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The Scarce Insights Blog

Original Perspectives on Mobile Health and Innovation


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2 May
2016

Harnessing the Internet of Healthy Things


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  • Healthcare
  • Innovation
  • Internet Of Healthy Things
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Today, everything and everyone is connected. Experts predict that by 2020, 26 billion everyday objects will be able to capture, receive and share data via a vast, interconnected global network linked together by inexpensive sensors, GPS and the cloud. Soon, real-time biometric data will be automatically captured and used to learn more about the impact of lifestyle on disease and wellness, and ultimately change behavior for the better.

2 May
2016

The Reality about the Prevention of Health Problems


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  • Mobile Health
  • Innovation
  • Strategy
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The role of mobile medical devices covers: (1) The prevention of the need to be treated for a medical problem, (2) To facilitate treatment to occur as early as possible to minimize the severity of the medical problem, (3) To provide personal health information collected over extended periods to enhance diagnostic capabilities, (4) To provide healthcare information about patients to their advocates or loved ones to help them participate in healthcare options, (5) To enhance the safety and efficiency of clinical trials. There is of course also a major role for M-Health to be actively used inside of various care settings such as Hospitals or Long Term Care Facilities etc., but we will blog about this at a later date. Make no mistake, an M-Health solution is a medical device - just ask the FDA. As an industry we are a long way from preventing most of the population from needing to interact with a clinician when it could have been prevented. In this Blog we look at four different categories of M-Health users. The first category is a large proportion of the population who have no known health problem (necessary for clinical intervention), and so the focus with them is to keep them healthly. This has been the primary initial focus of m-Health and generally viewed as part of the fitness industry. For people known to be at risk of developing a chronic disease, then the usage model here is to prevent people from developing a condition by helping them to avoid exasperating events and/or incentivise bevahiors that will prevent onset. The second category is patients who have health problems but do not interact with a clinican despite them needing to do so - they may not even know they need to do so. We will take an example - people who suffer from the disease known as Obesity. The American Medical Association voted to make Obesity a Disease in 2013. According to the World Health Organization (WHO), over 600 million people worldwide are Obese. The rate of growth of this disease is also alarmingly high, a growth of 50% since 1980. There is an enormous play for M-Health in preventing people from becoming Obese let alone the potential to reduce the prevelance of this deadly disease. The third cateogory puts us in the realm of people who know they have a chronic disease and have been involved in a clinical intervention. The role of prevention here is to ensure that the patient's treatment plan is followed in order to stop or slow whe onset of the disease - a compliance play - and/or ensure that essential clinical intervention happens in a timely fashion in order to prevent a worsening condition. The fourth and final category we look at is people who have been admitted to hosptital for a clinical intervention and have been discharged. The goal here is to prevent the patient from having to be readmitted within a period of time. In this Blog Scarce Insights looks at the reality of the focus of Prevention in healthcare systems. We find that the lack of focus on Prevention has an astronomical cost and by spending just a fraction of this cost on using M-Health in the prevention role makes clear economic sense for all payers, and would dramatically raise the quality of life for millions of people.

12 Apr
2016

Mobile Health in 2016. Current Landscape and How it's Changing.


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  • Mobile Health
  • Innovation
  • Strategy
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The world of Mobile Health has evolved over several years now, and has seen great successes and miserable failures. As we enter the second quarter of 2016 we have decided to take a close look at the current m-Health landscape. We will identify the existing and emerging players, and map their solutions across a broad segmentation of the market. Our approach to segmenting the market may provide some surprises to some, but demonstrates our multi-dimensional approach that has proven extremely successful in other parts of the healthcare market. In addition to identifying the major and emerging solutions in the market, we also provide a heatmap providing our views on where the highest growth and highest performing parts of the market lie - this includes performance in terms of clinical outcomes, cost effectiveness, rate of adoption, ability to increase the access to healthcare. Our stance has been that a mega solution will dominate in a new era of digital healthcare. We show how m-Health, combined with key capabilities in other critical healthcare segments offer unprecendented opportunities.

6 Apr
2016

The Rise of Diabetes and the Role of Mobile Health


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  • Mobile Health
  • Innovation
  • Strategy
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The World Health Organization (WHO) has just released a new report on Global Diabetes - Global Report on Diabetes (April 2016). We see an increase in Diabetes from 108 million people in 1980 to 422 million in 2014. Even with the growth in population during this period, we see a major increase in the prevalence of Diabetes. This is especially true of Type 2 Diabetes which is responsible for a major impact on lifestyle. Diabetes is responsible for 1.5 million deaths per year, making it the 8th biggest killer. In this blog we take a close look at the findings in this WHO report, and look at ways Mobile Health can have a major impact on the prevention of Diabetes, and also how it can dramatically reduce the costs of Diabetes, and the number of deaths from those who suffer from Diabetes given the unerlying economics and prevailing politics. We look at how we need to innovate with mobile sensors. We also look at how we can innovate in the world of mobile health apps. One of the things we do is to match the prevalence of mobile phones and access to data services with the the prevelances of the disease. Thus we look at the global market for mobile health apps and the business models needed to align the economics with social needs and demands to control and prevent the disease.

2 Apr
2016

Segmenting the Mobile Health Market


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  • Mobile Health
  • Innovation
  • Strategy
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Getting your market segmentation right is critically important. Your competitive strategic planning is done by segment, and your competitive landscape may look very different across different segments. When you size the market you are after, the scoping is driven by the segment in which you plan to take share. When it comes to M-Health, there are multiple dimensions to consider when you segment the market. The M-Health segment itself is part of a larger healthcare market that consists of segments such as Telehealth, Telecare, Analytics, etc. Segments at the same level as M-Health are important to know since you will often find effective collaboration strategies extend into adjacent segments. M-Health itself may be broken down into Apps and Wearables. Underneath these we may find common segments that separate Professional Healthcare (Strong Privacy) from Self Managed Healthcare (Standard Privacy). Depending on where you are within these segments, it is also very useful to separate High Confidence Data from Low Confidence Data applications. These are the types of considerations that define the particular market segment you are after. But there are more dimensions. A useful segmentation dimension to use is Disease State. Depending on which Disease States you go after, you will need to bring solutions with particular capabilities to market. In this blog we take a look at how to segment the M-Health Market and also where critical strategic partnerships may exist across adjacent segments in order to gain a strategic advantage. We also explore some differentiation strategies, driven by segmentation decisions.

31 Mar
2016

The 2020 New Mobile Health Business Model


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  • Mobile Health
  • Innovation
  • Strategy
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The size of the global M-Health market, by the end of 2020, is projected to be anything from $30bn to $50bn. Our view is that we will hit the elbow of an exponential growth path in 2018. Between now and then we will see steady growth of CAGR ~11-25%, but adoption will remain limited and centered around a fitness based theme. We will start to see dramatic growth once solutions move beyond offering nice to have information, into the realm of becoming an essential part of delivering professional healthcare. We believe that two key innovation areas will be the catalyst for this change: A new generation of mobile medical sensors, and, A new generation of mobile health apps that drive dramatic improvements in patient compliance. The effects of broad adoption of M-Health will be: Obsolescence of Spot Health Checks (replaced by trend diagnostic informatiion), Dramatically Higher Patient Compliance to Treatment Plans, and the Clarification of the Value of Preventing Health Problems. When new medical sensors, combined with intelligent patient health analytics, completely displace the need for Physical Assessments, the disruption will be enormous and M-Health will be at the center of a new era of Digital Healthcare. The wide spread adoption of Provider Prescribed M-Health will also open up the world of Validating the Efficacy of Treatment Plans, and moreover, the creation of data rich health outcome / evidence based information tied to populations (e.g. by disease state and demographics) on a very large scale. These changes will drive the need for a New M-Health Business Model. There will be an enormous focus on Professional Services to Design, Implement and Monitor solutions. There will also be a new Big Data Analytics Market driven by an unprecedented new set of health data. In this blog we disucss a New M-Health Business Model and how innovators today can position themselves to take a dominant position.

10 Mar
2016

The Regulation of Mobile Health in the age of the New Mobile Medical Sensor


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  • Mobile Health
  • Regulatory
  • Strategy
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The FDA is very clear that it encourages the development of mobile medical apps that improve healthcare and provide consumers and healthcare professionals with valuable health information. It also emphasises that it has a public health responsibility to oversee the safety and effectiveness of medical devices – including mobile medical apps. As M-Health becomes more sophisticated and indeed more useful, we are finding that healthcare apps are relying more and more on the use of a new generation of low-cost mobile health sensors. Scarce Insights gives its perspective on the regulatory implications of a profliferation of more and more sophisticated M-Health applications that have serious consequences for patient safety and wellbeing.

8 Feb
2016

The Economics of Mobile Health


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  • Mobile Health
  • Innovation
  • Strategy
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Numerous healthcare economic systems have a certain notoriety of driving behaviors that are counter productive from multiple perspectives. Although a gross simplifiaction, when a clinician is paid based on the number of sick patients they treat, then they are not well incentivised to reduce the number of sick patients they need to see. Of course, as with many ecosystems such as financial markets, the issue of capacity distorts how things operate. One of the underlying principles of M-Health is the early identification of health problems, and this inherently means a focus on prevention from needing to see a clinician in person. The prevailing way that a clinician is paid is by the "face time" they have with patients. They also get paid by using their medical equipment to perform diagnostics and treatments. These systems are exasperated by clinicians simply passing on any short-fall to their own overhead driven expectation of levels of payment they should receive by the patient's private health insurance (who pay an amount for a service delivered that they consider reasonable and customary) to the patient who thought their private health insurance was covering their medical costs. There has also been a lot of focus on new delivery models where a healthcare provider has a capitated budget that if managed well to deliver well against a defined set of adjusted clinical outcome goals, then they can make more money by actually being more effective with managing and treating their patient population as opposed to simply seeing patients and using their equipment on them. Conversely, they can make less money if their practices are less efficient, and this draws criticism of quality of care being compromised for economic gain by gaming an imperfect performance measurement system. Some of the tried and tested Healthcare Economic Systems that attempt to align incentives and rewards with evidence based medicine that enhance clinical outcomes while controlling costs are discussed in this recent article from Scarce Insights. In this blog we take a close look at how the adoption of M-Health (given its underlying principles) will need to overcome current behaviors - driven by payer economics, capacity issues, incentive and reward systems, peformance measurement and legalities - in order to succeed. The article also takes an interesting look at how trade-off's are made in the UK's National Health Service in order to manage treatment costs in a single payer system while attempting to maximize benefits to patient populations as a whole where limited resources must drive difficult decisions to be made.

13 Jan
2016

Core Competencies for a Healthcare Innovation Start-Up


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  • Mobile Health
  • Innovation
  • Strategy
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While there are a number of competencies that start-up’s need access to (e.g. accounting) they do not need to strive to be far better than their competition in these areas. Whereas for some competencies (e.g. an M-Health start-up with Mobile App Usability) being better than your competition may be essential. However, there is one step more to understand about core competencies. This is that they must also be difficult to replicate. If it is easy for competitors to acquire your core competencies, then you have no advantage. Hiring an App Usability Expert who designs a great UI for you may not very difficult to replicate. However, if you build a dynamic UI algorithm that optimizes the UI based on an intelligent analysis of, say usage patterns by disease state, then this may be very difficult to replicate. Building core competencies and using them to build assets that the competition cannot easily copy is critical for an innovation start-up. This blog explores how an M-Health start-up may go about defining its core competencies.

03 Dec
2015

Directions in Mobile Health Sensor Technology


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  • Mobile Health
  • Innovation
  • Strategy
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The directions we are seeing health sensor technology take are driven by three primary factors: Economic Pressures, Technology Trends and the Demand for the Personalization of medicine. We take a look at state-of-the-art and emerging mobile medical sensor technology. We examine how mobile healthcare will drive the next generation of mobile medical sensors and then move towards sensors simply merging into the background of life (or Internet of Things), as opposed to the current trend of wearables. This trajectory aligns with the need for lower costs and better clinical outcomes, and specifically how patient compliance issues may be addressed by sensor design in addition to things such as taptic notification and smart reminders.

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