App Centric Healthcare

8/8/2019 App Centric Healthcare

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App-Centric HealthcareAnd Why mHealth 2.0 May

Obsolete The Web


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The alchemy of healthcare and mobile computing have

combined to produce a seriously compelling value

proposition for providers, hospitals, medical practitioners

and most important - healthcare consumers. This paper

provides insights into the emerging app-centric world,

how it will influence and integrate with mobile healthcare,

and why the Web may soon be obsolete.

Sponsors

iOptimal Mobile Health Expo

Special Mobile Health Report Offer

Mobile Health Market Report

2010-2015 (discount code: ER447TH)

The Impact of Smartphone Applications on the Mobile Health

Industry[read more]

This report provides data, key market figures, technology trends and

social trends and analysis on the mobile health market. It highlights

and discusses strategies that mHealth market participants should

consider in order to become successful players in the market, and is

targeted towards multiple groups: traditional healthcare players like

pharmaceutical companies and device manufacturers, medcomms,

healthcare industry consultants, medical and government

organizations as well as app developers, app store operators, mobile

network operators and other new entrants to the healthcare market.

App-Centric Healthcare 2
http://www.research2guidance.com/shop/index.php/mhealth-reporthttp://mobilehealthexpo.com/http://www.research2guidance.com/shop/index.php/mhealth-reporthttp://www.research2guidance.com/shop/index.php/mhealth-reporthttp://mobilehealthexpo.com/http://mobilehealthexpo.com/http://ioptimal.com/http://ioptimal.com/


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APP-CENTRIC HEALTHCARE

Introduction

In an age of mobility, healthcare is changing in profound ways.

In almost every sense of healthcare, the needs of consumer health-related services

occur while away from home. If you aren't in a doctor's office or an ER waiting for care,

you'll likely deal with health issues

somewhere besides the comfort of

your own home. Healthcare

scenarios of every imaginable typealso occur when you're most

likely to be away from home. It's

the nature of healthcare and why

mobile healthcare has taken on a

significant importance in this decade

and beyond.

For healthcare workers, similar

requirements exist. Nurses, doctors,

and other healthcare professionals

rarely find themselves sitting at

desktop computers when collecting

or consuming health-related

information.

Mobile computing is the flip-side of mobile healthcare. Smart devices such as Apple's

iPhone, have led the mobile computing revolution. Smart phones have reached a

critical tipping point - they actually perform well, the networks they run on are relatively

reliable, and Internet and Web accessibility is pervasive and commonplace.

The alchemy of mobile healthcare and mobile computing have combined to produce a

seriously compelling value proposition for providers, hospitals, medical practitioners

and most important - healthcare consumers. And now we've entered the age of well-

designed tablets. Mobile healthcare is positioned for explosive and unprecedented

growth.



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Apps - Point-solutions for Everyone

Through its consumer campaigns, Apple has cemented the idea that there's an app for

that(and just about anything you could imagine). This positioning is taking hold in

business, government, religion and everyday lives as the popularity of iPhone,

iPodTouch, and now iPad, has grown rapidly and pervasively since iPhone's debut in

mid-2007. Conceptually, this positioning has also spilled over to non-Apple

environments such as Android-based phones and devices. App stores are erupting for

every viable smart-device platform and operating system.

Appshave become a meaningful abbreviation to something that just works. Apps

provide a common and easily understood idea that has been widely accepted as a

solution- indeed a means to get stuff done quickly and effectively. Humans across the

globe see appsas the pathway to achieving objectives whether simple tasks orcomplex processes and they've begun to vote [literally] with their fingers.

Good apps create and sustain long-lasting relationships with users and they find their

way into prominent visibility on mobile devices. Bad apps are quickly tossed aside as

users exercise real-time voting for solutions that make life better. Appsare quickly

becoming the life-link between users and businesses - they represent the brand equity

of that relationship and users can assess the benefits of an app at relatively low costs.

Forty percent of consumers surveyed by the Health Research Institute (HRI) said they

would pay for mobile healthcare services. According to HRI --

Mobile technology is untethering healthcare and enabling the practice of care

anywhere, the report says. Mobile health is creating business models that

unlock access to new players and technologies that support preventative, acute

and chronic care.

Michael Mathias, Aetnas chief technology officer, has this to say about the growth

opportunities that exist within mobile healthcare --

The days of mass communication are over. We can now deliver customized

communications through mobile apps, online, telephonically, or through the mail

based on our understanding of how each member wants to be communicated

with.

http://www.pwc.com/us/en/health-industries/health-research-institutehttp://www.pwc.com/us/en/health-industries/health-research-institutehttp://www.pwc.com/us/en/health-industries/health-research-institute


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Yan Chow, director of the Innovation and Advanced Technology Group at Kaiser

Permanente says --

... mobile is a synonym for independence; I think that the ability to be

independent and get data when and where you need it gives consumers a lot of

freedom. Having consumers be at the center of their own care is a concept

Kaiser has been working with for a long time. It gives us the chance to build a

new relationship with our members.1

Former global managing director of Verizon Connected Healthcare, Rajeev Kapoor,

says this about the emerging mobile paradigm of healthcare --

The paradigm of healthcare has changed. You used to bring the patient to the

doctor. Now you takethe doctor, hospital, and entire healthcare ecosystem to the

patient.

Consumers have come to believe mobile apps are synonymous with smart phones2

and mHealth experts generally regard smart phones as a necessity for viable mobile

medical solutions. However, the vast majority of mobile users in the United States

(more than 60%) presently carry devices that are not considered smart but which are

capable of texting (SMS3

).

Globaltel Media CEO, Robert Sanchez offers insight concerning opportunities to

leverage existing SMS infrastructure.

"Healthcare and mobile cellular will be tightly integrated in the near future with a

majority of mobile users demandingSMS text as the primary mode of

communications. Those communications MUST be two-way, not simply alerts or

notifications. Healthcare professionals cannot expect that their patients or staff

will have "smart" phones or Internet capability on their mobiles."


1 Mobile Marketer, Mobile technology can lower healthcare costs: PricewaterhouseCoopers

2 A smart phone is a mobile phone that offers more advanced computing ability and connectivity than a contemporary basic mobile phone.

3 SMS, also known as texting and short message service, is the most widely used data application in the world, with 2.4 billion active users, or 74% of all

mobile phone subscribers.
http://en.wikipedia.org/wiki/Smart_phonehttp://en.wikipedia.org/wiki/Mobile_phonehttp://en.wikipedia.org/wiki/SMShttp://en.wikipedia.org/wiki/SMShttp://en.wikipedia.org/wiki/Mobile_phonehttp://en.wikipedia.org/wiki/Mobile_phonehttp://en.wikipedia.org/wiki/Smart_phonehttp://en.wikipedia.org/wiki/Smart_phonehttp://www.mobilemarketer.com/cms/news/research/7302.htmlhttp://www.mobilemarketer.com/cms/news/research/7302.html


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Mr. Sanchez makes a compelling point concerning the present penetration of smart

phone handsets. However, smart phone adoption, especially in developed nations, is

racing at unprecedented adoption rates by consumers. In any case, SMS should be

taken seriously as a common and globally pervasive communications infrastructure

capable of providing mobile healthcare services. After all, SMS is indeed a mobile

app thats free and comes with almost every mobile phone.

As evidence that pervasive availability of SMS infrastructure may be a significant

mHealth business driver, Scripps Ranch Dermatology has successfully deployed

Globaltel's managed SMSmessaging platform to drive new business and improve

patient communications. With nearly 70 percent of initial contacts opting in to the

service, Scripps Ranch Dermatology has enjoyed the increased visibility andenhanced marketing communications that Globaltel's HIPAA-compliant texting platform

provides.

mHealth 2.0

The term "mHealth" has been around a long time; a roughly ten year failed period

(mHealth 1.0), and now an emerging and more successful period which is aptly

referred to as mHealth 2.0. mHealth 1.0 was not app-centric; it was based on a general

idea that the Internet and other wired and wireless protocols could serve as a

framework for web-based and traditional client-server mobile health solutions. Theoriginal mHealth movement presented a rosy picture at the turn of the millennium. Very

promising market projections indicated the mHealth market would soon grow in excess

of a billion dollars annually with a staggering growth ramp thereafter.

Research2Guidance.com4 revisits what really happened.

Based on those market estimates and the foreseen benefits for the users /

patients, first movers developed mHealth solutions. They generally made use of

existing PDAs and handheld computers or used SMS platforms to deliver their

services to simple phones. The mHealth solutions which were developed

between 2000 and 2008 very much resemble todays mHealth applications in the

various app stores. But with a few exceptions projects didnt progress beyond the

trial stage. Quite a few early mHealth solution providers discontinued their

mHealth business. Even global players like Qualcomm have paused their


4 Research2Guidance.com, http://www.research2guidance.com/will-smartphone-apps-become-the-killer-application-of-the-mhealth-market/
http://www.research2guidance.com/will-smartphone-apps-become-the-killer-application-of-the-mhealth-market/http://www.research2guidance.com/will-smartphone-apps-become-the-killer-application-of-the-mhealth-market/http://www.scrippsderm.com/http://www.scrippsderm.com/


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LifeComm project which aimed to become the dominant mHealth platform in the

world. The market was not ready to come out the trial phase at that time and did

not manage to gain significant size.

mHealth 2.0 is app-centric and stems from the "Apple Market Model".

Mobile technology and mHealth 2.0 opportunities are rapidly emerging as an app-

centric global mobile health model takes shape. All forms of mobile devices and

increased human connectedness are now emerging to play important roles in the

future of global health. Pervasive availability and access to low-cost mobile

technologies puts significant achievements for improved global health within reach.

According to Wikipedia5,

The motivation behind the development of the mHealth field arises from two

factors. The first factor concerns the myriad constraints felt by healthcare

systems of developing nations. These constraints include high population growth,

a high burden of disease prevalence, low health care workforce, large numbers

of rural inhabitants, and limited financial resources to support healthcare

infrastructure and health information systems. The second factor is the recent

rapid rise in mobile phone penetration in developing countries to large segments

of the healthcare workforce, as well as the population of a country as a whole.With greater access to mobile phones to all segments of a country, including rural

areas, the potentialof lowering information and transaction costs in order to

deliver healthcare improves. The combination of these two factors have

motivated much discussion of how greater access to mobile phone technology

can be leveraged to mitigate the numerous pressures faced by developing

countries healthcare systems. Both factors are discussed here.

mHealth 2.0 has little to do with the Web and everything to do with the Internet.


5 Wikipedia, mHealth - http://en.wikipedia.org/wiki/MHealth
http://en.wikipedia.org/wiki/MHealthhttp://en.wikipedia.org/wiki/MHealth


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Why the Web May Soon Be Obsolete

When we think of the web, we often think it is synonymous with the Internet. Here are

two scenarios to consider that may help to explain the difference.

In scenario A, all activities were all performed on

the Web using a Web browser. This is a very

familiar model but it should not to be confused with

the Internet. Web site applications such as

Weather.com and WebMD.com run in a browser but

utilize the Internet as the communication medium.

The Internet [metaphorically] represents the pipes,

and the content from these Web applications flow

through the pipes to you. Its more accurate to think

of your browser plus any given Web site as an

app running on the Internet.

In scenario B, you were happily running

mobile apps that help you get things done

quickly and efficiently. The apps you chose for these tasks are very specific and tend



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to focus your activities with economy of interaction because they were designed for

mobile use. In scenario B you spent the morning on the Internet but never actually

used the Web. The distinction is subtle

but the comparative user experiencesare not.

In mobile computing paradigms,

efficiency is key - user interfaces are

simpler and more concise because

they must be. This tends to yield a

higher degree of productivity than

broadly designed Web applications

and most

important -

user

satisfaction. For the most part, when it comes to life-tasks, no

user wants to spend more time clicking around on a large

screen even though the viewing experience is superior and

theres a large and forgiving keyboard with which to type.

But here you are, steps from a desktop or laptop computer

and still, you prefer to use your mobile device for many of

lifes every-day tasks. Why? Because app-centric systems

simply offer a better approach.

Apps require less typing, less time, and less user interaction. They are sleek and

focused point solutions. While they were primarily designed for mobile use, you find

them more appealing even in your office, your home, and at your desk.

App Market Model

The app market model emerged when Apple first released iPhone in 2007. Steve Jobs

vision assumed that consumers and developers would benefit most from a powerfulweb browser that pervasively supported open web standards. However, developers

had different ideas; they wanted direct access to native elements of the device through

an SDK (software development kit) and rightly so. Web standards and browser

technology doesnt mix all that well with native device features. Developers wanted the

ability to create optimized apps that performed as well as Apples own pre-installed

[native] apps.



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Jobs eventually agreed and went above and beyond the developers call for more

device-level access. Apple provided programming access to iPhone and its wealth of

hardware capabilities, but on one condition - all apps would be reviewed and

distribution (and sale of apps) would have to go through iTunes - the App Store wasborn.

As global mobile industry analyst Ralf Gordon Jahns6 describes it in a recent report,

The first six months in 2008, after the launch of the Apple App Store, proved to

be an Eldorado for developers who quickly jumped on the band-wagon, realizing

amazing download numbers for, generally speaking, very simple applications. In

2009 the market swelled with tens of thousands of new apps, making it more and

more difficult for individual apps not to be lost in the long tail. Nonetheless the

mass of developers adhere to IOS as their preferred mobile development and

distribution platform.

In 2010, the app market model is now at full throttle with likely many years of growth

ahead.

All mobile vendors have jumped in without hesitation given the overwhelming success

of Apples App Store. But this success has little to do with Apple or its vision and much

to do with what customers and healthcare workers want - simple, focused, point

solutions that just work. And their apps need to work across two critical dimensions; the

ability to purchase and install apps without friction, and fitness-of-purpose.

Just-in-Time Solutions

The app market model is partly successful because app users exhibit just-in-time

requirements and the app market model meets these requirements without breaking a

sweat. Expectation of urgency is a common behavior in mobile contexts - users want

answers and mobile apps tend to provide them faster, more efficiently, and with less

friction than other alternatives. This is a technology attribute that is even more

important in mHealth contexts.

Consider this [consumer] scenario...


6 Research2Guidance.com (6 major trends shaping the smartphone app ecosystem in 2010)
http://www.research2guidance.com/6-major-trends-shaping-the-smartphone-app-ecosystem-in-2010/http://www.research2guidance.com/6-major-trends-shaping-the-smartphone-app-ecosystem-in-2010/


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Youre sitting in a coffee shop listening to music overhead. A song starts to play

and you wonder - what is the name of this performer and the song shes singing.

In an app-centric world, theres an app for that. You launch the app store, search

for the app and locate it, purchase it with one click and install it. You launch theapp, it samples the sound playing overhead, and has identified the artist, the

song, and provided a buy button.

This is just-in-time computing and the app market model makes it possible. Equally

important, purchasing and possessing this song is just as streamlined as purchasing

the app. Less than 30 months ago, this scenario would have been considered science

fiction, yet it is now common-place in every-day mobile computing.

The opportunities to leverage the app market model in mHealth are huge and health-related organizations are beginning to realize this potential.

Mobile Healthcare Topology

At a very general level, 63% of the physicians who presently use mobile applications

and devices, are using personal devices that are not connected to their office or

hospital IT systems7. Healthcare Unwired Report further indicates that hospitals (for the

most part) have not placed any degree of mobile connectivity importance at the top of

their IT list.

More than 29% of physicians surveyed by HRI said their hospitals or practice leaders

will not support the use of mobile health devices. Its not surprising to also learn that

earl research data indicates that mobile health services reduces provider revenues. In


7 Healthcare Unwired Report, PriceWaterhoseCoopers.
http://www.pwc.com/us/en/index.jhtmlhttp://www.pwc.com/us/en/index.jhtml


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a variety of mobile health studies, overall

costs per patient dropped from 35% to as

much as 71% depending on services

impacted by measured care.

More interesting is whats dropping

through the cracks - information that

could be captured through home and self-

monitoring systems, is not available to

physicians when they must make decisions.

In spite of these findings, the mobile

healthcare landscape continues to expand at exponential rates because it can improve

the use and value of physicians time. Unfortunately, the focus on reduced costs tendsto focus on providers, but physicians are generally compensated by task with a

significant amount of time spent on processes that could be automated. Forty percent

of physicians surveyed said they could eliminate 11% to 30% of office visits by

leveraging mobile health technologies. This element alone could address physician

supply and shortage forecasts for the next decade and beyond.

iMedicalApps.com provides comprehensive coverage of mobile medical apps and is a

good indicator of the expanding app market model and growth in mHealth.

Touch-ComputingOne reason apps have become such an important gateway to effective mobile

solutions has as much to do with the first successful touch interface introduced in

iPhone as it does the capabilities of the device and pervasive connectedness.

Touch-computing is a critical element of viable mobile point solutions; without a well-

designed touch interface, even the most powerful app will be shown the door by users.

The absence of a keyboard coupled with a well-designed user interface, is herald by

many mobile experts, to be the single most important reason for runaway success of

Apple devices.

The age of gesture-based user interfaces is here to stay. Transforming existing user

interfaces to display on mobile devices without regard to gestures and touch

opportunities is a sure path to app failure. Companies that ignore gesture-based

opportunities in context with available touch paradigms, will invariably offer up their



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customers to disruptive competitors

who understand the new topology of

touch-computing.

Touch and gesture-based interfaces

require a wholly new approach to

meet user needs. The more

complex the processes of an app,

the greater the opportunity to

innovate and sustain loyal

appreciation for a mobile solution.

Experts and users agree - touch

interfaces typically produce greateroverall information throughput, productivity, and accuracy. But as wonderful as the

touch experience is for users, its important to have a platform or OS designed for

touch at the outset. Apple has done this and provided a touch-minded programmers

API, making it much easier to develop applications with great touch-based UIs. This

cannot [yet] be said for Android.

The touch API is very important for connected devices that enjoy a vibrant third party

app developer market. Leveraging Apples iPhone and iPad operating system or

Android OS for consumer apps has paved the way for literally transforming mobile

devices into standalone medical and health-related devices. A well-designed touchAPI also makes the app development process much more efficient and easier to test. Features like flick to scroll, swipe, and pinch are already native primitives

designed into touch operating systems such as Apples iOS and dont have to be re-

engineered from scratch each time an app is created or enhanced.

The touch-computing revolution has also sparked other revolutions in education for

example. As the search intensifies for technological solutions to the nation's and the

world's healthcare challenges which many argue are educational in nature, companies

and organizations such as Google are hosting entire events centered on mobile andtouch devices.

"Breakthrough Learning in a Digital Age," was the title of a recent summit at Google

HQ, a sector that has growing sums of money flowing into it from government and

private funding sources. Major foundations are specifically zeroing in on handhelds for



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preschool and the primary grades. Phoenix Wang, the head of a newly formed

philanthropic venture fund called Startl says --

"Young kids and multisensor-touch computing are a huge area of [education]

innovation."

Preventive medicine is all about education and mobile devices provide a very good

starting point at a global level. Startl is funded by the Gates, MacArthur, and Hewlett

foundations.8

Motion-computing

Theres a new dimension in mobile devices - motion detection. Early versions of iPhone

(and the operating system) provided very useful tools for measuring motion and

movement. iPhone 4 takes this concept to far greater heights including full gyroscope

functionality in addition to accelerometer, compass and of course, GPS. According to

Dr, Neil Paul , a British general practitioner who's now working on his fourth iPhone

app,

... it knows the speed and angle of an exercise and can detect if they're being

done properly. It's an exciting new area for medicine

The future of healthcare apps based on motion-computing capabilities represents a

wide open horizon of opportunities and the capability ceiling is lofty.

SecurityThreats in an App Market Model

According toRobert Smith, CTO and co-founder of M.A.D.Partners9,

The single biggest thing threatening any enterprise today on a security basis is

mobile. Furthermore, mobile phone application stores are the greatest malwaredelivery system ever invented by man.


8 A Is for App: How Smartphones, Handheld Computers Sparked an Educational Revolution

9 Mobile Active Defense (The Smartphone Security Company) - http://www.mobileactivedefense.com/
http://www.fastcompany.com/magazine/144/a-is-for-app.htmlhttp://www.mobileactivedefense.com/http://www.mobileactivedefense.com/http://www.mobileactivedefense.com/http://www.fastcompany.com/magazine/144/a-is-for-app.htmlhttp://www.fastcompany.com/magazine/144/a-is-for-app.htmlhttp://www.mobileactivedefense.com/http://www.mobileactivedefense.com/


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While the security and quality control of Apples App Store provides pretty good

consumer protection, the broader spectrum of apps that find their way onto devices

through enterprise app distribution systems are not typically evaluated with stringent

security in mind. This poses additional security threats to organizations becausemobile devices are pervasively used and when infected with a virus, it can easily

spread through the multitude of networks the device may come in contact with.

Smith goes on to point out that there isnt much of an approval process at all, and it is

feasible that someone couldwrite a virus and have it for sale in an app store an hourlater.Just because apps have surfaced in app stores for consumer distributionsuggests in no way that the app has passed any level of security review.

Mr. Smith makes a very compelling point; this is a threat at the consumer level, as well

as the enterprise level, because app store security, whether managed by Apple orbased on Apples Enterprise App Store, is really important in health-related apps.

Simply knowing what the app does isnt enough - the source code and architecture of

the app is a key indicator of security issues that might arise depending mostly on the

environment theyre used in.

When asked about strategic security advice for mobile healthcare, Larry Whiteside, Jr.,

CIO for Visiting Nurse Service of New York, makes this comment in a yet to be released

case study10 on mobile compliance in health care,

Get smart on securing mobile devices. Get past the marketing hype associated

with what certain vendors are calling security and recognize that most of them

are only offering management and thats all. There are many things that fall

under the umbrella of security, but if the user has the capability to turn them on

and off, its not security any more. My recommendation is that people need to

take their time and not fall into the most vendors marketing hype. If you just pay

attention to their literature or what the salesman says, youre gonna choose the

wrong solution.

Its crystal clear that vendors are stepping up to the challenges of mobile security;

Blackberry has established a legacy of security in mobile device management. Apple

has also come a long way since the release of the first iPhone OS in late 2007. In terms


10 M@D, A Case Study: Mobile Compliance in Health Care


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of data security, iOS 4.x opens the floodgates for the development of apps with

significantly improved encryption; all application data can now be encrypted.

Mobile Strategy: Multi-dimensionedLike all mobile strategies, mobile healthcare is multi-dimensioned; at a basic level,

there are healthcare consumers and

healthcare workers. Apps must

embrace each dimension in far

different ways. Services designed for

healthcare workerslikely have very

different IT and usability requirements

than services designed for healthcare

consumers.

It's important to develop mobile

healthcare strategies with discrete

awareness of the market topology and

the business drivers for each

audience. Apps designed for

healthcare workers may require native

OS-based solutions, whereas, apps built to serve

consumers may benefit from (or require) cross-platformapproaches that leverage hybrid app architectures.

Looking at this balance of arguments it can be concluded that the new smartphone

market model will help the mHealth market to reach a new level. The market will

develop from a trial market to a global market, which is about to realize its full potential.



17/18

IPAD AND IPHONE IN THE ENTERPRISE

Feel free to call me even if its just to chat about your app

strategy. I like to get feedback from the trenches and

understand real-world challenges. You can reach me via

email ([email protected]) or at my Google Voice

number (970.205.9121)

iPadConsulting ServicesAs businesses dramatically increase the amount of

information within and across their departments, it is a strategic imperative to leverage

the information to fuel innovation, responsiveness and efficiency. It is also critical that

enterprises learn how to provide greater relevance in the delivery and sharing of

information with and between information workers. iPadCTO provides consultative and

implementation services around four primary areas:

Business Intelligence and KPI Dashboards

Dynamic Workplace Applications

Portal Development and Integration

Advanced Information Discovery for Knowledge Workers

You may also find these additional free iPadCTO resources helpful.

Executive App Core The Executive App Core for iPad identifies the most

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Ebook: The iPad Executive Through a lot of experimentation and a continuing

search for the best apps for executives, specific

success patterns have emerged that continually

allow me to achieve hyper-productivity with iPad.Perhaps you've done the same, even subliminally.

This is a natural progression that all iPad-carrying

executives undertake at some level. But whats

typically missing from casual exploration is how our

chosen apps perform in two dimensions the overall

context of functional business tasks and how well

they work as a cohesive mobile solution. Onsite

training sessions include complimentary copies of

the comprehensive eBook, The iPad Executive.

iPad CXO Advisories iPad CTO is a high-velocity news portal that provides

breaking stories, opinions, and technology advisories

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intelligence report direct to your inbox with iPad

information that matters.

iPad Tips and Tricks This ebook scratches the surface of the ingenious

ways to use iPadmore efficiently and moreproductively. These tips have been culled from my

own experiences and research encounters as well as

some shared tips from iPadCTO readers.Mobile Apps: Native or Web? To help you wade through the pros and cons, Ive

created a strategy planning template and brief ebook

guide bundle. You can download it and share it with

your mobile development colleagues its free.

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