For many years the best way to insult a mobile operator was to suggest to them that they were just a pipe for voice and data. They’d foam at the mouth and point out that they were a brand, not a utility. They’d justify this by pointing out that they had marketing people and that they offered differentiated products. It took a far more expert brand in the guise of Apple to make the commercial point with the iPhone, which was offered to mobile operators on the “stick it up your pipe and smoke it” principle, giving the consumers to Apple and ultimately forcing the operators into a price war in supplying a largely undifferentiated consumer data pipe.
At the same time, utilities were beginning to think that they might be more than a pipe. Particularly in areas where the market is deregulated, allowing consumers to switch energy supplier, they’ve been toying with ways to attract customers through segmentation and selling other services.
On the same day this week, in the UK, we’ve seen two interesting examples of this playing out. O2, which had been chasing the health market with their Help at Hand and Health at Home products, unexpectedly pulled out. At the same time, British Gas launched an initiative to become the energy supplier of choice to young renters. It’s useful to consider what these say about the potential to gild your pipe and rise above the status of utility. As we enter the era of the Internet of Things, the market will need service providers who can aggregate services and who have trusted relationships with consumers. These moves suggest that although utilities and network operators ought to be well placed to extend their relationships, they may lack the skills to do so.
If you’ve been following the UK health pronouncements on telehealth, you’ll be aware of the policy of recruiting 3 million patients to become telehealth users by 2017. And if you’ve been following the industry analysts you’ve probably spotted the recent report by InMedica, suggesting that by 2017 there will be 1.8 million patients using telehealth worldwide. In other words, the UK’s program will be responsible for around 200% of telehealth patients. I know we did well at the Olympics, but that’s setting the bar rather high.
It suggests that either our ministers in the Department of Health are doing a Chris Huhne, or else the analysts are being uncharacteristically understated about the future.
If you follow the mHealth blogs and groups on LinkedIn you’ll see a constant debate about where mHealth is in out existing health services. I’ve been looking at some of the applications which are already in use within the NHS. As yet, there’s no central policy for mHealth, and it’s debatable whether much of the good practice using mHealth is even acknowledged, but that doesn’t mean it’s not providing benefit.
Much of mHealth is invisible. It’s not the high tech monitoring that we find in glossy medical device brochures, but far simpler, everyday applications. Many of these use SMS, but mHealth extends through voice and video, and we’re already seeing local use of applications on iPhones and Android. However, there is little coordination of deployment, and almost all that is happening is as a result of local initiatives.
Although they may seem strange bedfellows, both the mHealth industry the smart metering industries (both favourite children of the technology world), are facing the same problem. Both are moving from a world of almost no data to data overload of a level they never imagined, even in their worst nightmares. Whether it’s from an annual health check or a visit from the meter reader, both are used to getting one data point per customer per year. The advent of connected sensors means that is changing to anything up to one reading per second.
It’s a bit like the case of a child who has hitherto only been allowed chocolate on Christmas Day. Now they’re being led into a chocolate factory and told they can eat as much as they want. The inevitable result is a very happy child for a few hours, until they’re violently sick. At which point they either vow never to eat another chocolate, or learn to treat it in a more sensible manner.
Today the medical industry and energy utilities are being shown the doors of the chocolate factory. We have yet to see how they behave once they enter it. Some may emerge as triumphant Charlies, but others risk becoming the commercial equivalent of Augustus Gloop and Veruca Salt.
There’s an election looming in the UK, which is causing problems for the political parties. Everyone knows that we need major public spending cuts, but no politician is going to risk votes by committing to anything too great. So everyone is carefully skirting the issue, particularly where the NHS is concerned. The British public have a love-hate relationship with the NHS. They love to deride its inefficiencies and problems, but as soon as anyone attempts to take an axe to it, it transmutes into the most valuable aspect of being British.
Of course, those of us involved with healthcare know that this is more than just an election issue. The changing demographics mean that the NHS, and every other health system in the world is heading for financial meltdown. Rather than acknowledge it, our politicians (even those who have been pushing through the U.S. Health reform bill) are doing little more than being fitted for their lemming suits and asking for directions to the edge of the cliff. We cannot afford healthcare in its present form and we’re running out of time to address that inconvenient truth.
One straw that is invariable grasped and brandished is the potential of mHealth (or eHealth, telecare or eCare) to sweep away the costs. So in the spirit of helping our flailing politicians, I thought it might be an opportune time to review how it’s doing.
A few weeks ago I was talking to someone who mentioned the Talisman SOS bracelet that she and her family wore and suggested that people should be encouraged to add basic medical information into their phone. In the UK there have been a number of campaigns to persuade people to add an ICE (In Case of Emergency) number into their list of contacts. Her suggestion was that this could be expanded to include key medical details. Plenty of such phone apps like this already exist, such as My Life Record, Smart-ICE, Hermes and Allscripts Remote. The problem they bring is how much they can be trusted, particularly in an emergency. It’s something that is causing considerable anguish not only within the medical profession, but also within industry groups who are trying to move medical monitoring into the home. It was a hot topic at this week’s Wireless Communications in Healthcare Conference in London.
At the heart of the problem is the integrity of data that goes into a clinical record. Until recently, data was only ever entered by members of the medical profession. The advent of accessible electronic health records means that patients can begin to enter their own data or modify their records. Whilst I believe that’s the way the world has got to move, it raises important issues.