On the pulse

How to improve the health of your brand: The West’s rapidly ageing population means that everyone from car makers to mobile phone networks is looking to create products that can reap rewards in the healthcare market.

  • Low-tech health: ZubaBox and African telehealth, click here to read a Q+A with Anja Ffrench, marketing and communications director Computer Aid, and Fred Mweetwa, chief executive, Macha Works.
  • Hi-tech health: Ford, click here to read a Q+A with Pim van der Jagt, managing director Ford Research Centre
  • Click here for an O2 Health case study

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In developed countries, populations are ageing and individuals are living with medical conditions for longer. This trend is creating a market for new kinds of healthcare services.

Many consumer and business brands are moving into the healthcare sector to take advantage of the opportunities. Some are adapting their existing technology and expertise to meet demand for innovations in health; others are seeking to change the way healthcare is delivered.

Companies better known for selling anything from cars to mobile phone contracts are now seeking to become known as providers of medical services and products. Ford, for example, is bringing health technology to its cars with the development of an electrocardiogram (ECG) seat that measures the heart rate of the driver without the need to wear any additional monitoring equipment.

Pim van der Jagt, managing director of the Ford Research Centre in Aachen, Germany, says this innovation was a strategic business decision made on the basis of substantial market research. “Health and wellness is the new area where people will spend a lot of money and have a lot of interest,” he says (see Q&A, below).

Van der Jagt notes that consumers’ lives are becoming busier, while Ford’s customers are getting older. The ECG seat aims to meet a very real demand for a product that would constantly check the health of the driver without taking time out of the person’s day to visit a doctor.

“A very large percentage of our customers are going to be above 65. Data shows that among people above 65 there is a significant percentage with some form of heart problem. These people want to monitor their heart rate and check they are in good condition,” says van der Jagt.

The seat is not yet on production lines, but should it be approved for installation in Ford’s cars, data would be collected by the vehicles using the car’s Sync entertainment system and transmitted wirelessly over the internet to a third-party organisation.

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Ford’s ECG seat could save drivers a trip to a health centre

Exactly what would then be done with the information is a matter still under consideration, along with other technical details that still need to be worked out. Van der Jagt says Ford is unlikely to provide real-time feedback to the driver. “If he is going full speed on the autobahn, you do not want to tell him he should go to the nearest hospital,” he says.

Meanwhile, Microsoft’s Xbox Kinect motion capture gaming device, usually part of a family’s video game entertainment system, is being used by surgeons at Sunnybrook Hospital in Toronto. The motion sensor technology allows doctors to use physical gestures to switch between medical images on a screen without leaving the sterile area of the operating room and scrub in again.

The American Optometric Association has also suggested that Nintendo’s 3DS portable games console and other 3D viewing technology could help to diagnose problems in the vision of young people.

As well as creating new products or repurposing existing ones with new medical applications, some consumer brands are repositioning themselves as providers of comprehensive health services.

O2 last year launched O2 Health (see case study, below), while Virgin paid £4m for a 75% stake in Assura Medical in March 2010, 18 months after pulling out of plans to open its own primary care centre in Swindon. Both companies work in partnership with the NHS to deliver care services and products both to the industry and directly to patients.

According to Gaurav Batra, corporate development director of Virgin Management, which determines the business strategy of Virgin Group, the new opportunities for consumer-driven brands exist because patients have new priorities in what they seek from their healthcare providers. The current political climate, which aims to decentralise NHS healthcare, also supports this.

Batra says: “In terms of policy and how we as a society are evolving, people want to take greater control over their healthcare. That means they want more information about it. It means they want to exercise greater choice about what their treatment is, who is going to treat them, where, how and when.”

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ZubaBox mobile health centres in remote parts of Africa let health workers show specialists any problems

He adds that companies such as Virgin can bring experience in customer service into the NHS, an organisation that he claims has been poor at providing this. The general aims of Virgin’s involvement in health are to ensure this customer-centric ethos improves patient care, shortens waiting times, brings care closer to home and saves taxpayers money.

Healthcare professionals may need convincing of this, if the opposition of some medical associations to the government’s NHS reforms is any indication. But O2 Health managing director Keith Nurcombe expects the splitting up of some NHS services to pick up pace, allowing more private companies and consumer brands to position themselves as healthcare providers.

As with Virgin’s Assura business, all of O2 Health’s marketing is currently targeted at medical professionals. In the second half of 2011, however, it will launch its first consumer-facing campaign to accompany the introduction of a new mobile alternative to the panic buttons given to frail people in their homes.

Private companies have been involved in delivering services within the UK health industry for many years, but this could mark the beginning of their rise to prominence as recognisable consumer brands.

Virgin, which already has a health incentives business in the US called Virgin Health Miles, is building its profile among medical professionals in the UK and Batra says that “over a period of time we will see a greater role for a brand director at the patient interface”, although no decision has yet been taken to rebrand Assura Medical under the Virgin banner.

He explains: “I think the time will come when the Virgin brand means as much as the Assura brand does today to those various groups. That will be the right time to go.”

Case study: O2 Health

O2, best known as a mobile telecoms brand, is moving further into healthcare. In the second half of this year, O2 Health will launch a mobile telecare product that will be available both to medical organisations and to patients themselves.

Similar to the panic buttons given by NHS care services to elderly people in their homes, O2’s new product will function wherever the client wishes to take it, says O2 Health managing director Keith Nurcombe. It will also be capable of setting up exclusion zones to warn them if intruders enter their homes and of allowing carers to track their movements through global positioning system technology.

Nurcombe says: “As well as the frail and elderly, we will focus on young people with long-term conditions, who may want a level of reassurance and security around them. Traditionally they would not have been covered in the way an elderly, frail person is by the local authority or health authority.”

Offering this kind of product directly to patients is part of O2 Health’s eventual strategy to become known as a consumer-facing health brand. Until now, all its marketing has been targeted at the industry – primary care trusts, hospitals and practitioners.

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At the heart of the NHS: O2 Health’s activities involve supplying technology to hospital and community staff

The brand launched O2 Health in July 2010. This provides services to the NHS and private healthcare companies. Though parent company Telefónica has identified what it believes to be a lucrative market, it has required a move into a completely new area for the O2 brand.

Nurcombe explains: “It came about from a considerable level of research, interest and market examination by Telefónica UK. That resulted in an opportunity and it was decided the best way to exploit that was to bring in a team of people with health expertise.”

A big part of O2 Health’s activities so far involves supplying the NHS with technology to make its hospital and community staff more efficient. Examples include a digital pen, which allows midwives to make handwritten medical notes that are then converted into digital data and transmitted by a mobile phone on to hospital record systems.

In line with NHS reforms newly passed by the coalition government, O2 Health’s proposition is now to focus on the choice and convenience of the patient by serving them both direct and in collaboration with the public sector. Nurcombe predicts that this new focus will stimulate an expansion of the role of consumer brands in UK healthcare.

“I think you are already seeing more consumer brands involved in health that previously perhaps would not have been. The market situation and the fragmentation that is happening in the NHS will probably accelerate rather than slow down.”

While Virgin’s Batra and O2 Health’s Nurcombe are clear on the motives for stretching their brands into new areas, it might take longer for British consumers to grasp the concept. Both would have to overcome the unfamiliarity in healthcare of consumer brands better known for telecoms or transatlantic flights.

Technology company HP, which is the largest IT provider in the healthcare sector worldwide according to director of global health Paul Ellingstad, prefers not to draw patients’ attention to its branding. “We are not displacing providers today. We are working with and enabling the healthcare providers,” he says.

HP’s marketing is directed towards communicating its use of technology in order to solve medical problems. Indeed, prior technological expertise is an area common to nearly all of the brands newly exploring health and wellness. It is also one where there is perhaps a natural basis for marketing healthcare brand extensions to consumers.

Van der Jagt says Ford, for example, already employs medical doctors for research to aid its ergonomic design, making sure its cars are comfortable and easy to use. So the expertise already exists in the company to explore other health-related applications for its technology. The ECG seat is just one of many developments to come about in this way, he says.

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The Ford ECG seat

Similarly, O2 Health makes significant use of the mother brand’s telecoms experience. It has recently tested a system in the Western Isles of Scotland that allows patients to have remote consultations with a GP rather than a hospital, which might be a boat or plane journey away.

Called Side by Side, the video-link system allows the consultant to show the patient information such as MRI scans, X-rays, blood tests and whiteboard diagrams that can be drawn on the screen. O2 Health’s Nurcombe says: “It is obviously a much better service for the patient because they do not have to travel so far. It is much more efficient for the NHS because the consultant’s time is better used. Ultimately, it delivers a significantly lower cost of care.”

Using technology to cut the costs of delivering healthcare is a growing area. Forty-two per cent of chief information officers in hospitals across North America, Europe and Australia expect to spend more on IT this year than last, compared with only 17% who expect a drop, according to consultancy Ovum.

Brands can also get involved in this world by helping consumers or organisations take more control of their health-related data through technology. One new company started for this purpose is Massive Health. The San Francisco start-up raised $2.25m (£1.35m) from venture capital in February, and intends to launch mobile apps that update consumers’ health data in real time. The model can be compared to the Nike+ iPhone app, which records data associated with joggers’ running routes, and Google Health, which acts as an online health record for users in the US.

Massive Health co-founder Aza Raskin, previously a developer for Mozilla’s Firefox web browser, says he wants the company to be “the Apple of healthcare”. Its apps will enable diabetics, for example, to monitor their condition with feedback on data entered. As a result, Raskin says, they will provide information to help patients live healthily, infrastructure for which is currently lacking in the medical profession.

The real problem with health is that your body does not give you the kind of feedback that you need. Technology can add a feedback loop.

“If you are going to your doctor once every six months or every year, it does not really tell you about a problem you are having that was caused by what you had for lunch three days ago. The real problem with health is not that you do not care, it is that your body does not give you the kind of feedback that you need to make decisions. Technology can start adding a feedback loop, so you see the effect immediately,” says Raskin.

While technology at the leading edge is opening up markets in the developed world, comparatively low-tech products are furthering healthcare in poorer countries. Simply establishing an internet connection in areas that have never had one before can have profound impacts on doctors’ ability to save lives. Brands are participating in this both through charities and their own business initiatives.

British charity Computer Aid takes old IT equipment from businesses and puts it to use in telehealth applications in remote parts of Africa. One product, the ZubaBox, consists of an old shipping container filled with monitors and an internet-enabled computer powered by solar panels. Corporate sponsors can put their name on the side, pick the destination from a list of projects and send volunteers (see Q&A, below).

One of the three ZubaBoxes so far sent out was received by Macha Works, a development organisation in the isolated and rural area of Macha in Zambia. According to chief executive Fred Mweetwa, there have been economic and social benefits to the connection with larger towns that the region’s health professionals now enjoy. For one thing, more doctors are encouraged to stay.

“Since the introduction of the internet in Macha and the surrounding areas in Zambia, a lot of lives have been saved. Communication has been a lot easier between and among health experts,” says Mweetwa.

HP has undertaken similar telehealth initiatives in Africa, not just as a charitable cause but as part of its social innovation division, which director of global health Paul Ellingstad says marries its social and business objectives. For example, HP’s Palm Pre 2 smartphones are being used by Botswana’s Ministry of Health to collect geographically tagged data on malaria outbreaks. Coupled with cloud-based analytical tools, the government can now respond to patterns of infection in hours rather than weeks, as was the case when paper-based notes were taken. After an initial one-year pilot, HP plans to develop a cloud-based health services package for consumers in Botswana.

Ellingstad says: “There are clearly commercial opportunities for HP and other companies in driving this tech transformation in the sector. But at the same time, by virtue of where the global health sector stands, and the use or lack of use of technology, there is also an enormous opportunity from the social impact side to see significant improvement in health outcomes by doing very fundamental tech implementation.”

In both the developed and developing world, new business models in health and wellness are coming into existence at an increasing rate. While the move by consumer brands into unfamiliar areas might initially seem unlikely, the technology and customer-centric ethos of these companies could shake up the global healthcare market.

While many companies might never have considered how their brands could help keep people well, it might be time to start doing so. The strategy could have extreme health benefits for their bottom line.

Q&A

Low-tech health: ZubaBox and African telehealth
Anja Ffrench, marketing and communications director Computer Aid, and Fred Mweetwa, chief executive, Macha Works

Marketing Week (MW): How can companies’ IT equipment benefit healthcare in Africa?

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Anja Ffrench (AF): In sub-Saharan Africa, there is an average of 12 doctors per 100,000 people, compared with Europe, which has 340 doctors per 100,000 people. So there is a massive shortage of specialists. One of our projects is to provide laptops, digital cameras and webcams to doctors in remote areas of Africa so they can take an X-ray or a photo of a wound and send it to a specialist in the capital city, who can diagnose how it needs to be treated.

We also work with the African Medical Research Foundation, which has put together an elearning programme to help nurses train from certificate to diploma level so they can deal with new and re-emerging diseases such as HIV/Aids, tuberculosis and malaria.

MW: What is the idea behind the ZubaBox that was supplied by Computer Aid to Macha in Zambia?

AF: ZubaBox came about because there are vast areas that do not have electricity. It is to enable us to reach the most rural, isolated and poor communities. It is basically a shipping container with 11 monitors above one computer, so it is low-power, with solar panels on the roof. It can be put in the middle of the desert so they can access the internet via a satellite link through solar power.

We have sent three so far – two to Zambia and one to Kenya. In Zambia, one is 50 miles from the nearest surfaced road. They cannot use mobile phones in that community. It is used by medical professionals who want to communicate with specialists and students.

MW: What problems has this helped overcome for healthcare in Macha?

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Fred Mweetwa (FM): Macha is 380km from the capital, Lusaka. Before the introduction of the internet, doctors did not want to come to Macha. After the internet was introduced, we have retained a lot of specialist doctors. One doctor has just finished his studies in America. If it was not for the internet, he would not have stayed in Macha.

The pharmacy department in Macha is now able to buy medicine online and go to Lusaka to collect it. Before the introduction of the internet, they had to go to Lusaka without knowing if the medicine was there. They would come back and wait for maybe three weeks, then go again to Lusaka only to find the medicine had been taken by other rural health centres or other hospitals.

MW: How has the technology affected Macha’s ability to tackle specific diseases?

FM: If someone is discovered to be HIV-infected, they give him a card and next time he comes, all the information about the history of the patient will be there on the computer. It has made life much easier. Before that there were books, and books are easily misplaced.

Right now in Macha, malaria has been kicked into touch. Malaria was a killer disease in Macha and the surrounding area, but because the experts who are doing research into malaria have access to the internet, they are able to communicate with their fellow researchers in America at Johns Hopkins University. If I am discovered with the malaria parasite then, before I suffer from malaria, they will start giving me the medicine.

MW: What does the future hold for ZubaBox?

AF: We would like to send 10 more over the next year and we are looking for companies to sponsor a ZubaBox. For £22,000 they can have their brand put on the side and can have it put in a country they are working in. Computer Aid asset-tracks every single piece of donated equipment that comes into our workshop, to show exactly where it goes in a developing country. A lot of companies like that because we can then provide them with feedback on exactly where equipment has gone. Brands can be involved as much as they want, so if they want to send out staff to do volunteering, we can even offer that.

Q+A

Hi-tech health: Ford
Pim van der Jagt, managing director Ford Research Centre

Marketing Week (MW): How did you identify a need for incorporating an electrocardiogram (ECG) seat into Ford cars?

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Pim van der Jagt (PvdJ): We do market studies and look at consumer trends – one of which is a focus on health and wellness. A lot of people spend a lot of time in a vehicle. We thought, how can we make better use of the time?

To sit down and have your heart rate measured will cost you 10 or 15 minutes. If you do it in the car – while you are doing another task – we think there is a market for that.

MW: Did the expertise to develop the technology already exist within Ford?

PvdJ: We have medical doctors in our research centre who work on ergonomics. They have been looking at what else we can bring to the vehicle that could interest the customer. The ECG seat is only one development. There was an idea that came from the medical institute at Aachen University of how we could do contactless heart rate measurement. We tried it out in a seat and, though we have not sorted out all the technical details, if we get it to work, we think there will be an interest.

MW: What will happen to the data collected by the ECG seat?

PvdJ: The car can be pre-programmed to collect the data, so you just get in and have the analysis done. We have no plans to do that analysis ourselves. We will record the data and transmit it to another commercial company that can do the analysis and send reports back.

That is still an open research point. If you measure some critical data, how do you inform the driver? We need to do customer clinics and studies to work that out. We do not want to show them their heart rate while driving.

MW: How reliable is the technology?

PvdJ: We tried it with more than 200 people. It works 95% of the time. If we want to offer it commercially it needs to work 100% of the time. We cannot sell an expensive feature to a customer and find it does not work in his case.

If we cannot get it to work 100% reliably, there are other options, like putting on a wristwatch available from medical equipment suppliers like Siemens. Our new entertainment system, Sync, has an open interface, so for us it is very easy to connect these devices to our entertainment system, transfer data outside to the internet and to other companies.

MW: How does technology provide marketing opportunities in areas such as healthcare?

PvdJ: With Sync you can download apps, just like you do on an iPad. We are thinking what apps could be of interest to a driver, such as an app that informs drivers with allergies about air quality, which we hope to make available soon. They are capabilities we already have and we are applying them to a new area.

Not every app available on an iPad can be brought into the car. Very often the interface is not suited to use in a car. That is the main part of our work – getting a lot of the software and features available in a form that can be safely used in a vehicle. It is a reason to buy our car over another car. Then if people do buy our car, we would like to sell them more features and more apps so they can customise that vehicle.