Telemedicine 2010 & 2011 Part 2 - TECHNOLOGY

Telemedicine has never been bereft of electronic wizardry and 2010 included a host of exciting developments with clever new devices that see, analyze, and intervene with any number of medical maladies, all at steadily reduced prices. Here are a few thoughts on two leading technologies: mHealth and video.

mHealth, clearly the hottest topic in telemedicine technology for 2010, has become a trendy term used for a perplexing array of activities. Its expansive definition now includes low cost cellular-based services for developing countries, consumer health-and-wellness digital phone products and wireless applications for the hospital and clinician. The number of downloadable cell-phone health apps exploded with over 10,000 such products now available, created by hundreds of new entrants to health care seeking a part of the trillion dollar healthcare market.

Rosy forecasts abound. But, market watchers have reported that the mHealth industry is evolving into a more concentrated market. Further, the sheer pace of innovation has resulted in some consumers taking a wait-and-see approach before making a purchase. Last June I wrote about how mHealth is close to the top of the hype cycle (It’s mHealth but will it be a Revolution?). We may be due for an industry shakeout soon, termed by Gartner as the “trough of disillusionment,” which will pave the way for broader adoption. In 2011, mergers and acquisitions in mHealth are sure to be news.

Although many business plans appear to rely on consumer and third party buyers, it is important to note that 90 percent of direct healthcare purchases are made by individual doctors and health administrators. Most successful mHealth technologies, like the rest of telemedicine, will be those that integrate and mainstream with traditional healthcare. MobiHealth News recently profiled nine hospitals dabbling with mHealth applications (http://mobihealthnews.com/special-edition-9-mobile-health-hospitals). Many more are starting to look. A few applications are starting to get wide-spread adoption by individual providers. For example, Epocrates, providing drug information and interactions over a digital phone, is now used by over a million health professionals. Of particular interest will be the interplay between the next-to-nothing cost of some mHealth applications and the remote monitoring industry.

Video conferencing technologies were also a buzz in 2010. On the high end, telepresence applications became closer to mainstream with many large institutions. Also in 2010, high definition video became the de facto standard for videoconferencing. A lingering concern that may be addressed next year is interoperability between both high-end and medium level videoconferencing technologies. Customers are looking for it and it appears vendors are moving toward it.

On the other end of the spectrum, webcams powered by free or almost free software is now in use by tens of millions of consumers worldwide and has started to pick up steam for medical services such as telemental health. Last year a series of discussions about privacy and HIPPA compliance for such devices and applications created confusion in the market (for the record, there is no official HIPPA certification for technology; it’s how you use it not what you use). The new videoconferencing application for 4G and Wi-Fi cell phones may be a potential game changer for some telehealth services starting next year. A series of two-way video calls from my cell phone while I was in China to the ATA offices in Washington, DC this December still astounds me.

Also of Note –There has been a series of amazing innovations in robotics, micro technology and automated clinical decision making, which may also start to have a broad impact on health delivery in 2011.