ueda2013 mobile health solutions-d.michael

© GSM Association 2013

Meeting the MENA diabetes challenge

with mobile health solutions

Michael Morgan-Curran, Director mHealth Diabetes, GSMA Jan 2013


The GSMA represents the interests of mobile operators worldwide.

Spanning more than 220 countries, the GSMA unites nearly 800 of the world’s

mobile operators, as well as more than 200 companies in the broader mobile

ecosystem.

The GSMA

http://www.sfr.fr/do/Home


GSMA recognises the global and local challenge

North America and

Caribbean

38 million

10.7%

29.2% undiagnosed

Rise in diabetes associated with economic development, ageing population,

urbanisation, dietary changes, reduced physical activities and other lifestyle

changes

South and Central

America

26 million

9.2%

45.5% undiagnosed

Western Pacific

132 million

8.3%

57.9% undiagnosed

South East Asia

71 million

9.2%

51.1% undiagnosed

Europe

55 million

6.7%

38,6% undiagnosed

Africa

15 million

4.5%

81.2% undiagnosed

Middle East and

North Africa

34 million

11.0%

52.9% undiagnosed

Source: IDF 5th Atlas 2012


Source IDF 2012 Zhang Survey 2011 London School of Economics

In 2012;

The cost of prescribing medication for complications of diabetes is around

3 to 4 times the cost of prescribing diabetes medication

4.8m people died due to diabetes – ½ under 60

Half of people with diabetes don’t know they have it

12% of total healthcare expenditures attributable to diabetes = 471B USDs

Expenditure will rise by 34% by 2030

4 out of 5 people with diabetes live in low and middle income countries

We know that diabetes management carries a huge cost


mHealth has 2 broad categories

Source: GSMA PwC February 2012

Healthcare Systems Strengthening

Prevention Diagnosis Treatment Monitoring

Emergency Response

Healthcare Practitioner Support

Healthcare Surveillance

Healthcare Administration

Solutions across the Patient Pathway


Source: Intel

Monitor and

manage standard

vital signs

Physician Caregiver

Data-rich Health

management

systems

One-way communication Real-time two-way communication

Connection to friends

and caregivers

Connection to

healthcare advice

Independence

Safety and friendly

environment

Friendly check-in

mechanisms

Information sharing

Qu

ali

ty o

f c

are

an

d s

oc

ial c

on

ne

cti

on

Lets look at the evolution in mHealth

Monitor standard

vital signs


Where do Mobile Network Operators add value?

Connectivity Infrastructure Sensors

Glucose

Meter

Blood

Pressure

Pulse

Oxymeter

Implant

Monitor

Spyrometer

Gateway

Health Records

Health

Call centers

Hospitals

Care givers

Family

Health Service

Receivers

Patient

Inhaler

Chronic Disease Management Ecosystem

Source: GSMA


In 2010 we launched the GSMA Global mHealth

Programme

To support the development of

mobile health solutions

through cost-effective

delivery of better healthcare


Our objectives

Demonstrating outcomes and impacts on individuals,

healthcare systems and society by running trials and

producing evidence that show the benefits of mobile

health

Fostering new relationships and partnering between the

healthcare sector and the mobile industry

Stimulating scalable, replicable technical solutions that

promote hardware and software interoperability

Promoting policy and regulatory principles that will

stimulate growth and innovation

Showcasing mobile health solutions and advanced

cross-industry awareness and knowledge through

events and seminars in the healthcare industry


Our objectives align with many partners

WHO & ITU launch m-Health initiative to combat non-communicable diseases - 17th Oct 2012

Source: WHO, 1st Intnl Forum, IDF

The Diabetes Education Study Group (DESG) of

EASD, in collaboration with IDF-‐MENA Regional

Committee for Diabetes and Ramadan (DAR)

Diabetes And Ramadan

(DAR) 1st International Forum


Case studies – Chronic disease management &

mHealth implementation


Solution Features

• US FDA 510(k) for adults with

Type 2 diabetes**

• Fully scalable solution backed by

AT&T's highly secure network

infrastructure

• Compliant with HIPAA Privacy

and Security Rules

1. US - AT&T (WellDoc) DiabetesManager

Integrated Remote Patient Monitoring system to improve care of diabetes patients

Source: AT&T

Solution Benefits

• Real-time, clinically based

feedback and coaching to

patients

• Healthcare providers and case

workers/managers provide

instruction or intervene as

necessary.

• Shifts focus to the patients who

need help the most

• On-going feedback loop and

intervention helps drive down

costs


Source: Progress in Cardiovascular Diseases 53 (2010)

Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS

35): prospective observational study.

1. US - Demonstrated success through evidence

WellDoc ran cluster-randomised controlled trial 163 patients in 26 primary

care practices

Results

• A1c levels reduced by 1.9% among experimental group

vs 0.7% reduction in control

Benefits

• 37% decrease in risk of micro vascular complications,

14% decrease risk of myocardial infarction

• 14% decrease in risk of all-cause mortality with no

threshold effect

Results

• 58% reduction in emergency hospital stays over 12

months

• 100% increase in self management blood glucose

• 100% liked coaching feedback


Source: DOH, 3millionlives.co.uk, healthcare.co.uk

Achieve 3 million

target

Increase coverage to

100,000

Randomised Control Trial covering 6,191* patients and 238 GP practices in England

(*3,030 with one of three conditions: diabetes, heart failure

and COPD)

45% reduction in mortality rates

20% reduction in emergency admission

15% reduction in Emergency hospital visits

14% reduction in elective admissions

14% reduction in bed days

8% reduction in tariff costs

2013

2014 -

2018

2008 -

2010

Aims to provide support to 3 million people

with chronic conditions and/or in home

care needs using mHealth, including remote

patient monitoring

Strong support from Minister of Health

2. UK - 3millionlives initiative: demonstrated success

through evidence


Smart Health is the utilization of mobile communication technologies to deliver healthcare services. It is the du portfolio of all mobile health and eHealth services.

These services will enable a range of value added content and disease management opportunities for our customers.

3. UAE - Smart Health from du – providing clinically

relevant content with connectivity

Source: du


Central electronic health platform

Extensive health data– CHD & Diabetes

Reach 200,000 patients

Continua standards

Facilitated:

Greater insight into major health issues

Development of actions to improve health standards

Individuals awareness raised regarding their health

Standards for disease management programmes established

Diagnosis related groupings created

Alignment of economic value with health outcomes

Source: HAAD

4. UAE - HAAD Weqaya model: started with a successful

use of rich health data sources


D Database Business

layers

New consumer

channels & Services

• SMS

• Call Centre

• HD Voice

• PDF Health

Report

• Smart phone apps

• Decision prompts

Thiqa

(Daman)

New data sources

• Portable devices

• Sensors

• Remote

monitoring

• Point of care

diagnostics

Data

exchange

Weqaya

Health

Facilities

Mandatory reporting

• HbA1c

• Fasting plasma glucose

• Plasma glucose

• Fasting trigyceride

• LDL

• HDL

• Albumin

• Microalbumin

4. UAE - HAAD Weqaya model: demonstrating successful

use of rich health data sources


The key to successful mHealth Solutions

Providers End User

Groups

Regulators

Payers

mHealth

Products and

Services

Pull Push

Fund /

sponsor

Transnational /

National Health

Approvers

Patients Governments /

Insurance

Companies

Healthcare

Industry

Mobile

Operators /

Vendors P

rofita

ble

Pa

rtn

ers

hip

s

Dem

an

d m

Hea

lth s

olu

tion

s

Healthcare

Providers

Pre

scrib

e m

He

alth

Ensure appropriate

approval


Key outcome: Collaborative Agreement

• To work together to increase awareness and

acceptance of mHealth Solutions / Services

in the Middle East

• Shape mHealth services based on clinical

and organisational need

• Shape sustainable business models which

requires involvement of the government and

private sector – in order to make the service

affordable

• Collectively engage with Health

Ministry/Regulators to address barriers to

approval and implementation

UAE/Qatar/KSA example of partnership

GSMA Innovation Group


Take home message……..

… ‘Mobile Health Solutions

will help you improve

diabetes healthcare through

more cost-effective delivery’

…

Shukran Jazilan


Shukran Jazilan

Michael Morgan-Curran

Director of mDiabetes

Campaign

[email protected]

+44 7730 089240

mailto:[email protected]



ueda2013 mobile health solutions-d.michael

Health & Medicine

gsm association

diabetes management

healthcare systems

undiagnosed source

complications of diabetes

diabetes dont

benefits of mobile health

healthcare sector