Evaluating mHealth Adoption Barriers: Human Behaviour

Vodafone mHealth Solutions

Insights Guide

mhealth.vodafone.com

Vodafone mHealth Solutions 3

Vodafone mHealth Solutions Insights Guide

Welcome !"#$%&"'(%'%)*'+*,('-".#(/'0"1.("'2)1#3$.(3%4'5'(/"'64,37/(,'8)39":';)*'.3&'3,'(%'2*%<39"',%&"'"<39"4$"=1.,"9',(3&)#),'(/.('>3##'"4$%)*.7"'.##'(/%,"'>%*?347'in the different areas of healthcare to consider the 344%<.(3%4'%22%*()43(3",'(/.('.*"'4%>'.<.3#.1#"'(%'(/"&:'!"'1"#3"<"'(/.('*".#'2*%7*",,'$.4'%4#@'1"'343(3.("9'>/"4'.##',(.?"/%#9"*,'#%%?'1"@%49'(*.93(3%4.#'/%*3A%4,'.49'share ideas that challenge the status quo so that together >"'$.4'39"4(3B@'4">'>.@,'%B'.99*",,347'$)**"4('3,,)",:'

C/"'%2343%4,'"D2*",,"9'34'(/3,'9%$)&"4('.*"'4%('%)*,'1)('(/"@'.*"'(/%,"'%B'349"2"49"4('"D2"*(,'>/%,"'<3">,'>"'*",2"$('5'"<"4'3B'>"'9%4E('.#>.@,'.7*""'>3(/'(/"&:'6'(/.4?' (/"&'B%*'(/"'(3&"'.49'"BB%*('(/"@' /.<"'34<",("9'34'"D2#%*347'(/3,'(%23$:' 6'1"#3"<"'(/"@'/.<"'3&2%*(.4('(/347,' (%',.@'(/.(',/%)#9'1"'%B'34("*",('(%'.4@%4"'$%4$"*4"9'>3(/'(/"'#%47=("*&'B)()*"'%B'(/"'/".#(/$.*"'349),(*@:

!"'/%2"'(/3,'9%$)&"4('$.4'%BB"*'@%)',%&"'34,37/(,'(/.('>3##'2*%<39"'(/"'3&2"(),'(%'7"4"*.("'2%,3(3<"'$/.47":'6('3,'(/"'+*,('%B'.',"*3",'.49'>"'#%%?'B%*>.*9'(%'/".*347'@%)*'*",2%4,"'(%' our ideas in the months to come.

FD"#'G"&"(AHead of Vodafone mHealth Solutions

C/"'H%9.B%4"'-".#(/'0"1.("',"*3",'3,'2.*('%B'%)*'$%4(34)347'$%&&3(&"4('(%'(/%)7/('#".9"*,/32'34'/".#(/$.*":'6('1*347,'(%7"(/"*',"43%*'2/.*&.I'2)1#3$'.49'2*3<.("'/".#(/',(.?"/%#9"*,'(%'#".*4I',/.*"'.49'9"1.("'%4'3,,)",'.49'4">'(/34?347'1*%)7/('B%*>.*9'1@'*"4%>4"9'(/%)7/('#".9"*,'.49'349),(*@'"D2"*(,:

Vodafone mHealth Solutions 4

Vodafone mHealth Solutions Insights Guide

Table of contents3 Welcome

4 C.1#"'%B'$%4("4(,

5 J$%2"'.49'9"+43(3%4,

6 !/.('2.(3"4(,'.49'/".#(/$.*"'2*%B",,3%4.#,',.@

8 F4'%<"*<3">'%B'&-".#(/'%22%*()43(@

10 K<.#).(347'1"/.<3%)*'(%'&.*?"("9' mHealth services

14 F9%2(347'("$/4%#%7@L')49"*,(.49347'(/"' $/.##"47",'B%*'/".#(/$.*"'2*%B",,3%4.#,

16 M49"*,(.49347'/".#(/'2,@$/%#%7@' .49'(/"',$3"4$"'%B'1"/.<3%)*

26 Vodafone mHealth Solutions

26 References

Vodafone mHealth Solutions 5

Vodafone mHealth Solutions Insights Guide

Scope and !"#$%&%'$(

N''&-".#(/L'.22#3$.(3%4'%B'&%13#"'.49'4"(>%*?'("$/4%#%73",'(%'3&2*%<"'/".#(/$.*"'%)($%&",'%*'"B+$3"4$3",O' P%*'(/"',$%2"'%B'(/3,'*"2%*(I'>"' B%$),'%4'2.(3"4('.49'/".#(/$.*"'2*%B",,3%4.#'$"4(*"9'&-".#(/',"*<3$",'including remote care and healthcare 2*%B",,3%4.#'&%13#3,.(3%4

N''&-".#(/',"*<3$",L'34$#)9",'.4@',%B(>.*"I'/.*9>.*"I'.49',"*<3$",'*"Q)3*"9'(%'&.?"'(/"'"49=(%="49'&-".#(/',%#)(3%4

N''R.(3"4(,L'34$#)9",'1%(/'$%4,)&"*,' 3:":'S/".#(/@T'3493<39).#,I'.49'2"%2#"' >3(/'.'#%47'("*&'%*'.$)("'$%493(3%4'

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Vodafone mHealth Solutions 6

Vodafone mHealth Solutions Insights Guide

What patients and healthcare professionals say

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W"B%*"'.4.#@,347'(/"'$/.47347'.((3()9",'(%>.*9,' &-".#(/'343(3.(3<",I'H%9.B%4"'$%&&3,,3%4"9'*",".*$/1 34'%*9"*'(%'1"(("*')49"*,(.49'(/"'$)**"4('.22*%.$/'(%'/".#(/$.*"'9"#3<"*@'.&%47,('/".#(/$.*"'2*%B",,3%4.#,' .49'(/"3*'2.(3"4(,:'

Stakeholder Group What they want from mHealth

Specialists C%'/"#2'&.4.7"'9.(.'.49'&.?"'(/"'1",('),"'%B'("$/4%#%7@

GPs C%'"&2%>"*'(/"3*'2.(3"4(,'.49'/"#2'(/"&'&.4.7"'$/*%43$'diseases

Nurses C%'.$$",,'34,(*)$(3%4.#'34B%*&.(3%4'%*'2.(3"4('9"(.3#,'%4=(/"=7%

Pharmacists C%'/"#2'(/"&'&.4.7"'2.(3"4('2*",$*32(3%4,I'"4,)*"'.$$)*.$@'.49'/"#2'>3(/'2.(3"4('$%&2#3.4$"

Patients C%'1"(("*'&.4.7"'.49'(*.$?'(/"3*'3##4",,",

Table 1 What HCPs and Patients say

What patients have to say R.(3"4(,'$.4',""'(/"'1"4"+('%B'&-".#(/'1"$.),"'3&2*%<"9'.$$",,'(%'34B%*&.(3%4'"4.1#",'(/"&'(%'1"$%&"'&%*"'.$(3<"#@'34<%#<"9'34'(/"3*'%>4'$.*":'C/3,'3,'2.*(3$)#.*#@'(*)"'B%*'(/%,"'>3(/'$/*%43$'$%493(3%4,',)$/'.,'93.1"(",'%*'/37/'1#%%9'

2*",,)*":'X%13#"'("$/4%#%7@'$.4'/"#2'them to monitor their condition outside .'/%,23(.#'"4<3*%4&"4(:'6('&".4,'&%*"'2"%2#"'$.4'"4Y%@'.'4%*&.#'#3B"'1)('$.4'*".$(',>3B(#@'(%'*"$"3<"'(*".(&"4(',/%)#9'the need arise.

Vodafone mHealth Solutions 7

Vodafone mHealth Solutions Insights Guide

What healthcare professionals have to sayC/"'&.Y%*3(@'%B'/".#(/$.*"'2*%B",,3%4.#,',""'(/"'.9<.4(.7",'%B'&-".#(/'1)('>3(/34'(/"',"$(%*'93BB"*"4('"&2/.,3,'3,'73<"4'(%'93BB"*"4('"#"&"4(,:'P%*'"D.&2#"I'4)*,",'.49'8R,'.*"'&%,('$%4$"*4"9'>3(/'3&2*%<347'2.(3"4('$%&2#3.4$":'8R,'.#,%',""'(/.('&-".#(/'("$/4%#%7@'$.4'*"9)$"')44"$",,.*@'2.(3"4('<3,3(,'.49'(/"*"B%*"'$)('$%,(,:'G)*,",'%4'(/"'

%(/"*'/.49'1"#3"<"'(/.('&-".#(/'343(3.(3<",'&.@'>"##'*"9)$"'.9&343,(*.(3%4'(3&"I'>/3$/'>3##'34'()*4'.##%>'(/"&'(%',2"49'&%*"'(3&"'$.*347'B%*'(/"3*'2.(3"4(,:''P34.##@',2"$3.#3,(,'.49'2/.*&.$3,(,'1"#3"<"'(/.('&-".#(/',%#)(3%4,'$.4'3&2*%<"'$%&&)43$.(3%4' >3(/'8R,',%'(/.('(/"@'$.4',/.*"'93.74%,3,'.49'#".*4347E,'&%*"'"BB"$(3<"#@:

-"*"'3,'>/.('(/"@'/.<"'(%',.@L'

0",23("'(/3,'"4(/),3.,&'&-".#(/'.9%2(3%4'/.,'4%('1""4',$.#"9'.,'&)$/'.,'%4"'>%)#9'/.<"'"D2"$("9:'J)1,"Q)"4('"93(3%4,'%B'(/"'H%9.B%4"'64,37/(,'8)39"'>3##'"D2#%*"'%(/"*'*".,%4,'B%*'(/3,'34'&%*"'9"(.3#'1)('/"*"I'34'(/"'+*,('%B'(/"',"*3",I'>"'>3##'B%$),'%4'>/.(',%&"'>%)#9'.*7)"'3,'(/"'&.34'1.**3"*'(%'(.?"')2'5'/)&.4'1"/.<3%)*:'

Improving quality of life

ZFB("*'6'+*,('/.9'&@'+*,('/".*('.((.$?' B%*'(/"'(/*""'>""?,'1"(>""4'(/"'+*,(' %4"'.49'(/"',"$%49'%4"'6'/.9'(%'(.?"' &@'1#%%9'2*",,)*"'/.#B'.'9%A"4'(3&",'.'9.@'.('(/"'9%$(%*E,'%B+$"I'.49'6'$%)#9'/.<"'Y),('),"9'&@'2/%4"'(%'*"$%*9'3('.('/%&"'34,(".9E'

U.*93.$'R.(3"4(I'M['

Reassurance

Z64'&@'/%,23(.#'7*%)2I'>"'7"('34'(%)$/'%<"*'(/"'64("*4"(:'C/"*"E,',%&"%4"'(/"*"'(%'.4,>"*'@%)*'Q)",(3%4,'\]'/%)*,'.'9.@I' either a doctor or a nutritionist. I can do 3('B*%&'/%&"'%*'>%*?I'.49'3('73<",'&"'2".$"'%B'&349:E'

03.1"(3$'R.(3"4(I'J2.34

Discretion

Z6'9%4E('>.4('%(/"*'2"%2#"'(%'B""#',%**@'B%*'&"'1"$.),"'6E&'.'93.1"(3$I',%'6'9%4E('>.4(I'3B'6'(.?"'%)('.'$"##'2/%4"I'"<"*@%4"' (%'?4%>'Z%/I'(/"'2%%*'7)@'3,'.'93.1"(3$:E'

03.1"(3$'R.(3"4(I'J%)(/'FB*3$.

Caring for patients

Z6('>%)#9'1"'43$"'(%'1"',.('>3(/'(/"'2.(3"4('.49'/.<"'.'2/%4"'(%'*"73,("*'>/.('@%)E*"'9%347I'>/.('@%)E<"'9%4"I' and have that recorded and logged. 6(',/%)#94E('1"'.'4)*,347'Y%1I',/%)#9'3( ̂'6('(.?",'.1%)('(>%'/%)*,'.'9.@' >*3(347'(/"'4%(",:E

G)*,"I'M[:

Improved communication between professionals

Z&-".#(/'>3##'1"'.4'.99"9'<.#)"'1"$.),"'(/"'7"4"*.#'2*.$(3(3%4"*'>3##'#".*4'.1%)('93BB"*"4('2.(/%#%73",'1@'*"$"3<347' 34B%*&.(3%4'B*%&'(/"',2"$3.#3,"9'9%$(%*:E'

J2"$3.#3,(I'J2.34

C/"'B%##%>347'Q)%(.(3%4,'.*"'"D.&2#",'%B'(/"'&.34'1"4"+(,'>/3$/'>"*"'/37/#37/("9:

Vodafone mHealth Solutions 8

Vodafone mHealth Solutions Insights Guide

An overview of mHealth opportunity

C/"'&-".#(/'&.*?"('3,',(3##'<"*@'@%)47'/%>"<"*'3('3,'$#".*'(/.('(/"'%22%*()43(@'B%*'("$/4%#%7@'9*3<"4'/".#(/$.*"'3,'(/*3<347'as a result of a changing healthcare "4<3*%4&"4(:'V"&%("I'34("##37"4('&%43(%*347'.49'93.74%,3,'B%*'"D.&2#"I'/.,'(/"'2%("4(3.#'(%'"4/.4$"'Q).#3(@'%B'#3B"I'3&2*%<"'/".#(/$.*"'"B+$3"4$@'.49'%BB,"('1)*7"%4347'/".#(/$.*"'$%,(,'B*%&'.'7*%>347I'.7"347'.49'34$*".,347#@'%1","'2%2)#.(3%4:

64'.'>.@I'>"'.*"'<3$(3&,'%B'%)*'%>4',)$$",,'.49'1@'*"9)$347'(/"'$.),",'%B'9".(/'&.4@'&%*"'2"%2#"'.*"'4%>'#3<347'34(%'.7"'1.49,'(/"'>%*#9'/.,4E('"D2"*3"4$"9'1"B%*"'5'>/"*"'(/"@'4""9'&%*"'$.*"'5'.49'&%*"'"D2"4,3<"'$.*":'-".#(/$.*"',"*<3$",'.*%)49'(/"'>%*#9'.*"'(/"*"B%*"')49"*'2*",,)*"'(%'34$*".,"'(/"'Q).#3(@'%B'$.*"'(%'2.(3"4(,'.('.'(3&"'>/"4' (/"'7#%1.#'2%2)#.(3%4'3,'.7347I'(/"'1)*9"4' of chronic disease is rising and the economic $%493(3%4,'.*"'$/.##"47347:'64'K)*%2"I'B%*'"D.&2#"I'(/"'%<"*=_`,I'>/%,"'/".#(/$.*"'$%,('1)*9"4'3,'B%)*'(3&",'(/.('%B'@%)47"*'.7",I'>3##'.$$%)4('B%*'.('#".,('\`a'%B'(/"'2%2)#.(3%4'1@'\b]b\:'F#%47,39"'(/3,I')4/".#(/@'#3B",(@#"'$/%3$",',)$/'.,' ,&%?347'.49'2%%*'93"(I'(/"'34$*".,347'*3,?' %B'.49'$%4$"*4'.*%)49'(/"'2%("4(3.#'3&2.$('%B'2.49"&3$'93,".,",I'(/"'#3&3("9'4)&1"*'.49')4"<"4'93,(*31)(3%4'%B'/".#(/$.*"'>%*?"*,I'2%%*'9*)7'93,(*31)(3%4'.49'(/"'#"47(/@'9"<"#%2&"4('$@$#",'%B'4">'&"93$34",'.*"'$%&134347'(%'&.?"'(/"'$%,('%B'/".#(/$.*"'.#&%,(')4,),(.34.1#"'2.*(3$)#.*#@'34'&.()*"'&.*?"(,:'

64'.993(3%4I'&.4@'/".#(/$.*"'2*%<39"*,'34'9"<"#%2"9'&.*?"(,'.*"'"4$)&1"*"9'1@'#"7.$@'34B*.,(*)$()*",'(/.('/.<"'1""4')4.1#"'(%'.9.2('(%'&""('(/"'$/.47347'4""9,'%B'(/"'<"*@'2"%2#"'(/"@'>"*"'9",374"9'(%'2*%("$(:'J&.##'>%49"*'(/.('&.4.7"&"4('$%4,)#(.4(,'X$[34,"@'2*"93$('(/.('3B'#"B('.,'3('3,I'/".#(/$.*"'$%,(,'$%)#9'*".$/'cb'2"*'$"4('%B'80R'1@'\b]b:'C/"';KU0'3,'4%('B.*'1"/349'>3(/'$%,(,'*".$/347'cb'2"*'$"4('%B'(/"'&"93.4'80R'1@'\bdb:'64'"&"*7347'&.*?"(,',)$/'.,'FB*3$.'>/"*"'.9)#('&%*(.#3(@'*.(",'.*"'%<"*']bb'2"*'eIbbb'2%2)#.(3%4,I'.#%47,39"'$%,(I'#.$?'%B'34B*.,(*)$()*"I'#3&3("9'.$$",,'(%'(*".(&"4(,'.49'2%%*'Q).#3(@'&"93$34",'.*"'(/"'$%*"'/".#(/$.*"'2*%1#"&,:'

f%%?347'./".9'3('3,'/%2"9'(/.(',&.*("*'("$/4%#%73",'>3##'/"#2'(%'3&2*%<"'$%&&)43$.(3%4,'1"(>""4'2.(3"4(,I'/".#(/$.*"'2*%<39"*,'.49'(/%,"'(/.('2.@'.49'&.4.7"'(/"',@,("&:'F,'.'*",)#('(/3,'/.,'(/"'2%("4(3.#'(%'3&2*%<"'2.(3"4('B*""9%&'.49'349"2"49"4$"I'*"9)$"'(/"'%<"*.##'$%,('.49'3&2*%<"'2.(3"4('$.*":'C/3,'<3">'3,',)22%*("9'1@'X$[34,"@'(/.('",(3&.(",'(/.('(/"'("#"=/".#(/'%*'&-".#(/'349),(*@'>3##'1"'>%*(/'%<"*'MJ'g`b'13##3%4'1@'(/"'"49'%B'(/"'9"$.9":

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

By Dr Tim JonesI'P%)49"*'.49'R*%7*.&&"'03*"$(%*'%B'P)()*"'F7"49.I'.'7#%1.#'%2"4'B%*",37/('343(3.(3<"'

Vodafone mHealth Solutions 9

Vodafone mHealth Solutions Insights Guide

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Vodafone mHealth Solutions Insights Guide

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Figure 1 The common attributes of successful mHealth services

IMPACTENGAGEMENT

ADOPTION

Simplicity Empathetic design

Comprehensiveness

InteractiveCustomer delight

User valueJoined-up solutions

Clincal and economic results

Vodafone mHealth Solutions 11

Vodafone mHealth Solutions Insights Guide

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Vodafone mHealth Solutions Insights Guide

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Vodafone mHealth Solutions 13

Vodafone mHealth Solutions Insights Guide

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Vodafone mHealth Solutions 14

Vodafone mHealth Solutions Insights Guide

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innovation in life sciences

Adopting technology: understanding the challenges for healthcare professionals

Vodafone mHealth Solutions 15

Vodafone mHealth Solutions Insights Guide

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J(.49.*9'/".#(/$.*"'2*.$(3$"'3,',%&">/.('93BB"*"4('(%'(/3,:'64'9"<"#%2"9'"$%4%&3",'$%&&%4'2*.$(3$"'3,'(%'*"#@'%4'*"3&1)*,"&"4('B*%&'(/"'7%<"*4&"4(I'34'>/3$/'$.,"'(/"'("$/4%#%7@'3,'$%4,39"*"9'l4".*#@m'B*""'B%*'(/"'"49'),"*:'64'&%,('$%)4(*3",I'9%$(%*,'.*"'2.39'1.,"9'%4'(/"'4)&1"*'%B'2.(3"4(,'(/"@'(*".('%*'&""('in the consulting room. If doctors are *">.*9"9'34'(/3,'>.@'3('3,'<"*@'$#".*'>/@'(/"@'.*"'*"(3$"4('34'.9%2(347'("$/4%#%73",'(/.('*"9)$"'B.$"=(%=B.$"'34("*.$(3%4,:'P*%&'(/.('2"*,2"$(3<"I'349""9L'!/.('(%'(/"&'3,'(/"'1"4"+('%B'*"&%("'&%43(%*347^' An interesting recent initiative from F),(*.#3.')49"*,$%*",'(/"'3&2%*(.4$"'%B'*"3&1)*,"&"4(h34$"4(3<",'34'(/"'.9%2(3%4'%B'4">'("$/4%#%73",L',34$"'j)#@'\bee'.49'B%*'(/"'4"D('B%)*'@".*,I'(/"'F),(*.#3.4'7%<"*4&"4('3,'.$(3<"#@'2*%&%(347'("#"/".#(/'1@'2*%<39347'1%4),",'(%'/".#(/$.*"'2*%B",,3%4.#,'(/.('.9%2('("#"/".#(/'("$/4%#%7@'.49'(/.('2.*(3$32.("'34'<39"%=$%4,)#(,'>3(/'2.(3"4(,:

U*%,,347'(/"'l&-".#(/m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

Vodafone mHealth Solutions 16

Vodafone mHealth Solutions Insights Guide

Understanding health psychology and the science of behaviour

Introduction-.<347'"<.#).("9'.'4)&1"*'%B'&-".#(/',"*<3$",'%4'(/"'1.,3,'%B',)$$",,'34'),"*'.9%2(3%4I'(/3,'#.,(',"$(3%4'%B'(/"'*"2%*('.3&,'(%'$%4("D().#3,"'(/"'$)**"4(',(.("'of mHealth through relevant academic #3("*.()*"'%4'),"*'.9%2(3%4'1"/.<3%)*:

C/"*"'3,'.'7*%>347'$%*2),'%B'#3("*.()*"'9%$)&"4(347'(/"'9"<"#%2&"4('%B'93BB"*"4('mHealth technologies. Alongside technical .,2"$(,I'93,$),,3%4,'"D2#%*"'3,,)",'%B'93,,"&34.(3%4'.49'3&2#"&"4(.(3%4I'.49'(/"*"'/.<"'1""4'.'4)&1"*'%B'2*"#3&34.*@'"<.#).(3%4,'34'("*&,'%B'3&2.$('%4'/".#(/'%)($%&",I'2.(3"4(',.(3,B.$(3%4'.49'1"/.<3%)*'$/.47":'!/.('3,'#.*7"#@'.1,"4('B*%&'(/"'2)1#3,/"9'#3("*.()*"I'/%>"<"*I'3,'*37%*%),'*",".*$/'%4'(/"'2*%$",,'%B')2(.?"'.49'.9%2(3%4'%B'&-".#(/'B*%&'(/"'2"*,2"$(3<"'%B'1%(/'(/"'2.(3"4('.49'/".#(/$.*"'2*%<39"*:'64'(/3,',"$(3%4I'(/"*"B%*"I'>"'.99*",,'(>%'&.34'Q)",(3%4,L

N''!/.('"D3,(347'(/"%*3",'.49'*",".*$/'$.4'1"'),"9'(%'"D2#.34'.9%2(3%4'1"/.<3%)*'%B'("$/4%#%73",'%B'/".#(/^'

N''!/.('$%4,(3()("'(/"'&.34'1.**3"*,'(%'&-".#(/'.9%2(3%4^

Existing theories-".#(/=*"#.("9'1"/.<3%)*'3,'/37/#@'$%&2#"D'and efforts to understand and account B%*'3493<39).#'.49'$%##"$(3<"'1"/.<3%)*'and its determinants continue across &)#(32#"'93,$32#34",:'0*.>347'%4'(/"%*"(3$.#'B*.&">%*?,'B*%&'.4(/*%2%#%7@I'/".#(/'2,@$/%#%7@I',%$3%#%7@'.49'$)#()*.#'

"239"&3%#%7@I'(/"'B%##%>347'2*","4(,'.'1*3"B'%)(#34"'%B',"#"$("9'(/"%*3",'%B'1"/.<3%)*'.,'(/"@'*"#.("'(%'/".#(/$.*"'2*.$(3$",'.49'/".#(/',@,("&'*",2%4,":

The Health Belief Model P3*,('9"<"#%2"9'34'(/"'ep`b,'1@',%$3.#'2,@$/%#%73,(,'-%$/1.)&I'V%,"4,(%$?'.49'["7"#,e\IecI'(/3,'&%9"#'.(("&2(,'(%'"D2#.34'.49'2*"93$('/".#(/'1"/.<3%)*,'1@'B%$),347'%4'(/"'.((3()9",'.49'1"#3"B,'%B'3493<39).#,:'C/"'&%9"#'3,',(*)$()*"9'.*%)49'B%)*'?"@'$%4$"2(,'>/3$/'.$$%)4('B%*'.4'3493<39).#E,'*".934",,'(%'.$(L

N'2"*$"3<"9',),$"2(313#3(@'N'2"*$"3<"9',"<"*3(@'N'2"*$"3<"9'1"4"+(,'N'2"*$"3<"9'1.**3"*,

F993(3%4.#'$%4$"2(,I'$)",'(%'.$(3%4'.49',"#B="B+$.$@I'>"*"'#.("*'.99"9'(%'/"#2'(/"'-".#(/'W"#3"B'X%9"#'.99*",,'/.13().##@')4/".#(/@'1"/.<3%)*,',)$/'.,',&%?347I'%<"*".(347'.49'1"347',"9"4(.*@'l$%493(3%4,'(/.('&-".#(/'("$/4%#%73",'/.<"'.99*",,"9m:'W"#3"B'.49'/".#(/'&%(3<.(3%4'.*"',""4'(%'1"'$%493(3%4"9'1@',%$3%=9"&%7*.2/3$'<.*3.1#",'.49'(/"'2,@$/%#%73$.#'$/.*.$("*3,(3$,'%B'(/"'3493<39).#:'C/"'&%9"#'/.,'1""4'),"9'"D("4,3<"#@'34'9"("*&34347'/".#(/'2*%&%(3%4'.$(3<3(3",14:'-%>"<"*I'3('B.3#,'(%'34$%*2%*.("'B".()*",',)$/'.,'(/"'34i)"4$"'%B'2*"<3%),'"D2"*3"4$"I'.9<.4(.7",'%B'&.#=.9.2(3<"'1"/.<3%)*I'1"/.<3%)*.#'34("4(3%4'.49'2"*$"3<"9'$%4(*%#:

By Dr Juliet BedfordI'P%)49"*'.49'03*"$(%*'%B'F4(/*%#%73$.I' .'*",".*$/'1.,"9'$%4,)#(.4$@'+*&',2"$3.#3,347'34'(/"'.22#3"9'.4(/*%2%#%7@'%B'/".#(/$.*"

Vodafone mHealth Solutions 17

Vodafone mHealth Solutions Insights Guide

Theory of Planned Behaviour F4'"D("4,3%4'%B'(/"'C/"%*@'%B'V".,%4"9'F$(3%4I'B%*&)#.("9'1@'FYA"4'.49'P3,/1"34'34'epnb15I'>/3$/',%)7/('(%'",(3&.("'(/"'93,$*"2.4$@'1"(>""4'.((3()9"'.49'1"/.<3%)*I'(/"'C/"%*@'%B'R#.44"9'W"/.<3%)*'l.#,%',""'+7)*"'\m16'2*"93$(,'9"#31"*.("'1"/.<3%)*.#'34("4(3%4'),347'(/*""'$%4,(*)$(,L'1"/.<3%)*.#'1"#3"B,I'4%*&.(3<"'1"#3"B,'.49'$%4(*%#'1"#3"B,:'

N''W"/.<3%)*.#'1"#3"B,'l.((3()9",'(%>.*9,'(/"'1"/.<3%)*m'.*"'9"("*&34"9'1@'(/"'4%(3%4'(/.('.',2"$3+$'1"/.<3%)*'>3##'/.<"'a concrete consequence.

N''G%*&.(3<"'1"#3"B,'l(/"',)1Y"$(3<"'4%*&m'.*"'$%4$"*4"9'>3(/'<3">,'.1%)('/%>'2"%2#"'5'(/"'3493<39).#E,',%$3.#'4"(>%*?'5'>3##'*"7.*9'(/"'1"/.<3%)*'34'Q)",(3%4I'2#),'2"*,%4.#'&%(3<.(3%4'(%'B)#+#'(/"'"D2"$(.(3%4'%B'%(/"*,:'

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Healthcare Utilisation Model0"<"#%2"9'1@'F49"*,%4'.49'G">&.417 34'(/"'epdb,I'(/3,',%$3%=1"/.<3%)*.#' &%9"#'7*%)2,'(/*""'$#),("*,'%B'B.$(%*,' (/.('$.4'34i)"4$"'/".#(/'1"/.<3%)*'34'.'#%73$',"Q)"4$"L'

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C/3,'&%9"#'>.,'9"<"#%2"9'(%'34<",(37.("'(/"'),"'%B'13%&"93$.#'/".#(/',"*<3$",I'.#(/%)7/'#.("*'<"*,3%4,'>"*"'"D("49"9' to include other healthcare sectors18. 6('$"4(*",',2"$3+$.##@'%4'(*".(&"4(',"#"$(3%4'.49'34$#)9",'1%(/'&.("*3.#'.49'#%73,(3$.#'B.$(%*,'(/.('.*"'4%('B)##@'.$$%)4("9'B%*'34'%(/"*'&%9"#,:'[*%"7"*19 "#.1%*.("9'(/"'&%9"#'(%'34$#)9"'/".#(/',"*<3$"',@,("&'B.$(%*,I'*"B"**347'(%'(/"',(*)$()*"'%B'(/"'/".#(/$.*"',@,("&'.49'3(,'#34?'(%'(/"',%$3%=2%#3(3$.#'&.$*%="$%4%&@'34'>/3$/'3('%2"*.(",:'C/"'.9<.4(.7"'%B',%$3%=1"/.<3%)*.#'&%9"#,'3,'(/"'<.*3"(@'%B'B.$(%*,I'%*7.43,"9'34(%'$.("7%*3",I'(/.('&.?"'34("*<"4(3%4,'B%*'(/"*.2")(3$'.$(3%4'l%*'#.$?'%B'3(m'B".,31#":'6('2"*&3(,'(/"'",(.1#3,/&"4('%B'$%**"#.(3%4,'>3(/'7%%9'2*"93$(.13#3(@I'1)('4%(',2"$3+$.(3%4'%B'/%>'.49'>/@'(/"'93BB"*"4('B.$(%*,'.BB"$('(/"*.2")(3$',"#"$(3%4:

Behaviouralattitude

Subjectivenorms

Perceived behavioural

control

Intention Behaviour

Figure 2 Theory of Planned Behaviour

Vodafone mHealth Solutions 18

Vodafone mHealth Solutions Insights Guide

Social Cognitive TheoryP*%&'(/"'ep_b,'%4>.*9,I'W.49)*.\b'has 9"<"#%2"9',%$3.#'$%743(3<"'(/"%*@'(%'"D2#.34'/%>'2"%2#"'.$Q)3*"'.49'&.34(.34'$"*(.34'1"/.<3%)*.#'2.(("*4,:'W.,"9'%4'(/"'".*#3"*'C/"%*@'%B'J%$3.#'f".*4347\e'

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(/"%*3",'l>/3$/'2#.$"'.4'3493<39).#'.#%47'.'$%4(34))&'%B'.$(3%4'#3?"#3/%%9mI'Z,(.7"9E'(/"%*3",I',)$/'.,'(/"'C*.4,(/"%*"(3$.#'X%9"#'%B'W"/.<3%)*'U/.47"'l.#,%',""' +7)*"'cm\_'/.<"'.*3,"4'B*%&'9%)1('(/.('#34".*'&%9"#,'.*"'B)##@'$.2.1#"'%B'$.2()*347'(/"'$%&2#"D'2*%$",,",'(/.(')49"*#3"'9"$3,3%4,'(%'"47.7"'34'/".#(/'1"/.<3%)*,\d.

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C%')49"*,(.49'1"/.<3%)*'.,,%$3.("9'>3(/'(/"'.9%2(3%4'%B'("$/4%#%73",'%B'/".#(/I'>"'4""9'(%'%<"*#.@'(/"%*3",'9"*3<"9'B*%&',%$3.#'.49'1"/.<3%)*.#',$3"4$"I'>3(/'(/"%*3",'%B'),"*'"47.7"&"4('9*.>4'B*%&'(/"'+"#9,'%B'64B%*&.(3%4'U%&&)43$.(3%4'.49'C"$/4%#%7@:

Stage 4: ACTIONDedicates considerable time and energy; make

overt and viable changes; developes strategies to

deal with barriers

Stage 1: No intention to change, often unaware of the problem

Stage 2: CONTEMPLATIONAware the problem exists and serious evaluation of options but not committed to take action

Stage 3: PREPARATIONIntends to take action and makes small changes; needs to set goals and priorities

Stage 6: EVALUATIONAssessment and feedback to continue dynamic change process

Stage 5: ADAPTATION / MAINTENANCEWorks to adapt and adjust to facilitate maintenance of change

Stage 3: PREPARATION

Intends to take action and makes small changes;

needs to set goals and priorities

Stage 2: CONTEMPLATION

Aware the problem exists and serious evaluation

of options but not committed to

take action

Stage 1: No intention to

change, often unaware of the problem

Stage 6: EVALUATION

Assessment and feedback to continue dynamic

change process

Stage 5: ADAPTATION / MAINTENANCE

Works to adapt and adjust to facilitate maintenance

of change

PRE-CONTEMPLATION

Figure 3 Transtheoretical Model of Behaviour Change

Vodafone mHealth Solutions 19

Vodafone mHealth Solutions Insights Guide

Diffusion of Innovations TheoryV%7"*,E'03BB),3%4'%B'644%<.(3%4,' C/"%*@'l.#,%',""'+7)*"']m\p is the most 34i)"4(3.#'34')49"*,(.49347'/%>'.4'344%<.(3%4'34+#(*.(",'.'2%2)#.(3%4'l%*'4%(mI'.49'2*%<39",'.'$%&2*"/"4,3<"',(*)$()*"'B%*')49"*,(.49347'3493<39).#'.9%2(3%4'.49I'$%##"$(3<"#@I'93BB),3%4:'6('B%$),",'%4'(/"'conditions that increase or decrease the #3?"#3/%%9'%B'.'4">'39".I'2*%9)$('%*' 2*.$(3$"'1"347'.9%2("9:'

V%7"*,'2*","4("9'B%)*',(.7",L'(/"'344%<.(3%4'3(,"#BO'93BB),3%4'l%*'$%&&)43$.(3%4m'(/*%)7/'(/"',%$3.#',@,("&O'(3&"O'.49'$%4,"Q)"4$",:'-"'.*7)"9'(/.('.4'344%<.(3%4'3,'Z.4'39".I'2*.$(3$"I'%*'%1Y"$('(/.('3,'2"*$"3<"9'(%'1"'4">'1@'.4'3493<39).#'%*'%(/"*')43('%B'.9%2(3%4EI'93BB),3%4'3,'Z(/"'Z2*%$",,'1@'>/3$/'.4'344%<.(3%4'3,'communicated through certain channels %<"*'.'2"*3%9'%B'(3&"'.&%47'(/"'&"&1"*,'%B'.',%$3.#',@,("&EI'.49'$%&&)43$.(3%4'3,'Z(/"'2*%$",,'34'>/3$/'2.*(3$32.4(,'$*".("'.49',/.*"'34B%*&.(3%4'>3(/'%4"'.4%(/"*' (%'*".$/'.'&)().#')49"*,(.49347E:'

C/"'(/"%*@',)77",(,'(/.('1"$.),"'34B%*&.(3%4'i%>,'(/*%)7/'4"(>%*?,I'%2343%4'#".9"*,'34'(/.('4"(>%*?'2#.@'.'*%#"'34'9"("*&34347'(/"'#3?"#3/%%9'(/.('(/"'344%<.(3%4'>3##'1"'.9%2("9I'1)('.993(3%4.#'34("*&"93.*3",'l$/.47"'.7"4(,'.49'7.("?""2"*,m'.*"'.#,%'34i)"4(3.#:'P3<"'$.("7%*3",'%B'.9%2("*'.*"'%)(#34"9'>/3$/'B%##%>'.4'J=,/.2"9'93BB),3%4'$)*<"L'344%<.(%*,I'".*#@'.9%2("*,I'".*#@'&.Y%*3(@I'#.("'&.Y%*3(@I'.49'#.77.*9,:'

03BB),3%4'*",".*$/'/.,'B%$),"9'%4'+<"'&.34'"#"&"4(,L'(/"'$/.*.$("*3,(3$,'%B'.4'344%<.(3%4'>/3$/'&.@'34i)"4$"'3(,'.9%2(3%4O'(/"'9"$3,3%4=&.?347'2*%$",,'(/.('%$$)*,'>/"4'3493<39).#,'$%4,39"*'(/"'.9%2(3%4O'(/"'$/.*.$("*3,(3$,'%B'3493<39).#,'(/.('&.?"'(/"&'#3?"#@'(%'.9%2('.4'344%<.(3%4O'(/"'$%4,"Q)"4$",'B%*'3493<39).#,'.49',%$3"(@'%B'.9%2(347'(/"'344%<.(3%4O'.49'$%&&)43$.(3%4'$/.44"#,'),"9'34'(/"'.9%2(3%4'2*%$",,:'U#%,"#@'#34?"9'(%'03BB),3%4'%B'644%<.(3%4,'C/"%*@'3,'G"(>%*?'F4.#@,3,'.49'J%$3.#'G"(>%*?'C/"%*@cb'.49'U*3(3$.#'X.,,'C/"%*@31.

0

100

75

50

25

Market share %

Innovators 2.5%

Early Adopters 13.5%

Early Majority 34%

Late Majority 34%

Laggards 16%

Figure 4 Diffusion of Innovations Theory

X.*?"('2"4"(*.(3%4

f"<"#'%B'.9%2(3%4

''H%9.B%4"'&-".#(/'J%#)(3%4,''\b

Vodafone mHealth Solutions Insights Guide

Technology Acceptance Model C/"'C"$/4%#%7@'F$$"2(.4$"'X%9"#'3,' %4"'%B'(/"'&%,('34i)"4(3.#'"D("4,3%4,' %B'FYA"4E,'C/"%*@'%B'V".,%4"9'F$(3%4'.49'C/"%*@'%B'R#.44"9'W"/.<3%)*:'0"<"#%2"9'1@'0.<3,c\I'cc'3('3,'.4'34B%*&.(3%4',@,("&,'(/"%*@'(/.('&%9"#,'/%>'),"*,'$%&"'(%'.$$"2('.49'),"'.'("$/4%#%7@:'6('*"2#.$",'FYA"4E,'.((3()9"'&".,)*",'>3(/'(>%'("$/4%#%7@'.$$"2(.4$"'&".,)*",L'2"*$"3<"9'),"B)#4",,'l(/"'9"7*""'(%'>/3$/'.'2"*,%4'1"#3"<",'(/.('),347'.'2.*(3$)#.*',@,("&'>%)#9'"4/.4$"'/3,'%*'/"*'Y%1'2"*B%*&.4$"mI'.49'2"*$"3<"9'".,"=%B=),"'l(/"'9"7*""'(%'>/3$/'.'2"*,%4'1"#3"<",'(/.('),347'.'2.*(3$)#.*',@,("&'>%)#9'1"'B*""'B*%&'"BB%*(m:'C/"'&%9"#'.,,)&",'(/.('>/"4',%&"%4"'B%*&,'.4'34("4(3%4'(%'.$(I'(/"@'>3##'1"'B*""'(%'.$('>3(/%)('#3&3(.(3%4I'>/"*".,'34'(/"'*".#'>%*#9I'(/"*"'>3##'1"'<.*3%),'$%4,(*.34(,:';(/"*'&%9"#,'"D2#.34347'.$$"2(.4$"'2"*$"2(3%4,'.49'1"/.<3%)*,'.,,%$3.("9'>3(/'64B%*&.(3%4'C"$/4%#%7@'34$#)9"'U%&2)("*'J"#B=KB+$.$@34I'C.,?=C"$/4%#%7@'P3(35'.49'(/"'X%(3<.(3%4.#'X%9"#36.

United Theory of Acceptance and Use '3.4"/5$'*'-6.7.8$%#"!.45"',6.'3.Consumer Acceptance TechnologyRecent studies have sought to integrate ,%&"'%B'(/"'2*3%*'&%9"#,:'H"4?.(",/37 "D.&34"9'"37/('%B'(/"'&%,('$%&&%4'(/"%*"(3$.#'B*.&">%*?,'.49'&%9"#,'),"9'(%'"D2#.34'3493<39).#'.9%2(3%4'.49'),"'%B'("$/4%#%7@'.49'1*%)7/('(%7"(/"*'(/"3*'&%,(',.#3"4('$/.*.$("*3,(3$,'(%'B%*&'.')43+"9'(/"%*@I'M43("9'C/"%*@'%B'F$$"2(.4$"'.49'M,"'%B'C"$/4%#%7@'l.#,%',""'+7)*"'`m:'

C/3,'2*","4(,'B%)*'?"@'9"("*&34.4(,'%B'),"'l2"*B%*&.4$"'"D2"$(.4$@I'"BB%*('"D2"$(.4$@I',%$3.#'34i)"4$"'.49'B.$3#3(.(347'$%493(3%4,m'and four moderators of individual use l7"49"*I'.7"I'"D2"*3"4$"'.49'<%#)4(.*34",,m:'

J3&3#.*#@I'[)#<3>.(38 designed the Consumer F$$"2(.4$"'%B'C"$/4%#%7@'B*.&">%*?'1@'&"*7347'(>%'2*"<3%),#@')4*"#.("9'&%9"#,I'(/"'C"$/4%#%7@'F$$"2(.4$"'X%9"#'.49'(/"'R#".,)*"I'F*%),.#'.49'0%&34.4$"'2.*.937&'%B'.BB"$('l9"<"#%2"9'.,'.'&%9"#'34'"4<3*%4&"4(.#=2,@$/%#%7@'1@'X"/*.1.3439I'3(',)77",(,'(/.('.##'"&%(3%4.#'*",2%4,",'(%'2/@,3$.#'.49',%$3.#'"4<3*%4&"4(,'$.4'1"'$.2()*"9'>3(/'(/*""'93&"4,3%4,'%B'.BB"$(L'2#".,)*"I'.*%),.#'.49'9%&34.4$"m:'

Sun and Zhang]b'2*","4('.',@,("&.(3$'.4.#@,3,'%B'(/"'"D2#.4.(%*@'.49',3().(3%4.#'#3&3(.(3%4,'%B'"D3,(347'("$/4%#%7@'.$$"2(.4$"',()93",:'C/"@'$.##'B%*'&%*"'*",".*$/'34(%'(/"'3493<39).#'.49'$%4("D().#'factors that are often neglected in ("$/4%#%7@'.$$"2(.4$"',()93",'1)('$.4' 1"'$*3(3$.#'34'(/"'.22#3$.(3%4'%B'(/"'(/"%*"(3$.#'&%9"#,I'.49'39"4(3B@'("4'&%9"*.(347'B.$(%*,'$%4,39"*"9'(%'1"'34i)"4(3.#'l<%#)4(.*34",,I'(/"'4.()*"'%B'(.,?,'.49'2*%B",,3%4,I'("$/4%#%73$.#'$%&2#"D3(@I'(/"'2)*2%,"'%B'),347'("$/4%#%7@I'3493<39).#'<,:'7*%)2'("$/4%#%73",I'7"49"*I'3493<39).#'34("##"$().#'$.2.13#3(3",I'"D2"*3"4$"I'.7"' .49'$)#()*.#'1.$?7*%)49m:

Adoption behaviours – barriers and ways to overcome themF,'(/"'+"#9'%B'&-".#(/'&.()*",I'%)*')49"*,(.49347'%B'.9%2(3%4'1"/.<3%)*,' l1%(/'2%,3(3<"'.49'4"7.(3<"m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l1%(/'.,'3493<39).#,'.49'%*7.43,.(3%4,mI'.49'(/%,"'B.$"9'1@'2.(3"4(,I'9",23("',%&"'34"<3(.1#"'%<"*#.2:'!.@,'(%'%<"*$%&"' (/","'1.**3"*,'.*"'(/"4',"('%)(:J"<"*.#'Q)%(",'.*"'34$#)9"9'>/3$/'.*"'.9.2("9'B*%&'(/"',(.?"/%#9"*'*",".*$/'$%&&3,,3%4'1@'H%9.B%4"1.

Figure 5 United Theory of Acceptance and Use of Technology

Performance expectancy

Effort expectancy

Socialinfluence

Facilitatingconditions

Behaviouralintention

Behaviour

Age

Expe

rienc

e

Gen

der

Volu

ntar

ines

s of

use

Volu

ntar

ines

s

Determinants of use

Moderators of individual use

''H%9.B%4"'&-".#(/'J%#)(3%4,''\e

Vodafone mHealth Solutions Insights Guide

Table 2 Barriers to health technology adoption – healthcare providers 41, 42, 43, 44, 45, 46, 47

Barrier )"#$%&%'$

Clinical issues 0%)1(,'.*3,347'%<"*'(/"'Q).#3(@'%B'$.*"'2*%<39"9'l.,,%$3.("9'>3(/'*3,?,'%B'#3(37.(3%4I'2.*(3$)#.*#@'34'(/"'MJFm

Cost / reimbursement -%>'(%'*"$%)2'34<",(&"4('.49'2.,,'%4'),"*'$%,('l",2"$3.##@'.'$%4$"*4'34'(/"'MJFm

Lack of evidence J$.4('"<39"4$"'.1%)('(/"'"BB"$(3<"4",,'%B'("$/4%#%7@'%*'/%>'&-".#(/'3&2*%<",'$#343$.#'%)($%&",I' >%*?i%>'"($

Lack of user-engagement

64.9"Q).("'2/@,3$3.4',)22%*('1.,"'.49'2/@,3$3.4=1.,"9'#".9"*,/32I'#3&3("9'34<%#<"&"4('34'9",374'%*'3&2#"&"4(.(3%4I'$%4$"*4'.1%)('("$/4%#%7@

Organisational structure

U%4$"*4,'.1%)('34("7*.(3%4'.49'34("*%2"*.13#3(@'%B'&-".#(/'34'$)**"4(',(*)$()*",

Privacy 6,,)",'%B'$%4+9"4(3.#3(@'.49'$%4,"4(

Security V"7.*9347'(*.4,&3,,3%4I',(%*.7"'.49'*"(*3"<.#'%B'$#343$.#'9.(.

Work load and time management

64$*".,"9'(3&"',2"4('.49'*"#)$(.4$"'.1%)('Z%)(,39"'%B'%B+$"'/%)*,E'*",2%4,313#3(3",

9',:;'<.='!0*%&%"( f.$?'%B'2*%$",,",'.49'2*%$"9)*",'.*%)49'$%##"$(3%4I'%*7.43,.(3%4I'.4.#@,3,'%B'9.(.I'.49'/%>'(%'3&2#"&"4(' action needed

Clinical issues:

ZC/"'&%&"4('@%)E<"'7%('$%4(34)%),'&%43(%*347'%4I'(/"*"'&37/('1"'.'#"7.#'3&2#3$.(3%4'(/"*":'!/.('/.22"4,'3B'(/"'4"(>%*?'7%",'9%>4'%*'@%)'7%'(%'.'2.*('%B'(/"'/%,23(.#'>/"*"'3(E,'4%('.<.3#.1#"'.49',%&"(/347'>.,4E('23$?"9')2'2)*"#@'B%*'(/.('*".,%4^'G%>'>/%E,'#3.1#"^'6,'3('(/"'9.(.^'6,'3('(/"'$%&2.4@'(/.('&.?",'(/"'9"<3$"^'6,'3('(/"'/%,23(.#'%*'(/"'$%&2.4@'(/.('1)3#('(/"'/%,23(.#^'6,'3('(/"'9%$(%*' .('(/"'"49^E

C/%)7/('f".9"*I'M[

Cost / reimbursement:

Z!"##I'6E9',.@'$%,(I')49"*,(.49347'%B'3(,')(3#3(@I'.4@(3&"'@%)'1*347'34',%&"(/347'4">'5'2.*(3$)#.*#@'34'(/"'+"#9'%B'("$/4%#%7@'5'$%4<34$347'2"%2#"'(/.('3(E,'1*347347'1"(("*&"4(I'.4'.9<.4(.7"'(%'(/"'>.@'(/.('(/"@E*"'9%347'(/347,I'(/.(E,'.#>.@,'.'1.**3"*:E'

R/.*&.$")(3$.#I'MJ

ZC/"*"'3,'.'$%4$"2('$.##"9'$%,(=%22%*()43(@'>/3$/'&".4,'(/.('(/"'&%4"@'(/.('3,',2"4('%4',.43(.*@'3,,)",'3,'(.?"4'B*%&'.4%(/"*'2#.$"v3B'@%)',2"49'%4'("#"&"93$34"'.49'4%('34'.&1)#.4$",'%*'"&"*7"4$@',@,("&,v3(E,'.'7*".('*",2%4,313#3(@'(/"'>.@'@%)',2"49'&%4"@:E'

-%,23(.#I'J2.34

Lack of evidence:

ZC/"*"E,'Q)3("'.'B">'23#%(',()93",'Iv1)('(/"'2*%1#"&'>3(/'.##'%B'(/%,"'3,'(/"@E*"'<"*@',&.##',()93",:';*'"<"4'3B'(/"@'7%'%4'.'@".*I'(/"@E*"'.'<"*@',"#"$('7*%)2'%B'2.(3"4(,:'k%)'/.<"4E('9%4"'3('%4'2%2)#.(3%4',$.#",',%'(*@347'(%'+49'.' $%,('Y),(3+$.(3%4'B%*'(/.(vE'

C/%)7/('#".9"*I'M[

''H%9.B%4"'&-".#(/'J%#)(3%4,''\\

Vodafone mHealth Solutions Insights Guide

Organisational structure:

Z;4"'%B'(/"'*".#'$/.##"47",'B%*'),'3,'/%>'>"'$.4'3&2*%<"'%)*',@,("&,',%'(/.('(/"@'>%*?'&%*"'"B+$3"4(#@:'6(E,'.##'<"*@'>"##'3&2*%<347'@%)*'1.$?'"49',@,("&,I'1)('@%)E<"'7%('(%'1"'.1#"'(%'.$$",,'(/"&:'C/"'?"@'2*%1#"&'B%*'),'3,'/%>'9%'@%)'&.?"'(/","'43$"I',/34@I'4">',@,("&,'.<.3#.1#"'(%'(/"'$#343$3.4,^'F49'%)*'?"@'7%.#'3,'(%'&.?"'2.(3"4('34B%*&.(3%4I'*".#'(3&"'2.(3"4('34B%*&.(3%4I'*"7.*9#",,'%B'>/3$/',@,("&'3('$%&",'B*%&I'.<.3#.1#"' B%*'(/"'$#343$3.4'.('(/"'2%34('%B'$.*":E'

-%,23(.#'X.4.7"*I'M[

Privacy:

Z!"'34$*".,"'34'.',3743+$.4('>.@'(/"'*3,?'%B'4%('*",2"$(347'2"%2#"E,'*37/('(%'2*3<.$@'.,'>"##'.,'2*3<.$@'%B'9.(.v(/"*"' 3,'4%'2*%2"*'*"7)#.(3%4'(%'2*%("$('9.(.'.49'(/"'2.(3"4('34'(/"'B.$"'%B'(/"',2*".9'%B'34B%*&.(3%4'(/*%)7/'("#"&"93$34":E'

G8;I'J2.34

Lack of user-engagement:

ZC/"'%4#@'(/347'(/.('(/","'2*%B",,3%4.#,',""'3,'(/.('(/"@'>3##'1"'%<"*1)*9"4"9:' 6(E,'$#".*'(/.('3B'(/"@'4%>'/.<"'ebb'2.(3"4(,I'>3(/'("#"&"93$34"'(/"@'$%)#9'/.<"'&.4@'&%*":E'

F$.9"&3$I'J2.34

Work load and time management:

Z6B'@%)',"4('%)('ebb'*"&349"*,I'4%>'@%)E<"'7%('(%'*",2%49'(%'(/%,"'ebb'*"2#3",:'K<"4'>3(/'"&.3#I'@%)'$.4',"49'"&.3#,'(%'2.(3"4(,'>/%'.*"'%4'(/"3*'&%13#",I'1)('3(E,'93B+$)#('1"$.),"'(/"4'@%)',(.*('7"((347'(/"'"&.3#'Q)"*3",'$%&347'34I'.49'@%)'$.4E(',3('.49'*",2%49'(%'(/347,'"#"$(*%43$.##@'.##'(/"'(3&":'X"93$.##@I'#"7.##@'@%)E*"'7%347'(%'*)4' 34(%'(*%)1#":'J%I'3(E,'7"((347'.*%)49' (/%,"'$%4,(*.34(,:E'

8RI'J;MC-'FPV6UF

Z6B'.'#%('%B'2"%2#"'>"*"'),347'3(I'3('>%)#9'*"Q)3*"'.4'"D(*.'"&2#%@""'(%'&.4.7"' (/"'34B%*&.(3%4:E

8RI'J;MC-'FPV6UF

9',:;'<.='!0*%&%"(>

Z!/.('4""9,'(%'1"'9%4"'3,'(%'7.(/"*'efforts to create a common information ,@,("&O'34',)$/'.'>.@'(/.('"<"*@'J2.43,/'$3(3A"4'$%)#9'".,3#@'.49'*.239#@'#%$.("'.##'(/"3*'$#343$.#'/3,(%*@'34'.'9.(.1.,"'.49'1@'9%347',%'1"'$.2.1#"'(%',/.*"'>3(/',%&"'%(/"*'9%$(%*,I'4%'&.(("*'>/"*"'@%)'>"*"'.(I'J>3(A"*#.49'%*'X.9*39:E'

8RI'J2.34

''H%9.B%4"'&-".#(/'J%#)(3%4,''\c

Vodafone mHealth Solutions Insights Guide

Table 3 Barriers to health technology adoption – patients48, 49, 50, 51, 52

Barrier )"#$%&%'$

Cost -%>'(%'B)49'93*"$('.49'.,,%$3.("9'$%,(,

Design of the technology

U%&2#"D'34("*B.$"I'%1(*),3<"'("$/4%#%7@I'2/@,3$.#'.13#3(@'(%'),"'l$%493(3%4'%*'3&2.3*&"4(',2"$3+$m

Disruption to daily routine and normal healthcare practices

R"*$"3<"9'%*'.$().#'93,*)2(3%4:'U%&&%4'B".*'.&%47'2.(3"4(,'(/.(')(3#3,347'("$/4%#%7@'*3,?,'*"9)$347'%*' #%%,347'93*"$('$%4(.$('>3(/'(/"3*'9%$(%*:

Lack of evidence F1%)('),"B)#4",,I'".,"=%*=),"I'.49'.$$",,313#3(@

Lack of knowledge G%'%*'#3&3("9'?4%>#"97"'.1%)('&-".#(/'2*%/313(,'343(3.#'2.(3"4('34("*.$(3%4

Lack of access F,'$%4,)&"*,I'2.(3"4(,'/.<"'#3((#"'349"2"49"4('.$$",,'(%'&-".#(/')4#",,'3('3,'93*"$(#@'*"$%&&"49"9'%*'2*",$*31"9'l.#(/%)7/'.<.3#.13#3(@'.49'.$$",,'(%'1%(/'$#343$.#'.49'4%4=$#343$.#',&.*(2/%4",'.22,'3,'34$*".,347m

Level of technology literacy

0373(.#'93<39"'.49'<.*3.1#"'#"<"#,'%B',?3##'l#"<"#'%B'(/*".('2"*$"3<"9'1@'4">'("$/4%#%7@m

Privacy !/%'/.,'.$$",,'(%'(/"3*'9.(.'l,"$)*3(@'3,'4%(',)$/'.'$%4$"*4'B%*'2.(3"4(,'>/%'*"7.*9"9'3('.,'("$/43$.#'3,,)"'(/.(',/%)#9'1"',%#<"9'2*3%*'(%'("$/4%#%7@'*%##'%)(m

Reliability of the technology

V3,?'%B'("$/43$.#'B.3#)*"'%*'"**%*'#".9347'(%'"#"<.("9'/".#(/'*3,?

Cost:

Z`bb'2%)49,'>3##'&".4',%&"(/347'(%'&"I'1)('B%*',%&"%4"'"#,"'`bb'2%)49,'&37/('1"'2"*$"3<"9'.,'.'#%('%B'&%4"@'.49'3(E,'<"*@'/.*9'>3(/'(/","'$%,(347,:'F49'>/.("<"*'>.@'@%)'#%%?'.('3('3B'@%)E*"'(.#?347'.1%)('"Q)32&"4('.('.'/".<@'2*3$"'3(E,'7%('1"'&".4,'(",("9'1"$.),"'(/"'G.(3%4.#'-".#(/'J"*<3$"' Y),('$.4E('.BB%*9'3(:E'

03.1"(3$'R.(3"4(I'M[

Disruption to normal healthcare practices:

Z6'(/34?'9%$(%*,'>3##'/.<"'#%47"*'34("*<.#,'1"(>""4'<3,3(,'1"$.),"'@%)E*"'&%*"'$%<"*"9I'>/3$/'>%)#9'&.?"'&"'9%)1(I'1"$.),"'6'#3?"'B.$"=(%=B.$"'$%4(.$('>3(/'&@'9%$(%*I'1"347'.1#"'(%'("##'/3&'.1%)('&@'2*%1#"&,:E'

03.1"(3$'R.(3"4(I'J2.34

Level of technology literacy:

ZF4@'9"<3$"'&),('1"'),"*=B*3"49#@:'k%)',/%)#94E('4""9'.'9"7*""'(%'),"'3(:'6(E,'+4"'B%*'.'\b'@".*'%#9I'1)('>"'9394E('7*%>')2'>3(/'("$/4%#%7@'(/"'>.@'@%)47'2"%2#"'939:'6'9%4E('?4%>'/%>'(%',"(')2'&@'0H0:E'

03.1"(3$'R.(3"4(I'qF

Privacy:

Z;4"'%B'(/"'1377",('/)*9#",'(/.(' @%)E*"'7%347'(%'/.<"'(%'7%'%<"*'3,'(/"'.13#3(@'(%'"4,)*"'2.(3"4(,'(/.('(/"3*'9.(.'3,'2*%("$("9I'(/.('3('3,'4%('1"347'),"9' B%*'"D.&2#"I'1@'34,)*.4$"'$%&2.43",'(%'2*"<"4('(/"&'B*%&'7"((347'34,)*.4$"'1"$.),"'(/"@'/.<"'.'2.*(3$)#.*' 7"4"(3$'&.*?"*:E'

C/%)7/('f".9"*I'MJ

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Vodafone mHealth Solutions Insights Guide

Table 4 Ways to overcome barriers53, 54, 55, 56, 57, 58, 59, 60, 61, 62

How to overcome the barrier

)"#$%&%'$

Complement/augment normal practices

K4,)*"'("$/4%#%7@'.99,'<.#)"'.49',)22#"&"4(,'/".#(/$.*"'2*.$(3$",

Cost / reimbursement X.?"'3('$%,('"BB"$(3<"I'9"<"#%2'4">'1),34",,'&%9"#,

)0&0.(?"/%#/0&%'$( Collect targeted data that is required

Design and properties X.D3&3,"'(/"'),"*'"D2"*3"4$"'(/*%)7/'(.*7"("9'34("*B.$"'(/.('.##%>,'B%*'2"*,%4.#3,.(3%4I'$),(%&3,.(3%4'.49'.9.2(3%4I'&.?"'3('9",3*.1#"

Evidence V37%*%),'"<.#).(3%4'.49'"<39"4$"=1.,"9'*",)#(,

Increase awareness, knowledge base and recognition

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Increase accessibility 64$*".,347'(/"'<3,313#3(@'%B'&-".#(/'3,'%4#@'2.*('%B'(/"'"Q).(3%4:'F<.3#.1#"'("$/4%#%73",'&),('1"'2.$?.7"9'.49'%BB"*"9'34'>.@,'(/.('"4.1#"'$%4,)&"*,'(%'.$$",,'(/"&'93*"$(#@:

Organisational support

M49"*234'("$/4%#%7@'>3(/',@,("&,'.49'2*%$",,",'(%',)22%*('%*7.43,.(3%4.#',(*)$()*",'34'>/3$/'3('>3##'%2"*.("O'"4,)*"'34("7*.(3%4I'34("*%2"*.13#3(@'.49',(.49.*93,.(3%4

Overall, ensure the 2"$"#&(.'1&<"%-5. the costs

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Privacy J%#<"'#"7.#'.49'*"7)#.(%*@'3,,)",'.1%)('2*3<.$@'.49'$%4(*%#'%B'9.(.

Security J%#<"'("$/43$.#'3,,)",'.*%)49',"$)*3(@'%B'(*.4,&3,,3%4I',(%*.7"'.49'*"(*3"<.#'%B'$#343$.#'9.(.

Training C*.34'3493<39).#,'34'(/"'.22#3$.(3%4'.49'2*.$(3$.#3(3",'%B'(/"'("$/4%#%7@

User development K47.7"'.##',(.?"/%#9"*,'34'2*%9)$('9"<"#%2&"4('(%'"4,)*"'3(,'?"@'*"Q)3*"&"4(,'.*"'&"(I'3('3,'),"*'9*3<"4'(/*%)7/'2.*(3$32.(3%4I'.49'3,',$.#.1#"

9',:;'<.='!0*%&%"( K4,)*"'34B%*&.(3%4'$%##"$(3%4I'.4.#@,3,I'.49'93,,"&34.(3%4'3,'"B+$3"4(

Applying behavioural theories in technology and health64'(/"'.9%2(3%4'.49')(3#3,.(3%4'%B'&-".#(/I'1"/.<3%)*.#'.((3()9",'.*"'#3?"#@'(%'1"'&%*"'3&2%*(.4('(%'2*%7*",,'(/.4'("$/4%#%7@'tc]u:'F,'X.*(34,'tc\u'$%4$#)9",I'&-".#(/'2"*',"'3,'Z4%('"4%)7/'(%'3&2*%<"'/".#(/$.*"I',34$"'3&2*%<347'$.*"I'%*',)22%*(347'3(I'3,'&%*"'(/.4'Y),('73<347'2*%B",,3%4.#,'l.49'2.(3"4(,m'".,3"*'.$$",,'(%'34B%*&.(3%4'.49'$%&&)43$.(3%4E:

6('3,'>39"#@'.$?4%>#"97"9'(/.('&-".#(/'/.,'(/"'2%("4(3.#'(%'3&2*%<"'/".#(/'%)($%&",I'1)('>"'&),('9"&%4,(*.("'/%>'.49')49"*,(.49'>/@:'C/"'1.**3"*,'39"4(3+"9'.,'2*%/313(347'(/"'*".9@'.9%2(3%4'

%B'&-".#(/'$.4'1"'93<39"9'34(%'+<"'34("*=*"#.("9'$.("7%*3",L',%$3.#O'$#343$.#O'("$/43$.#O'"$%4%&3$O'.49'%*7.43,.(3%4.#'%*'#%73,(3$.#'l.#,%',""'+7)*"'_m:'

X"$/.43,&,'.49',(*.("73",'$.4'1"'2)(' 34'2#.$"'(%'&343&3,"'(/"3*'3&2.$(L'"&2#%@347'"BB"$(3<"'9",374'(/"%*@'>3##'*",)#('34'34$*".,347#@'*"+4"9'.49'.22*%2*3.("'34("*B.$",'1"347'9"<"#%2"9O'"&2#%@347'%*7.43,.(3%4.#'$/.47"'(/"%*@'>3##'$*".("',(.1#"'34,(3()(3%4.#',@,("&,'.49'>%*?i%>,'(/.('$.4'34$%*2%*.("'("$/4%#%7@'(%'3&2*%<"'"B+$3"4$@O'"&2#%@347'(.*7"("9',%$3.#'&.*?"(347'>3##'*.3,"'.>.*"4",,'%B' (/"'("$/4%#%73",E'"D3,("4$":

C/"'2%("4(3.#'%B'&-".#(/'3,'"D("4,3<"' .49',)22%*(,'.'B)49.&"4(.#'$/.47"'34'(/"'>.@'(/.('-UR,'.49'2.(3"4(,'34("*B.$"'>3(/'healthcare. Whilst changes are required for -UR,'(%'1"'.1#"'(%'$%2"'>3(/'4">'/".#(/$.*"'9"&.49,'.49',),(.34'(/"'Q).#3(@'%B'$.*"I'.,'.'93,*)2(3<"'344%<.(%*I'(/"'B.$('3,'(/.('&-".#(/'34(*%9)$",'$/.47"I'.49'$/.47"'&.@'4"7.(3<"#@'3&2.$('3(,'.9%2(3%4'.49'$.),"'4%4=)2(.?":'64'(/"'Q)%("'%4'(/"'4"D('2.7"I'B%*'34,(.4$"I'$%4$"*4,'.1%)('"#3&34.(347'$%##".7)",E'Y%1,'2*%/313('(/"'*".9@'.9%2(3%4'of technological interventions.

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Vodafone mHealth Solutions Insights Guide

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-%>"<"*'7%%9'(/"'("$/4%#%7@'.49',(*)$()*",'(%',)22%*('3(,'),"'1"$%&"I'&-".#(/'>3##'1"'*"9)49.4(')4#",,'"49=),"*,I'1%(/'2.(3"4(,'.49'-UR,I'.*"'>3##347'(%')(3#3,"'(/"'("$/4%#%7@'34'.',),(.34"9'>.@:'C/3,'3,'>/@'3('3,'$*)$3.#'(/.('>"')49"*,(.49'(/"'1"/.<3%)*.#'.((3()9",'.,,%$3.("9'>3(/'&-".#(/'.9%2(3%4:'

Conclusion&-".#(/'3,'.'*.239#@'"D2.49347'+"#9'>3(/'"D$3(347',$%2"'B%*'344%<.(3%4'.49'7*%>347'demand for technological solutions to health issues. As in other industrialised $%)4(*3",I'(/"'&.Y%*3(@'%B'F&"*3$.4,'4%>'*"B"*'+*,('(%'(/"'34("*4"('B%*'/".#(/'34B%*&.(3%4I'1"B%*"'<3,3(347'.'/".#(/$.*"'2*.$(3(3%4"*64:'P*"Q)"4(#@I'2.(3"4(,'*"2%*('(/.('(/"3*'34("*.$(3%4'>3(/',)$/'34B%*&.(3%4'$/.47"9'(/"'>.@'(/"@'(/%)7/('.1%)('(/"3*'/".#(/'2*%1#"&,'.49'2*%&2("9'(/"&'(%'$/.47"'(/"3*'1"/.<3%)*65:'C/"'&%13#"'2/%4"I'.,'(/"'B.,(",('.9%2("9'("$/4%#%7@' 34'/3,(%*@'/.,I'>3(/'3(,'"D2.49"9'B)4$(3%4.#3(@I'2*%<39"9'&-".#(/'>3(/'.'2"*<.,3<"'.49'B"*(3#"'2#.(B%*&'__I'_d

'Z6('$)(,'9%>4'%4'&"93$.#'#.1%)*'$%,(,I'.49'6E&'4%('34("*",("9'34'(/.(I'1"$.),"'6'9%4E('>.4('&@'$%##".7)",'%*'6'(%'1"'%)('%B'.'Y%1v3(E,'.'<"*@'7%%9'39".I'1)('6'(/34?'(/"*"E,'.4')#("*3%*'&%(3<"'1"/349'3('.49'3(E,'4%('(/"'>"##1"347'%B'2"%2#":E'

8RI'J2.34

LOGISTICAL / ORGANISATIONAL

SOCIAL

ECO

NO

MIC

CLINICAL

TECHN

ICAL

LOGISTICAL / ORGANISATIONAL

SOCIAL

ECO

NO

MIC

CLINICAL

TECHN

ICAL

LOGISTICAL / ORGANISATIONAL

SOCIAL

ECO

NO

MIC

CLINICALTECH

NICAL

LOGISTICAL / ORGANISATIONAL

SOCIAL

ECO

NO

MIC

CLINICAL

TECHN

ICAL

LOGISTICAL / O

RGANISATIO

NAL

SOCIAL

ECONOMIC

CLINIC

AL

TECHNICAL

SOCIAL CLINICAL

TECHNICALECONOMICAL

LOGISTICAL / ORGANISATIONAL

Figure 6 mHealth adoption barrier categories

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Vodafone mHealth Solutions Insights Guide

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