Will Microsoft and Google Take Mobile Health into the Clouds?
21st May 2009
Peter Kruger, Wireless Healthcare
The incumbent healthcare providers in both the UK and Denmark have already responded to the pressure wireless based healthcare is putting on their business models. Both have built their own online ehealth style services. In the UK NHSDirect has been set up to relieve the pressure on GPs while the Danish healthcare provider uses Sundhed.dk as personal health portal – enabling the patient to manage their own health. Both services use the basic ehealth model illustrated in the diagram below. In fact most ehealth services around the world currently adhere to a version of this model.
The Basic eHealth Model
Most healthcare providers aspire to a more complex ehealth model – one in which all information flows are automated, data is held centrally and surgery, like other procedures that require physical contact with the patient, is carried out in special treatment centres. This was the underlying thinking behind the NHS's National Programme for IT and is illustrated below.
The Advanced eHealth Model
The Sundhed portal, as it is based on IBM's WebSphere platform, could eventually act as a front end for the disease and public health monitoring applications being developed for the IT vendor's Big Blue supercomputer. However the healthcare IT world has changed since these healthcare providers started to deploy these ambitious IT programs – the most important change being the emergence of Google and Microsoft as potential suppliers of personal healthcare record vendors. IBM has itself acknowledged as much and is now, via the Continua Alliance, working with Google.
The idea that Microsoft and Google are merely a pair of disruptive new players in a healthcare market where the incumbents cannot provide the tools that enable consumers to manage their own health is a bit too simplistic. The threat to established healthcare providers is far more subtle than a direct and open attack on their business models. At first viewing, the threat appears to be from Google Health and Microsoft's HealthVault themselves. However it is the SDKs the IT vendors hand out free of charge to new entrants to the healthcare market that will facilitate the sort of death by a thousand cuts the newspaper industry has experienced over the last fifteen years - see Wireless eHealth – Read All About It.
Recently Google has started experimenting with web based healthcare content that enables viewers to state why they are accessing particular pages. (This is along similar lines to scheme whereby pay bush workers, who are in contact with wild animals, are paid for text messages notifying authorities of any symptoms of illness.) Such initiatives, combined with DNA profiling tools such as 23andMe, are an alternative approach to the 'Big Blue' approach to disease monitoring in diagram above.
23andMe and Google Health replacing the GP as the gateway between itself and its customer base is a serious threat to the incumbent healthcare provider. However more troubling for existing players is 23andWe, which by acting as a patient driven medical research program and disease knowledge base could challenge the relationship between the pharma and healthcare industries. For next generation healthcare provider to break the link between the two monopolies that have determined the structure of the healthcare industry for over half a decade would be a victory on a par with online providers stealing recruitment and real estate advertising from local newspapers.
As the ehealth developers armed with Google and Microsoft SDKs take healthcare into the clouds next generation healthcare providers will be start to use the disease knowledge-base their users construct to force the pharma industry into deals. In some cases these deals will disadvantage incumbent healthcare providers. This means that when, with the help of Google and Microsoft, cloud based ehealth providers start establishing themselves in the healthcare market the demise of the incumbent providers will be quick and bloody and make the one and a half decade decline of the newspaper publishing seem like a lifetime.
The Cloud Based eHealth Model
