MOBILE HEALTHCARE TECHNOLOGY TRENDS AND INNOVATIONS

MOBILE HEALTHCARE
TECHNOLOGY TRENDS
AND INNOVATIONS
Written by: mPulse
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MOBILE HEALTHCARE (mHEALTH) OVERVIEW
Mobile healthcare, or mHealth, can be broadly defined as the “delivery of healthcare
services via mobile communication devices.” More specifically, mHealth refers to
the delivery, facilitation and communication of health-related information via mobile
telecommunication and multimedia technologies – including cell phones, tablet
devices, PDAs and wireless infrastructure in general.
While the concept of eHealth, or electronic-based healthcare services, is closely
related to mHealth by definition, “eHealth” can largely be viewed as the technology
that supports the functions and delivery of healthcare, while mHealth rests largely
on providing healthcare access. For example, a project labeled “mHealth” that uses
mobile devices to access data on HIV/AIDS information would require an eHealth
system to manage, store, and assess the data. Thus, “eHealth” projects many times
operate as the backbone of mHealth projects.
CURRENT STATE OF THE INDUSTRY
During the past decade, there’s been significant investment and development
in the areas of mHealth, with most of it being centered on early-stage initiatives
geared exclusively toward early-adopters, forward-thinking hospitals and tech-
savvy physicians. Recently, however, technology and attitudes on both the
business management and provider sides have seen a major shift, making mHealth
approachable to a much broader audience – including a wide range of physicians,
nurses, patients, payers, healthcare administrators and consumers.
In addition, several recent developments have turned eyes towards the benefits and
possible applications of mHealth technology, including federal stimulus money being
poured into areas like electronic medical records (EMRs). Another primary force driving
interest towards the idea of mobile healthcare has been several large natural disasters
that have brought mobile to the forefront in terms of SMS-based donations and real-

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time global communication about the events via smartphones and other mobile
technology and infrastructure. Finally, the major push for healthcare reform has driven
interest in the streamlining, cost-savings and betterment of the healthcare industry as
a whole. In general, mobile is increasingly being looked upon to solve many of these
issues and more.
At present, there are four key areas driving the pace of adoption and the direction of
the mobile healthcare industry, including:
• Innovation in mobile technology
• The overall development and adoption of healthcare technology in general
• End-user interest and adoption
• The structural/regulatory barriers that already exist in the healthcare industry such as
reimbursement, HIPAA compliance, various privacy implications and many others.
In terms of mobile technology evolution, we’re now at a point where devices have
reached a price-point that make them available across a wide spectrum of users. In the
past, smartphones capable of facilitating new-age mobile healthcare applications were
costly and therefore unattainable by most average consumers. Today, smartphone
adoption has increased dramatically and made mobile healthcare accessible to nearly
everyone. In addition, feature phones are becoming more powerful and the mobile
Web is emerging as the primary channel to receive and disseminate information.
Together with SMS, the mobile Web is a technology available to nearly every
consumer in today’s mobile landscape.
A primary driver of mobile healthcare is the continued evolution of eHealth, or
electronic healthcare. The continued development and adoption of electronic
processes and delivery of health information across the entire ecosystem is vital to
mHealth and its future success, both on the consumer side and the physician side.
A prime example of this is electronic medical records (EMRs), which enable the easy
communication of patient data between different healthcare professionals.
On the consumer side of things, end-user adoption is vital to the future of mHealth as
this is where the benefits will have the greatest impact. The debate remains, however,
as to what delivery method will prevail. Consumer interest is growing in a big way

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as well, though it mainly lies with early-adopters and the younger demographic.
According to a recently released mobile health report by the Pew Internet and
American Life Project, 15 percent of 18- to 29- year olds had a mobile health app on
their phone compared to 8 percent of 30- to 49-yearolds, 6 percent of 50- to 64-year-
olds, and 5 percent of people 65-years-old and older. Like most new technologies,
younger people drive adoption in the beginning, followed by the older generation as
the timeline progresses.
Structural and regulatory barriers that continue to exist in the healthcare industry play
a pivotal role in the evolution of mHealth as well, with things like HIPAA compliance,
reimbursement questions and many others affecting the speed of adoption. Long-
term growth and market potential depend on broader evolution and reform of US
healthcare structure, including things like performance-based measurement models.
Most importantly, the healthcare industry’s tardiness to adopt new technologies and
lack of a historically proven ROI to providers will prove to be the most substantial
barriers to growth.
The advent of mHealth in the U.S. is a reminder of the obstacles companies face when
Impact of New Smartphone App Market Model on mHealth
My PCP/doctor is a middleman that delays me from
getting the medical treatment I need.
My PCP/doctor is a trusted advisor for general health,
information and treatment.
0% 20% 40% 60% 80% 100%

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dealing with the most regulated healthcare industry in the World. mHealth has been
deployed for the past decade in developing (India, Eastern Asia and Africa, et al.),
and developed (U.K., Australia, Western Europe, et al.) countries, with overwhelmingly
successful results. Many of these deployments were the concerted efforts of private
companies and government/public entities. The outcomes of these foreign initiatives
serve as a template for U.S. deployment by many mHealth constituents.
As the mHealth market enters the next phase, it is becoming more and more apparent
that the workflows, processes and datasets that are unique to healthcare are essential
in order to evolve wireless technology. Wireless and mobile delivery is not only
redefining healthcare, but is streamlining its delivery and consumption within various
settings – making it faster, more accurate and cost effective.

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CURRENT MARKET PLAYS
At present, market plays in the field of mobile health have only begun to surface.
Things like SMS-based appointment reminders and prescription reminders, in addition
to basic fitness and wellness applications
are just now coming into everyday use
for some providers. More advanced
concepts like remote monitoring and real-
time communication between patient and
physician are just starting to emerge.
Rather than focusing on what’s currently
being done, it’s more important to focus on
what’s not being done, which encompasses a wide array of concepts that are hindered
by inherent challenges. A prime example of which is secure mobile communications
via SMS and other forms of messaging.
The complexities associated with secure communication have turned many providers
away from developing solid solutions. Finding a middle ground between secure
communication that meets compliance regulations and a simple user experience that
will enable wide adoption by the end-user is a daunting task. Though innovation in
these areas exists, it’s at a relatively slow pace because of the inherent obstacles.

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KEY AREAS OF THE mHEALTH MARKET
There are currently eight broad areas of the mHealth market, including general
monitoring, personal emergency response systems (PERS), telemedicine, mobile
medical equipment, RFID tracking, health and fitness software, mobile messaging and
electronic medical records. Each area represents opportunities and challenges for the
road ahead.
General Monitoring
Mobile health monitoring is a very broad category with massive opportunity and
promise on both the patient and physician sides. Traditional health monitoring covers
a wide variety of issues, from glucose monitoring – a market worth over $8.9B in 2009
– to blood pressure and other traditional health-issue monitoring.
The bulk of current mHealth-related monitoring solutions involve clinical-grade
solutions, meaning one needs a prescription to take advantage. In the future, as the
infrastructure and mobile technology in general evolve, we’ll begin to see remote
monitoring via mobile
start to cover nearly every
medical condition and
transmit real time data
back to one’s physician for
instant analysis.
An early example of this
is a solution forward-
thinking providers are creating, which monitors and transmits real-time beat-by-beat
data to central monitoring locations. It works by leveraging a wireless connection to
a landline-connected cradle when in home and a cellular data network when mobile.

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Another example is the introduction of bio-metric remote monitoring solutions via
devices that take the form of arm bands or other devices that are easily wearable
for consumers. Utilizing bio-metric feedback involves leveraging low-power RF
connections to base stations that can be connected directly to smartphones.
Looking even further down the evolutionary road, digestible pills are being created
with embeddable wireless sensors and transmitters and even pill-box compliance
monitoring. Imagine a simple pill you can take that would automatically monitor several
aspects of your health, or even be tailored to monitor specific health conditions in
real time without any intervention on your part. This is the future of mobile health
monitoring.
While the opportunities are plentiful and the advantages are obvious, there are
still several limitations and barriers that persist including modularization and the
standardization of interfaces -- such as a standard sensor interface to interact with
multiple potential end devices. Overcoming these will be critical to drive growth
and acceptance across the health industry. In the long-run, wholesale (or other
collaboration) with mobile network operators will be required to bring real-time data
synching and facilitate centralized analytics.
Personal Emergency Response Systems (PERS)
The ideas of personal emergency response systems (PERS) have been around
a long-time, but have stayed relatively simple from their inceptions until today. A
company called “Lifeline” pioneered the concept in 1974 (you know you remember the
commercials; “Help, I’ve fallen and I can’t get up”), and the technology and capabilities
haven’t evolved significantly since. Initially, the concept involved PERS devices that
wirelessly connect to landline-connected cradles via traditional cordless-phone
technology. Call centers stand by to offer emergency service support, such as calling
911 in the event of user alert.
As the concept evolves, additional functionality and connectivity is being added such
as realtime location-tracking, fall-monitoring and basic bio-metric monitoring functions.
As the idea of internet-connected PERS devices proliferates, all the functionality

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that comes with having an always-on data connection becomes a reality. Again, the
evolution of mobile technology in general and wireless-data infrastructure are the
primary drivers. Instead of the traditional standalone devices that people wear, mobile
phones already have the capability to do the same thing and much more via mobile
applications.
Telemedicine
The concept of telemedicine can be defined as transferring medical information
through interactive audiovisual media for the purpose of consulting, and sometimes
for remote medical procedures or examinations. While this is a broad definition, it
can be as simple as two medical professionals discussing a case over the phone
or something as complex as using satellite technology and video-conferencing
equipment to conduct a real-time consultation between a patient medical specialists
in multiple countries. In its simplest
form, telemedicine is the practice of
using communication and information
technology for the delivery of clinical
care.
There are three main categories of
telemedicine: store-and-forward,
remote monitoring, and interactive
services. The first refers to acquiring
medical data such as medical images, biosignals, etc. and then transmitting the data
back to a physician or medical specialist at a convenient time for assessment in an
offline environment. Remote monitoring is another form of telemedicine that follows
the same principles explained above. Interactive telemedicine services provide real-
time interactions between patient and provider and include phone conversations,
online communication and home visits. As such, many activities such as history review,
physical examination, psychiatric evaluations and ophthalmology assessments can
be conducted comparably to those done in traditional face-to-face visits. In addition,
“clinician-interactive” telemedicine services may be less costly than in-person clinical
visits.

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The idea of telemedicine is inherently mobile, thus the evolution in mobile technology
in general will have a continued and profound effect on it. Handsets already have
digital cameras for potential mobile imaging solutions, for example, and they’ll
only continue to improve over time. In addition, the creation of 4G networks and
potential 2-way video capabilities built into handsets could expand options for remote
consultations across both wired and wireless networks.
Mobile Medical Equipment
Mobile medical devices encompass a wide range of equipment and already represent
a market valued in excess of $10 billion. There are two primary areas where the
advantages are multiplied. These include the use of devices in rural areas where the
availability of things like advanced diagnostic equipment is relatively lower, in addition
to use in hospitals where it’s viewed as a means to improve efficiency and overall care.
Long-term, the market is poised for mobile medical devices to become core primary
care physician (PCP) diagnostic tools in hospital settings much in the way every doctor
has a stethoscope.
Looking forward, as wireless infrastructure via cellular data networks and Wi-Fi
continue to evolve, these devices will see their usefulness and adoption multiplied
significantly. The advantages in terms of efficiency, real-time data transfer and storage
and the computerization/ automation of diagnostics will help the market for mobile
medical devices explode.
There’s also a degree of convergence occurring within the traditional healthcare
sector as incumbent healthcare providers continue to build their core IT infrastructure.
Pressure from small “nextgen” healthcare providers will create a struggle to open
up the last mile of the healthcare network similar to the battle between small
ISPs and incumbent Telcos during the late 1990s for access to the last mile of the
telecommunications network. This time, however, the key weapon will be mobile
rather than fixed line communications technology.

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RFID Tracking
RFID or “radio-frequency identification” is a technology that’s quickly affecting
industries of all shapes and sizes. The technology effectively digitizes asset
management and the organization of nearly anything for that matter. The technology
uses communication via electromagnetic waves to exchange data between a terminal
and an object – whether it’s a product, a physical file, device or even a person -- for
the purpose of identification and tracking.
RFID in terms of mHealth, also known as “real-time location systems (RTLS),” is still
very much in its infancy. Adoption of RTLS by U.S. healthcare providers is expected to
grow at a steady, but significant pace over the next five years, but according to recent
research, adoption of RFID is limited with only 5% of hospitals having adopted the
technology for widespread usage. Many hospitals cite the lack of understanding of
solutions as a key barrier, particularly of the benefits over and above current barcode
based non-real time inventory/sample tracking systems.
Overall adoption not only in the use of RFID, but in its use on a wide variety of medical-
related items is expected to rise substantially as costs decline and understanding
improves. As more and more mobile medical devices emerge and get smaller and
smaller, RFID-based management will play a pivotal role in asset management and
overall organization and infrastructure.
Health & Fitness Software
As smartphones have evolved and mobile applications continue to proliferate, health
and fitness software has emerged as an early indicator to how popular mHealth will
become in general. With mobile application software, they can act either as a health
care/medical device (either standalone or with specialty peripheral devices) or as a
gateway to personal health records (PHR), for example.

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Medical/healthcare apps currently account for 3-4% of all app store sales, with growth
being significant as the medical category was the third fastest growing category of
applications.
Type and capabilities of applications continues to expand as well. For instance,
Apple’s iOS software now allows application developers to sync medical devices such
as glucose monitors to the phone via Bluetooth or USB. Synching with consumer-
oriented devices such as smart weight scales or heart rate monitors is also an option
supported by new-age devices and software.
Even the most basic health and fitness software can prove beneficial from both a
wellness and cost-savings standpoint. For example, a solution from Nike places a small
sensor in your shoes and relays jogging data to a mobile application on your phone.
Impact of New Smartphone App Market Model on mHealth
Category Main Barriers Changes Impact
in the old mHealth market model related to the new smartphone app
market model
Device • Need for specialized devices to run • Key mHealth features are built in (GPS, sensors)
services • High penetration expected
• Very low penetration of capable • New opportunities through tablet devices
devices
Distribution • Lack of business incentives for • Possibility to market direct consumer/patient
traditional channels and professionals.
• Lack of reach: MNSs only provided • Global reach via application stores
local reach
Patients/ • In transparent markets to search for • Increased awareness
Doctors mHealth solutions. • Massive improvement of user experience from
• Little awareness discovery to usage
• Missing technology readiness in • Massive reduction of price level for mHealth
target groups applications and smartphones
Regulation •Little refunding as only few solutions • Awareness changed due to the application
were accepted by national regulation hype but still no major change in regulation
policies visible
High
Medium
Medium
Low

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The concept is simple, yet it promotes overall fitness and the idea of self regulated
health monitoring without the normal clinician intervention. This, in turn, saves costs.
Healthcare provider Humana has innovated considerably in terms of mobile health
software, applications and otherwise that show the power of unique mHealth
implementations. An excellent example of which is in relation to pediatric healthcare,
where Humana has created a solution known as “DIDGET,” which is an FDA-approved
blood-glucose monitoring system that explores how video games can help spur
healthy habits in children.
DIDGET plugs into
Nintendo DS or Nintendo
DS Lite systems and
awards points to users
for testing their glucose
levels. Points are used to
unlock new game levels
and buy items inside the
game. To date, DIDGET users have improved their self-care and reduced diabetes-
related urgent and emergency-care visits by 77 percent.
Another example from Humana is the development of a specialized in-home scale for
chronic heart patients to connect with physicians in real-time. Patients can step on the
scale at home and deliver live data, such as weight, blood pressure and blood-glucose
levels, directly to their primary care physician. This technology will enable physicians
to spot trends in patients’ conditions and, potentially, treat at-risk situations before
they become emergencies.
Secure Mobile Messaging
SMS and mobile messaging is a primary driver of the mHealth segment much like it
is in other areas of the mobile ecosystem. Its reach and inherent ubiquity provide a
perfect starting off point to introduce mHealth services and applications to consumers
in a way they’re already comfortable with. Introducing the technology in a medical
capacity, however, presents numerous challenges and barriers in terms of security,

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privacy and HIPAA compliance. Effectively and efficiently introducing the concept of
secured mobile messaging is looked upon to provide the same benefits of standard
two-way communication via SMS, while maintaining a secured and compliant
connection at all times.
The concept of secured mobile messaging is easier said than done, however,
which is why most mHealth solutions that utilize mobile messaging focus on basic
communication like appointment and prescription reminders via SMS. Finding a way to
secure this communication opens up numerous additional possibilities. At present, a
clinic can send an SMS notification to an opted-in user saying something like, “Your lab
results are ready,” which provides a convenience for the consumer but still limits the
advantages. Upon receiving the message, the consumer would still need to call or visit
the clinic to receive the full results of their lab testing.
With secured mobile messaging, that same SMS could read: “Your lab results are
ready, visit this secured link to see your results.” SMS can act as the gateway to a
secured, direct connection to your healthcare provider to send and receive health
information in real-time with little intervention on both the consumer and clinician side.
Through the integration of secured mobile landing pages and SMS, numerous layers
of security and privacy-consent can exist, which in turn satisfies many compliance,
privacy and security concerns.
An excellent example of the power of mobile messaging in relation to healthcare is
a recent pilot program facilitated by mPulse for Kaiser Permanente. Facing heavy
communication infrastructure costs, Kaiser was seeking a solution that would reduce
costs while allotting the increased fiscal budget to the delivery of health care and
professional stafﬁng instead. To achieve this goal, mPulse designed an end-user SMS
solution that allowed for the creation and delivery of general appointment reminders,
specific treatment reminders and specific notification of completed lab results to
patients.
At the end of the one month pilot program, the solution showed an improvement of
0.73 percent fewer “no-shows” for appointments, which equated to 1,837 fewer “no-
shows” in total. In the end, Kaiser was able to contain communication infrastructure

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costs at a staggering rate, with Kaiser saving $150 per appointment (their no-show
cost) which equaled a total cost savings of over $275,000 at just a single clinic. While
this is just one of many usecases for SMS and mobile communication in general in the
healthcare field, just imagine the possibility if secured mobile messaging was a viable
option.
Presently, there’s a lot of innovation happening in terms of secured mobile messaging
and it’s looked upon to solve many issues related to advanced mHealth solutions.
Once a solid, standardized and secured mobile messaging ecosystem emerges, it will
act as a foundation and building block to many innovative solutions in the future, many
of which are largely unrealized at this point.
Electronic Medical Records (EMRs)
Electronic medical records, or “EMRs,” were an early product of the eHealth
movement, with the benefits multiplied as mobile has been introduced into the
equation. Though the benefits are apparent, the healthcare industry has been slow to
adopt the concept of widely-used EMRs. Even though EMR systems with computerized
provider order entry (CPOE) have existed for more than 30 years, fewer than 10
percent of hospitals as of 2010 have a fully integrated system.
Relevant to EMR/PHR, a clear indicator of how far U.S. healthcare institutions must
go to modernize their operations is conveyed in a survey in the April 16, 2009 issue
of the New England Journal of Medicine, which found that only 1.5% of the U.S.
hospitals have a comprehensive electronic records system (i.e., present in all clinical
units) in place, and just 7.6% have a basic system (i.e. present in at least one clinical
unit). Hospitals cited capital requirements and high maintenance costs as the primary
barriers to implementation. Like other areas of mHealth, barriers to EMR usage such
as legality and compliance issues persist. EMRs, like medical records, must be kept
in unaltered form and authenticated by the creator. Under data protection legislation,
responsibility for patient records (irrespective of the form they are kept in) is always
on the creator and custodian of the record, which is usually a healthcare practice or
facility. As such, a major concern is adequate confidentiality of the individual records
being managed electronically.

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According to recent studies, roughly 150 people (from doctors and nurses to
technicians and billing clerks) have access to at least part of a patient’s records during
a hospitalization, and over 600,000 payers, providers and other entities that handle
providers’ billing data have some access. This introduces numerous challenges as well
as plenty of potential for mobile innovation.
Digitizing medical records is seen as a potential early driver in streamlining the
healthcare industry as a whole. As such, it has seen government intervention to
promote the benefits and encourage the healthcare industry in the U.S to move
quickly to adopt EMRs. Because of the many “after entry” benefits to EMRs over
traditional paper-based records, federal and state governments, insurance companies
and other large medical institutions are heavily promoting the adoption of EMRs.
Congress recently included a formula of both incentives – up to $44K per physician
under Medicare or up to $65K over 6 years under Medicaid – as well as penalties
(i.e. decreased Medicare/Medicaid reimbursements for covered patients to doctors
who fail to use EMR’s by 2015) for EMR/EHR adoption versus continued use of paper
records as part of the American Recovery and Reinvestment Act of 2009.
Interoperability of EMRs is another issue
that must be overcome before wide use
of the concept is realized. The ability to
exchange records between different EMR
systems would facilitate the coordination
of healthcare delivery in non-affiliated
healthcare facilities, for example,
improving communication and overall
care for patients. In addition, data from an
electronic system can be used anonymously for statistical reporting in matters such as
quality improvement, resource management and public health communicable disease
surveillance.

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Clinical–Focused Solutions
Introducing mobile technology on the clinical side of healthcare presents benefits
beyond the basic use of mobile devices, such as wireless and implantable robotics,
basic document management, informatics systems and wireless patient monitoring.
As healthcare providers continue to recognize the value propositions afforded by
wireless communications and
hospitals continue to embrace
wireless infrastructures,
innovation will continue to
expand exponentially.
Looking ahead, advanced
solutions such as implanted
wireless sensors and robotics
inside patients, combined
with an always-on mobile
data connection, can open
a wealth of opportunity in terms of real-time care, emergency response and remote
monitoring. Imagine having a health condition that’s monitored and managed remotely
to where your physician can easily know of problems before you do. Care can be
administered in real-time, without the need to schedule appointments or wait until it’s
potentially too late, and much more expensive, to treat effectively.
Innovation on the clinical side, while picking up pace in recent years, is still stifled by
healthcare providers maintaining a wait-and-see attitude to issues regarding payment
for such solutions and resistance to vastly altering the infrastructure that’s already
in place. As legacy systems and processes are increasingly becoming digitized and
modernized out of sheer necessity, advanced mHealth solutions will begin to be
realized on a larger scale.

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Consumer–Focused Solutions
Outside the scope of using mobile devices for the delivery of healthcare, consumer-
focused solutions like Personal Health Records (PHRs) and social health communities
are other examples of how the healthcare industry is fundamentally changing for
the better. The evolution of social communities in terms of healthcare puts personal
wellness more in the hands of the patients themselves, rather than solely relying on
healthcare professionals.
Allowing a patient with a certain disease or health condition to interact and engage
with other patients sharing the same conditions in a social capacity allows the sharing
of ideas, advice and solutions while providing an underlying support system that’s vital
for anyone suffering from a variety of medical conditions. In the same way traditional
social communities bring people together for a collective cause or discussion, social
health communities provide the same personal infrastructure.
Two large-scale examples of current consumer-focused health solutions are Google
Health and Microsoft HealthVault, both of which aim to streamline, digitize and
centralize consumers’ health activities, records and other data.
Google Health is a “personal health information centralization service,” which allows
users to volunteer their health records, either manually or by logging into their
accounts at partnered health services providers, into the Google Health system,
thereby merging potentially separate health records into one centralized Google
Health profile. Volunteered information can include health conditions, medications,
allergies, lab results and many other elements. Once entered, Google Health uses
the information to provide the user with a merged health record, information on
conditions, and possible interactions between drugs, conditions, and allergies among
other things.
Like Google Health, Microsoft launched a similar solution in October of 2007 called
“Microsoft HealthVault.” In its simplest form, it’s a platform designed to store and
maintain health and fitness information for use by both individuals and healthcare
professionals. Access to a record is through a HealthVault account, which may be

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authorized to access records for multiple individuals, so that a mother may manage
records for each of her children or a son may have access to his father’s record to help
the father deal with medical issues. In terms of mobile connectivity and integration,
HealthVault includes a “Connection Center” that allows health and fitness data to
be transferred from devices such as heart rate watches, blood pressure monitors
or otherwise into an individual’s HealthVault record. It can also be used to find and
download drivers for medical devices.
Solutions like Apple’s HealthKit or Microsoft’s HealthVault are prime examples of the
“eHealth” movement that’s been taking place for several years. As mobile technology
begins to be integrated with such solutions, as is the case with HealthVault’s
“Connection Center,” the line between eHealth and mHealth continues to dissolve and
the benefits of these platforms multiply.

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CURRENT ADOPTION RATES
The mHealth market covers a vast array of concepts and technologies, and as such
sees varying adoption on both the clinical and consumer side. Basic solutions such
as SMS reminders and fitness and wellness smartphone applications are seeing high
adoption rates due to their relatively simple nature and low barriers to entry. More
advanced solutions, however, are seeing very slow adoption and innovation due to
things like high regulatory scrutiny, education on the consumer side, and a lack of
suitable infrastructure to support them.
Low Adoption
There are two prime examples of low adoption concepts in mHealth; mobile Personal
Emergency Response Systems (mPERS) and wireless robotics. The first hasn’t
seen true innovation since the concept was introduced in the 1970s, and has been
embraced by very few providers as a result. Personal Emergency Response Systems
(PERS) is the concept of equipping consumers with the ability to signal emergency
responders remotely when and if a problem arises. The “Life Alert” solution that’s
been around for quite some time is a good example, but still relies on traditional
landline-based communication to operate. Introducing mobile technology and data
connections seems like the next logical step in the concept’s evolution, yet very little
movement has happened.
Wireless robotics present a wide variety of barriers that attribute to its low adoption
rates as well, including high cost of development and integration, advanced learning
curves in terms of operation and maintenance and a basic lack of understanding,
testing and implementation on a large scale. Given its highly advanced nature, many
healthcare providers have been resistant to embrace the technology out of fear of the
unknown. Implanting wireless sensors or employing wireless robotics inside a patient
is an extremely delicate process that presents many potential risks for everyone

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involved. Providers could face costly litigation if something goes wrong due to
inadequate testing or a lack of education, for example.
Another area that’s seeing marginal adoption is the area of asset tracking and
document management using technologies like Radio Frequency Identification (RFID).
Deploying wireless communication to organize and streamline asset and document
management is looked upon as an effective way to reduce costs, manage inventory
and streamline overall access to information, but is limited due to provider resistance.
A move to digital asset and document management is a daunting task through the
eyes of healthcare providers and facilities, as numerous legacy systems are usually in
place and intense fragmentation exists. Though the long-term benefits are apparent,
many providers are resistant to pull the trigger.
High Adoption
There are several key areas of the mHealth market that are seeing high adoption
either out of sheer necessity or low barriers to entry. In general, concepts seeing
high adoption rates are those driven by consumer demand such as social health
communities, EMRs, smartphone mHealth applications and services and telemedicine.
Electronic Medical Records (EMRs) and Personal Health Records (PHRs) are two areas
driving the most adoption and innovation as it streamlines the basic need to collect,
organize and disseminate personal health information between patient and physician
as quickly, safely and efficiently as possible. EMRs and PHRs represent solid building
blocks to further innovation in mHealth, and as such, many big players such as Google
and Microsoft are leading the charge to digitize medical records and make them
available to consumers in a streamlined and real-time fashion. Technology like Google
Health and Microsoft Vault are two large-scale deployments that aim to get the ball
rolling on electronic medical and personal health records. Extending these solutions
via mobile communications is the next logical step, and we’re already seeing a steady
shift.

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The infrastructure in terms of cloud computing and mobile technology in terms of
accessing the data increasingly being stored in the cloud has evolved to a point where
large-scale adoption is happening at a rapid pace. The idea of “mobile healthcare”
from a consumer perspective revolves around having mobile access to health
information anytime, anywhere, which is why EMRs and PHRs continue to drive high
adoption.
Other examples of mHealth segments driving high adoption are social health
communities and smartphone applications related to health and fitness. The simplicity,
ease-of-use and wide availability of these resources are contributing to their fast
paced adoption and evolution. Again, consumer demand for such solutions has been
a primary driver in the early innovation seen in these areas.

TM
DEVICES, PLATFORMS, AND
INFRASTRUCTURE
The advent of new-age devices like smartphones has greatly affected the innovation
and deployment of mHealth products, and is a growing trend in mHealth. For instance,
the iPhone has evolved into much more than a consumer electronics device, its
attractive interface, application marketplace, and consumer appeal have contributed
to a revolution in mobile computing.
The iPhone, and more recently the iPad, has created a dynamic disruption in patient-
to-doctor, doctor-to-doctor and patient-to-community interactions – all of which are
meaningful for healthcare. More important than the technological barriers that the
iPhone breaks down is the powerful distribution channel and social impacts it drives.
While other popular smartphone devices like BlackBerry, Google Android, and new
health-specific phones
emerge, the iPhone has had
an important role in mHealth
awareness and adoption.
Web developers, HIT
vendors, global technology
giants, mobile device
makers, and telcos all have
instrumental roles to play in advancing mHealth. The healthcare industry is likely the
most complex operating environment in the world, yet it has not embraced information
technologies as other industries have in the past. Many believe the U.S. healthcare
system is ten years behind most other industries with respect to technology innovation
and adoption. As a result, the current healthcare system is composed of disparate
legacy technology systems that are unable to address the dynamics required in
today’s healthcare marketplace.

TM
Smartphone applications have allowed companies that have applications to keep
closer contact with their customers, providing them with messages, account access,
and promotions. Also, the creation of a portal through the application itself, has lent
itself as a solution for vendors regarding HIPAA compliancy.

TM
FUTURE PREDICTIONS & LONG-TERM
TRENDS
The future of mHealth and its benefits have already been largely realized, so
the future of the industry will rely on the ability for those within the ecosystem to
overcome the many risks, challenges and
barriers. The healthcare industry is one of the
last big industries to be touched by automation,
and it can be very conservative and set in its
ways.
In addition, the enactment of the American
Reinvestment and Recovery Act (ARRA), Health
Information Technology for Economic and
Clinical Health Act (HITECH) and the passage of the Patient Protection and Affordable
Care Act (PPACA) has accelerated interest and adoption of healthcare technology
solutions. The timelines surrounding the adoption of these federal incentives, along
with changing patient expectations on how information can be accessed are fueling
some sense of urgency for the advancement of mHealth.
In a recent interview with the President and Head of Resurgens, the largest orthopedic
clinic system in the U.S., he pointed out that appointment reminders would be a great
service; however, communication electronically can, and has, led to malpractice
issues, whereby another risk (or barrier) is created due to non-reimbursement from
the malpractice suits, and a general fear of accidentally breaking the law. Overcoming
intricate situations and risks such as these will ultimately define the future of mHealth
in the U.S.
The future will also be defined by adoption, both on the clinical and consumer side.
Adoption has historically happened faster on the clinical side, though consumer

TM
interest in new-age mHealth concepts is quickly gaining momentum as concepts
like Personal Health Records (PHRs) and health applications for smartphones have
gained in popularity. Large-scale deployment from the likes of Google, Microsoft and
other industry players will work to define the future of the industry as well. A company
like Google, who’s already begun building its “Google Health” solution, as well as
controlling one of the most popular open source mobile operating systems in Android,
can produce heavy market shifts stemming from one decision or solution offering.
Recent events and accelerated adoption have caused a stir in healthcare that many
industry experts are considering to be the third wave of consumer-driven healthcare,
where meaningful disruption and change are impacting consumer awareness, demand
and engagement. This prediction is based on consumer access to information,
which is a central theme of how mobile devices and wireless delivery protocols are
impacting healthcare. Because of the technological inertia that plagues the medical
community, mHealth innovation must be driven by consumers, non-traditional players,
the general IT community, and more entrepreneurial, forward-looking healthcare
participants.
Beyond the many barriers and the intricate nature of the healthcare system in general,
one thing remains true; the benefits of introducing mobile technology into the highly
complicated area of healthcare in the U.S. will have one of the largest impacts on our
healthcare system since its initial formal inception. Because each and every one of us
can be counted as ‘customers’ of this industry, this will eventually result in one of the
largest impacts on our society that technology has ever produced.

TM
TM
ABOUT MPULSE
mPulse mobilizes the consumer experience by making healthcare
communications relevant to the modern lifestyle. We utilize complex
mobile technology to provide simplified, streamlined solutions that
enable health partners to effectively connect with consumers in the
most relevant and appropriate means. By improving communication,
we aim to improve the health and wellbeing of consumers everywhere.
For more information, visit mPulseMobile.com, formerly a MobileStorm
company.
Find out more by visiting
sales@mpulsemobile.com
mPulse Mobile Inc.
16530 Ventura Blvd. Suite 502
Encino CA, 91436
Telephone (805) 200-4848

MOBILE HEALTHCARE TECHNOLOGY TRENDS AND INNOVATIONS

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