Telemedicine Spending to Approach $3.6 Billion Annually by 2014

Wireless service providers likely will be key beneficiaries of increased spending on tele-medicine services and devices will generate nearly $3.6 billion in annual revenue within the next five years, says Pike & Fischer Senior Analyst Tim Deal.

The need to control health care costs, along with the development and expansion of faster wireless broadband networks, smartphones, and data compression solutions, will drive the market growth, Deal says.

Wireless applications, devices, and services solutions will account for more than 70 percent of the total market spend within five years.

Driving that spending is the economic stimulus law that President Obama signed earlier this year. That initiative includes $20 billion for health information technology, with a specific focus on electronic medical records and telemedicine, Deal says.

"We project that at least 25 percent of the $20 billion in stimulus funds earmarked for health information technology will be applied toward broadband-enabled telemedicine services such as remote patient monitoring and mobile access to medical records, and consumer applications such as interactive fitness guides and mobile health-related videos," says Deal.

AT&T will have the largest presence in this market, followed closely by Verizon and Sprint Nextel, Deal projects.

AT&T Chief Warns About Heavy Users

The top three percent of smartphone users consume 40 percent of all mobile data bandwidth, says AT&T Mobility and Consumer Markets president Ralph de la Vega. Those three percent of users also consume 13 times the data of the average smart phone user, he adds. Another way of quantifying such usage is to note that users who consume 40 percent of AT&T's mobile data bandwidth constitutute just 0.9 percent of all AT&T postpaid mobile subscribers.

The point was clear enough: Without adequate management of network access, most customers will find their experience damaged because of a small number of other users.

There are legitimate public policy concerns about anti-competitive behavior in the wireless and wireline businesses where it comes to gatekeepers of any sort using that power to impair competition. But that is a different and distinct matter from the obvious need to manage shared network resources in ways that actually preserve reasonable access for all other users.

De la Vega used the word "crowd out" to describe such contention, and it is a legitimate issue. Anti-competitive actions certainly are to be protected against. But there are valid network resource managment issues that obviously have to be addressed as well, especially in the wireless domain.

Beyond that, there are valid reasons for wanting competition protected, but without stifling consumer access to new products that offer mass market customers features enterprise users take for granted, such as the ability to prioritize their own use of bandwidth to perserve performance of mission-critical applications. If any consumer end user wants to prioritize their own video, voice or other bits, they ought to be able to do so.

There is nothing anti-competitive about this, so long as any applications in the class can receive such prioritization. Consumer advocates are right to note that issues can arise if voice bits sold by the ISP can be prioritized, but not voice bits sold by other competing service providers.

Some approaches will work better than others, and that is an issue one would hope policymakers take seriously into account as new "neutrality" rules are crafted.

FCC Chair Promises More Mobile Spectrum

"What happens when every mobile user has an iPhone, a Palm Pre, a Blackberry Tour or whatever the next device is?" asks Federal Communications Commission Chairman Julius Genachowski."What happens when we quadruple the number of subscribers with mobile broadband on their laptops or netbooks?"

"The short answer: we will need a lot more spectrum," he says. So look for the FCC to explore ways to promote spectrum efficiency and use of Wi-Fi, for example.
 
"Wi-Fi allows carriers to offload to fixed broadband as much as 40 percent of traffic in the home, freeing up capacity of licensed spectrum," he says.

But even efficiency measures do not alleviate the need for more spectrum. So the FCC chairman says he will work on reallocating spectrum currently being used for other purposes.

U.S. Wireless Data Hits New High

Wireless data service revenues climbed to more than $19.4 billion for the first half of 2009, CTIA-The Wireless Association says. This represents a 31 percent increase over the first half of 2008. In addition, wireless data revenues were more than 25 percent of all wireless service revenues.

The survey also found that more than 246 million data-capable devices are in use, while more than 40 million of these devices are Ssmartphones or wireless-enabled PDAs. More than 10 million are wireless-enabled laptops, notebooks or aircards.

More than 740 billion text messages carried on carriers’ networks during the first half of 2009, roughly 4.1 billion messages per day. That’s nearly double the number from last year, when only 385 billion text messages were reported for the first half of 2008.

Wireless subscribers are also sending more pictures and other multi-media messages with their mobile devices—more than 10.3 billion MMS messages were reported for the first half of 2009, up from 4.7 billion in mid-year 2008.

As of June 2009, the industry survey recorded more than 276 million wireless users. This represents a year-over-year increase of nearly 14 million subscribers.

Wireless customers used more than 1.1 trillion minutes in the first half of 2009—breaking down to 6.4 billion minutes-of-use per day—and six-month wireless service revenues of nearly $76 billion.

Study Finds Consumers Do Not Want Targeted Ads

“Contrary to what many marketers claim, most adult Americans (66 percent) do not want marketers to tailor advertisements to their interests, s new study from the Annenberg School for Communication, University of California Berkeley School of Law and the Annenberg Public Policy Center suggests.

“Moreover, when Americans are informed of three common ways that marketers gather data about people in order to tailor ads, even higher percentages— between 73 percent and 86 percent—say they would not want such advertising,” the Annenberg study says.

Respondents showed somewhat more interest in receiving personalized discounts and news, but still, less than one-half of Americans wanted any tailored Web content at all.

That was true of consumers in every age group—even young adults ages 18 to 24 were more likely to say no to behavioral targeting than to accept it, except for discounts.

More than two thirds of respondents to the Annenberg/Berkeley study felt they had lost control over their personal information. At the same time, however, they believed businesses handled their data well and that they were already protected by current regulations.

One suspects the responses might be different if consumers are asked whether they would be willing to receive tailored messages in exchange for some other tangible benefit, such as lower Internet access costs, free text or lower-cost voice, discounts or other tangible benefits.

The precedent is TV commercials. Just about everybody says they do not like commercials. But if asked whether they would rather watch TV without commercials, if the cost were higher, most people then say they will choose an ad-supported service.

New AT&T Mobile Browser

AT&T has developed its own mobile browser, providing customers three windows to the Web. From the homepage, users can easily browse the global Internet as well as assign bookmarks and shortcuts or set other preferences so they have quick access to their favorite content.

A second window gives users location-aware local news and weather; one-click results for nearby restaurants, nightlife venues, ATMs and other points of interest; and access to maps, driving directions and traffic information.

A third window delivers the latest headlines from popular news, sports and entertainment sites.

Additionally, customers accessing att.net from their PC can customize their mobile att.net page by sending shortcuts to popular Web sites through a "Send to Mobile" feature.

"The new browser powering the att.net service brings the best of the open Web to consumer feature phones while making the mainstay of the mobile Web easy to find and also delivering local tools and bookmarking management," says Ted Woodbery, vice president of Wireless Data, Voice and Ancillary Products for AT&T Mobility and Consumer Markets.

The custom browser suggests one way service providers can optimize mobile Web experiences for users by making navigation easier. AT&T also is introducing new phones late this fall, including the Samsung "Flight," which features both a touchscreen and a QWERTY keypad.

Does Net Neutrality Posse Credit Risk for U.S. Wireless Providers?

While there is still uncertainty around potential new rules regarding net neutrality and its impact on wireless operators, Fitch Ratings does not believe potential regulatory changes will materially affect the credit profiles of wireless companies over the longer term.

Fitch does believe the controversial plans outlined by the FCC chairman could face process delays and potential legal challenges once there is clarity about the proposed rules. In other words, there will be no clarity for some time after promulgation of new rules.

In Fitch's opinion, the competitive environment would have likely dictated that the wireless industry naturally evolve in this direction but the conditions and rules currently contemplated by the FCC will likely accelerate the pace at which this transition occurs and place more definitive regulatory restrictions on wireless operators.

Consequently, carriers will likely need to adapt access plans to mitigate the impact that devices with more data intensive applications could have on network quality.

Since nearly all markets experience lower demand when prices are raised, it is likely that access pricing will evolve in ways that generally  match consumption to usage, though that does not have to take the form of strict metering of usage, but more likely will take the form of buckets of use, one would suspect.

Fitch also believes that 4G networks offer the potential to generate additional revenue from several new sources like machine-to-machine applications which could more than offset pressure from further erosion of voice related average revenue per user.

From a credit perspective, Fitch believes the dominant market share, higher margins, strong free cash flow, and robust spectrum portfolios of Verizon Wireless and AT&T Wireless strongly position the companies to capture additional share and future market growth opportunities, at least partially offsetting structural changes that could pressure certain revenue and cash flow streams.

However, the market strength of Verizon and AT&T has implications for the remaining national, regional and niche wireless operators, which will likely face increasing credit risk as the wireless industry evolves to 4G and the competitive market intensifies for certain products and services.