integrated or worked around. There are relatively few
organizational “stovepipes” built up to defend particular proprietary information technology.
But with every day that passes without overall plans
and without standardized open architectures, ICT will
continue to flow into health systems based on thousands of uncoordinated, individual decisions. In a few
years this will create the same problems of interoperability between these thousands of systems that the
United States, the U.K. and other developed countries
are now spending tens of billions of dollars to correct.
5Mobile Phones are Just the Start
A mobile phone by itself will not save a lot of lives.
Strengthening the entire health system is the key to
the success of any kind of mHealth intervention. The
phone provides access. But access to what?
Leadership needs to focus on the center. Policymakers
at the international, regional and country levels must
foster community engagement. They must bring the
contributions of standards experts and ICT and health
professionals together to advance data interoperability
among disparate health information systems, to facilitate the design and implementation of standards for ICT
systems, to create strong policies and software to make
health records private and secure, and to create an environment that promotes incentives for the adoption and
proper use of mHealth solutions by health professionals. At the same time, they must develop the content
and use rules that will be most effective in each country.
Interoperability is possible if services fit into a common, open and standards-based architecture, which today
does not exist. Experts call this “enterprise architecture.”
The technical parts of this should be as common as possible across Latin America (and indeed the world), just as
the cell phone networks are based on common architecture and standards (and can therefore connect with each
other). Global technical standardization enhances country
and local control over information content, use and policies. Then the country-specific parts of enterprise architecture need to be determined: policies, governance and
decision making, use rules, privacy, security, and content.
All this requires strong leadership in the center, focusing on what all the various parties and uses need
in common.
Sana
by Edward J. Remache
After finding suc-
cess in India, Sana, a
team of MIT and Har-
vard School of Pub-
lic Health students, is
bringing its award-
winning technology to
Latin America. Sana,
formerly known as Mo-
caMobile, enables mo-
bile phones to capture
and send medical data,
even in areas with poor
cellular coverage. The
platform allows rural
practitioners to con-
nect in real time
with trained ex-
perts for di-
agnostic and
treatment assis-
tance. The technol-
ogy is currently being
used in Bangalore, In-
dia, in partnership with
health care provider
Narayana Hrudyalaya.
In Bangalore, Sana’s
mobile system has
been successfully
used to identify
and treat oral and
cervical cancer
and cardiovascular
diseases. Sana’s
ability to easily
transmit medical data
to expert medical
professionals has also
allowed nurses and
health practitioners to
screen and manage
conditions for
preventive treatment.
The company’s work
has earned it praise
and recognition, and it
recently won awards
from the Vodafone
Americas Foundation’s
Wireless Innovation
Project, the mHealth
Alliance Award and
the Massachusetts
Medical Society
Information
Technology Award
for its contributions
to the emerging field
of mobile health
technology.
Sana invested its
$150,000 of award
money in the development of an eHealth
curriculum with MIT’s
mHealth Lab, which
will include online resources and curricula and long-distance
learning via satellite.
The first training
program in Latin
America will be in
Monterrey, Mexico,
in January next
year. The course, in
collaboration with the
Instituto Tecnológico y
de Estudios Superiores
de Monterrey’s Ignacio
A. Santos School of
Medicine, will highlight
cutting-edge research
and best practices in
the field. But perhaps
just as important, the
effort seeks to spur
a ”dialogue between
Sana and Mexican
health care providers
that will allow for
eventual incorporation
of region-specific
applications into the
Sana platform,” says
Geoff Groesbeck,
an advisor with
Sana who is leading
their efforts in Latin
America. Future plans
include bringing their
curriculum, training
and technology to
Bolivia, Trinidad and
Tobago and Haiti. For
more information on
Sana, please visit www.
americasquarterly.org/
sana.
