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Tuesday 11 January 2011

mHealth India- Proof Of concept




Recent quote: “In the years to come, mHealth applications will be distributed primarily through healthcare distribution channels like hospitals and specialized healthcare product vendors and not the app stores as is currently the case, and that traditional will become the predominant distribution channel.”(Source: research2guidance)

Well this sounds promising. However, we all know that the success of a mHealth business model doesn’t depend on the distribution channel but on what you give for the money you take and in turn sustainability of that service”.

Positives: Growth of Smartphones market in India

India is witnessing a rapid growth in the smartphones segment. India shipped 4.8 lakh units of smartphones during Q3 CY2009. The top three smartphone vendors during Q3 of calender 2009 were Nokia, HTC and RIM. Together, these vendors had a share of nearly 90% of the Indian smartphones market in terms of unit shipments during the period July-September 2009. All the major handset makers like Nokia, HTC, LG, Motorola, Samsung etc are focusing on smartphone market this year. Launch of 3G technology in the Indian market will further accelerate the growth of Smartphones. With the number of smartphone users witnessing an upswing, prices are expected to see a phenomenal dip.

This means that after 5 years almost every value handset will have smartphone features..

How does these statistics affect the Business Scenario?

The end consumer will be immensely benefited. Smart phones will provide cost-savings, increased efficiency and a better quality of life. To give just one example, smartphones are being used as smart-health sensors, allowing heart patients to stay at home safely, while having their heart issues controlled and monitored by medical staff. In this way smartphones increase the patient’s quality of life and, at the same time, save healthcare costs.

...If we look at the mHealth business cases back in 2008, we will realize that with more value chain participants and higher costs of execution, there was very less reward (whether in the form of revenue gains or operational efficiencies) to go around. It therefore became progressively more difficult to achieve the financial impact that provides momentum and leads to partnership with larger players. Therefore today, with smartphones and other robust systems playing a volume game in mHealth, the latter will not be elusive anymore.

Efficient healthcare systems based on robust infrastructure like smartphones will drive revenue for all stakeholders in the next 5 years.

Which stakeholder will lead this Business?

It will be Mobile Operators/Carriers. Here is why:

Operators Define Connectivity: The progression of mHealth will largely be dependent on innovations in telecom and the speed of implementation of the same. 4G /LTE (Long-term evolution) will revolutionize the way data is sent over wireless networks. In the near future, I envision a scenario where a consumer can set up a telehealth appointment and get a physician consult leveraging the high speed wireless connection and high-def video conferencing capability right from his handset.

Hands on experience: Operators have a proven track record of implementing innovative technologies on a large scale (2G/3G/4G capability, smartphones connected to “app stores” with thousands of applications etc) and adapt them to different geographies in a highly competitive market.

Knowledge of Local customer needs: Deploying telecom solutions in various geographies and complying with local regulations, legal framework has enabled operators understand the local customer and their needs. Partnering with operators will enable organizations deliver specific solutions that meet local customer needs.

Already, Mobile operators have tremendous influence and strong relationships with handset manufacturers, and they should leverage this position to bring to market phones and other devices that can provide the mHealth and other mobile services consumers in developing countries need.

What is the way ahead for the torchbearer?

For POC, Operators should pro-actively seek out opportunities to improve health outcomes by initiating public-private partnerships, teaming up with governments and NGOs to address pressing national health issues, and collaborating with software providers to develop targeted healthcare solutions. Joint projects help ensure that key stakeholders are on board, increasing the potential for successful outcomes. As we discuss above that smartphones and robust healthcare systems will lead this foray, we can now afford and allow “n” number of stakeholders to get involved.

An Ideal mhealth Business Model Organization should be this way:

(Missing link= Yellow)







We should remember that while some of the role players will play a bigger role in driving the mHealth market, each and every player is a key ingredient in making this a service that the end-user will consume.

Monday 10 January 2011

mHealth and Network security


1. What are the major trends you’re noticing in healthcare mobility?

In a country like India where Doctor to patient ratio is 1:900, Doctors are a few and work is like 24/7. Patient demands low cost, timely and quality healthcare coverage. For Healthcare enterprises, Patient Data is critical to collect and manage and hence mhealth is primarily aimed at bridging the economic divide in terms of healthcare. Mobility is the key here- Many Healthcare enterprises which are spread over 10-20 establishments in India are now using VPNs as the enabling technology which allows Doctors to use standard public Internet ISPs and high-speed lines to access closed private networks. A simple use case for this is to access Virtual Patient Health records and there are other wireless technologies designed specifically for use in the provision of healthcare, like:

  1. Standard Mobile enterprise services used by health-care workers, such as remote access to e-mail and health-information systems;
  2. Mobile Applications to meet a specific need of medical workers, such as mobile prescriptions and remote diagnoses;
  3. Applications that play a direct role in the provision of care, such as mobile data collection and wireless transmission of health data; and
  4. Consumer-targeted applications to encourage health and help prevent illness.

2. What are the security concerns around these trends?

Security of patient data is important. Even if you comply with HIPAA, it doesn’t have that depth and breadth of protection which is required as health care is comprised of exceedingly complex information environments that demand comprehensive patient data security approaches especially when the data is shared across networks. For a simple use case of accessing a patient’s Virtual Electronic Patient Records with a wireless device, there are 3 main security issues to address:
1. To Authenticate & authorize from the wireless to the wired network
2. Secure Data share in transit
3. Integrity & Good Resolution in the information that is requested and visualized by the users/doctors.

3. Is there a security risk re: healthcare mobility that is overrated or underrated? What are they?

Not overrated actually. Healthcare mobility is the key. As manpower is scanty in hospitals, therefore in scenarios where large volumes of background traffic needs to be sent from automated programs talking to other automatic programs, IPsec here serves the best. End to end security is however required in several Govt Health missions where there are a lot of private partners in the value chain and secured/encrypted communication is a must. SSL enabled VPN is useful here. With SSL, a secure tunnel is established directly from the client to the resource the client is accessing. With true end-to-end security, no data is sent in the clear, either on the internal network or on the Internet. Everything from the client to the resource is securely authenticated and encrypted.


4. What are the security concerns around sensor technology, portable medical devices and wireless health applications – and how will they be mitigated?

There are several security concerns and hence before we deploy mobility we need to understand that fully automated Remote Access VPN Management is necessary. Solutions should be easy to use and efficient as well. A holistic remote access solution is required to integrate all essential technologies regarding security and communication. Hospitals and Healthcare enterprises are looking to upgrade and hence low switching costs is the major driving force coupled with greater efficiency and ease to use and deploy.

5. What role will IPsec play in mobile health security?

Two parties who wish to create an IPSec tunnel must first negotiate on a standard way to communicate. Since IPSec supports several modes of operation, both sides must first decide on the security policy and mode to use, which encryption algorithms they wish to communicate with and what type of authenticate method to use. IPSec and WPA EAP-TLS solutions are very efficient against MITM, impersonation and session hijacking attacks. Both solutions are not efficient against DoS attacks. It is possible to successfully perform DoS attacks using freely available tools. For systems where availability is essential, it is necessary to complement those solutions with more mechanisms that reduce the risk of such attack. It is thus necessary to use tools like Intrusion Detection Systems (IDS) and vulnerability scanners. Because IPSec sits at the network layer not only is all your network traffic encrypted, but all users gain access to all company resources as if they were physically resident in the office connected to that LAN. Hospitals may or may not want partners or temporary remote employees to be part of their network. The network may only need to have a small portion of its traffic secure. Hospitals may not want to encrypt everything from the remote client to the corporate network. Also scalability is a problem with IPsec. On the other side, SSL proxies enforce much stronger authentication methods than a back-end resource could ever support natively. Many Web servers today do not natively support authentication methods other than SSL.

Inference: Solutions require high degree of integrational ability and interoperability that makes it possible for Healthcare enterprises to deploy these software products in an already available IT infrastructure.
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