ueda2013 mobile health solutions-d.michael

1. © GSM Association 2013
Meeting the MENA diabetes challenge
with mobile health solutions
Michael Morgan-Curran, Director mHealth Diabetes, GSMA Jan 2013

2. © GSM Association 2013
The GSMA represents the interests of mobile operators worldwide.
Spanning more than 220 countries, the GSMA unites nearly 800 of the world’s
mobile operators, as well as more than 200 companies in the broader mobile
ecosystem.
The GSMA

3. © GSM Association 2013
GSMA recognises the global and local challenge
North America and
Caribbean
38 million
10.7%
29.2% undiagnosed
Rise in diabetes associated with economic development, ageing population,
urbanisation, dietary changes, reduced physical activities and other lifestyle
changes
South and Central
America
26 million
9.2%
45.5% undiagnosed
Western Pacific
132 million
8.3%
57.9% undiagnosed
South East Asia
71 million
9.2%
51.1% undiagnosed
Europe
55 million
6.7%
38,6% undiagnosed
Africa
15 million
4.5%
81.2% undiagnosed
Middle East and
North Africa
34 million
11.0%
52.9% undiagnosed
Source: IDF 5th Atlas 2012

4. © GSM Association 2013
Source IDF 2012 Zhang Survey 2011 London School of Economics
In 2012;
 The cost of prescribing medication for complications of diabetes is around
3 to 4 times the cost of prescribing diabetes medication
 4.8m people died due to diabetes – ½ under 60
 Half of people with diabetes don’t know they have it
 12% of total healthcare expenditures attributable to diabetes = 471B USDs
 Expenditure will rise by 34% by 2030
 4 out of 5 people with diabetes live in low and middle income countries
We know that diabetes management carries a huge cost

5. © GSM Association 2013
mHealth has 2 broad categories
Source: GSMA PwC February 2012
Healthcare Systems Strengthening
Prevention Diagnosis Treatment Monitoring
Emergency Response
Healthcare Practitioner Support
Healthcare Surveillance
Healthcare Administration
Solutions across the Patient Pathway

6. © GSM Association 2013
Source: Intel
Monitor and
manage standard
vital signs
Physician
Caregiver
Data-rich Health
management
systems
One-way communication Real-time two-way communication
Connection to friends
and caregivers
Connection to
healthcare advice
Independence
Safety and friendly
environment
Friendly check-in
mechanisms
Information sharing
Qualityofcareandsocialconnection
Lets look at the evolution in mHealth
Monitor standard
vital signs

7. © GSM Association 2013
Where do Mobile Network Operators add value?
Connectivity InfrastructureSensors
Glucose
Meter
Blood
Pressure
Pulse
Oxymeter
Implant
Monitor
Spyrometer
Gateway
Health Records
Health
Call centers
Hospitals
Care givers
Family
Health Service
Receivers
Patient
Inhaler
Chronic Disease Management Ecosystem
Source: GSMA

8. © GSM Association 2013
In 2010 we launched the GSMA Global mHealth
Programme
To support the development of
mobile health solutions
through cost-effective
delivery of better healthcare

9. © GSM Association 2013
Our objectives
 Demonstrating outcomes and impacts on individuals,
healthcare systems and society by running trials and
producing evidence that show the benefits of mobile
health
 Fostering new relationships and partnering between the
healthcare sector and the mobile industry
 Stimulating scalable, replicable technical solutions that
promote hardware and software interoperability
 Promoting policy and regulatory principles that will
stimulate growth and innovation
 Showcasing mobile health solutions and advanced
cross-industry awareness and knowledge through
events and seminars in the healthcare industry

10. © GSM Association 2013
Our objectives align with many partners
WHO & ITU launch m-
Health initiative to combat
non-communicable
diseases - 17th Oct 2012
Source: WHO, 1st Intnl Forum, IDF
The Diabetes Education Study Group (DESG) of
EASD, in collaboration with IDF-‐MENA Regional
Committee for Diabetes and Ramadan (DAR)
Diabetes And Ramadan
(DAR) 1st International Forum

11. © GSM Association 2013
Case studies – Chronic disease management &
mHealth implementation

12. © GSM Association 2013
Solution Features
• US FDA 510(k) for adults with
Type 2 diabetes**
• Fully scalable solution backed by
AT&T's highly secure network
infrastructure
• Compliant with HIPAA Privacy
and Security Rules
1. US - AT&T (WellDoc) DiabetesManager
Integrated Remote Patient Monitoring system to improve care of diabetes patients
Source: AT&T
Solution Benefits
• Real-time, clinically based
feedback and coaching to
patients
• Healthcare providers and case
workers/managers provide
instruction or intervene as
necessary.
• Shifts focus to the patients who
need help the most
• On-going feedback loop and
intervention helps drive down
costs

13. © GSM Association 2013
Source: Progress in Cardiovascular Diseases 53 (2010)
⃰ Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS
35): prospective observational study.
1. US - Demonstrated success through evidence
WellDoc ran cluster-randomised controlled trial 163 patients in 26 primary
care practices
Results
• A1c levels reduced by 1.9% among experimental group
vs 0.7% reduction in control
Benefits
• 37% decrease in risk of micro vascular complications,
14% decrease risk of myocardial infarction
• 14% decrease in risk of all-cause mortality with no
threshold effect ⃰
Results
• 58% reduction in emergency hospital stays over 12
months
• 100% increase in self management blood glucose
• 100% liked coaching feedback

14. © GSM Association 2013
Source: DOH, 3millionlives.co.uk, healthcare.co.uk
Achieve
3 million
target
Increase
coverage to
100,000
Randomised Control Trial
covering 6,191* patients and
238 GP practices in England
(*3,030 with one of three
conditions: diabetes, heart failure
and COPD)
 45% reduction in mortality rates
 20% reduction in emergency admission
 15% reduction in Emergency hospital visits
 14% reduction in elective admissions
 14% reduction in bed days
 8% reduction in tariff costs
2013
2014 -
2018
2008 -
2010
 Aims to provide support to 3 million people
with chronic conditions and/or in home
care needs using mHealth, including remote
patient monitoring
 Strong support from Minister of Health
2. UK - 3millionlives initiative: demonstrated success
through evidence

15. © GSM Association 2013
Smart Health is the utilization of mobile communication technologies to deliver healthcare services. It is the du portfolio of all mobile health and eHealth services.
These services will enable a range of value added content and disease management opportunities for our customers.
3. UAE - Smart Health from du – providing clinically
relevant content with connectivity
Source: du

16. © GSM Association 2013
 Central electronic health platform
 Extensive health data– CHD & Diabetes
 Reach 200,000 patients
 Continua standards
 Facilitated:
 Greater insight into major health issues
 Development of actions to improve health standards
 Individuals awareness raised regarding their health
 Standards for disease management programmes established
 Diagnosis related groupings created
 Alignment of economic value with health outcomes
Source: HAAD
4. UAE - HAAD Weqaya model: started with a successful
use of rich health data sources

17. © GSM Association 2013
DDatabase
Business
layers
New consumer
channels & Services
• SMS
• Call Centre
• HD Voice
• PDF Health
Report
• Smart phone apps
• Decision prompts
Thiqa
(Daman)
New data sources
• Portable devices
• Sensors
• Remote
monitoring
• Point of care
diagnostics
Data
exchange
Weqaya
Health
Facilities
Mandatory reporting
• HbA1c
• Fasting plasma glucose
• Plasma glucose
• Fasting trigyceride
• LDL
• HDL
• Albumin
• Microalbumin
4. UAE - HAAD Weqaya model: demonstrating successful
use of rich health data sources

18. © GSM Association 2013
The key to successful mHealth Solutions
Providers
End User
Groups
Regulators
Payers
mHealth
Products and
Services
PullPush
Fund /
sponsor
Transnational /
National Health
Approvers
PatientsGovernments /
Insurance
Companies
Healthcare
Industry
Mobile
Operators /
VendorsProfitablePartnerships
DemandmHealthsolutions
Healthcare
Providers
PrescribemHealth
Ensure appropriate
approval

19. © GSM Association 2013
Key outcome: Collaborative Agreement
• To work together to increase awareness and
acceptance of mHealth Solutions / Services
in the Middle East
• Shape mHealth services based on clinical
and organisational need
• Shape sustainable business models which
requires involvement of the government and
private sector – in order to make the service
affordable
• Collectively engage with Health
Ministry/Regulators to address barriers to
approval and implementation
UAE/Qatar/KSA example of partnership
GSMA Innovation Group

20. © GSM Association 2013
Take home message……..
… ‘Mobile Health Solutions
will help you improve
diabetes healthcare through
more cost-effective delivery’
…
Shukran Jazilan

21. © GSM Association 2013
Shukran Jazilan
Michael Morgan-Curran
Director of mDiabetes
Campaign
mmorgan-curran@gsma.com
+44 7730 089240