Will The UK's GP commissioners embrace telehealth?

The UK Government is currently in the process of attempting to radically transform healthcare in the UK. Over the course of the next 2 to 3 years, the top-down NHS model will be replaced by a bottom-up, GP-led commissioning model. In this new model much of the NHS’s current funding will be given over to, and managed directly by GP-led consortia.

A key reason for the desired change is that GPs are best placed to manage and focus budgets in-line with the requirements of the local community. As a result, centralised management costs are expected to be significantly reduced and patients will enjoy better outcomes.

This process has already started with the establishment of a number of path-finding consortia who will, during the early stage of this process, start to deliver healthcare based on this new model. These pathfinders will enable early visibility of any issues arising and highlight the benefits of the new model.

The context for telehealth

In this context, budgets could be used to purchase telehealth and other related technology such as mobile healthcare (mHealth). Whether or not this will happen to a greater degree than is currently the case depends on a number of things including:

·         the level of awareness that GP commissioners have of these services

·         their level of believe in these technologies to add value and reduce costs

·         the availability of the required skill sets in terms of assessing patients suitability for telehealth, recommending equipment and training patients to use the equipment

·         their ability to provide on-going support for telehealth services that they recommend  

There is no doubt that telehealth will be used more and more, driven partly by patients such as the article’s author who know what is available, understand the benefits and request these services and also by GP consortia that have already had exposure to telehealth through research or pilot programs and believe that there are significant benefits.

Embracing telehealth will still be challenging

But over the next couple of years, GP commissioners will have enough work to do as they change their working practices to be aligned with the new funding model. Finding the time to investigate new technology will be challenging. Even in the most positive scenario where commissioners do embrace telehealth in a major way, a national roll-out is unlikely. GP-led commissioning is intended to be bottom up not top down so it will be up to locally led consortia to determine whether telehealth is relevant to the core services that they provide. This could change if telehealth is accorded “specialist service” status in which case it will still be the responsibility of centralised NHS commissioning board.

Should commissioners wish to investigate the telehealth solutions available, within the existing NHS structure there are tools in place that can help them. One of these is the Assistive technology framework agreements that are in place. Managed by the Government procurement agency, these cover a large number of telecare and telehealth suppliers providing a potential focal point for commissioners keen to see what commercially available solutions are available and obtain a view of the costs involved.

Still waiting for evidence

Currently, evidence from the numerous pilots and trials that have taken place over the last few years places the burden of proof back with technology providers. As recently as August 2010, a paper entitled, “sustaining innovation in telehealth and telecare”, published by the UK’s Whole System Demonstrator Action Network indicated that “there is still a lack of robust evidence for the cost-effectiveness of telecare and telehealth”.

Faced with this conclusion, the wider adoption of telehealth could be some way off but whilst this particular debate continues there is a bottom-up opportunity to ensure that newly and recently qualified healthcare professionals are formally introduced to the relevant technology and concepts. This should take place whilst in the final stages of formal training and through continuous professional development. Only in that way will a deeper understanding of the technology and associated telehealth skillsets be developed in a systematic way so that eventually telehealth becomes part of a core service rather than an “add-on”.

Brands / Publishers Continue to Integrate Print, Mobile, On-line

As mobile is increasingly integrated into the marketing mix, brands and magazine publishers are finding all sorts of ways in which to integrate mobile with their printed and on-line editions.

The recent campaign by Allure featured the large scale use of 2D bar codes which readers could scan for a chance to win beauty product giveaways, a great way introduce new products and samples.

In the UK, a leading cosmetic brand Collection 2000 and IPC Media’s weekly glossy, ‘Look’ are collaborating to engage readers and promote the Collection 2000 brand through an innovative MMS competition. Readers are invited to send picture of themselves to a mobile Short Code for a chance to win prizes including a photo shoot and chance to appear in a future edition of the magazine.


Smart phones continue to revolutionise the way in which customers use mobiles and the way in which brands and publications interact with their customers. With the right tools and processes business of sizes can take advantage of the growing use of Smart Phones to promote business and win new customers.

Visa Gets Serious About Mobile Commerce - Will This Accelerate Mobile Commerce Adoption?

Following PayPal’s recent high profile and successful launch of PayPal for mobile on the iPhone, practical mobile commerce moved another step closer to wide spread adoption. 

Visa Inc’s approach to securing its own place in the mobile commerce space is to acquire CyberSource Corp, a long term provider of e-commerce transaction management solutions. The deal has in part been motivated by PayPal’s recent activities in the mobile payments space. For the industry, the $2B acquisition highlights the fact that mobile payments provide massive opportunities in the years ahead and that security will be one of the key challenges.

Mobile Commerce As A Separate Channel?

Currently, Visa sees mobile commerce as a separate channel from desktop based on-line commerce. This goes against the grain of many industry analysts who see the growing use of mobile internet as a potential threat to desk-top access. From a consumer’s viewpoint it is irrelevant. They just want the same ease of use and confidence whether they transact on desktop or mobile. For retailers, it might well be seen as a separate channel but only from the point of view understanding which channels are most effective at delivering sales. Their main requirement is to provide customers with a practical and secure mobile transaction environment.

New Opportunities For Business To Deliver Mobile Commerce

An increasing number of retailers want to get involved in mobile commerce but find it hard to do so. Navigating the range of mobile payment schemes and understanding the underlying rules, regulations and standards is daunting. Some retailers look at existing bill-to-phone methods and find them both expensive and restrictive. Others look at how they can enable users to submit credit card payments over mobile just they would on-line even though they accept that it is too cumbersome for consumers to enter the relevant data on a mobile device.

Visa’s announcement along with PayPal’s recent activities should give retailers who are serious about mobile commerce a cause for optimism. These players can ensure:

• Transaction fees that are much more in-line with retailer’s business models when compared to some bill-to-phone options
• Scalability both in terms of infrastructure and reach amongst the potential buying community

Consumer Acceptance

Consumer acceptance of mobile payment methods is of course key to wide spread adoption of mobile commerce. Solutions such as those enabled by PayPal and those created by the Visa / CyberSource tie-up will allow consumers to leverage their existing banking relationships and the familiarity and trust that goes with it. This will continue to make it more acceptable for consumers to transact on mobile so retailers more than ever before are beginning to have access to the correct mobile commerce enabling infrastructure.

Global CMO Survey: Digitally Empowered Clients Threaten Traditional Ad Agencies

Technology advancements and a radical shift in the way that customers engage with brands are creating challenges for traditional agencies. Whilst on the one hand the global economy starts to offer the promise of growth, a lack of appropriate skills threatens to remove access to this opportunity.

• Digitally empowered clients dissatisfied with agency online, viral and mobile marketing skills
• CMOs plan on more in-house skills development; less agency dependency
• Customer data management seen as moving up the agenda 

Digital Empowerment

One of the issues highlighted in the CMO Council’s State of Marketing Report, 2010, is that clients who have become more digitally empowered in recent years are dissatisfied with their agencies digital skills. Traditional agencies are struggling to convey to their clients that they can make channels such as mobile and social work. They are also not delivering viral marketing and are finding it harder to justify the online campaigns that they run.

Technology is the issue here. Creativity, branding and targeting have always been key areas of focus for agencies but mobile, social and online campaigning are driven by a combination of technology and vast amounts of customer data.

The rate at which technology continues to be developed makes it hard for traditional agencies to keep pace, leaving clients to bring in specialist agencies to the fill the skills gaps or do it themselves. Digitally empowered clients are also placing more focus on customer data. Specifically, how can the data that they have about their customers be used to improve campaign approach and planning? This highlights another issue with traditional ad agencies which is the lack of infrastructure or technology to manage the ever growing volumes of customer data.

Forward thinking agencies are already developing in-house skills or working with specialist agencies. However, it seems that this is not enough for clients who have started down the road of digital empowerment and believe that the best way forward is to increase their own knowledge, experience and technology assets.

Association of Online Publishers - Investing In Mobile A Top Priority

The Association of Online Publishers (AOP) in their annual census across 1,500 publishers and brands identified investing in mobile skills as a top agenda item for publishers in the year ahead.

Where To Invest?
Publishers that adopted mobile early will continue to test the promise offered by this channel whilst expanding their efforts into identifying business models that will replace declining revenues from existing channels, keep existing customers engaged and win new audiences. In pursuit of these objectives, investments should focus on the broader distribution of content and improved ability to monetise content effectively.

Investing In Distribution
Currently, mobile apps, almost exclusively iPhone apps, continue to be favoured as the best way of making content available on mobile. It almost guarantees a desirable user experience and whether charging for downloaded apps or providing them on a sponsored basis they are easy to monetise. However, with other smart phones enjoying more prominence, publishers that want to maintain an app only approach will need to develop them across several platforms or risk missing the opportunity to provide services to a broader customer base.

The other mobile channels - mobile internet, messaging, mobile video – also offer publishers a platform for distributing content to their readers, providing sponsorship opportunities to their advertisers and attracting new audiences. These should be considered alongside apps as additional methods for the delivery of content.

Mobile Internet - Data describing handset characteristics and capability is readily available and can be easily incorporated into mobile website publishing systems. This makes it easier to publish mobile sites that will adapt to each handset and ensure that the consumer gets the best user experience regardless of the handset that they are using.

Although it is not yet possible to provide as rich an experience when compared to apps, developments in HTML 5 are allowing the gap to be closed. Publishers wishing to broaden the audience that they can reach without going down the route of developing apps for each platform can still provide consumers with a rich experience through mobile internet sites.

Messaging - Messaging can be used to drive indirect content distribution. For example, SMS can be used to deliver scheduled notification or reminders of content availability. Links can be included with each message to ensure easy and immediate access to that content. Messaging in combination with suitable mobile payment options can also be used to sell subscriptions or support occasional content purchases.

MMS, is typically underused for business applications but it does provide a method for the delivery of rich content that can include text, audio, images and video. Several niche online and mobile only publications are already using MMS to distribute content rich news letters on a free or subscription basis.

Mobile Video - The rapid rate of smart phone adoption together with more readily available access to data subscriptions is allowing more and more consumers to enjoy mobile video content.

Whilst mobile video streaming is highly dependent on the willingness of network operators to provide sufficient bandwidth, the ability to quickly download clips that will last for a few minutes provides a practical alternative to streamed video or mobile TV. Whether it is news, information or entertainment, packaging this type of content as mobile video clips provides a rich, sharable user experience to consumers with appropriate smart phones.
As Publishers continue to invest in online video production, encoding content for distribution via mobile should also be considered.

Integration With Existing Channels – In adopting mobile more aggressively, integration with existing print and online channels should not be overlooked. As an example, some publications are already using 2D codes and short codes in print and online to connect with readers.

2D barcodes or SMS short code / key words combinations can be printed alongside product descriptions or featured articles. Readers can capture barcodes using readers installed on the phone and be directed to a mobile website for further information. Alternatively, readers can send a text message to the short code and receive an SMS that contains links to mobile sites or other downloadable content such as mobile video clips or eBooks that deepen their engagement with the product.

Mobile's Many Angles
There are many areas that Publishers should consider when incorporating mobile as a core part of their digital strategy. Apps are just one of them. Both Mobile Internet and Mobile Video continue to grow in importance and offer the possibility of enabling publishers to distribute a variety of rich content to their readers.

Google Sees Price Of Mobile Ad Units Increasing. Are There Alternatives?

The mobile industry is united in the thought that the use of mobile search and the high response rates associated with mobile ads will continue to grow. Taking this view one step further, Google exec Gundotra expects the actual price per mobile ad unit to increase and ultimately exceed the price of desk top ad units.

Paid Search Is Already Expensive. Can It Really Go Much Higher On Mobile?

For mobile ad unit pricing to increase, marketers will have to

• Increase their overall marketing budgets and
• Increase the amount that they allocate to mobile 

But the unit cost of paid search is already very high. It is difficult to see how it can go much higher and still present an attractive option for marketers even on mobile. This is especially true if there are credible alternatives.

One consequence of the increasing cost of paid search is the shift of budgets to Search Engine Optimisation. Another, more recent consequence is the growing use by marketers of Social Networks. Both of these will put pressure on the price of desktop search. This will be carried through to mobile.

  

Are There The Budgets Support Higher Priced Mobile Ads?

Marketers continue to shift their budgets to more personally engaging channels rather simply increase them. Mobile and social networks are amongst the beneficiaries. To anticipate a growth in the price per mobile ad unit and at the same time a growth in the use of mobile ignores the growing importance of Social Networks as a direct to consumer channel. Social Networks will continue to gain at the expense of mobile and here again, mobile search will come under pressure.

What Will Marketers Allocate To Mobile Search?

Determining the budget that should be allocated to mobile is difficult for advertisers and will continue to be so whilst it remains difficult to measure and evaluate the effectiveness of mobile advertising. comScore’s recent efforts in producing an industry standard model for mobile metrics will start to make measuring some aspects of mobile more transparent. This in turn will ensure a greater allocation of budgets to mobile. However, the increase will be shared across all mobile channels – Mobile Apps, Messaging, Mobile Video – not just search, and this too will put pressure on the price of mobile ad units.

  

Challengers To Mobile Search
Mobile search is on the increase and marketers do want to tap into this channel. However, marketing ROI is ultimately more important than the fashion of using mobile. If the cost of mobile search ad units does soar, there could be a shift away from search to other mobile channels and social networks.

   

m-health sector’s healthy opportunities? - Same old claims, same old problems

There is once again much focus on the opportunities presented by the m-health market. Several major mobile network operators have announced “new” m-health initiatives. O2, Orange, Vodafone (NYSE:VOD) and MTN are amongst those active in some way in the m-health market.

In fact m-health is not at all new since many of these operators have been active for a number of years. Orange for example announced the creation of their Orange Healthcare division back in 2007.

Before m-health it was e-health and along side these, tele-care, tele-medicine and other similar names exist to describe solutions that essentially have the same objectives. These are to alleviate the systemic pressures that are endemic in the healthcare industry such as the rising cost of healthcare and the inability of healthcare service supply to meet demand for services. These objectives are just as relevant to developed countries as well as developing countries. With the latter there is more focus on being able to deliver some form of affordable healthcare more broadly across the populations.

Statistics still not translating into Market Size
The McKinsey & Company report speaks of a $50bn to $60bn market for m-health in 2010 and cites this as one reason why operators are stepping up their efforts to create and deliver m-health services.

The magnitude of demand that will drive this market is based on a study of 3,000 consumers across 6 countries. Even though the countries involved in the study have the largest populations in the world, the number of consumers involved in the study is statistically insignificant given the fact that a large part of the target market is the 4 billion people using mobile phones that are struggling to access affordable healthcare.

The report suggests that 70% of respondents were very interested in using at least one m-health product and that “a surprisingly high number” were willing to pay. They would be, but this is not the same as saying that they could pay in which case the claimed market size starts to shrink quickly and significantly.

So what happened to e-health et al?
Analyst’s expectations for tele-care, tele-medicine and other related markets never reached their market expectations. Many pilots have been carried out and much experience has been gained. Work has been repeated and re-reported but the reality is that long-term commercial successes have been few. Most of the projects are government or research funded and do not readily translate into commercial success. Simply put, the huge potential is not matched by the ability or real willingness of people to pay despite what they say when questioned in a survey. Will it be any different for m-health?

Segment the m-health market to get a better understanding of the true market potential
In any consumer market, segmentation of the sector is critical in determining product / service functionality and price points. The m-health has yet to be subjected to this discipline in any substantial way because the market is still largely driven by government grants and research donations. The requirement to prove the technology, process or benefit far outweighs the requirement to prove the cost benefits.

At one extreme, sending SMS messages that carry public healthcare information and general advice to remote regions can easily be costed and is generally affordable. At the other extreme, solutions require the provision of high tech, personal medical devices that connect to remote monitoring centres either directly or through mobile phones. These kinds of solution are not affordable by developing countries and are only available on a limited basis in developed countries.

Search for the appropriate value chain continues
Over the years, the drive to incorporate technology as a key aspect of personal healthcare delivery has suffered from technological, logistical and legal issues amongst others. It is fair so say that with mobile operators being involved in m-health great strides can be made towards resolving some of the logistical issues. After all which industry is better placed to deliver and manage data and physical products directly to end users on such a grand scale? It is also fair to say that with organisations such as Continua driving standards for medical monitoring devices and electronic patient records great strides continue to be made towards resolving some of the technological issues that keep the availability of monitoring devices low and their prices unacceptably high.
The legal and support issues however remain largely unresolved. If anything, they will become even more complicated for anything other than simple SMS based m-health solutions. Who will take responsibility for loss of, or non-delivery of data at a critical moment? How can medical data, recommendations and advice be validated, assured, audited and tracked in an m-health driven system? Will the medical profession get behind m-health en-masse? If they do, how will the profession deal with the increased demand for advisory and follow-up services generated as a result of the sudden and huge increase in customers?

The role of mobile operators
Despite the size of the potential market, it continues to remain difficult to provide affordable solutions to a segment of the m-health market that would generate the most benefit for consumers and healthcare service providers alike.

If, by their involvement, operators are able to create an environment in which more of these support issues can be resolved, then further steps towards the mass adoption of m-health will have been taken.