Enterprise mHealth Strategy

Enterprise mHealth StrategyDavid Shiple,Practice Leader, Advisory Services

1© 2012 Divurgent. All rights reserved.

November 15, 2012

• The explosion of mHealth products is reminiscent of the dot.com phenomena – Almost deafening hype, and only a small percentage of the 1000’s of

mHealth products being introduced will make it

• But like the internet, we know mHealth is a game-changer– So, how do we pick the mHealth winners? – More importantly, how do we plug the winners into an architecture

that is sound from both a technology and business model perspective?

• DIVURGENT has developed a framework which:– Outlines various definitions and components of mHealth– Shows current state of the industry solutions and considerations– Provides a methodology organizations can use when developing an

enterprise mHealth strategy.

© 2012 DIVURGENT. All rights reserved.2

Executive Summary


Innovation

GE Healthcare’s Vscan is a pocket-sized ultrasound scanner that allows physicians to scan any part of the body by placing the attached wand on it. The wand sends and receives sound wave data upon contact

West Health Institute’s Sense4Baby captures the heart rate of the fetus and mother, and monitors uterus contraction

AliveCor ‘s mobile ECG heart monitor fits onto the iPhone and allows patients to monitor their heart health anywhere and anytime

Google – integrated computer & eyeglasses; unlimited possibilities: MD sees patient chart while talking to a patient; surgeon sees radiology images during surgery, etc.

… and More Innovation

GlucoDock by Medisana tracks glucose/insulin levels and charts them into easy-to-analyze monthly reports

EyeNetra’s NETRA-G is part of a portable solution to make eye exams affordable and accessible for all - interactively aligns patterns displayed in the lens and the software calculates the refractive error

Proteus Digital Health’s Event Marker, is swallowed and activated by stomach fluids - transmits the time, identity, and characteristics of the medication taken (and heart rate, temperature, activity, and rest patterns) to a skin patch

The Zeo Sleep Manager Mobile tracks sleeping patterns by recording brainwaves as a user sleeps

Smartphone Apps100’s of iPhone applications are available… some downloaded once and

used once, others going viral

Power of Social Media

Patientlikeme – Find people with similar symptoms/ conditions; learn from the real-world treatment and symptoms reports, forum discussions, health profiles, one-on-one conversations, and more

Everyone Wants InQualcomm has announced it will form a new subsidiary, called Qualcomm Life, to manage the development of the company's mobile health platforms. The new company will focus on connecting mobile devices through machine-to-machine (M2M) technology. M2M connects remote-monitoring devices through wireless connections.

Many large companies have entered the mHealth market including Qualcomm, Samsung, AT&T, Verizon, and Cisco, focusing on not just “cool apps”, but on the interconnectivity requirements of mHealth.

• © 2012 DIVURGENT. All rights reserved.

http://www.qualcommlife.com/

8© 2011 DIVURGENT. All rights reserved.

mHealth SWOT AnalysisStrengths

• Huge momentum• Money flowing in from investors• Technical talent coming in from other

industries• Growing acceptance of online living• Smartphones becoming ubiquitous• Not contending w. large legacy base• A game-changer toward the 3 Aims

Weaknesses

• Interoperability/ Infrastructure• Quality of data• Many patients not engaged• Reluctance of health system to

embrace wholesale change• Reimbursement for e-visits• MD’s slow to recommend mHealth

products to patients

Opportunities

• Risk-sharing payment models should give home devices a positive ROI

• The “high engagement patients”, esp. for social media

• Fast innovation cycles• Aligns with aging population

preferences• Possibilities are almost limitless• Developing countries may see most

dramatic increase in mHealth use

Threats

• May take a while for market to “shake-out” and stabilize

• Intent of large EHR vendors is unclear• mHealth may not “move the needle”

on population health as predicted• Regulation• Political environment


Breaking it Down

Mobile Caregiver Devices

Telehealth

Home Health & Wellness

• Within “the four walls”• Often smaller, wireless

form factors for EHRs• Also mobile imaging, EKG,

etc.• Depends heavily on

wireless

• Home electronic devices: wellness, chronic disease, real time monitoring – 100’s in the marketplace• PHRs and Social Networks• Smartphone and capitation

likely to be major drivers and enablers

• Primary drivers are over-coming distance barriers and lowering costs of remote care• Primarily creates a rich care

giver experience from a distant locale• Video, high-bandwidth, and

remote nurses/ facilities/ vehicles are primary enablers

Divurgent has focused its mHealth efforts on telehealth, home health, and wellness

© 2012 DIVURGENT. All rights reserved.

10

mHealth Strategy Methodology

Business Drivers

HealthcareDrivers

Vision Statement

mHealth Environment

Mar

ket S

urve

ys /

Rec

eptiv

ity /

St

akeh

olde

r Ass

essm

ent

Telemedicine

Remote Monitoring

Health and Wellness

Personal Health Records

EHR / Clinical Decision Support

Cons

ensu

s W

orks

hops

(v

ario

us c

onsti

tuen

ts)

ImplementPlan

Level-Setting Requirements Strategy / Implementation

Technology Drivers

Mar

ket S

can

/ Ed

ucati

on

Wor

ksho

p(s)

Business Model

Standards

Technical Architecture

VendorList

mHealth Operations

Cons

iste

nt T

hem

es


11

HIE Strategy Methodology

Provisional Governance

Matching Funding

Letters of Commitment

Sustainability Model

Who

’s In

?

Governance

Privacy/ Security

Technology

Financial Model

Adoption Plan

Criti

cal M

ass

Parti

cipa

tion

Build/ Signup

Launch

Implementatio Plan

Start-Up Design Strategy / Implementation

Constituents

Visi

on /

Mis

sion

Data Types

Data Sources

Workflows


12


Business Drivers

HealthcareDrivers

Vision Statement

mHealth Environment

Mar

ket S

urve

ys /

Rec

eptiv

ity /

St

akeh

olde

r Ass

essm

ent

Telemedicine

Remote Monitoring

Health and Wellness



Cons

ensu

s W

orks

hops

(v

ario

us c

onsti

tuen

ts)

ImplementPlan


Technology Drivers

Mar

ket S

can

/ Ed

ucati

on

Wor

ksho

p(s)

Business Model

Standards


VendorList

mHealth Operations

Cons

iste

nt T

hem

es

• What is the mHealth state-of-the-art?• Who is doing mHealth well? What are they doing?• Where is it the mHealth trajectory heading?• Can we separate the “hype” from the “real”?• What do our stakeholders need to know before going into

this strategic process?

• Healthcare Reform• Accountable Care Organizations• Patient Centered Medical Homes• Value Based Purchasing• Meaningful Use

• If possible, keep patient “out of the system”• Capitation means higher ROI on home health • Continued, relentless drive for cost reduction• Geographical barriers to care (need for telemedicine)• Aging population (more “home-bound”) • Huge market momentum for mHealth products &

innovation


13


Business Drivers

HealthcareDrivers

Vision Statement

mHealth Environment

Mar

ket S

urve

ys /

Rec

eptiv

ity /

St

akeh

olde

r Ass

essm

ent

Telemedicine

Remote Monitoring

Health and Wellness



Cons

ensu

s W

orks

hops

(v

ario

us c

onsti

tuen

ts)

ImplementPlan


Technology Drivers

Mar

ket S

can

/ Ed

ucati

on

Wor

ksho

p(s)

Business Model

Standards


VendorList

mHealth Operations

Cons

iste

nt T

hem

es

• Smaller, better, faster, cheaper technologies• Smart phones, Touchpads• Expanding wireless / mobile networks• Low barrier to entry – stand-alone personal health

applications and devices• Easy dissemination via Apple, Google, and other markets• Affordability

Can we craft an overall vision statement that provides:• An encapsulation of what your

mHealth position stands for and what it will mean to physicians and our patient community?

• A tagline that sums it all up?

• How is the market framing “mHealth”?

• What do we mean when we say mHealth?

• What’s in / what’s out?


14


Business Drivers

HealthcareDrivers

Vision Statement

mHealth Environment

Mar

ket S

urve

ys /

Rec

eptiv

ity /

St

akeh

olde

r Ass

essm

ent

Telemedicine

Remote Monitoring

Health and Wellness



Cons

ensu

s W

orks

hops

(v

ario

us c

onsti

tuen

ts)

ImplementPlan


Technology Drivers

Mar

ket S

can

/ Ed

ucati

on

Wor

ksho

p(s)

Business Model

Standards


VendorList

mHealth Operations

Cons

iste

nt T

hem

es

• Who are our mHealth stakeholders?• What do our stakeholders want?• Where do they see the value?• What will the patient / physicians pay for?• What technologies/products do they use/ are interested in today ?

Patient Clinician ACOs Investors

• What is there receptivity for future products/ services?• What are their safety/ security/ privacy expectations?• Do the parties trust the health system ?

• What is the health system currently doing in the telemedicine realm?

• What disease-types / conditions lend themselves to Telemedicine?

• What are the health system’s plans for future telemedicine investment? Within the health system? Within the health system ’s

affiliated providers/ partnerships?

• How receptive is the medical staff and associated caregivers?


15


Business Drivers

HealthcareDrivers

Vision Statement

mHealth Environment

Mar

ket S

urve

ys /

Rec

eptiv

ity /

St

akeh

olde

r Ass

essm

ent

Telemedicine

Remote Monitoring

Health and Wellness



Cons

ensu

s W

orks

hops

(v

ario

us c

onsti

tuen

ts)

ImplementPlan


Technology Drivers

Mar

ket S

can

/ Ed

ucati

on

Wor

ksho

p(s)

Business Model

Standards


VendorList

mHealth Operations

Cons

iste

nt T

hem

es

• Much growth in the mHealth market including smart pills, sleep studies, vital signs, EKGs, etc.

Who reads the data? Who responds to the data? What is captured by the EHR

and PHR?• What is the Interoperability with

EHRs and PHRs?• Which modalities are being called

for by patients/ physicians?

• Is health and wellness a targeted program?

• Is there an existing business model?• Are patient incentives in place?• To what extent is the health

system’s primary care function utilizing electronics? Can it be integrated?


16


Business Drivers

HealthcareDrivers

Vision Statement

mHealth Environment

Mar

ket S

urve

ys /

Rec

eptiv

ity /

St

akeh

olde

r Ass

essm

ent

Telemedicine

Remote Monitoring

Health and Wellness



Cons

ensu

s W

orks

hops

(v

ario

us c

onsti

tuen

ts)

ImplementPlan


Technology Drivers

Mar

ket S

can

/ Ed

ucati

on

Wor

ksho

p(s)

Business Model

Standards


VendorList

mHealth Operations

Cons

iste

nt T

hem

es

• What is the current state-of-art use of mHealth and your enterprise vendor?

• Does your vendor have an mHealth partnership list?

• What is the mHealth connectivity record with your vendor?

• How can data fed from mHealth devices being integrated into the EHR CDS?

• Is a PHR and associated strategy for PHR’s in place? What is it?

• What is the alignment with MU stage 2• What type of PHR is in place - stand-

alone or interactive with EHR?• What is the current patient adoption of

the PHR? How is the adoption trending?

• What role will the PHR play in the mHealth strategy?

• What role will social networking and the interne t play?

• Can internet search and social networking, and be linked to the PHR?

• Presentation of evolving mHealth model

• Is there a “there there”?• Which constituents are in/

out?• What are alternatives?• Can consensus on general

business model be achieved?

• The dimensions of mHealth will invariably overlap, e.g. Remote monitoring may

automatically upload to the PHR/ EHR and CDS rules and alert may ensue

Common infrastructure can be shared between telemedicine, home health, etc.


17


Business Drivers

HealthcareDrivers

Vision Statement

mHealth Environment

Mar

ket S

urve

ys /

Rec

eptiv

ity /

St

akeh

olde

r Ass

essm

ent

Telemedicine

Remote Monitoring

Health and Wellness



Cons

ensu

s W

orks

hops

(v

ario

us c

onsti

tuen

ts)

ImplementPlan


Technology Drivers

Mar

ket S

can

/ Ed

ucati

on

Wor

ksho

p(s)

Business Model

Standards


VendorList

mHealth Operations

Cons

iste

nt T

hem

es

• RMA Platform• Java ME• .Net CF• Android SDK• IOS SDK

• Mobile O/S• IOS X• Android• Blackberry OS

• Network Standard• GSM• CDMS 2000• W-CDMA• EDGE

• Value proposition• Target market• Go to market strategy• Consumer relationship• Activities, resources, personnel• Required core competencies• Network/affiliation SWOT analysis• Sustainability model• 2012-2013 pro forma• Service offered• High level implementation plan• Governance model• Commercialization opportunities

• High-level technical requirements

• Technical schematic• Role of middleware• Role of the HIE• Hardware/ software players• Mobile platforms supported• Security/ Privacy


18


Business Drivers

HealthcareDrivers

Vision Statement

mHealth Environment

Mar

ket S

urve

ys /

Rec

eptiv

ity /

St

akeh

olde

r Ass

essm

ent

Telemedicine

Remote Monitoring

Health and Wellness



Cons

ensu

s W

orks

hops

(v

ario

us c

onsti

tuen

ts)

ImplementPlan


Technology Drivers

Mar

ket S

can

/ Ed

ucati

on

Wor

ksho

p(s)

Business Model

Standards


VendorList

mHealth Operations

Cons

iste

nt T

hem

es

• Roles and responsibilities driven by the defined business model

• Operational plan• Org chart• Customer support• SLA’s• Vendor management• Contract management

Stratify vendors• Those “that matter”• Strategic vs. tactical• Standards embraced• Remote monitoring vs. health &

wellness• Recommended by the health system • Vendor track record• Connectivity options

• Charter• Scope• Funding/ budget• Program management• Timeline• Resources• Risk mitigation• Change management• Communications


David [email protected]

Divurgent4445 Corporation Lane, Suite 228Virginia Beach, VA 23462877.254.9794

Contact Information

© 2012 Divurgent. All rights reserved.19

mailto:[email protected]

Appendix

© 2012 Divurgent. All rights reserved.20

Scanadu Scout (pictured), which reads vital signs from a person's temples; Project ScanaFlo that can analyze urine; and Project ScanaFlu, which can test a person's saliva for cold or flu symptoms. All three devices are still pending FDA approval before then can be sold to the public, but the Scout appears to be the furthest along in development. Scanadu claims that the device will cost less than $150, and can record and analyze vital information like blood pressure, pulse, heart rate, blood oxygenation, and temperature.

Health & Medicine

Enterprise mHealth Strategy