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Rogers’ Role in the new M2M-
Healthcare Ecosystem:
Introducing Rogers Enterprise
Medicom System (REMS)
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Seventh Heaven
Consulting
2. Executive Summary 1
Introduction 2
The Business Environment: A Lay of the Land 2
Disruptive Technology and REMS 2
Wearable Technology 4
Cloud Service and Big-Data Analytics 4
Healthcare 4
Internal Analysis 5
Rogers 5
Core Competencies and Partnership Synergies 5
REMS: Details 7
Developing Philosophy 7
Conceptual Framework: How is it going to work? 7
Potential application-features that can be achieved by REMS 8
Possible future uses 9
Security and Privacy 9
Revenue Model & Financial Projection 9
Buy-in for Stakeholders 10
Implementation 10
Reference 12
Appendix 15
Appendix A: Financial Projection 15
Appendix B: Grantt Chart 16
Table of Content
3. Executive
Summary
The market for smartphones and tablets is
currently reaching a state of maturity, and
telecoms like Rogers must prepare for the
future of communication.‘The Internet of
Things’(IofT) and new disruptive machine to
machine (M2M) innovations, will soon
penetrate all areas of our lives, with
potentially one trillion 'things' across several
industries connected to the Internet and
100 million global M2M device connections
(Manyika et al., 2013). In order to gain the
best position in the promising M2M
marketplace, what should Rogers invest in
and how should it focus its competencies
and grow its product offerings to remain
relevant and profit generating in the
changing landscape of telecom operations?
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Because of the growing need for value and
efficiency in the healthcare industry, with
nearly one-fifth of all M2M devices having
healthcare applications by 2015 (Kane
2013), we have focused on growth for
Rogers in the M2M-Healthcare ecosystem.
The creation of Rogers Enterprise Medicom
System (REMS) through strategic
partnerships between Rogers (network
infrastructure), IBM (cloud-service,
analytics), and Google Glass (wearable
technology), will ensure that Rogers plays a
major role in the future of telecom in
Canada.
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REMS' success depends on focused
consideration of its business environment
which consists of four key factors:
(a)disruptive technology, (b)wearable
technology, (c)cloud computing and big-
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data analytics, and (d)healthcare trends. By
using its own competencies in fibre optics
infrastructure, security, government
lobbying power and expertise in
developing healthcare apps it will be able
to create great potential synergies with its
strategic REMS partners.
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The REMS process follows a four step cycle:
(a) a camera and a microphone situated on
Google Glass provides graphic, auditory and
location inputs to proxy servers located
within the hospitals via a closed-network (b)
servers encrypt and compress inputs that
are transmitted to private cloud-servers for
data storage and analysis; (c) processed data
is forwarded to (IBM’s) Content Delivery
Network and finally (d) data is transmitted
back to the Google Glass’on-screen display
as needed by the healthcare practitioner.
The implications of REMS in the M2M-
Healthcare ecosystem within five years are
vast, but when REMS can be perfected
through use and pilot project analyses, and
as the M2M universe grows, the future
application of REMS is truly unlimited.
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Initial financial projections indicate that
upon the deployment of REMS, Rogers will
generate $46M gross profit and a 49% gross
profit margin derived from three standard
revenue models: (1) enterprise hardware
sales of Google Glass on contracts, (2) on-
demand fee schedules for network and
proxy server usage, and (3) maintenance
and implementation fees.
The future of M2M communication is
limitless, and Rogers has the know-how,
creativity and forward-thinking abilities to
make REMS a reality.
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4. Introduction
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As the market for smartphones and tablets
matures, telecoms must embrace and
prepare for the new reality of how the world
is going to be communicating in the coming
years. The‘Internet of Things’(IofT) is a very
real concern with major implications for the
telecom industry. Companies such as
Rogers, Bell and Telus have traditionally
been concerned with human to human
(H2H) communications, but now because of
new disruptive machine to machine (M2M)
innovations, and the predicted $1B market
revenue potential within the“M2M
ecosystem”over the next three years in
Canada (Trichur, 2013), Telecoms are
recognizing the need to invest heavily in
M2M services and solutions. Focus must be
shifted from the human factor to the
machine factor in order to remain relevant
and revenue generating in the M2M
ecosystem, where connectivity is becoming
a commodity (Kane, 2013 & Chen, 2013).
Seven Heaven Consulting has been tasked
with the challenge of determining which
industry will be impacted most dramatically
by the IofT and M2M communication, and
what the implications are for Telecoms over
the next five years within a Canadian
context. The following report elucidates the
fact that the IofT and M2M communications
are going to have drastic implications for
the healthcare industry with nearly one-fifth
of all M2M devices having healthcare
applications by 2015 (Kane 2013).
Investment by telecoms in the M2M-
Healthcare industry is where they will reap
the most rewards by creating urgently
needed value for all stakeholders in the
healthcare industry. With the creation of
Rogers Enterprise Medicom System (REMS)
through key partnerships between Rogers
(network infrastructure), IBM (cloud-service,
analytics), and Google Glass (wearable
technology), Rogers will be positioned as a
market leader in the M2M-Healthcare
ecosystem; leading the charge to capitalize
on the great potential that M2M-Healthcare
can provide.
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The Business
Environment : A
Lay of the Land
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In order to understand the context within
which REMS will operate, it is important to
consider four factors that concern its
business environment: a) disruptive
technology, b) wearable technology c) cloud
computing and big data analytics, and d)
healthcare trends.
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Disruptive Technology and REMS
Much of the information and
communication technology (ICT) industry,
including telecoms, is becoming
increasingly influenced by disruptive
innovations such as cloud computing and
M2M communication. As "telecom
companies are in the process of reinventing
themselves...there's been a gradual shift
from telephony as a major source of
revenue" (Trichur, 2013), and disruptive
technologies present an attractive prospect
for investment in continued growth. M2M
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5. technology, in combination with the IofT
could make it possible to implant
intelligence into anything at all. This fact
alone elicits major implications for health,
safety and overall global productivity
(Manyika et al., 2013) . It is essential that
telecoms such as Rogers are able to identify
the potential uses for these disruptions
within their current set of competencies,
adjust their business models, and invest
wisely to ensure they are not left behind in
an ever-changing ICT industry.
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Disruptive Innovation Theory identifies two
types of innovation: sustaining innovation,
and disruptive innovation (Christensen &
Bower, 1995). As can be seen in Figure 1,
sustaining innovations (blue line - i.e. Cloud-
services, content delivery networks (CDN),
and data-analytics (Babin & Magee, 2013))
maintain a steady performance and improve
on an existing product or service.
Innovations can only be considered as
disruptive“when the value of a technology
surpasses the value of a competing
market”(Stutman, 2013). This event is
recognised by red circle in Figure 1 where
REMS’performance-improvement trajectory
will exceed the goals of e-health in a 5-year
period (Infoway, 2014; Anderson 2007).
REMS combines existing sustaining
innovations (blue line) with (possibly
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disruptive) Google Glass, to achieve a result
that can revolutionize the way hospitals are
able to communicate and store data.
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Figure 1: REMS as a disruptive innovation
Source: Adopted from Bower, J.L. & Christensen, C.M.
(1995). Disruptive technologies: catching the wave.
6. Wearable Technology
Wearable technology is a constantly
growing industry that is being catapulted by
the Google-Samsung patent truce (Essers,
2014). Already on the market, and coming in
2014, are Nike’s extremely successful
FuelBand activity tracker, and Sony’s smart
watches and clever wristbands (Griffin,
2014). Nike’s profits jumped 18% largely due
to the Fuel Band’s success, proving that
there are profits to be made in this market
(Warthon, 2014). In addition to the
aforementioned examples, Jay Bird’s heart
rate monitor, Georgia Tech’s Wearable
Motherboard, and Google’s Google Glass
(which has already been used in conjunction
with healthcare by the surgical team at the
University of Alabama (Farmanfarmaian,
2014)) all represent growth in the wearable
technology industry, and now is the time for
REMS to be carving out its own enterprise
niche in the M2M-Healthcare ecosystem in
order to take advantage of the great growth
potential in wearable technology in the
healthcare industry.
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Cloud Service and Big-Data Analytics
According to a report on disruptive
technologies by McKinsey,“cloud
technology has the potential to improve
productivity across $3 trillion in global
enterprise IT spending, as well as enable the
creation of new online products and
services for billions of consumers and
millions of businesses alike.”(Manyika et al.,
2013). Forbes has also predicted that
worldwide public IT cloud services spending
will increase $59.8B from 2013 to 2017
(Columbus, 2013). This is the reason why
telecoms like Rogers have plans to develop
cloud-based hosted data analytics (Trichur,
2013), however it is still companies like IBM
(and Cisco) that has been quickly
establishing itself as a major player in this
field (IBM, 2013). The vast amount of data in
the healthcare field is being collected at a
pace that is“growing and moving faster
than healthcare organizations can consume
it”. In fact 80% of clinically relevant medical
data is unstructured and therefore nearly
inaccessible for medical practitioners.
Changing the way that healthcare data is
stored and communicated can save lives,
reduce costs and improve the overall quality
of care hospitals are able to provide (IBM,
2014).
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Healthcare
Canadian federal and provincial
governments have recognized the degree of
importance in improving the healthcare
industry (Canada Institute for Health
Information, 2011) and making such
improvements first requires an
understanding of how technology like REMS
can be used to make these improvements.
Because the success of REMS will depend on
government support and healthcare
spending in Canada, it is important to
evaluate spending trends which may
provide insight into possible opportunities
that REMS can take advantage of. Total
healthcare spending in Canada was
expected to reach $207B in 2012, and
continue to slow down because of
budgetary deficits modest economic
growth (Canadian Institute for Health
Information, 2012), which is why it is even
more important that the government uses
funds in the most efficient way by investing
in technology like REMS that is going to
make the healthcare ecosystem function at
an optimal level.
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7. Internal Analysis
Rogers
Rogers Communications Inc. has established
itself as a Canadian company by investing in
the following three business lines; Rogers
Cable, Rogers Media and Rogers Wireless
Inc, which is Canada’s largest wireless voice
and data communications service provider
(Office of the Commissions of Lobbying of
Canada, 2013). According to Rogers
Business Resources (2014), the use of
technology can be a catalyst in response to
health outcomes for doctors, health
practitioners and above all the patients
themselves. Rogers has already invested in
aspects of the healthcare industry by
developing wireless applications for
healthcare professionals (Rogers Business
Resources, 2014).
Core Competencies and Partnership
Synergies
As Rogers uses the IofT and M2M
communication to expand its healthcare
offerings beyond its mobile healthcare
solutions, it will need to supplement some if
its existing competencies with healthcare
analytics and augmented reality hardware
through strategic partnerships with
industry-leading technology firms such as
IBM and Google, who are also interested in
making waves in the M2M-Healthcare
ecosystem (IBM, 2014; Guynn, 2013). Figure
2 below displays the core strengths and
weaknesses of Rogers, IBM and Google in
regards to establishing REMS and highlights
the synergistic potential of this partnership.
Because of several acquisitions of
companies like Atria Networks, Rogers has
developed an extensive fibre optic and
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communication dissemination network,
making it the leader of wireless race in
Canada (Britten, 2010; Trichur, 2014), placing
it in the ideal position to grow its healthcare
product offerings over the next five years to
incorporate the commoditization of M2M
communication. It has invested heavily in
owning, not renting, much of its
infrastructure, and therefore has reliable
access to the infrastructure necessary to
physically implement REMS (Rogers
Business Solutions, 2014). This also increases
the security it is able to offer to its clients, as
it can maintain and service its own systems
and does not have to risk the possible
security breaches of a third party. Rogers
has already seen the potential of the M2M-
Healthcare ecosystem and has started
considering the virtualization of healthcare
through wireless applications for healthcare
professionals and wireless solutions for the
healthcare industry in general (Rogers
Business Resources, 2012). Rogers is one of
only three major telecoms in Canada, and
because of its recent $3.3B investment in 22
licences at the 700MHz spectrum auction to
increase mobile video power (Trichur, 2014),
and its $117B government contracts
(Southern, 2010), it is an attractive partner
for the government in implementing M2M-
Healthcare solutions (REMS) across Canada.
Though Rogers does have well established
business analytics, it does not currently have
the experience to analyze and utilize the
approximately 80% of unstructured medical
data (IBM, 2014), and in order to enable the
effective use of this data within REMS,with
big data healthcare analytics that IBM has,
nor the expertise in manufacturing the
necessary augmented reality hardware for
REMS. This is where IBM and Google Glass
round out the skill set necessary to make
REMS a reality.
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Figure 3 shows how the strengths of the
three pillars in this partnership (network
infrastructure, analytics, and hardware)
marry the necessary components for the
creation of REMS. Rogers provides the Fibre
Optic Network, expertise in privacy, and
government relationships. IBM also has
expertise in data security, but contributes
the powerful analytics necessary, the
operational cloud service, and the CDN
while Google Glass provides its
augmented reality wearable
technology hardware.
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Figure 2: Synergistic Potential of Partnership Strengths
Figure 3 - The Creation of REMS
IBM Rogers Google (Glass)
Weakness Strength Weakness
• Cloud market share (5%) is
not as high as Akamai nor
Amazon (Synergy Research
Group, 2012)
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• Recently sold their hardware
division
• Infrastructure ownership
• Interest in Health Care
• Lobbying Power
• Large fibre optic network
• Security tunnels
• Capital
• Google Health failure (Lohr, 2011)
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• Fear of being a “one trick pony”
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• Uncertain sales predictions and
popularity amongst mainstream
consumers (IHS, 2013)
Strength Weakness Strength
• Healthcare analytics (eg.
Watson)
• Hyper focused on cloud
service
• Existing CDN
• Experience and reputation
• No capability for healthcare
analytics
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• No wearable hardware creation
competencies necessary for
REMS
• Product past beta phase
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• Has proven healthcare
applicability
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• Intuitive, unobtrusive, portable
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9. REMS: Details
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REMS is an M2M solution for the healthcare
ecosystem to disseminate large amounts of
processed medical data to medical
practitioners, in an intuitive and unobtrusive
way. REMS is formed by three strategic
partners and takes advantage of Google’s
wearable hardware Google Glass; Rogers’
ability to provide network coverage and
secure channel; and IBM’s cloud-service,
healthcare analytics, and Content Delivery
Network (CDN).
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Developing Philosophy
REMS enables frontline healthcare workers
to access processed, prioritized, and context
aware information. This is important
because the current system of
dissemination used by e-health goes against
the Technology Adoption Model (TAM)
(Figure 4). Traditional user interfaces are not
easy to use in the hospital setting since
healthcare professionals are constantly“on
the run”, and sitting down in front of a
computer creates wasteful downtime. This
conclusion is supported by low adoption
and utilization rate of current e-health
systems in Canada (which are 14%, 8%
respectively), and physicians listing IT and
accessibility as a major barrier to e-health’s
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ease of use (green box in Figure 4)
(Anderson, 2007). REMS is developed with
TAM in mind, which greatly increases the
usefulness and accessibility of healthcare
information .
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Conceptual framework: How is it going to
work?
The camera and microphone on Google
Glass will provide graphical, auditory and
locational inputs to proxy servers located
within the hospitals via a closed-network;
these servers will encrypt and compress the
inputs and pass the information to private
cloud-servers for data storage and analysis.
Existing electronic medical record data will
be used for in-depth data analysis; then the
processed data will be forwarded to (IBM’s)
Content Delivery Network for reliable and
speedy distribution (since data size will be
large). Finally, processed data will be
transmitted back to the Google Glass’on-
screen display as needed (graph 1).
REMS algorithms and analytics provided by
IBM could enable REMS to learn the habits
of the user, and predict the types of
information needed by interpreting
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Figure 4: Technology Adoption Model
10. graphical and auditory data, thus making
unprocessed data“context-aware”.
Google Glass is an optimal wearable
technology for REMS because it provides an
on-screen display right in front of user’s
eyes, thus achieving reality augmentation
by overlapping the physical world with
computer generated sensory input. For
example, if we use Google Glass to look at a
patient, related information such as age and
medical condition will appear next to the
patient on the screen.
Figure 5 explains activities at different levels
of REMS.
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Potential application-features that can be
achieved by REMS
Automatically scans the environment and
communicate meaningful data to the
proxy server without user manipulation,
truly achieving M2M
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Figure 5: Detailed Explanation of REMS
11. Facial recognition for patients to prevent
identification errors Medication
administration aid
Electronically store traditional paper-
based information
Use camera to take pictures of physical
forms transferred to algorithms which
digitize the content (for privacy
considerations)
Location of key personnel during
emergencies
Provide medical practitioners with
preemptive information
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Possible future uses
As new sensors are introduced to the
hospital setting, M2M communications
become more valuable
Bio sensors will allow doctors to have
access to real time patient status
More accurate bio-signature
authentication will allow doctors to enter
medical orders wirelessly
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Security and Privacy
REMS uses a closed-network
between Google Glass and proxy servers,
and employs a private cloud system
between those servers and IBM’s data
centre. These two infrastructure choices will
minimize the risk for accidental data loss.
Fibre optics cables provide additional data
transfer security, because photons are very
difficult to be intercepted and decoded.
Even in the case of data-tapping, the
immediate cessation of light signals due to
exposed wire will warn cable providers of
leaks (Thyagarajan & Ghatak, 2007).
In addition, encryption measures through
the Wireless Application Protocol 2, and
secure network channels provided by
Rogers will effectively prevent external data
theft (Wexler, 2010). As for internal data
security, Google Glass has the capability to
use bio-signatures such as unique ECG-
waves or fingerprints to authenticate users
instead of the traditional password method
(Dvorsky, 2014).
For patients and doctors, privacy
may be a more immediate concern in
comparison with data security, because of
the video and audio monitoring nature of
REMS. However, with the increasing
prevalence of surveillance cameras, mobile
device location tracking, and social
networks, there may be less resistance to
REMS technology today and into the future
than there was even 10 years ago. The
benefits of REMS far outweighs its potential
drawbacks, as long as the appropriate
security measures are taken to ensure data
safety.
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Revenue Model
& Financial
Projection
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There are three standard revenue models
available for Rogers: (1) enterprise hardware
sales of Google Glass as contracts (2) on-
demand fee schedules for network and
proxy server usage, and (3) maintenance
and implementation fees. All three should
be used in conjunction to amortize initial
capital investment from the hospital,
because surveys have shown that financial
restraints were the number one concern for
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12. hospitals when e-health was implemented
in Canada (Anderson, 2007).
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Financial projections indicate that upon the
deployment of REMS, Rogers will generate
$46M gross profit and a 49% gross profit
margin (Appendix 1). $4.6M will be derived
from carrying Google Glass; $37.6M from
providing network and intermediate servers;
$7M from on-going maintenance fees and
implementation fees (Figure 6).
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We approximated 4 major variables in our
financial projection: a) the cost-structure of
REMS for Rogers; b) the wholesale and retail
price for Google Glass; c) benchmarked
profit margin from each revenue models;
and d) the market size for REMS (according
to the number of healthcare professionals,
hospitals’potential cost-savings, and
percentage of initial adopters). A detailed
explanation and reference for these
estimations can be found in Appendix A,
along with market growth rate predictions,
and the effects of economy of scale.
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Buy-in for
Stakeholders
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From Figure 2, it is clear that Rogers has
strong bargaining power in the value chain
of REMS. REMS can provide Google Glass
and IBM exposure to the emerging
profitability in the M2M-Healthcare
ecosystem that makes use of all three firms’
core competencies. However, IBM and
Google Glass are not the only stakeholders
that need to be considered when
generating buy-in. Hospitals, medical
practitioners and the government must all
be consulted and sold on the idea of REMS,
and why it will work for them.
One of the major benefits for hospitals to
invest in this project is the access to care will
increase allowing patients to be dealt with
in a quick and effective manner ultimately
reducing costs. The Canadian Medical
Association recognizes the high costs
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Figure 6: Financial Projection for REMS
13. associated with excess wait times. The
cumulative economic cost of waiting for
treatment in 2007 was estimated at $14.8B
(The Centre for Spatial Economics 2008).
Among other improvements, incorporating
REMS into the healthcare ecosystem can
reduce wait times by making doctor-patient
interactions more efficient, and in turn,
contribute to reducing overall costs.
Another benefit of REMS for hospitals is the
reduction of diagnostic error. Studies have
shown that an electronic medical record
that facilitates computerized physician order
entry can significantly prevent serious
medication errors, and electronic
prescribing has been shown to reduce
prescription errors and improve compliance
with managed care formularies (Anderson,
2007).
The Canadian government has faced
extreme obstacles in the communication
and uptake of e-health by medical
practitioners (Canadian Medical Association
Journal, 2011). There is an urgent need to
create value out of the e-health debacle,
and it has been noted that“the future of e-
health...will be driven by consumer-friendly
innovations such as the tablet and the
consultation application”(Magazine, 2012).
REMS is the next step in healthcare. It
tackles the problem by using a cloud service
where doctors and hospitals are able to
input and extract information from a
network that is flexible, cost effective and
intuitive.
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Implementation
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Pre-Execution tasks
Phase 0 starts in July, 2014 and is planned in
3 stages (see Gantt Chart in Appendix B):
Stage 1) Conducting in-depth market
research, drafting and prioritizing
partnership models, legal considerations,
initial negotiations with partners,
government lobbying, and perfecting the
business plan and business model
Stage 2) Rogers finalizes partnership and
revenue/responsibility split, sales model
(incorporate exclusivity contracts both with
partners and hospitals), receive necessary
government approval, adapt Rogers’Health
Division.
Stage 3) Partners customize their product/
services, prepare for the pilot project
Pilot project (Stage 4)
The execution phase starts with a pilot
project with limited scope, in conjunction
with the development of a training program
for future REMS users. The pilot project will
take place in one or two hospitals with
minimum system setup requirements, and
REMS (with limited features and capabilities)
will be tested by healthcare professionals as
users. The feedback generated by this phase
will be crucial in fine tuning REMS before its
full scale launch.
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