Archive for the ‘Communications’ Category

mHealth – The Genie in the Lamp

Wednesday, December 11th, 2013

Tuesday, December 10, 2013

By Dawood Khan,

mHealth Summit, Washington DC

WASHINGTON, D.C. – mHealth – The mobile phone is Aladdin’s Lamp!

The mHealth sector is definitely in the initial phases of a hype cycle. It is rattled with endless point-solutions; thousands of apps, hundreds of wearable devices, no real idea of business models, a blatantly “patient un-centric” approach to mHealth, and unimpressive solutions showcased as the “latest mobile health technology” that would remind anyone in the mobile industry of 2006.

2006 was an era the mobile industry was full of point solutions, more content than anyone could find on carrier portals – a.k.a. walled gardens. The Blackberry was the pinnacle of a smart mobile device, an entirely un-centric user experience, and a business model that basically gauged consumers.

Then came Apple in 2007 and the mobile industry changed. Apple’s ingenious approach went far beyond technology in the iPhone. It came with a markedly consumer-centric approach from revolutionizing the content revenue-sharing business model, and an engaging end-user experience. Apple negotiated Digital Rights Management deals with record labels, content aggregators, and distributors. It allowed application developers to keep 70% of revenues. This was unheard of among Western MNOs, who kept 80% of application and content revenues, and controlled their portals.

In retrospect, Apple was the mobile industry’s genie.

Fast forward to 2013, and while anyone who has observed hype cycles in industries undergoing change can see that mHealth is all hype and little substance. At this time, there are some glimmers of hope, offering a potential to change the hype to hope.

mhealth

Enter Mohammad Yunus – an unassuming, humble, simply dressed global change leader – A Nobel Prize winning inspiration for social change. Among many innovative ways of challenging social, business, and technology status quo, he established Garmeen Bank, acquired wireless spectrum and set up a cellular service provider in Bangladesh to serve the underserved. His target was the poorest women in the world. They were the “telephone ladies” – allowing villagers to make calls, conduct banking, etc.. He grew this to 400k “telephone ladies” within 5 years.

He dreamed of creating Aladdin’s lamp with a magic genie who would solve the problems of people – he believes the mobile phone to be that magic lamp with a digital genie – granting wishes, solving people’s problems, allowing them to make money to feed their family, access banking, and “dial a doctor”. In trying to achieve Bangladesh’s Millennium Development goals, Yunus has been working on addressing medical issues among the most vulnerable. Using mobile to offer “dial a doctor” service and even for portable ultrasounds. His current dream is to use the mobile phone as a portable Ultrasound device (instead of a tablet) with an ultrasound app that can be downloaded.

While applications exist for mobile eye scanning, ECG, and detecting certain types of cancer, his vision is that mobile collects info from the body in every way allowing machines to analyze trends over time and pre-emptively alert  you when there is a problem. In this way, diagnostics can be provided at a personal level without having to go to a doctor.

After this, speaker after speaker spoke of the best solution their company either enables or delivers. The challenge is that these solutions are all closed loop and not necessarily the best for consumers. In many cases, solutions don’t have a business model. Given the US centric crowd, the approach to funding was, as expected, US centric. And so, the discussions around what kind of business model will work still need to be thought through. In essence, what may work for a particular solution in one Country, will need to be totally reformed for another. Eventually, the players will sort things out.

mHealth – Will it Go Viral or End Up Bacterial?

Tuesday, December 10th, 2013

Monday, December 9, 2013

By Dawood Khan

mHealth Summit, Washington, D.C.

WASHINGTON, D.C. – In many ways, today was a day of juxtapositions.

While an impressive array of keynote speakers spoke about the incredible future as a result of innovative technologies and solutions, the audience of close to four thousand healthcare practitioners, entrepreneurs, vendors, service providers, regulators, sat patiently listening as the lights flickered at a state-of-the-art facility in Washington DC, experiencing electrical problems as a result of what many would consider a mild storm.

The mobile industry was revolutionized with the inception of the iPhone in 2007 and then Android in 2008 – the possibilities for healthcare from mobile are limitless. There are close to 6.6B mobile connections worldwide today according to the GSMA[1], and these are expected to exceed the human population shortly. According to the keynote speaker from Qualcomm, the Internet of Things (IOT) will be everywhere – even doorknobs can be made mobile. IOT is expected to generate revenues of $1.5T by 2017. The predictions on the number of connected devices vary between 25B and 50B connected devices by 2020 – admittedly a large window, but a difficult prediction to make.

The healthcare industry spends more than $6.5T globally on an annualized basis. An aging population with a growing need for chronic disease management represents roughly 860M patients worldwide. Some developed countries report spending close to 84% of healthcare spending on chronic disease management. A study for the NHS reported an almost 45% reduction in mortality from chronic diseases when telehealth was adopted[2].

The revenue predictions of the global mHealth market also vary. According to Transparency Market Research, the global mHealth market is expected to reach $10B in revenues by 2018, up from $1.3B in 2012 – representing a CAGR of 41.5% from 2012 to 2018. Majority of the revenues thus far have been from monitoring services contributing about 63% of the global mHealth market revenue in 2012[3]. According to research2guidance[4] the mHealth app market will reach $26B by 2017, with 50% of mobile users expected to download a health app by then. Today, majority of the apps have been lifestyle focused, with smaller, nimble app developers and innovators avoiding diagnostic apps as a result of regulatory concerns.

Speaking of regulation, the Food and Drug Association (FDA) in the US recently issued its final Mobile Medical Applications Guidance for the industry[5]. This is a first of a kind guidance. The FDA claims that innovation isn’t counter to patient safety, and has identified categories of devices to “focus only on the apps that present a greater risk to patients”. However, defining what “greater risk” is trickier than one would assume. So, a Food and Drug Administration Safety Innovation Act (FDASIA) Workgroup has been set up to provide expert input on issues identified by the FDA, Office of the National Coordinator for Health IT (ONC), and the Federal Communications Commission (FCC) to help develop a risk-based regulatory framework pertaining to health information technology including mobile medical applications. The framework promises to promote innovation, protect patient safety, and avoid regulatory duplication. The folks at HIMMS couldn’t wait for further regulatory guidance and have issued their roadmap version 2.0[6] for the adoption of mobile and mHealth devices. mHIMMS also launched its 3rd survey of mHealth today. Results of the previous survey indicate interest in consumer focused applications[7].

The CEA discussed its Wearable Devices Market Study[8], identifying that there is over a billion dollar industry of wearable fitness devices in the US by 2014, with products from companies such as Jawdrop, Bitfit. 75% of consumers who own devices are in the 18 – 34 years bracket. However, older more affluent shoppers also own fitness devices. Most purchase devices at brick-and-mortar sports stores rather than online – as consumers want to know how they feel. While price is the most compelling driver for selecting a wearable lifestyle device, battery life, form-fit and ability to keep them clean are important decision criteria for consumers.

So, why has mHealth been so slow to take off? Esther Dyson, the Chairman of HICCup likened these early days of mobile in healthcare to be like the late 80’s for Internet, when people thought it was very sleazy to put commercial traffic on the Internet, which was till then purely a research Network. “Mobile in healthcare is like that. But it is charging.” She said.

AOLs founder, Steve Case lamented that it took the Internet almost two decades to reach main stream, and mobile in health will also take time – especially as older and established stakeholders try to maintain status quo.

Major barrier to adoption of mHealth include the resistance by established Vendors and Providers of accepting new, unknown entrants with nascent, sometime unproven innovation. Clinician reimbursement models were also identified as a barrier for the US market.

Trust is a major concern. This can only be overcome through maturation of the mHealth Industry.  In terms of mPayments – how many people rip up the cheques after they deposit it? Only a handful, most hold onto it in case the deposit didn’t work well. It will take time for people to start trusting the app. As noted earlier, another challenge is that most firms want to stay out of the critical health care apps and stay in fitness and wellness to avoid being regulated.

Jordan Shlain, an MD and entrepreneur who founded HealthLoop – a startup focused on providing Clinicians the ability to follow-up with their patients digitally, put the situation of mobile in Healthcare well – “will mobile go viral?” he asked, and then responded “…like most things in health – I think it may end up going bacterial instead.”

Perhaps so – but only for the near term. I came to mHealth to see if the Healthcare industry was ready for the change, ready to move at a much faster pace, adopt innovation, and adapt its existing processes and regulation to meet the needs of a much faster moving Mobile Industry converging with a slow moving, established Healthcare Industry in. I am happy to report that I think that while we’re at the very early stages of the phenomenon, the trend is definitely irreversible. Exciting times ahead!

Is your enterprise looking for a mHealth strategy? Contact us at redmobileco@redmobileco.com to receive a copy of the mobile enterprise strategy best practice paper for the Healthcare industry. You can also reach us to discuss how you can determine if your organization is ready to adopt mobile through use of our mobile readiness assessment.


[1] https://gsmaintelligence.com/

[2] http://3millionlives.co.uk/about-telehealth-and-telecare

[3] http://www.transparencymarketresearch.com/mobile-health-market.html

[4] http://www.mobilemarketer.com/cms/news/research/15023.html

[5]http://www.fda.gov/medicaldevices/productsandmedicalprocedures/connectedhealth/mobilemedicalapplications/default.htm

[6] http://www.mhimss.org/roadmap

[7] http://www.himssanalytics.org/research/AssetDetail.aspx?pubid=81559&tid=131

[8] http://www.ce.org/i3/Features/2013/November-December/Digital-Health-Breaks-New-Ground-at-CES

The Wireless Industry – Here We Shrink Again!

Monday, July 15th, 2013

By Dawood Khan

Red Mobile Consulting, Toronto, Canada

TORONTO – Consolidation seems to be the global trend in the wireless carrier sector today. A combination of full or near-full market penetration rates; burgeoning consumer appetite for data services leading to pressure on spectrum; and the need for carriers to save costs in light of declining service revenues are all leading to the phenomenon. While acquisition activity is reducing the number of competitive players in the market, leading to better economies of scale and greater access to spectrum for carriers, regulators fear this resulting in increased pricing for consumers.

AT&T $1.2 billion bid for Leap Wireless’ 5 million pre-paid subscribers and PCS and AWS spectrum spanning 35 states is just the latest in a series of acquisition activity. T-Mobile, who recently acquired MetroPCS – competitor to Leap, is itself a potential target for takeover, with Sprint (anti-trust regulation permitting) pegged as a suitor.  This comes on the heels of Sprint’s recent acquisition of the remaining part of Clearwire, allowing it access to spectrum to offload broadband data, as Clearwire pursues deployment of its TD-LTE network.

According to the GSMA, recent consolidation activity in Ireland and Austria have given concern to regulators that these acquisitions not lead to reduced network investment or increase in consumer prices.

Canada has its own share of consolidation activity in the air, albeit at much smaller scale. Verizon’s potential entry into the Canadian market given recent rules allowing foreign firms to acquire Telcos with less than 10-percent market share, can lead to competitors Wind Mobile and Mobilicity coming under the Verizon umbrella. In the upcoming 700MHz spectrum auction, rules that favour new entrants which allow them to purchase twice as much spectrum at a fraction of the price will be in Verizon’s favour. Furthermore, the Canadian market is still growing. According to a Red Mobile Consulting report for Industry Canada – “Study of Future Demand for Radio Spectrum in Canada 2011-2015,” Canadian subscriptions are expected to grow from approximately 30 million to 35 million by 2015, leading to full market penetration.

Consolidation Now – What’s Next?

As carriers role out their LTE networks, the ability to actively share network assets including the base station, the radio front-ends, antennas can make the deployment of new networks much more economical and practical for carriers. In Canada, Bell and TELUS already share network access as part of a roaming arrangement, in addition to sharing towers and cell sites. Network sharing with LTE can enable carriers to provide access to customers of another carrier on that carrier’s spectrum through a common shared network.

Could Technology Have Helped Contain the Devastating Impact of the Alberta Flood?

Tuesday, July 9th, 2013

By Dawood Khan

Red Mobile Consulting, Toronto, Canada

TORONTO — On June 20th 2013, Alberta, Canada experienced heavy rainfall that initiated catastrophic flooding. The flooding impacted Calgary, High River, and several areas across southern Alberta. Estimates of damage range between $3 billion and $5 billion. Over 100,000 people were evacuated as their homes were damaged or destroyed by vicious currents and flooding. This is the 2nd so called “100-year storm” to hit Alberta within 8 years. Residents and officials reported that the floods came with little or no warning.

On June 27th 2013, a major Canadian Pacific Railway bridge broke down in Calgary, Alberta. Several oil tankers carrying highly flammable content, were left stranded on the bridge. The calamity was due to faulty piers at the bottom of the river. It was the speed of the flood that scoured away the gravel under the support. The support gave way and the tracks buckled under the weight of the train. This occurred despite the fact that the 101 year old bridge had been inspected 18 times since the start of the flooding.

Government officials have claimed that it may take 10 years for Calgary to recover from the event.

Early warnings through the use of smart technologies and investment in intelligent infrastructure can greatly help authorities and communities deal with calamities by preparing for them in advance. Through the use of sensors and wireless connectivity, it is possible to measure rapidly rising water tables, eroding construction materials, and support systems. And to alert or even take pre-emptive measures to minimize the impact of an impending disaster.

While one doesn’t know if the Alberta flood warning would have come soon enough for authorities to fully operationalize a flood emergency plan, but it certainly would have provided some heads up to at least initiate measures such as starting to sandbag the most vulnerable areas, and issue public alerts to provide the public some time to plan ahead of the evacuation.

Certainly, in the case of erosion of materials or support mechanisms for bridges, warnings can be provided to trains, and even pre-emptive measures can be taken automatically to ward off trains from proceeding on the line.

A sizable number of Canadian infrastructure are believed to be over 40 years of age.

By 2027, 50% of Canada’s existing infrastructure will have reached the end of service life

Canada’s new Economic Action Plan proposes to set aside $50B for infrastructure over the next 10 years through funding programs including the Building Canada Fund, Community Improvement Fund, and P3 Canada. As these new infrastructure projects are planned, it is imperative that intelligence be incorporated into them from the very start of the initiative rather than as an after-thought.

Infrastructure is typically designed to last generations, making it even more critical to the advance planning. It is interesting to note how far Information and Communications Technologies (ICT) and services have progressed over the life span of most infrastructure.

Making infrastructure intelligent by incorporating smart technologies and progress in ICT and big data analytics can allow local, provincial, and federal authorities to not only track infrastructure decay, but also enable preventive maintenance when required. This can greatly enhance the useful service life of such infrastructure, reduce cost of repair before it is too late, and avert recurring costs as a result of damage to individuals or property.