Interview: Cell phone inventor on mobile health

By Brian Dolan

Marty CooperThis week at the American Telemedicine Association (ATA) conference in Tampa, Florida MobiHealthNews sat down with Marty Cooper, the inventor of the modern cellphone to discuss mobile health's future, tech hype, current challenges and more. The New York Times' technology columnist David Pogue interviewed Cooper on-stage at the event during a plenary session this past Sunday, but their conversation only briefly touched on mobile health. Cooper is co-founder and chairman of GreatCall, which offers the Jitterbug phone service. He is also executive chairman and co-founder of ArrayComm, a wireless antenna solutions provider.

MobiHealthNews: How do you describe the mobile health opportunity?

Marty Cooper: The introduction of mobile telephony, the cell phone, was a revolution. A revolution changes your behavior—makes you live differently. And there’s no question that people live differently because they have cell phones.  But I think there are going to be two new revolutions, both of which have already started. The one that’s most underway now is mobile health, also called telemedicine. The other one is social networking.

Telemedicine is really important because our healthcare system is broken. In fact, when I talk to the experts they tell me we don’t have a "healthcare system" we have a "sick care system". The focus of our entire system today is on curing disease. There is a belief that all diseases are preventable and that’s really profound. We don’t know how to stop all of them, but that vision is a realizable one. The beginnings of telemedicine, are things like remote diagnosis and things of that nature. And those things are starting to become very common, but the dream is being able to monitor people continuously. I get a physical every five years whether I need it or not. And all the doctor gets is a snapshot. Most of it is meaningless. Instead of having an annual physical, with telemedicine you can have one every minute. Then we’d have a reference point for every measurement. That way when things go awry you can anticipate somebody getting a disease and stop it before it becomes a disease. That’s the dream.

And there a whole bunch of things that have to be done before that dream can be realized. The technology is difficult because to reach that ultimate, you have to be able to sense just a few cancer cells in a person’s body... We’re getting there, but the biggest problem — far greater than the technology -- is the system. The way that the medical profession is compensated today has gotta change. The whole concept of fee for service has gotta change. Because doctor’s today are only paid today when they treat diseases -- when they try to fix you -- not when they do things to anticipate disease or to prevent disease. The bottom line is that it is going to take at least a generation to make real headway in telemedicine.

You said the technology is not the biggest problem. I hear that all the time: "Technology is not the problem." You're an engineer, are there really no technology problems left to solve for mobile health? Any important ones come to mind for you?

Oh, absolutely. Well the biggest problem is with sensors. Sensing disease -- sensing the presence of just a few cancer cells -- that really needs to be worked on. The technology of transmission, sending information from the human being to another human being or to a computer is a relatively minor problem, but we still have to get the cost of doing that much, much lower. Orders of magnitude lower. The technology already exists to do that though.

You know, I have to say this about the concept of technology: People think of technology as being science and engineering, but technology doesn’t mean anything if it doesn’t involve people. Technology is the application of science to create products, services, and devices that make people’s lives better. You can't separate the two.

You have a lot of experience with new technologies and the hype that inevitably goes with them. Do you have any advice for those working in mobile health on how to navigate  hype? There’s so much excitement. What dangers result from that in your experience?

That is a creative question -- nobody has every asked me that before. Hype is something you deal with in every part of human life. People just have to be skeptical. All the problems have to be solved -- not only the technology problems, but the behavior problems. To assume that these problems will be fixed in some miraculous, immediate way is foolish. These things are going to take time and we have to be skeptical about everything. The one thing that we can always rely on is science. When people are exposed to hype, the solution is to look for the data. That’s what I always do. I would love for everything to happen immediately, but when people say that they have evidence, I want to see that evidence. And you really have to examine that evidence carefully.

When did you start thinking about telemedicine?

The guy that got me into that was Jay Sanders. [Ed note: Sanders is widely credited as the "Father of Telemedicine".] I ran into him about 20 years ago in San Francisco. Boy, he’s a passionate guy. The minute that he talked to us about what the potential was, I got excited about it. This concept of people being mobile has been my passion for 50 years, which is well before you were born.

These days a lot of the hype and excitement is around health apps. What's your take on those?

Health apps are superficial and incomplete. It’s so easy to come up with an app that attacks the surface or the easy stuff. To create something that people will really use is hard. This issue of which platform has got more apps is humorous. This discussion over the hundreds of thousands of apps is a signal of immaturity in the wireless industry. That might apply to telemedicine too. We’re not going to be able to consider that a mature discussion until we can measure an app to determine what good it’s doing. If you’ve got 100,000 apps, you know that 99 percent of them aren’t going to work. And that’s very confusing for consumers.

Let's switch gears to device. Some companies are calling for dedicated wireless spectrum for health devices and services. Do you see a need for that?

We might need the whole day for that discussion. I don’t know if we’re going to need special spectrum, but we are certainly going to need special handling of medical data. The cellular carriers, as an example, have ways of carrying text, video, voice, but I don’t think they’ve got a really effective way of sending a couple of bits of information every minute or two.

OK, let's move beyond the technology. Why has healthcare only just now become known as a big opportunity for the wireless industry? We spent the last five to ten years on television services for mobile phones -- for music on the phone or games on the phone. Why is it that we needed to wait until 2008 or 2011 for healthcare to be considered the big opportunity?

Well, it may be a little discouraging, Brian, but if you look at how our culture attacks problems, we wait for the crisis to happen. And we have a crisis in health care right now. People don’t realize it but we have gotten people to accept that we can get everything for nothing. We have a free or very low-cost health care system. We started out this interview discussing how the healthcare system is broken. My general view is that problems don’t seem to be getting solved until they become crises. There is no question in my mind that technology can help solve all of these problems. It is only a matter of applying ourselves to them. So, the short answer is: We waited so long because it hadn’t yet become a crisis.

Earlier you said it would take a generation for telemedicine. What sort of timelines are you seeing for mobile health adoption?

The general rule is that for any product that is going to be practical, we know about it at least ten years ahead of time. So, for a lot of these health and medical sensors that we are just starting to hear about today, the soonest that they will be practical is ten years from now. It's another ten years after that before they are are widespread.

They did a study once about how long it takes from when a product first gets into the market. How long do you think it takes before your neighbor has one? Think about the microwave oven. How long did it take from when it was a "practical" device to when the average person had one? It took 19 years.

OK, last question and I'm sure you get this all the time: Which cell phone are you using?

I do get that question all the time. Last year I was being interviewed on C-SPAN and they asked me that question and you know I said I have a new phone every couple of months or so. I try them out. And at the time I had just finished trying out an iPhone, which I gave to my grandson. At the time I had a Droid X, I think. This was around the time I had just joined Twitter and after that interview aired all you media types wrote: "Cell phone inventor ditches iPhone for Android."

That's a good headline.

But I'm always trying out new phones. I'm trying out the new [Android-powered] HTC ThunderBolt now.