In February of this year Keith Nurcombe took the helm of Telefónica UK’s first foray into the field of medicine as head of O2 Health. He joined the telecoms industry after 18 years in the health sector, saying that he was attracted to the role by the idea of helping a mobile brand move into the health market and make health services a key operator offering.

The new unit launched in May, coinciding with the rollout of a handful of other operator mhealth initiatives, and is tasked with the decentralisation of clinical processes and ubiquitous and remote access to these services across Telefónica’s European operations as well as its Latin American presence. The potential for mhealth is as great in mature markets as it is in the developing world and for much the same reason – a lack of resource.

According to the presentation given in Madrid in July by Trinidad Jiménez, Spain’s minister of health and Telefónica chairman, César Alierta at the launch of O2 Health, in 2010, 13.5 per cent of the world’s population – 980 million people – will be over 65, and 60 per cent of these will suffer from chronic and degenerative illnesses. This situation, combined with the current shortfall of specialists in key medical assistance sectors, and the fact that these specialists must spend between 30 per cent and 50 per cent of their time on administrative tasks instead of healthcare activities, are putting additional pressure on public healthcare budgets.

Consider this alongside statistics revealed by Vittorio Colao, CEO of Vodafone Group and keynote speaker at the inaugural Mobile Healthcare Industry Summit held in London in December 2009, who said that although there are 2.3 billion mobile subscriptions in the developing world, there are only 11 million hospital beds and 300 million computers.

The numbers are depressing and are likely to become more so as time goes by. “Global healthcare spend is running at a 5.5 per cent increase year on year,” says Nurcombe. “That trend has got to stop, otherwise by 2080, 40 per cent of global GDP will be on healthcare, which means none of us will be able to afford it.”

He explains: “The NHS is looking for ways to do more with fewer resources, but this can’t be at the expense of patients, service or standards. We understand the NHS and can help it – and our private partners – to deliver more through smarter working.”

Nurcombe reveals that Telefónica has been looking at health for 12 to 18 months and, in the UK at least, already has many NHS trusts and private healthcare organisations as customers of its telecoms services. The company extended its offering with the launch of financial services in the shape of prepaid Visa cards in the last 12 months and is preparing to branch out into other key verticals. “We’ve got to be able to demonstrate that we have a right to enter a new market,” says Nurcombe. “So we have to prove ourselves. We’re creating a new business area that has its own brand identity. It’s made up predominantly of people from health industry. We have people from a telecoms background but we also have lots of people with 15 years of experience in health. We need that real understanding and insight, that’s very important.”

The issue of trust is a big one when it comes to healthcare, and this is where experience clearly counts (during his 18 years in the health sector Nurcombe spent five years at GlaxoSmithKline). “We need to deliver these solutions with credibility, which means we recognise that we are moving into a new market and our approach is very much crawl, walk, run, so we can demonstrate our credibility and gain trust. We’ll only get one bite of this cherry so we have to get it right first time,” Nurcombe says, acknowledging that O2’s role as an operator with an existing billing relationship with many customers already serves as a strong foundation in this respect.

But O2 Health’s customers won’t always be the end users. While some propositions will go direct to the consumer, with some others the operator will have a relationship with the local trust and will work in partnership with the NHS to deliver services. There will be more focus on prevention rather than cure, on health rather than illness, with a focus on wearable devices, or self measurement – taking some ideas from the sports field and making them mass market.

This point is key. Mhealth services are often perceived as very expensive to deploy and run, but Nurcombe insists this is not the case. “When we’re talking with the NHS and other healthcare providers it’s an ROI conversation very early on,” he says. “We have to be in a position to deliver ROI in the financial year that the NHS is in, not in three to five years like we used to.”

Fortunately, mhealth technology, which some may consider to be on a distant horizon, exists today. It’s just that most people are unaware of it, Nurcombe says. “Often it’s a case of using an existing model in a completely new environment, lifting and shifting technology. It’s very much not tomorrow’s world, it’s here now, but we might be joining a handful of existing technologies from other sectors to create the offering. None of this is particularly expensive technology, it’s just redeployed in a different way,” Nurcombe says.

In the UK with East Berkshire NHS, O2 is trialling a service called Home Physio that is already in commercial use via Telefónica in Spain. This is a home based physiotherapy service using sensors that fit on the body along with a touch screen PC that shows patients how to do exercises and sends the info to the hospital to make sure it’s being done correctly.

O2 Health is also trialling a service called Side by Side in the Western Isles of Scotland where travel is often difficult for healthcare professionals as well as patients. This service, which is already in commercial use in Spain and the Canary Islands, allows patients and consultants to interact over video with the ability to share data.

Mobile Healthcare Industry Summit, London UK
21 – 22 Sept, 2010

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