mHealthGlobal

mHealth Global Applications

Executive Summary
(March 16, 2012)

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Opportunity
Its no secret that todays advanced communication technology is a catalyst to the growing disappearance of human, personable interaction. In fact, some forms of communication have completely replaced the need for a human-to-human relationship. We see it more so than ever in the Healthcare industry. Doctors and their medical advice are being replaced with self-medication and selfdiagnosis websites. International Pharmacies advertise on these sites, then sell untested, unregulated medications to these same consumers following free medical information that these very sites provide. With that, the market is beginning to realize the importance of certain human-to-human relationships (ie Doctor Patient) and utilize the current technology NOT as a replacement, but rather as way to enhance the accountability, the attention, and medicinal communication that occurs between these intimate parties. This communication technology would thus allow for more efficiency and more meaningful visits to the doctors office. mHealth Global has created a solution and, in this executive summary, will address the following questions, and provide a sound solution: Why is there no software platform that highlights, enhances, and re-strengthens the bond between the doctor and their patients? Why is there no trusted platform to handle (secure and track) the enormous amount of data between doctor and patient? Why is there no platform that provides enhancement/reward to the patient for following prescribed advice and medication instructions by their primary care physician? Why is the doctor being circumvented by technology and, if the tech is present, are these companies including the doctor in their revenue stream? Why is there no mobile platform/app answer to these issues for the ailing population in rural areas or developing countries? Why are there no mobile Health platform/apps with agnostic characteristics as to who the cell carrier and provider are?

mHealth Concept and Description

The design of the software platform is elementary. Our platform will be the front-end of a larger service offering within the cloud. The content and functionality that the platform encompasses is much more detailed and, as you will see, will bring value to several micro-verticals markets in the Healthcare space.

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The front-end design will have the look and feel of most user-interfaces (see screen shots below & hyper-link) Customers identity will be protected through the use of avatars (a widely accepted form of online protection). With this personalized user-interface, doctor and patient will be able to converse, auto-SMS for medical advice reminders or prescription intake, recommend other medical applications to download or articles to read.

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The support, or Back-end, of the platform will allow Doctors to be able to track data of patients compliance and advice given and, provide a Gamification (Rewards) atmosphere to the patients for following the prescribed advice and/or medication given by their doctors. This Gamification, or Reward, model is a multi-billion dollar market that has captured the human conditioning application opportunity. Through our contracted network of APIs (see API model below), the platform can provide rewards for following doctors advice or prescription instructions (Rewards would include a monthly (or bi-monthly) $10.00 gift card to Target, itunes, Best Buy, etc.). This would serve as a motivating factor to adhere to medical given by their primary care physician, allow for the doctor to track and document when instructional notifications (take medicine, check blood sugar, etc) are being sent out, and would allow our mHealth to track and store all data (medications being taken, advice being given, retailers that customers are using) as a future IP Asset. This would also warrant consideration in the form of a monetary return for those patients coming out of pocket for the service.

What will all of this do? 1) It will allow the doctor-patient relationship to become the focus again. 2) It will provide incentive for the patient to adhere to the advice given by the doctor and the pharmacy. 3) It will allow the doctor to track and monitor the patients progress so face-to-face meetings are more meaningful and substantive. 4) It will provide a shared revenue stream for the doctor thus incentivizing them to use and recommend the service.

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5) The platform with carry agnostic qualities and will be available to every cell phone owner, regardless of content-carrier. 6) Since the platform will be bi-lingual (English & Spanish), it will capture a larger audience. 7) Additional traffic will be drive to our Urls (we own): - www.mHealthapps.com - www.mHealthgames.com Lastly, the mode by which auto-notifications are sent (SMS) is critical. This allows us to reach a larger economic demographic and, studies show that SMS communication is responded to 80% of the time over email correspondence (Application-to-Person (A2P) messaging showing that just revenue from A2P SMS alone is projected to reach more than $70B by 2016. The data also suggests that A2P messaging will overtake person-to-person texting by 2016 Textmarketer, Jan 2012.) In addition, EMS will be able to receive SMS notification when necessary. Software Platform will be meet HIPAA compliance.

Mission & Vision

Our mission is simple. Utilize the current state of technology to provide and re-establish a communication and security bridge between the doctor and their patients. Provide this invaluable service to everyone with a cell phone, regardless of language and economic barriers. Include the doctor in the revenue stream, provide open lines of communications and patient-data tracking, and provide a higher security against malpractice complaints. Vision: Domestically, Doctors (and Nurses) will eventually be able to fulfill the CME/CNE requirements through this platform. This should save time and capital coming out directly out of their pockets. On a larger, global scale, we see this type of platform/application being driven in developing countries. Governing Medical bodies using the cloud capabilities to inform, educate, and notify via SMS medical patients in last-mile or rural areas. Since 89% of the worlds population has a cell phone (30% in China), it is the most efficient way to communicate. In essence, this platform can provide a scalable solution in the mobile Health Platform/Application marketplace that will allow for a long-term, large-scale, economically viable and sustainable medical service, a rudimentary user interface, complete identity and content protection and privacy, and an OS that overcomes language barriers so developing nations and their governing bodies (private/public/hybrid) can access, implement, manage, and educate their populous in a more efficient and streamlined manner. We will eventually have the elements necessary for the successful scale up of mHealth. This includes building sustainability and scale into the projects from the beginning, ensuring the solution is locally

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appropriate, securing buy-in from key stakeholders, creating strategic partnerships, ensuring alignment with local and national health priorities and integrating into local healthcare structures. Lastly, we will have the capacity to assist governments in the creation of an enabling environment for scale up mHealth system, mainstreamed into existing healthcare structures, agencies, and national health authorities policies and priorities frameworks. We will provide data and interoperability standards that are in place to ensure that health information being collected is fed back into the system and informs resource allocation decisions. For the global community including donors and institutional players, it is essential that monitoring and evaluation is planned and budgeted for within programs to ensure sustainability beyond a successful pilot phase. Organizations need a global network and repository of information that they can rely on for best practices, recommendations, frameworks for success, applications and an evidence base of what works and what doesnt for various contexts.

Management Team (Brief)

Steve Epstein -Steve Epstein is the Founder and Chief Technology Officer for mHealth Global. Steve has over 30 years of experience in the eCommerce/mCommerce Space. Steve will head up all project development and ongoing updates to the product and service MHealth offers. Prior to mHealth Global, Steve was a CTO consultant to Mobile TV, NFC (Near-Field Communication), RFID (Radio Frequency Identification) in US, Japan, Korea, and China. In 2001, He was Director of eCommerce for Qwest in the US-West managing 14 state intranets. In 1993, he acted as a Director of Risk Management (RTC Portfolio) for GE Capital. Post-graduation, Steve joined the Navy where he was directed to Naval Intelligence as a Cryptography Lt. at the Japanese Station. Steve holds a MBA in Finance from UCLA and has a degree from Columbia University in Chinese and Japanese

CEO Doctors.

-We are discussing this potential opportunity with three different

Chris McGhay -Chris McGhay will direct Operations and Finance (initially) for mHealth Global. Chris has 15 years of experience in Operations and Senior Business Development positions within various vertical markets. Currently, Chris is the Founder and CEO of Small Axe Capital, Inc (SAC). SAC is an underwriting outlet for small to mid-cap companies needing assistance in Recapitalization, Structured Debt, PE, and/or Public Offerings. To date Chris has successfully settled over $200MM in capital transactions. Prior to Small Axe Capital, Chris was President of the Capital Markets Division for SIXON Group. In 2005, he was a partner in Blue Cap Funding, a commercial/residential mortgage firm based in Baltimore, MD. In 2000 Chris acted as Director of National Sales for a Technology Start-up in the home/light-commercial Confidential Page 7

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automation sector. Chris got his start in corporate finance in 1996 with Mackenzie Commercial Real Estate, a Mid-Atlantic Regional Firm with full-service, CRE amenities. Chris holds a B/S in Environmental Science from Towson State University, in MD.

Chris Driggs - Chris Driggs will direct Business Development and Sales for mHealth Global. With over 18 years of experience in Business Development, Sales, & Project Management in various vertical markets, Chriss network in the Healthcare space and his knowledge of structured alliances will bring much needed support to the mHealth Team. He has a proven track record of growing companies from the ground-up and is currently structuring a short-term (3-year) M&A of his current business located in Orange County, CA. A company he has grown from Seed in 2004. Prior to that, Chris Owned and Operated a wholesale and retail mortgage banking business with over 20 full time employees. Chris holds a BS from the University of Virginia.

Dan Nease -Dan Nease will act as Chief liaison into Domestic and Foreign Government agencies for mHealth Global. Dan currently acts as Founder and President of D&D Capital Group. D&D aids domestic/foreign Governments with large project-based structured finance. D&D has been successful in bridging over $1B in large, Structured Capital for various developing countries. D&Ds relationships with high level contacts inside various, developing national government will allow for direct access to decision makers inside these large bureaucratic systems. Prior to D&D Capital, Dan spent over 8 Years in Asia acting as both Managing Director and Owner of two different Water Filtration/Delivery Service Companies (Waterman Asia, LLC & Offshore Marine Labs, Inc.) working with both the private and public sector. In 1987, Dan headed west coast operations for Optrotech International, an electro-optical systems manufacturer that was able to become the market leader in its field helping transform the printed circuit board, enabling companies to begin the first of a series of dramatic productivity improvements. Dan holds a MS in Industrial Engineering from Arizona State University and a BS in Science & Mathematics from Cal State Poly-tech U.

Objectives
Projected Gross Revenues for fiscal year 2012, without external (PE/Debt) funding, are expected to be $180,000. That would reflect a customer base of 5000 single users. Growth in 2013 is projected to be 300% (15,000 single users, PGR $540,000) and another 300% every year through 2017. Within three (3) years mHealth Global will be in a suitable position for further expansion or a profitable M&A. At this

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time, our objective is to establish a foothold in a new and emerging industry and, to seize an opportunity to fill a market gap in the mobile Healthcare industry. To achieve our objectives, we plan to establish strategic partnerships with the Healthcare Tech Space and leverage our already well-positioned network of Doctors within the Primary Healthcare Market. This will require extensive travel, AMA based trade show attendance, and a very savvy marketing pitch.

MARKET ANALYSIS
MARKET SIZE The mHealth Industry that Mobile Health Visions is venturing into experienced total sales of $1.7 Billion in 2011, which is a 233% increase from 2010, according to statistics from Parks Research (http://mobihealthnews.com/7270/mhealth-predictions-1-9b-4-4b-4-6b/). Mobile Health Visions has recognized the opportunity, and is implementing the necessary marketing strategies to break into the market. The overall Mobile Phone Platform/Application market for the mHealth Industry is projected to be $23 Billion by the end of 2017 according to PriceWaterHouseCoopers (http://edition.cnn.com/2012/02/29/tech/mobile-health/index.html). Approximately 5.6 Billion mobile phone devices are active today in 2012. Because healthcare applies to all people, some more than others, the demographic for mHealth Platform is 5 and up (or earlier, just depending on when a child can read and understand how to operate a mobile phone). There are approximately 320 medical applications for mobile devices in this specific market today. Epocrates, Voxiva, GE, PharmaSecure, & NeuroVigil are five of the top mHealth companies as reported by Fast Company in March of 2011. We consider broad-based exposure a large chunk of our emerging market. Demographic evaluations will be used to determine the areas which are most appropriate to conduct business. While understanding the United States is the best place to begin because many people have a home computer, work computer, and mobile phone, one must understand that in many undeveloped countries, mobile devices are the only source of connectivity. Most people in undeveloped countries do not own a home or work computer. It is the mobile phone that serves as their online gateway. Our market research has helped to identify our niche market. Because we can seek out small segments of the larger markets, we can generate a regular income stream by targeting and serving a loyal customer base. MARKET CONDITIONS Market conditions in our industry are increasing and projected by most experts to continue at that trend. Between 2010 and 2011 the market grew 233% (600 Million to 1.7 Billion - Parks Research). An expected growth rate of 1350% over the next 60 months is anticipated (23 Billion by 2017 according to PriceWaterHouseCoopers). Management will use several forms of marketing to take advantage of the favorable market conditions. Confidential Page 9

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GEOGRAPHIC SEGMENTATION Geographic segmentation allows us to divide and understand the area in which we are establishing our business. By categorizing and identifying the regions around mHealth Global will allow us to understand the market within our area, and where they are located. Below you will find descriptions on the Area, Counties, and Regions that we will offer our business in. Region Description: UNITED STATES DEMOGRAPHIC SEGMENTATION Analyzing the demographics of our specific market allows mHealth Global to examine and identify the ages, gender, and income levels of our particular target market. This will enable us to appropriately design a marketing strategy based on this information. The following identifies the demographics of our likely target market. Research suggests that mHealth Global's target 5 years old and up mHealth Global's typical customer will be any person that needs healthcare. Family Size: Any Size The nature of mHealth Apps will be targeted towards all people. Our segmentation analysis indicates our primary customers are those that have health issues that require daily, weekly, or monthly care (ex. diabetes patient).

TARGET CUSTOMERS Our initial target to Market penetration will be through the primary care givers. Initial revenues will come from our end-user market, the Patients. Future targets for revenue verticals include both Pharmaceutical Companies and Insurance Companies. Potential Ad Revenue will occur once critical mass is reached in user/account numbers.

STABILITY OF MARKET As mentioned before, sales in this market have increased 233% from 2010 to 2011. This vertical continues to be in the growth stage and different firms are seeking to build market share by maintaining quality and routinely adding new features to mHealth apps. More and more mHealth Companies and Spin-offs are forming as a result of increase in demand. mHealth Global will plan accordingly to accommodate this growth in the market.

SWOT ANALYSIS mHealth Global's mobile platform brings a considerable pool of products and marketing strengths to the Confidential Page 10

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mHealth marketplace. In terms of product strength, mHealth Globals mobile platform has several distinct advantages over the competition. First, is its marked advancement in software development for cloud operated applications and network agnostic qualities. Second, the structured alliances with our API Family allows for the "Gamification or Rewards program incentivizing the patient to properly follow Medical advice and/or Prescription Instructions. Third, SMS communication and Bilingual (English/Spanish) would increase our target market across a larger economic spectrum. Fourth, all tracked, stored, and analyzed date will add to the IP Asset revenue stream (Ins Co, Pharms, Retailers, Etc). Lastly, our revenue stream will include the Primary Care Physician thus incentivizing the service for their customers and eliminating any doubt of capital circumvention. The Founder and CTO of mHealth is fluent in Chinese and Japanese so, Asia is a market for future growth. The mHealth Global team has a strong network and relationships to hospitals, doctors, and insurance companies. These established relationships will be leveraged for immediate Sales and Business Development. Strengths: mHealth Global's greatest strength is the innovative approach it has taken to designing and building mHealth Apps operated in the "cloud" environment and providing both a front and backend that supports and highlights the relationship between the Doctor and patient. Being a smaller company, mHealth Global has greater flexibility than its larger competitors to try different methods since it does not have to consult with an entire panel of IT engineers or obtain unanimous approval from multiple divisions to implement a viable new customer-approved solution. This means that the latest breakthroughs in design will be implemented and tested before comparable products are even off the drawing board at competitive companies. In marketing, our most powerful assets are: Sales Executives with strong database of doctors, insurance companies, and associations Executives based on East and West Coast's Adding doctors to mHealth Platform Revenue stream to differentiate ourselves from all competition Partners with previous start-up experience Exceptional promotional materials Appropriate pricing as it relates to competition Weaknesses: Because of its relatively small size, mHealth Global is not yet a "household" name among doctors, patients, and insurance companies. If mHealth Global had the resources to finalize the final product, it would be possible to create sales revenues in the lucrative market that is made up of hospitals & private practices that are anxious to find a new revenue stream to offset today's astronomical operating costs and want a product that will reduce liability and improve doctor patient care.

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There are some minor handicaps inherent in our product. In order for the platform to work properly, doctors and patients must develop a habit of using it. That means breaking routines that doctors and patients have followed for decades. The only notable marketplace disadvantages caused by this weakness are updating current systems and trusting that a new way will work. Company weaknesses, at this time, consist only of our cash position. However, we are taking steps to raise capital to allow us to grow and provide a very realistic return for the investor. We feel these measures should eliminate or significantly reduce the problem. Research has shown that this market annually generates total sales of $1.7 billion in the United States. Currently, software companies in the U.S. and Europe dominate this market. mHealth Global has a substantial amount of work to do in order to secure a portion of the United States market. Opportunities: The upside potential for growth will support substantial revenue increases in the immediate future. Over the next two years, our current mHealth Global App products are expected to perform at rapidly increasing levels in Unites States markets where until recently, likely customers lacked access to the technology required to use mHealth Global products. Based on current and projected market conditions, it is apparent that mHealth Global will be able to develop new mHealth apps and upgrade already developed apps, to take full advantage of the projected 1350% growth of the mHealth space between 2012 and 2017. Allowing for economically or politically driven drops in sales, market trends indicate that mHealth Global stands to realize a significant jump in revenues, due to the market being so new. Unexploited Opportunities: mHealth Global could create a completely new product platform/ application by using the current platform and applying it to other businesses like the teacher and student relationships, thus entering the Education market and positioning mHealth Global products as an educational tool rather than the healthcare use for which it was originally designed. Further opportunity for our product exists in numerous other market(s). Threats: Known threats include the newness of the market and a failure to act quickly as more companies are deciding to enter the mHealth space.

Vertical Stats below

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Revenue and Billing (please see financials for other associated costs & NOI) The revenue model will address the growing concern by Doctors/Physicians about capital circumvention they are facing with the Governing Legislation and other technological advances and care offered direct to patients. mHealth will dedicate 20% of the its revenues to the Doctors who utilize and recommend our product and service This will obviously add incentive to refer mHealth to their clients as well as to other doctors in the community. Furthermore, the data we collect, store, and analyze may act as a deterrent to malpractice torts. This will be treated as a cost to the company and Doctors and/or private practices will be regarded as ICs and 1099d. Price Points: Single user Family of 8+ $2.99 monthly ($35.88 annually) $4.99 monthly ($59.88 annually)

Billing can be handled 3 ways: -Direct from Client -Direct from private practice -Direct pass-thru billing from Carrier (AT&T, Verizon) -Insurance provider (TBD) Other than direct-to-market revenue, mHealth will have the capability to sell/lease the data we collect and store (once we have reached critical mass in users) to Pharms and Ins carriers. Valuation of this IP Asset is TBD.

Investment Opportunity
Friends and Family: Given the market conditions and similar start-up business models in this space, pre-money valuation of mHealth Global is $2,000,000.00 (Two Million Dollars). mHealth Global is raising $100,000.00 in Convertible Notes with a 15% return (simple interest), for 3 years (ending June 1st 2015). Voluntary Optional maturity conversion: The Notes and any accrued interest shall be convertible, at the option of holders of a majority-in interest of the outstanding principal amount of the Notes (Majority Holders), on the June 1, 2015 (the Maturity Date), into shares of Non-Participating, Preferred Stock at a conversion price equivalent to a pre-money valuation of $2 million USD.

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Our goal is to secure an initial capital raise of $50,000.00 by April 15th of 2012 and the balance of the $100,000.00 raise by May 1, 2012. This will allow the development begin immediately and sales/business development to commence contiguously.

Financials
Start-up costs

Owners' Investment (name and percent ownership) Steve Epstein/Dan Nease Chris McGhay Chris Driggs Angel Equity for Leverage Total Investment % Angel/Seed Inv 1 Inv 2 Inv 3 Inv 4 Inv 5 Total Equity Sold Other Loans SBA Source 2 Total Loans STARTUP EXPENSES Legal Corp Register OpAg Legal Counsel Alliance Contracts (API) Oversight/Retainer Other Total Legal Demo App English Working App (Demo)

40% 20% 20% 5% 15% 100%

$20,000 $20,000 $20,000 $20,000 $20,000 $100,000

$100,000 $200,000 In the event its deemed necessary

$1,000.00 $ 500.00 $4,000.00 $5,500.00

$2,500.00

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Spanish Working App (Demo) Total $1,000.00 $3,500.00

App Framework WireFrame/UI Design English Spanish iOS/Android/HTML Front End Design & Implement (Eng) Spanish Java/Database/Analytics/Mult API Test and Implement Total Capital Build-Out Admin Expenses E/O salaries (2000 x 4) Total Admin Expenses Advertising and Promotional Expenses Printing Travel/entertainment Other/additional categories Total Advertising/Promotional Expenses Other Expenses web design and host Other expense 2 Total Other Expenses Working Capital SUMMARY STATEMENT Sources of Capital Owners' and other investments Bank loans(SBA) Confidential $3,000.00 $3,000.00 $34,600 $2,500.00 $1,000.00 $5,000.00 $2,000.00 $20,000 $30,500

$ 500.00 $8,000.00 $8,500.00

$ 400.00 $4,000.00 $4,400.00

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Investors Total Source of Funds $100,000 $200,000

Startup Expenses Demo App Legal App Framework Location/administration expenses Salary/Expense Coverage Advertising/promotional expenses Web Design/Host Working capital (COH) Total Startup Expenses $3,500.00 $5,500.00 $30,500 $10,500 $8,000.00 $4,400.00 $3,000.00 $34,600.0 $100,000

CASH ON HAND

$134,600

With additional SBA

One-year projections (Please See Attached for Capital Breakdown) Fiscal Year 2012 (6/1) Single Users June JulyAugustSeptember October NovemberDecemberJanuaryMarchApril@ $2.99 100 500 1000 1500 2000 2500 3000 3500 4000 4500

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MayMulti-Family Users (8 or more) @ June JulyAugustSeptember October NovemberDecemberJanuaryMarchAprilMay5000 $4.99 10 50 100 150 200 250 300 350 400 450 500

Exit Strategy
While its hard to determine future positions in this New vertical market mHealth believes that once enough market share has been gathered and/or penetrated, a larger outfit (Competitor at that time, Ins Co, Pharm Co, etc.) will want to discuss potential M&A offerings.

Thanks in advance for your time and consideration. For more information or to arrange a time to speak/meet, please contact either: Chris T. McGhay Small Axe Capital, LLC PO Box 1242, Carefree, AZ 85377 (Cell) 480-273-6734 Skype chris979797 Chris Driggs 4334 North Charles St Baltimore, MD 21218 (Cell) 949-300-7710 Skype chrisdriggs

Please read a few articles on the following pages supporting our mission and the market opportunity

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Articles
Why mHealth will go main-stream in 2012 http://www.mhimss.org/news/why-mhealth-will-go-mainstream-2012 March 14, 2012 James Monaghan The start of a new calendar year often ushers in a raft of bold predictions from industry experts and pundits alike. Depending on what you read, 2012 could be the year we ditch plastic en masse and start waving our smartphones to pay for groceries or, perhaps even less likely, we sound the death knell for SMS by migrating to a proprietary OTT messaging system. Some predictions are nakedly over-optimistic, while others sound eerily familiar because the technology's ascendance has been heralded many years in a row. At first glance, healthcare, with its labyrinthine regulations, antiquated reimbursement models and reticence to yield to mainstream IT practices, seems like a highly unlikely industry to "go mobile" this year and experience the surge of innovation and adoption associated with the payments, gaming and communications sectors. However, a perfect storm of factors is coming together to ensure that mHealth explodes into mainstream consciousness by the end of 2012. Follow the money Like any massive industry, U.S. healthcare is rife with inefficiencies, and since spending on health and medicine in this country accounts for 16 percent of the GDP, both incumbents and entrepreneurs alike understand that a small incremental efficiency in this market could yield tremendous opportunity.

Anyone who has been to a doctor's office has experienced long waits due to sub-optimal scheduling, filling out paperwork with details already shared on a past visit, or presenting multiple credentials (ID, insurance information, payment information) to receive care. But it doesn't have to be this way there are many ways mobile technology can make this process more efficient and cost effective. With integrated GPS and adoption of open APIs, patients can find nearby practitioners with open appointment slots minimizing wait times and unbillable practice hours just as diners search for last-minute restaurant options. Low-cost, self-service platforms for SMS alerts will soon replace manual phone calls and handwritten notes for appointment reminders and prescription refill notifications, ensuring that billable services and products are used and patients receive their scheduled care. Cloud-based electronic medical record (EMR) platforms, backed by sizeable government incentives for adoption, will render paper-based filing completely obsolete and streamline care with accurate, detailed and portable information. NFC and emerging mobile wallet technologies will go beyond just payment information and act as unified, secure credentials for accessing insurance information and personal health records, completing forms and paying for services with one easy tap.

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Wide adoption of these examples in the hospitality and finance industries proves that the technology is ready, and it presents an opportunity to save healthcare providers the cost of missed appointments and drive timely prescription refills. The chance to take a piece of that revenue is attracting both traditional investors with a track record in health technology, such as Qualcomm Ventures, and upstart incubators like RockHealth looking to help entrepreneurs with a traditional web background break into healthcare. With revenue models and venture capital in place, we can expect a slew of exciting announcements and product launches this year. Let the gamification begin The revenue opportunity doesnt stop at the patient and provider end of the spectrum either. Insurance companies and other payers have large incentives to foster better communication with their members and provide greater access to health information, because healthier people use fewer healthcare services and cost less to insure. Recently, hospital networks, insurers and charitable foundations have tested various informational alerts and wellness programs from finding the nearest HIV testing center to getting weekly pregnancy tips via SMS and many have been a big hit with consumers. Today, addictive gaming and social reinforcement models the game mechanics" pioneered by Zynga and Foursquare are helping people adopt healthier behavior. Setting goals, tracking progress bars, earning badges for achieving milestones, challenging your friends and sharing your stats on Twitter or Facebook all of these elements can make healthy actions such as picking salad over french fries, walking to work, losing a few pounds or even getting a prostate exam almost addictive. For a long time, the healthcare industry assumed that providing enough facts or incentives was the only way to encourage healthier choices. Now many believe that the secret lies in basic psychology and reinforcing positive behaviors. Several applications applying this principle have debuted in recent years; smartphone food tracker The Eatery and social exercise stream Dailymile are two popular examples. Venerable favorites like Nike Plus and even Wii Fit now incorporate many of these features, but never have the mechanics been so well understood (thanks, Farmville), the technology available to so many consumers or the tide of entrepreneurs wanting to do something good been so strong. Research2guidance estimates that the size of the mHealth app market will nearly double in 2012 to $1.3 billion, up from $718 million in 2011. Know thyself A huge challenge in healthcare is the perception that care only happens when a patient is in front of a doctor. In fact, daily decisions often have the greatest effect. Of course, all the fancy visualizations and game mechanics in the world can't operate in isolation, no matter how incented a consumer is to use them or stakeholders in their wellbeing are to fund them. Data drives everything. In order to change something, you must be able to measure it and much more frequently than at an annual physical exam. Fortunately, there has been a huge proliferation of devices aimed to provide crucial data points for those on the path to the quantified self. Recent advances have made them small enough to be mobile, cheap enough for consumers to buy and, in many cases, connected to wireless networks for ready aggregation and sharing of data. Vibration and GPS-driven pedometers, electromagnetic and optical heart rate monitors, blood pressure cuffs, glucose meters, scales and body composition analyzers and sleep trackers all of these sensors are either available for home use or packaged in wearable wristbands or smartphone accessories.

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Mobihealth predicts that the U.S. market for wireless home-based healthcare applications and services will become a $4.4 billion industry in 2013. To say there is demand for these devices would be a massive understatement. The first batch of Nike's FuelBand, a new goal-based activity tracking device, reportedly sold out online in just four minutes. Pulling it all together All of these trends maturing technology, willing consumers and available funding are promising, but things get really exciting when data is freed from proprietary, vertically integrated silos and made portable. Consumers should be able to selectively share their exercise data with their health team. Data from a weight tracking application is most meaningful when displayed alongside activity and caloric intake data. A host of mash-ups bringing together not just disparate sources of ones own health data, but local and regional trends, social graphs and demographic statistics are possible if this information is set free. This presents both a technical and marketing challenge. Sensors need reliable carrier connectivity for M2M messaging to upload their measurements. Data exchange formats and centralized hubs are necessary for the interconnection of these applications. Finally, we must establish consumer trust around identity management, privacy and security of data. Startups and enterprises alike are innovating in this area, with Runmeter's Health Graph API and the AT&T mHealth Platform representing two prominent examples of cloud solutions tackling these complexities. Even simple components delivering an alert to remind someone to take their medication, for example require integration with multiple wireless carriers and OEM platforms to reliably reach every user, but new platforms exist to tackle this challenge. With these strategies and other pieces in place, the pace of innovation for mHealth is sure to accelerate this year. James Monaghan is director of solutions innovation and consulting at OpenMarket. Follow him on Twitter at @james_monaghan.

mPrescribe Prescribing Health Apps 3/5/12

via HIStalk Mobile by travis.good on 3/6/12 The BBC had a story last week about general practitioners (GPs) in the UK prescribing health apps to patients. The idea is that prescribed apps would be free to patients, even if they had a cost associated with them, so Im assuming that the NHS would pick of the tab for such apps. The story has gotten a lot of attention, and I think with good reason. Ive written before and believe that physicians need to prescribe health apps, whether they are mobile or web, in order for patients to signup and use them on an ongoing basis. There are several huge benefits that exist from this approach:

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system. In my utopia, health apps are used to enhance that relationship, providing constant touch points between provider and patient, even if some of the content from the provider is somewhat generic and/or canned. I think that constant contact and accountability for the patient, whether real or perceived, will be a huge driver of ongoing usage. Also, collecting additional data and summarizing it for the provider, potentially with clinical decision support built in, makes the time spent face-to-face that much more valuable. Minimizing disruption. If the provider can have select apps for each condition or cohort of patients then it makes disruption of clinical flow less for them as they only have to learn to view and act on results from a small subset of apps. Also, if these targeted apps are then integrated into the EMR, even as attached reports, that is less disruption. Or maybe more app developers start making physician apps for viewing patient data. Again, the number of apps has to be limited. If all app makers agree to push data to one platform, such as MS HealthVault or Dossia or whatever, then this problem is solved, but I dont see the convergence of one storage platform to be very realistic in the near future. Reducing silos. This relates to disruption above. Reducing the number of apps used by patients reduces the number of silos of data from different app makers. It also filters the huge number of potential apps out there. Virtually linking patients and providers. If a doc prescribes an app, ideally they could do it with an invite code or QR code or someway for the patient to choose them as part of the app registration process. I realize very few apps do this today but were going to be seeing more and more of this coming. Instead of walking out with directions memorized or on printed documents, prescribed apps can pull data into the app and present it a more meaningful way, or maybe automatically add events to a calendar, or create a specific health calendar. This is definitely future-state but has a ton of potential. Linking the two makes access to data easier and also enables messaging between parties, once both patients and providers are ready to message. Lowering the cost of care. Regardless of provider involvement, I think engaged patients that use health apps on an ongoing basis will be healthier. I think patients feel more accountable if something is prescribed to them and can be tracked. Accountability leads to more active engagement, which then leads to better outcomes and lower costs.

With so many benefits, why arent physicians prescribing apps? Unfortunately, I believe we are a long ways off from seeing most docs prescribe health apps to patients. The UK has a bit of an advantage because it is a more centralized health system. Systems that are similar in the US, like Mayo, Kaiser, Intermountain, and Geisinger, I could see being some of the first to start having providers prescribe institutionally approved apps. But, for the vast majority of providers and, by extension, patients, several very large obstacles remain:

The vast majority of providers dont know anything about health apps. If youre a provider reading this post, Im not talking about you. Most practicing physicians dont have any idea what apps are out there for their patients. Heck, most providers dont have much of an idea of what apps are out there for themselves (Epocrates and UpToDate excluded, although my wife only knows UpToDate has a mobile app because I installed it on her phone). Assuming providers knew about apps, they need guidance on what apps are safe. I believe docs are never going to prescribe an app unless a trusted organization confirms its value and accuracy or a trusted colleague tells them about how great it is. Maybe that is where the FDA comes in? But, even with FDA approval, apps dont fit into nice categories like drugs do (its Confidential Page 22

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easier to compare two statins than it is to compare two diabetes apps). Im not sure how this will work exactly but I know there needs to be some higher authority validating, and in essence taking some of the responsibility, from providers. This is what Happtique is trying to do; well just have to see how well it works from a clinical buy-in perspective. Providers dont know how it fits into practice. Providers are going to want to know how the apps fit into their practice. Right now I think thats still unclear. Obviously more data on mood trends as somebody is starting new meds for depression is great, as long as it is presented to the provider in a digestible way. But, what if the patient is suicidal according to the app and there is no feedback mechanism to trigger an alert. If providers are now prescribing patients to enter this additional information, are providers on the hook to assure they know when an immediate response is warranted and then to respond to it? Lack of payment. Unfortunately this might be the biggest obstacle. In the NHS story references above, the apps were going to be free to patients. In the US, that is not the case, at least it isnt today. Prescribing patients to spend additional money is likely going to prevent widespread uptake. Or maybe different payers will have different app formularies so providers will have to wade through lists to see what approved apps are free based on payer. That would be great. Also, if providers arent paid for responding to app messages or alerts its likely not going to happen.

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