There's something rather resilient about the English language - it does a pretty good job of shrugging off silliness. I've noticed a decline in geek-inflicted bastardizations, such as adding 2.0 to anything (yes, guilty as charged) and removing vowels from company names. In today's post-crash world Twittr and Facebk would seem too flimsy.

So too, I predict the 'm' as in mHealth will soon go the way of the 'e' in ecommerce. Recently mHealth discussions have been shifting from the technology (doctors and patients using mobile phones and sensors) to what I think is the most important point - improving patients' service quality and reducing society's costs.

Two recent reports each make (at least) one important point. The first from Research2Guidance talks about the potential for cost savings for integrating mobile solutions, primarily due to better compliance (this graph reprinted by mobilemarketing watch, I don't have $2k to buy my own copy). Diabetes is the clear 'winner' here, and big pharma should be embracing this and driving the change to efficiency.

The second report mentioned in the article is the mHealth report from mobilestorm that provides a readable snapshot of the market and provides a useful summary of the different elements that make up mHealth today:

There are currently eight broad areas of the mHealth market, including general monitoring, personal emergency response systems (PERS), telemedicine, mobile medical equipment, RFID tracking, health and fitness software, mobile messaging and electronic medical records.

Moving on from narrow definitions of mhealth towards broad related categories is part of growing up. Before long the conversation will be less peppered with distracting and ill-fitting monikers, and be more about improving service quality and reducing costs, with technology just as assumed, ubiquitous and invisible as oxygen in the air. Or homeless dudes in San Francisco.

It must be true because it says so in a press release. This one in fact, from the folks at United Healthcare. Who knows, but still a nice data point:

The University of Texas Medical Branch estimates that widespread implementation of telemedicine, for example, could save the U.S. health system more than $4 billion annually, and improve health outcomes for millions.

Good use case in the Washington Post for mobiles as a way to speed up diagnosis and accelerate treatment. 

Physicians use photos from patients' cellphones to deliver 'mobile health'

The other day I got hit on the head by a big chunk of timber in a garage - and having the ability to send a picture of the wound to the 911 operator who asked me to describe the cut ("I don't know, it's on the top of my head")  would make sense. 

It seems to be pretty accurate:

"The initial data is encouraging," Sikka said. The study will continue through October, but so far, he says, about 90 percent of diagnoses are accurate. Sikka said camera phones with at least three megapixels, autoflash and autofocus work well.

Sometimes, however, the picture quality is poor or the patient information is not specific enough. Fifty percent of the cases where the doctor did not make an accurate diagnosis involved images that Sikka said were too grainy.

So, when high quality cameras become ubiquitous, look for accuracy rates for remote diagnoses to get up towards 95% - pretty good considering the alternative. 

Now that Facebook is jumping on the location bandwagon expect to see more integration of location to web services.

It's about time - the most glaring gap for web services has been their lack of a clue when it comes to location. The web can't really help you live a richer life if you need to be chained to your desktop. As we get more comfortable using location in web services, and more of our healthcare moves online, look for more of our health-services to be location aware. 

[Another data point that support this - mHealth devices (mobile health related gadgets, some of which will be location-centric) will be coming to high street stores.] 

The recent review by ReadWriteWeb outlines a few of these, and one thought in particular stands out: 

Putting a few thousand dollars of monitoring equipment into a home, if it prevents someone from visiting an emergency room, it pays for itself with the avoidance of one visit.

This is a powerful idea, and relates to an area that was not discussed much - proactive health. As Esther Dyson said in a Health2.0 Meetup I went to the other day, Health2.0 is about health, not just healthcare. Monitoring of people's activities and behaviors and identifying outliers (combination of activity, genetic makeup and protein markers in the blood) could help identify early onset of diseases and keep people out of hospital in the first place.  

Interesting little device I saw today (that am not affiliated with), which sits on the cusp of mobile, healthcare / wellness and data-as-a-consumer-service trend, and does it as a combined device+service, rather than just an app:  Fitbit. It has an inbuilt accelerometer to measure your steps, or your sleep patterns, and spits it out to a dedicated web service to track your progress.

The CPU, tech features and storage are no doubt fairly trivial - most smart phones wouldn't get out of bed for that (and a bunch already do similar things), but Fitbit are betting on simplicity. This removes many of the intimidating tech obstacles that put most people off ever trying to push their mobile limits  - downloading apps, navigating a UI and syncing with a computer /  web service.

Single use devices win on simplicity, but have a big downside: they make up for the lack of redundancy at the software level with wasted packaging. I hope they minimize this, making the charger compatible with other home electronics for example. More electronics enviro-waste is a big turn off for these gadgets.

Waste aside, these focused devices are here to stay. I don't see Nokia's decision to go for free navigation as necessarily being the end for TomTom and Garmin, or that the iPad will necessarily blitz Kindle. Single use devices (can) do one thing very well, rather than lots of things passably. If enough people care about that difference, both the focused device and the swiss army knives will continue to co-exist.

There are no shortage of predictions about what this year will bring for mobile, so at the risk of piling on a bolted bandwagon here are a few more. Not exhaustive by any means, more of a selection of some of my favorites.

1. Celebrities figure out how to monetize social media, even if social media doesn't.

If Kim Kardashian can get $10k for a single Twit, how much could someone with a broader following and even greater respect coin? Lots of outrage and fuss predicted (can you trust anyone?), but the market will reward credible endorsements, and affiliate technology will enable both transparency and revenue.

Location-based posts and pics/ videos submitted via mobile will be a big part of this, as the mundanities of daily life are manna from heaven to the celebrity obsessed.

2. Developers expand focus from the device to the hardware ecosystem

A big challenge until now has been making it easy and reliable for phones to make calls, send texts, browse the web and download apps. Thankfully this is more or less a solved problem, so I suspect part of the battle will shift to the hardware ecosystem. People will start to integrate mobility into their physical environment - TVs, thermometers, speed cameras and sensors will become part of the extended operating system. Creative developers for Apple are already straining at the leash; first flashlights, spirit levels and compasses, and now blowers and handwarmers take us beyond the digital to the physical environment.

Look for big growth in the m2m market and intriguing modular hardware initiatives like Nokia's NOTA, Aduino and BugLabs and a fun new concept out of Portland, Green Goose (thanks Rob!).

In addition, companies like Nokia and RIM/Blackberry who are overdue for an operating system upgrade could take this opportunity to leapfrog even even Palm's fabulously slick WebOS and ensure their next OS is integrated more tightly into the physical environment.

3. Mobile augmented reality as a new search interface

Continuing the theme of moving beyond the phone, here we'll see the the overlay of digital intelligence with the real world. Google Goggles is an important validation - and gives them the advantage of having an alternative search trigger (their location algorithms deliver the search term, rather than the keyboard). This is a new enabler for many services that can overlay digital with physical, and there are some intriguing proof of concepts popping up like mushrooms, subway finders, interior design and ski slopes.

Bruce Sterling's speech at Layar's launch provides a good summary of the state of play and potential here.

Video: Bruce Sterling's Keynote - At the Dawn of the Augmented Reality Industry from Maarten Lens-FitzGerald on Vimeo.

4. Health goes online and mobile at the same time

Healthcare eats up massive amounts of consumers' attention,' powerpoint ink and investment dollars (the second quarter of 09 saw more VC investment in healthcare than in IT). Professional-grade startups such as AmericanWell are quickly dismantling barriers to online health such as onerous insurance liability, online doctor-patient relationships and restrictions on cross-border medicine. At the same time Congress is on the verge of throwing another 30m uninsured Americans into the system who will need cheap yet effective treatment, and the shortage of primary care physicians is set to increase. I predict mobile as platform of choice here - more secure and personal than a computer and able to take, send and store pictures, sounds and videos of questionable body parts, and deliver location-based services that will help patients find services easier.

Every year for the past few years has been billed as the year that mobile will break through. As AdMob and Quattro proved late last year - 2009 was actually the year for mobile, but it came and went. Mobile is no longer another place, it is all around us, like the Internet now is. I think 2010 will be the year that mobile starts to integrate with the physical world to deliver genuine user benefits (such as saving lives) as well as more trivial ones (such as Kim K painting her nails). Either way, a busy time for innovation ahead.

Went along last night to the well attended Health2.0 meetup, organized by Eugene Borukhovich. A capacity crowd - I thought there might be a danger of overcrowding and asphyxiation but relaxed when I remembered about 95% of the people in the room were MDs.

Two impressive presentations which go to show why mHealth is such an interesting space. The first was by Rick(?) Tedescu from Handhold Adaptive. It's a technology company making solutions for people who are, as their tagline reads, "differently enabled". Powerful story of a guy being motivated to create a solution to improve the life of his family and his son, Evan - who has autism. Their first product, iPrompts provides visual icons on the iPhone linked to words to make it easier for developmentally challenged people to interact. They're selling this on the App Store for $50. Lots of development plans there. My concern was whether the Apple rights management system was secure enough to prevent piracy of such a high value app.

Second up was a very smooth - apart from the technical glitches - presentation by Healogica, who make it easy for people with illnesses to find and register for relevant clinical trials. The founders Jean Luc and Jeff are MDs who have come fresh from heading the healthcare practice at Gerson Lehrman, and have raised 750k in angel funding in April this year, having self funded it for a year. Very polished performance and technology that seems to solve an identifiable problem for a certain group of people (the size of which is obviously the key question). They have an iPhone app whose revenues will be 100% given to research Pancreatic cancer research (Steve Jobs' disease, a savvy but well meant marketing touch).

Looking forward to more of these events, congrats Eugene.

I've not been in the US long, but one name that I have consistently come across with regard to top of the line health care is the Mayo Clinic. They featured strongly in the recent Time cover story about the health care crisis - a rare US medical institution that saves money and gets results. My takeaway from the article was that it gets results because it saves money, focusing on a results -based approach rather than a process-based one (get paid for every procedure, whether or not it's actually helping).

So, happy to read this piece about Mayo in Mobihealthnews about their move to mobile.   Their director of product management Scott Eising talks knowledgeably about the space, noting the platform fragmentation and the need for providers to make simple and relevant services that customers haven't even thought of yet (but will want them when their friends have them).

As I see it, mobile health will emerge as the result of a pincer movement, with customers getting increasingly engaged and familiar with living their life online with contextually smart mobile applications becoming ever more important, combined with irresistible pressure from healthcare providers and goverments to find efficiencies in the system that do not kill people. This is probably best done by shifting some people away from the expense and long waits of the doctor's office and towards more "lightweight" solutions - nurses rather than doctors and automatic, algorithmic based assessments that cheaply extend medical cover to more people and shift our system to a proactive, preventative approach.