At the end of November last year Apple aired a new commercial for the iPad called "iPad is Amazing." Within the first few seconds the commercial showed a brief clip of AirStripOB, a vital sign monitoring app from AirStrip Technologies, and the first iOS app to secure clearance from the FDA.

"When I first joined AirStrip, I realized that everyone was talking about us. Apple had just aired a commercial that featured one of our apps and all the healthcare organizations were suddenly inviting us to present, even though we had been in business for five years and already had 200 customers," AirStrip CEO Alan Portela told attendees last week at Informa's Mobile Healthcare Industry Summit in Brussels. "After presenting to many of these organizations it was clear to us that for most of them we were a 'nice to have' not a 'must have.'"

Portela said that problem is one that many other companies working in mobile health today are experiencing. The publicity from Apple helped AirStrip become more acutely aware of it though.

"I decided to treat this problem as if it were a patient. I began by looking at the chief complaint: Sure, there were a lot of issues that led to the 'nice to have' problem, a lot of co-morbidities, but what was the chief complaint?" Portela asked.

Portela said his sales team told him it was all about money. The customer feedback was that the technology was great but they didn't have the money to spend on AirStrip because they were focused on working toward Meaningful Use (MU) and becoming an Accountable Care Organization (ACO). While the focus in healthcare today is on clinical operations, Portela said, the focus of tomorrow is quality of care.

"By tomorrow I mean this is happening already. It's happening Thursday. It's happening now," Portela said. "The model is changing from a transactions-based model to an outcomes-based model."

Once AirStrip decided to change its pitch and focus on chronic disease -- Portela was vague on the specifics -- it saw a dramatic response from its customers: "We added 200 hospitals in the past year," Portela said. "That's more than we added in the first 5 years of the company."

In January one potential customer asked for exclusivity in its area -- none of its competitors would have access to AirStrip monitoring for a number of years. That hospital then posted billboards that promised prospective patients that their EKGs would arrive at the hospital before they did. Remote medical monitoring -- the latest roadside marketing tool for hospitals?

"Since then five integrated networks have asked for exclusivity," Portela said, but the company is "trying to stay away from that, because we don’t want to determine who gets the best care." Portela said it's more typical for AirStrip to grant a three to six month exclusivity period to new customers, because that's about how much time it takes to react for the competition anyway.

Prior to AirStrip, Portela spent much of his time working on electronic medical record (EMR) deployments. He made a powerful yet simple analogy for EMRs and mobile health, which I'm surprised I don't hear more often.

"EMRs are platforms," he said. "The same way that your computer has an [operating system] -- EMRs are the OS," Portela said. "You benefit from the apps that you put on top of the OS, while you don't benefit so much from the OS. I gave this talk at Microsoft recently -- they didn’t like that line so much."

Not surprisingly, Portela believes now that the value of health information systems will be realized on mobile devices: "Mobile will enhance every aspect of the EMR you deploy" and "all physicians will have smartphones by 2013," he said.

With millions more patients entering the system there is "no way we can take care of this new population unless we use communication technology to achieve virtualization," he said. "The virtual clinician is here now and we need to support him with mobile technology."