One of the key pillars of eHealth is online symptom databases and one of the earliest vendors to enter that space was A.D.A.M., which sold CD-ROMs during the dotCom days of yore. The company has recently white labeled their Symptom Navigator as an iPhone app that caregivers can re-brand and offer to their patients. Mobihealthnews caught up with A.D.A.M.'s Greg Juhn, SVP Product Strategy to discuss the company's journey from CD-ROMs to iPhones, PHRs and upcoming offerings from their mobile solutions group.

How did A.D.A.M. get its start and how did it lead to the recently announced A.D.A.M. iPhone application?

Juhn: In some ways, A.D.A.M. is the grandaddy for the eHealth space. A.D.A.M. grew out of a company during the late 1980s and started out largely as a CD-ROM company with educational and interactive applications covering anatomy, physiology and health information. We still have our flagship product from the old days but, obviously, it's gone through a number of iterations.

When the Internet took off in the late 1990s we transitioned into a Web-based content company and provide consumer-oriented health information tools. So, we don't create anything for physicians, really. Our content helps consumers learn about diseases, symptoms, treatment options. We try to help people make decisions about which options are best for them. We also give tips for prevention. We also have our own little personal health record (PHR) that we've developed, but the core of it really is the reference applications, like our encyclopedia and in-depth reports.

Our revenue models is that we license this content to hospitals, managed care practices, web portals like GoogleHealth or New York Times, and others, who then make the information available to their patients or users. We are business-to-business, so we license our information to someone who wants to pay us, and they, in turn, make that information available to their audience. Several years ago, we developed this product called Symptom Navigator, which a lot of different Web portals use and we have played around with mobile applications in the past few years, but until the iPhone came out we didn't do much with it. When the iPhone came out, we took a look at it before it was even released and realized that this was perfect for what we want to do. Perfect for both the Symptom Navigator and a whole bunch of other things we want to do with mobile as well. When we created the Symptom Navigator that was just a baby step that we took--we created that even before iPhone's software kit for developers came out. It was just a Web application, but we got a lot of interest from hospitals who want to take it and make it their own with their own branding. Really, we want to go a lot further with our mobile strategy with both the iPhone and other mobile phones. Our next step: We are developing a native application for the iPhone, which will be available via the iTunes AppStore. We demo'ed the app last fall at the Health 2.0 conference and got great reception for it. We hope to get that wrapped up early this year.

Is your personal health record mobile?

Juhn: The PHR is not mobile. We actually have a whole other piece of our business where we develop web portals for employers. It's a health and wellness benefit solution, which gives workers information about their benefits and also includes our A.D.A.M. health reference materials. We developed a PHR for that, which others can license, but we built it mainly for that. It's based on people entering in their information--the PHR does not pull information from anywhere like GoogleHealth might. We don't emphasize that product strongly and there are no mobile plans for that. When it comes to our benefits portal, though, we definitely have ideas [for mobile] percolating, because we think it's going to be very important for people to access benefits information through their cell phones in the future. If someone goes to their dentist, for example, and they don't remember what is covered under their plan or if it's a qualified medical event or what--they can just pull up the information right there on their cell phone.

You indicated that the iPhone's user interface signaled the tipping point for your development team to explore mobile. Are there other mobile platforms out there now that are good enough to develop applications for?

Juhn: We have got a handful of phones here in the office that we've been playing around with but we really don't like anything else that we've been playing with for various reasons. We do have a partnership that I cannot go into with a Windows Mobile-based phone, and it's just kind of frustrating playing with it. It doesn't do nearly what the iPhone can do. Of course, we don't expect the iPhone to be it--there are a number of phones that have come out recently. Phone makers are all upping their game, but as far as we are concerned the iPhone is still the main game in town.

Have you tried to work with wireless carriers or go direct-to-consumer?

Juhn: We don't have anything concrete right now, but we are certainly exploring all of those avenues. There are any number of revenue channels though--the possibility of selling directly to consumers via these AppStores is there, but we're not taking that revenue stream too seriously. We assume we'll be giving our apps away. That's the trend. You can do advertising, but that's not our model either. You can work with phone makers and carriers, and we haven't ruled that out, but we also aren't necessarily pursuing that as our focus. Our initial focus for mobile revenues is through our traditional clients, which include everybody from Walgreens to some of the biggest hospital institutions in the country. We are looking at ways to build mobile apps for them, which we sell b-to-b to them. That's the gist of our strategy: sell more products to our existing client base.

What do you see happening this year that could potentially change mHealth?

Juhn: To frame it, we think that with the iPhone, for the first time mobile phones are an extension of the desktop computer. They aren't the same as a desktop, though--you aren't going to use your mobile phone to research a potentially serious condition you may have. You aren't going to sit there and read volumes of information about it from a phone. We have that type of information and if you have multiple sclerosis, you can go to A.D.A.M. and read about it, but you're going to want to sit at a computer and do that instead of thumbing through a little screen. What a mobile phone is for is really convenient access to health information wherever you need and wherever you are--we all understand that.

First and foremost, the cell phone is a communication device, so tying together health information you might need in a particular point in time--like a symptom--with the ability to make a phone call and things get interesting. Add in GPS functionalities so you can locate care facilities for consumers to actually call, and I think you have a powerful suite of services for consumers on the go. Examples include news and alerts about an ongoing salmonella scare or building communities around particular fitness goals. These are pieces that lend themselves well to the mobile phone. So it's accessing health information when you need it, which is the A.D.A.M. piece, but it's also being able to access the healthcare system, which is the piece that isn't there yet. First applications coming out, which we're already seeing bits of in iPhone's AppStore, are access to health information like symptoms. What are the symptoms? Should I call a doctor? Do I need to go to an ER? Those are the easiest applications to get out into the market. The piece that is not there is really tying it to the healthcare service. I think where it's going is being able to email your doctor, make appointments online, refill prescriptions. Those aren't quite there yet, but they are fairly soon in coming. That's the best we can hope for this year. Down the road though, I think we can hope for more interactions with your providers via the phone.