With apps and phones as mediators
I recently attended Mobile Health Summit 2013 in Stockholm. The event presented 12 different “mini cases”, where different large and small companies showed their innovations or products followed by a great panel discussion afterwards. The common denominator among all cases was not so much about the mobile apps or even mobile phones as about service set-up. Yes, apps and phones were part of the mix, but the most important thing was indeed service setup. For what is an app without its service? A game? Or even something that only takes megabytes of space on your phone? Of course you may say, it has to be filled with content and have a clear purpose. This is why a mobile health system is somewhat different than an app…
Services at the heart of a good mobile health system
A health system is a business system purpose-built for addressing a health issue/problem – its “solution” in other words. What I heard at Mobile Health Summit was how important it is that the solution has the right service. In this context it is about how the system renders services to its users. A service, according to TOGAF (The Open Group Architecture Framework), is “a logical representation of a repeatable business activity that has a specified outcome. A service is self-contained, it may be composed of other services, and is a ‘black box’ to its consumers”.
Transparency and security are key
Quite a fuzzy definition according to myself. And should a service really be a black box to its consumers. Well, it might be, but it should not be (other than in a very technical system, do not mix it with components now…). Why? Because today, transparency is seen as more and more crucial. Any politician knows it and any teenager knows that most things will end up on Facebook, Instagram and other places, regardless whether you want to or not. Corporate transparency towards customers is getting more vital by the day, as social media and the web, with its many fora makes it so easy to complain if something is not right. So should also services providers of any kind think: We are offering our customers a service and our service must be the best available service. And our customers must rest assured that the information they have provided is secure and used in the right way.
In a health perspective it is even more important that the information provided is secure, only reached by the people who need access, at the right time: It might be a matter of life or death. Information in the wrong hands can be dangerous or at least harm the person it is regarding. So, security is crucial. But even more important is to ensure the users get the information when it is a matter of life and death.
A mobile health system has some additional unique characteristics. It must let you reach the system while you are on the run. It must be boundless in its location, and maybe even in time (if its that kind of system). Mobility the way I see it has to do with that you are totally mobile, physically and something that you can carry with you at all times or at certain times, if and when you need it – like a mobile phone or a laptop computer.
A mobile health system needs to help someone with a health issue/problem, help defining it or learn how to prevent it to even occur. It can be of general help to anyone (like a training app) or very specific (an app that helps a sick child to understand its diabetes).
Common to all 12 cases and the panel discussion was the problems faced by an innovator when trying to make a global health system, any kind of health system. Service design is vital! Every country has its own rules and laws regarding how to treat information, what policies it has and even about its infrastructure. Taking only that into account. it is hard for any small (and often also large) company to create a global solution. Of course, when talking about an app/system for weight control or an app that motivates you to go to the gym more often or even record you latest running session, service design is somehow easier from a security stand point. But now I mean health issues/problems that are more “serious”, a matter of life and death.
Innovation, personal experience and secure information
One innovation challenge in this area is to make sure that the mobile health system users have access to the specific tools that a specific situation requires. I can think of many situations where I would have benefited from this. Sometimes it is very easy, like when I broke my foot and went to the hospital. I got my x-rays, a pair of crutches, some bandaids and a “good luck” from the doctor. I was not very happy with that, so after a week or two, when it did not get that much better, I went to get a second opinion. The next doctor wanted to see the x-rays and since I had taken a picture of the x-rays with my mobile he could see it without the need to repeat taking new x-rays. In an ideal world he would have them on his computer, but since this was a private clinic and the hospital a public own facility he could not access it very easily. He said he needed to to do an additional MRI to get a better view of the complete injury, but the fact I had the x-rays with me helped him a lot and I got quicker help. The same goes for a friend who has cancer, but it is much more complex. The best way for my friend to make sure that each doctor gets the right information is for her to carry a copy of each of her medical files or at the very least the important ones. We are talking 2013?!? There should be standards for that (and yes some exists). Yet, standards are hard to decide upon, they take time and a lot of effort to implement. Security can also be a hard nut to crack, but what is the purpose of security? Is the purpose of security to ensure patient safety or to enforce hospital regulations? There is a huge difference between patient security and patient safety. Mobile systems can change this around, make it much more natural for everyone to demand access and get the right information to the right person at the right time.
What can we expect forward?
Mobile health is very important and very (very very) interesting from an innovation perspective. Mobile health is truly about how to reach the right information at the right time, and making the right decision for a patient or community or for YOU. Its mobility has nothing (or very little) to do with whether or not a mobile phone or app is involved. Mobile systems have already saved lives and given a higher quality of life for some.
In 2013 we demand that we have the right information at the right time. Most of us are mobile and we live an active life. I’m sure that mobile health systems have a great future, and that they will become commodity, eventually. We just need to agree on what is important: Share that vital and secure information and – for the sake of our kids and their kids – agree on the right standards so that we can share it with everybody that needs (and I mean really needs) that information. The expression “Mobile First” is something I am a big fan of and I am sure you do too. I wish we can make our lives better, healthier and more mobile in all aspects.
Bill Gates vision “Information at your fingertips” from 1995 has never been more real than today, but I’m sure its more mobile than he thought at the time.
Do you agree to my thoughts? What is your opinion? Please tell me and let’s discuss how we can create more systems and solutions that benefit global health.