The Journal of mHealth Vol 1 Issue 2 (Apr 2014) | Page 32

Who Put the 'm' in Health?

Who Put the ‘m’
in Health?
By Keith Nurcombe
Keith Nurcombe has worked in healthcare for over twenty years spending the last few years working
with businesses in the health and technology space, most recently building O2 Health where he was
Managing Director until the end of 2012, since when he has been providing consultancy services
to businesses.

mHealth is currently the topic of
much discussion. The problem is
nobody really knows what it is, and
nobody’s defined what it is - everybody’s interpretation is different. So
when you talk about mHealth services people immediately put it into a
box according to their interpretation.
To some it involves electronic health
records, to others it is something you
do on a mobile phone. The problem
I have with this is where do you draw
the line? Does a standalone fitness app
that records how many steps you take
in a day count? How does that differ
from an application that monitors a
serious condition? Others take a wider
view, including anything health related
that isn’t a traditional approach, something other than having an old fashioned face to face conversation with
your doctor, for example a remote
consultation with a doctor over Skype
would be mHealth. It’s all very confusing.
All of the above probably are mHealth
in the widest interpretation, but to me
it’s just health. Take the ‘m’ off the
front. We’re simply delivering health
care in a different way.

THE EVOLUTION OF
HEALTHCARE
The concept of delivering health support to a patient outside of a healthcare setting has gone through a journey. It started with the telephone,
enabling patients to speak to someone
when they had concerns. That took
a step forward and became

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April 2014

telemonitoring, which we now see as
clunky, unfashionable, bespoke pieces
of kit, hard-wired into a monitor
the size of an old school tv. We connected blood pressure monitors but
they were hard wired through USB
and provided very basic information
back to whoever was monitoring you
at other end. This was large, intrusive
equipment for patients and it was also
hugely expensive for health payers,
not just in providing the equipment,
but also managing installation, maintenance, logistics and support.
In the last year or 2 this has started to
move forward and we have seen the
introduction of much slicker, more
manoeuvrable devices - tablets, mobile
phones, laptops - that allow people
to have more flexibility to move. But
these programs have mainly provisioned devices, still require hard wiring in terms of broadband, and as
a result hold similar expense for the
payer.

THE REMOTE CONTROL
TO OUR LIVES
The real win-win for both health payers and for patients as I see it is to
get to a place where you can use the
patient’s own communication, health
and lifestyle devices. Not only is the
patient already familiar with it, payers
are not required to purchase, provision and install the kit, and you scale
back the level of support required.
Initially this means mostly manual
entry of data from external devices,
glucometers, pulse-oximeters etc., but

over time many of these devices will
come with Bluetooth (or the next generation of connectivity).
This will be truly advantageous to the
payer because the upfront system is as
minimal as can be, and will bring huge
benefit to patients because they can
be being monitored and supported,
but don’t have to have extra devices.
I find this personally if have a work
phone and my own phone – charge
2 phones, bring them with me – it’s
just a matter of time before I forget
one, or it becomes a hassle. Someone
said to me recently the mobile phone
is becoming the remote control to our
lives – but you want that on a single
device, how did we live before the universal remote!
mHealth solutions deployed on
patients own devices empower them
to better understand and to make
more informed decisions about their
conditions in a light and easy way,
removing the need for costly provisioning and expensive set ups.
I believe this model will bring phenomenal results for payers, but the
benefit is only going to be seen if
these solutions have low entry costs,
and more importantly, the patient
actually uses them – if the patient
does not use them there will never be
a return on investment (RoI).

ARE PATIENTS READY?
There is a big misnomer being bandied around, that patients do not
want to or cannot use technology.