Brazil: An up-and-coming mobile health market

By Jonah Comstock
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New Cities Foundation

Clinical results from the New Cities Foundation pilot study

A 2012 PricewaterhouseCoopers (PwC) report suggested that in the years to come, US mobile health development would trail developing countries like South Africa, India, and Brazil, and another PwC report predicted a $46.6 million health app market in Brazil by 2015. That Brazilian market has been the focus of a lot of attention lately, with three new research and analysis reports in the last month dealing with mobile health in the country of Brazil.

GSMA: Better adoption could lead to 43.9 million more mobile health patients in Brazil and Mexico

GSMA, a global association for mobile operators, teamed with PwC on research saying 43.9 million additional patients could be treated with mobile health technology in 2017 in Brazil and Mexico, if steps are taken to drive adoption.

"mHealth can help countries like Brazil and Mexico tackle the significant challenge of providing universal healthcare to a large, dispersed population," Jeanine Vos, Executive Director of mHealth at the GSMA said in a statement. "The pressures on healthcare resources and the increasing burden of chronic diseases make it key to deploy innovative and cost-effective solutions. mHealth will enhance the reach, efficiency of spend and effectiveness of care to provide better quality health services to more people. Therefore it is critical that governments and regulators work with healthcare providers and mobile operators to drive mHealth adoption."

The report highlighted several challenges to adoption in Brazil and Mexico, which are not too different from those in the United States: the absence of a clear regulatory framework, a focus on treatment rather than prevention, and a lack of standardization and interoperability. In addition, the release states "the fragmentation of healthcare systems in Brazil and Mexico restricts the sharing of information and alignment of processes, preventing mHealth from scaling effectively."

If these challenges are addressed, GSMA predicts mobile health could lead to $14.1 billion in healthcare savings in Brazil and $3.8 billion in Mexico by 2017, and create 200,000 jobs across the two countries. If not, they predict only a modest savings of $1.5 billion in Brazil and $400 million in Mexico, with only 4.7 million new patients treated across the two countries.

Research2Guidance: Android health apps outsell Apple in Brazil

Research2Guidance reports that Android medical apps are significantly more popular in Brazil than Apple apps. The firm tracked the average accumulated downloads of the top 10 health and fitness apps for Android, iPhone and iPad. Android was 17 times as popular, with 238,000 downloads to the iPhone's 92,000 and the iPad's 14,000.

"Similar to the US and the German mobile health market, apps that are listed in the Health & Fitness category attract significantly more iPhone, iPad and Android users than apps in the Medical category. One reason for the performance gap of paid apps is the four times higher pricing level of medical apps," analyst Emad Yaghmaei writes in a statement. "The Brazilian mHealth app market seems to offer higher chances for local apps to reach the top 10 than other Western app markets. However, global mHealth players like Runtastic also rank amongst the top 10 in Brazil with some of their apps."

New Cities Foundation: Mobile health pilot saves money and lives in urban Rio de Janeiro

New Cities conducted an 18-month pilot project in the community of Santa Marta in Rio de Janeiro, where doctors and nurses at a family clinic were equipped with a $42,000 eHealth backpack to make home visits to 100 elderly patients (the staff used the backpack on more than 100 patients, but only 100 met the inclusion criteria for the study). The backpack included a Vscan portable ultrasound, a TuffSat pulse oximeter, an Accutrend blood monitor, an EKG machine, a blood pressure monitor and a weight scale, as well as a digital thermometer, tape measure, and stethoscope. The staff was also trained to use the tools.

The researchers estimated that the kit saved the clinic $200,000 per 100 patients per year in prevented hospitalizations for kidney disfunction, $32,000 for stroke, and $4,000 for heart failure. The kit also saved $136,000 per year per 1000 patients with cardiovascular conditions. Data was also collected on patient and medical staff satisfaction, which was very positive. Seventy percent of patients rated the home visit experience as "good" in a survey.

"On average there’s a 15-day delay to get blood exam results," Caroline Marques, head of the Family Clinic in Santa Marta, is quoted in the report. "Now we have them in 180 seconds." Dr. Pedro Hakme, another doctor at the clinic, said the eHealth kit "allows us to take immediate decisions, without patients going to a laboratory or a hospital where the delay in getting results is important."

In future iterations, the New Cities Foundation, which had support from GE and Cisco, wants to include a tablet in the backpack to make the various devices easier to use. Although the report doesn't go this far, the evolution of mobile health technology could take things even further. Down the road, replacing the backpack with a tricorder-like device that can perform many of the diagnostics the various mobile health tools perform now could increase the cost savings of a program like this considerably.

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