The South African mHealth Market

The South African mHealth Market

The ubiquity of mobile connectivity presents opportunities to improve healthcare in South Africa by using mobile platforms to provide health services. This market insight examines how the healthcare and ICT sectors have merged in the mHealth market. It considers the complexity of the mHealth landscape, which has many participants still uncertain of their roles in the broader market. Market challenges, drivers, and restraints are provided. Further, overviews of key market participants as well as the regulatory environment are given. The base year is 2012, and the forecast period is 2013 to 2019.

Key Findings

•The ubiquity of mobile devices and connectivity presents numerous opportunities to improve health outcomes through the provision of greater access to health services and information.
•Mobile health (mHealth) is a nascent market with segments that are not yet clearly defined. Moreover, the roles of various market participants have yet to be established.
•Merging the healthcare and ICT sectors has made the mHealth landscape a complex one. In addition, many participants remain uncertain of their role in the market.
•To date, most mHealth service offerings in South Africa follow a non-profit model. However, awareness of the need to establish viable business models to ensure on-going sustainability and a broader reach of services is increasing.
•Regulatory concerns are key considerations for investors, but what form specific mHealth regulations will take remains uncertain for the South African market. This study highlights the key laws and policies affecting the South African mHealth environment.
•The imminent roll-out of a National Health Insurance (NHI) scheme is also likely to positively affect the mHealth environment, with several opportunities for ICT participants arising.
•Key drivers of mHealth development in South Africa include a huge need for healthcare services, high mobile service penetration, government prioritisation of healthcare, likely reductions in mobile service and device costs, the rising costs of healthcare, and increasing awareness of mHealth benefits.
•However, the market is restrained by concerns over securing an individual’s data, an uncertain regulatory environment, an unconvincing business case for mHealth, the perception that mHealth is not an urgent healthcare priority, an uncertain cost-benefit trade-off for end users, and practitioner barriers to ICT adoption.
•The potential for mHealth interventions to provide commercially sustainable and effective health services is now broadly accepted in South Africa. As a result, increasing numbers of participants are exploring the market.
•There are tremendous opportunities for partnerships between various mHealth market participants, particularly between those with credibility in the healthcare market and those with an established presence in the ICT market.
•Resolving regulatory and policy concerns will provide a boost to mHealth investment and innovation and, ultimately, the adoption of mHealth interventions.

What is mHealth?

•Frost & Sullivan defines mobile health (mHealth) as mobile device use in the healthcare value chain to deliver health services and improve information exchange. The information and communication technologies (ICT) infrastructure associated with mobile is included in the landscape.
•The ubiquity of mobile devices and connectivity presents numerous opportunities to improve health outcomes by using mobile platforms to provide health services and information.
•mHealth is a nascent market with segments that are not yet clearly defined.
•The Mobile Health Alliance (mHealth Alliance) was established at the 2009 GSMA* Mobile World Congress to maximise the impact of mHealth by promoting open source-based solutions and encouraging interoperability.
•A wide variety of mHealth applications has been introduced to the global market. To date, however, few have experienced widespread adoption.
•Limited market data, especially in less developed countries, makes accurate market sizing and forecasting extremely difficult.

mHealth within the Context of Connected Health

Key Takeaway: Connected health refers to the use of ICT in the healthcare sector to improve healthcare services and their delivery, particularly through the transfer of information.

Connected Health Industry: mHealth within Connected Health, South Africa, 2012
Remote Monitoring: Remote monitoring devices predate mobile phone-based applications and continue to play an important role, particularly in permanent locations.
Telemedicine: Telemedicine, which has a longer history than either connected health or mHealth, entails voice or video communication related to healthcare and possibly even diagnosis or treatment.
General Healthcare IT: Information technology (IT) includes all software and system applications used in the administrative and business settings of health providers.
mHealth: mHealth refers to the transmission of information and data through mobile devices, such as mobile phones, ruggedized devices, voice recorders, and personal digital assistants (PDAs).

Specific Applications in the Connected Health Ecosystem

Connected Health Industry: Examples of Applications, South Africa, 2012
Remote Monitoring:
•Home and disease management monitoring
•Activity monitoring
•Diabetes management
•Wellness programs
•Remote cardiac electrocardiogram (ECG)
•Personal emergency response system (PERS)
•Medication management

Telemedicine:
•Video diagnostic consultation
•Remote doctor/specialist services
•Distance learning/simulation
•Retail telehealth
•Teleimaging

General Healthcare IT:
•Electronic health records (EHRs)
•Health information exchange (HIE)
•Patient portals
•Hosted cloud infrastructure
•Stock management systems

mHealth:
•Stock management
•Workforce management
•Demand generation
•Registration
•Mobile monitoring

What are the Potential Benefits of mHealth?

•Even in a relatively early stage of adoption, mHealth has proven to increase the accessibility, affordability, and quality of healthcare services.
•Specific applications of mHealth services include improved monitoring systems (various applications), more effective and targeted health education programmes, increasingly comprehensive and accessible data recording and storage options, more responsive emergency services, and programmes that increase the accuracy of a diagnosis.
•Broader health outcomes resulting from mHealth implementation include the increased efficiency of healthcare management and services; an increased reach for governments, hospitals, and the pharmaceutical industry; and greater interaction between consumers and healthcare providers.
•Mobile device penetration is key to the success of mHealth solutions. Close-to-universal mobile penetration in many countries, coupled with anticipated declines in mobile prices in the near future, predicts a rapid uptake in effective applications.
•The increasing adoption of smartphones, tablets, and machine-to-machine (M2M) technologies has enabled the development of increasingly sophisticated mHealth solutions.
•The introduction of mHealth applications also promises to expand the use of mobile devices as they begin to substitute for more expensive medical devices.

The 5 Key mHealth Application Segments

Stock Management
Mobile technology enables a more efficient distribution of stock, including pharmaceuticals and hospital inventory (e.g., when replenishing stock levels, distributing ARVs*, and monitoring counterfeit drugs).

Stock Management
Mobile technology enables a more efficient distribution of stock, including pharmaceuticals and hospital inventory (e.g., when replenishing stock levels, distributing ARVs*, and monitoring counterfeit drugs).

Demand Generation
Mobile technology enables direct-to-consumer products and services through various channels (e.g., through health education and prevention resources, the promotion of specific products, and participation in awareness campaigns).

Registration
Mobile technology enables the creation of secure and easily accessible information databases (e.g., with various forms of patient registration using a regulated mobile identity).

Mobile Monitoring
Mobile technology enables improved monitoring capabilities and a greater health system reach (e.g., through the monitoring of vital signs, applying automated emergency alarms, and tracking underlying conditions).
Table of Contents

Executive Summary 4
Introduction to mHealth 7
The Healthcare Landscape 13
The ICT Landscape 18
The mHealth Landscape in South Africa 23
External Challenges: Market Drivers and Restraints 26
Key mHealth Market Participants 39
The mHealth Regulatory and Policy Environment 48
Examples of mHealth Initiatives in South Africa 53
Potential mHealth Revenue Sources 57
Conclusions 59
Appendix 63
The Frost & Sullivan Story 66