Presentation at AMCP 2011 Educational Conference in Atlanta

1. Healthcare in Motion
AMCP Education Conference
October 21, 2011
Steven Peskin, MD, MBA, FACP
EVP and Chief Medical Officer, MediMedia
Associate Clinical Professor of Medicine, UMDNJ

2. Mobile Technology Landscape
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3. "Every generation needs a new revolution."
-Thomas Jefferson
• Mobile technology has become ubiquitous in our consumer
lives…and it’s bridging to other areas
• Today, we are at the leading edge of it, revolutionizing the way
we manage our individual health
• Three major areas of mobile health that will drive this change:
– Health Care Professional: Knowledge building, increased interaction,
and improved clinical actions
– Consumer: Creating excitement and ease to drive engagement and
behavior change with relevant and actionable information and topics
– Connected Care: Integrating all key stakeholders (HCPs, life sciences
companies, payers, consumers) to efficiently achieve desired health care
outcomes
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4. Mobile Statistics
Mobile devices are personal, ubiquitous, connected and
advanced. They create a unique opportunity to deploy
acquisition, loyalty and engagement solutions
Implications
• 292 million American cell phone users;
93% of the population in the U.S. • Market for mobile is reaching
• 5 Billion text messages sent daily in the maturity as most consumers have
U.S.; over 1.5 Trillion in 2009 smart phones and are rapidly
increasing their use especially for
• Mobile users outnumber internet users non-voice related activities
3:1, growing to 4:1 by 2012
• Mobile phones are private devices
• Smartphone market share will overtake
that can be directly associated
that of the feature phone by 2011 Q3
with an individual facilitating
• 97% of SMS messages are opened, 83% micro-targeting and engagement
are read in an hour programs
Source: 1. Pew Internet & American Life Project – Mobile Health 2010; 2. Morgan Stanley‟s Internet Trends Report 4/2010; 3. Nielsen‟s State of Mobile Media 12/2009; 4.
Insight Express, Digital Consumer Portrait, June 2010; 5. Direct Marketing Association‟s

5. Mobile Statistics
Mobile health projections vary greatly…but the data
suggests a positive environment for deploying mobile
solutions across the entire healthcare industry
Implications
• Physicians use mobile web more • Mobile Solutions in healthcare
than 2X the general population…but are rapidly maturing from
interesting novelty to accepted
are just beginning to use mobile
practice and will become
tools in patient communications commonplace in the near term
• Consumer market for mobile
• mHealth market is a large
monitoring devices estimated at market that will effect the
$7.7 billion to $43 billion by 2015 entire healthcare delivery
system
Source: 1. Pew Internet & American Life Project – Mobile Health 2010; 2. Morgan Stanley‟s Internet Trends Report 4/2010; 3. Nielsen‟s State of Mobile Media 12/2009; 4.
Insight Express, Digital Consumer Portrait, June 2010; 5. Direct Marketing Association‟s

6. By 2014, Mobile Internet Should Take Over
Internet Usage
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7. How Much Do People Use Their Mobile
Phones?
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8. How Has Mobile Usability Changed?
• Because of the increasing use of mobiles, their
versatility is always growing…
• One half of all local searches are performed on
mobile devices
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9. Mobile By Numbers: Consumers
• Approximately, 224+ million of the 292 million U.S. subscribers today use text
messaging, 75 million access mobile web.
• 90% of 18-29 year-old mobile users, 67% of 65+ send texts.
• 97% are SMS capable, 59% are web access capable.
• 97% of mobile messages are opened, 83% read (within 4 minutes). Only 24% of
e-mails are opened when there is a coupon offer
• 36% of mobile users took action based on a mobile campaign.
• Typical U.S. mobile subscriber between the ages of
35 and 44 will now send or receive more text messages
than phone calls per month.
• 5 billion+ text messages are sent daily.
• Typical Smartphone Web access in Healthcare:
 iPhone 58.52%
 Google Android Browser 34.04%
 BlackBerry 6.94%
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10. Mobile By The Numbers: Consumers
Consumer adoption of mobile health is strong given the early stage of
development
Believe m-health
will be widely 75%
accepted by 2015
Expect health
insurers to pay for 72%
m-health
Clinician adoption
viewed as the 62%
number one driver
Willingness to use
a mobile health 41%
application
Male Individual
Policy holders
36%
wiling to pay $25
for an e-visit
Female Individual
Policy holders
27%
wiling to pay $25
for an e-visit

11. Mobile By The Numbers: Consumers
Consumers show a willingness to pay for mobile healthcare, want to monitor
health and communicate with their doctor
% of Consumers Willing to Pay
for Mobile Healthcare
Yes
Would pay for a
No device that would
40%
send health info to
a doctor
50% 50%
Monitor Fitness or
20%
wellbeing
Want doctor to
monitor health 18%
remotely
Source: PWC Healthcare Unplugged 2010, Health Research Institute
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12. Mobile By The Numbers: Consumers
Key Statistics
57% of 50-64 demo sends text
regularly
43% of 30-49 demo access the
internet regularly
20% of 18-29 demo made
purchases on their phone
Source: Pew Research Center's Internet &
American Life Project, April 2010
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13. Mobile Technology & Apps Will Redefine the Way
Consumers Manage Their Health…
• 4.7 billion mobile subscribers
worldwide1
• Mobile health apps have grown
by 78% in the United States
• Currently, there are
17,000mHealth apps ̶ 74%
adhere to the paid business
model
• 76% of mHealth market revenue
will come from related services
and products such as sensors
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14. …And Address Many of the Challenges Traditionally
Associated with Poor Outcomes
Pre-diabetes
Lack of Engagement
Obesity
At-risk
Patients
Poor Compliance
Poor Prenatal
Care
Boredom Disconnection
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15. Opportunity: Health eGames Bigger than
Disease Management
Consumers: Industry:
Health Health &
eGames Health eGames Productivity
$6.6 Billion1 +
$2.3B2
Social Media
+
Exergaming Mobile
Condition +
Management Analytics & Outcomes
Nutrition =
Brain Fitness …Superior Health & Performance
Professional
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16. Example: POC Patient Engagement Workflow
Sam, remember to take
your morning meds on
an empty stomach. Dr
Other delivery options: Katz
Reply “Yes” to confirm.
eRx/EMR point-of-care – E-mail
HCP interface – Call Center
– IVR
To: 232-141-2567 To: 232-132-2076
From: 53016 To: 232-132-2076 From: 53016
03/25/11 8:00am From: 53016 03/25/11 8:05am
03/25/11 8:00am
Sam, remember to
take your morning Sam has replied
Sam, remember to “Yes” to confirm
meds on an empty
take your morning his morning
stomach. Dr Katz
meds on an empty
Reply “Yes” to regimen.
stomach. Dr Katz
confirm.
SMS or audio
dosage reminder
with caregiver
monitor Caregiver
alert options
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17. Mobile Pain Care
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18. Mobile Technology and
Healthcare Professionals
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19. Market Drivers for Connected Health
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20. Wireless Health Information Flow
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21. Mobile By Numbers: Practitioners
Doctors have a broad view of the potential application of mobile across the care
provider continuum
• 94% of Practitioners use a Smart Phone (Typical OS Access Breakdown, 07/11)
 iPhone: 56.52%
 iPad: 21.75%
 Android :11.56%
 RIM BlackBerry: 5.88%
 Misc: 7.12%
• 59% of Practitioners use their mobile device for researching medical
information
• 57% consult their Smart Phones with their patients
• 63% Use Apps frequently
• HCP Apps:
J&J Black Bag
Medscape
eProcrates
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22. Mobile By Numbers: Practitioners
75 % of U.S. Physicians own some form of Apple device
• Study from pharmaceutical and healthcare market research (Manhattan Research), 75% of U.S.
physicians own some form of Apple device, such as an iPhone, iPad or iPod
• An additional 28% of physicians plan to purchase an iPad in the next 6 months.
• 72 percent of US physicians now use smartphones, more than 80 percent of U.S. physicians will
have smartphones by 2012 (up from 64% in 2009), -- more than half of that group will use their
phones for patient care & administrative functions (like charge capture and continuing medical
education) according to Manhattan Research
• Spyglass Consulting Group says that an astounding 94 percent of doctors are using smartphones
to communicate, manage healthcare and personal workflows and access medical information--up
from 59% in November 2006.

23. AmeriHealth Mobile Wellness Program
• Utilizes the GoMo™ Mobile Platform to provide wellness
engagement for AmeriHealth corporate clients and their
employees.
• Empower AmeriHealth clients to deliver important wellness and
care content to their insured employees.
• Inclusive of any wellness program, disease state, or other
healthcare regimen (fitness & nutrition, diabetes, pregnancy,
weight management etc).
• Employee participants are also able to send in data and create
their own personal wellness diary card.
– This diary program is a great way to track progress
with a particular wellness regimen and employers
can offer rewards for participation and progress.
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24. Point-of-Care Mobile Technology
• 87% of physicians who use a Most Influential on
PDA/smartphone said the PDA Prescribing
channel provides clinical PDA/Smartphone
Direct Mail
information that is most Journal Ad
influential in their prescribing Rep Visit
e-Detail
and treatment decisions Pharma brand web site
• 92% of physicians agree that 6% 3% 2% 1%
“clinical information on my 2%
PDA/S, smartphone improves my
knowledge and capabilities” 87%
“Effect of PDA-based information on treatment decisions.”
Mix of 594 primary care and specialty physicians.
Marlborough, MA: Skyscape; March 2008.
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25. “There’s an App for That”
• Apps for electronic medical records
• The software developer, Epic, just released a
new suite of apps that feature PHR access for
a PDA
• Apps for patient information
delivery
• AirStrip Technologies: offers a suite of
HIPAA-compliant apps that collect all
relevant patient information and sends it
to your PDA (including lab
results, cardiology, temperature, etc)
• From QuantiaCare: EatSmart, with
content from Hope
Warshaw, RD, MMSc, CDE, BC-ADM
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26. Clinical Decision Support
• Epocrates
– Founded in 1998, over 400,000 members
– Not strictly a social professional network
– Features immediate formulary checks and drug information, point-of-
care references, discussion topics, and an electronic game on Facebook
called “Diagnose the Disease.”
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27. More Apps for Health Care Professionals
• Apps for medical education and reference
• Krames Patient Education: iPatientED is a quick reference tool for
physicians with 118 animations spanning 22 medical specialty
areas, many with narrations in English and Spanish
• Modality: this company features 120 apps, 55 of which are focused on
medical education
• MedCalc: a medical calculator with a wide array
of medical formulas and scores. Includes
information and bibliographic references for each
formula
• ICD-9 Lite: contains all 13,677 ICD-9-CM
diagnosis codes for quick retrieval by disease
classification in a drilldown format with no typing.
Code to the highest level of specificity every time
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28. New Mobile eRx Impact on Healthcare Reform
eRx “Point-of-Care” deployment
enabling mobile patient
engagement to enhance
compliance & persistence
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29. Social Media:
Transforming the Healthcare Ecosystem
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30. If Facebook were a country it would be the 3rd
most populated – March 2010 (TechXav)
• As of 2011, there are over 800 million active Facebook users –
approximately 1 in every 8 people ON EARTH. (Digitalbuzzblog.com)
• 57% of people talk to people more online than they do in real life
(Digitalbuzzblog.com)
• The average visitor spends 66% more time on social media sites than
they did a year ago (6 hours in November 2010 versus 3 hours 31
minutes in 2009) (mashable.com)
• The number of people who are visiting social media sites has
increased by 24% over the last year (Tech Crunch)
• Internet users worldwide spend more hours per week with social
media than any other online activity (mashable.com)
• The change in social media use among Baby Boomers rose from 9% in
Dec. 2008 to 43% in Dec. 2010 (Marketingcharts.com via David
Erickson)
• Social networking site usage grew 88% among Internet users aged 55-
64 between April 2009 and May 2010 (Pew Research)
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31. Physicians are Highly Engaged with Online
Networks and Social Media.
• Nearly 90% of physicians use at least one site for personal use, and over 65% for
professional purposes.
• Overall, clinicians express significant interest in the potential applications of social
media to their professions – whether via online physician communities, online patient
communities or sites that could facilitate physician-patient interactions.
• A group of “Connected Clinicians” is using multiple social media sites for both
personal and professional uses. These clinicians are the front-runners in applying
social media to medicine, and are most eager to use it to positively impact patient
care
• The vast majority of physicians are already using social media; Facebook tops the list
for personal use, while online physician communities are driving professional use.
• Physicians familiar with online patient communities believe they positively impact
patient health; however, awareness of these sites is low.
• There is significant need for secure, convenient forms of electronic communication
that clinicians can use to communicate with each other, and with patients.
• There are opportunities for constituents across the health care system to use social
media as a tool for improving patient care.
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32. (Mobile) Social Community Benefits for Health
Care Professionals
• (Mobile) social communities facilitate sharing of clinical insights
and solutions to practical clinical problems in a way that
promises to hone “best practices”
• Allows physicians to:
– Access dialogue on best practices
– Source and disseminate immediate research
– Solicit useful feedback about preferred treatments, protocols, and
practice tools that yield best health and patient satisfaction
– Build business arrangements
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33. New Mobile/Social Collaboration in Healthcare
New Healthcare Social Communities being formed for sharing and networking
via mobile…
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34. Integrated HCP/Patient Engagement
HCPs visit Web/WAP disease state or brand portals driven by
QuantiaMD promotion from peer-to-peer educational initiatives
QuantiaMD
• Link to/from portal
• Access to
>300,000 HCPs
• Engagement &
promotion
• Educational &
resource materials
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35. Social Networks Influence Patients’ Treatment
Decisions*
Ages: 35 - 44
53%
Strong
+ some
47% impact
No impact
+ don‟t know
*Adapted from: Pharma 2.0. A How-To Guide to Consumer-Generated Content.
ePharma Consumer v7.0, Manhattan Research 2008

36. Doctors
like wikis
Because of:
Speed
Differential diagnosis
or to jog memory
Ease
A useful starting
point to do research
*Jessica Berthold, Web Watch: Living in a Brave New World of Medical
Wikis, American College of Physicians, 2008 www.acponline.org

37. Examples of HCP Social Media Platforms
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38. Proven Platform
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39. Typical Community Data for 1 Month
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40. Medical Directors Forum
• Private community developed by
Medical Directors for Medical
Directors
• Communicate with colleagues on
a social or professional level
• Share best practices
• Ability to create interest groups
• Access to:
– A broad group of Medical Directors
– Updated guidelines
– Healthcare news
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41. Healthcare Social Networking Looks Set to be
Data-Driven
Not just shared experiences,
but shared personal health data
Patients share structured
information about their disease
to help themselves and others
Quantifiable, measurable, actionable

42. Disease Networks Will Look and be Radically
Different
Data provided by
1056 Betaseron
patients
„People who use
it will live longer;
people who
don‟t won‟t‟
Jamie Heywood
Co-founder,
Patientslikeme

43. Key Takeaways
• Mobile health and social media will
be a part of everyday health care
• Health care professionals will
embrace digital tools/communities
for clinical performance
improvement, time, and $$$
savings/revenue
• Increased
availability, accuracy, “searchability,
Image from the January 2010
” and dissemination of Information Consumer Electronics Show in
Las Vegas. Note “digitalHealth”
in the center.
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