An edited version of my presentation at the Mobile Health Workshop for Engineers and PhD scholars at National Institute of Technology Surathkal, Mangalore.

1. Mobile Health as I see it!
Dr. Neelesh Bhandari
MBBS (AFMC), MD (Path)
PGP Human Rights

2. In 1816
The stethoscope was invented in France in 1816
by Dr. René Laennec at the Necker-Enfants
Malades Hospital in Paris.

3. m-Deerghayu, CDAC Mohali, 2016:
Currently Cost About 6500/- INR
Dr Bhatia, Project Lead; says prices can be brought down substantialy
by mass prouction
(Illustrative only)

4. What Do I Want To Share
• Why I believe in mHealth
• The Evolution of mHealth as I saw it
• India's Flirtations with mHealth
• Current mHealth Markets in developed and developing
countries
• Best Practices

5. Why Do I Talk on This?
• Graduated From Armed Forces Medical College, 1997
• Ran Medical Website Designing agency 1998-99 (which
obviously bombed!)
• Practiced and specialized in Pathology 2007
• 2007-2010 in corporate medtech MNCs
• Serial Entreprenur since 2010
• Founder CEO: Digital MedCom & CoFounder: Healtho5 Solutions
• "Best HCSM Agency 2012": Time research Media
• Chairman, Social Media Commiittee , Indian Association for
Medical Informatics
• Chief Mentor; Society for Knowledge and Health

6. Internet Users in Dec 2014
1) 600+ Million in China
2) 300+ Million in India
3) 285+ Million in US
Internet And Mobile Association of India (IAMAI) latest press release

7. Growth Mainly in Mobile Internet:

8. Mobile Internet has overtaken desktop

9. More Smartphones soon

10. Mobiles more acceptable than toilets!

11. Why India needs mHealth:
• We lack 10 Lakh Doctors
• We have less than One bed for 1000
population
• We have 210 mobile phones per 1000
population
• Vast Population; Vast land
• Rapid uptake of mobile solutions
• Successful pilots

12. Our Data for Mobile Physicians :
Data from many Medical
blogs and digital
properties maintained by
Digital MedCom
Solutions show 25%-
40% of Indian doctors
access content and
enewsletters via
smartphones or Tablets.

13. Sensor packed Smartphones:
For example, an iPhone 4 has the following
types of sensor:
• Accelerometer
• GPS
• Ambient light
• Dual microphones
• Proximity sensor
• Dual cameras
• Compass
• Gyroscope

14. Rise of Smartphones mean for mHealth
• technology-based diagnosis support,
• remote diagnostics and telemedicine,
• GPS navigation,
• access to web-based patient information,
• post-visit patient surveillance,
• decentralized health management information systems
(HMIS).

15. What i see...
• More and More Indians are Using Smartphones to
access the Internet
• Medicine/Health has always been among top 5 uses of
Internet in all surveys
• Wireless communication is the way to go for India
• Poor Accessibilty to healthcare services at present
• Sharp uptake of smart devices among HCPs

16. But What Exactly is mHealth?
• Ask those in #mHealth hype and they say
(smart)phones.
• Ask those who DO #mHealth and they talk
about holistic ICT ecosystems.

17. World Health Organization def:
Medical and public health practice
supported by mobile devices, such as
mobile phones, patient monitoring
devices, personal digital assistants
(PDAs), and other wireless devices.

18. eHealth --> mHealth
• Remember eHealth?
• Popular term in late 90s and early 2000s.
• Defined: "E-health is the transfer of
health resources and health care by
electronic means"
• Many professionals refuse to distinguish
between eHealth and mHealth

19. mHealth for me:
Provider is Mobile
OR
Consumer is Mobile
OR
Data is Mobile

20. Benefits of correct mHealth
• improved productivity,
• increased information access,
• better communication,
• fewer medical errors,
• greater mobility, and
• improved quality and care

21. Objectives of mHealth in Public Health:
• increased access to healthcare and health-related
information (particularly for hard-to-reach
populations);
• improved ability to diagnose and track diseases;
• timelier, more actionable public health
information;
• expanded access to ongoing medical education
and training for health workers.

22. Famous Public Health Use
• Dial 1298 for Ambulance was the first responder
during the Mumbai attacks in 2008, which
subsequently led the company to engage with
the public sector through state government
contracts
• Voice telephony and SMS functionalities
extensively used during Tsunami, later
landslides and floods
• Many govt and private services allow triaging of
patients and for non-emergency care
• Widely used by ASHA workers for surveys in
India

23. Beyond Smartphones:
• Patient monitoring devices
• Mobile telemedicine/telecare devices
• MP3 players for mLearning
• Microcomputers
• Data collection software
• Mobile Operating System Technology
• Mobile applications (e.g., gamified/social
wellness solutions)

24. Are Mobile Apps Any Good?
Study shows that 19 percent of all
adults who have downloaded and
routinely used at least one health app
show better health outcomes; among
full-time workers, this percentage rose
to 23 percent

25. The Mobile Health Network

26. We Have ECGs on Physician's Phones

27. Sense Sleep Pattern

28. Smartphone Assisted UltraSonography

29. The Swasthya Slate:

30. Social Entreprenurs in mhealth:
KickStarter Project

31. mDhil
• mDhil is a health promotion organization launched in
India with a for-profit business model. For 1 rupee a day,
consumers receive to their mobile phone three health
messages created by registered nurses and physicians
on topics such as weight management, sexual health,
and H1N1.
• At the end of 2009, mDhil had 150 000 paid subscribers,
and closed a ‘series A financing round’ with a venture
capital firm.
• mDhil sent out 1 million public health SMS messages by
the end of 2010

32. Apollo Telemedicine Networking Foundation
• Led by Prof Krishnan Ganapathy, senior
consultant neurosurgeon, and a pioneer in
introducing and popularizing telemedicine in
India
• Apollo made its first steps into mHealth with
triaging services, health information and advice.
• Now includes remote ICU monitoring, electronic
health records and a mobile telemedicine unit.
• Early signs of success are encouraging.

33. Narayana Hridyalaya
• Ably led by Tech Savvy Dr. Devi Shetty
• mHealth Projects in South and East India
• Telemedicine/ Telecardiology/
Teleopthalmology/ patient monitoring/ Cloud
services
• Hopefully change India's healthcare scenario..

34. Current Markets in Developed world
About 10-15 Billion USD at Present...

35. Early Rapid Boom in Progress:

36. "Monitoring and Diagnosis" apps Rule!
Mobile Health in India to be a 3000 crores INR opportunity by 2017

37. Niches Within mHealth ecosystem

38. Specific Therapy Areas with large markets

39. 5 sources of Revenue
• Services: The most important and constant source of
revenue for most mHealth apps, maybe monthly or pay-per-
use
• Selling Devices (sensors, BP monitors, bracelets) is a
fast expanding source of revenue
• Initial Download fee: a small upfront fee at download has
contributed to revenues for many
• Other Financial Transactions: like insurance, connected
pharmacies selling drugs, etc
• Advertising

40. mHealth Adoption by professionals..

41. Barriers
The following is a list of potential obstacles to successful
implementation:
• User perception and acceptance of the device
• Privacy issues
• Interoperability with the EHR and other sensor derived
information;
• Reimbursement; currently there are no codes for
reimbursing clinicians for monitoring the data
• Social inclusion of wearers
• Technological capabilities of the system including power
requirements

42. Key Factors in India:
• Government
• Regulatory
• Acceptance by Healthcare Industry
• User Adoption

43. A Good Mobile Solution
At its core a good mobile health strategy will
consider:
• Device integration
• Data standards
• Data integration back into the EMR
• Physician workflow and usefulness
• App usability by the patient

44. Democratization of Healthcare..
Mobile health is ready to come-in as
the de facto Do-It-Yourself
healthcare platform of the masses.

45. Contact Me:
• Twitter: @edrneelesh
• Mail: drneelesh@healtho5.com
• Posts: blog.digmed.in
• Phone: 07022025536