A new report contains a set of recommendations for mHealth policy-makers (including governments, health NGOs and regulators); telecommunications operators; systems integrators, manufacturers and technology providers; and healthcare providers and insurers to enable innovation in mobile health that can transform healthcare in both the developing and the developed world. The University of Cambridge and China Mobile teamed up to conduct a study describing and forecasting a vision of mHealth they state "can contribute to bringing healthcare to unserved or underserved populations; increasing the effectiveness, and reducing the costs, of healthcare delivery; improving the effectiveness of public health programmes and research; preventing illness (for example through behaviour change); managing and treating chronic diseases; and keeping people out of hospital" as well as serving as a platform for global sustainable development.
The recommendations in Mobile Communications for Medical Care are:
Policy-makers should ensure that policies and priorities for healthcare are complemented by financial incentives that reward those who deliver outcomes, particularly in disease prevention.
Policy-makers, healthcare agencies and professional healthcare bodies should provide guidance for assessing the healthcare and public financial benefits from emerging applications in a manner that can be understood by application providers, and create an expectation that such assessment should be an integral part of provision.
Public health authorities and agencies should engage in assessing the benefits and costs of acquiring information – whether as “by-products” or directly – from mobile applications, either to replace existing data gathering or to gain new knowledge. This requires clarity of ownership of, and access to, personal information.
Regulatory regimes and the medical establishment’s guidance-setting need to strike an appropriate balance between the risks and benefits of specific mHealth applications, distinguishing between those apps for which a light touch or a market-based approach is appropriate (i.e. those that pose no risk to health and may be effective, and which typically have little or no interaction with the established health delivery system) and those which have the potential to bypass or substitute other healthcare systems (i.e. those that might pose a risk to health unless properly regulated, or which might need to be robustly evaluated if health system money is to be put into them).
Telecoms regulators should review any constraints that existing regulations may place on the deployment of mHealth applications. In particular they should consider allowing mobile operators to operate as micropayment banks, i.e. directly handling small financial transactions.
Operators should have clear strategies – which might be different in different markets – for how much of the value chain (basic services, generic platforms, application provision) they wish to operate, balancing investment, financial return, reputational risk and the presence/absence of other players operating parts of the value chain.
Mobile operators should promote their networks as platforms for innovation and small-scale application deployments, and should invest in the provision of generic service platforms for this purpose. They should facilitate the use of the platform for domain specific innovation (here healthcare, though the recommendation is more generally applicable) by third parties, recognising that, even if they choose to operate some applications directly, some applications will be too small (or present excessive risk) for the operator to provide.
Medical device manufacturers should exploit the power of the mobile handset as a computing and communications platform, even when the computation required to deliver a particular application cannot reside completely on the handset. The swiftest take-up will be of applications that rely only on voice, SMS and WAP.
There is an opportunity for technology providers to provide the tools for creating or running managed services related to mHealth, which will in turn enable operators to provide generic service platforms. Technology providers need to decide whether their strategy is (a) to build and sell or (b) to build, sell and operate, perhaps in direct competition with operators.
Healthcare providers should examine mHealth applications as a means of managing exposure to costs – e.g. through the use of in-home monitoring to avoid hospital or residential stays. This might allow reduced charges or premiums, or increased profits.
Healthcare providers should consider how they might use data generated by mHealth applications to monitor and optimise the healthcare delivery chain itself, e.g. by improving the management and efficiency of expensive assets, or by better understanding the patterns of use.
To download and read the full report... that contains several useful models for thinking about the mobile health space and its applications to diverse health issues. A very insightful and timely piece!