pwc emerging mhealth countries

7/31/2019 Pwc Emerging Mhealth Countries

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C o n t e n t s

1 Executive summary

2 mHealth maturity scorecard

3 Key findings

4 Country breakdown of key data

5 Key global contacts

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1. Ex e cu t iv e S u m m a r y

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Ex ecu t iv e s u m m a r y

Report assesses the market opportunities and challenges for mHealthfrom the perspective of patients, payers, and providers

EIU report, commissioned by PwC, with analysis from PwC

Go a l o f t h e r e p o r t

Expectations are high for mHealth from patients, providers andpayers

Significant differences in adoption among emerging and developednations

Consumers are ready to adopt mobile health faster than the health

industry is ready to adapt Solutions, not technology, are the key to success

Key f in din gs

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A b o u t t h e r es ea r ch

T h e s u r ve y in c lu d e d 10 c o u n t r i e s :

Brazil China Denmark Germany India South Spain Turkey UK USAfrica

R e p o r t s u r ve ys c o ve r e d p a t i e n t s , p h y s ic ia n s a n d p a ye r s

1 Ap a t i e n t s u r v e y with over 1,000 respondents with a broad distribution ofeconomic backgrounds, ages, levels of education and states of health

2 Aphys i c i ans s u r v e y with 433 physicians public and private sector, urban vs. rural,wide range of years in experience

3 Ap a y e r s u r ve ywith 345 respondents roughly evenly divided between public andprivate sector and 55% are C-suite or above

4 20 in -dep t h i n t e r v iew s with key experts

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2 . m H e a lt h r e a d i n e s s s co r e ca r d

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m H e a lt h s co r e ca r d m e t h o d o lo g y

Source: PwC analysis based on EIU research, 2012

Overall Score - Maturity of the market

Four Pillars

Eight Dimensions

1. Awareness andopenness for mHealth

2. Regulatory,reimbursement and

business model3. Technology 4. Impact

1.2 Current use ofmHealth

2.2 Encouragingregulatory and legal

environment

3.2 Interoperability 4.2 Healthcare system

1.1 Encouragingenvironment

2.1 Reimbursementand business model

3.1 Access andsecurity

4.1 Institutional

Provides an overview of the countries surveyed and the maturity of their mHealthmarket through four key pillars. Each pillar is further divided into eight dimensions tosupport the findings

Survey questions are grouped into the eight dimensions Each country receives a score per pillar and dimension, and an overall score

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T h e s co r e ca r d is b a s e d o n t h e s u r v e y o f p a t i en t s , p h y s icia n s

a n d p a t i en t s a n d s co r e s f r om 10 ( m a t u r e ) t o 1 ( im m a t u r e )

S c o r e c a r d

f r a m e w o r k Da t a a na l ys i s

Norm al i s a t i on

o f da t a

D i m e n s i o n

s c o r e

ca lcu la t ion

P i lla r a nd

overa l l s co r e

ca lcu la t ion

Apply scorecardframeworkabout themHealthmarket basedon eightdimensions

Collect andanalyse datafrom

doctor/payersurvey

patient survey

expertinterviews

Normalise dataon a scale of 1 to10, with 10

being the mostmature

Calculate thescores for eachof the eightdimensions

Calculate thescore for thefour pillars andthe overallscore

1 2 3 4 5

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Em er g in g m a r k e t s lea d t h e w a y in m H ea lt h , fo llo w ed b y t h e

US a s t h e m o st m a t u r e m a r k e t


6.07.8 6.8

3.85.6

7.84.8

2.65.4

3.4

7.56.4 7.4

5.1

7.5 3.66.6

7.3

6.16.6

6.53.4 4.7

7.6

5.1

4.16.6

6.35.1 8.1

6.28.2 6.2

6.5

4.3

6.93.8

5.1 4.4 2.4

SouthAfrica

India Brazil US Spain China Germany UK Turkey Denmark

Awareness and openness for mHealth

Regulatory environment, reimbursement and business model

Technology

Impact

6.6 6.5 6.3 5.7 5.6 5.6 5.5 5.3 5.2 5.1

Over a l l scor e

10 most mature

1 immature

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Fir s t p i lla r : A w a r e n e s s a n d o p e n n e s s f o r m H e a lt h


7.9 6.4 7.7 7.3 6.8 5.2 5.1 3.0 4.2 3.3

7.6 9.2 5.9

4.8 4.5 5.6 4.54.5 2.6 1.9

India China Brazil SouthAfrica

Spain Turkey Germany US Denmark UK

Encouraging environmentCurrent use of mHealth

10 most mature

1 immature

Det a i led s co res6.0 5 .7 5 .6 5 .2 5 .1 5 .1 5 .0 4 .8 4 .7 4 .77 .8 7 .8 6 .8 6 .0 5 .6 5 .4 4 .8 3 .8 3 .4 2 .6

The emerging markets score high in doctors encouraging patients to use mHealth as well as patientsusing mHealth solutions

The most established mHealth market today, the US, scores very low in awareness and openness ofmHealth. The same could be said of the UK. Reasons may be due to physicians who are already usingmHealth are more aware of its possible drawbacks

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Developed and emerging countries have no significant differences on reimbursement, and theregulatory and legal environment

According to survey respondents, too few proven business models and an unsupportive regulatoryenvironment are key barriers to mHealth

Chinas score is the lowest for both dimensions in this pillar, with 83% indicating there are too fewproven business models (survey average is 64%)

S e co n d p i lla r : R e g u la t o r y e n v i r o n m e n t , r e im b u r s e m e n t

a n d b u s in e s s m o d e l


8.1 6.6 8.2 5.9 5.9 7.1 7.5 6.0 4.7 4.2

6.9 8.5 6.7 8.67.2

6.1 5.36.1 5.5

3.0

SouthAfrica

Spain Brazil UK Germany Denmark India Turkey US China

Reimbursement and business modelEncouraging regulatoryand legal environment

Det a i led s co res6.0 5 .7 5 .6 5 .2 5 .1 5 .1 5 .0 4 .8 4 .7 4 .77.5 7.5 7.4 7.3 6.6 6.6 6.4 6.1 5.1 3.6

10 most mature

1 immature

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Th ird p i llar : Techn o logy


Det a i led s co res6.0 5 .7 5 .6 5 .2 5 .1 5 .1 5 .0 4 .8 4 .7 4 .78.1 7.6 6.6 6.5 6.3 5.1 5.1 4.7 4.1 3.4

In technology, the developed markets e.g., US, Denmark or Germany are ahead

The higher smartphone penetration, a much higher emphasis on interoperability with existing systems,as well as a more advanced access and security features lead to a perception of high readiness formHealth from a technological point of view

7.3 5.7 5.57.8 6.5 4.7 5.0

7.23.3 5.2

9.09.4

7.7

5.1

6.0 5.5 5.2 2.34.9 1.7

Denmark US Germany SouthAfrica

UK Spain Turkey Brazil China India

Access and securityInteroperability

10 most mature

1 immature

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Fo u r t h p i lla r : I m p a c t


Det a i led s co res6.0 5 .7 5 .6 5 .2 5 .1 5 .1 5 .0 4 .8 4 .7 4 .78.2 6 .9 6 .5 6 .2 6 .2 5 .1 4 .4 4 .3 3 .8 2 .4

The emerging markets and the US score high in this pillar

The impact on institutions is measured by the expected impact on medical care, on the relationshipswith patients and on internal operations. For example, 92% of physicians in India expected a noticeableeffect of mHealth in 3 years. In Denmark, only 80% believe this is the case

The impact on healthcare can be illustrated by the following figure: 52% of physicians in India believethe widespread adoption of mHealth is inevitable, vs. 34% in Denmark

9.1 7.9 7.1 6.4 5.4 5.5 4.6 4.4 3.7 2.4

7.25.9 5.9

6.0 7.0 4.6 4.2 4.2 3.92.3

India China US SouthAfrica

Brazil UK Turkey Spain Germany Denmark

Impact on institutionImpact on Healthcare system

10 most mature

1 immature

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3 . T o p t e n f in d i n g s o f t h e su r v e y

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Fin d in g # 1 m H e a lt h c o u ld e n a b le a d is r u p t i v e m o v e f r om

d o c t o r -d i r ect e d c a r e t ow a r d s a m o r e p e r s o n a lis e d ,

co n s u m e r - o r ie n t e d m o d e l

P a t i e n t s b e li eve t h a t m H e a l t h o f fe r s t h e m c o n v e n i en t

acce ss t o p ro v ide r s a s we l l a s t h e poss ib i li t y t o r edu ce

t h e i r o w n h e a lt h c a r e co s t s


4 6 %

of surveyedpatients expect

more

convenient

access tohealthcare

prov iders

through

mHealth

0%

10%

20%

30%

40%

50%Reduce own healthcare costs Convenient access to provider

Ability to obtain information

Encouragement from myhealthcare provider

Encouragement from myhealthcare payer

Greater control over own healthManage aspects of my life from

my mobile phone

Manage a particular medicalcondition

Access better quality healthcare

Access to a greater choice ofapplications

D ri ve r fo r pa t ien t s

Drivers

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Fin d i n g # 2 P a t ie n t s w it h h e a lt h i s su e s a r e m o s t lik e ly t o

u s e m H e a lt h p r o d u c t s a n d s er v i ce s

P a t i e n t s w i t h c h r o n ic d i se a s e s l ik e d i a b e t e s a r e b e t t e r

in f o r m e d a b o u t m H e a l th , m o r e l ik e ly t o b e u s i n g

m H e a l t h s e r vic e s a n d m o r e lik e ly t o p a y fo r t h e m


8 2 %

of patients w ithpoorly

managed

conditions

engage in som esort of m Health

(vs. 64%

survey

average)

49%

64%

47%

62%

82%

72%74%79%

68%

0%

20%

40%

60%

80%

100%

Familarity with termmHealth

Engage in mHealth Currently use 1 or more apps

m H e a l t h a d o p t i o n fo r p a t ie n t s w it h c h r o n i c

d i sea se s v s . su r vey ave rage

Survey average

Patients with poorly managed conditions

Healthcare spending >30% of income

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Fin d i n g # 3 Pa t i en t s a r e h i g h l y p r i ce s e n s it iv e , m a i n l yb e ca u s e t h e y t h in k h e a lt h c a r e p a y e r s s h o u l d b e a r t h e

cos t s P a t i e n t s in e m e r g in g m a r k e t s a r e w i llin g t o p a y m o r et h a n t h o s e in d e ve lo p e d o n e s l ike ly r e f lec t ing t h eh i gh e r p r o p o r t io n o f a l l h e a lt h c a r e c o s t s th e y h a v e t o p a y

t h e m s e l v e s


2 0 %

of patients inemerging

countr ies w ould

pay m ore than

$5 annuallyfor an m Health

serv ice, vs. 10%

in developed

countries

44%

16%

30%

10%

20%

27%

33%

20%

0%

20%

40%

60%

Nothing Up to $1 per year Between $1-$5 per year More than $5 per year

Pa t i en t s w i lli ngness t o pay

Developed countries Emerging countries

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Fin d in g # 4 Pa y e r s a n d t o a lo w e r ex t en t p h y s icia n s

s e e t h e p o t e n t i a l f o r im p r o v in g q u a lit y o f c a r e a n d

red u ced cos t s . .. P a y e r s s e e m m o r e o p t i m i s t ic a b o u t t h e p o t e n t i a l fo rm H e a l th i n p r o m o t in g b e t te r h e a lt h t h r o u g h g r e a t er

p a t i e n t in vo lve m e n t i n ca r e a n d r e d u c e d h e a l th c a r e co s t s


4 0 %

of pay ersencourage

patients to

m onitor their

conditionthrough

mHealth

(vs. 25% of

physicians)

(1 of 2)

0%

10%

20%

30%

40%Lower overall cost of care for

patientsEasier access to care

Reach previously unreachablepatients

Improved quality of care

More efficient internalprocesses

Patient expectations/demand

Expectation of medicalpersonnel

Opportunity to provide newservices

Ubiquity of smartphones

Encouragement by regulators

Reduction in administrativetime for medical personnel

D r i ve r s f o r p h ys ic ia n s a n d P a y e r s

Medical Doctor Payers

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Fin d in g # 4 b u t p h y s icia n s a r e co n c er n e d t h a t

m H e a lt h w ill m a k e p a t ie n t s t oo in d e p en d en t

P a t i e n t s a r e a w a r e o f t h i s r e l u c ta n c e a m o n g p h ys ic ia n s .

6 0 % o f a c t ive u s e r s o f m H e a l t h s a y t h a t p a t ie n t s a n d

t e ch n o lo gy co m p a n ie s a r e m o r e in t e r e s te d i n m H e a l th

t h a n p h ys ic ia n s


4 4 %

of phy siciansare w orried

that m Health

w ill m ake

patients tooindependent

(2 o f 2 )

0%

10%

20%

30%

40%Other areas needing

investmentExisting reimbursement

structure

Lack of compatibility

Lack of evidence

Lack of necessary technology

Regulatory and legal barriersLack of interest by key users

Privacy and security issues

Culture of medicalprofessionals

Lack of information onmHealth

B a r r ie r s f o r p h ys ic ia n s a n d p a y e r s

Medical Doctor Payers

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Fin d in g # 5 Pa y e r s a r e m o r e lik e ly t o co v e r m H e a lt h

s e r v ic es t h a n p h y s ic ia n s a r e t o p r o v i d e t h e m

P h ys ic ia n s f r e q u e n t ly cit e e x is t in g p a y m e n t s t r u c tu r e s a s

a b a r r i e r t o t h e ir gr e a t e r d e p l o ym e n t o f m H e a l th ye t

r e i m b u r s e m e n t s e e m s t o b e le s s a n i s su e a m o n g p a ye r s

t h a n e x p e ct e d


70 %

of payers planto pay for

m obile access to

EMR in the next

three years, butonly 55% of

physicians plan

to offer this

service

47%

71%

83%

68%73%

61%

55%

65%67% 69% 68% 69% 66%

70%

0%

20%

40%

60%

80%

100%

Text-basedconsultations

Telephoneconsultations

Administrativecomm.

Drugadherence

RemotePatient

Monitoring

General healthdata

Access EMRremotely

Serv ice s doc t o r p l an t o o f fe r a n d pa ye r

p l a n t o p a y fo r in t h e n e x t t h r e e ye a r s

Doctors plan to offer Payers plan to pay for

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Fin d in g # 6 E m e r g in g m a r k e ts w ill le a d t h e w a y in

m H e a lt h

m H e a l t h i s le s s d i sr u p t ive t o h e a l t h c a r e i n e m e r g i n g

m a r k e t s b e ca u s e fo r a m a j o r i t y, it is n o t a s u b s t i t u t io n t o

c a r e b u t r a t h e r t h e o n l y a c ce s s


6 1%

of surveyedpatients in

emerging

m arkets are

aw are of termm obile health

(vs. 37% in

developed

markets)

(1 of 2)

0%

20%

40%

60%

80%

I seekinformation

on healthissues

Providerssend megeneral

information

I manageoverall health

I measureand share myvital health

data

I manage mymedication

I manage anychronic

conditions

Icommunicate

with myprovider

Providersmonitor my

condition andcompliance

H i gh p a t i e n t e x p e ct a t io n s in e m e r g in g c o u n t r i e s :

m H e a l t h w i ll ch a n g e h o w

Developed markets Emerging markets

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Fin d in g # 6 E m e r g in g m a r k e ts w ill le a d t h e w a y in

m H e a lt h

M o r e m H e a lt h s e r v ic e s a r e c o ve r e d b y p a ye r s in

e m e r g in g m a r k e t s t h a n in d e ve lo p e d c o u n t r i es


4 3%

of payers inemerging

m arkets pay or

plan to pay for

telephone

consultations

(vs. 29% in

developed

markets)

(2 o f 2 )

29%

21%23%

34%

23% 23%25%

43%

24%

37% 38%

33%35%

39%

0%

5%

10%15%

20%

25%

30%

35%

40%

45%

50%


Videoconsultations

Text basedconsultations

Administrativecomm.

RemotePatient

Monitoring

General healthdata

Access EMRremotely

Serv ice s paye r s h ave a lr ead y begun t o pay fo r

Developed markets Emerging markets

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Fin d i n g # 7 A t a le o f t w o co u n t r ies In d ia a n d t h e UK

L o w e r c o s t fo r p a t i e n t s i s t h e le a d i n g d r ive r o f m H e a lt h

i n I n d i a , w h e r e a s t h e r e d u c t io n o f a d m in i st r a t ive t im e is

a l e a d i n g co n c er n o f p h y s ic ia n s i n t h e U K w it h t h e N H S

s y s t e m .


8 8 %

of Indiarespondents do

engage in

mHealth

activity(vs. just 52%

of UK

respondents)

(2 o f 2 )

0%

10%

20%

30%

40%

50%

Lower overall cost of care

for patients

Easier access to care

Reach previouslyunreachable patients



Patientexpectations/demand

Expectation of medicalpersonnel

Opportunity to providenew services

Ubiquity of smartphones

Encouragement byregulators

Reduction inadministrative time for

medical personnel

D r i ve r s fo r p h ys ic ia n s a n d p a y e r s

India UK

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Fin d i n g # 8 Fo cu s o n s o lu t io n s , n o t t e ch n o lo g y

I m m e n s e h i gh d r o p o u t r a t e s illu s t r a t e s t h e n e e d fo r

e n ga g in g , in t e gr a t e d , i n t e r o p e r a b l e , a n d i n t e llig en t a p p s


4 8 %

of surveyed

patients w ho

have used an

m Health appdiscontinued it

after the first

six m onths

(2 o f 2 )

I n t e g r a t e d

Integrated into existinghealthcare plans, personallifestyles, and clinical process

Utilizes multiple technologies

I n t e r o p e r a b i l i t y

Incorporated into Allscriptselectronic health record system

Enables data from app to beaccessed by physicians throughEHR

In t e l l i g en t

App provides real time alertsand intelligent guidance forusers based on data inputted

Doctors receive clear,actionable data that they canuse as a basis forrecommendations

Social ized

Improves treatment andmedication while providingpersonal coaching, directphysician support, andcaregiver linkage

O u t c o m e O r i e n t e d

Demonstrated clinical successin trials

Demonstrated economic

success in the reduction ofhealth care costs

En g ag i n g

Patients can configure settings,messaging, tonality, andinteraction modes

Exam ple for PwC Six Success pr inc ip les :

W e llD oc Di abe t e s m an age r

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Fin d i n g # 9 T e c h n o lo g y s t ill p r e s e n t s c h a lle n g e s fo r

m H e a lt h a d o p t er s

L a ck o f in t e r o p e r a b i lit y, s ta n d a r d s a n d i n t e g r a t i o n i n t o

e x is t in g IT -s ys t e m s i m p e d e s u p t a k e o f t h e f r a g m e n t e d

m H e a lt h m a r k e t


4 7%

of surveyedphysicians say

that m Health

applications

they use w illnot w ork w ith

their

organisations

IT

53%

37%

27%

23%

15%

0%

20%

40%

60%

IT systems of myorganisation

IT systems of localhospitals and

clinics

IT system of thenational healthcare

system

IT systemsaccessible by

colleagues in otherorganisations

Health datasystems that

patients can accessdirectly

m H e a l t h s e r vic e s u s e d b y p h y s ic ia n s / p a y e r s

i n t eg ra t ed i n t o . ..

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Fin d i n g # 10 R e g u l a t o r s co u l d e n c o u r a g e a d v a n ce s in

m H e a lt h , b u t t h e su r v e y s h o w s o th e r w is e

S u r ve ye d p h y s ic ia n s a n d p a y er s s e e lit t le e n c o u r a g e m e n t

fo r m H e a lt h b y r e g u la t o r s , d u e t o r e g u la t o r y a n d l eg a l

b a r r i e r s


4 5%

of phy sicians

and pay ers

think m Health

advances areheld up by

regulation

4 5%

4 3%

12%

m H e a l t h a d v a n c e s a r e b e in g h e l d u p b y

r egu la t i on c rea t ed fo r o l de r t e chn o l ogi e s t ha td o e s n o t t r a n s la t e w e ll t o n e w e r o n e s

Agree

Neither agree or disagree

Disagree

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Ov e r v ie w o f k e y d a t a

(1 of 2)

1 Expectation of physicians and healthcare payersabout the widespread adoption of mHealth

2 Services physicians would like to offer and payers

plan to reimburse for in the next 3 years

3 Top 3 drivers and barriers for patientsand physicians (including average of the peer group)

22%

52%

54%

29%

34%

52%

0% 20% 40% 60%

Access betterquali tyhealthcare

Convenient access toprovider

Reduce own healthcarecosts

Drivers

32%

25%

28%

31%

31%

49%

0% 20% 40% 60%



Easieraccess tocare

Drivers

44%

39%

48%

31%

36%

55%

0% 20% 40% 60%

Lack ofknowledgeabout services

Lack ofrelevantapplications

Cost

B ar r i e r s

29%

35%

24%

37%

37%

40%

0% 20% 40% 60%

Culture ofmedicalprofessionals

Privacy and securityissu es

Lack ofcompatibi lity

Barriers

Br azil Emer ging cou ntries (excl. Br azil)Pat i ent s

Doct or

49%

69% 74%91%

66% 71% 60%51%

59%70%

60% 65%80%

65%78% 75%

0%

20%

40%60%

80%

100%

Textbasedconsultations


Videoconsultations

Administrativecomm.

Drugadherence

RemotePatient

Monitoring

Generalhealthdata

Access EMRremotely

D oc to rs pl an to of fe r P ay er s pl an to re im bu rs e

S e rv i ce s physi c i a ns w ou l d l ike t o o f f e r a nd pa ye r s p l a n t o r e i m bu rse fo r i n t he ne x t 3 ye a r s

56 %33 %

11%

Agree

Neither agree ordisagree

Disagree

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B r a z il - Po t en t ia l a n d s er v ices

W i d e s p r e a d a d o p t io n o f m H e a lt h s e r vic e s in m y co u n t r y is i n e vit a b l e in t h e n e a r fu t u r e

Serv ice s ph ys ic ian s w ou l d l ike t o o ff e r an d pa ye r s p lan t o r e i m bu r se fo r in t h e nex t 3 yea r s


(1 of 2)

56 %33%

11%

Agree


Disagree

49%

69% 74%91%

66% 71% 60%51%59%

70%60% 65%

80%65%

78% 75%

0%

20%

40%

60%

80%

100%



Videoconsultations

Administrativecomm.

Drugadherence

RemotePatient

Monitoring

General healthdata

Access EMRremotely

Doctors plan to offer Payers plan to reimburse

31


32/59

PwC

B r a z il - To p 3 d r iv er s a n d b a r r ier s fo r p a t ien t s

a n d p h y s icia n s

P a t i e n t s


(2 o f 2 )

22%

52%

54%

29%

34%

52%

0% 20% 40% 60%

Access better qualityhealthcare



Drive rs

32%

25%

28%

31%

31%

49%

0% 20% 40% 60%




Drive rs

44%

39%

48%

31%

36%

55%

0% 20% 40% 60%

Lack of knowledgeabout services

Lack of relevantapplications

Cost

B a r r i e r s

29%

35%

24%

37%

37%

40%

0% 20% 40% 60%


Privacy and securityissues

Lack of compatibility

B a r r i e r s

Brazil Emerging countries (excl. Brazil)

32

Phys i c i ans


33/59

PwC

Ch i na - P o t en t ia l an d s e r v ices



(1 of 2)

8 0 %

15%

5%

Agree


Disagree

69%

89%

67%

91% 85% 89% 77% 81%100% 97% 90%

100% 97% 97% 97% 94%

0%

20%

40%

60%80%

100%

120%



Videoconsultations

Administrativecomm.

Drug adherence Remote PatientMonitoring

General healthdata

Access EMRremotely


Source: PwC analysis based on EIU research, 2012 33


34/59

PwC

Ch in a - T o p 3 d r iv e r s a n d b a r r i er s fo r p a t ie n t s

a n d p h y s icia n s

P a t i e n t s

(2 o f 2 )

30%

58%

49%

31%

36%

45%

0% 20% 40% 60% 80%


Reduce own healthcare costs

Convenient access to provider

Drive rs

27%

27%

26%

33%

38%

44%

0% 20% 40% 60%




Drive rs

45%

40%

53%

28%

31%

35%

0% 20% 40% 60%



Cost

B a r r i e r s

34%

34%

25%

38%

38%

49%

0% 20% 40% 60%


Lack of necessarytechnology

Existing reimbursementstructure

B a r r i e r s

China Emerging countries (excl. China)


Phys i c i ans


35/59

PwC

Den m a r k - Po t en t ia l a n d s er v ices



(1 of 2)

6 3%

30 %

7%

Agree


Disagree

40%

71%65%

84%

58%60% 60%

49%58% 55% 42% 58% 48% 58% 45% 48%

0%

20%

40%

60%

80%

100%



Videoconsultations

Administrativecomm.


General healthdata

Access EMRremotely




36/59

PwC

Den m a r k - To p 3 d r iv er s a n d b a r r ier s fo r

p a t ien t s a n d p h y s icia n s

P a t i e n t s

(2 o f 2 )

35%

25%

27%

29%

30%

33%

0% 20% 40%




Drive rs

44%

33%

21%

31%

33%

42%

0% 20% 40% 60%




Drive rs

30%

39%

48%

36%

47%

47%

0% 20% 40% 60%



Cost

B a r r i e r s

22%

27%

23%

36%

42%

44%

0% 20% 40% 60%



Regulatory and legalbarriers

B a r r i e r s

Denmark Developed countries (excl. Denmark)


Phys i c i ans

(1 f 2)


37/59

PwC

Ge r m a n y - Po t e n t ia l a n d s e r v i ce s



(1 of 2)

33%

53%

13%

Agree


Disagree

37

S e r vic e s p h y s ic ia n s w o u l d l ik e t o o f fe r a n d p a y er s p l a n t o r e im b u r s e fo r in t h e n e x t 3 ye a r s

31%

77%

25%

71%61% 61%

39%27%

70% 67%

50%

63%70% 70%

55%

80%

0%

20%

40%

60%

80%

100%



Videoconsultations

Administrativecomm.


General healthdata

Access EMRremotely


(2 f 2 )


38/59

PwC

Ge r m a n y - T o p 3 d r iv e r s a n d b a r r ie r s f or


P a t i e n t s

(2 o f 2 )

Germany Developed countries (excl. Germany)

27%

30%

32%

31%

39%

41%

0% 20% 40% 60%


Greater control over ownhealth


Drive rs

24%

43%

32%

31%

33%

42%

0% 20% 40% 60%




Drive rs

25%

50%

39%

38%

40%

46%

0% 20% 40% 60%

Privacy or securityconcerns

Cost


B a r r i e r s

30%

28%

36%

31%

40%

47%

0% 20% 40% 60%




B a r r i e r s


Phys i c i ans

(1 f 2)


39/59

PwC

In d ia - Po t en t ia l a n d s er v ices



(1 of 2)

6 0 %

31%

9 %

Agree


Disagree

75% 73% 73%85%

71%83% 77% 77%73%

79%73%

65%

83% 78% 73% 77%

0%

20%

40%

60%

80%

100%



Videoconsultations

Administrativecomm.


General healthdata

Access EMRremotely



(2 f 2 )


40/59

PwC

In d ia - To p 3 d r iv er s a n d b a r r ier s fo r


P a t i e n t s

Phys i c i ans

(2 o f 2 )

India Emerging countries (excl. India)

28%

47%

52%

40.00%

55.00%

58.00%

0% 20% 40% 60% 80%


Convenient access to provider


Drive rs

26%

29%

23%

35%

40%

42%

0% 20% 40% 60%



Lower overall cost of care forpatients

Drive rs

19%

36%

48%

36%

47%

53%

0% 20% 40% 60%

My provider is unwillingto work with mHealth


Cost

B a r r i e r s

27%

29%

19%

33.3 %

33.30%

37.50%

0% 20% 40%



Lack of interest by keyusers

B a r r i e r s


(1 f 2)


41/59

PwC

S o u t h A f r ica - Po t e n t i a l a n d s e r v i ce s



(1 of 2)

59 %23%

19 %

Agree


Disagree

38%50% 52%

83%76%

83%

60%50%58% 58% 58%

76% 76% 70%61%

58%

0%

20%

40%

60%

80%

100%



Videoconsultations

Administrativecomm.


General healthdata

Access EMRremotely



(2 f 2 )


42/59

PwC

S o u t h A f r ica - T o p 3 d r iv e r s a n d b a r r ie r s fo r


P a t i e n t s

Phys i c i ans

(2 o f 2 )

South Africa Emerging countries (excl. South Africa)

30%

47%

46%

42%

55%

82%

0% 20% 40% 60% 80% 100%


Convienient access to provider


Drive rs

31%

31%

24%

33%

33%

38%

0% 20% 40% 60%



Lower overall cost of care forpatients

Drive rs

27%

48%

34%

39%

53%

71%

0% 20% 40% 60% 80%

Privacy or security

concerns

Cost

Lack of knowledge aboutservices

B a r r i e r s

28%

29%

36%

31%

41%

45%

0% 20% 40% 60%




B a r r i e r s


(1 of 2)


43/59

PwC

S p a i n - Po t e n t ia l a n d s e r v i ce s




(1 of 2)

53%35%

12%

Agree


Disagree

58%

84%

51%

87% 84% 80%71%

51%

69%60%

69% 63% 62% 62% 66% 62%

0%

20%

40%

60%

80%

100%



Videoconsultations

Administrativecomm.


General healthdata

Access EMRremotely


43

(2 o f 2 )


44/59

PwC

S p a in - T o p 3 d r iv e r s a n d b a r r i er s f o r


P a t i e n t s

Phys i c i ans


(2 o f 2 )

Spain Developed countries (excl. Spain)

31%

25%

44%

33%

38%

47%

0% 20% 40% 60%




Drive rs

26%

29%

37%

38%

49%

58%

0% 20% 40% 60% 80%




Drive rs

42%

31%

45%

32%

32%

58%

0% 20% 40% 60% 80%

Lack of knowledge

about services


Cost

B a r r i e r s

39%

29%

22%

33%

33%

36%

0% 20% 40% 60%




B a r r i e r s

44

(1 of 2)


45/59

PwC

T u r k e y - Po t e n t i a l a n d s e r v ic es



(1 of 2)

56 %31%

13%

Agree


Disagree

61% 63% 61%76%

61%

87%

63%76%

62% 59%55%

64%

45%

62%

50%

65%

0%

20%

40%

60%

80%

100%



Videoconsultations

Administrativecomm.


General healthdata

Access EMRremotely



(2 o f 2 )


46/59

PwC

T u r k e y - T o p 3 d r i v e r s a n d b a r r ie r s fo r


P a t i e n t s

Phys ic i an

(2 o f 2 )

Turkey Emerging countries (excl. Turkey)

31%

57%

47%

40%

40%

53%

0% 20% 40% 60%




Drive rs

26%

31%

31%

26%

29%

34%

0% 20% 40%




Drive rs

43%

38%

49%

36%

40%

50%

0% 20% 40% 60%

Lack of knowledge

about services


Cost

B a r r i e r s

17%

18%

32%

26.30%

28.90%

44.7 %

0% 20% 40% 60%

Other areas needinginvestment

Regulatory and legalbarriers


B a r r i e r s


(1 of 2)


47/59

PwC

U n i t e d K in g d o m - Po t e n t i a l a n d s e r v ic es



(1 of 2)

59 %

36 %

5%

Agree


Disagree

26%

82%

33%

91%

54%59%

52%

27%

46%

69%

51%

71%

51%

60%69% 66%

0%

20%

40%

60%

80%

100%



Videoconsultations

Administrativecomm.


General healthdata

Access EMRremotely



(2 o f 2 )


48/59

PwC

U n i te d K in g d o m - T o p 3 d r iv e r s a n d b a r r ie r s

fo r p a t ien t s a n d p h y s icia n s

P a t i e n t s

Phys i c i ans

(2 o f 2 )

UK Developed countries (excl. UK)

26%

29%

44%

27%

43%

49%

0% 20% 40% 60%




Drive rs

34%

23%

42%

36%

36%

40%

0% 20% 40% 60%




Drive rs

32%

40%

48%

28%

44%

50%

0% 20% 40% 60%

Lack of relevant

applications


Cost

B a r r i e r s

29%

39%

18%

33%

33%

33%

0% 20% 40% 60%



Lack of interest by keyusers

B a r r i e r s


(1 of 2)


49/59

PwC

Un i t ed S t a t e s - P o t en t i a l an d s e rv ices



(1 of 2)

70 %

30 %

0 %

Agree


Disagree

23%

44%

26%

72%58%

54% 55%58%

56%

60%

54%

66% 69%74%

68%77%

0%

20%

40%60%

80%

100%



Videoconsultations

Administrativecomm.


General healthdata

Access EMRremotely



(2 o f 2 )


50/59

PwC

U n i t e d S t a t e s - T o p 3 d r i v e r s a n d b a r r ie r s

fo r p a t ien t s a n d p h y s icia n s

P a t i e n t s

Phys i c i ans

(2 o f 2 )

US Developed countries (excl. US)

28%

43%

28%

25%

50%

53%

0% 20% 40% 60%




Drive rs

33%

33%

41%

33%

42%

44%

0% 20% 40% 60%




Drive rs

13%

42%

49%

28%

35%

46%

0% 20% 40% 60%

Own not a mobile device


Cost

B a r r i e r s

20%

37%

26%

31%

44%

49%

0% 20% 40% 60%

Lack of evidence



B a r r i e r s



51/59

PwC

5 . Glob a l con ta c t s

51


52/59

PwC

Globa l con t a c t s

David Levy MD

Global Healthcare Leader+1 646 471 [email protected]

Christopher Wasden, EdDGlobal Healthcare Innovation Leader+1 646 471 6090

[email protected]

Dan DiFilippoGlobal Technology, Communications and Entertainment & Media Leader+1 646 471 [email protected]

Pierre-Alain Sur

Global Communications Industry leader+1 501 907 [email protected]

52
mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]


53/59


54/59

PwC

m H e a lt h s co r e ca r d D et a i le d s co r e s p e r d i m e n s io n


Area SouthAfrica India Brazil US Ger-many Spain China Denmark Turkey UK

Overa l l Score 6.0 5.7 5.6 5.2 5.1 5.1 5.0 4.8 4.7 4.7

Aw a r e n e s s a n d o p e n n e s s 5.5 7.0 6.2 3.5 4.4 5.1 7.0 3.1 4.9 2.4Encouraging environment 6.6 7.1 7.0 2.8 4.7 6.1 5.8 3.9 4.8 3.0Current use 4.3 6.9 5.3 4.2 4.1 4.1 8.3 2.4 5.0 1.8

Re g u l a t o r y e n v i r o n m e n t , r e -

i m b u r s e m e n t a n d b u s i n e ss m o d e l

6.8 5.8 6.7 4.6 5.9 6.8 3.3 6.0 5.5 6.6Reimbursement and business model 7.3 6.8 7.4 4.2 5.3 6.0 3.9 6.4 5.4 5.4Encouraging regulatory environment 6.3 4.9 6.0 5.0 6.5 7.6 2.8 5.6 5.5 7.7

Techno logy 5.9 3.2 4.3 6.8 6.0 4.6 3.7 7.3 4.6 5.7Access and security 7.1 4.8 6.5 5.2 5.0 4.3 3.0 6.6 4.6 5.9Interoperability 4.7 1.6 2.2 8.5 6.9 5.0 4.5 8.1 4.7 5.5

I m p a c t 6.0 6.6 6.0 5.3 4.2 2.9 5.9 4.0 3.8 4.0Impact on institution 6.5 6.7 6.7 4.3 4.7 3.7 6.4 4.0 3.8 3.9Impact on Healthcare system 5.4 6.5 5.3 6.3 3.6 2.2 5.4 3.9 3.9 4.2

54


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PwC

Qu e s t io n s p e r d i m e n s io n


1 Aw a r e n e s s a n d o p e n n e s s

1. 1 E n c o u r a g i n g e n v i r o n m e n t

Doctors encouraging patients to adopt a range of mHealth applications and servicesPatients expecting that mHealth applications/services will improve the quality of healthcare they receive in the next 3 years.Patients expecting that mHealth applications/services will make healthcare substantially more convenient in the next 3 years

Percentage of patients familiar with the terms mobile health or mHealth

Percentage of patients who would be interested in using mHealth applications/servicesPatients who are willing to pay more than $5 annually for a service - median from a set of services

1.2 Curren t u s e

Patients using mHealth services to manage their personal healthcare

Doctors using mHealth services in managing their personal healthcareDoctors who use mobile internet at work to provide healthcare

Doctors who have begun to offer services via mobile devices2 R e gu l a t o r y e n v ir o n m e n t , r e i m b u r s e m e n t a n d b u s i n e s s m o d e l

2 . 1 R e i m b u r s e m e n t a n d b u s i n e s s m o d e l

Doctors who say that existing payment structures for health services discourage them from taking advantage of potentialefficiencies in mHealth

Doctors who say that todays mHealth market has exciting possibilities but too few proven business modelsPatients willing to pay annually for an application/service more than $5

Patients expecting that mHealth applications/services will substantially reduce their overall healthcare costs in the next 3years

2 .2 R e g u l a t o r y a n d l e g a l e n v i r o n m e n t Doctors believing mHealth advances are being held up by regulation created for older technologies that does not translate

well to newer ones

Payers who say that the regulatory and legal framework are leading barriers to greater adoption of mHealth applications orservices

Providers who say that the regulatory and legal framework are leading barriers to greater adoption of mHealth applicationsor services

55


56/59

PwC

Qu e s t io n s p e r d i m e n s io n ( co n t . )


3 T echno logy

3 .1 A cces s an d s ecur i t y

Doctors with access to mobile internet at workPercentage of doctors considering their internet access at work very secureMobile penetration rate (Source: ITU)

3 .2 In te roperab i l i t y

Patients frustrated by incompatibilities of mHealth solutions

Organisations that are reluctant to invest heavily in mHealth until the technology becomes more standardised, orinteroperable

4 I m p a c t

4 .1 Ins t i tu t iona l

Doctors expecting a noticeable effect on their medical care from mHealth - CurrentlyDoctors expecting a noticeable effect on their medical care from mHealth - In three yearsDoctors expecting a positive impact on relationships with patientsDoctors expecting a positive impact on internal operations

4 . 2 H e a l t h c a r e

Patients who are expecting little effect on healthcare through mHealthPatients who are expecting mHealth services will improve a great deal in the next three yearsPatients who are considering mHealth as a more effective way to adopt healthier lifestyle

Doctors expecting inevitable widespread adoption of mHealth applications and services is in the near future (6)

56


57/59

PwC

Det a iled r esu lt s o f d r iv er s a n d b a r r ier s fo r p a t ien t s

D ri ve r s

B a r r i e r s


Dr ive r s To ta lR e duc e own he a l thc a r e c os t s 444 43.2 %

Conve n ie n t a c c es s to p r ov ide r 477 46.4 %

Abi l ity to ob ta in in f o r m a t ion 289 28.1 %

E n c o u r a g e m e n t f r o m m y h e a l t h ca r e p r o v id e r 153 14.9 %

E n c o u r a g e m e n t f r o m h e a l t h ca r e p a y er 123 12.0 %

Gr e a te r c on t r o l ove r m y own h e a l th 329 32.0 %

M a na ge a spe c t s o f m y l if e fr om m y m ob i l e phon e 104 10.1 %

M a na ge a pa r t i c u la r m e d ic a l c ond i t ion 149 14.5 %

Ac ce ss to b e t t e r q ua l i ty he a l thc a r e 261 25.4 %

Access to a grea te r choice of app l ica t ion s 97 9.4 %Othe r 32 3.1 %

Tota l 1027 100.0 %

Barriers Tota l

Cost 498 48.5 %

La c k o f r e l e va n t a pp l ic a t ions 357 34.8 %

M y pr ov ide r s a r e un wi ll ing to wor k wi th m He a l th 190 18.5 %

P r iva c y o r s e c u r i ty conc e r n s 295 28.7 %

La c k o f knowle dge a bou t s e r v ic es 419 40.8 %

I nc onve n ie nc e a n d t im e invo lve d in se t t i ng up m He a l th 117 11.4 %

Alr e a dy sa t i s f ie d wi th c u r r e n t p oss ib i li t ie s 124 12.1 %

I nc om pa t ib l e m He a l th a pp l ic a t ions / se r v ic e s the r e f o r e t a ke s m or e t im e to se t up

m H e a l t h 92 9.0 %

Diff ic u l t ie s un de r s t a nd ing the c on te n t o f s e r v ic e s 104 10.1 %

Dont own a m ob i l e de v ic e 134 13.0 %

Othe r 17 1.7 %

Tota l 1027 100.0 %

57


58/59

PwC

De t a iled r esu lt s o f d r iv er s a n d b a r r ier s fo r p h y s icia n s

D ri ve r s

B a r r i e r s


Dr ive r s To ta l

Lowe r ove r a l l c os t o f ca r e f o r pa t i e n t s 109 25.2 %

Ea s ie r a c c e s s to c a r e 140 32.3 %

R e a c h p r e v ious ly un r e a c ha b le pa t i e n t s 122 28.2 %

I m p r ove d qu a l ity o f c a r e 154 35.6 %

M or e e f f ic ie n t i n t e r na l p r oc e sse s 126 29.1 %

P a t ie n t e x p e c t a ti o n s / d e m a n d 112 25.9 %

Expe c ta t ion o f m e d ic a l pe r sonn e l 57 13.2 %

Oppor tun i ty to p r ov ide ne w se r v ic es 75 17.3 %

U b iq u i t y o f s m a r t p h o n e s 69 15.9 %

E n c o u r a g e m e n t b y r e g u la t o r s 60 13.9 %

R e duc t ion in a dm in i s t r a t ive t im e f o r m e d ic a l pe r so nn e l 137 31.6 %

Other , p lease sp ec ify 2 0.5 %

Tota l 433 100.0 %

Barriers Total

O t h e r a r e a s n e e d i n g i n ve s t m e n t 83 19.2 %

E x is t in g r e i m b u r s e m e n t s t r u c t u r e 132 30.5 %

Lack of com pat ibi l ity 111 25.6 %

Lack of eviden ce 96 22.2 %

La c k o f ne c e ssa r y t e c hno logy 140 32.3 %

R e gu la to r y a nd l e ga l ba r r i e r s 103 23.8 %

La c k o f in t e r e s t by ke y use r s 96 22.2 %

P r iva c y a nd se c u r i ty i s sue s 159 36.7 %

C ul tu r e o f m e d ic a l p r o f e s s iona l s 118 27.3 %

La c k o f in f o r m a t ion on m He a l th 126 29.1 %

Other , p lease spe c ify 5 1.2 %

Tota l 433 100.0 %

58


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2012 PricewaterhouseCoopers LLP, a Delaware limited liability partnership. All rightsreserved.

PwC refers to the US member firm, and may sometimes refer to the PwC network. Eachmember firm is a separate legal entity. Please see www.pwc.com/structure for further details.

This content is for general information purposes only, and should not be used as a substitutefor consultation with professional advisors.

2012 The Economist Intelligence Unit Ltd. All rights reserved.

Whilst efforts have been taken to verify the accuracy of this information, neither The Economist
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