Children in their connected classroom in the village of Suruacá

Just over ten years ago I went backpacking in Brazil for a month with some friends. We arrived in Rio de Janeiro, one of the world’s great party towns, at nightfall and found, to our dismay, that we couldn’t get a caipirinha for love nor money. It turned out that we’d landed on the day of the presidential elections and there was a blanket ban on sales of alcohol because the authorities were concerned that violence might erupt if politics mixed with booze.

Eventually we managed to persuade a man running one of the street food outlets on the Copacabana beach to sell us a beer. He told us that the winner of the election would be a man known as Lula. Lula, leader of PT, the worker’s party, went on to become perhaps the most popular president in the history of Brazil, introducing sweeping social reforms designed to lift millions of Brazilians out of poverty.

Ten years on, 40 million of the country’s people have been brought above the poverty line into a new middle class thanks to the creation of a welfare programme, the taxable population has been increased, and there is rising demand for a wide range of consumer products and services.

Brazil will host the FIFA World Cup and the Olympic Games in the next four years and many of the people you speak to in the cities today project a sense of great optimism about the country’s upward trajectory. Of course the corporate extravagance of Sao Paulo, now surely one of the most expensive and traffic-congested cities in the world, and the carefree glitz of the Copacabana are only part of the story.

Socio-economic diversity in Brazil is on the scale of the country itself and it is in the poorer communities that you can perhaps see the changes most visibly. Communications services are central to these changes and, from the Favelas of Rio to the remote communities of the Amazon River, access to the internet, and to one another, is changing people’s lives. It is a reminder that the Connected World is about more than machine-to-machine communications.

The view from the Connect to Learn installation in Vila Cruzeiro

The current president of Brazil, Dilma Roussef, is alive to the importance of these services, something that Communications Minister Paulo Bernardo said she stressed to him when he was appointed in 2010. Bernardo was speaking at Ericsson’s Business Innovation Forum, which took place in Sao Paulo in November.

“One of the missions of the [communications] ministry was that we had to make an effort to give widespread access to ICT,” Bernardo said. “The new middle class had buying power now and was willing to buy services and devices like tablets and smartphones. We are working with these goals,” he said.

A 2010 census revealed household internet penetration of 27 per cent, Bernardo said. That figure rose to 38 per cent as 6.3 million homes came online in 2011 and the government is aiming to have broken the 50 per cent barrier by the end of 2012. The number of 3G devices—smartphones, tablets and wireless modems—grew by 99 per cent in 2012 and the expectation is that growth will be in the region of 70 per cent this year, he said.

Meanwhile there are ambitious plans in place for the digitisation of domestic power meters which will be internet connected and enabled as access points for the homes at which they are sited. The energy ministry is currently working to install 70 million such meters.

Bernardo said that the government has pledged to connect more than 80,000 schools that are currently without internet access by 2015, alongside a programme that will supply tablet computers to teachers. “The internet is a means,” he said. “Access to these technologies will improve our performance in education and health, and it will connect rural areas where there are large agricultural businesses, small fishing communities and Indian tribes.”

The private sector, inevitably, has an important role to play, as Bernardo was at pains to stress. But the government is keen to ensure that at least some of the benefits that private sector companies derive from investing in the country remain in Brazil.

Bernardo explained that the government will continue to require that a significant portion of telecoms network equipment is manufactured locally as it seeks to harness the sector’s growth to create jobs and local wealth.

He said that, in Brazil, the state is responsible for over 50 per cent of investment in innovation and was committed to creating the right environment for continued private sector participation. In return, he said, the government expects technology developed locally to be available at a low enough cost to make connectivity across some of the most challenging geography in the world truly viable.

“The treasury has been removing taxes from equipment and civil construction works because two reach our objectives, and our national broadband plan next year, we need infrastructure available at fair prices,” he said. “We have policies that will demand products made in Brazil because it helps create jobs and trade. In my opinion this is a policy that is here to stay; it is reasonable for companies to invest to develop here in Brazil.”

Read about how Brazil is delivering care to the riverside communities

He added that Brazil is “betting on LTE from the beginning”, as the performance of WCDMA networks reaches its limits. Sergio Quiroga da Cunha, Ericsson’s head of Latin America, said that the Brazilian government had originally suggested that all LTE technology deployed in the country be locally produced. But while the vendor does manufacture equipment and conduct R&D locally, and is the only large network vendor to do so in its own factories, he said, many components have to be imported. Instead the firm gets tax breaks for guaranteeing that its products contain up to ten per cent of locally produced hardware.

But investment alone cannot guarantee that Brazil’s targets will be hit. Quiroga da Cunha said that a fund for the universalisation of telecoms in Brazil, created by collecting 0.4 per cent of operator revenues since 1998 currently sits at almost $5bn but is not being tapped because “nobody is sure how to use it”.

One thing is clear, he said: greater density of mobile networks is essential in Brazil. Currently there are only 60,000 cell sites in the country and, while much of Brazil is sparsely populated or uninhabited, this number needs to have more or less doubled before the kind of coverage and capacity that the market requires is available.

The mast at Suruacá

One problem is that the aims of the communications ministry are not always in tune with other government departments, he said. “Site acquisition is a nightmare. 99 per cent of the time you can be guaranteed a refusal for planning applications for a new cell site.” It was a point echoed by Minister Bernardo, who said he was constantly battling with regional and municipal governments whose planning legislation made it impossible to expand and densify the network. “We have many cities where they say we cannot have antennas near schools. But how can I connect a school if not with an antenna nearby? We need to change this, the law has to help us.”

Up in the Amazon this is much less of a problem. Here the challenge lies in convincing Brazil’s mobile operators that there is value in connecting the remote region’s inhabitants to the mobile network. Such was the operators’ resistance to the idea that it was Ericsson that undertook the region’s first deployment. In 2009 the Swedish vendor installed a base station site in the small town of Belterra, bringing 3G connectivity to the Amazon for the first time.

The site was attached to the Vivo network, owned by Spain’s Telefónica, but Vivo did not contribute to the cost, which was in the region of $300,000. It began to generate traffic immediately, according to Carla Belitardo, head of sustainability in Latin America for Ericsson, at a rate that led the firm to forecast that RoI, had it been paid for, would have been delivered inside six months. A significant number of Belterra residents already had mobile devices, which they would use when travelling to Santarém, a far larger city 50km to the north. When connectivity reached their town, they were ready to take advantage immediately. “We demonstrated that there was hidden demand,” said Belitardo. “One year after the site was deployed, 43 per cent of students in the town were using it to access the internet. This was about finding ways for [companies in] the private sector to invest in areas that they would never think about.”

Card operated phone booths in the village never functioned

Sufficiently convinced of the opportunity, Vivo and Ericsson deployed a second Amazonian site, across the river in the remote community of Suruacá. This installation was complicated by the fact that riverside villages such as Suruacá are off-grid. The river is 18km wide at this point, preventing any connection to the grid at Belterra on the opposite bank, meaning that Ericsson and Vivo had to install large numbers of solar panels to power the base station.

The same power source also enabled charging points for laptops and mobile devices, although regulations prevent Vivo from charging for this energy. In other markets, however, telecoms operators can also provide energy services and off-grid base stations can present more than just a communications opportunity to the companies investing in the installations, Belitardo said.

Technology and innovation can solve problems like remote installation, although Belitardo conceded that there have been a number of instances of downtime when there has been insufficient sunlight to power the base station. The impact of the internet on such an isolated community—with all the positive and negative experiences it can bring—is a far more subtle and complex issue to address.

Eugenio Scannavino, who heads up a Brazilian NGO, Projet Sáudi e Alegria, that partners with Vivo and Ericsson on a number of projects in Brazil, said that some time after the Suruacá site went live and the village got its first glimpse of the internet, he found the village’s female elders huddled in a group. When he asked them what they were doing they told him they were holding a discussion about the problems of the world—the wars, famines and social issues that they had discovered online—and what might be done to solve them. For those of us who have grown up with ready access to information from around the world it is impossible to imagine what it must be like to go from almost complete information isolation to a window on the world with the switch of a button. For this reason, said Scannavino, it was very important that internet access arrived in Suruacá before television.

Television would have offered the community visibility of the outside world with no opportunity to participate. It is very important, Scannavino said, that the people of these communities are empowered to share their own views as well as absorbing those of the outside world.

“Connectivity gives [the villagers] visibility,” he said. “They can understand what’s happening outside but they also have a voice to be able to let other people know that they exist. They can become citizens and get respect from the rest of the world. Our biggest aim is to empower them to become citizens. “

Eugenio Scannavino

He continued: “With the internet they discover that they have just as much culture to offer other people as other people have to offer them. They can connect with people globally but they don’t lose their identity. Now they are proud of themselves and their culture and they can communicate that to other people.”

An impulse to travel outside of the community is bound to result from a sudden awareness of the wider world, but Scannavino said this is not something that the NGO necessarily wants to encourage. Wherever there are communities living in the rainforest, he said, the ecosystem is more likely to remain healthy. “They are the guardians of the forest,” he said. Instead one of the aims is to foster a manageable level of eco-tourism that will generate further economic benefits to the locals. It is unsurprising that a group of international journalists visiting the community of Suruacá should, en masse, produce smartphones and begin filming the welcome ceremony laid on by the locals. But the fact that the villagers were filming us arriving on their own handsets was truly unexpected. That footage is now on their blogs and social network profiles; the visitors to their community a part of their story as well as the other way around.

The lives of the children who live in the favela of Vila Cruzeiro, which is in Rio de Janeiro’s Zona Norte (north zone), could not offer a starker contrast to that of their counterparts in the Amazon village of Suruacá. They have language and poverty in common but not much else.

Vila Cruzeiro was previously renowned as one of the most violent of the Rio favelas; just two years ago, according to the Rio Times, it accounted for one third of the city’s murders. Stray bullets from the frequent exchanges of gunfire between gangs were one of the most common causes of death. Today, in the wake of the ‘pacification programme’ that saw the army sent in to confront gangs and suppress the drug trade, it has improved somewhat.

The Connect to Learn project, founded by the Earth Institute at Colum¬bia University, the Millennium Promise and Ericsson, is working in Brazil to create communication channels between the children of Vila Cruzeiro and those of Suruacá, providing education services to both communities using cloud technology, thin client laptops and a reliable wireless broadband connection.

In the past, according to the directors at Projeto Atitude Social, a commu¬nity centre that offers educational, arts and sporting facilities to more than 8,000 children in Vila Cruzeiro, there were only two cultures; football and gangs. By connecting children in the favela to schools in other parts of Brazil, it is hoped that wider cultural exchanges can be created that will enable them to see beyond the own immediate confines.

There are obvious potential downsides to giving internet access to chil¬dren who have never had it before. But the Connect to Learn project allows for their online behaviour to be monitored. And the video connections that are available to both sets of children enables remote education in internet usage to be delivered. There is no attempt to restrict the access that the children have, according to Carla Belitardo. Rather the emphasis is on teaching them about the benefits that are available to them beyond the doubtless appeal¬ing worlds of social media and online gaming.

Despite the dense population of the favela, social workers in the area talk in terms of the children being just as isolated as their opposite numbers in remote villages. Indeed, prior to the Connect to Learn initiative arriving in the favela there was no more awareness among the children of what life was like in the Amazon than there was in the Amazon of life in the city slum. They may be 3,500km apart but now they are connected.

Carla Belitard

Carla Belitardo is head of sustainability for Latin America at Ericsson. She oversees projects across the region that focus on connecting people isolated by poverty, geography or both. Well-meaning as these projects may be, Belitardo is insistent that they are not driven by charity or philanthropy.

“Most people think sustainability and corporate social responsibility is something to do with green activities or charity. But our view is that it must be aligned to the business. Everything we do has to demonstrate a positive impact on what we call the ‘triple bottom line’; People, Profit and Planet,” she says. “In our view we’re creating a positive business impact with technology, and the more balanced that impact is across the three elements of the bottom line, the better.”

Ericsson’s position in the value chain means that it is dependent on its customers to provide the link to end users. “We can’t do anything on our own because we do not have a relationship with consumers,” she says. “So the only way I can have a positive impact on the triple bottom line is by partnering with operators. So I work with our sales organisations, our account managers, who have the relationships with operators. Operators have foundations for social activities.”

Vendors like Ericsson can provide human resources, though, and Belitardo has created a ‘Virtual Volunteer’ programme that sees employees delivering educational classes over video links to teachers in remote or impoverished areas. The programme covers traditional academic subjects like maths and science, as well as best practice for internet usage.

“We are starting a revolution, helping to teach the teachers. Sometimes the call quality isn’t that good but everybody is eager to make it work. What we really want to do next is connect our volunteers to the children in the village so that, whenever they have a question to ask, we have someone trained to answer it.”
Not every project is successful, she says. Two years ago Ericsson tried to deploy a remote health solution that used connected health devices to chart metrics such as weight, blood pressure and insulin levels in diabetics. The solution had met with success in Croatia but did not travel well. “It was a bit too much, too soon,” says Belitardo. “We learned a lot but healthcare is an area where you’re required to involve a lot of stakeholders and they didn’t really need that solution at that time.”

Fabio Tozzi

Twenty years ago the Brazilian Government decreed that health services should be available to all of the country’s inhabitants. In Southern Brazil, the wealthier, more developed and heavily populated part of the country, this pledge was comparatively easy to address. In the dense rainforest of the Amazon its fulfilment is altogether more difficult.

There the communities are remote, and separated from one another by great distances.

There are four people to every square kilometre if you set the overall population against the overall geographical area. When you consider that vast swathes of the region are uninhabited, the difficulty of providing blanket healthcare to the population starts to become clear. The people that live in the Amazon are still largely dependent on barter economies— and on catching and cultivating their own food.

“The final challenge of healthcare in Brazil is delivering care to the riverside communities where there are no roads and no money,” says Fabio Tozzi, a medical doctor who leads the team on the Abaré, a hospital boat that travels up and down the waterways of a section of the Para region in the Amazonian rainforest, taking medical services to the people who live in these isolated villages.

Read the main feature about health and education developments in Brazil

The Abaré—which in the indigenous Tupi language means ‘care-giving friend’ (the boat was named by the villagers)—has been bringing healthcare services to 15,000 people in 73 villages and small towns for six years. In total there are more than six million people living in the Brazilian Amazon’s riverside communities, including some 60 tribes with which contact has not yet been established.

The Abaré works on a cycle of 20-day voyages around its coverage area, each trip focusing on a different medical issue. These range from vaccination, dentistry and gynaecology to child develop or hypertension (a particular problem in a region that, lacking refrigeration, relies heavily on salt curing). The boat has a fully equipped surgical theatre and emergency room and its team are able to resolve 93 per cent of the medical problems they encounter. The remainder are referred to the nearest city, Santarém.

In the municipal region covered by Santarém there are 150 doctors responsible for 1.5 million people. “This is the reality for the whole of the Amazon,” says Tozzi. “There are no doctors.”

Connectivity is essential to the success of the project. The Abaré is 3G-enabled, linking to masts in the small town of Belterra and the riverside village of Suruacá. It also has signal amplifiers that allow remote dwellers to access communications services when it visits their community. “Connectivity is very important,” says Tozzi. “The doctors can ask for help, for second opinions or specialist analysis of blood tests or x-rays and remote diagnoses. They have access to vital information from the internet.”

One of the medical rooms on the Abaré

But a link to the world beyond the rainforest is important for more than medical information, he says. “It is very difficult to get qualified doctors and nurses to come and work on the boat. Having connectivity stops them feeling so isolated.” As well as remaining in contact with friends and family, he says, doctors are able to check their fears that, so far from the advanced environment of the cities where they trained, they might make a wrong decision.

A visit to the Abaré, and the communities that it serves, is an effective illustration of the benefits of the connected world. People living in these remote communities are not keen to visit the city for medical attention, because of the amount of time they inevitably have to stay away from their community and their responsibilities.

There are two boats a week available to these people if they want to go to the city.

When they get there they have to find somewhere to stay and, if they have to have medical tests, they must wait until the results are available.

It is not uncommon, Fabio Tozzi says, for people who make the trip to the city for medical reasons to be away for a month. Part of the problem is that they will often delay seeking help until the problem becomes so acute that lengthy hospitalisation is necessary. Sometimes they are too late even for this.

The boat was purpose built with funding from Dutch non-profit organisation Terre des Hommes and is operated by Brazilian NGO Projet Sáudi e Alegria (which translates as Health and Happiness). But funding is in the process of being moved over to the state, which has judged the project sufficiently successful to want to replicate it.

The Abaré

The boat runs at an annual cost of around US$500,000, 80 per cent of which is now provided by a combination of federal and local government. There are now plans to introduce a further 100 boats to deliver services to riverside communities throughout the region. Public funding has been secured for 32 of them and the challenge now will be to see how the project can scale.

The team working on the Abaré is fortunate enough to have reliable 3G access but boats servicing even more remote communities will have to depend on satellite connectivity. Eugenio Scannavino, who leads Projet Sáudi e Alegria, says the NGO hopes that, as services are delivered to ever more communities, Brazil’s mobile operators will be motivated to provide cellular connectivity more widely across the region.

More than 90 per cent of the world’s 40 largest telecom network operator groups are active in the enterprise healthcare market, according to research from Informa Telecoms & Media. And a ranking of all operators – based on their commitment to the healthcare market worldwide – puts BT in top spot, closely followed by Verizon and France Telecom.

Informa Telecoms & Media this week published its Enterprise Verticals Activity Monitor (EVAM), which ranks telecom operators by their activities in the sector. The ranking is based on public information released between 1Q11 and 4Q12 regarding B2B and B2B2C services for the healthcare and life sciences markets.

BT leads the ranking with high scores on market presence, geographic reach and financial potential. The UK’s dominant operator not only sells high value networks, Cloud services and specialist applications into its home market but increasingly into Asia. Signaling its ambitions to export its expertise, in June 2012 it set up a dedicated health practice for the Asia region with over 130 staff.

Bharti Airtel, Etisalat and China Mobile represent the emerging markets in Informa’s healthcare top 30. The priority in Africa and India is for low-cost m-health services to open up public access to primary healthcare. SMS is the enabling technology for consumer drug verification, medication information, and remote doctor-patient consultation and advice. Offered free or at minimal cost for consumers, these services also deliver value for pharmaceutical companies and healthcare providers.

Informa’s activity monitor shows that 46 operators made public announcements between 1Q11 and 4Q12, demonstrating the momentum that is building in the healthcare market. Today more than 90 per cent of the world’s 40 largest operator groups by revenue are active in the sector.

“Transformation in the healthcare sector puts communications technology at the center of more efficient, cost-effective and equitable means of delivery,” said Sheridan Nye, senior analyst, Informa and author of the EVAM study. “Network operators are responding to opportunities to become an essential part of the delivery chain and extend their presence beyond generic networking services.”

The top ten operators in the ranking are as follows: BT, Verizon Group, France Telecom, AT&T, Vodafone Group, NTT Group, China Mobile, Telefonica, Telenor and SK Telecom.

The reduction in hospital admission costs is “not significant” the report found

In a blow to operators’ ambitions for the telehealth market, results from the world’s largest randomised trial have cast doubt on the cost benefits of managing long-term conditions at home. The UK’s Whole System Demonstrator (WSD) program monitored the progress of 3,230 people with diabetes, pulmonary disease or heart failure over the course of 12 months from 2008-9. In the first of five peer-reviewed evaluations just published, academics from the Nuffield Trust and eight universities conclude that the reduction in hospital admission costs is “not significant”.

The two-year, £31m program was rolled out in three regions of the UK to test different impacts of telehealth and telecare. The results have been eagerly awaited around the world, reflecting both the size of the trial and its careful monitoring of control groups. A total of 6,191 patients and 238 GP practices took part overall.

In the first British Medical Journal paper, researchers focus on the impact of telehealth on mortality rates and readmissions to hospital. On the positive side, the patients were “significantly less likely to die” within the 12 months than the control group, and hospital stays were measurably shorter. However, the reduction in the number of hospital visits was too small to be accurately measured. Consequently, the impact on costs was deemed insignificant. In any case, the size of the cost saving totaled only £188 per patient over the year – a drop in a very large test-tube, compared with the upfront technology investment required.

The cost findings will be frustrating for telehealth advocates, especially as services were shown to have prolonged lives – a notable 45 per cent improvement in mortality rate over the control group. But the cost equation must be solved if healthcare providers are to invest both in the technology and inevitable organizational disruption.

Of course, such a complex trial cannot hope to exclude all possible influences. The researchers point out that a relatively high number of ‘low-risk’ participants were recruited, whereas real services can be targeted at patients at more advanced stages of illness. And 12 months just might not be long enough to capture responses to such an unfamiliar patient-doctor interaction.

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Four more papers will be published later this year, focusing on patient quality of life and organizational factors, as well as costs. Operators will be hoping for a less equivocal outcome.

In the meantime, the UK government continues to cite the preliminary, more optimistic results from last year in support of its 3 Million Lives policy. BT Health, O2 Health and Cisco are among the communications companies leading the program to promote of telehealth and telecare across the country over the next five years.

It’s a political prerogative to be selective about academic evidence. But healthcare providers will look to industry for a stronger case that these services equip them to tackle the twin challenges of aging populations and reduced budgets.

Matthew Key, head of Telefónica Digital

Speaking at an event in London on Thursday, Matthew Key, head of Telefónica Digital since its inception nine months ago, said his unit expects to drive annual revenues of approximately €5bn by 2015 with an annual revenue growth rate of 20 per cent.

The division was created to target new opportunities within services sitting beyond the traditional network connectivity offered by operators, and will take an active role in the development of these initiatives, rather than that of financial investor only.

Key said the main focus of the company will broadly cover three sectors: mhealth; cloud services; and M2M, but individual initiatives stretch much further afield.

On Thursday the carrier unveiled a wide ranging agreement with UAE-based Etisalat whereby the two companies will jointly develop business opportunities in M2M, financial services, cloud computing, eHealth, mobile advertising and OTT communications, including the acquisition of video content, while Etisalat will also participate in Telefónica’s global device procurement process.

Another program saw Telefónica secure a global framework agreements with Facebook, Google, Microsoft and Research In Motion to offer carrier bill payments as a means of driving the monetisation of mobile content, particularly in Latin America where credit card penetration is low and 60 per cent of the population do not have bank accounts.

Direct to Bill in Europe is already proving popular with customers. In Germany, 400,000 customers per month on average are now making payments for a variety of products and services across different platforms. Telefónica plans to have the capability live in 14 markets globally by year end.

A lot of the initiatives focus on Latin America and in Brazil the firm is making a multi million Euros investment to kick start the mobile advertising market, using its UK O2 Media model as a blueprint. The investment will see a local team put in place to accelerate the deployment of platforms and capabilities in a rapidly expanding overall ad market, currently worth €15bn, where mobile advertising is growing faster than Western Europe.

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M-health is gaining momentum

Among the massive displays of TVs, gaming consoles, mobile devices and other gadgets at last week’s International Consumer Electronics Show, mobile health and fitness solutions were among the most dynamic new areas of focus at the conference.

Industry heavyweights Qualcomm and Verizon Wireless were among the most prominent firms to dedicate substantial booth space to display their growing set of partners and wireless health solutions. Verizon’s health section focused on several clinical health devices including LTE enabled devices for use in ambulances, remote patient diagnostics and home health monitoring.

This year’s conference also included an expanded section that included dozens of companies such as Body Media offering its FIT arm bands with sensors that monitor body vitals and Telcare with its innovative blood glucose monitor that includes built-in cellular connectivity to send a patient’s daily glucose readings to his/her physician.

In addition to these health-focused products, health and fitness related games were also prominently featured in Microsoft’s XBox 360 area. While the sales volumes of this growing array of products continues to be modest in comparison to the broader mobile phone space, BestBuy CEO Brian Dunn stated that the growth trend for the category has prompted the giant retailer to create a health focused product team for wireless health solutions and carve out dedicated floor space for the new products throughout its chain of stores.

Within the US market, the complexities of device certification, health insurance and payment mechanisms continue to present a challenge to new wireless clinical solutions. but the expanded offering of wireless consumer fitness and wellness products is proving to be one of the most compelling new product categories for 2012.

Mobile operators are well positioned to help the health sector to modernise

African healthcare provider Sanlam Health has struck a deal with systems integrator GlobeTOM to offer mobile health services to large undeveloped areas of Africa.

To make the project viable, Sanlam Health partnered with operators including MTN and integrator GlobeTOM to deploy a transparent and convergent billing platform to process detailed accounts for pre and post-pay users.

According to Philip Stander, managing director of GlobeTOM, agile convergent billing platforms play a pivotal role in tracking multiple billing transactions from various third party providers. “Convergent billing and revenue assurance in this sense, is as important to third party service providers and mobile networks as a watertight tax collection process is to a government,” said Stander.

Other billing gateway applications include services such as insurance and prepaid distribution. “What they get is a single interface for their business service delivery billing irrespective of the network needed to integrate and deliver the service. The platform is network agnostic; an ideal platform for service delivery across coexistent but competing networks,” said Stander.

A sea of sensors would give a UI to devices that do not have one

Qualcomm chief executive Paul Jacobs outlined a vision of the connected future focused on proximity-based peer to peer networking at the company’s Innovation conference in Istanbul on Wednesday.

With an estimated four billion smartphones to be sold between 2011 and 2015, according to Jacobs, consumers and professionals will be equipped to interact with a “sea of sensors” covering the planet.

Alongside already well documented developments in areas such as mobile healthcare and machine to machine (M2M), where sensors are implanted in everything from blood pressure monitors and trucks to TVs, Jacobs demonstrated emerging technologies such as a gesture interface similar to Microsoft’s Kinect and a proximity-based P2P offering.

The idea behind the latter is a software framework called All Joyn developed by the US firm to “give a UI to things that don’t have their own UI”. The framework is ideally implemented at a platform level – in a demonstration we saw it running on Android – although it could technically be implemented on an application level too. Operating agnostic of platform/OS, radio technology and device, All Joyn establishes P2P data sharing between two or more devices.

The offering has not been commercially implemented yet, although an Android version is already running, with Linux and Windows Phone versions in the pipeline. Japanese gaming firm Namco has already used the technology in a showcase version of its Pacman racing game on Android, allowing several users to play head to head with each other regardless of the device or platform they are using, with connectivity established over either Bluetooth or wifi.

Other implementations could allow users to share data or documents and media files, or collaborate on material. However, the same technology could also give users an interface for connected devices like a utility meter, TV, car or even washing machine.

A new report says e-prescription vendors need to up their game if adoption of the technology is to increase

While e-prescription systems can cut the costs and inaccuracies often associated with their paper counterparts, uptake of the technology has been low. A new report from analysts Ovum indicates that, despite the technology’s capacity to fundamentally change the healthcare systems of Europe and America, vendors of the software need to “up their game and improve the design of their systems” if widespread adoption by hospitals and surgeries is to be reached.

The report, entitled ePrescribing brings fundamental change to the Healthcare and Life Sciences Ecosystem, states that a major cause of resistance to e-prescription adoption is that healthcare practices, particularly those in the private sector, believe that current IT solutions “are not sophisticated enough to integrate well with other IT systems.” Report author Andrew Brosnan says that the software’s inability to “mesh seamlessly” with other IT infrastructure is “of great concern to prescribers.” Brosnan also points to high up-front costs and patient confidentiality fears as two further key reasons behind slow up-take, particularly in the US.

“E-prescribing not only delivers cost savings but also improves patient care and reduces the number of prescription errors,” says Brosnan. “It also streamlines the dispensing process for patients and provides practitioners with medication histories, reducing fraud.”

Bucking the European and American trend, Australia has been an early adopter of e-prescribing solutions, beginning as early as 1990. According to the report, 90 per cent of physicians in the country use the solutions, but it hasn’t been a trouble-free process: data quality remains an issue there, thanks largely to a lack of standards. The report finds that Australian vendors should “adhere to the framework for e-health interoperability set for the by the National e-Health Transition Authority (NEHTA) if the full potential of e-prescribing solutions is to be realised. NEHTA has published standards catalogues for clinical documents and messaging on its website.

Brosnan further points to a lack of user-friendliness in vendor interfaces as an inhibitor to uptake, saying that these are often viewed as cumbersome by healthcare professionals. These difficulties “increase the time it takes to write a prescription, affecting the value that e-prescriptions hold over paper-based ones,” he says.

The report concludes that vendors must improve their software’s ability to integrate with other IT systems by complying with industry standards. “Improving the interoperability of software will enhance its perceived value to users, enabling the market as a whole to grow. Until these issues are ironed out, widespread adoption of e-prescribing is unlikely to happen,” says Brosnan.

Australia

Australia

Australia’s incumbent fixed and mobile operator, Telstra, is targeting the health sector with services to be deployed in the next year or two. Its strategy has been formulated by a cross-company team that aims to deepen the operator’s involvement in the health sector and incorporate all of its core telecommunications products, in particular expanding on the existing customer relationships owned by Telstra Enterprise & Government and Telstra Business.

As the dominant player, Telstra is an early mover in the slowly developing Australian e-health market. But its competitors are increasingly aligning with the same strategic partners to offer services and the operator faces competition not only from other telecommunications companies but also from IT suppliers.

In July 2010 Telstra signed a memorandum of understanding with the Royal Australian College of General Practitioners to make a suite of national e-health services available to more than 17,000 GPs. It announced the first service as a web-hosted service, offering a range of health-specific applications, including clinical software and decision-support tools, aimed at preventing GPs from having to purchase different applications separately.

Target markets include a variety of healthcare providers and enterprises and, potentially, consumers. According to Telstra, products developed for one sector are often requested by another: MyGlucoHealth, a Bluetooth-enabled blood-glucose meter and application, was originally developed for the consumer market but, according to Izaak du Plooy, who is responsible for Telstra’s mobile health services, “it has found its home in the private health market, which identified the product as a key enabler for their healthcare plans for their members.” But reliability is essential. “The delivery of any product will only be successful if the products being delivered allow connectivity and communication between all the key participants,” du Plooy says.

The operator purports to meet a need that exists in the Australian health sector to stretch finite resources for an increasingly demanding, ageing population. “E-health has the potential to deliver significant productivity gains and improve patient outcomes,” says du Plooy.

Telstra is using proof-of-concept projects and trials, sometimes with technology partners, to demonstrate the capability and benefits of services to key industry decision-makers, such as state governments, the federal government and private-health-fund firms. Government incentives will heavily influence the scale and timing of the adoption of e-health, m-health and telehealth services and the operator is targeting these where there is an opportunity to pursue a widespread deployment and accelerate time-to-market.

According to Informa Telecoms & Media, Telstra is in a strong position to partner with key health players and deploy services, especially with its increased focus on content and services over network management, but it faces challenges in the e-health and m-health market at large.

Although the passing of the Health Identifiers Bill in 2010 (giving a unique ID to patients and providers) and the MoU between Telstra and RACGP suggest progress toward a workable e-health system, in reality the supporting structures behind, for example, electronic clinical consultation are not yet established. In fact, the RACGP has run a survey on its website to gather insight into how GPs think they might be remunerated for such services in order to “inform the College’s submission to the Department of Health and Ageing regarding the 2011-2012 federal budget.”

Yet the health sector presents an opportunity to deploy a range of core and innovative telecommunications services with large, long-term enterprise customers. The opportunity for services is timely, because, like its European and US counterparts, the Australian health sector is facing the problem of unmanageable demand by an aging and increasingly chronically ill population.

As a result, with its fixed and mobile assets and dominant market position, Telstra is in good shape to capitalise on any new revenue opportunities that exist in the health-enterprise sector. But although challenges such as remuneration structures are still not ironed out, such opportunities are unlikely to amount to a quick return on investment; they are more of a long-term proposition.