Dr Adesina Iluyemi, co-founder and vice president of MoDise is speaking at LTE MENA

Dr Adesina Iluyemi is co-founder and vice president of MoDise, a mobile diagnostic company focused on preventing diseases in the developing world. An mHeath and telemedicine expert, he is speaking at the LTE MENA conference taking place on the 29th-30th April, Westin Mina Seyali, Dubai, UAE. He speaks to Telecoms to explain how next generation mobile technology such as LTE is in unique position to make a crucial difference in this valuable field.

In the developing world, where funds for medical equipment are a scarce resource, it pays, literally, to be as innovative as possible with what you have. A prime example is the work of MoDise, which, as its co-founder Dr Adesina Iluyemi explains, has come up with a way for a camera equipped mobile phone to replace a microscope. Thus an affordable handset can replicate equipment that would otherwise cost between US$5,000 and US$10,000. As Iluyemi explains, this type of out-of-the-box thinking requires an investment in R&D that most companies aren’t prepared to spend. This is why he founded MoDise, to invest in new ideas and take them, “from the laboratory to the market”.

“That is just an example of a different type of application that is coming on the market,” Iluyemi says. “Turning the mobile phone into a medical diagnostic device. So, it could be a microscope, [or any other] kind of physical phenomenon (such as an ECG device) that could be analysed and recorded by mobile phone”.

This is clearly a fine example of mHealth innovation, but it’s not just handsets though that are important to the work of MoDise. Iluyemi says that the mobile network is critical, as the data the mobile phones collect has to be transmitted to make it useful. The network has to be speedy, but also reliable and secure. “When sending medical data, [you need] a time critical network, that is secured and guarantees high throughput.  [And] you want the integrity and privacy of data from point A to point B to be retained.”

It’s true however that these critical factors can be achieved with a 3G network. Therefore, is a 4G network something that can actually be of benefit to mHealth applications?  Iluyemi thinks so and specifically picks out video conferencing as a major application. “LTE technology could enable real-time video conferencing between a patient and a doctor. [There might be] a doctor in another area, doing a clinical call and in a clinic, the nurse can call on that doctor for a second opinion. And LTE would guarantee the bandwidth that is required for this. That is just one example of how LTE could make a difference.”

In a continent where Doctors are in short supply the ability to assist and make diagnoses from a remote location is an invaluable one that could save lives, and where the devil is in the detail it’s one that realistically can only be done with a high bandwidth link. While dedicated links could be established a standard commercial LTE network is the only way it can become affordable.

Iluyemi is confident that the economies of scale that wide LTE deployments will bring will eventually dramatically lower the cost of sending data. “A study carried out in Uganda in early 2005 found that there was a 1000 per cent reduction in the cost of transmitting the same amount of data when the operators moved from GSM to GPRS,” he says. “So that extra bandwidth of just 30Kbps more, actually led to a 1000 per cent reduction in the amount they paid for bandwidth.  So if you take GSM as a baseline, LTE promises [an improvement that’s] one million per cent better.”

However, while data costs could eventually come down, Iluyemi is concerned at the current high cost of LTE terminal devices. “One of the problems in Africa is that there is a lack of affordable devices to use the network, so right now the LTE devices are not coming to the market. And if they are available they are not affordable for many people to buy it or use it. Globacom in Nigeria has deployed LTE but nobody is using the network. And why? There are few LTE devices on the market and secondly, they are not affordable.”

Iluyemi says that hospitals are keen to work with operators that create a dedicated medical division, citing AT&T as an example of a model that works, and even suggests that being connected to a mobile network is a better solution for doctors than wifi. “Hospitals depend on a lot of communication within the building. Even in the NHS now our hospitals are replacing wifi with GSM based networks. There is seamless integration and doctors can use their mobile phone within the hospital instead of carrying multiple devices around.”

Iluyemi though makes it clear that development of a fast LTE networks will have a tangible effect on the medical community, especially in Africa where there is a chronic lack of standard fixed connectivity. “There’s no fixed-line or broadband going to homes or offices for coverage everywhere. So LTE could provide add relief from that.”

When operators are spending many millions of dollars upgrading their networks it’s important to appreciate that it’s not being done just so teenagers can watch videos of each discussing the latest pop sensations. In the right environment, LTE could literally become a life saver.

Dr Adesina Iluyemi, co-founder and vice president of MoDise is speaking at the LTE Middle East and North Africa conference taking place on the 29^th-30^th April, Westin Mina Seyali, Dubai, UAE. Go to the website now to register your interest.

Telenor told of its focus on mHealth at MWC 2012

Although mobile health is already a reality, many initiatives are struggling with scale. These is a key finding of a study looking at the potential reach and breadth of mobile health innovations in both developed and emerging markets. The survey, which was commissioned by Telenor Group and carried out by The Boston Consulting Group, analysed the impact that mHealth initiatives can have in 12 countries.

The findings from the research showed that more than 500 mobile health projects are currently taking place around the world, and suggests that costs in elderly care can be reduced by 25 per cent with mobile healthcare, while maternal and perinatal mortality can be reduced by 30 per cent using mHealth.

The technology richness and network capacity is sufficient, both on simple feature phones and on smart devices, according to Telenor, and the technology allows twice as many rural patients worldwide to be reached per doctor. The firm also said that the necessary infrastructure is already in everyone’s hands, with 7.4 billion mobile subscriptions projected by 2015.

“Mobile health is already a reality, with hundreds of projects launched worldwide. However, many projects are struggling with achieving scale. Both regulatory actions and ecosystem collaboration is required to create the necessary scale. We need to commit to common standards, increase access to mobile services and document the impact of mobile health,” said Jon Fredrik Baksaas, president and CEO at Telenor Group.

And the results drive home the scale of innovation occurring in mobile health, and  also provides a taste of how diverse services are according to Charlie Davies, principal analyst at Ovum.

“These range from the provision of pre-natal information provided via mobile phones for pregnant women in India to significant potential reductions in costs for elderly care at home using mobile alarm and communication systems.”

“The industry as a whole needs to ram home the benefits of E-health to sceptical policy makers, which will require a significant amount of patient stakeholder engagement.”

Telenor Group has launched a number of mobile health initiatives across its markets. For example, in Norway, an assisted living project helps the elderly stay longer at home through mobile alarm systems. In Thailand, a mobile text messaging service provides epidemic surveillance. In Bangladesh and Pakistan, a service called Healthline provides patients with a simple number to dial for both serious and non-serious medical needs and In India, mothers can obtain critical information about prenatal health via their phones.

MobiWire sees NFC as an enabler for mhealth

IT management systems provider Advanced Health & Care (AHC) has partnered with MobiWire – the French firm formerly known as Sagem Wireless – to deliver an NFC-based mobile healthcare offering.

While NFC is expected to play a major part in mobile finance initiatives, MobiWire and AHC see a future for the technology in other applications. Building on MobiWire’s NFC enabled COSY phone and AHC-developed application iConnect, the offering enables real-time communication and information transfer between care workers and office staff. For example, on arrival and departure at a resident’s location, care workers touch their handsets against NFC tags placed in the user’s home to “check-in” or “check out”. The information collected works to locate the remote worker with an arrival timestamp to update the bookings and manage service delivery and subsequent financial processes.

“The iConnect application is an excellent demonstration of the value of NFC as part of whole systems design. Remote workers simply “check-in” and trigger a set of processes allowing them to focus on the service they provide.  The next generation of NFC enabled devices will allow even more information to be displayed for the remote worker, surfacing patient details, diagnostics, even rich interactive media”, said Jerome Nadel, EVP of user experience and marketing at MobiWire.

Patient in Your Pocket enables mobile healthcare professionals to access and update patient information at the point of care

US mobile systems provider CSC has launched its Patient in Your Pocket mobile system in the UK to enable mobile healthcare professionals to access and update patient information at the point of care using a BlackBerry smartphone.

Aimed at healthcare professionals in frontline patient care such as community nurses, midwives, health visitors and doctors on house calls, the system can be used to plan day-to-day appointments, retrieve up-to-date information about the patient’s condition during an assessment, and to collect data. Data is gathered via dictating notes or filling in forms using a digital pen.

Patient confidentiality is protected through the use of smartcard log-on and secure data encryption.

CSC told Clinica that future releases will target hospital doctors, who are highly mobile within the hospital and might benefit from immediate access to patient information without needing to find a PC.

The system’s activity monitoring system enables staff to register expected times for lone-working tasks, particularly late at night, with a call centre. An alarm is raised if those activities exceed the expected duration without contact from the healthcare worker. The alarm is sent to operators who will assess the situation and engage the appropriate services.

Asked if there are plans to deploy the system on other types of smartphones, the company told Clinica that Research In Motion (RIM), BlackBerry’s manufacturer, is CSC’s partner of choice. “Currently, for Patient in Your Pocket, BlackBerry is the preferred platform,” said the spokesperson. “In the future if there is specific and sufficient customer demand for other platforms, we will consider it. But they will have to offer the same levels of security and manageability as the RIM platform.”

Patient in Your Pocket will run on BlackBerry devices that can run version 5 or greater of the RIM platform, such as the Bold 3700 and the new Torch model. “The NHS is expected to continue to purchase their handsets and airtime through their existing agreements with telecoms providers,” she said.

“The applications are deployed to the handsets through the BlackBerry enterprise server. This allows us to ensure that all users have the latest versions of the applications. We consider this type of approach to be essential where the applications are being used to support frontline healthcare delivery.

“Although both the BlackBerry and Android operating systems run on Java platform, there are no current plans for CSC to do this. We would do so if there is specific market demand for this type of phone.”

First published on Clinica

The Apple device is quickly gaining favour amongst the younger generation of healthcare practitioners

The iPhone and its apps might still have some way to go to be formally acknowledged as a ‘medical device’ by the US FDA and the European Notified Bodies (NB), but the Apple device is quickly gaining favour amongst the younger generation of healthcare practitioners.

The iPhone is soon to be deployed for use by students of medicine at Leeds University, UK, and Swedish firm Medhand, the supplier of Medical References for mobile platforms, has been selected to supply mobile medical resources for the Mobile Medical Learning Programme at the university.

The project will see iPhone 3GS 16GB devices loaned to 520 fourth-and fifth-year medical students who will be spending much of their time off-campus at hospitals, GP surgeries and community health clinics.

The smartphones will be pre-loaded with a range of dedicated apps that will let students record notes on interesting cases whilst still on the wards, and test their knowledge of procedures or protocols they have just observed. Copies of key medical textbooks and reference works, including up-to-date guidelines on administering prescription drugs, will also be distributed as iPhone apps. A range of other relevant medical apps that can be downloaded free-of-charge or purchased will be provided too.

“No other UK medical school is taking advantage of the virtual learning environment to such an extent,” said Professor Trudie Roberts, Professor of Medical Education at the University of Leeds. “It is vitally important that medical students continue to develop their skills and record their progress when they are in practice, as well as when they are on campus. Mobile phone technology means that students can do this quickly and easily, wherever they happen to be working.”

Magnus Stuart, CEO of MedHand, said there isn’t a medical student who doesn’t prefer the MedHand iPhone application.

The company previously won a three-year contract to furnish medical students at the Brighton and Sussex Medical School with the medical reference library Dr Companion.

First published on Clinica

Thierry Zylberberg, executive vice president of the Health Line of Business at Orange, speaking at the summit

At Informa’s second Mobile Healthcare Industry Summit, held in London in September, telecoms.com sat down for half an hour with Thierry Zylberberg, executive vice president of the Health Line of Business at Orange and Michael Reilly, director of Orange Healthcare UK, to discuss the recent flurry of activity in the mobile health sector.

Zylberberg, who was one of the keynote speakers at the event, is quick to point out that this flurry of activity does not mark Orange’s debut in the mhealth space. Orange Healthcare was created as a division three and a half years ago, with Zylberberg adding that the company has been learning, experimenting and developing products and services in this sector for a significant period of time.

UK-based Reilly has been heading up the healthcare line of business in the UK for two years now. Originally, his function was part of the group organisation but with the establishment of Everything Everywhere he’s developing strategies with regards to the new entity now.

Mhealth, or ehealth to use a broader term, feels like an alien topic to explore as a member of the telecoms press. The attendees at the summit, many of which telecoms.com was not familiar with, highlighted the difference between the two sectors, while Zylberberg acknowledged the difficulty of breaking into the space as an operator.

“There’s the brand lesson,” says Zylberberg. “In France we launched a test product called Orange Santé and the response was a unanimous: ‘We don’t want to see Orange there, you don’t belong there.’ So we called it something else, the branding is green, not orange, and we said ‘powered by Orange’ instead. And that added a lot of value for consumers. No to see it our brand on the frontline but to see us adding technological support.”

Trust is a major consideration in healthcare and Zylberberg believes that there is enough confidence in the Orange brand to allow the operator to unlock potential in the sector. “We bring trust in hosting medical data and telcos are in a unique position to enter that space. They have the data centres and the very high security, ideal for hosting medical data,” he says.

According to Reilly, 30 per cent of all data stored worldwide on computers is medical data. And the big question for Orange is: “How do you liberate that information? How do you make it more easily moveable and manageable in a secure environment? Governments are now imposing severe regulations on who can host medical data. You need to be able to prove that your processes are good enough in order to get a government approval,” Reilly adds.

Zylberberg is quick to point out that telcos should be aware of their place within this new ecosystem. While some carriers expect to have a direct relationship with the end user in the delivery of mhealth services, Orange acknowledges the importance of relevant partners and sees its place as somewhere further along the value chain. “It’s not a common belief among the operators but I don’t think the operator will have a direct relationship with the end user. There are many dangers in that model and one is that I don’t want to be responsible for a patient in a life threatening situation with a life critical service,” Zylberberg says. “Telecom networks are not 100 per cent, they’re 99 point something per cent. You get dropped calls. I don’t want someone to depend on a network that drops calls. They’re not designed for it.”

Instead, Zylberberg sees the device manufacturers as having a more direct relationship with the consumer. “The patient is really always attached to a device, because that’s where the information is, so the device manufacturer controls the patient, not the telco. The telco takes the info and transports it somewhere else,” he says. “The telco’s role in my view will be hosting, transport, billing, security, cloud computing, but not much more. The partners will be the software industry, the over the top players, and the device manufacturers,” Zylberberg adds.

The importance of partnerships is a common mantra heard among telcos shifting into the healthcare space, and not least because the healthcare ecosystem is very complex. “You have the insurers which pay for health. You have doctors, You have private and public hospitals. All the various parts of the ecosystem are misaligned, which makes it very difficult for the whole system to change. Today it’s in some form of equilibrium but if you want to change any process then it means someone will gain and someone will lose. This is why technology takes so long to penetrate into this domain when compared to other sectors like finance and travel,” Zylberberg explains.

“Ehealth is really about two different ecosystems: the classical one we know from the telecom world – the telco and the vendor; and the other is the classical medical ecosystem and the two are merging, they’re colliding, it’s not just operators, it’s the whole telco ecosystem that’s going in that direction,” Zylberberg says. “Mobile health is not just about patients. Its not really a very solid concept, it includes many things, including access to medical information for doctors, medical devices for caregivers but also sending SMSes to people, iPhone apps, also measuring devices, pedometers, monitoring blood pressure or glucose level of the patient. Today it’s very fuzzy.”

There’s also a vast distinction in the drivers for mhealthcare between mature and developing markets. In emerging markets the main issues is access to healthcare, it’s as simple as that. In the face of economic challenges, mobile is bringing health services to the population, by allowing the sending of medical information, or organising people to meet a doctor in one village. While in mature markets it’s a quest for efficiency.

“Health costs are rising around the world at around five per cent per year. In Europe, healthcare represents ten per cent or 11 per cent of the GDP, and in the US it’s 16 per cent. By 2020 it’s going to be 20 per cent of GDP in the US,” says Zylberberg, adding that, “Over 50 per cent of the world’s population have a chronic condition.” And the drivers here are an ageing population and the rise of chronic diseases. Everyone is looking for a solution to curb rise in expenses. We need to contain the explosion. But it’s not as easy as in other economic systems.”

Orange, like many of its peers, sees a bright future in healthcare but acknowledges the fact that as a telco it has a very specific role to play. With patients increasingly demanding health service access at their convenience – and these are not necessarily high risk patients, but more the ‘worried well’ and low-risk consumers – there is an opportunity to put health information or remote access to health services in their hands, easing the communication between providers and their patients as well as internal communications for healthcare providers themselves.

Orange’s view is that the area of health management – essentially, internal communications for healthcare providers and communication between providers and their patients – offers the most promise. The opportunity to improve communications in the health sector has also captured the imagination of other operators besides Orange: Telefonica O2 UK considers the business case in the UK market to be proven and already works with NHS trusts all over the country to deploy a range of enterprise services.

But, as Zylberberg pointed out, ‘mobile healthcare’ means many things. Mobile services for healthcare go beyond distributing Blackberries among nurses or sending SMS appointment reminders. They include new innovative products such as a digital pen, which records and transmits data as it is written on paper, or diagnosis-aiding mobile functions such as using a camera-enabled phone to assess wounds remotely, both of which have emerged from Telefonica O2’s health division.

Further examples include remote monitoring of chronic disease sufferers using specialist devices which transmit data to a managed data centre, a service developed by Orange for cardiac disease sufferers in partnership with medical device manufacturer Sorin. Many more services and applications in development or deployment by a range of companies were discussed at the conference, from international mobile medical records to intelligent pill bottles that not only remind patients to take medication but also enable them to re-order when supplies are running low.

But are healthcare providers embracing these new types of tools, which may fundamentally change their day-to-day working lives? Apparently so, despite their reputation as being resistant to innovation and change. Representatives at the conference from both public and private health providers, including medical practitioners, made it clear that the healthcare landscape is in need of transformation to cope with exponential growth in demand (caused by increased chronic disease, aging and obesity) and its impact on expenditure. Importantly, they believe that communication technology has a key role to play in this transformation. ‘Saving time and saving money’ will be the key short-term drivers of service adoption, explained Don Jones, Vice President of Business Development for Health and Life Sciences at Qualcomm, during his on-stage interview.

Of course, the desire to save time and money is true of any vertical. But in healthcare, the patient landscape is also changing. As one panel member and medical practitioner explained, a fundamental shift is occurring: patients are becoming consumers who demand health service access at their convenience and in many forms. This, combined with the need to eliminate the burden of the ‘worried well’ and low-risk patients on health systems by putting health information or remote access to health services in their hands, may well be the impetus for real communication technology innovation and adoption.

Dr Nicholas Robinson of NHS Direct outlined this concept well: if a member of the public can use a trusted source of health information on their PC or mobile to satisfy themselves that they don’t require a visit to the doctor (as 5.2 million people did during the UK’s swine flu outbreak this year), then that time spent in a face-to-face consultation – at the provider’s or insurer’s expense – is freed up. One medical practitioner at the conference suggested that as many as 65 per cent of patients actually present ‘dis-ease’, not disease, so don’t necessarily require the kind of face-to-face assessment needed by the other 35 per cent.

Yet widespread deployment of myriad mobile services in healthcare, whether b2b, b2b2c (or b2b2patient) or b2c, is not without its barriers. The question of who pays for services, where the bill isn’t picked up by a public provider, is still unanswered. Insurers were not represented at the conference and this is presumably because they are, reportedly, only just becoming interested in having a direct relationship with patients and reimbursing new types of health service delivery.

Furthermore, any behavioural change required by patients who already fail to engage in their health management will also be met with its own challenges: one panel-member and psychologist explained that as many as 25 per cent of kidney transplant patients fail to take their post-surgery medication, so short-term incentives are paramount to maintain patient interest in services such as those that enable self-monitoring. Additionally, regulation surrounding the use of mobile devices as medical monitoring devices remains early-stage and requires the collaborative effort of both telecoms and health regulators.

Collaboration and partnership were key themes to emerge from the conference: ‘No single operator can deliver an end-to-end service without collaborating’ was the central message of the keynote presentation given by Sarah Sanders, Global Commercial Manager at Vodafone Health Solutions. She cited the work that the operator has done in Tanzania with pharmaceutical company Novartis and IBM to develop mobile-enabled stock management tools that ensure medical centres don’t run out of antimalarial drugs. Emerging markets present a different set of needs and ‘mobile healthcare’ opportunities from developed markets in their lack of both fixed line telecoms and health access infrastructure.

Along with over 200 other companies, Vodafone is also member of the Continua Alliance, a US-based organisation established specifically to foster cross-sector collaboration and develop standards for interoperability in ‘mobile healthcare’ technologies. Given the wide-reaching nature of ‘mobile healthcare’, fora such as this that enable collaboration between key stakeholders will hopefully serve to convert the many ideas and wealth of enthusiasm present at last week’s conference into practical implementations, beyond simple enterprise services.

Keith Nurcombe, head of O2 Health

In February of this year Keith Nurcombe took the helm of Telefónica UK’s first foray into the field of medicine as head of O2 Health. He joined the telecoms industry after 18 years in the health sector, saying that he was attracted to the role by the idea of helping a mobile brand move into the health market and make health services a key operator offering.

The new unit launched in May, coinciding with the rollout of a handful of other operator mhealth initiatives, and is tasked with the decentralisation of clinical processes and ubiquitous and remote access to these services across Telefónica’s European operations as well as its Latin American presence. The potential for mhealth is as great in mature markets as it is in the developing world and for much the same reason – a lack of resource.

According to the presentation given in Madrid in July by Trinidad Jiménez, Spain’s minister of health and Telefónica chairman, César Alierta at the launch of O2 Health, in 2010, 13.5 per cent of the world’s population – 980 million people – will be over 65, and 60 per cent of these will suffer from chronic and degenerative illnesses. This situation, combined with the current shortfall of specialists in key medical assistance sectors, and the fact that these specialists must spend between 30 per cent and 50 per cent of their time on administrative tasks instead of healthcare activities, are putting additional pressure on public healthcare budgets.

Consider this alongside statistics revealed by Vittorio Colao, CEO of Vodafone Group and keynote speaker at the inaugural Mobile Healthcare Industry Summit held in London in December 2009, who said that although there are 2.3 billion mobile subscriptions in the developing world, there are only 11 million hospital beds and 300 million computers.

The numbers are depressing and are likely to become more so as time goes by. “Global healthcare spend is running at a 5.5 per cent increase year on year,” says Nurcombe. “That trend has got to stop, otherwise by 2080, 40 per cent of global GDP will be on healthcare, which means none of us will be able to afford it.”

He explains: “The NHS is looking for ways to do more with fewer resources, but this can’t be at the expense of patients, service or standards. We understand the NHS and can help it – and our private partners – to deliver more through smarter working.”

Nurcombe reveals that Telefónica has been looking at health for 12 to 18 months and, in the UK at least, already has many NHS trusts and private healthcare organisations as customers of its telecoms services. The company extended its offering with the launch of financial services in the shape of prepaid Visa cards in the last 12 months and is preparing to branch out into other key verticals. “We’ve got to be able to demonstrate that we have a right to enter a new market,” says Nurcombe. “So we have to prove ourselves. We’re creating a new business area that has its own brand identity. It’s made up predominantly of people from health industry. We have people from a telecoms background but we also have lots of people with 15 years of experience in health. We need that real understanding and insight, that’s very important.”

The issue of trust is a big one when it comes to healthcare, and this is where experience clearly counts (during his 18 years in the health sector Nurcombe spent five years at GlaxoSmithKline). “We need to deliver these solutions with credibility, which means we recognise that we are moving into a new market and our approach is very much crawl, walk, run, so we can demonstrate our credibility and gain trust. We’ll only get one bite of this cherry so we have to get it right first time,” Nurcombe says, acknowledging that O2’s role as an operator with an existing billing relationship with many customers already serves as a strong foundation in this respect.

But O2 Health’s customers won’t always be the end users. While some propositions will go direct to the consumer, with some others the operator will have a relationship with the local trust and will work in partnership with the NHS to deliver services. There will be more focus on prevention rather than cure, on health rather than illness, with a focus on wearable devices, or self measurement – taking some ideas from the sports field and making them mass market.

This point is key. Mhealth services are often perceived as very expensive to deploy and run, but Nurcombe insists this is not the case. “When we’re talking with the NHS and other healthcare providers it’s an ROI conversation very early on,” he says. “We have to be in a position to deliver ROI in the financial year that the NHS is in, not in three to five years like we used to.”

Fortunately, mhealth technology, which some may consider to be on a distant horizon, exists today. It’s just that most people are unaware of it, Nurcombe says. “Often it’s a case of using an existing model in a completely new environment, lifting and shifting technology. It’s very much not tomorrow’s world, it’s here now, but we might be joining a handful of existing technologies from other sectors to create the offering. None of this is particularly expensive technology, it’s just redeployed in a different way,” Nurcombe says.

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It is fast becoming evident that national health services cannot deliver all the care that is needed

In a world where health services often don’t exist in emerging markets and are overstretched in developed ones, mobile health represents a balm, rather than a panacea, for lack of medical resource.

The subject of health is never far from the headlines both in the emerging markets, where services and infrastructure can be dangerously scarce, and in developed nations where resources are increasingly overstretched. In many countries it is a sector for which the future does not hold much promise in terms of additional funding and resources—and for many people it is fast becoming evident that national health services cannot deliver all the care that’s needed.

For those of us lucky enough to live in wealthy societies with access to decent healthcare services, there is a serious concern that, in the not too distant future, the cost of care will rise to unaffordable levels. To make matters worse, regions like Europe with ageing populations face the very real risk of not having enough carers to look after the sick. According to figures from O2’s recently launched healthcare unit, global healthcare spend is running at a 5.5 per cent increase year on year. If that trend continues, by 2080 40 per cent of global GDP will be spent on healthcare, which means no one will be able to afford it.

The communications industry touches more lives than most and it is uniquely positioned to help develop new ways of looking at healthcare.

At the inaugural Mobile Healthcare Industry Summit hosted by Informa Telecoms & Media in London in December 2009, it emerged that there are plenty of apparently robust mobilehealth “solutions” out there supported by compelling business cases. Yet most are still in the pilot phase of deployment, awaiting widespread take-up. Why is this the case? Well, one large and unsurprising barrier is budgetary constraints. But more significantly, there is substantial resistance to change within the healthcare sector itself—it is one of the last big verticals to be touched by automation.

Some of the resistance is based on risk aversion—the fear of what harm these new technologies might do to patient-data privacy or patient health itself. But there is also resistance based on vested interests—on the fear that new technology might make certain tasks or jobs performed by humans redundant. This is despite the fact that health services are overstretched already, and demand is still increasing.

Resistance to change is a very human condition and, in the case of healthcare, that resistance is harder to fight in countries where there is a well established health industry.

So it is in emerging markets, where many areas lack even the most basic healthcare infrastructure, that the first opportunities may arise. A large void is waiting to be filled—with no legacy institutions obstinately clinging to old ways. According to the analysts, it is in these countries that operators can actually spearhead the provision of frontline health services in the same way they are doing with banking and digital-money services.

The nascent m-health sector is certainly ripe with potential. A recent global market survey from management consultancy McKinsey & Company pegs the value of the global mobile healthcare market at between $50bn and $60bn in 2010, with opportunities worth $20bn in the US alone.

To gauge consumer demand for m-health services, McKinsey conducted a global market survey of 3,000 consumers in six countries (500 each in Brazil, USA, Germany, South Africa, India and China), with findings indicating that a large proportion of the four billion people using mobile phones today struggle to gain access to good quality and affordable healthcare, both in emerging markets and more developed societies.

Obviously, the problem is exacerbated in the developing world. A telling statistic, revealed by Vittorio Colao, CEO of Vodafone Group and keynote speaker at the Mobile Healthcare Industry Summit, is that although there are more than 2.3 billion mobile subscriptions in the developing world, there are only 11 million hospital beds and 300 million computers.

So it makes sense to use mobile as a foundation. Dr Adesina Iluyemi, co-founder of SinseProd, a UK-registered social enterprise company stimulating technological innovations and investments into Africa, believes that, because low access to power stops crucial medical devices being used in certain regions in Africa, mobile phone connectivity is a more realistic platform for healthcare delivery.

“We are talking about technology obsolescence, devices that were phased out 30 years ago,” he said. “To get a vendor to retro fit parts to an old medical machine would cost ten times more than it would cost to buy a new machine, when even a new machine is not affordable.”

According to Iluyemi, even in South Africa, the most economically advanced country in the African region, an estimated 50 per cent of medical devices are useless. “There are no standards and there is nowhere to plug these devices in, because only 20 per cent of Africa has access to a national power grid. These devices are power hungry, they are not green, they are big, they are not mobile, and to solve 90 per cent of the population’s difficulties we have to use mobile.”

Iluyemi has a point that is supported by McKinsey’s research, which found that almost 70 per cent of respondents were extremely or very interested in at least one m-health product, with Indian and South African consumers showing the highest levels of interest (40-60 per cent across all products). Willingness to pay for such services was also surprisingly high for several products across geographies, with Indian customers willing to pay ten times their standard airtime rates, and US consumers 20 times standard airtime rates, to be able to speak to a doctor via PhoneDoctor. Brazilian and Chinese consumers meanwhile were willing to pay the equivalent of a new mobile phone subscription for the patient monitoring system HealthWatch.

The product names—PhoneDoctor and HealthWatch—and the very concept of electronically delivered health services have a somewhat futuristic connotation but this is reality rather than science fiction. Keith Nurcombe, head of O2 UK’s recently launched health unit, said that the technology itself exists today but most people are unaware of it.

“It’s very much not tomorrow’s world. It’s here now. We’re just joining a handful of existing technologies from other sectors together to create the offering. None of this is particularly expensive technology, it’s just redeployed in a different way,” he said.

With m-health, the focus is on prevention rather than cure, on health rather than illness. It’s an initiative facilitated by wearable devices and self measurement, and often involves taking some ideas from the sports field and making them mass market. O2 Health has a service called Home Physio trialling in the UK and already in commercial use in Spain, which offers home-based physiotherapy using sensors that fit on the body and a touch screen PC, which shows patients how to do exercises and sends info back to the hospital to make sure they are being done correctly.

But this is not to say that mobile applications will replace an MRI scanner. Accurate readings are still needed, especially in serious cases, but SinseProd’s Iluyemi argues that the industry needs to consider extending some medical technology to processes that are not blood-based, like saliva tests, where a fridge or adequate storage is not needed to preserve the sample.

So by moving and shifting existing technologies to a new environment, O2’s Nurcombe claims that health can and will be a key offering from Telefónica—and he’s not alone in this attitude. It may well be coincidence, but during July, there were no fewer than four mobile health offerings launched.

Telefónica’s new unit will build on the carrier’s existing efforts in m-health including the creation of the Living Lab R&D department in Granada in 2005, with products and services based on converging communications, managed web services with point-to-point coverage and a pay-per-use policy, and a model that provides economies of scale to extend applications with a minimum outlay on technology.

Orange also joined the movement with Smartnumbers, a healthcare specific service that gives callers instant access to the best placed medical professional or team available, providing patients and workers with the ability to reach the right person the first time they call. Meanwhile, Vodafone, a founding member of the m-Health Alliance, already has an m-health initiative up and running.

For Orange, health is one of three new areas of business growth, alongside audience and advertising and content. The operator has identified a market opportunity in the healthcare sector based on three key factors: healthcare expenditure is unsustainably allocated to chronic disease treatment; populations are ageing, particularly in France, adding to the burden on resource; and there is a fundamental shift occurring in the approach to care by both patients and doctors that crucially depends on new ways to manage information.

As an integrated operator, with both fixed and mobile operations, Orange sees itself as a natural player to connect the various domains of the healthcare ecosystem—from pharmaceutical companies and hospitals to subscribers and patients—and puts this role of “intermediary” squarely at the centre of its strategic goal to be a European leader in e-health.

The brand may well be of core importance to the success of this strategy because trust is essential, and given that operators and services providers already have a billing relationship and a cache of sensitive data on their customers, the foundations are already there.

“We need to deliver these solutions with credibility, which means we recognise that we are moving into a new market,” said O2’s Nurcombe. “Our approach is very much crawl, walk, run, so we can demonstrate our credibility and gain trust. We’ve got to be able to demonstrate that we have a right to enter this new market. We’ll only get one bite of this cherry so we have to get it right first time,” he said.

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The new company will absorb GE Healthcare's Home Health division and Intel's Digital Health Group

US chip giant Intel said Tuesday it has entered into an agreement with General Electric to form a 50/50 joint venture healthcare company focused on electronic health and independent living. The new company will absorb GE Healthcare’s Home Health division and Intel’s Digital Health Group, and will be owned equally by GE and Intel. It is expected to become operational by the end of the year.

Designed to address the dramatic increase of people living with chronic conditions and a global aging population, the company will develop and market products, services and technologies that promote healthy, independent living at home and in assisted living communities around the world.

“New models of care delivery are required to address some of the largest issues facing society today, including our aging population, increasing healthcare costs and a large number of people living with chronic conditions,” said Intel president and CEO Paul Otellini. “We must rethink models of care that go beyond hospital and clinic visits, to home and community-based care models that allow for prevention, early detection, behaviour change and social support.”

The company will be headquartered in California and Louis Burns, currently vice president and general manager of Intel’s Digital Health Group will be CEO of the new company, and Omar Ishrak, senior vice president of GE and president and CEO, GE Healthcare Systems, will be chairman of the board.

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