When companies like Apple take a direct interest in how patients get care, including installing an app called ‘Health’ on your phone by default, you can be sure that mobile health, or ‘mHealth’, is no longer about niche experimentation. It’s ready for the big time.

Longer lifespans mean higher expectations and ageing populations. These in turn are putting unprecedented pressure on healthcare budgets. Patient care is still largely reliant on traditional face-to-face interactions with healthcare professionals (HCPs), in the main with some of the most expensive and scarce resources in the healthcare system – GPs.

While the patient-GP model has been unchanged for decades, many healthcare organisations have recently made significant steps in updating their business model to reflect the new digital reality – adopting classic ‘bricks to clicks’ approaches to digitising back-office functions such as record keeping, appointment booking and billing.

But Apple’s move represents a far more disruptive challenge. How should incumbent companies respond to the world’s most valuable company creating devices and cloud-based ecosystems that go to the heart of how patients think about health, and about their relationship with doctors and payers?

Traditional healthcare organisations, from payers and providers to life science companies and regulators need to be asking themselves how their business model will work when healthcare knowledge becomes increasingly democratised, through ubiquitous smartphones and cheap biometric sensors.

Forward-thinkers in the industry are increasingly seeing how mHealth could drive a step change in the value of clinical care and how it is delivered (Box 1). Smart companies are not wasting time in positioning themselves.

Recent mHealth examples give a flavour of how the world of healthcare is changing:

  • The FDA recently permitted marketing of the first mobile medical systems incorporating apps for continuous glucose monitoring in diabetes, enabling real-time data sharing.
  • ExcoinTouch is working with major pharma companies to develop mHealth apps which capture real-world evidence and patient-recorded outcomes – while complying with regulatory frameworks.
  • Patient monitoring companies such as Aparito are increasingly working with pharmaceutical companies to improve the effectiveness of clinical trials, addressing the c. 42% failure of paediatric trials due to inconclusiveness of results

SIX WAYS mhealth will change healthcare as we know it

  • Patients who want to be more empowered by managing their own disease
  • Healthcare Professionals (HCPs) s requiring decision support to offer more real-world evidenced-based care
  • Hospitals wishing to streamline clinical care pathways
  • Payers looking to enforce cost-effective pathways and prevent over-service
  • Pharma companies trying to capture more real world data with fewer errors
  • Governments & policy makers seeking to prioritise budgets with bigger, richer, data sets


Crucially, the end game for mHealth is likely to be far removed from the current generation of ‘opt-in’ consumer devices such as FitBit and Jawbone. The mHealth of the future is likely to have a much ‘harder edge’, and forms an important gateway for patients to access care.

In this new world, patients would have symptoms robotically triaged, and – for some – conditions may have to follow initial treatment recommendations before being referred to specialist doctors and HCPs. Continued treatment with expensive drugs could require users to submit real-world evidence and feedback that enable payers to evaluate true patient outcomes. Taken to its logical extreme, big data algorithms could eventually replace doctors for many treatments – with profound impacts on the selling model for many drugs, devices, surgeries and other treatments.

So how can Gate One help you prepare for the mHealth era?

Our deep expertise in digital transformation regularly helps clients begin to answer some of the key questions that disruption of mHealth poses:

  • What scenarios should we plan for, and what might the impact be on my business?
  • Does our mHealth strategy have a compelling business logic, and is it aligned with our broader business strategy digital transformational agenda and business strategy?
  • How can we execute our mHealth strategy – including realistic roll-out timetables, resource implications and expectation management?
  • How do we think about and manage the risk of a roll-out in a complex regulatory environment that includes medical devices, HCP engagement and direct-to-consumer advertising?
  • How should we select and manage mHealth vendors, especially since specialised players with roots in clinical trials seem more grounded in healthcare reality but will require interfacing with global systems?
  • What are the economic and other incentives for key stakeholders that we should consider to ensure successful adoption?
  • What capabilities should be developed to embed mHealth in our corporate DNA and enable a repeatable process for follow-ups?

The potential of mHealth is unquestionable and its era has now truly arrived. Budget deficits in the NHS and other global health economies will further catalyse the exciting developments already underway. As ever, risks accompany the opportunities, which is why strategic planning and excellent execution of the right applications and systems are so crucial.

For advice and support on how to maximise the benefits of mHealth for your organisation, contact us today.

T | +44 (0) 207 293 0893
E | info@gateone.co.uk

James Swaffield | Client Director

James is an experienced strategy and business transformation consultant with a background working across the full cycle of complex change programmes, particularly in the public sector. He has 10 years’ experience of consulting in the public, private and third sector, most recently leading an MCA Award Finalist engagement for a Local Health Economy in turnaround.


  • “healthcare knowledge becomes increasingly democratised” – not sure if democratised is the right word here, possibly commoditised. The degree of monitoring envisioned in this article has an Orwellian feel to it. Can we be assured that big business will use the information gleaned from its consumers for their benefit rather than to their detriment? Rationing of healthcare is a hot topic at the moment and the technologies promoted in this article would be able to evidence whether patients are taking the recommended action to mitigate their symptoms and limit the cost to providers of treatment. What safeguards would there be to contain the information harvested by this technology so that it does not fall into the hands of insurers who would use it to determine premiums, decline cover for risky patients and perhaps refuse payouts for patients who have not done all that they can to mitigate their condition?

  • This is a really interesting area and one where Government is striving to stay on pace with data and technology developments (see NHS Digital’s strategy and the yearly debates over at HIMSS in the US).

    Two things that I would pick out in reply:
    (1) Can we be assured that big business will use the information gleaned from its consumers for their benefit rather than to their detriment? We know that both patients and consumers value privacy and data protection extremely highly. Scrutiny on how business uses personal data is high and rising. If businesses are seen to be behaving in a way that erodes this trust, then businesses will suffer reputationally. As we have seen with Samsung and others recently, reputation is key and valued perhaps more than big data, which should manage this to a degree. That being said, with the rise of cybersecurity concerns it might well be a greater risk that others can access and use the data that is being held, rather than the businesses themselves.
    (2) What safeguards would there be to contain the information harvested by this technology? There are a number of safeguards in place already. The Information Commissioner is leading on making sure that health data is secure and only collected when required, as are NHS Digital and Caldicott Guardians nationally. That doesn’t mean that more can’t be done though. For example, while in the US genetic information ion for underwriting is strictly prohibited, in countries such as German there is already limited use with health insurers able to access and use pre-existing genetics tests. This is an area that will need to be watched keenly.