Business Models of mHealth Vary with Technology


     Wireless health technologies vary from apps geared towards wellness and fitness, to management of chronic diseases, patient monitoring, and telemedicine.  One of the barriers to widespread adoption of mHealth is the establishment of a business model: who will pay for the product and/or service?  The answer is, it may be as variable as the range of technologies themselves.  It is also time-dependent.  Simpler technologies not requiring FDA approval or involvement of a third-party payer are immediately ready for prime time.  Apps that are educational, geared to healthier and younger tech-savvy people are the ones taking off.  Unfortunately, I do not believe that these apps will be extremely financially successful in the long-term. Patient education tools, provider education tools, Pharma and device marketing apps, and other technologies are different.  They can be readily available today, and have different revenue streams. They will be incorporated into payer patient portals or not generate sufficient revenue to become a driving force. Telemedicine is the most similar to the existing patient care model with the unique features of convenience and immediacy. Issues regarding reimbursement and physician licensure are being addressed.

The technologies related to chronic disease management are probably the ones that will become the most widely used and provide the most impact from a national healthcare cost-savings standpoint.  Adoption of these is integrally related to education of the public about mHealth, as well as increasing patient engagement (http://davidleescher.com/2011/10/13/patient-engagement-and-mhealth-bringing-the-horse-to-water-3/).  It is also tied to the adoption and connectivity of electronic health records (EHRs).  The importance of EHRs is being magnified by sectors like mHealth and insurers that are geared more towards maximal utilization of the patient portal or patient health record (PHR), which is the patient’s gateway to the EHR.  The technologies requiring FDA approval will lag behind the others because of the required time to approval. More complex sensor-driven technologies and others which will actually help in diagnosis and treatment will be the ones that will be the most exciting for providers and adoption will be driven by their awareness and possibly clinical trials.

The fact that mHealth is on the radar of governmental agencies recently (recommendations to the HHS on using text messaging for health, and the telemedicine bill signed by Gov. Jerry Brown of California) bodes well for gaining momentum in the regulatory and reimbursement arenas.

So the speed of adoption of these technologies will not be uniform.  But higher visibility in the provider and regulatory audiences, education and adoption by providers, and further developments in EHR adoption and technological developments will increase it for all types of mHealth products.

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About davidleescher

David Lee Scher, MD is Director at DLS HEALTHCARE CONSULTING, LLC, which specializes in helping digital health technology companies, their partners and clients. As a former cardiac electrophysiologist and pioneer adopter of remote patient monitoring, he is uniquely qualified to address both clinical and operational concerns of clients. Scher was Chair of Happtique's Blue Ribbon Panel which established standards for certification of medical apps in the categories of safety, operability, privacy, and content. He is a well-respected expert in mobile and other digital health technologies and lectures worldwide on technology and its impact on patients and healthcare systems.
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