The appification of healthcare – potential and pitfalls

At the beginning of every year, it is a worthwhile exercise to consider the changes that we have seen in the past year, and to reflect on the future and to contemplate where the Healthcare industry is headed. Gabor Fari considers how healthcare is embracing apps, in our health technology themed month, and explores their potential and pitfalls.

Over the last two years mobile technology has continued its explosive growth and to further embed itself into our daily lives. We have passed a seminal moment: according to several studies, by the end of 2013, there were more mobile devices in use world-wide than the number of people. That is an astounding development. However, we are still very much in the beginning of this transformation. People now expect the most relevant information and services in their daily lives to be delivered via mobile devices, and they expect ubiquitous connectivity. While some have expressed concerns of an Orwellian world being thrust upon us, I believe that barring a cataclysmic event, this trend will continue, and it will continue to accelerate to the point where smart mobile devices will be embedded into every facet of our life. We are at the beginning of the next transformative wave leading to the Internet of Things. Internet-connected devices will become so inexpensive that eventually they will become disposable. Wearable devices are already starting to become mainstream (e.g. FitBit, Nike FuelBand, etc.). By the time prices drop by another order of magnitude, embedded devices will make their way even into the clothing we wear.

The cloud as an enabler and unifier

To quote a popular movie 'With great power comes great responsibility'. Next to all the wondrous and rosy projections, it is simply naïve to imagine that having Billions of devices connected to the Internet will simply herald in the age of The Internet of Things. If we do not solve the very fundamental security requirements and if we do not address key privacy and regulatory issues, we might very well end up with the Wild West of Things instead. There are already worrisome signs of things getting out of control, as the speed of technology innovation is outpacing the ability for regulators to implement an enforceable regulatory framework. As troubling as they are overall, the recent NSA scandals do have the beneficial side effect of highlighting potential issues around security. It is important to note that by itself the Internet can only connect these devices. The essential ingredient that can make the Internet of Things vision reality is the Cloud Services back end. This is what provides the security and implements the logic and business process orchestration to make it all work. As Internet-connected devices become cheaper and cheaper, they will also become simpler and simpler, and they will not be able to execute the complex business rules and functions that used to be performed on-device in the PC era, so this role has to be taken on by the Cloud Service, which in fact becomes the 'brain' for the Internet of things.

Implications for healthcare

So what does all this mean for the Healthcare industry? The title for this article is the Appification of Healthcare. We are seeing an explosion of Healthcare Apps on Smart Phones. I have even read several predictions that future medicine will bring innovations such as prescribing a treatment regimen, and an App could be part of that regimen. Hence the name 'Appification'. However, I am not sure how soon this can happen. And that is not because the technology is not mature enough. More importantly, we also need to consider the state of the industry and the regulatory environment. Recently, a colleague told me of a case where she was undergoing heart monitoring, and she had to carry around a device weighing over a pound strapped to her body all day long, and nightly sync it up with the hospital's system via an audio modem and her home phone. This begs the question: how do we get from the Industrial Era to the Internet Era in one fell swoop? It will take some time for regulatory authorities to come to grips with the issue of how to regulate Apps and the newly emerging class of Internet-connected devices. The recent FDA Warning Letter to 23andMe is also an indication that the FDA needs more time to implement the safeguards and processes designed to protect public health, and the effect will be likely to slow down the rush into personalized medicine facilitated by the Internet of Things. The plethora of devices and Apps already makes it possible for patients to create their own Quantified Self, but what are the right conditions for using all this information to help with treatment? And of course the exploding amount of information that is generated by these devices also needs to be stored securely in a central place. Once again, that is where Cloud Services can play a crucial role. Such services already exist, to name HealthVault as an example. It is evident that the healthcare system is practically insolvent, and something must be done to lower the cost of care while increasing quality of care at the same time. However, I doubt that all this technology will replace the physician any time soon. What I expect is that the new generation of Internet savvy Healthcare Professionals will be able to use all this amazing technology to supplement their own knowledge and skills, generated over many years of medical school and practice. There are a myriad of areas where it could be put to immediate use, even as the Regulatory authorities develop a broader framework. Some notable examples are virtual diagnostic aids, devices and Apps to help with coordination and continuity of care, appliances for remote care and medical counsel, preventative care programs, and even solving simple problems such as a better means to schedule appointments, follow-ups and as a way to keep in touch with patients.

About the author:

Gabor Fari is currently Director of Business Development and Strategy in the Health & Life Sciences Industry Unit at Microsoft.

Gabor has been a founding team member of the Health & Life Sciences Industry Unit at Microsoft, starting in 2006. He has been involved with the biopharmaceutical industry throughout his professional career. Gabor plays a key role in defining and executing Microsoft's Life Sciences solutions and business strategy. His main areas of focus are Enterprise Content Management, Regulated Document Management, Clinical Trials, Cloud Compliance and Sales Enablement. Gabor is the driving force behind the Intelligent Content Framework, with the mission to introduce an entirely new way of managing Enterprise Content in Regulated Industries, based on the latest XML technologies and standards. He also serves as product and technology advisor to several key Microsoft Life Sciences partners. Gabor is the Microsoft representative on several DIA SIAC groups and the OASIS DITA Pharmaceutical Content Subcommittee. He holds a Master's Degree in Chemical Engineering, specializing in Bioprocess Engineering, from the Budapest Institute of Technology, and an MBA from Rutgers University.

Closing thought: How soon can apps bring innovation to healthcare?