The Future Of mHealth: Discussion With Don Jones, Industry Leader

Donald Jones Portrait mHealthDon Jones is one of the consummate experts in the entire area of mHealth. Best known by many people for his leadership role in Qualcomm’s Wireless Health program, his 30-year career encompasses holding an array of leading positions in virtually all aspects of the healthcare industry.

We were taken by this comment from Don on the web about the future of healthcare:

“We are only a few years away from an emerging, significant millennial group who consume their healthcare the same way they consume everything else – via their mobile on a ad hoc basis, with providers that meet them on their definition of the competitive field.”

Clear thinking, we mused, and we agree; we better speak with this man.

In a recent discussion with us, Jones covered a number of the key points about the future of mHealth, and healthcare in general, with some extremely perceptive and creative observations. The topics include:

1) mHealth – Healthcare Industry Disrupters;
2) Transparency and Portability;
3) Wearables and Healthcare;
4) mHealth, Referrals, And The Future Of Healthcare;
5) Outcomes Based Medical Services – Pros and Cons

mHealth – Healthcare Industry Disrupters

Jones points out that there are about 5000 companies in the U.S. and 7000 worldwide that have adopted connected, mobile strategies. He points to Walgreens as one of the most successful of new entrants, noting that what started as an app has already resulted in billions of dollars of transactions.

He sees disruption to existing healthcare business models coming from a number of possible directions, including major entrants of the Walgreens, Amazon, Google ilk, as well as startups and certain healthcare companies that “reinvent themselves from a consumer point of view.”

The key, he states is “figuring out how to use the new technology tools.” These started with the iPhone. He asserts that traditional providers, in general, don’t understand the implications of the new tech.

As an example he mentions the relationship between the Apple HealthKit and traditional EHR (electronic health records, also EMR – electronic medical records) providers, such as Epic and Cerner. As announced in late 2014, a person’s data from HealthKit can, for example, be piped into the Epic EHR through Epic’s patient portal, Epic MyChart. However, over time, Jones anticipates that the HealthKit will also be able to pipe information out, in a two-way exchange and feed it into new consumer apps that developers devise for HealthKit.

Jones concludes, “Apple will create the healthcare records portability system that the government spent $30 billion on and failed to create.” He is generally positive on Apple’s role in healthcare. He states that they can have a “huge impact” because they operate a health ecosystem and can enable exchange of and accessibility to, data, which they do not manipulate.

Transparency and Portability

“EMRs replaced filing cabinets,” Jones states, “but they didn’t provide for any customer relationship management.” has written about this issue of the difficulty of penetrating EMRs several times. A year ago we quoted a representative of Cleveland Clinic who stated that they were trying to “liberate data from EMRs.” (“Key Issues in mHealth + Telehealth” 8/7/14.)

Jones notes that even mobile apps – such as AllScripts’ FollowMyHealth – don’t provide portability. He states, perhaps tongue in cheek, that there is a “nuclear option.” If a major company such as a big cellular carrier or an Apple or Google, provided a way for millions of patients to easily request their health records, “it would bring the healthcare system to a halt.”

Healthcare institutions are obligated, under law, to provide patients a copy of their records. But, as so many individuals have experienced, such requests are often subject to delays and after considerable effort usually result in receiving paper copies, film or DVDs, not in a form that can be digitally manipulated.

Wearables and Healthcare

Jones extends the definition of wearables somewhat to “anything you wear or carry.” So it may include a phone, as well as a watch, or peel and stick disposable, or clothing. He is optimistic about peel and stick strips, which may deliver medications or perform monitoring functions and cites many use cases that are currently in development in the pharmaceutical industry.

He also states that “clothing has real potential” since makers have solved the key issues in attaching electronics to fabrics. He refers to “cool software interfaces” that will make the garments useful for athletes, bicyclists and anyone working out.

Consumer products and apps, he believes, will increasingly embrace healthcare functionality, such as shirts that provide heart rate monitoring. He points out that a cellphone or device such as a watch may provide adequate vital signs monitoring for many, however, the apparel and strips can give more information and specific targeting.

mHealth, Referrals, And The Future Of Healthcare

Regarding the future of healthcare, Jones asserts that, “payment reform will drive change.” He refers to a number of trends and developments in healthcare supporting this conclusion.

One example is that of big employers, such as Boeing, Walmart and Loews who have reached arrangements with selected hospitals, including Cleveland Clinic and Johns Hopkins, to handle surgeries and other procedures on a basis that makes it free for their employees, as opposed to those employees going to local hospitals.

Another trend is the growing acceptance of telemedicine. He points out that large employers are driving employees to telemedicine. While big hospitals ordinarily think of telemedicine as only treating average, primary care type problems, Jones notes that if telemedicine is the primary contact it will increasingly control the referrals. With respect to referrals for specialty care, he states, “These will increasingly be controlled by aggregators on the front end.”

Jones also mentions that capitation (the practice customarily used by managed care organizations of paying a fee to doctors per enrolled person regardless of treatment required) also leads physicians to allocate their resources more efficiently, since they are assuming higher levels of risk.

Underlying the major overhaul of healthcare practices that he foresees is his view on the rise of mobile-astute millenials, who relate easily to mHealth services. Jones wrote about the millenials: “These consumers will begin to think of their telemedicine providers as their primary care, and bricks and mortar based services as something to avoid unless absolutely necessary.”

Projecting ahead he stated: “The word ‘telemedicine’ will begin to disappear and telecomm based exchanges with healthcare providers will be the new ‘front end’ of a brand (yes, brand) experience. Most alarming to many in traditional care settings, will be that the new provider interlopers will begin seriously impacting and changing traditional referral patterns. There are far too many examples to argue that the trend is not already underway.”

Outcomes Based Medical Services – Pros and Cons

We also asked Jones about the outlook for medical compensation based on treatment outcomes. He welcomes the change.

He describes the current state of medicine as ranging from “very messy,” to “incompetent” and compares it to “playing Russian Roulette with your health.” This is the case because there is so little transparency and a large number of entrenched organizations that are committed to preservation of existing revenue streams.

He acknowledges that there are many issues to be worked out in defining outcomes and states that the industry is still “playing around the edges” in this regard. However, he predicts that “everything will change – how doctors get paid, when they get paid, who pays, and how much.”

Doctors, he states, have historically been paid as piece workers. Knowledge is passed down largely through apprenticeship. Healthcare organizations don’t have systematic management systems. While this allows some experimentation, it results in a lack of consistency of results. He points out that healthcare organizations do not have the kind of interdependent systems that other industries, such as aerospace and communications have developed.

He believes that the coming era of sweeping, technology-driven change can offer real benefits for consumers.

Donald Jones has spent over 30 years developing, founding and growing healthcare enterprises. He currently advises companies, governments and foundations on digital health with his expertise in wireless technologies, mobility and network effect for fitness, health and healthcare products, apps and therapies. For eleven years, through 2014, he served as Qualcomm’s Vice President of Wireless Health Global Strategy and Market Development.

Among his other previous affiliations: COO of MedTrans (now American Medical Response), the world’s largest emergency medical services provider and physician practice; founder and Chairman of EMME, Mexico’s largest member-based subscription health service; senior executive for HealthCap, which grew to become the second largest provider of women’s health in the US., founder of OnCall Medicine, a pioneer in modern medical house calls.

He is Chairman of the Wireless Life Sciences Alliance, which he co-founded and has numerous other affiliations with leading healthcare organizations.

Visit his website:

Photo by NEC Corporation of America with Creative Commons license.