#mHealth and Innovation – 2 Recent Reports

We all know that healthcare is clearly one of the darlings in the market right now.  One doesn’t have to look any further than these stories:

• IMS IPO
• Castlight IPO
• Angel Investors  Focus on Healthcare
• Year in Funding by RockHealth

You can see companies building innovation teams and innovation labs within healthcare.  You see lots of new entrants trying to figure out how contribute in this space (e.g., Qualcomm Life).  But, some of these just become ivory towers where they pontificate and put out cool ideas.  Others disappear because they can never be commercialized.  Others fall into the “fast fail” bucket of companies, and only a portion of those actually innovate well.

Of course, it begs the question of “What is innovation?”  Is it:

• Something completely new
• Something re-engineered
• The same thing delivered differently
• Combining of multiple things (i.e., product with services)
• Solving old problems with new technology

With that in mind, I was reading two reports which I thought I’d share with some initial reactions.

The Boston Consulting Group report “Fulfilling the Promise of mHealth Through Business Model Innovation”.

This is a nice report, but it’s a little too high level for me.  It has some great frameworks about what to do and some nice graphics, but it’s not operationally practical (although that may not have been the purpose).  Here’s a few things I highlighted:

• “Mobile Health – The use of mobile applications and devices to deliver medical information, access or record data, or provide clinical services – has the potential to revolutionize patient care.”  [good definition]
• “The gap between the current market size and five-year projections is significant.”  [so is it a warranted gap or will it get closed…I think it will be a challenge to meet expectations.]
• Their big example of success is Welldoc’s BlueStar “mobile prescription therapy”.  [it’s an interesting product with some interesting studies, but I’m not sold yet…will the Rx process work for a device?  Can they justify their price?  Will buyers do more than pilot?]
• They hold out 3 barriers – entrenched behaviors, reluctance to pay, and fragmented infrastructure.  [I would agree but how do I work through these…they provide some thoughts.]
• They talk about creating a “must-have app” that would consolidate multiple offerings into a single solution.  [I don’t even think this silver bullet approach should be considered…It won’t happen.]
• They seem to fall into the traditional trap that people other than the payers and employers will fund these programs (telcos, pharma, device companies).  [Everyone wants that, but I think that’s the wrong framework.]
• They talk about an option of creating and charging a premium for mHealth offerings because some of them “deliver objectively better outcomes or lower costs compared with traditional health-care offerings”.  [Really?  That’s great news, but I wouldn’t consider that a fact.  I’d say we’re seeing some promising studies.]
• They talk about “an orchestrated ecosystem” and integration of data.  [This would have been a perfect time to highlight what Vladic is doing or what Dossia is doing.]

There were some things missing that I personally would have called out.

• What about learnings from prior models like electronic prescribing?
• What about things like EMR integration and the difficulties there?
• What about the issue of privacy and security?
• What about the fact that people abandon devices and apps very quickly?
• What about learnings from gamification or incentive management?
• What about prescribing apps to patients? (like Happtique or IMS)
• What about the whole issue of FDA approval of apps and devices?
• What about what the large companies are doing – Aetna, Cigna, CVS, Walgreens, WalMart?  I think understanding their view of this market is so critical.

Triple Tree report “Connected Health”. 

It starts with a great tag line from IBM – “Does Your Kid Have Better Technology Than Your Business?”  They reference Steve Case’s framework from a presentation he made (see below):

What I liked about this report is that it’s based on lots of real world examples.  (It’s still not operationally helpful, but these are investors not consultants so it met my expectation.)  They certainly could have gone deeper to explain why certain companies they highlight got acquired such as Diversinet, Epocrates, BodyMedia, CardioCom, Healthagen, Vitality, and ConsultADoc.  But, if I look at their list of companies, I see a lot of the innovative companies that I would have on my list – Proteus Digital Health, Healthrageous, iTriage, TelaDoc, Telcare, Eviti, Change Healthcare, and Asthmapolis.  (I know Healthrageous shut down – see postmortem – but I think they had some great vision.)

I also think they’re list of major inhibitors to growth was very believable:

• Physician adoption
• ROI
• Regulatory hurdles
• Security and governance
• Lack of standards

The report shares an interesting stat that 45% of the companies that applied for their rewards were led by MDs in 2009 while it’s only 21% now.  To me that shows the movement of IT and business executives into the healthcare space.

Triple Tree does talk about remote monitoring and CMS which I think is important.  While the Veteran’s Administration was mentioned in the BCG report, I think that the government efforts here and influence was generally overlooked.

Overall, two interesting reports.  Worth a read although I would choose the Triple Tree report over the BCG one if I had time to only read one.

Two other places that I would recommend going if this topic is interesting are:

• The Center For Connected Health
• The Story of Digital Health