How pharma can help scale mHealth? The three things pharma companies need to do

Vaibhav Gujral

mQure

Despite the global boom in mobile phone penetration, particularly in the last five years, adoption of mHealth solutions at scale appears to be lagging. About 70% of the world’s population now owns a mobile phone and coverage is practically universal. However, as Dr. Ganapathy of Apollo Hospital said recently at the Mobile Health Summit, mHealth solutions seem to suffering from a case of “pilotitis” i.e. there are numerous pilots but very few initiatives are operating at scale.

Even in the most developed markets, use of mobile phones for health is limited. A recent survey by Manhattan Research indicated that only ~26% of US consumers use their mobile phone for health. While that represents a marked increase from the fewer than 10% who were using mobiles for health services two years ago, it shows that three quarters of people who own a phone still don’t use it for any health-related activities.

Developing countries in South Asia and Africa are home to many promising pilots. mPedigree’s innovative SMS authentication solution is helping prevent drug counterfeiting in Africa. HMRI in India and MediCall in Mexico are helping millions get access to remote advice over their mobile phone. However, given the rapidly growing burden of disease, particularly lifestyle driven ailments such as diabetes and hypertension, the need for cost-effective mobile health solutions in developing countries is tremendous and has never been greater.

"…it shows that three quarters of people who own a phone still don’t use it for any health-related activities…"

Barriers to adoption – the behavior problem

A recent Vodafone report examining barriers to mHealth adoption highlights resistance to behavior change as one of the biggest obstacles for mHealth solutions. The resistance to change is both from physicians and consumers. From the physicans’ perspective, there is insufficient scientific evidence proving impact at scale. In addition, doctors who are already overburdened with patients fear that an increasing amount of real-time data and information will overwhelm them.

From the consumers’ perspective, there has been resistance because of a lack of awareness and a limited focus from solution providers on engaging consumers. Most patients are unaware of how they can use their mobile phone to better diagnose, treat or manage their health problems. Greater awareness requires a concerted effort from providers, pharma companies, government and public health institutions. Many existing solutions fall short in terms of design and ease of use. Conversely, great design seems to work. The early success of HealthTap, an online and mobile-based health Q&amp,A service in the US, highlights the importance of “game-ification” and user engagement to achieve scale quickly.

The pharma emphasis on apps

An important and noticeable feature of existing mHealth pilots has been the limited participation of pharma companies. Most pilot programs tend to be led by not-for-profit organizations, academic institutions or tech start-ups. Our conversations with pharma companies indicate that most companies are still unsure about how they can leverage mHealth solutions to achieve their objectives and are concerned about regulatory constraints.

Driven by the booming popularity of smartphones, over the past few years, the primary emphasis of pharma companies in mHealth has been on mobile apps for smartphones (iPhone and Android especially). According to an E&amp,Y report, over 80% of pharma investments in mHealth in 2010 were focused on smartphone apps.

What’s surprising is that when you look at how users access health information on their phones, over 75% say they do so through search and browsing for information as opposed to using apps. So while there is much hype around smartphone apps and a race amongst pharma companies to create the “killer app”, most users are still using traditional tools to access health information. This dissonance emphasizes the importance of understanding consumer behavior and using the appropriate tools to drive behavior change.

"Most patients are unaware of how they can use their mobile phone to better diagnose, treat or manage their health problems…"

3 things Pharmacos need to drive growth of mHealth solutions

Given the immense domain knowledge and relationships that pharma companies have with physicans and the broader medical community, they can play an instrumental role in driving the adoption of technology-enabled solutions. Creating successful and sustainable mHealth solutions is not just about creating an app but instead requires focusing on gaps in delivery and addressing these gaps using technology solutions.

In the short to medium term, there are 3 things that Pharma companies should do to become active and effective participants in the mHealth space:

(1) Define a strategy for mHealth that is centered around improving patient outcomes: existing efforts by pharma companies in mHealth are trying to achieve multiple objectives – brand building, patient engagement, physician engagement. As a result, despite growing investments, there is still limited evidence of real impact on patient outcomes. Pharma companies need to develop a robust strategy, which is centered around improving patient outcomes. Outcomes need to be defined and measured rigorously to understand works and what doesn’t. There are certain outcomes such as improving adherence and compliance that mHealth solutions are particularly well suited to addressing.

(2) Choose the right technology mix: most pharma mHealth initaitives are focused on smartphone applications. However, there are two issues with this. First, very few patients actually use smartphone apps to access the health information they need. Second, a large number of patient segments where the disease burden may be high (e.g., elderly patients) do not use or are not adept at using smartphones. As a result, by overemphasizing smartphones, pharma companies are not able to capitalize on opportunities for improving patient outcomes using simpler technology solutions. A leading pharma company in India recently implemented a large-scale pilot to improve medication adherence amongst pregnant women using a text-based reminder solution. The VA in the US is launching a similar program later this year using SMS as their primary platform.

"…most users are still using traditional tools to access health information...

(3) Engage with stakeholders on solution design: given the resistance to behavior change amongst physicians and consumers, pharma companies need to be patient and flexible. It is crucial to engage and get feedback from users – both patients and physicians - early on and then encourage influential users to become early adopters. Many of the existing solutions today are too complex or cumbersome to use because of an insufficient focus on design. Pharma companies can leverage their relationships with physicians and expertise in sales and marketing to design solutions that are engaging and exciting for patients and physicians. A typical pharma company has relationships with thousands of doctors and can go-to-market and get feedback much faster than a typical healthcare provider.

Pharma companies are uniquely positioned, given their resources, expertise and relationships to drive adoption of mHealth solutions. By focusing on patient outcomes, choosing the right set of technologies and engaging with stakeholders on design, pharma companies can develop effective mHealth solutions that create considerable value for patients, physicians and the companies themselves

About the author:

Vaibhav Gujral, CEO, mQure is India's leading mobile health services provider focusing on adherence, medical content and chronic disease management solutions. Vaibhav is passionate about and has extensive experience in healthcare and specifically in the use of technology solutions for development. He was formerly a management consultant with McKinsey and Company and graduated from Harvard University.

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