The last decade has seen rapid growth and adoption of mobile computing devices, such as smartphones and tablets, by both consumers and enterprises, and the health care industry is no exception.  Health care providers, clinicians and medical device manufacturers are seeking new and innovative ways to leverage the power of mobile to increase efficiencies and workflow, decrease health care costs and ultimately improve the quality of patient care.  The health care industry’s adoption of mobile technologies directly impacts patients, particularly in Remote Patient Monitoring (RPM) solutions that enable monitoring, evaluation and management of an individual through a remote interface that collects clinical data from an individual (e.g., blood pressure, weight) and transmits the data to a remote health care provider for clinical review, care management and patient education [1]. This paper examines the RPM market’s needs, opportunities, and the impact of mobile technologies.

1. Market needs and opportunities
Research has shown that the U.S. market for advanced patient monitoring systems has grown from $3.9 billion in 2007 to $8.9 billion in 2011, and is forecast to reach $20.9 billion by 2016. Efforts to reduce costs in health care are driven by a few key trends including a growing number of elderly patients in the years to come, a decreasing number of health care providers (including nurses and physicians), and an increasing rate of emergency room over-utilization and hospital readmissions [2]. Please refer to [3] for more RPM. The figure below shows examples of RPM devices.

2. Mobile phone as the gateway for connected RPM solutions

he combined growth of mobile computing power and consumer’s increased usage of and reliance on mobile phones today position them extremely well to serve as gateways for RPM solutions. As shown in the figure below, a mobile gateway combines hardware, software and Apps that enable a variety of smartphones and tablets to collect and visualize biometric data from health care devices and sensors sensors, and to securely transmit that data via the smartphone or tablet’s wireless wide area network (WWAN) cellular connection or Wi-Fi, to cloud-based platforms, systems and services.

3. Defining the mobile experience
The versatility of mobile computing devices, the pervasiveness of the cellular network and the power of wireless drive a user’s Mobile Experience. Some of the defining parameters include:

· Always on, connected, and current

· Power efficiency

· Scale

· Growth and availability of 3G/4G high-speed cellular networks

· Flexible data plans

· One or more short-range wireless radio sensors (e.g. Bluetooth (BT), Wi-Fi) to communicate and collect sensor data in a concurrent fashion, across multiple devices

· Ample on-board memory storage for system and health care data

· Powerful and feature-rich mobile operating system’s (OS) software

· Appropriate security measures (E.g. Data encryption safeguards, communication to authorized devices)

· Over-the-Air (OTA) software updates for gateways in remote locations (e.g. in the home) by the associated or other cloud platform

· On the medical and wireless fronts, securing appropriate certifications and approvals as may be necessary from regulatory agencies and the cellular operators

4. Mobile platforms
The power of the mobile application is derived from the OS platform, that manages the hardware and software resources of a mobile device, similar to that of a computer OS. Application platforms are built on lower-level kernel OS with Application Programming Interfaces (APIs), that enable rich feature sets and resources that a higher-level app can build upon to achieve desired functionality and create a compelling Mobile Experience. The figure below gives a snapshot of the smartphone operating systems (OS) market share in the US.

Most of the mobile app stores today feature medical, health or wellness app categories. Some of the most common health apps include Body-Mass-Index (BMI) and calorie calculators, diet, nutrition and exercise guides, and fitness or activity monitoring apps.  Although these are the more common categories, there is an increasing number of medical reference and chronic disease management apps, including ones targeted to medical processionals. Table 1-1 below shows the choices of the major app stores and associated metrics in the market. However, the sheer number of apps and variance in relevance and quality can inundate the consumer.

It is estimated that 500 million smartphone users worldwide will be using a health care application by 2015, and that by 2018, 50 percent of the more than 3.4 billion smartphone and tablet users will have downloaded mobile health applications. [6]

MobiHealthNews found 103 FDA clearances for medical devices that included a mobile software component in the device’s description. In many cases, the mobile software component acts as a viewer for data collected by another medical device, while the mobile app acting, as a standalone offering was less common.  Analysis of the available data shows a majority of the devices registered as FDA Class 1 [7].  A snapshot of some of the metrics from the report is reproduced below:

Please refer to [6], for more information on the FDA issued Mobile Medical Apps Guidance.

RPM is a promising emerging space that will gain adoption in the coming years.  By putting the power of mobile technologies into the hands of patients and providers, there is an opportunity to reduce the burden on the failing health care system while simultaneously empowering consumers to take charge of their health management.

6. References

[1] Continua Health Alliance
[2] Remote Patient Monitoring Market to double by 2016 (July 25, 2012). care/mobile-wireless/remote-patient-monitoring-market-to-doub/240004291
[3] Wirelessly Enabled Remote Patient Monitoring Solutions – By Rajeev D. Rajan, Medical Design Technology (MDT) magazine (MDTMAG.COM). January/February 2013 edition
[4] Top Smartphone Operating Systems, by US Market Share.
[5] Berg Insight: Berg Insight: mHealth and Home Monitoring, M2M Research Series 2013.  
[6] Mobile Medical Apps:
[7] MobiHealthNews Research: 103 FDA Regulated Mobile Medical Apps 2013.