Gaming healthcare Getting mobile health technology to the next level requires the engagement of key players own conditions using apps or mobile phones What is more, investors with an interest in healthcare may not see much profit in products that will keep people healthier It’s the taking part that counts H ealthcare administrators are under pressure to find a way of dealing with an epidemic of chronic illnesses—heart and circulatory disease, diabetes, arthritis, dementia and depression The world’s burgeoning elderly population is going to defeat even the most efficient health systems if we persist in trying to deliver care using the current models that rely on expensive hospitals and an even more expensive human workforce One potential solution focuses on the increased use of mobile devices, games and apps in healthcare Researchers predict that the market for such technology will continue to grow—albeit from a low base (according to one estimate, global value will expand from US$6bn in 2013 to more than US$23bn by 2018) Major drivers of this socalled “mHealth” market include the increasing awareness of chronic diseases, the growing adoption of smartphones, and more widely available mobile connectivity Consumers are less resistant than might be expected A recent eightnation survey of 12,000 adults aged over 18 by Intel, the microchip manufacturer, showed that up to 70% were comfortable with the idea of remote healthcare monitoring, with more than one-half saying they expected traditional hospitals to become obsolete For the moment, however, there is a sizeable gap between technology and take-up The reasons for this are manifold Doctors and nurses, for instance, are worried about job losses and changes to working practice Outside of telehealth trials, patients are not supported to manage their SPONSORED BY: Against this backdrop, the challenge is to incentivise the developers of this mobile health technology, who are finding ever more ingenious ways to adapt software originally developed for computer games, social networks and smartphone apps In December 2013, during the latest mHealth summit in Washington, DC, the Games for Health workshop attracted more than 5,000 contributors eager to show off their latest innovations But Ben Sawyer, head of Digitalmill, the software company that runs Games for Health, says he is resigned to the process of take-up taking longer than had been hoped “People are being funded to build these products, but not to commercialise them We need the bigger pharma companies to get involved,” says Mr Sawyer Ultimately, he sees the big breakthrough coming with the advent of one piece of irresistibly brilliant software, adaptable for a variety of clinical and health maintenance functions In the meantime, some inventions have already foundered The Didget blood glucose monitor for young diabetics was intended to use Nintendo DS software Launched by Bayer in the UK, Germany and North America, it offered children a mixture of rewards and entertainment for regular input of data “When it was launched [in 2010] we had a lot of interest and we sold a good number of meters in the first year,” says Ros Barker, strategic marketing manager at Diabetes Care, the UK’s leading charity campaigning for sufferers of the condition “The idea was to foster good compliance with the testing guidance, and we had great stories of how Didget had really helped families come to terms with testing “The main issue was that the Nintendo DS platform continued to develop over time, and the newest devices launched soon after the launch of Didget were not compatible The expectations for new games and updates also created significant pressure on Bayer, as ‘gaming’ is not a core strength for Bayer Diabetes I think compatibility will always be a challenge for connected devices Smartphone apps clearly present an easier, more flexible opportunity.” Not just a game One of the biggest problems in managing long-term illness is ensuring that patients continue with medication and adherence to treatment— especially when they begin to feel better Efforts to enhance the use of technology here are continuing The EU’s Healthcare 2020 project has invested billions of euros in a variety of pilot projects to help people better understand their illness and self-manage their treatment The devices being trialled provide remote monitoring of movement, temperature, blood pressure and oxygen or glucose levels Voice prompts can assist with drug data collection and messages to remind patients to take their medication, with monitors that can even be attached to lavatories or medication dispensers The technology is not just being used for drugs A brain-training project involving hundreds of elderly people with memory impairment is using tablet-based games technology called “Sociable” to allow patients to create diaries of their past lives as a way of connecting and communicating with other similarly affected people One promising development here is the Helius smart pill This edible sensor, activated by stomach fluid, not only tracks compliance with drug regimes, but also provides remote surveillance of exercise and body functions Results of the first trials in the US and the UK are due in 2014 But again, potential obstacles to mainstream acceptance lie in wait While the take-up of the device may be good news for patients, it may not be entirely good news for drug manufacturers: “It is very common for drugs designed to prevent high blood pressure not to work at all,” says Robin Suchan from the manufacturers, Proteus Digital Health of Redwood City, California “The Helius will quickly show when treatment is ineffective.” Ultimately, improving the take-up of many of these initiatives will require more than consumer openness to their adoption Key players and decision-makers will need to be brought on side “Use of technology hasn’t moved hand-in-hand with service redesign,” says Nick Goodwin, head of the Dutch-based International Foundation for Integrated Care “The system has to change before the tools can become effective If doctors and nurses don’t want to home-based care, it’s going to take a long time to happen.” ... wait While the take-up of the device may be good news for patients, it may not be entirely good news for drug manufacturers: “It is very common for drugs designed to prevent high blood pressure not... adherence to treatment— especially when they begin to feel better Efforts to enhance the use of technology here are continuing The EU’s Healthcare 2020 project has invested billions of euros in a variety... redesign,” says Nick Goodwin, head of the Dutch-based International Foundation for Integrated Care “The system has to change before the tools can become effective If doctors and nurses don’t want to