mHealth - “mobile” healthcare in the modern world

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

Not so long ago, PwC conducted a survey assessing the current state of health care in the world, as a result of which the majority of respondents noted the primary 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, health care 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 implemented, including in our country, and this is due to the so-called e-health (the common term is eHealth). Perhaps, many have already heard about telemedicine, electronic medical records, remote recording to a doctor, and someone has already seen it in action. But all this is only a small part of what can be used in health care. Talk about a relatively new e-health branch called mobile health (mHealth).
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MHealth market: its division and development

Mobile health care 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 for many examples of mHealth technologies are programs for mobile phones and tablets related to the control of physical condition (for example, weight) or fitness. When I think about mHealth, I often 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 is two major areas that develop in parallel, at different speeds, exerting a mutual influence on each other. The first is technologies, devices, applications and services for the treatment and care of patients, the second is systems and devices designed to monitor compliance with a healthy lifestyle (wellness) and fitness (fitness). You will say that the second direction has a very weak relationship to medicine and health care and you will be right, but mHealth is gradually converging, or rather merging these areas. Therefore, it would be more correct to speak not about health care or medicine, but about ensuring human health in all senses with the use of mobile and not only technology.

Devices for maintaining a healthy lifestyle

The market for devices and applications for fitness and maintaining a healthy lifestyle today is developing significantly faster (see sidebar) than the second mHealth line. This is due, not least of all, to the fact that the healthcare industry is very conservative - new products and services appear in it only after numerous tests, clinical studies and approvals 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, around the world, 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 the specified devices and independent applications for monitoring and managing their own physical state

This market is very mobile, new devices are appearing all the time, there are no obvious leaders yet, although the heavy giants of the electronic industry are heard, which one after another began to produce products in this category. Note that the wearable device industry can be reoriented 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, according to a PSFK Labs report and Intel's iQ magazine. In 2015, according to their forecast, the functions of wearable devices will expand and the transfer of information for medical purposes and behavioral changes will be inherent in clothing, and bracelets will be used for communication, verification of passwords and showing health data using an “emotional mirror”. Ultimately, the communication and control functions will shift to points, the report states, and in 2018 almost all the functions will be implanted.

Wearable technologies

The market of wearable technology would not be entirely correct to refer to mHealth, but it is very closely connected with the sphere of devices for maintaining a healthy lifestyle, and very often it is simply impossible to understand what a particular device belongs to. The list of products in this category includes:

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

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

Devices for health monitoring, diagnosis and patient care

As noted above, this sector is not developing as rapidly as the fitness sector. But, nevertheless, the mobile monitoring and diagnostics market already in 2012 amounted to 650 million USD, according to a report by 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 category of mHealth includes:

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



It is in this direction that the future success of mHealth is laid, it is with him that analysts link the reformatting of the medicine and health care industry, as well as the gigantic growth of market participants' revenues.

MHealth Investments

The growth of consumer demand for digital medicine technologies, supported by the targeted policies of many states to improve the health of the nation and the promotion of a healthy lifestyle, has generated unprecedented entrepreneurial activity. Investors rushed in a new, so many promising industry (although this does not apply to Russia). Last year, investments in companies related to digital medicine amounted to 712 million USD only in the United States, according to the StartUp Health report. In 2014, investment in this area continues to grow, with two areas showing a particularly sharp jump upwards. Investments in decisions related to the inclusion of patients in the treatment process increased by 410%, the second most important was the market of sensory 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 United States.

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

Today, new and new products in this area are appearing on the market; 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 core patients, and works without recharging for up to two weeks in a row. Scientists from Stanford University have created a wireless pacemaker, the size of a rice grain. There is a new health monitoring system called Cue, which allows you to take samples from your body and in a few minutes to check five key indicators of health and lifestyle.

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

FIGURES AND FACTS

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

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

Fitness trackers that were worn on the wrist became the most popular device, according to estimates by Canalys, in 2014, about 17 million such devices would be sold. 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 will be 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 in or on the user's body.

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

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

MHealth perspectives

The opportunities that are currently available in mobile medicine are growing rapidly with the advent of new devices, sensors, applications. Telemedicine and remote monitoring, patient data transfer, e-cards, e-prescriptions, sleep and pregnancy control, etc. This industry is developing rapidly all over the world, even in poorly developed countries, where it can become a “lifesaver” for people who do not have access to medical care. Increasing the time use of doctors and their productivity, improving service quality, simplifying access and returning justice to health care (attitude towards the elderly, unequal access to services, etc.), greater participation of the patients themselves, potentially reducing costs or, at least, much great investment benefits.



mHealth is not only new technologies, it is a completely new way of patient interaction with the doctor and patient care. This facilitation of such 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, thus allowing more time to devote to the actual diagnosis and treatment. Mobile access to information facilitates data acquisition 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 models and processes for patient care in order to improve patient care and ensure their safety.

Here are just a few specific examples that are already really working.

In Sweden, a system is successfully operating that allows remote reading of stimulants of the patients' hearts. The Soarian Clinical system allows monitoring the status of both the patient and his pacemaker from afar, eliminating him (and this is usually very elderly) from having 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, which the patient himself often simply does not notice, or does not pay attention.

Here are some more similar projects:

- Care Innovations remote support system for chronic diseases (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 in any place wherever they are.

- Visi Mobile - a system worn on the body of small sensors, which allows you to fix the deterioration of the owner's health in time and connect it with your doctor, regardless of where the patient is at the moment.

- There are also solutions based on the use of specialized miniature systems that control individual indicators of human health. For example, the company Glucovation has developed a system for continuous monitoring of blood sugar SugarSenz, which can be used by both diabetics and healthy people. The device is attached (glued) to the skin and periodically penetrates the skin to obtain a blood sample for measurement. Or a HealthWatch solution in the form of hWear T-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 the sphere of healthy lifestyle and medicine around the world is uneven. According to the GSM Association, the United States and China are the largest markets in the field of mobile health and by 2017 they will share more than one-third of the global market. It is here that most of the new technologies and ideas emerge that in the future should become the basis for new devices and services. The Brookings Institution report states that in 2017, mHealth revenue in the United States will reach 5.9 billion USD, while in China it will be around 2.5 billion USD.

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

A constraining factor in all countries are 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. And in China, the regulation is more stringent and today it is allowed to use mobile devices in healthcare only for counseling.

What to expect?

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

And where should 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 increasing. The only way to maintain good clinical results in the face of the growing shortage of primary care physicians is the use of automated remote monitoring systems for people's health and self-care of patients with the help of mobile solutions.
If mobile operators actively join this market, this will be a powerful step forward. They are in a unique position that allows you to solve many mHealth problems at once - to ensure mass connectivity, eliminate the problems of finding and connecting medical applications by pre-installing them on mobile devices. At the same time, they get new opportunities for themselves - this is an additional paid service, and additional traffic and time for communication, software downloads from their “mobile app stores”, etc. In addition, mobile operators are interested in bandwidth and latency-sensitive mobile applications, which allow for a faster 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 rapidly expanding availability of high-speed communications, which provides new opportunities for complex mHealth applications, such as remote video tutorials. mHealth provides numerous opportunities for the pharmaceutical industry, ranging 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 at the same time improving the quality of services and treatment. According to the analyst firm SNS Research, by the end of 2014, mHealth systems will save about 250 billion USD in healthcare systems around the world.

Admit it, because many of you thought more than once that it would be great if each of us, as is sometimes shown in a fantastic movie, had such a device that constantly monitors our health and tells us what and when to swallow. so as not to get sick. Either there were sensors built into the body or clothes that would monitor our health and inform us if any problems occurred. Who among us has not dreamed of this? Dreams are starting to come true ...

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