The Smartphone Is The Platform For The Digital Health Stack

Smartphones are eating the digital health world and making mHealth irrelevant.

“Mobile is eating the world” says Andreessen Horowitz’s Benedict Evans in his epic presentation deck of the same name, where he outlines the rapid growth of the mobile industry in 45 slides. More specifically, however, Evans means the ‘smartphone industry’ is eating the world since slide 7 of said deck clearly states that by 2020 80% of all adults on earth will own a smartphone.

While these powerful computers that we carry with us all day and check on average 110 times each day aren’t exactly eating us, they are fundamentally changing society and industries (including health) in many new ways.

4bn people buying smartphones every 2 years compared with 1.6bn PCs every 5 years

Smartphone Industry
Source: Gartner, Apple, Google, A16Z

As the graph above illustrates, the smartphone industry is far outgrowing the PC industry and will continue to do so unless a new paradigm shift in PC innovation presents itself (hint: it won’t).  Smartphone adoption will continue to outstrip its older and more archaic PC cousin indefinitely meaning we can safely assume that the smartphone will be more important to the digital health era than the PC.

While the comment above is stating nothing new, the impact of the smartphone industry is only beginning to be realized. When Mark Zuckerberg launched Facebook from his dorm room in 2004, people consumed online content mainly from a PC since the smartphone and both iOS and Android operating systems were yet to be introduced. Mobile browsing from a cell phone at the time was a relatively poor experience and expensive mobile data prices were a concern to those tempted to use wap sites. When Apple shook up the mobile phone industry in 2007 with the launch of the first iPhone, consumer habits began changing fast and Facebook began its pivot from a PC platform to a mobile one. Why? Because now it generates more of its ad revenue from mobile than desktop.

Likewise BuzzFeed, a preeminent media company for the social age is turning into a ‘mobile first’ platform for its users. BuzzFeed’s founder and CEO, Jonah Peretti, constantly touts his company’s mobile stats and a late 2014 trends report by the company said, “mobile has taken the lead as the primary platform for social and sharing, and usage continues to rise.” According to the report, sixty percent of BuzzFeed’s traffic comes from a mobile device.

More powerful CPUs, larger screens, more intuitive apps and a lower cost base are all playing a part in driving smartphone adoption, especially from the younger generation.

mHealth has lost its meaning 

The term mHealth has been around for sometime and is a product of the pre-smartphone era since there are mHealth related books written prior to the iPhone’s 2007 launch. It’s perhaps a reflection of the ever-advancing digital landscape that mHealth as a term is increasingly losing its meaning. Now Facebook and BuzzFeed are mobile first platforms should they define themselves as a ‘mobile social network’ and ‘mobile media publication for the social age’? Of course not, the transition from PC to mobile is merely a reflection of a changing market. Regardless of the platform their goals are still the same: Facebook is to connect the world and BuzzFeed is to inspire and entertain.

The same principle applies to mHealth. Because someone happens to take their blood pressure using a device that connects to my smartphone does that mean they’re participating in mobile health? I don’t think so. And let’s not mention the term ‘telemedicine’ which is up there with ‘web surfing’. It may have sounded innovative in the late 90s but now it’s embarrassingly cringeworthy.

Now, you could argue that the term ‘digital health’ is irrelevant too since it’s all just ‘health’, but the digital health revolution will be so transformative that it needs to be defined and differentiated from general health. It’s why after the invention of the automobile it wasn’t named the mechanical horse or the Industrial Revolution wasn’t just labeled as a new kind of manufacturing. Their impact on the world were so substantial that they needed to be clearly defined as such.

The general trend is moving toward using the term digital health too. The charts below show mentions of the term ‘digital health’ alongside ‘mHealth’ and, excluding Twitter, every platform including news publications favor digital health as the term.

Figure 1. 

digital-health-vs-mhealth - total
Mentions of Digital Health compared with mHealth in social media and news media. Source: Sysomos

Figure 2.  

digital-health-vs-mhealth - breakdown
Mentions of Digital Health compared with mHealth with breakdown of mentions in social media and news media. Source: Sysomos

Smartphones are the conduit for the Digital Health Stack 

In technical terms, a technology stack comprises multiple layers of technologies to produce a bespoke solution. In digital health terms we could say that the smartphone is the conduit for the Digital Health Stack. A health device or wearable that connects to a smartphone will utilize its CPU power to perform an analysis of the patient, the accompanying app will gather the data produced and organize and archive it, then a cloud based software-as-a-service utility such as IBM Watson Cloud will be used to make sense of the data along with recommendations with what the patient should do next.

Each section (device, smartphone, app, data and cloud) of the journey is useless without the other, but the smartphone plays a prominent role in facilitating each of the other part’s role in the process. Wearable technology holds promise to remove the smartphone from the equation completely but that future is not here yet and for now the increasingly powerful and functional smartphone will play the prominent role within the digital health stack.

In short, the smartphone is more than ever the star player in digital health as new third-party devices are turning it into a life saving machine and new apps are giving it personalized health intelligence on an unprecedented scale. Just don’t call it mHealth.

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