The Journal of mHealth Vol 1 Issue 3 (June 2014) | Page 36

Can We Really Deploy mHealth at Scale?

Can We Really Deploy
mHealth at Scale?
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 then he has been providing consultancy services to businesses.
This is a question that gets asked a lot
and asked of most companies either
delivering in the mhealth space or looking to provide services for consumers,
patients or healthcare professionals. I
don’t believe it is the right question, I
think there are far more pertinent ones
for investors or those who procure these
services for their patients to be asking.
Such as talk to me about the quality of
your products and the systems you have
in place, show me how they work for
my patients and users or what is it that
you are developing that could help me
change the way I work and deliver care
to my patients.
I think the answer to the question is a
very firm YES and YES in both cases.
It is delivering and there are good examples of where and how that delivery is
changing the way care is delivered. One
of the best examples is the Whole System Demonstrator in the UK, which
delivered really significant results in hospital admissions and mortality rates for
patients.
Can it be deployed and be effective at
scale, there are good examples of where

this has happened and the US Department of Veterans Affairs is the best
example currently of scaled deployment
in the USA which has delivered excellent
results.
Are there issues that we as an industry
face – yes and some of these are harder
to get past than others.
Technological issues – sometimes we
struggle to get the technology to do
what we want it to reliably and certainly
we have to make sure that the users and
the procurers of the service really understand what we are providing and equally
what the technology can't do!
Regulatory issues – the differences
between the US (FDA) and the European Bodies (EMA and the EU) are creating obvious strains for organisations
that want to provide services in both
markets. We need to get uniformity of
agreement on what is a medical device,
what software is a medical device and
equally importantly which isn’t analysing and therefore doesn’t need to be
classed as a medical device. Currently
that interpretation is mainly made by
organisations and developers themselves

and that will lead to procurers becoming
confused and concerned about potential
safety.
Acceptance and uptake – is very mixed
in the market currently with a number
of countries making steady progress
forward with the adoption of technology and solutions but this is very varied
across Europe and within the US as well.
For me the positive acceptance seems to
be in two key areas:
1. Strong uptake and understanding
of managing patients at home, remotely
and using technology to provide this
solution.
2. Usin