Healthcare in Motion

AMCP Education ConferenceOctober 21, 2011

Steven Peskin, MD, MBA, FACPEVP and Chief Medical Officer, MediMedia

Associate Clinical Professor of Medicine, UMDNJ

Mobile Technology Landscape

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"Every generation needs a new revolution."-Thomas Jefferson

• Mobile technology has become ubiquitous in our consumer lives…and it’s bridging to other areas

• Today, we are at the leading edge of it, revolutionizing the way we manage our individual health

• Three major areas of mobile health that will drive this change:– Health Care Professional: Knowledge building, increased interaction,

and improved clinical actions

– Consumer: Creating excitement and ease to drive engagement and behavior change with relevant and actionable information and topics

– Connected Care: Integrating all key stakeholders (HCPs, life sciences companies, payers, consumers) to efficiently achieve desired health care outcomes

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Source: 1. Pew Internet & American Life Project – Mobile Health 2010; 2. Morgan Stanley’s Internet Trends Report 4/2010; 3. Nielsen’s State of Mobile Media 12/2009; 4. Insight Express, Digital

Consumer Portrait, June 2010; 5. Direct Marketing Association’s

• 292 million American cell phone users; 93% of the population in the U.S.

• 5 Billion text messages sent daily in the U.S.; over 1.5 Trillion in 2009

• Mobile users outnumber internet users 3:1, growing to 4:1 by 2012

• Smartphone market share will overtake that of the feature phone by 2011 Q3

• 97% of SMS messages are opened, 83% are read in an hour

Implications

• Market for mobile is reaching maturity as most consumers have smart phones and are rapidly increasing their use especially for non-voice related activities

• Mobile phones are private devices that can be directly associated with an individual facilitating micro-targeting and engagement programs

Mobile devices are personal, ubiquitous, connected and advanced. They create a unique opportunity to deploy acquisition, loyalty and engagement solutions

Mobile Statistics

Source: 1. Pew Internet & American Life Project – Mobile Health 2010; 2. Morgan Stanley’s Internet Trends Report 4/2010; 3. Nielsen’s State of Mobile Media 12/2009; 4. Insight Express, Digital

Consumer Portrait, June 2010; 5. Direct Marketing Association’s

• Physicians use mobile web more than 2X the general population…but are just beginning to use mobile tools in patient communications

• Consumer market for mobile monitoring devices estimated at $7.7 billion to $43 billion by 2015

Implications

• Mobile Solutions in healthcare are rapidly maturing from interesting novelty to accepted practice and will become commonplace in the near term

• mHealth market is a large market that will effect the entire healthcare delivery system

Mobile health projections vary greatly…but the data suggests a positive environment for deploying mobile solutions across the entire healthcare industry

Mobile Statistics

By 2014, Mobile Internet Should Take Over Internet Usage

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How Much Do People Use Their Mobile Phones?

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How Has Mobile Usability Changed?

• Because of the increasing use of mobiles, their versatility is always growing…

• One half of all local searches are performed on mobile devices

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Mobile By Numbers: Consumers• Approximately, 224+ million of the 292 million U.S. subscribers today use text

messaging, 75 million access mobile web. • 90% of 18-29 year-old mobile users, 67% of 65+ send texts.• 97% are SMS capable, 59% are web access capable.• 97% of mobile messages are opened, 83% read (within 4 minutes). Only 24% of

e-mails are opened when there is a coupon offer• 36% of mobile users took action based on a mobile campaign.• Typical U.S. mobile subscriber between the ages of

35 and 44 will now send or receive more text messages than phone calls per month.

• 5 billion+ text messages are sent daily.• Typical Smartphone Web access in Healthcare:

iPhone 58.52% Google Android Browser 34.04% BlackBerry 6.94%

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Consumer adoption of mobile health is strong given the early stage of development

Female Individual Policy holders wiling to pay $25 for an e-visit

Male Individual Policy holders wiling to pay $25 for an e-visit

Willingness to use a mobile health application

Clinician adoption viewed as the number one driver

Expect health insurers to pay for m-health

Believe m-health will be widely accepted by 2015

27%

36%

41%

62%

72%

75%

Mobile By The Numbers: Consumers

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Mobile By The Numbers: ConsumersConsumers show a willingness to pay for mobile healthcare, want to monitor health and communicate with their doctor

50%50%

YesNo

% of Consumers Willing to Pay for Mobile Healthcare

Want doctor to monitor health remotely

Monitor Fitness or wellbeing

Would pay for a device that would send health info to a doctor

18%

20%

40%

Source: PWC Healthcare Unplugged 2010, Health Research Institute

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Source: Pew Research Center's Internet & American Life Project, April 2010

Key Statistics

57% of 50-64 demo sends text regularly

43% of 30-49 demo access the internet regularly

20% of 18-29 demo made purchases on their phone

Mobile By The Numbers: Consumers

Mobile Technology & Apps Will Redefine the Way Consumers Manage Their Health…

• 4.7 billion mobile subscribers worldwide1

• Mobile health apps have grown by 78% in the United States

• Currently, there are 17,000mHealth apps ̶ 74% adhere to the paid business model

• 76% of mHealth market revenue will come from related services and products such as sensors

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…And Address Many of the Challenges Traditionally Associated with Poor Outcomes

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ObesityLack of Engagement

Poor Compliance

Boredom Disconnection

Poor Prenatal Care

Pre-diabetes

At-risk Patients

Industry:Health &

Productivity $2.3B2

Consumers:Health

eGames$6.6 Billion1

Health eGames +

Social Media +

Mobile+

Analytics & Outcomes =

…Superior Health & Performance

Opportunity: Health eGames Bigger than Disease Management

ExergamingCondition

ManagementNutrition

Brain FitnessProfessional

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Example: POC Patient Engagement Workflow

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Other delivery options:– E-mail

– Call Center– IVR

SMS or audio dosage reminder

with caregiver monitor

To: 232-132-2076From: 5301603/25/11 8:00am

Sam, remember to take your morning meds on an empty stomach. Dr Katz

To: 232-132-2076From: 5301603/25/11 8:05am

Sam has replied “Yes” to confirm his morning regimen.

To: 232-141-2567From: 5301603/25/11 8:00am

Sam, remember to take your morning meds on an empty stomach. Dr KatzReply “Yes” to confirm.

Sam, remember to take your morning meds on an empty stomach. Dr KatzReply “Yes” to confirm.eRx/EMR point-of-care

HCP interface

Caregiver alert options

Mobile Pain Care

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Mobile Technology and Healthcare Professionals

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Market Drivers for Connected Health

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Wireless Health Information Flow

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• 94% of Practitioners use a Smart Phone (Typical OS Access Breakdown, 07/11) iPhone: 56.52% iPad: 21.75% Android :11.56% RIM BlackBerry: 5.88% Misc: 7.12%

• 59% of Practitioners use their mobile device for researching medical information

• 57% consult their Smart Phones with their patients

• 63% Use Apps frequently

• HCP Apps:J&J Black BagMedscape eProcrates

Mobile By Numbers: PractitionersDoctors have a broad view of the potential application of mobile across the care provider continuum

75 % of U.S. Physicians own some form of Apple device

• Study from pharmaceutical and healthcare market research (Manhattan Research), 75% of U.S. physicians own some form of Apple device, such as an iPhone, iPad or iPod

• An additional 28% of physicians plan to purchase an iPad in the next 6 months.

• 72 percent of US physicians now use smartphones, more than 80 percent of U.S. physicians will have smartphones by 2012 (up from 64% in 2009), -- more than half of that group will use their phones for patient care & administrative functions (like charge capture and continuing medical education) according to Manhattan Research

• Spyglass Consulting Group says that an astounding 94 percent of doctors are using smartphones to communicate, manage healthcare and personal workflows and access medical information--up from 59% in November 2006.

Mobile By Numbers: Practitioners

AmeriHealth Mobile Wellness Program

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• Utilizes the GoMo™ Mobile Platform to provide wellness engagement for AmeriHealth corporate clients and their employees.

• Empower AmeriHealth clients to deliver important wellness and care content to their insured employees.

• Inclusive of any wellness program, disease state, or other healthcare regimen (fitness & nutrition, diabetes, pregnancy, weight management etc).

• Employee participants are also able to send in data and create their own personal wellness diary card. –This diary program is a great way to track progress

with a particular wellness regimen and employers can offer rewards for participation and progress.

Point-of-Care Mobile Technology

• 87% of physicians who use a PDA/smartphone said the PDA channel provides clinical information that is most influential in their prescribingand treatment decisions

• 92% of physicians agree that “clinical information on my PDA/S, smartphone improves my knowledge and capabilities” 87%

2%6% 3% 2% 1%

Most Influential on PrescribingPDA/Smartphone

Direct Mail

Journal Ad

Rep Visit

e-Detail

Pharma brand web site

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“Effect of PDA-based information on treatment decisions.” Mix of 594 primary care and specialty physicians. Marlborough, MA: Skyscape; March 2008.

“There’s an App for That”

• Apps for patient information delivery• AirStrip Technologies: offers a suite of

HIPAA-compliant apps that collect all relevant patient information and sends it to your PDA (including lab results, cardiology, temperature, etc)

• From QuantiaCare: EatSmart, with content from Hope Warshaw, RD, MMSc, CDE, BC-ADM

• Apps for electronic medical records• The software developer, Epic, just released a

new suite of apps that feature PHR access for a PDA

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Clinical Decision Support

• Epocrates– Founded in 1998, over 400,000 members

– Not strictly a social professional network

– Features immediate formulary checks and drug information, point-of-care references, discussion topics, and an electronic game on Facebook called “Diagnose the Disease.”

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More Apps for Health Care Professionals• Apps for medical education and reference

• Krames Patient Education: iPatientED is a quick reference tool for physicians with 118 animations spanning 22 medical specialty areas, many with narrations in English and Spanish

• Modality: this company features 120 apps, 55 of which are focused on medical education

• MedCalc: a medical calculator with a wide array of medical formulas and scores. Includes information and bibliographic references for each formula

• ICD-9 Lite: contains all 13,677 ICD-9-CM diagnosis codes for quick retrieval by disease classification in a drilldown format with no typing. Code to the highest level of specificity every time

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New Mobile eRx Impact on Healthcare Reform

eRx “Point-of-Care” deployment enabling mobile patient engagement to enhance compliance & persistence

Social Media: Transforming the Healthcare Ecosystem

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If Facebook were a country it would be the 3rd most populated – March 2010 (TechXav)

• As of 2011, there are over 800 million active Facebook users – approximately 1 in every 8 people ON EARTH. (Digitalbuzzblog.com)

• 57% of people talk to people more online than they do in real life (Digitalbuzzblog.com)

• The average visitor spends 66% more time on social media sites than they did a year ago (6 hours in November 2010 versus 3 hours 31 minutes in 2009) (mashable.com)

• The number of people who are visiting social media sites has increased by 24% over the last year (Tech Crunch)

• Internet users worldwide spend more hours per week with social media than any other online activity (mashable.com)

• The change in social media use among Baby Boomers rose from 9% in Dec. 2008 to 43% in Dec. 2010 (Marketingcharts.com via David Erickson)

• Social networking site usage grew 88% among Internet users aged 55-64 between April 2009 and May 2010 (Pew Research)

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Physicians are Highly Engaged with Online Networks and Social Media.

• Nearly 90% of physicians use at least one site for personal use, and over 65% for professional purposes.

• Overall, clinicians express significant interest in the potential applications of social media to their professions – whether via online physician communities, online patient communities or sites that could facilitate physician-patient interactions.

• A group of “Connected Clinicians” is using multiple social media sites for both personal and professional uses. These clinicians are the front-runners in applying social media to medicine, and are most eager to use it to positively impact patient care

• The vast majority of physicians are already using social media; Facebook tops the list for personal use, while online physician communities are driving professional use.

• Physicians familiar with online patient communities believe they positively impact patient health; however, awareness of these sites is low.

• There is significant need for secure, convenient forms of electronic communication that clinicians can use to communicate with each other, and with patients.

• There are opportunities for constituents across the health care system to use social media as a tool for improving patient care.

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(Mobile) Social Community Benefits for Health Care Professionals

• (Mobile) social communities facilitate sharing of clinical insights and solutions to practical clinical problems in a way that promises to hone “best practices”

• Allows physicians to:– Access dialogue on best practices

– Source and disseminate immediate research

– Solicit useful feedback about preferred treatments, protocols, and practice tools that yield best health and patient satisfaction

– Build business arrangements

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New Mobile/Social Collaboration in HealthcareNew Healthcare Social Communities being formed for sharing and networking via mobile…

Integrated HCP/Patient Engagement

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HCPs visit Web/WAP disease state or brand portals driven by QuantiaMD promotion from peer-to-peer educational initiatives

QuantiaMD• Link to/from portal• Access to

>300,000 HCPs• Engagement &

promotion• Educational &

resource materials

Social Networks Influence Patients’ Treatment Decisions*

Ages: 35 - 44

53%Strong + someimpact47%

No impact + don’t know

*Adapted from: Pharma 2.0. A How-To Guide to Consumer-Generated Content.ePharma Consumer v7.0, Manhattan Research 2008

Doctorslike wikis

Because of:

SpeedDifferential diagnosis or to jog memory

EaseA useful starting point to do research*Jessica Berthold, Web Watch: Living in a Brave New World of Medical Wikis, American College of Physicians, 2008 www.acponline.org

Examples of HCP Social Media Platforms

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Proven Platform

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Typical Community Data for 1 Month

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Medical Directors Forum

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• Private community developed by Medical Directors for Medical Directors

• Communicate with colleagues on a social or professional level

• Share best practices• Ability to create interest groups• Access to:

– A broad group of Medical Directors

– Updated guidelines

– Healthcare news

Healthcare Social Networking Looks Set to be Data-Driven

Not just shared experiences, but shared personal health data

Patients share structured information about their disease to help themselves and others

Quantifiable, measurable, actionable

Disease Networks Will Look and be Radically Different

Data provided by 1056 Betaseron patients

‘People who use it will live longer; people who don’t won’t’ Jamie Heywood Co-founder, Patientslikeme

Key Takeaways

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• Mobile health and social media will be a part of everyday health care

• Health care professionals will embrace digital tools/communities for clinical performance improvement, time, and $$$ savings/revenue

• Increased availability, accuracy, “searchability,” and dissemination of Information Image from the January 2010

Consumer Electronics Show in Las Vegas. Note “digitalHealth” in the center.