Analysys Mason: M-health could benefit – but when will we be able to trust it?

Gareth Williams


Last year my snoring got so bad that I regularly woke myself up, which resulted in sleep deprivation for me as well as facing the embarrassment of annoying passengers on trains and planes. Enough was enough, time to sort it out. I endured many visits to see consultants, attended a sleep clinic, which involved an overnight stay in hospital, and was put to sleep to find out what was causing my snoring. Fortunately, I was not suffering from sleep apnoea (interrupted breathing during sleep); surgery was a possibility, but a less invasive option was recommended. I now use a mouth guard, a piece of plastic inserted between my upper and lower jaw, and have said goodbye to snoring.

The solution to eradicate my snoring was a simple one, but the prolonged diagnosis got me thinking about the cost to the NHS. Is there a more cost-effective approach? To my mind, completing a sleep study at home was a good place to start, given my interest in m-health. The below chart provides hypothetical cost savings that the NHS in England could make by transferring 25 percent of sleep studies from hospitals to patients' homes. We have only taken into account the cost of supporting a hospital bed[1], when calculating potential cost savings.

 

2007

2011

Number of sleep study interventions (per 1000 people) annually[2]

1.2

1.8

England, population (million)[3]

50.9

52.2

Number of sleep studies performed in England[4]

61 080

93 960

Sleep study growth (%)

53.8

Total annual bed cost to support sleep studies, assume one overnight stay per study (GBP million)[5]

15.3

23.5

Total annual bed cost savings achieved by transferring 25% of sleep studies to patients' homes (GBP million)

3.8

5.9

Source: Potential cost savings by transferring sleep studies to patients' homes, England [Source: NHS Atlas of Variation 2011, Office for National Statistics, Analysys Mason, 2012]

But what of the practicalities of supporting a sleep study at peoples' homes? We recently highlighted some of the barriers and challenges facing healthcare providers and their ability to deploy m-health solutions. We also referenced NovaSom's home-based sleep study service, suggesting the technology is available--so surely cost savings will automatically follow? As discussed at a recent Cambridge Wireless Healthcare event there are other considerations.

·         What financial benefits can be achieved?

·         Can the data provided by remote monitoring applications be trusted?

·         Where is the evidence to show m-health works in large-scale deployments?

·         Can mobile phones be used for remote monitoring to minimise costs?

·         Will patient data be stored on patient devices or in the cloud?

·         Who is going to fund the roll-out of m-health (irrespective of what cost savings are possible)?

·         How can m-health data traffic be prioritised over other data?

Many of these considerations are uppermost in the thoughts of clinicians, some of whom are more sceptical about m-health than others. Those concerns include regulation of m-health; the security of the systems; the investment in ICT; clinicians' duties to patients; and the merging of primary and secondary care. In addition, proving that there are positive outcomes from m-health is a big issue: who or what is best placed to prove and promote its benefits?

In an age of austerity, organisations and government are likely to be risk averse about m-health. So collaboration between many participants in the healthcare value chain (including clinicians) will be necessary to ensure mass roll-out of m-health. So the question for an MNO seeking to enter the m-health market is: do you have the commitment and desire to drive such collaboration and influence other market participants? If MNOs do not take the initiative then they will miss out on an opportunity to shape the market: other organisations and companies in the healthcare value-chain will overcome the barriers and challenges noted above, matching their core competencies and capabilities to the needs of the m-health market. The ultimate challenge for the healthcare industry will be to migrate towards proactive rather than reactive healthcare, highlighting the value of communications services in the m-health value-chain.

Gareth has worked within the telecoms/ICT industry for over 13 years as an analyst and consultant. Gareth has supported a wide variety of clients with go-to-market strategies, proposition development, market evaluation/assessment through thorough benchmarking, gap analysis and forecasting techniques.  Previous clients he has worked with include Etisalat, Panasonic, Cisco, SK Telecom, Millicom, the GSMA and BT. He has a degree in Physics from Manchester University.



[1]          It should be noted that the cost of supporting a bed is the same whether it is used or not

[2]          NHS Atlas of Variation 2011, data shown for January 2007 and 2011

[3]          Office for National Statistics

[4]          Assuming the number of sleep studies remains constant throughout the year

[5]          GBP250 per day to support a bed. Source: Management of NHS hospital productivity, National Audit Office, 17 December 2010