mHealth masters: Rob McCray

From the mHealthNews archive
By Eric Wicklund

Editor's Note: Today begins a new series on mHealth News. We're reaching out to the movers and shakers in the mHealth and telehealth world and asking them questions about the industry, the future, and their own interests. Each week we'll profile a different person.

Today we feature Rob McCray, president and CEO of the San Diego-based Wireless-Life Sciences Alliance (WLSA), chairman of the Alliance Healthcare Foundation, special advisor to TripleTree, LLC, a member of the Board of Directors for both the Midmark Corporation and CONNECT and an active advisor to several companies. He has more than 25 years in the legal and healthcare industries and co-founded OnCall Medicine.

Q. What's the one promise of mHealth that will drive the most adoption over the coming year?
A. The adoption of mobile tools that deliver knowledge and convenience to consumers and providers will continue to lead adoption. These knowledge and convenience platforms offer services such as personal diagnosis and healthcare management (e.g. Aetna’s iTriage, HealthTap and ShareCare’s AskMD), scheduling (e.g. ZocDoc), charges and quality (e.g. CastLight, BetterDoctor and PatientFusion), personal supply chain (e.g. Walgreen’s refill app) and telehealth (e.g. TelaDoc and American Well). 

Q. What mHealth technology will become ubiquitous in the next 5 years? Why?
A. Selecting and scheduling provider appointments, managing prescriptions and DME, and telehealth on consumer devices (phones, tablets and televisions) will be ubiquitously accepted if not fully adopted. Why? The technology is available and inexpensive, and continuing changes in the financing of healthcare services and products are making consumers more responsible for decisions they previously outsourced to care providers.  All the tools mentioned increase consumer convenience and sometimes save money.  Consumers value convenience and saving money.

Q. What's the most cutting-edge application you're seeing now? What other innovations might we see in the near future?
A. The most cutting edge technologies that I have seen recently are alternative non-invasive methods for continuous blood glucose measurement and one readily implantable technology for BGM. These are not near market approval. As to applications, I might choose ZocDoc for its ease of use and simple value proposition.  It is relevant to the consumer’s desires outlined in question 2.

Q. What mHealth tool or trend will likely die out or fail?
A. Non-regulated stand-alone apps for personal health will largely fail in the market due to lack of a revenue model and outcomes (or entertainment). The category will remain, but the successful mHealth apps will be combined with other services that are attached to major healthcare or consumer brands. “2.0” branding will wither away (or has this already happened?).

Q. What mHealth tool or trend has surprised you the most, either with its success or its failure?
A. I have been in business too long to be surprised by failures. For every successful pathway from startup to a successful business there are 99 dead ends. Some surprises in tools and trends:

  • The continuing resistance of the medical community to adopting systematic improvements in the delivery of healthcare in spite of increasing exposure of the failures of U.S. healthcare. This includes non-digital steps like the consistent use of procedural checklists (made easier with digital platforms) and even extends to the EMR, where providers are actually paid to adopt new systems (acknowledging these systems are flawed). 
  • I have been surprised by the (reported) traction of ZocDoc, as it implies that there is much more capacity in doctors’ schedules than is apparent to those of us who use other methods for scheduling. If the actual situation is that lower-paying patients are being deferred in favor of last-minute premium-priced visits, I would not be surprised.

Q. What's your biggest fear about mHealth? Why?
A. My biggest fear for the U.S. healthcare system is that access to care will be increasingly concentrated on the basis of ability to pay premium prices. In this context, mHealth will fail if it does not contribute to delivering greater personal health outside the healthcare system. I do not believe that it is possible to expand healthcare resources fast enough or at an affordable investment level to meet rising demands. From this perspective the biggest opportunity for mHealth is to accelerate personal and cultural changes that decrease the avoidable (behavior related) demand for healthcare services. 

Q. Who's going to push mHealth "to the next level" – consumers, providers or some other party?
A. Consumers. Few providers want to change, especially when an industry is being downsized.

Q. What are you working on now?
A. OOBR (Open Outcomes Based Regulation) is an alternative framework for the evaluation and regulation of all medical products, including devices, software, drugs and services. I outlined it in WLSA’s comments (joined by CTIA) on the FDASIA Report (linked here).
Have a suggestion for a future profile? Contact mHealth News Editor Eric Wicklund at