Ic T can leverage limited
resources to extend
the reach of health knowledge.
ing health care needs of their citizens. The essence of
mHealth is that ICT can leverage limited resources to
extend the reach of health knowledge. There are not
enough funds to extend health care in the traditional
way to entire populations (and the experience of the developed world is that the traditional approach is hardly
a model to emulate). So bring open-minded leaders together, think about how to empower the public and
health workers with information and efficient systems,
and see if you can develop a shared vision.
This shared vision needs to include all levels of government, NGOs, health practitioners, and the private
sector. Taking mHealth to a sustainable scale requires
creative new public-private partnerships.
Information about m Health and eHealth—all uses of
digital technologies for health, not just mobile ones—is
hard to come by. It is difficult to find out who is working on particular solutions in a single country, much
less all of Latin America or the world.
Tools such as HealthUn Bound (www.healthunbound.
org), recently deployed by the Health Metrics Network
of WHO, mHealth Alliance and other partners, are designed to bridge information sharing gaps. In addition,
newly developed networks such as the QUIPU Network
established by the QUIPU Project at UPCH will help to
close this gap.
3look for Scale
Innovative projects are under way across the region with
the potential to create an even larger impact. For example, UPCH launched Cell-PREVEN—a real-time surveillance system using low-cost cell phones and the Internet
to monitor adverse reactions to the antibiotic metronidazole among female sex workers. The project showed
that it is unnecessary to have the latest smart phone
or tablet PC to create a sophisticated public health surveillance system.
Every year hundreds die of dengue fever. Mosquito
bites can spread outbreaks quickly
with devastating effect. Working
with the Secretaria de Estado de Saúde
do Amazonas and the Fundação de
Vigilância em Saúde in Brazil, a team
of Nokia researchers developed Nokia
Data Gathering, using cell phones
to help fight the disease’s spread. Fifty health workers
equipped with Nokia smartphones helped reduce the
number of cases of dengue dramatically from 3,522 in
2008 to 245 in 2009.
The Enhancing Nurses Access for Care Quality and
Knowledge through Technology project empowered
nurses by providing remote training and support via
PDAs in the Caribbean. In Guatemala, the National School
for Nurses of Cobán, the Canadian Agency for International Development and the Centre for Nursing Studies
in Newfoundland created a virtual nursing course, which
is taught via a combination of telephone and two-way
data communications. Microsoft Research provided a
grant to professors at the University of the West Indies
to create a mobile phone-based health care management
system, to be deployed first in Trinidad and Tobago, followed by a broader regional rollout. The system can also
send suggestions directly to patients via SMS message or
pre-recorded voicemail.
This is only a sample. The critical point is that almost every mHealth project so far has been a single application aimed at part of a single problem, rather than
an integrated set of applications sharing information
along the full continuum of care, with associated decision support and administrative systems.
Thus, for example, we see projects doing public messaging about HIV/AIDS, but they are not connected
to community or clinic-level care. The real power of
mHealth for better and more efficient outcomes—and
as a business—comes from creating value chains of information sharing. mHealth needs to be comprehensively integrated with mainstream health care systems,
including electronic medical record systems.
4Don’t wait to Develop Policy
Digitization in health care is just beginning in low- and
middle-income countries. There are relatively few legacy information technology systems that have to be
