Reflecting on the recent GSMA-mHA Mobile Health Summit in Cape Town I was struck by the different views and approaches of various industries when talking about the structure of mHealth systems in the future.

What I found intriguing was that the more established industries such as health insurers and clinical service providers view the effects of mHealth as complementary to their existing services. Meanwhile handset vendors and mobile operators see mHealth as interacting with the end-user over their platforms, so augmenting the user experience of healthcare through their technology.
 
The examples given of mHealth systems at the summit in Cape Town ranged from drug verification services to SMS appointment reminders and health advice services. I liken these examples to process re-engineering, or optimisation, and while good at showing how different approaches to mobile technology can be used to bring about refinements to systems, they are not the radical game changers that really excite the futurist inside me.

Looking at the world of the smartphone and apps in particular it is apparent that there is a change happening within the world of the consumer and what they can now quantify about themselves. The consumer has already embarked on a journey to change their approach to healthcare with access to many more information sources regarding their health. By pushing this information to the consumer rather than the traditional model of the consumer pull of data from their clinicians, the change is already taking place. I hate to think how many GPs are faced daily with comments such as “I looked this up on Wikipedia..”, nevertheless the change in the quantification and education of the consumer has already happened.

Looking from the point of view of the established health insurers and clinicians, the future of mHealth seem to be of one of enhancing the existing system. By providing access to health information through mobile platforms in a timely manner it might be possible to implement incremental improvements to health systems, care pathways, policies, and reimbursement routes.

I see these two perspectives as different forms of innovation. On the part of the consumer you have the potential for what we can term continuous innovation, or the potential for the game-changing concept of putting the point of care into the consumers’ pockets through a variety of means such as new data capture sensors, algorithm, apps and joined-up processing.

On the part of the established industries I see a process of continuous improvement meaning an application of procedures such as 6 Sigma, Lean, JIT, Kanban and all those other good-to-do practices taught by the expensive day-rate consultants. These two strategies should be complementary but in reality often lead to exclusivities being implemented into systems that prevent true integration.

Eric Dishman, Intel’s Director of Health Innovation commented recently that “mHealth is about fundamentally changing the social contract between patients and doctors, it will take time” I think this sums up mHealth perfectly. On the one hand we are delivering changes that empower consumers to take better care of themselves and on the other we are looking at how we can implement small step changes to our existing medical infrastructure.

At the moment i believe that these two strategies are being driven separately from each other, and there is little real integration between them. We are implementing change at each end of the social contract between patients and doctors because we are designing improvements from an already established commercial model and mindset. To really encompass the potential power of mHealth I believe that systems that work both on the consumer’s handset, offering them a personalised benefit, and work in the hospitals of the future will really achieve the promise of mHealth.

The developing economies offer the most promise as they can start from a less cluttered canvas than those of the developed world. It was Einstein who said “You cannot solve a problem with the same thinking that created it”. The real promise of mHealth is coming and it is going to take time but the empowerment of the consumer’s handset will cause a rapid redesign of the primary care pathway which the insurers and hospital providers must be open to, or else the consumers will redesign secondary care as well.

The editorial views expressed in this article are solely those of the author(s) and will not necessarily reflect the views of the GSMA, its Members or Associate Members.