mHealth stands for mobile-based or mobile-enhanced health solutions - solutions that are underpinned by the near ubiquity of global wireless networks and mobile devices. A new generation of cellphones, smartphones, or mobile-enabled diagnostic devices are opening up all kinds of opportunities of delivering innovative medical and health services direct to the patient, be they within the local community or remote parts of the globe. But what does mHealth mean  from a commercial perspective? And which competitors will end up dominating this new arena?

The shape of the industry and the key success factors are evolving fast, reflecting the convergence of two very different sectors. One is healthcare delivery, imploding under ever increasing demands on a finite pool of resources and limited capacity. Aging populations will see the proportion of people over 65 in Europe doubling over the next 50 years to make up 30% of the populations (Eurostat data). In addition, there is the epidemic of chronic disease requiring long-term clinical management. The German Advisory Council on the Assessment of Developments in the Health Care System (Sachverständigenrat für die Begutachtung der Entwicklung im Gesundheitswesen) estimates that chronically ill patients could currently account for 75% of healthcare expenditure.

Traditionally, the healthcare industry is conservative, with development occurring over many years in a highly regulated environment. Suddenly that culture is coming into contact with mobile telephony, whose level of innovation and consumer adoption has established new precedents for speed of evolution. Global markets have been created in months and traditional business transformed by new applications, business models and market structures.

What does this mean for the pharmaceutical industry? mHealth evangelists point to new sources of revenue, new marketing channels, better R&D, greater patient safety, more effective R&D and cost savings. One of the challenges is that the mHealth opportunities cut across all the different functions. Often no one company or partner has access to the full range of technologies, skills and insight to realise these opportunities. This often creates a tension between a coordinated strategic approach to investing in mHealth and a more entrepreneurially decentralised approach recognising the breadth of different applications.

Why is mHealth so significant? The capacity and functionality of the mobile telephone is growing each year and provides a platform for a host of applications tailored to the individual user. Mobiles phones are becoming universal, not just in developed countries, but also in emerging countries where there is no alternative than to build a wireless national infrastructure for data and communications. By 2015, some forecasts suggest 1 in 5 people will have a mobile phone – the most universal channel for reaching patients, doctors, nurses and carers alike.

How could mHealth contribute to better R&D?

Mobile phones potentially provide a platform that could help with screening populations as well as patient monitoring during trials. Screening can lead to more homogeneous populations being used, reducing the number of variables in the trial, so that fewer people may be required for investigations. This can reduce the cost of trials as well as the time they take. It also facilitates the move towards more ‘personalised’ research where the patients are screened initially for relevant biomarkers based in their genotype and phenotype. Continuous physiological monitoring can provide many more data points, thus enhancing the sensitivity and specificity of trials, as well as characterising their ‘physiotype’.

A digital audit trail can have fewer entry points than one based on paper. It also allows more data to be collected, providing scope for gaining other forms of feedback from patients and investigators alike. This may create a challenge to analyse such massive amounts of data. It certainly poses challenges for regulators to establish guidelines so that such datasets are seen as an asset rather than a liability requiring extra analysis, diligence and creating uncertainty about what is an appropriate level of monitoring.

mHealth and disease management

M-health applications can also lead to value added applications in disease management, be it through improving compliance, reminding patients of medication or by linking patient monitoring with the calibration of dosages, or even dietary guidance, all of which can lead to better outcomes. Trials applying mHealth to monitor glucose levels of diabetes patients as well as to encourage healthy behaviour have been found to improve significantly the patients’ quality of life in the short term. In the long term, they reduce complications such as heart attacks, strokes, blindness and kidney failure. Trials with Chronic Heart Failure patients have shown how mHealth devices can encourage healthier behaviour and provide early warning of pulmonary oedema which is so often responsible for emergency admissions to hospital. In Chronic Obstructive Pulmonary Disease (COPD), the continuous monitoring of disease related symptoms can enable the patient’s medication to be properly calibrated, thereby reducing acute deterioration of the patient’s condition.

There are cost savings that come from automated digital processing with a single input, be it for patient monitoring, prescription management or inventory control. Finally there is the promise of greater safety through patient monitoring, surveillance of larger populations and patient alerts.

In short, mHealth promises better outcomes for the pharmaceutical industry as the patient benefits from better quality of life, enhanced compliance, longer life and fewer hospitalisations.

For pharma companies the applications are so broad and the potential of the mobile phone as a platform is changing so quickly that is it often difficult to know where to start. Against this backdrop, what should pharma companies be doing? There are three key steps:

1. Familiarise themselves with underlying smart telephone technologies

2. Learn from other industries and see how mobile phone applications have led to new sources of revenue, improved customer services, new business models or cut costs.

3. Adopt an open innovation policy – in such a fast moving field it is not so much about having the idea, but in making it happen – getting it to the market early and then learning from that experience and building on the insights gained.

These steps will be analysed in more detail in forthcoming IBT briefings.

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