How Apple, Google and Samsung Are About to Reshape the mHealth Landscape
Just two weeks ago, Apple introduced HealthKit, a developer's toolbox that will allow makers of health and medical devices (e.g., Fitbit, Jawbone UP, Misfit, iHealth) to integrate their offerings with Apple's newest mobile operating system, iOS8.
Not to be outdone for long, next week Google plans to announce Google Fit, a “health aggregation” service that, like HealthKit, promises to enable seamless integration of data provided by “healthwear” devices, as well as by mobile phones themselves.
Meanwhile, a week before Apple's announcement, Samsung rushed out its own mHealth announcement, touting that it's been striding in a similar direction, with its SAMI platform and Simband line of wearables. (If you want to impress people in a geeky kind of way at a 4th of July barbecue, you can tell them that SAMI stands for Samsung Architecture for Multimodal Interactions. The only thing important about that is that it means SAMI will be used for much more than healthcare data. Pass me a hotdog.)
So why does this matter to healthcare marketing executives? Aside from further evidence of the arms and ego race among the current big three tech companies, the news signals that pharma and medical device companies now have a new set of partners/competitors in the business of making people healthier (which is really how our industry should be redefining our mission, by the way).
As we have all seen over the last few years, mounting pressure from payors and the government to reduce costs has meant that innovators have been looking for new ways to bend down the cost curve. The goalposts for success have moved—away from "simply" safety and efficacy of products (not that safety and efficacy is ever simple to prove) towards superior healthcare outcomes. With the simultaneous rise of super-smart devices and cloud-based data sharing, tech companies have decided healthcare is a growth market.
But, you say, so what? It may be interesting that the tech companies are targeting healthcare, but I am still in the drug or device business. How does this help to move my business?
A healthy degree of skepticism is certainly warranted when talking about the “revolutionary impact of new technologies on the healthcare industry.” (We have heard this trope many times before. Remember Google Health? Microsoft Vault anyone? Yet, somehow, despite these “revolutions,” the world has not been turned upside down.) But please indulge me for a moment as I argue why this time it is indeed different.
The biggest reason is that the movement to “fitness awareness” is going to accelerate dramatically, and that will have an enormous impact on people's awareness of their own health, and their ability to take better control of managing it. This may have more impact on reducing the burden of disease and costs to the system than any other single change we have seen in our lifetimes. (I say this as someone who has lost 30 pounds since beginning to use a Jawbone UP 18 months ago.)
But even for the existing reality of the healthcare marketplace, this movement bears real significance. In fact, I see at least three ways in which the GAS (Google-Apple-Samsung) health initiatives will fuel significant changes that will matter to your business in the relatively near term (say, the next 24 months).
1. Relevance at Last: Tying Healthwear to EHRs
A little-noticed (or, at least, little-commented-upon) subset of Apple's announcement was the news that the company had also formed a partnership with Epic Systems and the Mayo Clinic to integrate HealthKit into electronic health records (EHRs). As the leading provider of EHRs, Epic holds a powerful position in the market.
The implication of Apple's engagement with Epic and Mayo is that data from healthwear sensors and mobile phones will begin to be directly rolled into EHRs, which means that the impact of fitness activity on outcomes will be much easier to measure; this will likely lead to the medical community expecting (and insurance companies and the government perhaps requiring) that fitness tracking be built in to any therapeutic regimen. (I also hope it means that Apple's famous commitment to superior User Experience will help transform the currently woeful state of most EHR interfaces. But let's not go too crazy here.)
In any event, pharma and med-device companies will not be able to stand by while the rest of the industry speedwalks to quantify the impact of activity on clinical outcomes. Rather, the smarter companies (and more visionary marketers) will want to get on the right side of this trend and build in data-sharing messaging and functionality to their disease management communications to HCPs, patients and caregivers—beginning now. It will take time to sort out all the possibilities and build the right alliances, but there is always a huge strategic advantage to moving decisively to anticipate the inevitable.
2. Solving the Data Uniformity Problem
Today, if an ambitious marketer wants to bring real data tracking to patients or HCPs, he faces an environment of mind-boggling complexity. He would need to create an app or device, and if it does anything of value at all, he will probably submit it for approval by the FDA, make sure the data coming from the app/device is properly encrypted and sequestered, prove that he has obtained the patient's permission to access the data (sometimes with a triple opt-in requirement), and endure 15 rounds of M/L/R review (we at Heartbeat have been through all this; it ain't pretty).
Tomorrow, with the GAS drive into mHealth, and with even the FDA calling for data consistency in order to encourage innovation, standards will become far more unified. 1 Of course, there will be a pitched battle among Apple's IOS and Google's Android, with Samsung's own operating system causing additional headaches for Google Fit (Android had been Samsung's operating system, but the Korean giant has been attempting to convert users to its own OS called Tizen, and now it's own mHealth platform, SAMI). However that battle plays out, the result will be dramatically greater uniformity than exists today.
That means for a pharma brand, implementing a meaningful compliance or data-tracking program will actually become much simpler (and cheaper), while also becoming expected, if not mandated, in the marketplace. Especially as you begin to reframe yourself as being in the “making people healthier” business, not the “treating sick people” business.
3. Proof to the Payors
Think about this: You run a brand that claims to significantly improve patient outcomes if it is prescribed early on in the disease progression continuum. You have prepped your sales force and focused all your marketing materials on the “early use” message. But your brand is expensive, and the payors are balking, seeking to make your product third line, or worse. You need a way to prove that your medication lowers overall costs if administered early, but you don't have data to back up that claim.
Enter an mHealth program that uses additional layers of health data (well beyond simply counting steps and hours of sleep; the new generation of sensors will give us much more medically relevant data) to track patients' vital signs and prove that the product is having a substantial impact on measures that correlate to greater efficacy and lower long-term risks. This scenario, once thought to be “beyond the pale” for pharma marketers, will now become feasible, promising truly compelling cost/benefit arguments to be made to an increasingly financially-driven healthcare marketplace.
These are just three ways in which the torrent of news from these tech titans in the late spring of 2014 may change the near-term realities on the ground for pharma and medical device companies.
Who will win the race? Apple has the advantage of a truly integrated platform (across all forms of hardware, form factors, Operating System, App Store) plus a reputation for innovation and exceptionally strong user experience. Google is extremely formidable. It has the largest market share for phone operating systems—Android is predicted to hold about 80% by the end of 2014, according to IDC. But Google has some new headwinds to overcome. (Full disclosure: I am a member of the Google Healthcare Advisory Board, but all of my opinions and observations are my own, not based on any inside Google information.)
As noted earlier, Samsung is attempting to break free of Google's control of Samsung's highly successful Galaxy phones by introducing its own operating system, and now its own biometric data platform, SAMI (can you remember what the acronym stands for? Give me back that hot dog). Oh, and then there's Microsoft, which is rumored to be launching its own healthwear device, a Smartwatch (and maybe its own data platform tied to Microsoft Vault?) later this year.
But in a sense, it really doesn't matter to us who wins. The key point is that this is all coming and coming fast. It's time to understand how the landscape is changing beneath our feet, and reach out and make your own alliances, while you still have the ability to influence the “outcomes.”
Bill Drummy is CEO & founder of Heartbeat Ideas & Heartbeat West, now members of the Publicis Healthcare Communications Group, and a member of the Google Healthcare Advisory Board.
 Patel, Bakul. FDA Encourages Medical Device Data System Innovation. http://blogs.fda.gov/fdavoice/index.php/2014/06/fda-encourages-medical-device-data-system-innovation/?source=govdelivery&utm_medium=email&utm_source=govdelivery. Published June 20, 2014.