The greatest barrier to
mhealth is that policymakers
are mostly uninformed
about its possibilities.
sionals instant access to individual electronic health
records and decision support.
Nevertheless, the introduction of such systems in
Latin America and other regions has been hampered
by national leaders’ lack of awareness of the advantages
and uses of mobile technology for health care systems,
the lack of training of health professionals in health informatics, and the weak coordination and partnerships
among stakeholders. Inflexible telecommunications and
health regulations also play a role, along with the absence of incentives for individual physicians to employ
new technology to provide patient services outside traditional office and hospital settings.
Still, there are a growing number of examples of
health-related mobile technology projects throughout
the region. The Instituto Carlos Slim de la Salud in Mexico
City has been the leader in Mexico, where it has begun
trials of mHealth services for diabetes, innoculations
and maternal health.
In Peru, researchers at the Universidad Peruana Cayetano Heredia (UPCH) have been pioneers in developing
this field and other biomedical informatics applications
in Latin America. 2 The Inter-American Development
Bank is also encouraging progress in mHealth, most recently with its Mobile Citizen program.
Coupling the possibilities of modern ICT with the ex-
pertise of dedicated health professionals will help take
these new tools to the next level—but it will require a
high degree of public and private leadership. Indeed,
the greatest barrier to the rapid and effective
deployment of mHealth is that policymakers
are mostly uninformed about its possibilities.
1 learn from other Industries
Health care is the only large industry in the world that
has not fully embraced modern information technology.
Health care informational flow should be as efficient
and comprehensive for health purposes as Walmart’s
information management system is for retail. When a
pair of jeans is purchased, a series of data events is set
in motion: queries go to the bank’s system to confirm
the purchaser’s identity, check for sufficient money in
the account, and debit the account. Information on each
sale is transmitted in real time from the individual store
to Walmart’s central financial and inventory databases.
Independent organizations up and down the supply
chain, inside and outside the country of purchase, also
receive data notification in real time so another pair
of jeans can be produced and shipped. Aggregated purchasing, financial and supply chain data is “mined” and
linked with other inputs such as advertising or changes
in market demographics to research everything executives might want to know. Data are entered only once,
and trends are detected immediately.
Today’s health information systems have none of
those capabilities. They remain functionally weak, la-bor-intensive and paper-based—which results in poor
quality health services and information inefficiency.
Patient records are kept on paper. Public health information is usually collected by entirely separate house-to-house or hospital paper surveys. Paper summaries are
then created and delivered up the chain. At some point
David K. Aylward, JD, is executive director of the mHealth Alliance, hosted by the United Nations Foundation.
Beatriz Leão, MD, is a cardiologist from São Paulo, Brazil, and a world authority on health ICT standards. Walter
H. Curioso, MD, MPH, PhD, is a Research Professor at Universidad Peruana Cayetano Heredia in Lima, Peru, and
a specialist in biomedical and health informatics. Fabiano Cruz works at the Science and Technology Division of
the Inter-American Development Bank, in charge of the use of modern ICT for development, including health.
the opinions expressed in this article are the sole responsibility of the authors acting and do not
reflect the opinions of the organizations by which they are employed.
