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mHealth Myths and Reality part 5

After last week’s diversion I’m returning to my theme of ‘mHealth Myths and Realities’ to look at the myth of price – that ‘mHealth is too expensive’.

Show me the money

Instinctively I find this objection odd, but I think it may emanate from some of the negative publicity that arose from the UK’s ‘Whole System Demonstrator’ (WSD) trial which I blogged about previously here

mHealth

Too expensive?

As I said, one of the ultimate conclusions (and I do believe it was flawed) was that costs were actually slightly higher with the telehealth group.  But as it was based on old technology and a non-optimised service design, then perhaps this wasn’t surprising.  Certainly the leaders in this field, the Veteran’s Health Administration, are confident that they are achieving savings of $1200-$2000 per patient per annum (you can see Dr Adam Darkins talk about this on video here).

Why do we think “mobile=expensive”?

I think the real problem here is a mismatch between expectation and understanding of what is really possible:

  • Expectation with mobile technology is that the costs will be high – there is an in-built bias that devices (think iPhone or Samsung S5) and mobile data (think of those roaming charges you ran up on your last holiday) are prohibitively expensive.
  • Less people understand that the reality is very different – let me give you a couple of examples:
    • At Vodafone we won a number of deals to connect medical devices that were used in patients’ homes. The device manufacturers were amazed to find out that mobile data connections were significantly cheaper than using old-fashioned telephone lines – typically 4-5x cheaper – even if the mobile connection was fully roaming. How is this possible?  Simply because Machine to Machine (M2M) plans charge by the amount of data shipped – and most medical devices only send 1 or 2 megabytes a month
    • Similarly, a number of pharmaceutical companies have started to offer ‘patient support services’ to guide, monitor and support patients taking new drugs, often at the insistence of regulators and payers.  Instead of offering limited telephone-coaching services, more automated services deployed to patients’ own phones can be achieved for as little as €2 a month – for a fully managed service.

So what could you buy for €2 a month – or 7 cents a day? By my calculations about 15ml of coffee from a coffee shop or 1 slice of bread from the supermarket.  Surely this is cheap!

 However, the more fundamental questions are a) are you trying to fix a real problem b) can the necessary budgets be re-aligned across the health system? If you can’t answer yes to those then mHealth will always look ‘expensive’. 

As usual, please feel free to agree or disagree, or of course contact me to discuss the practical application of all this.

 

 

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