Value-based mhealth today & tomorrow

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From wearables to disappearables

Last week, Hilde Eylenbosch joined Sentiance as VP Healthcare and newest member of the Sentiance management team. I am very excited about this. Together, we caught up with Fonny Schenck, CEO of Across Health, a global consultancy focused on innovative, customer-centric approaches in healthcare. Fonny has over 2 decades of experience in the healthcare industry. An ideal setting then to talk about the growing importance of mobile in healthcare.

Toon: Thanks for talking to us, Fonny. What are, according to you, the great healthcare challenges for the near future?

Fonny: There are almost too many healthcare challenges to mention! Consider the aging population, the shift from cure towards prevention, the challenges of better handling the tsunami of healthcare data that’s coming our way,... But also keeping healthcare affordable, the cost of clinical trials, the trend towards personalized medicine and so much more. If there is a leitmotif running through these many challenges it’s, above all, a growing focus on healthcare outcomes. We are entering an era, where, if you don’t have an outcome, you won’t have an income.

Toon: How do you see the role of mobile in all of this?

Fonny: Increasingly, individuals will be expected to take their health into their own hands. And mobile plays a crucial role here. Consider home monitoring and remote patient monitoring, for instance. Wearable tracking devices enable, for instance, the elderly and chronically sick to stay in their own homes longer. Contextual data solutions derived from sensor data, like the ones you guys have developed, can continuously capture vital signs and suggest actions accordingly. Preventive nudges that are linked to lifestyle-related health issues, for example, can help us make better day-to-day decisions. I believe we are entering a whole new level of prevention and warning. Developments in wearable technologies let us measure various physiological parameters while innovations in data science make sense of those measurements depending on both an individual’s context and their real-time activity.  We will be able to send meaningful recommendations to an individually tailored to their personal profile and current situation. Even up to the point where we can start to predict potential dangerous situations before they actually happen.

Toon: So, again, data is the goose with the golden eggs?

Fonny: Data gathering can now happen 24/7, in both expected and unexpected places. Through self-testing and continuous tracking, much more context is added to the decision-making cycle. Mobile health enables us to form a more complete view of a patient, but also of a condition. How, where and when do treatments interact and influence an outcome?

This trend of capturing more and more data will continue for a long time, as it is a means to better balance the cost of care with the quality of care. Personal motivation, self-empowerment, the visualization of data, artificial intelligence, all of these allow the individual to better manage his/her own health. And this, in turn, will generate enormous insights for healthcare professionals (HCP) and anyone else involved in the healthcare industry, from pharmaceutical companies to payers. So we are at the dawn of a complete revamp of healthcare.

Hilde: A massive cost for life sciences companies are clinical trials. According to you, how can mhealth help in this part of medicine development?

Fonny: Besides speedy recruitment of the right patients, another main challenge in clinical trials are drop-outs and strict adherence to a treatment schedule. These trial subjects are lost for the final results. Nudges through mobile can keep patients on track while mobile monitoring can generate a more complete 360° overview of the state of a patient. Today, clinical trial data is still often captured by an HCP while the patient undergoes not just the treatment but also the process. But we shouldn’t just rely on forms completed by HCPs. Better will be to increasingly rely on automatic and continuous data capturing. The correlation between context, patterns & routines with the personal health data will give much richer insights. At the same time, contextual data capturing will decrease the cost for clinical trials and allow larger groups of people to participate. There’s a big win in efficiency and effectiveness to be gained when mhealth and clinical trial research are matched.

Toon: What type of ‘unexpected’ or disruptive mhealth initiatives do you see happening (or would you like to see)?

Fonny: I have high expectations of the mix of social, mobile, precision diagnostics and big data. If the current trend continues, where patients increasingly become payers and products become more commoditized, real-time, value-added services will be key. From the wellness space through to the treatment phase.

For example, the quantified self is on the rise. Lifelogging is becoming a natural thing to do. That data can be very valuable, not only for personalized medicine development but also for research on orphan drugs. This could potentially shake up the current research cycle – and disrupt the pharmaceutical industry.

At the same time, we shouldn’t underestimate the importance of our psychological health. It’s not enough that the body functions well, the mind has to be in good shape too. Social media definitely have a role to play here. Sites such as MyHealthTeams let people connect and get emotional support from peers who experience the same thing they do. The combination of social with contextual data that captures the emotional state of a person and uses this to provide, for instance, gentle nudges that can help people to experience a more complete life, could also add a whole new layer of social mhealth.

Hilde: Do you see any potential downsides to the whole mobile health trend?

Fonny: Privacy remains a crucial element. There are clear rules on what we can and can’t do with personally identifiable information (PII). And rightly so. Both the industry and the authorities will have to continue to balance privacy with advancements in healthcare that could benefit the many. Not in the least to avoid security breaches by malicious groups.

Data ownership is another tough subject and related to privacy. Who owns the data that is collected and as of when can / should data be shared with HCPs? What should happen when data contains abnormalities? In the future, consent will be of a completely different magnitude than today’s  ‘yes, I accept cookies’.

The success of mobile health will also depend largely on accuracy. We don’t want to ‘play’ with our health. Some early health apps were definitely not as accurate as they should have been, and such failures can jeopardize the future of mhealth.

There will also be more ethical questions and discussions. Where does machine interference end and human interference begin? We can track more and more health information and, at the same time, machines are becoming smarter by the day. But, will we ever allow machines to make life-critical decisions? As of when do we accept a ‘description’ to become a ‘prescription’? This is a discussion we also see with the self-driving car now. Must a self-driving car crash itself (and so, its ‘driver’) in order to save one, two, five bystanders? Can people be forced to wear sensors, or to have sensors inserted in their body? The ethical implications are still open-ended and these questions could have big implications for the advancement of mhealth.

Toon: Any closing remarks?

Fonny: The possibilities of mhealth are enormous. We have the opportunity to greatly improve the lives of many people and, at the same time, these new transformational trends will have a significant impact on the `incumbents’ – from pharmaceuticals & Medtech to providers and insurers. We will continue to live in exciting times, to paraphrase the Chinese proverb. Or, as the Americans would put it: “you ain’t seen nothing yet…Despite all this, we should not ignore the potential perceived and real risks, but I believe we can overcome these step by step, as we move towards a smarter and healthier world.

By the way, in December, we’re taking some of our customers to Silicon Valley on our first-ever Healthcare Disruption Tour to view many of these new developments first-hand. Have a look at

Hilde: Sentiance will be there ! See you then.

Fonny Schenck is CEO of Across Health, a global consultancy focused on impactful, innovative, customer-centric approaches in healthcare.

Check out the Healthcare Disruption Tour (December 2015) for the latest in healthcare innovation and disruption.

Hilde Eylenbosch is VP Healthcare at Sentiance. She recently joined Sentiance to further develop the healthcare business. Do you also want to be part of the contextual data revolution? Take a look at our open positions.

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