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What if the next time you step into your doctors office for an examination, she reaches into

her white coat and pulls out an iPhone instead of a stethoscope? Thats the idea behind
smartphone healthcare, an evolution of the physical exam using only smartphones and a few
devices that connect to them. This trend is not just creating Internet-connected doctors, its
spawning a whole new breed of tools that help connect patients to their health and even
allows them to manage their care on their own terms.

Patients can now measure their blood pressure, glucose levels and other vital statistics at
home and transmit them to the cloud. With these tools, and an increased drive towards
integrated healthcare, we are seeing a self-care ecosystem emerging. It is one that directly
offers patients valuable and accessible healthcare while indirectly offering the healthcare
system a connection to the end user. Due to this new connection, the self-care movement
offers four key benefits to those working in the healthcare industry.

1. Care Providers Can

Better Monitor Patients
In England, The National Health Service (NHS) Flo Program has pioneered a user-friendly
text messaging service thats helping patients to remotely manage their care. This is an
important step towards integrated and technology enabled self-care.

This particular telehealth tool isnt even especially high tech, but its success has been due to
widespread adoption. According to Paul Midgley of the Rushcliffe Clinical Commissioning
Group & East Midlands Mental Health Commissioning Network who leads the
implementation of Flo, one of the reasons so many people use it is because it is so simple. Flo
is fundamentally a texting service that allows patients to input data regarding their health into
a web-based app. It is also highly accessible because the tool works on any mobile phone
not just smartphones.

The aim of Flo was always to be really simple and cheap, says Midgley. It empowers
patients to take their own vital signs, allowing for self-monitoring; secondly, it informs their
HCPs about their current state of health. Its a fantastic device that helps to spot early
warning signs and intervene if necessary, which can help reduce unplanned admissions. There
are a lot of great products similar to this out there, but I think this excels due to its simplicity
and HCP adoption.

This type of value-added service is also something that pharma or med device companies
could help develop. However, Midgley has some advice for any healthcare company
considering approaching an organization like NHS about a partnership to work on something
similar to Flo.

Understand [the organizations] issues, and present relevant and innovative solutions that
improve quality of care to patients, while reducing the cost of the whole pathway of care
where their drug is to be used, explains Midgley. Value-added services wrapped around the
product are great, but please bring data to prove the value. I see the future of healthcare to be
integrated, where we [NHS] contract with prime providers to share the risk. And
subcontractors deliver high-quality services at lower price per transaction.

2. Access To Useful New

The Internet of Things is almost a movement of its own as companies work to connect any
and every deviceeven home appliancesto the web, so they can be controlled and
monitored from anywhere. However, a medical world built around connected mobile medical
devices and the Internet of Things will be revolutionary. Cloud data via connected devices
will turn the system of healthcare data recording into a system of healthcare engagement, not
only allowing self-care, but also driving user engagement in their personal health. Some of
the tools paving the way include:

Kinsa: A thermometer that plugs into your iPhone or Android smartphone. The device and
corresponding app takes your temperature and can also track changes over time enabling you
to build a record of your personal health. Currently Kinsas plug-in device is on the market
for $15, but eventually the company may be able to give them away for freeselling the data
will provide revenue.

Muscle Trigger Points: Another useful app for researching muscle trigger points and tight
places in the body that cause pain. The app includes more than 100 trigger points for over 70
muscles. Once you identify a trigger point through a specific muscle or zone search, the app
recommends the best course of action to take.

Cardiac Designs ECG Check: An iPhone case that connects to the device and allows users
to obtain an instantaneous electrocardiogram (ECG) in the palm of their hands. The device
has two electrodes on the case where users places their index fingers in order to conduct the
electrical rhythms to the onboard smartphone app. The device can also be held up directly to
the chest in order to obtain an ECG. While this seems like just another piece of gadgetry
hitting the blogospheres, this particular innovation paves the way to a whole new line of at-
home medical products.

The implications of this device are twofold: One, it is a device that can allow patients with
cardiac issues to have an instantaneous visual communication with their care provider, and
two, it is a way for individuals to be more aware of their own health concerns.

3. More Efficient Medical

A third benefit of the self-care movement is the chance to deliver more efficient medical
research. The study, Why Most Published Research Findings Are False, published by
epidemiologist John P. A. Ioannidis in the journal PLoS Medicine in 2005, exposed ways that
science has over-interpreted the significance of findings from research with small sample

Meanwhile, a series of five papers about clinical research published by The Lancet revealed
that in 2010 about $200 billion (an astonishing 85% of the worlds spending on medical
research) was squandered on studies that were flawed in their design, redundant, never
published or poorly reported. Thats hugely wasteful.

With a deluge of data from self-care tools, we might see a step change in the way that
medical research is conducted. The researchers dream is a clear longitudinal record of
patient experience and outcomes that offers a real-world detail on the actual and relative
effectiveness of a health product or service. Currently EMR or claims data struggle to deliver
this. What sets self-care data apart is its continuity. A self-managed record can be truly
longitudinal as patients take their care data with them when they move between insurers or
providers. Engagement in ones health drives health data collection and with that, it can direct
self-care and long-term health management.

4. Better Understanding
Of Customers
Finally, the area that has the potential to be the most powerful: The opportunities that the self-
care movement will afford in terms of integrated health and customer insight.

With more customer data coming from the self-care movement, brand teams and marketers
have a greater chance of understanding customer needs to more accurately predict and deliver
valuable services. Thanks to this integrated approach to care, pharma is in a position to
provide help as well as profit. Sounds good, but to do it well pharmas approach to customer
understanding has to be refined.
The old model of understanding and communicating need to the provider or healthcare
professional will be overtaken by a need to understand what all healthcare consumers
respond to along the whole continuum of careright through to patients and caregivers.

The first step will be using data to understand the needs of consumers. Its easy to obtain
patient insight. An abundance of market research and social listening tools provide lots of
interesting data. But reading about climbing Everest isnt the same as doing it. To truly
understand people, their motivations and feelings about their illness and medications, you
need to create a strong two-way dialogue.

So the next step will be connecting with consumers along the care continuum to ideate and
test solutions that meet their needs. Think of it as user-centered design in healthcare. A
smartphone enabled way to do this is through open collaboration.

For example, in upstream R&D, pharma companies are increasingly pooling resources to
attack complex issues. For instance, Enlight Biosciences is a venture backed by AbbVie,
AstraZeneca, Eli Lilly, Johnson & Johnson, Merck, Novo Nordisk and Pfizer to find new
drug technologies, in part through pre-competitive collaboration. One of its first initiatives is
to develop an oral delivery technology for peptides.

Service delivery wont be about closed door testing and validation in the same way as a new
drug would be in a clinical trial. The integrated healthcare providers will test, develop and
launch ideas into the real world. The reach and insight that self-care tools provide will
facilitate this open dialogue, spawning detailed healthcare analytics and healthcare consumer

As companies become more comfortable with collecting insight from consumersboth on an

analytic and a collaborative leveland the need to be customer centric moves higher up the
agenda, expect to see smartphone health and self-care tools used with increasing frequency to
find surprising customer-led ideas and insights.