ICTs in Health Sector : The Rise of mHealth Programs

The Mobile phone usage has significantly increased in recent years. It is making a huge impact and transforming lives, especially in Africa. The impact of mobile phones is not only being felt in the urban areas, but in the rural areas, due to their cheap prices, and easy access. One of its potential benefits to impoverished populations is in the health sector. In recent years, mHealth has emerged as an important sub-segment of the field of electronic health (eHealth). It can be defined as the use of mobile communications such as mobile phones and PDAs for health services and information.

Though the mHealth field is still in its early stages, it has already begun to transform health delivery throughout the developing world. Benefits include:

  • Increased access to healthcare and health-related information, particularly for hard-to-reach populations.
  • Improved ability to diagnose and track diseases.
  • Timely public health information….making it more easy to take immediate action.
  • Expanded access to ongoing medical education and training for health workers.

Despite the broad economic advances of this decade, the 2008 UN report indicates continuing dire conditions in crucial public health areas. For example:

  • Every minute, at least one woman dies from complications related to pregnancy or childbirth.
  • An estimated 2.5 million people were newly infected with HIV in 2007.
  • Communicable, and entirely avoidable, diseases such as tuberculosis (TB) and malaria continue to claim lives due to preventable factors such as lack of access to proper drugs and medical treatment.

Promise of Mobile Phones in mHealth:

Mobile communication offers an effective means of bringing healthcare services to developing country citizens, due to their low-cost and high penetration rates – 64% of all mobile phone users can now be found in the developing world, and by 2012, half of all individuals in remote areas of the world will have mobile phones. Hence, the possibilities are endless.

The key applications for mHealth in developing countries are:

1) Education and awareness: SMS messages are sent directly to users’ phones to offer information about testing and treatment methods, availability of health services, and disease management. Evidence suggests  that SMS alerts have more of an impact on and a greater ability to influence behavior than radio and television campaigns.

2) Remote data collection: Gathering data where patients live is vital, and information should ideally be updated and accessible on a real-time basis. The data collection process is more efficient and reliable if conducted via smartphones, PDAs, or mobile phones rather than paper-based surveys that must be submitted in person and manually entered into the central health database. It also enables public officials to gauge the effectiveness of healthcare programs, allocate resources more efficiently, and adjust programs and policies accordingly.

3) Remote monitoring: This group of applications consists of one or two-way communications to monitor health conditions, maintain caregiver appointments, or ensure medication regimen adherence. monitoring patients at home for chronic conditions dramatically improves survival rates.

4) Communication and training for healthcare workers: Connecting health workers with sources of information via mobile technology is a strong basis for empowerment, as it provides the support they need to perform their functions effectively and self-sufficiently.

5) Disease and epidemic outbreak tracking: Deployment of mobile devices, with their ability to quickly capture and transmit data on disease incidence, can be decisive in the prevention and containment of outbreaks.

6) Diagnostic and treatment support: With mHealth-enabled diagnostics and treatment support, patients are able to receive treatment in their villages and homes, averting the need for expensive hospital visits, which are beyond reach for many.

Impact of mHealth…a few examples:

Peru: Health workers use mobile phones to send SMS messages with real-time data on symptoms experienced by clinical trial participants. Enables immediate response to adverse symptoms.

Uganda: SMS-based HIV/AIDS awareness quiz led to an increase of nearly 40% in the number of people coming in for free HIV/AIDS testing.

South Africa: A SMS message campaign promoting HIV/AIDS awareness resulted in nearly a tripling of call volume to a local HIV/AIDS helpline.

Philippines: Phoned Pill Reminders for TB Treatment. TB patients were given mobile phones and called daily with reminder to take their TB medication—90% did.

Rwanda: In 2004, Rwanda’s Treatment and Research AIDS Centre (TRAC), began to implement TRACnet – designed to allow for the exchange of critical information relating to HIV/AIDS in a more timely and efficient manner. As of May 2007, 143 of the 148 health facilities providing ARV treatment in Rwanda were connected to TRACnet.

Clinical studies of mHealth programs have shown that the patient health has been improved in 3 ways:

1) Improved compliance with treatment regimes: A 2007 pilot in South Africa showed that with SIMpill, 90% of patients complied with their medication regime, compared with the typical 22 to 60% compliance rate without the system.

2) Improved public awareness outcomes: In South Africa, Project Masiluleke, which promotes an AIDS hotline through SMS messages, resulted in a 350% increase in phone calls to the hotline.

3) Improved disease management: A recent US study on the use of wireless-enabled PDAs by Type 2 diabetes patients found greater improvements in blood sugar indicators among regular users than among less frequent users

Critical Factors in Future Plans:

For the success of the mHealth projects in the future, there are some critical factors to keep in mind:

– Work closely with the local and regional governments. The service must respond to the local needs. Also, the government support is critical for long-term success.

– Maintain a focus of usability. The solution has to be as user-friendly as possible.

– A component of sustainability for mHealth programs is building capacity to enable programs to be locally implemented and maintained. Also, open source software is a tool for self-sufficiency, as it reduces costs, increases the available pool of programmers, and eliminates the need for outside consultants. It also encourages innovation.

Conclusions:

Technology is transforming lives in the developing world. But one cannot just introduce technology and expect it to work. “Diffusion-based” strategy is the key, by collaborating with the governments, learning/understanding the needs of the locals, and teaching/training the locals about the positives of the technology being introduced. Without high levels of local adoption rates, none of the technologies will work.

Having said that, all trends indicate that investment will continue and mHealth projects will serve an ever wider range of constituents in the years ahead. M-Health projects are operating and making an impact in a wide variety of developing countries. Documented results – in both the developed and developing world – reveal that mobile technology improves the efficiency of healthcare delivery. The next stage in the evolution of the mHealth field is to increase the scope and scale of operations. The long-term goal and expectation is that mHealth programs will have a significant positive impact on health outcomes such as reduced infant mortality, longer life spans, and decreased contraction of disease.

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About pritamkabe

Originally from Bombay, India. Relocated to the United States in 1997 for attending graduate school at The University of Texas. Completed my Masters in Electrical Engineering in 1999 and then worked in the Hi-Tech industry for the next 11 years in Austin, Texas. I have a passion for travelling, meeting new people, and experiencing new cultures...and i've been very fortunate to have gotten the opportunity to travel quite a bit. Sports and food are my other big passions in life. Some life-changing experiences in my life a years ago changed my perspective of life, after which, just have an engineering job was not meaningful to me anymore. Hence i quit my engineering career, and I'm now motivated to give back to society and make a positive impact in some way. To get started on that journey, i went back in graduate school, and recently graduated as a "Mid-Career Fellow in Foreign Service", from the Edmund A. Walsh School of Foreign Service, at Georgetown University, Washington DC. Currently in New Delhi, India, on a research fellowship, to learn about the educational issues in India, and brainstorm my ideas about technological interventions for resolving those issues.
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