1. Tunis, Tunisia, 28 January 2014 Mobile Healthcare Services In Developing Countries Adel AMRI COO Trustiser, Professor at Ecole Centrale de Paris and ISEP ITU Workshop on “ICT Innovations in Emerging Economies” (Tunis, Tunisia, 28 January 2014)

2. Tunis, Tunisia, 28 January 2014 2 Agenda Motivations Mobile Healthcare services Mobile Healthcare services areas Technology enablers for mobile healthcare Recommendations

3. Tunis, Tunisia, 28 January 2014 3 Motivations One the triggers of the Arab uprising revolutions: Large disparities between geographical regions on income, infrastructure and public services Very large number of individuals don’t receive the care they need in term of employment, healthcare services, education Healthcare is a big issue on rural regions (people with low income and far from medical centers). Bad weather conditions on winter and bad transport infrastructure add tremendous hurdles for these population to join these centers.

4. Tunis, Tunisia, 28 January 2014 4 Motivations Public hospitals become very crowded with poor quality services. High unemployment rate and low income workers cannot afford private doctors services Alarming increasing rate of cardiovascular, diabetes diseases du to bad nutrition and poor diet. There is a big lack of preventing the problems before they happen Chronic long duration diseases cost a lot of money to the healthcare system: ~75% of medical expenditures takes place in small number of diseases (cardiovascular, diabetes, asthma and cancer) There is a big lack of using mobile technologies to reduce these huge costs.

5. Tunis, Tunisia, 28 January 2014 5 Mobile Healthcare Mobile Healthcare is a big desert in the Arab World! Mobile Healthcare could: Fix disparities between the regions by providing an affordable access to healthcare services to low income worker and jobless Offer better prevention against chronic diseases through educational information (guidance to smokers to stop smocking, advices for better nutrition, calories counters, monitoring of critical health indicators, etc) Reduce the cost of chronic diseases through the use of mobile systems to monitor patient symptoms and raise alerts in the case of a problem Remote monitoring reduce unnecessary visits to doctors and could improve patient quality of life (visits to the hospitals generate a lot of stress to them)

6. Tunis, Tunisia, 28 January 2014 6 Mobile Healthcare Services Remote monitoring, testing and diagnosis: Data collection Disease surveillance Diagnosis support Mobile technology (smart phones connected to medical sensors, mobile networks) become an information transmission tool of patient medical data to centrally located providers. These information is processed automatically by specialized software programs which raise alerts to doctors in case of abnormal data Prevention management: Pregnant woman control Young infants control Prevention against chronic diseases

7. Tunis, Tunisia, 28 January 2014 7 Mobile Healthcare Services Two types of remote monitoring services: Lightweight remote monitoring service: Medical data gathered by local sensors connected to a smart phone Heavyweight remote monitoring service: The monitoring is done through a trained intermediaries and local facilitators and medical data sent through mobile networks

8. Tunis, Tunisia, 28 January 2014 8 Mobile Healthcare Innovations Explosion of mobile healthcare innovations: More than 50 000 applications in Apple Store! Mobile Apps features examples: Management of chronic diseases Calories counters Prescription reminders, appointment notices, medical references, etc Track Alzheimer’s patient position (case the patient get lost) Explosion of medical wearable sensors and devises: Example: Android smart watch connected heartbeats sensors, etc Explosion of mobile healthcare backend platforms: Example:2net platform developed by Qualcomm, etc

9. Tunis, Tunisia, 28 January 2014 9 Mobile Healthcare Innovation (Example) An ECG (Electrocardiogram) in your pocket: The AliveCor System is made up of a smartphone-based Heart Monitor and the AliveECG application coupled with optional AliveCor Services that include professional ECG analysis in as little as 30 minutes and a free AliveCor account to connect doctors and patients. (Ref: http://www.alivecor.com/)http://www.alivecor.com/

10. Tunis, Tunisia, 28 January 2014 10 Technology Enablers for Mobile Healthcare Services Expansion Cloud Computing 4G and high speed networks Big Data / Data Mining Expert Systems Social Networks

11. Tunis, Tunisia, 28 January 2014 11 Technology Enablers for Mobile Healthcare Services Expansion Mobile Cloud Computing

12. Tunis, Tunisia, 28 January 2014 12 Technology Enablers for Mobile Healthcare Services Expansion Mobile Backend As A Service Backend as a Service: a model for providing web and mobile app developers with a way to link their applications to hosted backend cloud storage while also providing features such as user management, push notifications, and integration with social networking services, all as an integrated offering. Key goal is to abstract away all the complexity related to cloud and cloud management, and provide simple APIs that can be used across all popular mobile platforms. “Don’t worry about the server side, we’ll take care of it for you.” This is a very popular area these days; 40+ startup companies in this area have sprung up recently.

13. Tunis, Tunisia, 28 January 2014 13 Recommendations for Mobile Healthcare Services There are huge opportunities of mobile healthcare in developing countries: Public sector should build a strategic plan to deploy mobile healthcare services: Offer good quality healthcare services to disadvantaged regions Offer better patient experience and reduce crowded hospitals Big cost saving Better prevention Private sector could also have tremendous business opportunities with mobile healthcare: Private doctors could reach more patients with mobile technology New business models based on monthly subscription fees for remote monitoring => recurrent revenues

14. Tunis, Tunisia, 28 January 2014 14 Mobile Healthcare Services Opportunities to Operators Mobile operators could play an important role by moving from passive communication network providers to an active partner Mobile Money will be targeted at those without bank accounts in rural regions or for jobless Mobile Healthcare services are generic, mobile operators could deploy the same solutions to different countries