We attended the mHealth (mobile health) conference in Washington DC, and I must admit to a feeling that something very big is unfolding right in front of our eyes. I still don’t know what to make out of it; is it going to truly revolutionize the way we practice medicine, or is it one of those familiar “new new things” that quickly peter out into a footnote in history.

That a potential paradigm shift is in the making occurred to me when I heard Peter Tippett, MD Ph.D. deliver a plenary talk. Dr. Tippett trained in protein chemistry at the Rockefeller Institute, doing stellar research under Drs. Merrifield and Moore, both Nobel prize winners. So what is he doing at Verizon? Turns out he is also a well-known information security visionary, widely credited with creating the first commercial anti-virus product, which later became Symantec’s Norton Anti-Virus. So from brilliant protein chemistry that enabled the development of groundbreaking pharmaceuticals, to the application of biological principles in neutralizing virus attacks (receptor inhibition, antibody neutralization) in combating the virtual kind, his migration to mobile health speaks volumes.

From Amazon to Apple to General Motors, almost every industry that interfaces with customers is now inextricably connected to the cloud. Medicine, notoriously resistant to change, is one of the few holdouts. Admittedly, medicine has its own unique constraints, HIPAA being one of them. How do you protect patient privacy in an interconnected world? Solutions are emerging fast. Rather than remembering all your passwords a technology is emerging whereby identity is verified by a variety of unique identifiers: your address, your present location, the phone you are using, the car you are calling from, the last call you made, its time and location, your doctor’s name, etc. Verizon, for instance, established a non-profit foundation whose mission is to support young companies that bring innovations in improved quality of care, increased accessibility, lowered costs, and enhanced compliance. Why would they do it? Obviously, because that’s where the money is. But that’s not the only reason. All the incredible platforms that they are developing will be freely accessible through other gadgets and network. Whatever the motives –the promise of these initiatives is breathtaking in its scope. What we are witnessing is a significant disintermediation of the health care field, reminiscent of such developments brought about by the internet in the fields of finance, industrial supply chains, and sales of consumer goods. Think of the huge disruption Amazon has wrought.

Lest I come across as a starry-eyed enthusiast, here is my more cynical view. A walk along the endless booths in the exhibit hall was a bit sobering. Most of the exhibitors are thechies, with deep knowledge of technology and superficial acquaintance with the myriad facets of medicine. Do we really need a sophisticated gadget to take one’s pulse? Is there a better gadget than your finger on the radial artery? How many companies do we need to monitor one’s diet and exercise? There were dozens of those vying for attention. My prediction: the vast majority of them will fail, but the best and most innovative and useful will survive and thrive. Remember the internet-inspired tech boom? It ended in the big bust of 2000. Hundreds of young companies disappeared literally overnight.  But the best survived in the form of Amazon, Yahoo, Microsoft, Apple and Google. Reason? They were useful, they filled a need.

At the end of my walk in the exhibit hall (literally, at the edge of the exhibit area) were Qualcomm, Verizon, AT&T, and Aetna pavilions; mHealth hit the big time.

Even more telling: among those leviathans was the X-Prize pavilion. Yes, this is the same outfit that awarded prizes for challenges such as private, suborbital space flight, and rapid cleanup of oil spills. The former will take to the sky next year (sir Richard Branson’s Virgin Galactic) the latter was inspired by the BP disaster and resulted in technology that makes oil spill cleanup hundreds of fold faster. Grand challenges all, and each one not only met specifications but far exceeded them. So the challenges in mHealth?

The Nokia (a phone company!) is funding a challenge to develop a sensing device that will allow anyone to collect and analyze their personal health data…anytime, anywhere. Next time I climb mount Kilimanjaro and feel a bit dizzy at 19,000 ft. my doctor in California can tell me to get my rear end in gear and go down because my pO2 is too low and my pCO2 is climbing rapidly.

Qualcomm is an American global semiconductor company that designs, manufactures and markets digital wireless telecommunication products and services. So what is their interest in mobile Health? They fund an X-Prize challenge to “create the first affordable, portable, wireless consumer-friendly medical device that literally puts healthcare in the palm of your hand. The device will offer reliable diagnoses of fifteen disease states and health conditions with real-time health status.” Judging by its amazing track record, when X-Prize issues a challenge, you can bet on the results.

So are we on the cusp of a revolution? Only time will tell, but one cannot escape the sense of promise in the air.

Dov Michaeli, MD, PhD
Dov Michaeli, MD, PhD loves to write about the brain and human behavior as well as translate complicated basic science concepts into entertainment for the rest of us. He was a professor at the University of California San Francisco before leaving to enter the world of biotech. He served as the Chief Medical Officer of biotech companies, including Aphton Corporation. He also founded and served as the CEO of Madah Medica, an early stage biotech company developing products to improve post-surgical pain control. He is now retired and enjoys working out, following the stock market, travelling the world, and, of course, writing for TDWI.


  1. I would distinguish mHealth for monitoring people with common chronic conditions — the low-hanging fruit for diabetes etc. — from some of the more next-gen offerings you’ve described. For people with chronic conditions, no one has found the holy grail of engagement and behavior change so all the monitoring in the world won’t help. There are plenty of studies showing reductions in hba1c etc, but they are all based on people who were high to start (regression to the mean) and people who stuck it out the whole way (participation bias).

    For the rest of us, I share your sense of wonderment. I would love to be able to do those things. But the companies should focus on the worried well. To paraphrase Jesus, the chronically ill will always be with us.

    One big concern is HIPAA (or as you call it, HIPPA–yes, Al strikes again). They have to change the rule to assume that a cellphone is personal and not require password protection. One thing we’ve learned in disease management, you add steps, you lose people.

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