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Delivering the mHealth message

Axel Nemetz Global Head of Vodafone mHealth Solutions

Q. Vodafone provides many mobile health (mHealth) solutions to key stakeholders involved in the provision of healthcare, such as pharmacists, physicians and patients. What are these solutions and how easy are they to implement?
We are working with the pharmaceutical industry to apply mobile communications in an innovative yet practical way. We help companies extend their value proposition ‘beyond the pill’ and to introduce process efficiencies across a number of different functions.

The basic premise for all of our solutions is to provide healthcare stakeholders, including patients, with more freedom and flexibility. This can be achieved through remote communications, enabling those stakeholders to access, capture, share, and report data instantaneously. The solution areas in which we enable the application of these types of capabilities are in remote care services, mobile flexible working, access to medicine, clinical research, and marketing & engagement.

Vodafone offers these solutions as end-to-end managed services that include hardware, software, and connectivity, which can be network agnostic if appropriate from a regulatory perspective. Our solutions leverage best of breed capabilities. Since Vodafone is the world’s largest multinational mobile network operator with about 400 million users it allows us to take out complexity for our customers and deploy these solutions across our footprint.

Q. Please outline which applications can be used to support business strategies, especially in an industry that has cost-saving at front of mind in the next five years.
Mobile health technologies can play an important role in driving down costs by optimising and simplifying process workflows across two major business functions: clinical research and sales & marketing. Within clinical research mobile can bring improved communications with patients, providing more effective recruitment campaigns and better engagement with patients during trials, promoting retention and compliance. Through the use of mobile patient reported outcomes diaries, patient data can be collected more accurately, and in real-time to meet increasing regulatory criteria or to stop trials more quickly during development. This will help offset some of the challenges presented by government’ cost containment measures, helping customers provide value back into their pipeline.

Within the area of sales & marketing, the new range of tablet devices demonstrate how mobile devices can be used to make field forces operate more effectively – or more specifically how pharma representative and KAM teams can leverage mobile devices to access CRM and ERP systems on the move, optimise detailing calls, and reduce time spent on administrative tasks outside normal office hours. In addition to cost and process optimisation, mHealth services can provide value added services to physicians and patients that extend ‘beyond the pill’, varying from learning and content tools, compliance management services and remote monitoring.

Q. Please outline what barriers there may be to these types of mHealth implementations, especially when applied to varying healthcare systems around the world.
From an adoption point of view mHealth, or any introduction of new technology, will mean change to those involved in providing or receiving healthcare, whether such change is complementary or disruptive to an existing process, barriers to adoption are evident across a number of areas. In our 12+ years of experience within this field, we feel that most of the barriers come from three different sources: human behaviour of the actual patients and healthcare professionals; the policy and regulatory environment; the technological environment encompassing interoperability, security, and data privacy.

In November 2011, we published our first report in a series of Insights Guides in which we reflect and evaluate on those specific barriers. Through the Insights Guides we aim to stimulate new thinking within this space. Additionally we are organising special Health Debates in which we bring together stakeholders from across the health ecosystem to discuss their views upon the guides and build thinking upon the topic more comprehensively.

Q. What advice do you have for overcoming these barriers?
The only way in which mHealth implementations can be truly successful is by engaging all of the stakeholders involved and making sure there is win-win for all of them. This also means shaping the solution requirements around the local needs and having on-the-ground resources available to carry projects through to implementation. Elements like training and incentive schemes (where applicable) need to be considered and planned through carefully.

Q. The pharmaceutical industry is looking to expand its reach into emerging markets. How can it use mHealth within such markets? Despite the absence of many basic facilities and infrastructures across large areas of the emerging and developing world countries, mobile phone penetration is high and growing. Within Africa, mobile phone penetration in 2011 exceeded 62%. To put this in context, in 2007, within a total population of 5.3 billion, there were 2.3 billion mobile phones and only 11 million hospital beds.

Without a doubt, the mobile phone is shaping up to become a true gateway to healthcare services in these countries. Two great opportunities are presented to the pharmaceutical industry to leverage mHealth for improving access to medicine across these regions. Specifically, we have worked together with customers to provide a solution to monitor in-country drug supplies to prevent stock-outs of drugs for Malaria, TB, Leprosy, and others. We are also providing an anti-counterfeiting solution, enabling pharmacists and patients to authenticate a drug before intake.

Q. How do these types of applications vary from uses of mHealth in established markets such as Western Europe and the US?
In addition to our mobile flexible working area, with solutions in field force enablement as discussed earlier, we see the biggest opportunity across the Western economies in the application of remote care services to decentralise certain elements of healthcare through ongoing patient/condition management services as well as the enablement of a speedier transition from hospital to home based care. Within this area, a great opportunity further resides in the application of machine to machine (M2M) connectivity specifically, where we can remotely connect medical devices and sensors to capture data on usage, registered vital signs or patient data (dependent on the type of device), as well as device maintenance needs. Along with capturing the patient view through mobile diaries, a truly rounded patient view can be administered remotely. For the pharmaceutical industry, this could translate in a beyond the pill value proposition to physicians and patients, but perhaps more importantly, can enable organisations to capture post-marketing effectiveness data in a non-clinical environment and produce data banks that will enable improved clinical trial recruitment.

Q. What advise do you seek from the pharmaceutical industry when creating mHealth applications, and how does this influence the applications you provide?
mHealth is a great and exciting opportunity that brings the best of two industries together in which no single party holds all the answers and close collaboration is the key to success. In our projects, we look at our pharmaceutical customers to bring in their deep clinical understanding as well as their knowledge of the local political environment and their relationships with healthcare professionals – those are vital for us to be able to support the development and adoption of new configurations and integrations of our capability platforms. At the same time, the pharmaceutical industry benefits from working with us through our end-user experience, the engagement of mobile data services, and the transfer of private data in a secure and regulated environment.