Mobile Health Maximize Impact

Video Transcript
Speaker: Executive Director of Mobility Services, Lisa Mitnick Managing Director of Connected Health Practice, Frances Dare
JESSICA: Were very fortunate to have with us today Lisa Mitnick and Frances Dare. Lisa Mitnick is an executive director in Accenture Mobility, which is a strategic initiative of the firm. She is responsible for Accentures mobility practice across health and public service in North America. Lisa has more than 20 years of communications media and information services and is a frequent speaker at industry conferences on the topic of mobility and healthcare. Prior to her current role she led strategy and business development functions for Accenture Mobility. Frances Dare is a managing director in Accentures connected health services practice. With her clients, Frances creates initiatives to transform organizations through new organizational and business models, process change and advance technologies. She has worked with a wide range of private and public health systems, public health programs, advocacy organizations and government health agencies. Frances speaks and publishes regularly on a variety of connected health topics including ways to more actively engage customers in strategies to connect the continuum of care. Welcome and thanks for being with us today. At this time I would like to turn the floor over to Lisa.

LISA MITNICK: So what is mHealth? Well, we take a broad view of the definition of mHealth. We look at the entire continuum from wellness and chronic disease management, aging in place to things like point-of-care tools in telemedicine as well as plain old service and administration services that make it easier to do business

with payers and providers. So perhaps a better way to look at mHealth is by looking at these three circles you see on the slide. The first area is around wireless connectivity and theres lots of ways to connect wirelessly; 3G, 4G, bluetooth, wi-fi. The second area is mobile devices and its not just about Smartphones and tablets, but its also about things like sensors and biometric monitors as well as medical devices with wireless chip sets and then finally applications. That can take many forms: mobile, web, native, hybrid applications as well as techs and video. All in all mHealth really can support a wide range of clinical services and administrative interactions among clinicians, patients and organizations in any location. So lets now switch over to some of the benefits associated with mobile health. Mobility truly enables payers strategies with both business and beneficiary impact. It enables you to engage beneficiaries and provide exemplary experiences, also providing value-added services to your physician networks. Another thing thats really important is it enables you to effectively manage population health driving better utilization, lowering costs. Another reason that folks are interested in getting into mobile health is because it can drive competitive differentiation with new services delivered through new channels and reaching new end customers. Another area thats important is to prepare for business expansion in the direct consumer marketplace and finally, to compete for national accounts with new and innovative programs.

So whats cool? What do we think thats cool out there? Things like gaming and social media and loyalty programs are very exciting. A lot of payers are experimenting in this area. Were even seeing some VC funding attracting in this area. Theres some new companies out there like San Francisco-based Mango Health that got $1.5 million funding for their medication adherence solution, but whats particularly interesting is the founders of the company are from the gaming industry, so were seeing an influx of folks from gaming and media and entertainment looking at health as the next cool place to invest because they see such tremendous impact.

benefits, but services that consumers or others would pay for directly as value-added services. LISA: Okay, lets move onto the next slide here. So mobility can be transformative to healthcare in many ways, across patients, across physicians, payers and employees. So if we take patients, patients are engaging their own health and wellness through mobile. Everything from learning and self-diagnosis to tracking their health and accessing health records and lab results so that its really helping them to get engaged and from a physicians standpoint were seeing all sorts of exciting new point-of-care tools. Some are very simple ranging from calculators for dosing, but we are also seeing a lot of innovation from companies like Air Strip Technology. Its where doctors can now receive weigh-form data and other critical data from EMRs, bedside monitors to monitor mom while shes in labor or the future mom or the cardiac patient. Theres also tools like Calgary Scientific which is transforming radiology by delivering iPhone images that can be used to diagnose stroke victims, for example, these three-dimensional images that enable collaboration and a zero footprint that are HIPA compliant, make it much easier for physicians to work anywhere and support diagnosis. And then we have payers. Obviously one of the key areas that payers have been focused on is service and administration...making it easier to do business with them, availability of your ID card, being able to check on your coverage, find a doctor, but were also seeing a lot

FRANCES DARE: And, you know, Lisa, I love that example of gaming because its a great way to engage a population of consumers and patients who historically have been really tough to reach and thats young men in that kind of 18 to 30year-old age range that are often healthy, but also have some highrisk behavior sometimes around health and wellness and gaming is just a natural fit, a great way to get those folks involved in health and thinking about their lifestyle and ways to stay healthy and active as long as they possibly can and what this like says to me in general is that there are so many opportunities through mobility and mHealth approaches for real innovation by payers around business models and new products that drive business growth, opportunities that target specific populations and even new revenue-generating products that could be in addition to health plan

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of focus now on care management and disease management and leveraging the power of remote health monitoring to bring additional data to manage certain populations. And then last, but not least, we want to really focus on employees, we dont want to leave that out. Lots of companies are mobile-enabling their workforces whether its sales force enablement with tools that make it easier to sell to large payers, improving transparency around processes, business intelligence, as well as mobile enabling the back office in terms of HR finance and procurement so lots of great ways to mobile enable the payer today.

Wild West out there, everybody off doing their own thing and increasingly companies are coming forward and saying hey, I want to set up a mobile center of excellence, I want to think through everything from mobile device and application management, to secure devices and ensure I get the right apps to internal employees as well as how to do development of apps, should they use cross-platform tools, how should they set up for success. So lots of work to be done in that area. I think were starting to see progress across the healthcare industry in adopting new types of standards and governance to really harness the power of the mobile channel. So lets switch over to what we really mean by mobile. Theres mention dimensions to mobile technologies and you see four quadrants here on this next slide. The first in the upper left-hand quadrant is around communication, things like web-based video and chat and text messaging alerts and campaigns and I dont know how many of you realize this but SMS or text messaging has eight times the response rate of email and thats from studies done by folks in the retail industry who are obviously very focused on getting high response rates here. But text messaging is oftentimes thought of as, oh, thats being used in the developing world, but thats not just the case for the developing world. Its really important here in North America and in the developing world. Its very, very effective particularly among the young demographic. The program which Im sure youre familiar with, Text for Babies, is a free service, its

very successful, has over 280,000 folks enrolled and its delivering three texts per week about how mom should have a healthy pregnancy or the mom-to-be so to speak, and these types of tools are just very, very effective and cost effective as well.
In the upper right-hand side youll see mobile web and many payers have adopted mobile web due to the broad accessibility, ease of use as well as its less costly to maintain, so well see a lot of mobile websites out there, but for those that want to take advantage of the rich features of the phone, more frequently folks are pursuing what we call native mobile applications like for IOS and Android as well as hybrid apps which is a combination, do that theyre able to take advantage of things like the camera, the GPS, the bar code reader as well as support things like off-line engagement. Another benefit is the real estate that you get on the phone or the tablet, which many payers find attractive. And then in the bottom right-hand corner you see something called Mto-M connected devices or machine-to-machine and we think this is really one of the most exciting areas for health because it involves things like sensors, monitoring devices, the ability to collect information off the body, in the home, off these devices and provide really rich information that can be used to manage folks health and so you see all sorts of applications out there: MyGlucoHealth, med apps, Telcare, Health Buddy, VitalityGlowCaps, lots and lots of innovation. Even a digestible pill, things like you see from Proteus Pill,

FRANCES: You know, Lisa, there are so many neat things happening and something new virtually every day in terms of a new app or a new service, but I know that when you and I are working with clients, we also do see that an awful lot of these initiatives are happening and maybe one part of the organization is focused on beneficiaries and mobility for beneficiaries and another part of the organization is really focused on innovation with mHealth directed more at the physician network, and more and more were advising clients to really be sure they have an enterprise-wide view of everything thats going on, in part to support the technology teams that are key to all of this and so that were not driving unnecessary technology costs and technology complexity. That enterprise-wide view and enterprisewide strategy is, we say a critical success factor for all of this.
LISA: Yes, its a great point and sitting in the mobility practice at Accenture we see a bit of the Wild,

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so lots of exciting advances. Today a lot of the products youll see out there are sort of purpose-built, they do one thing where I think where the industry needs to go is have more of a system-integrated whole person solution, but were moving in that direction and we are seeing quite a bit of innovation.

on? Where are we in terms of market readiness?

FRANCES: And the other exciting trend were seeing is that more and more its a combination of voice, text and video. Video is really coming to life partly with tablets, right? A little bit larger screen space and thats both recorded video for learning and that kind of thing, but as well live interactions from mobile devices that have that rich, human dimension to them as well. LISA: So where is mHealth? Its really at a tipping point and I know youve heard this before. All the prognosticators are saying, its going to be a multi-billion dollar industry and its going to take off this year, but we really do think in the next 1218 months were going to see tremendous progress in mobile adoption in the healthcare industry and while health is far behind other industries like financial services or retail or automotive in terms of adoption, we think it stands to have a larger impact on society in terms of lowering cost, driving improved health outcomes and I think we all know from statistics that we look at every day that health expenditures as a percentage of GDP are through the roof and the United States is the highest in terms of expenditures relative to the other developing nations and we really need to bring those costs down. So whats going

So we are starting to move beyond early innovators to mainstream health systems and Im going to show you a slide in a few minutes that shows some benchmarking that weve been doing across different payers and youll get a sense of the heavy activity thats going on among payers.
The second thing thats happening is FDA clearance of mobile devices really continues to increase. Even in July we saw over a half a dozen clear devices, whether its Asthmapolis or new evolutions of air strip, the BodyGuard System, InTouch Health, lots of different devices coming onto the market or new enhancements to devices so thats been really great. A lot more availability of these medical devices. The next this is that leading health organizations are moving from pilots to larger sale programs and services. So in the old days we might have seen a pilot that involves 30 to 60 people and while the results in terms of ROI in terms of these trials was strong, the numbers were low. Now were starting to see larger trials instead of being 50 or 100 people, more like 1,000, 2,000 people and while thats not as big as what we saw with the VA which has been a tremendous trial with over 30,000 patients, we are starting to see a lot more momentum by the payers and providers in adopting these programs to bring down costs and we have seen impacts like for the VA. They saw reduction of 19 percent in hospitalizations or 25

percent reduction in bed stays for participating patients so the evidence from these trials even though there are not as many as we would like to see has been very good.
Health organizations see the need for mHealth, but are still struggling through with a bit of market confusion and noise. We did some research back in 2010 and it showed that the biggest barrier right now is the business model, whos going to pay for this stuff and second was the issue around interoperability. I spoke a little bit earlier about the notion that theres all these purpose-built devices, but what we really need is a system where everything works together. The FDA had been an issue earlier, but I think were starting to see a lot more momentum in that area so that is really not one of the bigger barriers today. So I think were going to see more momentum. We really have to get through the business case and the business model, but I think the evidence from these trials is looking very positive.

So as I mentioned to you earlier, we regularly scan the web and the Apple App Store and Android marketplace to see whats going on with payers and providers in terms of mobile adoption and so this chart then Im going to walk you through in just a minute kind of gives you a snapshot of what five different payers are doing in mHealth based on just this third party research and its done at a point in time so things could change, but it gives you a good feel for whats going on in the market, what people are doing and

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how theyre pursuing mobile to engage with their members and increase ease of use. So I just wanted to kind of acquaint you with the slide for a minute because its a little bit busy. So along the bottom youll see a legend with different colors. The yellow is mobile web; blue is native applications; green is hybrid app; gray (I think hats gray) is SMS; and red is available. And so what you can see along the left-hand side are different types of functionalities available in the mobile apps or solutions that are out in the market today and so we looked here at HCSC, Aetna, United Health Group, Humana, Blue Cross/Blue Shield, Florida. And what you can see is that there is a lot of activity going on in the service and administration area in terms of view your claims, UNID card, look up your benefits, find a doctor. Those sorts of things are becoming very mainstream, but what you can see is that folks have taken a slightly different approach to their development. Some have gone with mobile web, others are saying they want to take advantage of some of the rich features of the phone. So, for example, in a find-your-doctor kind of situation having GPS can be quite helpful. Across the board everybody is using SMS-based patient medication reminders and also everyone seems to be using social networking. Now, it still may be at an early stage of engagement, but its great to see that the payers are actively involved there.

As you go down the page and Im not going to go through every one of these in the timeframe, what you can see is on wellness apps and remote help monitoring, there is quite a bit of activity going on there and quite a bit of experimentation, folks are taking different approaches, and then lastly youll see theres a bunch of white space that there are things that folks arent doing today, working with an online health coach, setting up direct deposit, using the camera like they do on Citibank to take a picture. I think you all remember the Citibank commercial where you take a picture of your check and you can deposit it while youre sitting in your living room. Were not yet taking advantage of all that capability yet, but there are more opportunities to continue to deliver convenience and services for your members. So I would give the payers a good mark for really getting in the game, for getting applications out there and really working to make it easier to do business. I think we still have work to do around moving from pilots and remote health monitoring and wellness to really adopting that on a full-scale basis, but I think its just the beginning of the journey.

Copyright 2012 Accenture All rights reserved. Accenture, its logo, and High Performance Delivered are trademarks of Accenture.