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Guest Blog...Jon Linkous, CEO, American Telemedicine Association (ATA) ... It’s mHealth, but will it be a Revolution?


Please see guest blog from MedTech-IQ member, Jon Linkous from his American Telemedicine Association (ATA) blog ...



The funny thing about “mHealth” is that it has taken on such a cult-like status among investors, industry and the media. Certainly the potential for the use of mHealth in the delivery of healthcare is huge and it may
have an impact on other parts of healthcare such as chronic care management, emergency response services and the role and responsibilities of the consumer in their own health.

The market for mHealth is still in its infancy. There is still confusion about all that is encompassed in the term. It may include a mobile device or a service using mobile technology. The devices include an array of
products and services that use mobile, wireless technology: cellular phones, wide-area, local-area and personal networks. These use different parts of the radio spectrum, different standards and protocols and
different levels of signal strength or power. Generally the term mHealth does not include the use of satellite technology.

Some parts of mHealth are devices and services focused on direct consumer purchases and use. For example, the vast majority of the 6,000+ health-and-wellness smart phone applications are designed for use by consumers. However, when measured by dollar volume, these applications are probably smaller than other mobile devices and services aimed at the use in the traditional healthcare system.

The wide-spread media attraction in the mHealth market is because it’s new and it’s fun. It is still a bit of a Wild West atmosphere with new ideas and crazy applications coming up every day. Some include incredibly smart and exciting approaches to solving age old health care problems; others appear to be solutions in search of a problem. The investment money is flying out the door. Although there is a positive growth in sales, almost all of the mHealth companies or divisions have not yet made a profit. It reminds me a bit of the dot com (sometimes called the dot bomb) market of the 1990s. Certainly at this point mHealth is close to the top of the “hype cycle” (as described by Gartner, Inc). There are new associations and think tanks devoted to the subject, academic and commercial conferences galore. We are approaching the cycle's "Peak of Expectations."

For those on the sidelines it makes great fun. For developers and investors it is much more serious. It is a bit like a game of musical chairs. Most of the mHealth ventures are hoping to be bought up or merged into another, larger venture. At some point the music, or the outside funding, is going to stop (as we enter the Trough of Disillusionment) and those ventures not bought out or turning a profit will be in trouble.

But here is an important point – mHealth is not a stand-alone market. It is part of a mature, two trillion dollar healthcare business. To be successful, mHealth devices and services have to understand how the healthcare market operates; how it is funded and regulated; and, most important, how buying decisions
are made. Developing a way to use a mobile device to measure blood glucose and send the data to another location may be interesting but is not nearly enough.

Further, relying on consumer expenditures for mHealth is probably not the answer for most such ventures. Out of pocket expenditures for healthcare in 2008 were a little below 12 percent, following a steady decline of over fifty years. This still represents a lot of money but it describes a public expectation that insurance,
private or public, will pay for almost all of health care. Efforts to have consumers get more “skin in the game” will have only limited success when consumers are not even paying for their own drugs or eyeglasses anymore. Even the use of Flexible Spending Accounts will be restricted or eliminated as health reform is implemented.

Therefore, to recognize the benefits and opportunities offered by mHealth applications for healthcare delivery, they need to be incorporated into traditional healthcare financing and services. Surprisingly, despite the huge increase in health expenditures, the place where health dollars are spent has stayed relatively the same. Hospital care continues to be roughly one third of expenditures, physician services at about 20 percent and prescription drugs about 10 percent. Home health constitutes about 2 percent of national expenditures. What is changing is the source of these funds and who controls the spending. Accompanying the decline of direct consumer expenditures is the growth of public funding. On the horizon are more comprehensive regional healthcare networks with a broad authority to provide integrated, comprehensive care. This will dramatically accelerate with health reform.

The point of all of this is that the success of the mHealth revolution in the United States is directly linked with developments occurring in broader health reform and how mHealth applications may be an option for use in such developments as Accountable Care and Independence at Home initiatives. Such change is coming fast, really fast. In three to five years we may see an incredible change in the way various organizations are involved in health care delivery. It will be interesting to see how much mHealth is picked up and integrated into these changes.

Finally, assuming mHealth becomes recognized as an important component of mainstream health delivery, regulatory oversight is sure to increase. The Food and Drug Administration has played it light so far but the
agency's role in reviewing and approving mHealth devices may grow. Similarly the Federal Trade Commission, Federal Communications Commission and all of their counterparts in other countries will also soon take notice and start similar regulatory oversight activities.

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Comment by Marcia Eichenauer on July 5, 2010 at 4:16pm
Hi, Jon, thank you for your insights into mHealth and the opportunity to share our own purview and perspective. I am formerly in high level PR and media. I helped to launch TV Markiza, Slovakia, after the fall of the communist system. At this time, investors were going into former communnist new markets all the way to Russia, as was the US Gov't. I had launched many, many products, projects, companies before this, however, this was where my experience was halted.

I would say that our 'image and reputation' left a lot to be desired as we as a nation and global business community were slow to understand that healthcare was / is critical to what the world sees us doing to walk our bring democracy, freedom and most especially human rights.....and for women and children, (along with our global business model(s)) to the Nations. We were not wanted any further than Russia, once other nations saw how rapacious our business model had become.

I am thankful to see the AMA having a voice and a role in creating a new business model, globally, as it so greatly and critically impacts on what the traditional model has been, driven by Wall Street, global business, government(s) and not for profit orgs. Without a doubt healing is what is needed by the Nations and we have outstanding doctors in this country. Praise God this is being brought to the grassroots level, now, in the US and even globally as the Defense Department and State Departments see the real value, now/ banks are failing, media finally catching a vision and the world waiting...for what we call mhealth.

As a marketing exec, I disagree with you about whether mHealth will be a revolution. I believe from what I understand you are saying the regultory agencies will largely rein this back. This will be akin to trying to rein back capitalism that broke through communist gates; that is, there is no reining this back, it is being driven by the incredible spirit of those of us to savor freedom at all costs and love our neighbors.

Jon, this will happen too quickly to be regulated/reined in as the need is so dire. Just like former communist nations waiting for the business opportunity capitalism brings, foreign markets have their handhelds ready and waiting. No kidding, Haitians may not have food, water, shelter but they have a cell phone.

Are you/ will anyone not give a cup of cold water to someone who asks, nor a piece of bread?

healers? I do not think so.

I am sure that many doctors recognize the power of God in the miraculous healings they witness, against all odds. The healings wouldn't be miraculous, nor would there be an opportunity for God to show up and show His face if what traditional medicine is capable of were where the buck stopped.

I am seeing the outpouring of interest on every level for the use of mobile technology, new media, streaming media, programming and for women and children against violence, finally, praise God and because our nation sees our global image clearly now and the need / time has come.

My former traditional networks in broadcast TV and high level PR thought I really lost it when I told them over 15 years ago healthcare was going to occur over the Internet, TV was going to lose their ad dollars and we were going to soon be running flat networks over the Internet, with programming bringing healthcare to far away lands. Today, they are not laughing, look at NBC and GE.

The need always drives the market and like we all needed freedom and democracy in communist nations, (their business model broke) we now need healthcare for women and children and against violence. Ask every mother and father, every child and they will tell you what regulators may not.
God watches over and protects the innocent. The government is on His shoulders. The increase of government and peace there will be no end; the zeal of the Lord will accomplish this.

He sees, Jon. And, now, even governments and agencies see. Healthcare buys us that peace.

Grace and peace, Jon,
Marcia Lynn Eichenauer , Founder
Christ King Of kings Network
addressing trafficking and the abandonment
and abuse of women and children

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