What’s wrong with mHealth? Ask Rube Goldberg…. Part I

What's wrong with mHealth? Ask Rube Goldberg.... Part I 2011-01-05 16:47:46

I attended a meeting the other day where buzzwords like “mhealth”, ehealth, “connected health,” “wireless health”, and a slew of others (collectively “xhealth”) were thrown around the room like confetti at a parade.

At one point, the discussion became pretty heated around the attributes of the mhealth market compared to ehealth as well as which was higher in the perceived health information technology (HIT) hierarchy. I listened carefully as each participant passionately shared their unique point of view about the size and definition of each respective market and, of course, how their company was positioned to be the market leader. I have to admit, it was pretty tempting to jump in especially when someone in the group tried to create a new buzzword in an effort to plant their flag in yet another nebulous and ill-defined mobile healthcare niche.

In the race for healthcare innovation, coining buzzwords, and carving up prospective market segments, it seems like people have lost sight of the real prize — adoption. Specifically, near-term adoption.

This is as alarming to write as it is to read, but based on the mhealth “innovations” that I’ve seen, it’s no wonder this market category is struggling.

Rube Goldberg’s complex devices that performed simple tasks in circuitous and convoluted ways are considered by many as entertaining and innovative. Many mhealth innovations share some similar characteristics; they take a long time to build, are interesting to see and play with once or twice, but don’t add much perceived value in the daily lives of people. I think Rube would agree that; innovation, unadopted, isn’t true innovation.

Chilmark Research (www.chilmarkresearch.com) recently pointed out that 90 percent of mhealth technologies presented at the last mhealth summit (www.mhealthsummit.org) are unsustainable. The parody is that companies are designing unsustainable mhealth technology for an unsustainable healthcare system. That’s pretty dysfunctional.
One can argue that this dysfunction is par for the course at this point of the xhealth evolution cycle, but does it have to be?

The U.S. healthcare market, or more accurately and politically incorrect “sickcare” market, is not like other markets. The rules are different. Healthcare in the U.S. isn’t driven by market-based forces. As Paul Keckley, Executive Director Deloitte Center for Healthcare Solutions points out in a comparison between public education and healthcare, the healthcare market is driven by “the people with the loudest and best funded voices committed to maintaining the status quo to protect their needs, even if it doesn’t work….1”

There are some markets where change is simply too disruptive to the status quo. Our current healthcare system is one of these. So, as you continue your efforts to improve healthcare by leveraging mobile technology and building a sustainable business, you might be more successful using an approach that I call “tempered disruption” to speed adoption. Essentially, tempered disruption follows the 80/20 principle and the notion that a few things are much more important than most things. It promotes the idea of designing and implementing a simple change in a smaller and more important part of a system that will positively align and affect the less important larger part of a system.

This approach, which I’ve tailored for innovators targeting healthcare providers like hospitals and physicians, is comprised of a basic framework of six simple principles (there are more, but if you’re not addressing the six, it may not be worth finding out what the others are.)

To help illustrate a few of the principles and the framework’s applicability, I’ll also provide an example of a problem that’s gone largely ignored and hits a healthcare mobility sweet spot.

Check back next week for Part 2 or subscribe and be notified

1 Deloitte Health Care Reform Memo: Dec 6, 2010, quoted retired New York City Education Chancellor Commissioner Joel Klein

http://twitter.com/3GDoctor David Doherty

There’s nothing ill defined about mHealth: http://t.co/pX2O3Yx

In fact it’s got 8 unique abilities/attributes, I’ve given examples of each here:
http://t.co/pzYnaXo

John Moore @ChilmarkResearch is wrong about the fate of 90% of the companies at the mHealth Summit. To prove the point about 100 companies exhibited:

http://www.mhealthsummit.org/exhibitors/list

To make the point I’ve copied and listed the names of 25% of these and I assure you all of these organisations will still be around for at least as long as Chilmark Research or alargepond.com:

3G Doctor, USAir Force, American Telemedicine Association, AT&T, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Gates Foundation (Bill & Melinda Gates Foundation), George Washington University, Health Resources and Services Administration, Intel Corporation, Johns Hopkins, Lenovo, National Institute on Alcohol Abuse and Alcoholism,
National Institutes of Health Public Private Partnership, National Library of Medicine, National Institute of Biomedical Imaging and Bioengineering,
Qualcomm, Samsung, Sprint, Telecoms Sans Frontieres, U.S. Agency for International Development, UNICEF, United Nations Foundation/Vodafone Foundation, Verizon Wireless, West Wireless, World Food Program USA.

Obviously not everything in the world of mHealth is going to offer untold riches but the fact that the event was attended by at least 3 billionaires is a very positive sign.

As with most things in life there will be winners and losers and with mHealth there may even be rewards that are better than a return on investment eg. capping growth in healthcare spending, improved quality of living, end of needless suffering, cures to diseases, etc etc
http://twitter.com/john_chilmark John Moore

Hi Vincent and thanks for inviting me to comment.

As I stated in my post over on the Chilmark Research site that you reference here and I still hold to it is that at least at the mHealth Summit and from what I have observed both on the Android and iTunes App Stores, 90% of these mHealth apps & the companies that developed them will not make it long term.

Even David Doherty, who I happen to have high respect for and what he is trying to do list of the “25%” of exhibitors at mHealth that will be around for years to come is flawed. I mean really, the ATA, heck that’s an industry org, not an App developer, same holds true for the various foundations and educational institutions he lists. Strip all those out and we’re back down to 10% of all exhibitors.

But the main point I was trying to make in that post and you have reflected in yours is that there is a tremendous amount of buzz around the topic of mHealth, but extremely few well documented successes, especially in the developed world. And as you so succinctly put it, without adoption, there really is no innovation.

When it comes to mHealth, I prefer to see myself as a realist. There really is tremendous potential for mHealth and it could be highly disruptive to current healthcare models in the US. To get there, however, we are going to need far more robust apps then I’ve seen to date. And as a reference point, our recently published mHealth in the Enterprise forecasts some pretty big growth as clinicians adopt touch tablets and smartphones which will become an integral part of their daily rounds.
http://www.healthcarehiring.com/blog/?p=4328 What’s wrong with mHealth? Ask Rube Goldberg…. Part I | LargePond « health care commentaries from around the world

[...] At one point, the discussion became pretty heated around the attributes of the mhealth market compared to ehealth as well as which was higher in the perceived health information technology (HIT) hierarchy. I listened carefully as each participant passionately shared their unique point of view about the size and definition of each respective market and, of course, how their company was positioned to be the market leader. I have to admit, it was pretty tempting to jump in especially when someone in the group tried to create a new buzzword in an effort to plant their flag in yet another nebulous and ill-defined mobile healthcare niche. In the race for healthcare innovation, coining buzzwords, and carving up prospective market segments, it seems like people have lost sight of the real prize — adoption. Specifically, near-term adoption. via alargepond.com [...]
http://twitter.com/3GDoctor David Doherty

Hi Vincent & John,

Great debate here.

It seems that there’s confusion of mHealth as something synonymous with Smartphone Apps – it’s far from that as can be seen by appreciation of this accurate definition: http://bit.ly/9gcKmk

Surely the event we are talking about was the “mHealth Summit” not the “mHealth App Summit”

Okay so the ATA is not my personal favorite on the list – next is AT&T who are the 7th largest company in the US and they’re currently completely reorganising their business to target mHealth – but it’s still a valid example even if it is JUST an industry association.

The ATA’s remit is to “promote access to medical care for consumers and healthcare professionals” and there are therefore enormous opportunities for it to leverage mobile – the newest and most misunderstand mass media.

To think it will be unable to make sustainable $’s from mobile is shortsighted in assuming that everything will remain static – it’s worth remembering that the giants of mobile weren’t even making mobiles until relatively recently eg. Apple were a computer manufacturer and Nokia was a rubber boot manufacturer.

To give you an idea of how the ATA could “make it long term” through leveraging mobile consider the savings it could make if it stopped printing its publications tomorrow and moved to digital formats. Then think of the opportunity to make money if it began leveraging mobile communities to engage members more effectively with one another?

It’s a shame you didn’t get a tour of our booth. I was demonstrating mobile services that are being adopted by leading medical schools and hospitals around the world as well as consumer devices from Korea and Japan that aren’t yet available in the US which run native apps that integrate with transformational mHealth services.

Suggested reading would be “m-Profits” written by an ex-Nokia Exec in 2002 it’s still current and talks of the opportunities in mServices:

http://www.tomiahonen.com/mprofits.html

Services are what underpin success in the mHealth world. In my opinion analysts are getting concerned about a mHealth App hype but this is just a necessary stepping stone towards a future where patients and care providers are properly engaged with their care and this will only be achieved through leveraging the personal, permanently carried and always on mobile.

The end game will be mHealth services for patients, providers and communities.
http://twitter.com/3GDoctor David Doherty

Hi Vincent & John,

Great debate here.

It seems that there’s confusion of mHealth as something synonymous with Smartphone Apps – it’s far from that as can be seen by appreciation of this accurate definition: http://bit.ly/9gcKmk

Surely the event we are talking about was the “mHealth Summit” not the “mHealth App Summit”

Okay so the ATA is not my personal favorite on the list – next is AT&T who are the 7th largest company in the US and they’re currently completely reorganising their business to target mHealth – but it’s still a valid example even if it is JUST an industry association.

The ATA’s remit is to “promote access to medical care for consumers and healthcare professionals” and there are therefore enormous opportunities for it to leverage mobile – the newest and most misunderstand mass media.

To think it will be unable to make sustainable $’s from mobile is shortsighted in assuming that everything will remain static – it’s worth remembering that the giants of mobile weren’t even making mobiles until relatively recently eg. Apple were a computer manufacturer and Nokia was a rubber boot manufacturer.

To give you an idea of how the ATA could “make it long term” through leveraging mobile consider the savings it could make if it stopped printing its publications tomorrow and moved to digital formats. Then think of the opportunity to make money if it began leveraging mobile communities to engage members more effectively with one another?

It’s a shame you didn’t get a tour of our booth. I was demonstrating mobile services that are being adopted by leading medical schools and hospitals around the world as well as consumer devices from Korea and Japan that aren’t yet available in the US which run native apps that integrate with transformational mHealth services.

Suggested reading would be “m-Profits” written by an ex-Nokia Exec in 2002 it’s still current and talks of the opportunities in mServices:

http://www.tomiahonen.com/mprofits.html

Services are what underpin success in the mHealth world. In my opinion analysts are getting concerned about a mHealth App hype but this is just a necessary stepping stone towards a future where patients and care providers are properly engaged with their care and this will only be achieved through leveraging the personal, permanently carried and always on mobile.

The end game will be mHealth services for patients, providers and communities.
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