Business Models of mHealth


     PriceWaterhouse Coopers’ Health Research Institute released a comprehensive report describing business models and opportunities for the mobile health industry.

The majority (57%) of American adults used a laptop or mobile phone to access the Internet in a 2010 poll.  78% of these people searched for Internet-based health information, versus 79% of those only using a desktop PC and 59% of all American adults.

The first model is the operational/business model in which providers see mHealth as more efficient and beneficial to the patient.  One-third of physicians according to the study, make decisions based on incomplete information and that mHealth by providing more robust and timely information from the patient or device can result in better care. Forty percent of physicians stated that they can eliminate up to 30% of office visits with information provided by mHealth technology. 56% of physicians said it would expedite decision-making. 39% said it would decrease time to perform administrative tasks. 36% estimated that it would increase colleague collaboration, 29% believe it would allow more time to spend with patients, and 24% it would not affect their day-to-day work.  Interestingly, physicians surveyed related that lack of leadership support, privacy/security issues, and reimbursement are seen as the major roadblocks to adoption of mHealth.

The second model is what is described as the consumer products and services model.   This model is consumer focused and driven.  50% of those surveyed would utilize mobile health technology. 20% of people surveyed say they would use it to monitor fitness or wellbeing and 18% want their doctors to monitor their health conditions via the technology.

The third model is the Infrastructure business model aimed at connecting and increasing speed of health information and services, dovetailing with the operational business model. Aspects of this model include interoperability with EHRs, security issues, and addressing the decreasing bandwidth concern.

The report emphasizes the market and needs of mobile health but the lack of business models to support the technology that will address both acute and chronic health problems as well as preventive health. The Health Research Institute \estimates the annual consumer market for remote/mobile monitoring devices to be $7.7 billion to $43 billion, based on the varying amounts that surveyed people would be willing to pay for subscriptions and possibly mobile devices (less than $10/month and $75 respectively).

Interestingly the report goes on to say that preliminary mHealth studies show that provider revenue decreases with the use of mHealth and sites a few studies.  Cost-efficient healthcare is certainly one of the goals of mHealth, however, in the current system of fee-for service or rewarding treatment of existing diseases per encounter or procedure, and not the patient’s outcome, there exists a financial conflict of interest for providers to adopt mHealth.  The advent of outcomes-based reimbursement would be a huge boost for mHealth technology. Insomuch as ACOs are not gaining large footholds in the near future, this push for reimbursement might suffer. It has, however, been addressed nicely by CMS in the past with implanted cardiac rhythm device remote monitoring and follow-up.

The majority of physicians polled (88%) would like to track/monitor their patients at via remote monitoring.  Of interest is the both consumers and physicians responded with weight being the most desired parameter to follow.  This has profound implications.  It shows that both consider obesity to be the number one priority in healthcare.  It shows that consumers may be more motivated to lose weight than previously thought.  It is also important because obesity spawns other chronic illnesses such as diabetes, high blood pressure, sleep apnea, chronic lung disease, and heart disease.  It is also easy to track remotely and can be easily done with technology available today.

Payers realize the value of mHealth. Companies like Kaiser-Permanente state they are aware of the importance of people’s mobility and their desire for independence. Michael Mathias, Aetna’s chief technology officer sums up the mission of mHealth well. “The days of mass communication are over. We can now deliver customized communications through mobile apps, online, telephonically, or through the mail based on our understanding of how each member wants to be communicated with.”  This tells us two things: That payers already value mHealth, and that they are ready to pay for it.  We must deliver quality technology that makes it worth their while to pay for.

The entire study may be viewed at (need to register to obtain):

http://pwchealth.com/cgi-local/hregister.cgi?link=reg/healthcare-unwired.pdf

About davidleescher

David Lee Scher, MD is Founder and Director at DLS HEALTHCARE CONSULTING, LLC, which specializes in advising digital health technology companies, their partners, investors, and clients. As a cardiac electrophysiologist and pioneer adopter of remote patient monitoring, he understood early on the challenges that the culture and landscape of healthcare present to the development and adoption of digital technologies. He is a well-respected thought leader in mobile and other digital health technologies. Scher lectures worldwide on relevant industry topics including the role of tech in Pharma, patient advocacy, standards for development and adoption, and impact on patients and healthcare systems from clinical, risk management, operational and marketing standpoints. He is a Clinical Associate Professor of Medicine at Penn State College of Medicine.
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