibrate patients’ health and safety 5) drug adherence solutions that focus on improving drug treatment compliance.

In contrast to stand-alone offerings, comprehensive solutions provide an end-to-end service that encompasses patient education, diagnosis services and ongoing disease management. While the value delivered to patients can be substantial, developing such solutions requires intensive effort and collaboration with a multi-player alliance of independent companies, each bringing specialized medical, technology or management capabilities and assets to the table. Nonetheless, there have been promising collaborations to deliver comprehensive solutions. Now insurance providers are becoming active participants in the development of comprehensive mHealth services. With collaborations among companies like Best Buy, Significa, AllOne Health, Orange Telecom Company and even the National Health Service of England, the results of mHealth initiatives are more encouraging.

Given that comprehensive mHealth requires a significant information technology infrastructure and can involve development of new devices or products, companies known for their engineering like Bosch, Intel and Philips all have begun investing in mHealth solutions, sometimes partnering with provider groups to test offerings. The momentum behind mHealth is accelerating in part because these trials and pilots as well as others have shown positive results and improvements in patient care.

The Future of Mobile Health Care

The question for biopharmaceutical companies is what roles they can play in mHealth to advance patient health and improve companies’ current future business opportunities. The dramatic growth in mobile technology and emerging innovations in care and disease management, biopharmaceutical companies should be motivated to adopt new systems to innovate by using mHealth opportunities to address basic to comprehensive benefits that enable improved outcomes and decreased health care costs.

In drug compliance improvement level, mHealth will likely bring increased unit sales of products and lower the costs with stand-alone, single-purpose technology solutions that meet key attributes.
In the health outcome improvement stage, strengthened relationship with payers and improved market access and pricing are expected. For these positive outcomes, credible design execution of data generation and integrated technology platform that enable info sharing across stakeholders will be necessary.

Lastly in the last level where there are opportunities to lower health care costs and obtain target health outcomes, mHealth could bring further revenue from services and outcomes for care and disease management. Likely approaches include funding mechanisms to support investments and obtain reimbursement, joint venture management, and disease and cost management services and integrated technology platform.

By 2014, mHealth is estimated to be at least a 5 billion dollars industry, satisfying electronic medical records (EMR), reimbursement and technology standards.
There are various opportunities as levels of involvement for pharmaceutical companies to participate in mHealth to better serve patients, respond to stake holder business concerns and secure the right collaborators and partners. Most mHealth products are either stand-alone or comprehensive types. The early part of the mHealth evolution will be mainly characterized by independent solutions but will evolve to a more integrated approach with a blend of stand-alone and comprehensive solution stage that will improve patient outcomes.
Pharmaceutical companies have the relevant resources to play a key role in this evolution. It is now time to derive the most benefit from related investment and innovation.

This article was provided by Accenture.