mHealth - “mobile” healthcare in the modern world

Today, a revolution is taking place in the world, which is still not very noticeable. In the near future, one must think that it will have a direct impact on us. It is about healthcare and penetration into this sphere of mobile technologies.

Not so long ago, PwC conducted a survey assessing the current state of healthcare in the world, as a result of which the majority of respondents noted the paramount importance of easy access to medical services, as well as the ability to independently monitor their health. Such a survey was not the first, and, apparently, healthcare around the world is gradually approaching that stage, followed by a transition to a patient-oriented instrumental model of healthcare. Such a transition is already being carried out little by little, including in our country, and this is due to the so-called e-health (the generally accepted term is eHealth). Perhaps many have already heard about telemedicine, electronic medical records, remote recordings to the doctor, and someone already saw this in action. But all this is only a small part of what can be used in healthcare. Let's talk about a relatively new branch of e-health, which is called mobile health (mHealth).

MHealth market: its division and development

Mobile healthcare is a term that refers to the use of mobile devices and wireless technologies for medical care, as well as ensuring a healthy lifestyle. The most familiar example to many mHealth technologies is the program for mobile phones and tablets related to monitoring physical condition (for example, weight) or fitness. When I think about mHealth, I most often still think about its functionality from two points of view: the use of mobile technologies by medical organizations to improve the provision of medical care and the use of these technologies by patients to control their own health.

Today mHealth - these are two major areas that are developing in parallel, at different speeds, while providing mutual influence on each other. The first is technologies, devices, applications and services for treating and caring for patients, the second is systems and devices designed to monitor the observance of a healthy lifestyle (wellness) and fitness (fitness). You will say that the second direction has a very weak relation to medicine and health care and you will be right, but in mHealth there is a gradual rapprochement, or rather, a merger of these directions. Therefore, it will be more correct to speak not about health care or medicine, but about ensuring human health in every sense using mobile and not only technologies.

Devices for maintaining a healthy lifestyle

The market of devices and applications for fitness and maintaining a healthy lifestyle is developing much faster today (see the sidebar) than the second direction of mHealth. This is due, not least, to the fact that the healthcare industry is very conservative - new products and services appear in it only after numerous trials, clinical trials and coordination with various departments. For fitness devices, this is not required and they quickly find their way to the consumer. According to a survey conducted by Accenture, worldwide, 43% of consumers want to buy a device for monitoring physical activity and physical condition. The list of products in this category includes:

• Trackers of physical activity of various kinds (bracelets, smart clothes, headphones, glasses, etc.);
• Sports watch;
• Wearable sensors, heart rate monitors;
• Applications for these devices and stand-alone applications for monitoring and managing their own physical condition

This market is very mobile, new devices appear all the time, there are no obvious leaders yet, although one can hear the heavy tread of the giants of the electronic industry, which one by one began to produce products in this category. Note that the wearable device industry can reorient itself from bracelet trackers, which are so popular in 2014, to health sensors that will be fully integrated into or on the human body in 2018, the PSFK Labs report says.and in the iQ magazine that Intel oversees. In 2015, according to their forecast, the functions of wearable devices will expand and the transmission of information for medical purposes and behavioral changes will be characteristic of clothes, and bracelets will be used for communications, password verification and display health data using an “emotional mirror”. Ultimately, the communication and control functions will go to points, the report states, and in 2018, almost all functions will be implanted.

Wearable mobile systems (Wearable technologies)

The market for wearable technologies would not be entirely right to relate to mHealth, but it is very closely related to the field of devices for maintaining a healthy lifestyle, and very often it is simply impossible to understand what this or that device is related to. The list of products in this category includes:

• Smart watches and glasses;
• Trackers of movements in 3D (a shot thrower in basketball, impact monitoring systems for American football, etc.);
• Wearable cameras

“Smart” wearable gadgets have existed for a long time, but right now there is a rapid development of the corresponding segment. According to Deloitte forecasts, this year around 10 million computerized glasses, smart watches and various fitness trackers will be sold around the world. In this case, only “smart” watches will be sold approximately 2 million units. According to the research company Juniper Research, the market of smart wearable devices will reach 19 billion USD in 5 years.

Devices for monitoring health, diagnosing and providing patient care

As noted above, this sector is not developing as rapidly as the sector of fitness systems. But, nevertheless, the market for mobile monitoring and diagnostics in 2012 was equal to 650 million USD, according to a report from Transparency Market Research. According to the research company, this market will grow at a rate of 43.3% per year from 2013 to 2019 and will amount to 8 billion USD in 2019. This mHealth category includes:

• Monitoring systems: heart function, pressure, glucose, brain function, sleep, etc .;
• Multiparameter monitoring systems;
• Systems of remote interaction with the doctor;
• Wearable, implantable and swallowed sensors of various vital signs;
• Diagnostic systems and quick analysis systems (blood, saliva, urine, respiration, etc.);
• Systems for caring for the elderly, chronically ill and children;
• Applications for monitoring health, monitoring drug use, treatment planning, training systems, etc. The



future success of mHealth is laid in this direction. Analysts associate reformatting of the medicine and healthcare sectors with this, as well as a huge increase in the income of market participants.

MHealth Investments

The growth in consumer demand for digital medicine technologies, supported by the targeted policies of many states to improve the health of the nation and promote a healthy lifestyle, has generated an unprecedented entrepreneurial activity. Crowds of investors rushed into a new, promising industry (though this does not apply to Russia). Last year, investments in companies related to digital medicine totaled $ 712 million in the United States alone, according to a StartUp Health report. In 2014, investment in this area continues to grow, with two areas showing a particularly sharp jump up. Investments in solutions related to the inclusion of patients in the treatment process increased by 410%, the second largest market was the sensor systems and monitoring of vital signs, investments in which increased by 243%. Although the number of transactions in the first quarter of this year was less than in 2013, their total volume more than doubled and amounted to 1, 35 billion USD (last year - 599 million USD). Again, data for the USA.

This is the fastest growing segment in terms of attracting foreign investments: according to various estimates, investments in it account for up to 10% of the total volume of venture transactions. The number of startups focused on online content and medical services is increasing. Another promising area is the development of various devices and applications for monitoring health indicators.

Today, more and more new products appear in the market in this area, we constantly hear about technologies that used to seem fantastic. The American company iRythm has released a “patch” Zio, which works as a wearable sensor used to monitor arrhythmias of cardiac patients, and works without recharging for up to two weeks in a row. Scientists at Stanford University have created a wireless pacemaker the size of rice grains. There is a new health monitoring system called Cue, which allows you to take samples from your body and in five minutes check five key indicators of health and lifestyle.

And the number of mobile medical and fitness applications for various platforms is now approaching 2 million.

NUMBERS AND FACTS

Recently, the Consumer Electronics Association published a report in conjunction with Park Associates, which indicates that the market for healthy lifestyle products (wellness and fitness) generated around $ 3.3 billion in 2013 and will increase to more than $ 8 billion by 2018. year. Device manufacturers sold more than 40 million products for this market in 2013 and this figure will grow to 70 million by 2018.

According to ABI Research, in 2014 about 90 million wearable devices used for health and fitness will be sold (mainly physical activity trackers of various kinds). In addition, the so-called “smart clothes” belonging to the same mHealth category will also make a very tangible contribution to market growth. The estimated sales of such products in 2013 amounted to 30,000, and in 2014 - 720,000 and 1 million units in 2015.

The most popular device was the fitness trackers wearable on the wrist - according to Canalys analytic firm, about 17 million such devices will be sold in 2014. The best-selling bracelet in this category is Fitbit (market share 58%), mainly because this company released its Flex and Force products in May and October 2013, respectively. At the same time, analysts believe (if the prediction of PSFK Labs and iO by Intel is accurate) that such devices will cease to be so popular over the next 5 years. They predict that future wearable devices will move from the bracelet form factor to health sensors, which by 2018 will be placed on or on the user's body.

Almost all devices in this category come with their own mobile application that provides data processing and visualization. At the same time, the profit from this type of product is minimal, since applications are usually downloaded for free.

According to analysts at Research and Markets, “the global market for mHealth applications in 2013 is estimated at $ 6.6 billion, while it is estimated that in 2018 it will reach $ 20.7 billion. Those. on average, it will increase by 25.5% per year. ” The main income will come from applications for medical devices, the report says, in 2013 their share was about 80%.

MHealth Prospects

The opportunities that are available today in mobile medicine are growing rapidly with the advent of new devices, sensors, applications. Telemedicine and remote monitoring, patient data transfer, electronic cards, electronic prescriptions, sleep and pregnancy control, etc. This industry is developing very rapidly around the world, even in underdeveloped countries, where it can become a lifesaver for people who do not have access to medical care. Improving the time use of doctors and their productivity, improving the quality of service, simplifying access and returning justice to health care (attitude to the elderly, unequal access to services, etc.), greater involvement of the patients themselves, potentially lower costs or, at least, much Great return on investment.



mHealth is not only new technologies, it is a completely new way of patient interaction with a doctor and patient care. This facilitates this interaction on both sides: for the patient, the process of obtaining medical care is simplified, for the doctor, the load from routine operations is reduced, thereby allowing more time to be devoted to the diagnosis and treatment itself. Mobile access to information facilitates the acquisition of data and speeds up decision-making, as well as reduces the distance between the patient and the doctor. Doctors and nurses can communicate more effectively and efficiently. Hospitals and clinics are constantly striving to rethink patient care models and processes to improve patient care and safety.

Here are just a few specific examples that really work.

In Sweden, a system is successfully working that allows you to remotely read the testimony of heart stimulants for patients. The Soarian Clinical system allows you to monitor the condition of both the patient and his pacemaker from afar, eliminating the need for him (and this is usually very elderly people) to come to the reception every six months to check the condition. This technology is not only reliable, but also very sensitive - the monitoring system responds to such changes in the patient’s health, or stimulant problems that the patient himself often simply does not notice, or does not pay attention.

Here are a few more of these projects:

- Care Innovations Remote Chronic Disease Support System(a joint product of Intel and GE), which allows people suffering from chronic diseases to receive medical information about their own health and the necessary medical support wherever they are.

- Visi Mobile - a system of small sensors worn on the body that allows you to timely detect the deterioration in the health of the owner and connect it to your doctor, regardless of where the patient is currently located.

- There are also solutions based on the use of specialized miniature systems that monitor individual indicators of human health. For example, Glucovation has developed the SugarSenz continuous blood sugar monitoring system, which can be used by both diabetics and healthy people. The device is attached (glued) to the skin and periodically penetrates through the skin to obtain a blood sample for measurement. Or the HealthWatch solution in the form of hWear shirts with built-in ECG sensors, which allows these clothes to be used as an ECG meter.

Who is first?

The development and implementation of mobile technologies for healthy lifestyles and medicine is uneven throughout the world. According to the GSM Association, the US and China are the largest markets in the field of mobile healthcare and by 2017 will share more than one third of the world market. It is here that most of the new technologies and ideas appear, which in the future should become the basis for new devices and services. A report from the Brookings Institution states that in 2017, mHealth revenue in the United States will reach 5.9 billion USD, and in China about 2.5 billion USD.

This research company, by the way, is very optimistic about Russia, suggesting that in 2017 the mHealth market in our country will reach 800 million USD and, thus, it will be included in the list of Top 10 countries in this area. Hopefully. In our country, there are still few companies that have felt the trend and have begun to develop this market, primarily the market for devices to maintain a healthy lifestyle. Perhaps the pioneer in this area is Medgadgets.ru , which has been operating since 2011.

A limiting factor in all countries is the requirements of regulators, which limit the use of these systems in the field of medicine and development is mainly in the field of fitness. Moreover, in China the regulation is more stringent and today the use of mobile devices in healthcare is allowed only for counseling.

What to expect

The future is rapidly approaching us. The development of mobile technologies is faster than all forecasts; in essence, today we already live in a world of things and people that is constantly connected to each other by all kinds of connections. Work in the field of mHealth is being carried out at an ever-increasing pace, and Russia is no exception, they are being carried out by enthusiasts with the support of the state that has already appeared, and the result will appear sooner or later.

Yes, and where do we go? The population is aging, and this is happening in all developed countries, the burden of chronic diseases that falls on our health care system is growing. The only way to maintain good clinical results in the face of an increasing shortage of primary care physicians is the use of automated remote monitoring systems for human health and independent patient care using mobile solutions.
If mobile operators actively join this market, then this will be a powerful step forward. They are in a unique position that allows to solve many mHealth problems at once - to ensure mass connectivity, eliminate the problems of searching and connecting medical applications due to their preliminary installation on mobile devices. At the same time, they get new opportunities for themselves - this is an additional paid service, and additional traffic and communication time, downloading software products from their “mobile application stores”, etc. In addition, mobile operators are interested in mobile applications that are sensitive to bandwidth and delays, which make it possible to quickly provide a return on investment in their modern 3G and 4G network infrastructure.
What other factors bring this fantastic picture closer to real life?

This is the fast-spreading availability of high-speed connectivity that provides new opportunities for complex mHealth applications, such as remote video consultation. mHealth offers numerous opportunities for the pharmaceutical industry, from controlling the development of new drugs and monitoring its supply chains to tracking the appearance of counterfeit medicines on the market.

In addition, mobile applications and systems have the potential to significantly reduce costs in the healthcare industry, while improving the quality of services and treatment. According to the analytical company SNS Research, by the end of 2014, mHealth systems will save about 250 billion USD in healthcare systems around the world.

Admit, because many of you have thought more than once that it would be great if each of us, as is sometimes shown in science fiction movies, had such a device that constantly monitors our health and tells us what and when to swallow so as not to hurt. Either there were sensors built into the body or clothes that would monitor our health and inform us in case of any problems. Which of us has not dreamed about this? Dreams begin to come true ...

* All the figures given in the article are taken from the reports of well-known research companies. Certain discrepancies in the data of various firms may be associated with different calculation methods.