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STRATEGIC REPORT & FORECASTS

Executive
summary
Mobile
Healthcare:
Markets and Trends for
M-health Applications

Worldwide Market Analysis
and Strategic Outlook

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STRATEGIC REPORT & FORECASTS

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Mobile Healthcare: Markets and Trends for M-health Applications
Mobile Healthcare: Markets and Trends for M-health Applications assesses
current and future implications of m-health across global markets. It
reviews a whole spectrum of possible m-health products and services and
analyses what is driving these to commercial deployment.

The report gives in-depth consideration to the procedural, technological and
regulatory barriers that must be overcome for market potential to be realised.

The Mobile Healthcare report is essential for:
Mobile operators:
• Identify where the potential opportunities to drive revenue exist
• Find out who key players are and where successful partnerships
may lie

Device and component vendors:
• Understand what new technologies are emerging and which to pursue
• Identify who to partner with
• Find out the potential market size and who is driving demand

Healthcare professionals, pharmaceutical companies and government health and
regulatory departments:
• Find out how m-health can improve efficiency and health outcomes
• Identify key suppliers and who is innovating where
• Understand the issues that must be overcome for deployment

“The use of mobile communications to support health
services is a growing global trend. M-health - as it is
commonly referred to - promises cost-efficiencies and
improved health outcomes with a dizzying array of services
beyond the humble appointment reminder. The explosion of
mobile broadband and the promise of high data speeds
with LTE make high bandwidth applications for remote
monitoring and diagnosis an exciting value proposition.
Philippa Hobbs, Business Research Executive, Informa Telecoms & Media ”
For more information visit www.informatm.com/mobilehealth

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MOBILE HEALTHCARE:
MARKETS AND TRENDS FOR M-HEALTH APPLICATIONS

Chapter 1
Executive summary
Mobile healthcare: what and why?
Mobile healthcare is a relatively new term in telecoms. Often referred to as m-health, it is
used to describe a myriad of mobile services and wireless technologies designed specifically
for use in the provision of healthcare. The majority of the m-health market currently sits
within the enterprise segment, although the number of consumer-targeted health and wellness
applications is on the rise.

Activity in the mobile healthcare space grew considerably in 2008, shown by the particular
focus placed on mobile healthcare at the Mobile World Congress 2009. The expansion of
HSPA networks with the explosion of mobile data demands, the growth of mobile broadband
and the promise of even higher speeds with LTE mean that deploying advanced applications
requiring higher data capacity on a wide scale is becoming increasingly viable.

A number of major network operators offer services to the healthcare industry; healthcare
organizations have been corporate customers of the operators for many years. Pressure on
health systems to manage resources better has created a valid market need for applications
which increase operational efficiency within healthcare organizations. The majority of
deployed services are basic enterprise telecommunications for communication or information
transfer with a particular customization for use within a healthcare organization; this
customization might include features such as guaranteed network coverage for emergency
services and security features to protect sensitive clinical data.

To support functions that relate more directly to the process of healthcare provision, M2M services
such as tracking, tagging and remote patient monitoring are key emerging trends. The EU is
investing more public funds in this area – notably into remote monitoring and the development
of ‘intelligent environments’ using wireless sensor networks, and innovation in the private sector
is growing, but the market remains largely untapped while barriers to market persist.

There is a potential value proposition in monitoring services with medical devices connected
wirelessly to handsets. These services and devices could be either outsourced to monitoring
companies, or perhaps self-managed by mobile consumers enabled with data analysis software
supported on their own handsets by advanced operating systems. Data collection is already
possible on a basic level, on smartphones which can track activity levels via GPS. Applications
for measuring distance run, counting calories, encouraging smoking cessation and collecting
basic vital signs are growing in number and suggest a rising trend in self-monitoring and a
potential readiness to accept medical monitoring among the target patient population with
extra devices such as sensors.

© Informa UK Limited 2009. All rights reserved.
CHAPTER 1 MOBILE HEALTHCARE:
MARKETS AND TRENDS FOR M-HEALTH APPLICATIONS

Increased penetration of consumer handsets with functionalities such as Bluetooth and GPS,
the explosion of smartphones with enhanced usability and the growth of enhanced networks
with high data capacities are key enablers for the deployment of connectable monitoring
devices. The proliferation of high data speeds for mobile devices will drive the commercial
viability of advanced applications such as remote patient monitoring, which requires
high-speed transfer of clinical data.

Humanitarian foundations and telecoms players have also identified m-health as a way to
use existing mobile networks to bring health services and information to a large number of
people otherwise unable to access healthcare.

The healthcare sector as a target enterprise market for mobile operators
Global health trends are indicating a need for urgent change in healthcare provision: global
healthcare expenditure is rising and in some countries is becoming unsustainable. The rise in
chronic illnesses, such as diabetes, heart diseases and pulmonary diseases, caused by lifestyle
diseases, such as obesity and aging populations, is placing unprecedented long-term pressure
on health systems.

The healthcare market is not a straightforward enterprise segment, like the retail or
automotive industries. It is wide-reaching and diverse, made up of a variety of different types
of healthcare organizations which may control between one and several hundred healthcare
providers. As an enterprise segment, it must be considered in the context of the healthcare
system of the market in which it may be found, as this determines its funding structure.

Most healthcare systems combine both public and privately funded healthcare provision in
varying degrees. Extreme cases of each – the UK with its predominantly public system based
on the National Health Service (NHS), the US with its heavily private model based mostly
on a corporate structure, and low-income African countries with unstructured care provision
– reveal differences in m-health barriers, opportunities and emerging trends.

In the UK, for example, modernization of the public sector is slow, and even basic mobile
communications are not fully deployed across the NHS nationwide. Public sector procedural,
logistical and political barriers stand in the way of adoption of advanced mobile services. A
need for more efficient communications systems has been highlighted by several instances of
public sector data loss, as well as the sometimes fatal consequences of a lack of information
transfer between care organizations.

In the US, the healthcare market is under pressure to reform its systems to cope with health
trends and depleted resources and fully integrated health IT continues to be stalled by a lack
of infrastructure. Operators have offered mobile enterprise services for some time, however,
and telecoms players as well as third-party organizations are now spearheading industry
collaboration in mobile healthcare innovation.

© Informa UK Limited 2009. All rights reserved.
MOBILE HEALTHCARE: CHAPTER 1
MARKETS AND TRENDS FOR M-HEALTH APPLICATIONS

By contrast, in low-income African countries such as the Democratic Republic of Congo,
healthcare provision is unregulated and treatment has become commoditized – health
workers offer services for high fees in people’s homes in addition to their daily work.
However, in these regions, access to mobile services is widespread and growing and the
potential for mobile healthcare services to fulfill a desperate need is quite different. M-health
is increasingly seen as a tool to bring healthcare to communities which lack primary care
provision and education with information and surveillance applications.

Key barriers to the mobile healthcare market
Rolling out mobile healthcare services within healthcare organizations may be a slower
process than it usually is for enterprise services, because ‘business as usual’ must be
maintained throughout the adoption process and delays in rollout will be inevitable as clinical
safety remains paramount. Services must be effective from day one at the grass roots level to
minimize churn; cash-strapped health administrations will be looking for even minimal
reticence from the users as an excuse to halt services and save costs. Ultimately, there must
be a valid need or a valid financial incentive for clinical users to adopt new systems and allow
the disruption of their existing systems.

For advanced mobile healthcare applications, costs are a key barrier. The high power
consumption of wireless technologies such as Bluetooth is a barrier to bringing M2M
healthcare products to market. Low-energy technologies are emerging but they are costly.

The most significant barrier to a scalable deployment of mobile healthcare services is
probably market fragmentation. Application developers and vendors themselves are
fragmented, offering applications based on their particular field of expertise. Mobile
technology is fragmented, with a number of applications restricted to particular platforms,
high-range handsets or specialist devices. The end-user healthcare market is structurally
fragmented, with private, public and unprovided health systems innovating at different paces,
and healthcare professionals requiring simplified adoption processes to ensure business can
proceed as usual.

Summary conclusions
In the case of the UK’s NHS, the amount of financial loss caused by problems that can be solved
by mobile solutions points to m-health as a viable market to invest in, and this fact is now
recognized by the country’s Department of Health. However, implementation must be backed
up with adjusted payment structures; for example, clinicians must be incentivized to provide
remote care provision, but financial incentives for surgeries to innovate are non-existent and
clinicians are remunerated only for face to face treatment.

© Informa UK Limited 2009. All rights reserved.
CHAPTER 1 MOBILE HEALTHCARE:
MARKETS AND TRENDS FOR M-HEALTH APPLICATIONS

The market for the biggest emerging trend – remote monitoring technology – is dictated not
by the target market – health administrators – but the patients. However, many of the patients
are likely to be unfamiliar with mobile technology; when financial hurdles and the risk of
loss and damage are overcome, this factor may well be m-health’s biggest long-term hurdle.
Patients will need considerable training and support, and clinics must be incentivized to meet
this extra burden. Additionally, any strategy which could be seen as a veiled attempt to
remove or reduce clinicians or carers is highly politically sensitive.

Similar challenges are faced in the US, despite it having a different healthcare system from
the UK. The healthcare system itself is considered a contributory factor to declining health
trends in the US with its inequitable access to medical services and subsidized private health
insurance. In addition, the system also must meet the challenge of a growing need for care.
A shift towards the promotion of wellness and self-care via patient engagement – a key part
of the hot industry topic of ‘personalized care’ Health 2.0 – is gaining significant traction
among healthcare organizations and insurers looking to improve their business model, and
the government looking to reform healthcare provision. This presents a potential long-term
opportunity for the mobile industry to penetrate the healthcare enterprise market beyond just
connected workforces to connected workforces and patients. But innovation is fragmented
and the question of who foots the bill for monitoring devices remains unresolved.

As for emerging markets, operators stand to gain from developing brand loyalty by deploying
services to these countries as future potential mobile market growth is a stronger proposition
there than it is in mature markets.

Across all markets, there are clear opportunities for customized mobile voice and data services.
These are already being exploited by some mobile network operators, but operators must
highlight the cost-efficiencies of their services as a key selling point whether it is a long-term
saving or a capex saving on a must-have service. There are also opportunities for more
advanced mobile uses in clinical environments, which could be exploited with the emergence
of multi-standard chipsets and low-energy wireless technology at commercially viable prices,
and high network capacity.

Fragmentation in innovation, technology and the end-user market is preventing scalable
deployment of m-health applications. Application providers include a variety of technology
and healthcare players, predominantly in the US, that largely develop services based on their
own field of expertise – and a wide-ranging customer base is faced with a complex choice of
services dependent on different devices, platforms and service providers. The two industries
of mobile communications and healthcare with their specialized technical expertise should
be able to converge effectively, as long as the short-term benefits are discernable at grass roots
level beyond improved health outcomes.

© Informa UK Limited 2009. All rights reserved.
Contents
CHAPTER 1 CHAPTER 4
EXECUTIVE SUMMARY ...............1 M-HEALTH CONTENT AND
Mobile healthcare: what and why? . . . . . . . . . . . . . 1 A P P L I C A T I O N S T R E N D S . . . . . . . . . . . . 27
The healthcare sector as a target enterprise Key points . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
market for mobile operators . . . . . . . . . . . . . . . . . . 2 Market status . . . . . . . . . . . . . . . . . . . . . . . . . 27
Key barriers to the mobile healthcare market . . . . . 3 General categories and trends . . . . . . . . . . . . . . . 27
Summary conclusions . . . . . . . . . . . . . . . . . . . . . . 3 Figure 4.1: M-health application categories . . 28
Deployment trends . . . . . . . . . . . . . . . . . . . . . . . 28
CHAPTER 2 Figure 4.2: M-health applications: geographical
MOBILE HEALTHCARE ECOSYSTEM .5 trends. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Defining terms . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Key players . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
What is mobile healthcare? . . . . . . . . . . . . . . . . . . 5 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Figure 2.1: Principal m-health categories . . . . . 6 Information/communication m-health
Trends in mobile healthcare. . . . . . . . . . . . . . . . . . 6 applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
General conclusions . . . . . . . . . . . . . . . . . . . . . . . 7 General overview . . . . . . . . . . . . . . . . . . . . . 30
Global operator trends . . . . . . . . . . . . . . . . . . . 8 Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
Emerging trends . . . . . . . . . . . . . . . . . . . . . . . . . 8 Monitoring m-health applications . . . . . . . . . . . . 31
General conclusions . . . . . . . . . . . . . . . . . . . . . . . 8 General overview. . . . . . . . . . . . . . . . . . . . . . 31
Content and applications . . . . . . . . . . . . . . . . 8 Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Emerging trends . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Surveillance m-health applications . . . . . . . . . . . 33
General conclusions . . . . . . . . . . . . . . . . . . . . . . . 9 General overview. . . . . . . . . . . . . . . . . . . . . . 33
Mobile devices and technology . . . . . . . . . . 9 Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Emerging trends . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Diagnostic m-health applications . . . . . . . . . . . . 34
General conclusions . . . . . . . . . . . . . . . . . . . . . . . 9 General overview . . . . . . . . . . . . . . . . . . . . . 34
Mobile healthcare value chain. . . . . . . . . . . 10 Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Figure 2.2: Mobile healthcare value chain . . . 10 Market drivers . . . . . . . . . . . . . . . . . . . . . . . . 34
Figure 2.3: Examples of members of the mobile Market barriers . . . . . . . . . . . . . . . . . . . . . . . . 35
healthcare value chain . . . . . . . . . . . . . . . . . 11 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

CHAPTER 3 CHAPTER 5
GLOBAL MOBILE OPERATOR M-HEALTH DEVICES AND
T R E N D S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 T E C H N O L O G Y . . . . . . . . . . . . . . . . . . . . . . . 39
Key points . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Key points . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Market status . . . . . . . . . . . . . . . . . . . . . . . . . 15 Market status . . . . . . . . . . . . . . . . . . . . . . . . . 39
Vodafone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Figure 5.1: M-health device types . . . . . . . . . 39
France Telecom . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Market size for monitoring devices . . . . . . . . . . . . 41
Telefonica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Background . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Telecom Italia . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Figure 5.2: Devices and technologies used in
Sprint Nextel . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 m-health, by location where used . . . . . . . . . 42
Verizon Wireless . . . . . . . . . . . . . . . . . . . . . . . . . 19 In the hospital . . . . . . . . . . . . . . . . . . . . . . . . . . 42
AT&T Mobility . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 In the field . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Bharti Airtel . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 In the home . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
SingTel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Figure 5.3: Telefonica Sensor Network
Infrastructure . . . . . . . . . . . . . . . . . . . . . . . 44
Telstra . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Market drivers . . . . . . . . . . . . . . . . . . . . . . . . 45
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Market barriers . . . . . . . . . . . . . . . . . . . . . . . . 46
Market drivers . . . . . . . . . . . . . . . . . . . . . . . . 22
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Market barriers . . . . . . . . . . . . . . . . . . . . . . . . 23
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
CHAPTER 6 Market barriers . . . . . . . . . . . . . . . . . . . . . . . . 68
HEALTHCARE SYSTEMS Figure 8.2: Key m-health market barriers . . . 68
O V E R V I E W . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Figure 6.1: Summary of healthcare system types
and m-health trends . . . . . . . . . . . . . . . . . . . 49 APPENDIX
Public healthcare markets . . . . . . . . . . . . . . 49 Selected mobile healthcare applications. . . . . . 72
What are public healthcare markets? . . . . . . . . . . 49
M-health trends in public healthcare markets . . . 50
Private healthcare markets . . . . . . . . . . . . . . 50
What are private healthcare markets? . . . . . . . . . 50
M-health trends in private healthcare markets . . . 51
Unfunded healthcare markets. . . . . . . . . . . . 51
What are unfunded healthcare markets? . . . . . . . 51
M-health trends in unfunded healthcare
markets: Africa . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Kiwanja case study . . . . . . . . . . . . . . . . . . . . 52
Ericsson case study . . . . . . . . . . . . . . . . . . . 53

CHAPTER 7
MOBILE HEALTHCARE IN A
P U B L I C LY- F U N D E D M A R K E T:
T H E U K ’ S N H S . . . . . . . . . . . . . . . . . . . . . . 55
Key points . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Market status . . . . . . . . . . . . . . . . . . . . . . . . . 55
Telecommunications services. . . . . . . . . . . . . . . . 56
Asset-tracking and lone worker protection
services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Remote monitoring services . . . . . . . . . . . . . . . . . 57
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Market drivers . . . . . . . . . . . . . . . . . . . . . . . . 59
Figure 7.1: Key m-health market drivers . . . . 59
Market barriers . . . . . . . . . . . . . . . . . . . . . . . . 60
Figure 7.2: Key m-health market barriers . . . 60
Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

CHAPTER 8
MOBILE HEALTHCARE IN A
P R I VAT E LY- F U N D E D M A R K E T:
T H E U S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Key points . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Market status . . . . . . . . . . . . . . . . . . . . . . . . . 63
Operator overview . . . . . . . . . . . . . . . . . . . . . . . 63
Mobile billing . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Asset tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
Vendors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Health information management services . . . . . . 65
Market adoption . . . . . . . . . . . . . . . . . . . . . . . . . 65
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
Market drivers . . . . . . . . . . . . . . . . . . . . . . . . 66
Figure 8.1: Key m-health market drivers . . . . 66
ABOUT THE AUTHOR
Philippa Hobbs is a Business Research Executive at Informa Telecoms & Media, specialising in mobile services and industry
research. She has also produced events on mobile content and applications. Philippa holds a first class honours degree from
the University of Bath and a Masters degree from City University London.

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