The Journal of mHealth Vol 1 Issue 3 (June 2014) - Page 36

Can We Really Deploy mHealth at Scale? Can We Really Deploy mHealth at Scale? By Keith Nurcombe Keith Nurcombe has worked in healthcare for over twenty years spending the last few years working with businesses in the health and technology space, most recently building O2 Health where he was Managing Director until the end of 2012, since then he has been providing consultancy services to businesses. This is a question that gets asked a lot and asked of most companies either delivering in the mhealth space or looking to provide services for consumers, patients or healthcare professionals. I don’t believe it is the right question, I think there are far more pertinent ones for investors or those who procure these services for their patients to be asking. Such as talk to me about the quality of your products and the systems you have in place, show me how they work for my patients and users or what is it that you are developing that could help me change the way I work and deliver care to my patients. I think the answer to the question is a very firm YES and YES in both cases. It is delivering and there are good examples of where and how that delivery is changing the way care is delivered. One of the best examples is the Whole System Demonstrator in the UK, which delivered really significant results in hospital admissions and mortality rates for patients. Can it be deployed and be effective at scale, there are good examples of where this has happened and the US Department of Veterans Affairs is the best example currently of scaled deployment in the USA which has delivered excellent results. Are there issues that we as an industry face – yes and some of these are harder to get past than others. Technological issues – sometimes we struggle to get the technology to do what we want it to reliably and certainly we have to make sure that the users and the procurers of the service really understand what we are providing and equally what the technology can't do! Regulatory issues – the differences between the US (FDA) and the European Bodies (EMA and the EU) are creating obvious strains for organisations that want to provide services in both markets. We need to get uniformity of agreement on what is a medical device, what software is a medical device and equally importantly which isn’t analysing and therefore doesn’t need to be classed as a medical device. Currently that interpretation is mainly made by organisations and developers themselves and that will lead to procurers becoming confused and concerned about potential safety. Acceptance and uptake – is very mixed in the market currently with a number of countries making steady progress forward with the adoption of technology and solutions but this is very varied across Europe and within the US as well. For me the positive acceptance seems to be in two key areas: 1. Strong uptake and understanding of managing patients at home, remotely and using technology to provide this solution. 2. Usin