Mobile health is not about mobile phones or even apps, it’s about creating systems.

Last week I went to Mobile Health Summit 2013 (here translated into english using Google Translate) here in Stockholm. It was really mainly about 12 different “mini cases” where different large and small companies showed their innovations/products and a great panel discussion afterwards. The main common thing with all the cases was not really about the mobile apps or even mobile phones. Yes, it was there, but the main thing regarding each and every case was its service setup. What is an app without its service? A game? Or something that just takes MB of space in your phone? Of course you say, it has to be filled with a content and have a purpose. A mobile health system is somewhat different than an app…

First, what is a system?

A system (regardless if it’s on paper or computerised) can be defined as “A system is a set of interacting or interdependent components forming an integrated whole or a set of elements (often called ‘components’ ) and relationships which are different from relationships of the set or its elements to other elements or sets.” (Wikipedia on systems, read it if you like to understand any system, not just IT systems. It’s good!). According to TOGAF 9.1 (The Open Group Architecture Framework)  the definition of a business system is “Hardware, software, policy statements, processes, activities, standards, and people which together implement a business function”. A business system is as good as its “Hardware, software, policy statements, processes, activities, standards, and people”. When defining each and every part of a business system it can get tricky and here is of course why we will get so many different takes on the same issue/problem that a system “solves”.

A mobile health system

A health system is about a business system related to a health issue/problem – its “solution”. What we heard at the Mobile Health Summit was how important it is that the solution has the right service. In this context it’s about how the system service its users. A service according to TOGAF is “A logical representation of a repeatable business activity that has a specified outcome. A service is self-contained, it maybe composed of other services, and is a ‘black box’ to its consumers.”. I think it’s quite fuzzy definition. Also, I don’t agree that it is a ‘black box’ to its consumers. It might be, but it shouldn’t be (other than in a very technical system, don’t mix it with ‘components’ now). Why? Because today we see that transparency is more and more important. Any politician knows it and any teenager knows that most things will end up on Facebook, Instagram and other places regardless if you want to or not. Transparency for companies towards its customers is getting vital, as the social media and the web with its many forums makes it so easy to complain if something is not right. So should also services providers of any kind think, we are servicing customers that needs to have the best available service and know that the information they have provided is secure and used in the right way.

In a health perspective it’s even more important that the information provided is secured, reached only by the people who needs access, at the right time; it might be a matter of life or death. Information in the wrong hands can be dangerous or at least harm the person its regarding. So, security is important, but maybe not as important as getting the information when it’s a matter of life and death.

A mobile health system has some certain characteristics more. It needs to possible to reach the system when you are on the run. It must not have a boundary in location, maybe not even in time (if its that kind of system). Mobility the way I see it has to do with that you are not fixed to a place, something that you might carry with you at all times or at certain times when you need it – like a mobile phone or a laptop computer. A mobile health system needs to help someone with a health issue/problem, help defining it or learn how to prevent it to even occur. It could of general help to anyone (like a training app) or very specific (an app that helps a sick child to understand its diabetes).

What did we learn?

One common thing with all the 12 cases and discussed during the panel discussion was the problems an innovator faces when trying to make a global health system of any kind. The service design is very important and is vital! Every country has its own rules and laws regarding how to treat information, what policies it has and also its infrastructure. Taking only that into account it’s  hard for any small (and often also large) company to create a global solution. Of course, if it’s an app/system for weight control or an app to make you go to the gym more often or record you latest running session it’s not that hard from a security point of view. But now I mean health issues/problems that are more “serious”, a matter of life and death.

Innovations, personal experience and secure information

One innovation challenge in this area is to make sure that the users to the mobile system has access to the tools that the situation requires. I can think of many situations where I would have benefited from this. Sometimes its very easy, like when I broke my foot and went to the hospital. I got my x-rays, a par of crutches, some bandage and a “good luck” from the doctor. I was not very happy with that, so after a week or two when it didn’t get that much better, I went to get a second opinion. The next doctor wanted to see the x-rays and since I had taken a picture of the x-rays with my mobile he could see it without the need to repeat taking new x-rays. In an ideal world he would have them on his computer, but since this was a private clinic and the hospital a public own facility he could not access it very easily. He said he need to to do an additional MRI to get a better view of the complete injury, but the fact I had the x-rays with me helped him a lot and I got quicker help. The same goes for a friend who has cancer, but it’s much more complex. The best way for my friend to make sure that each doctor gets the right information is to carry a copy of each journal or at the very least the important ones. In 2013?!? There should be standards for that (and yes some exists) but standards are hard to decide upon, it takes time and a lot of effort to implement. Security can also be hard, but what is the purpose for the security? Is the purpose of the security the patient safety or the hospital regulations? It’s a huge difference between patient security and patient safety. Mobile systems can change this around, make it much more natural for everyone to demand access and the right information to the right person at the right time.

What can we expect forward?

Mobile health is very important and very very interesting from an innovation perspective. Mobile health is truly about how to reach the right information at the right time making the right decision for a patient or community or for YOU. It’s mobility has nothing (or very little) to do with whether or not a mobile phone or app is involved. Mobile systems have already saved lives and given a higher quality of life for some. In 2013 we demand that we have the right information at the right time. Most of us are mobile, we live an active life. I’m sure that mobile health systems have a great future, it’s will become commodity eventually. We just need to agree what is important, share that vital and secured information and – for the sake of our kids and their kids – the right standards so that we can share it with everybody that needs (and I mean really needs) that information. The expression “Mobile First” is something I very much agree and I’m sure you do too. I wish we can make our lives better, healthier and more mobile in all aspects.

Bill Gates vision “Information at your fingertips” from 1995 has never been more real than today, but I’m sure its more mobile than he thought at the time.

Do you agree to my thoughts? What is your opinion? Please tell me and let’s discuss how we can create more systems and solutions that benefits global health.

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