Guest post by journalist Eleni Natsi on behalf of MoMoAth
What if we put an e before health? “Healing is a matter of time, but it is sometimes also a matter of opportunity” (Hippocrates). Nikos Papachristou, the person behind ehealthgr, the successful greek blog themed around ehealth, BioMed LabS Magazine, co- author of Pharma Market Journal and co-curator of #opnhealth the first Greek tweetchat on healthcare and ehealth takes us to a fascinating journey to a brave new world of unlimited possibilities and opportunities for health sector.
An e before health for an A+ mark to the quality of our daily life
Nikos Papachristou: Well, there are a number of reasons…I felt I had to learn more about web 2.0 and social media and at the same time keep myself updated on the latest developments in any type of technology that supports the functions and delivery of healthcare (that’s all ehealth is about).
Putting my energy in creating a blog focused on ehealth I satisfied my curiosity for new things and expressed myself in areas I find intriguing.
Eleni Natsi: What is your opinion for entrepreneurship in the health sector in Greece? Any good examples to follow or to take into consideration?
Nikos Papachristou: To tell you the truth I don’t know if there are many health companies in Greece that try to differentiate themselves from the prevalent model and offer some really innovative solutions in the healthcare sector. I remember having a conversation with George Kakoulidis, Vice Chair of HL7 Hellas and Founder & CEO of Apollo SA, trying to explain to me the problems of the Greek healthcare market. What I kept from our discussion is that there are basic institutional problems regarding the implementation of e-health policies in Greece, putting a considerable barrier to its development.
To be more specific, there are big ehealth projects, like e-prescription, that are undervalued. E-prescription is the process of the electronic transfer of a prescription by a healthcare provider to a pharmacy for retrieval of the drug by the patient. Apart from Greece, in this strict sense, only few European countries can claim to have implemented a fully operational ePrescription service.
Also, in cases of big European projects, in which Greece participates, there is lack of financial and operational support from the Greek state to keep these projects sustainable after the european funds end.
Let’s say we have an idea for a telemedicine service, a revolutionary product integrated with a sophisticated medical app. Will this service be supported by the insurance companies in Greece? If not, who is going to invest in it in Greece? How many people are buying healthcare services not included in their insurance plans, especially now that Greece undergoes a severe economic crisis?
Also, Greece is a very small market and a rather conservative one, compared to the US health market for example.
People are used to face to face appointments with their doctor having the key authority regarding their health condition. Without the doctors supporting this kind of services how will they get to the patients? And we have to keep in mind that many doctors globally are skeptical about these services as they disrupt the current value chain in the healthcare system So, again the government should reinforce ehealth delivery with specific policies. At least, the existing ehealth policies, should be kept consistent with our commitments towards European Union.
However, there are companies like Vidavo, Gnomon SA, Datamed Healthcare Integrator AE, that participate in big European Projects, but as I explained above it isn’t clear to what extent the services they provide will find their way to the Greek market.
Eleni Natsi: In your blog, you are referring to the slow development of ehealth in Greece. Can you make a comparison, through examples, between Greece and other countries? What needs to be done?
Nikos Papachristou: Greece and EU make slow steps due to their strict policy framework compared to the US for example. However, Denmark being a small country and a member of the European Union, is considered to have the best national ehealth system in the world!
In Denmark, the national ehealth system has been developing and improving for the the past 15 years. How has this been accomplished? Concerning ehealth sector, everything from security to organizational issues is tackled with specific policy documents. The first goal of the roadmap for ehealth was defining every single policy for standards, privacy and security issues. Unfortunately, in Greece there isn’t such a thing. It is a back and forth situation.
Besides that, in Greece ehealth sector is a scheme still being hatched. I believe a national ehealth body or community is needed in order to raise public awareness about all these, and also force the state to make policy changes. Lobbying plays a great role in Greece but ehealth community lacks in it. Furthermore, modern academic curriculums are needed in the direction of educating healthcare professionals on healthcare services based on technology.
Eleni Natsi: Textbased messages VS mobile health apps. Which is better and what is your general opinion about mobile health apps. For example, do you see a significant growth in that field in the future?
Nikos Papachristou: I don’t think that one is better than the other. It depends on the circumstances. A textbased messages service is more affordable, reachable and easy to use. It is more proper for areas with low income, poor telecommunication infrastructure and technology literacy. On the other hand smartphones are more sophisticated but are suitable for countries with high incomes, extended access to telecommunication services and large percentages of technologically literate users, professionals and consumers.
I am not sure what will happen in the future – what I see now is a very big wave of wireless and mobile health. The fact that mobile phones, compared to sophisticated medical devices, are ubiquitous, easy to use, cheap, always on and part of our daily life make them great means of supporting healthcare. Due to the global ageing problem the healthcare systems struggle to keep costs down. The need for cheaper, qualitative and cost effective solutions in order to reduce costs is driving much of the current mhealth hype. And you have to consider that lifestyle apps are in a way preventive medicine delivery. The focus gradually moves from getting treatment to leading a healthy life.
There are a few particularities though regarding the regulation of medical apps and smartphones as medical devices, which may slow down the development of a mhealth startup. For example, a blood pressure monitor connected to a smartphone makes the whole thing (customized smartphone with blood pressure monitor and software) a medical device. Also, apps which compute drugs doses or a dose of any pharmaceutical or medical substance are considered medical devices. In the near future we may see doctors prescribing medical apps. The more these apps and “medical devices” are getting tested and launched in the market the more acceptance they will gain from the healthcare professionals and the public. The use of voice texting, a large amount of medical data in the cloud used in epidimiology and drug development, will make mhealth an even more important part of the healthcare system in the future.
Eleni Natsi: Crowdfunding and mhealth. What’s your opinion on raising funds from a crowdfunding platform for a mhealth business?
Nikos Papachristou: I think it can be a good idea for health lifestyle apps. This kind of apps address to the majority of people. Consequently, it is easy for them to estimate their value in their daily life. I am not sure though if this is the case for medical apps. Medical apps address to specific consumer groups (healthcare professionals, patients, carers), with specific needs. How ordinary people can perceive something which is out of their everyday experience and invest some money in it? Maybe specialized healthcare crowdfunding platforms would be more suitable for this purpose as it would attract people aware of and familiar with healthcare delivery and its problems.
Eleni Natsi: Let’s say you have someone, in front of you, having a mhealth idea for a startup. What would be your advice to them?
Nikos Papachristou: During the MoMo Athens event themed around mhealth, there was a student telling me that she would like to be occupied with mhealth and so she asked me what she should do.
Like in her case, I think that someone should make it clear in their mind what is mhealth. For example many people confuse telecare with telemedicine. Telecare has to do only with lifestyle monitoring to support the individual or their carers, while telemedicine is providing clinical health care at a distance. We have already mentioned that depending on the market and region we may have text mhealth or mhealth apps. In a recent report of the World Health Organization twelve different kinds of mhealth services were mentioned. When it comes to smartphones, you can find from encyclopaedic apps to health lifestyle apps and medical devices apps.
- Which one of the above is someone most interested in or aware of?
- To whom exactly mhealth solutions address to?
- How many different professionals, organizations, industries, services, health problems constitute a healthcare delivery system?
- What is the problem we want to offer solution to?
- What is the market size of the problem we want to address to?
That’s the kind of questions someone with a mhealth idea should pose, before putting their idea into practice.
A partnership with a healthcare professional, connecting with patient communities, could be useful in order to answer many of the above questions. Keeping in touch with some of the global mhealth conferences and events would also help to get answers for the rest of the above questions. Regarding apps, a student or anyone who comes up with a mhealth idea, should definitely check the healthcare incubators and startup accelerators like Rock Health, StartUpHealth, Blueprint Health and HealthBox in order to get an idea of innovative mhealth implementations.
Eleni Natsi: Niko, I would like to thank you for this interview and the fascinating “journey’’ to ehealth “universe’’.
Nikos Papachristou: Thank you as well!
This interview can not be reposted without the written permission of MoMoAth