The potential for mHealth

A few days ago, I was listening to the energetic CTO of the U.S. Department of Health and Human Services, Todd Park, talk about Text4baby, a text message service which provides pregnant women and new mothers in the U.S. weekly text messages with information they need to take care of themselves and their babies. Launched in February this year by the National Healthy Mothers, Healthy Babies Coalition (HMHB) in collaboration with a number of private and public sector organizations, Text4baby has sent nearly 6 million messages to more than 100,000 subscribers to date. And its reach is growing.

I was listening to Park at the mHealth Summit in Washington, D.C. Organized by the Foundation for the National Institutes of Health (NIH), the event attracted over 2,400 attendees, and panelists included representatives from NGOs, governments, academia, and the private sector. It was fascinating to learn about the pace with which mHealth, short for mobile health, is taking advantage of new technology to create health impact. At the event, HMHB announced a bold new commitment by Text4baby to reach 1 million moms and moms-to-be by the end of 2012. While the impact of this program is yet to be seen, I was excited to hear about the coverage expansion.

Conference attendees learned about how cell phones, PDAs, the Internet, and even robots are becoming critical tools for improved health outcomes. While the Internet and other sophisticated gadgets – like a smart pill box that can call your phone to remind you to take your medicine – are changing how health care is delivered in the developed world, to me the real potential of mHealth lies in the use of cell phones in developing countries. In India, 50 cell phones are sold in a second, and in Bangladesh, there are now 60 million cell phone users. These markets can provide significant scale to any successful mHealth model.

Bill Gates also agrees. Speaking as a keynote, he noted the use of cell phones to collect birth data of newborns to ensure vaccine coverage in remote areas like Northern Nigeria as the most important use of mHealth.

Not everyone was equally excited about the use of mHealth, though. The lack of profitable models that can be scaled was a concern, as was the utilization of mHealth applications without really understanding the needs of end users. I think we absolutely need to take advantage of the technological advances, but we also need to identify some strategies and goals. We need a definition of what mHealth means, perhaps not a common definition for the whole field, since we all know how challenging that exercise can be, but for each organization attempting to use mHealth. Using cell phones to collect birth data, for example, requires very different resources and systems than deploying robots to carry around sick patients.

And while the use of cell phones by illiterate patients remains a challenge, I see a brighter side to this story as well. During my last visit home to Bangladesh, where cell phones are becoming ubiquitous, I saw rickshaw pullers and day laborers using cell phones. Typically, these are segments of the population that have little, if at all any, education. But with the popularity of cell phones, these users now have a novel incentive and method to learn to read and write in English, a pleasant unintended outcome of the use of cell phones. Hopefully the day isn’t far when these users will pick up their cells not only to call loved ones, but also to use applications that will improve their health outcomes.

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