1. Inclusive innovation in healthcare: research evidence on mobile health solutions

2. Università Bocconi, Marketing Department and CERMES
Università Bocconi, founded in 1902, was the first Italian university to grant a degree in management.
For over a century, Bocconi has played a leading role in Italy's social and economic modernization. It is a major research university, with democratic values and open to the world, as well as financially and politically independent.

3. Marketing Department and CERMES Research Center at Bocconi
The Department of Marketing and the Center for Research on Marketing and Services (CERMES) aim at developing research projects on the crucial themes of customer orientation and competitiveness in the service sectors.
Bearing in mind 1 main element:
The empowerment of
customers - citizens - patients.

4. Citizens Lab
Public, healthcare and social marketing are the research priorities of «Citizens Lab»;
«Citizens Lab» fosters innovation through marketing strategies and tools in the area of public services provided to citizens (in markets or quasi-market contexts or where public administration is the main player).
The main research fields of Citizens Lab include:
Healthcare services (hospitals and local healthcare units)
and Public utilities (transportation, urban network, energy, telecoms, etc.)
Not for profit sector and Corporate Philantropy
Value creation for patients and citizens through empowerment
Territorial branding and value
Social marketing: the systematic application of marketing, along with other concepts and techniques, to achieve specific behavioural goals for a social good

5. «Citizens» Lab researches
Patient Behaviour
Healthcare services use
Patient Empowerment
Patient Trust
Innovation acceptance
Citizen-Customer Behaviour
Public Services use
Lifestyle
Empowerment and participation
Citizen Trust
Senior Citizen Behaviour
Attitude towards innovation
Attitude towards healthcare
Consumption behaviour
Senior Citizen Trust
Donor Behaviour
Understanding donor’s motivations
Innovation in fundraising
Social Marketing and «consumer» behaviour

6. Agenda A marketing approach to mobile health for patient 2.0
Research evidence on Italian citizens’ approach to Mobile Health

7. A marketing approach to mobile health for patient 2.0

8. Marketing definition (AMA)
Marketing is the activity, set of institutions and processes for creating, communicating, delivering, and exchanging offerings that have value for customers, clients, partners, and society at large.

9. Growing attention over new Patient’s behaviors

10. Patients’ healthcare demand evolution
Wider extent of demand: from «healthcare» to «wellbeing»;
Growing expectations (low acceptance of queues, travels, waste of time, medical doctors arbitrary behaviours);
Patient more aware of his own rights to manage and control his clinical data;
Patient more «informed» and «connected».

11. Patient’s healthcare demand evolution
Patient’s behaviors are changing over time.
The emerging health behaviors can be summarized as follow:
(Masters Ken et al 2010)
Patient education
(Khalid M. AlGhamdi et al 2012; Fox Susannah 2006, Horrigan J. et al 2000);
Patient Empowerment
(Kjeken I. et al. 2006; Nerney M. et al. 2001; Hjortdahl P. et al 2001; Webb 2007);
New patient-doctor relationship
(Masters Ken et al. 2010; Forkner-Dunn J. 2003; Eysenbach G. 2003);
Engagement in health-related social media platforms
Whelan T et al. 2003; Eysenbach Gunther 2003; Powell John et al. 2004; Skiba 2009; Lober William B. 2011) .

12. The new «educated» patient

13. The new «educated» patient
Good news. According to Google, you are healthy!

14. The patient 2.0 is more connected:
The Patient 2.0 profile
The patient 2.0 demands empowerment:
asking health practitioners to be
involved in the
decision-making process
The patient 2.0 is more informed:
Seeks health-related
information online
The patient 2.0 is more connected:
actively participates on online
health-related communites
to get information and
support from other patients
The patient 2.0 wants real time communication with clinical professionals

15. Health condition control PERSONAL HEALTH RECORDS
Patient 2.0 Empowerment
Access to relevant, adequate and immediately usable health information simply Googling the “question” (Hesse et al. 2005);
Have a greater control over their own personal conditions of health (Cox et al. 2008, Kevin et al. 2008, Buccoliero and Prenestini 2009);
Patient Empowerment
Information
Health condition control
PERSONAL HEALTH RECORDS
MOBILE HEALTH
Health 2.0
TELEMEDICINE

16. Mobile Health key solutions:
Apps patient centered;
Apps provider centered;
Gamification solutions;
Chatbots;
Health Wearables.

17. Apps Patient Centered
«Solutions across the Patient Pathway»: aimed to offer a direct interaction with patient.
Wellness;
Prevention;
Diagnosis;
Treatment;
Monitoring.

18. Apps Provider Centered
«Healthcare System Strenghthening: aimed to increase health systems’ efficiency.
Emergency response;
Healthcare Patient Support;
Heathcare Surveillance;
Healthcare Administration.

19. Gamification solutions
The use of game mechanics and game design techniques in non-game contexts.
The process of game-thinking and game mechanics to engage users and solve problems

20. Gamification

21. Do we need to gamify mobile health?
Absolutely as it can:
Drive patient engagement & satisfaction;
Create loyalty;
Increase social value;
Improve compliance;
Boost social sharing;
Increase inclusiveness.

22. Chatbots
Through chatbots, patients have convenient access to health support from doctors and nurses, during and even after stipulated business hours.
This secure and personalized communication can be used for anything from medication advice from physicians to administrative tasks like scheduling appointments, prescription refills and test results.
Be it via text, phone, or website contact, chatbots can use techniques like sentiment analysis and image recognition to provide patients and caregivers with immediate and personalized answers to their most pressing healthcare queries.
While there are associated risks like hacking of private patient information, healthcare providers will have to ensure utmost security of data to combat this risk.

23. Chatbots

24. Health Wearables
Wearables come in myriad types – sleep sensors, smart clothing, smart glasses, skin patches, activity monitors, fitness and heart rate monitors, smart watches, continuous glucose monitoring and more. Most contain sensors that collect raw data from wearables.
This data then needs to be to fed into and analyzed by a software application.
This type of analysis can then trigger an appropriate response which could range from a smartphone notification to an action by a physician or nurse.
While earlier, there were no studies that could link wearables to positive clinical outcomes; there have been many studies over last year to prove that wearables do benefit physicians and patients.
According to the Huffington Post, the number of wearable devices shipped to consumers is expected to reach 130 million by 2018.

25. Research evidence on Italian citizens’ approach to Mobile Health

26. Research Objectives
To get a first understanding of mobile health usage and perceptions in Italian Citizens.
To investigate the presence of similarities and differences between age and health status groups.

27. Total number of respondents: 387
The Sample
Total number of respondents: 387
52.5%
47.5%
North 46%
Center 17.1%
South 37%
Age
Min:20 years
Max: 88 years

28. The Sample
Housewives: 8.3%
Retired: 14.5%

29. Health status

30. Apps use
Among those using apps 87.60% is between 20 and 64 years of age, 12.40% over 65 years of age.

31. Devices use 27.13% owns a 50.90% owns a desktop computer notebook
33.85%
owns a tablet
8% owns a
smartwatch
6.7% owns a smart bracelet

32. Mobile general use

33. Mobile general use & age
Mean
age 20-64
N:339
age >65
N:48
Mean overall sample
Chat
5.95
3.90
5.70
Internet
5.75
4.85
5.64
Info search
5.32
4.21
5.18
Mail
3.73
5.12
News
5.14
5.02
Pics
4.88
3.71
4.73
Video
4.10
2.46
3.89
Sms
3.87
3.85
Social Media
4.08
2.17
3.84
Gps/maps
3.55
2.69
3.44
Games
2.31
1.48
2.21

34. Mobile general use & health status
Feeling very bad
Feeling so and so
Feeling very well
Mean
overall sample
Chat
5.78
5.36
5.79
5.70
Internet
5.89
5.31
5.72
5.64
Info search
4.89
5.09
5.21
5.18
Mail
5.56
4.79
5.20
5.12
News
4.56
5.17
5.02
Pics
4.67
4.24
4.87
4.73
Video
3.78
3.44
4.02
3.89
Sms
2.67
3.62
3.97
3.87
Social Media
4.22
3.88
3.81
3.84
Gps/maps 3
3.43
3.45
Games
1.44
1.97
2.29
2.21

35. Mobile health solutions use

36. Mobile health solutions use & age
Mean
age 20-64
N:339
age >65
N:48
Mean overall sample
Apps for healthcare appontiments
1.66
1.52
1.65
Fitness apps
1.58
1.21
1.53
Hospitals' apps
1.33
Diet and healthy food apps
1.08
1.3
Apps for medical results download
1.27
1.46
1.29
Apps to manage clinical data
Apps to chat with a doctor
1.10
Telemonitoring/teleallarm apps
1.12
1.02
1.11

37. Mobile health solutions use & health status
Feeling
very bad
so and so
very well
Mean
complete sample
Apps for healthcare appontiments
1.89
1.67
1.63
1.65
Fitness apps
1.22
1.53
1.55
Hospitals' apps
1.44
1.29
1.33
Diet and healthy food apps 1
1.31
1.3
Apps for medical results download
1.36
1.26
Apps to manage clinical data 2
1.20
1.19
1.21
Apps to chat with a doctor
1.56
1.25
1.27
Telemonitoring/teleallarm apps
1.13
1.11

38. Mobile healthcare percepitions

39. Mobile healthcare perceptions & age
Mean
age 20-64
N:339
age >65
N:48
Mean complete sample
Ease of use
3.65
2.85
3.56
Useful in use
3.55
2.71
3.45
Quick in use
3.47
2.73
3.38
Integrated health management
3.29
2.63
3.21
Control in healthcare management
2.6
3.14

40. Mobile healthcare perceptions & health status
Feeling very bad
Feeling so and so
Feeling very well
Mean
complete sample
Ease of use
3.89
3.41
3.54
3.56
Useful in use 4
3.12
3.60
3.45
Quick in use
3.67
3.21
3.43
3.38
Integrated health management
3.44
2.95
3.28
Control in healthcare management
3.22
2.90
3.14

41. Desired empowerment and mobile health use

42. Mobile use & social interactions
Regression analisys shows a relationship between mobile use levels and satisfaction in term of social interactions (Beta= 0.317, sig.=0.000)

43. Mobile health use and empowerment satisfaction
Regression analisys shows a relationship between mobile health use levels and satisfation in term of perceived empowerment (Beta= 0.104, sig.=0.042)

44. Privacy perceptions

45. Summarising…
Whilst in the general usage of mobile some differences appear among age groups, in the healthcare solutions’ use no significant differences are registered both in term of age group and health status.
Significant differences are registered in term of perceptions on mobile health between age groups only.
Mobile usage positively affects social interactions.
Mobile health usage positively affects perceptions of patient empowerment.
Privacy issues are underconsidered and not clearly perceived by the sample: action is required.

46. Social interactions & Age
Mean
age 20-64
N:339
age >65
N:48
Mean complete sample
I have satisfying social relations
4.57
5.75
5.93
I have people with whom to share social events, cultural activities, trips
4.93
5.23
5.71
I have relatives and friends who help and support me
5.60
4.88
5.51

47. Social interactions & Health
Feeling
very bad
so and so
very well
Mean
Complete
sample
I have satisfying social relations
4.22
5.78
6.02
5.93
I have people with whom to share social events, cultural activities, trips
3.89
5.53
5.81
5.71
I have relatives and friends who help and support me
4.78
5.42
5.56
5.51