The document outlines opportunities for using mobile technologies (mHealth) to improve health outcomes and systems. It discusses how mHealth can enable direct communication, improve disease surveillance and management, support emergency response and telemedicine, and enhance health communications. However, challenges include limited impact evaluation of mHealth integration and differential access to technologies. Key lessons are that technology is a tool, successful integration requires participation, access should drive use, and monitoring and evaluation are important.

1. Creating an Enabling
Environment for mHealth
Patricia N. Mechael; PhD, MHS
presented at
International Technology Institute
5th Conference on Information and
Communication Technology:
Media Convergence- Moving to the
Next Generation
Cairo, Egypt
16-18 December 2007

2. Presentation Outline
• Introduction
• Identification of mHealth opportunities
• Technology lifecycle and integration decision-
making
• Maximization of mHealth: Lessons and
challenges
• Improving health outcomes and efficiencies

3. Technologies under
consideration & applications
Mobile technologies that facilitate
communication, processing of data, and
transfer of information
• Mobile phones
• PDAs
• Patient Monitoring Devices
• MP3 Players
• Microcomputers and mobile computing

4. mHealth Opportunities
• Mobile phones enable direct communication and
information transfer in motion
• Increasing numbers of subscribers and coverage-
reaching & superceding MDGs for connectivity
• Direct relationship between improved
communication and access to health care
• Technology prioritized by people in developing
countries for work and social communication
(connectedness)

5. Key Outcomes of Interest
• Reducing mortality
• Reducing morbidity
• Reduced feelings of isolation for rural health care
workers- part of a network
• Saving time
• Saving money
• Increased productivity within health system
• Enhanced quality of care
• Enhanced disease surveillance and control

6. Health Systems Opportunities
• Emergency response systems (MVAs and EOC)
• Disease surveillance, management, and control
(including health promotion to general public via SMS
for early detection and warning)
• Mobile telemedicine (diagnostic and decision support)
• Human resources coordination, management,
supervision, and support (decentralized health
services)
• Services monitoring and reporting (HMIS, vaccine
programs, quality assurance, patient
hotlines/directories, accountability to clients- increasing
demand)
• Supply chain management

7. Health Communications
Opportunities
• Health promotion campaigns/ messages to
general public- BCC especially youth
• Public service messages and early warning
systems
• Training and capacity building of health care
personnel-mLearning (formal and informal)
• Call centers and hotlines
• Networking- communities of practice
• Advocacy

8. Technology Integration
In-house development
Strategic
Pre-tech
Adoption of
Planning:
off-shelf
Identifying
software
objectives,
users, resources,
workflows
Full
Integration Customization
or configuration
Small-scale testing
Large-scale and mature
distribution, development
utilization,
Evaluation training

9. Strategic Aims and Objectives
Improve function of health care system
• Patient care, administration, patient information
Improve delivery of health care
• Accessing up to date medical information,
professional development, remote diagnostic
support, decision support, quality assurance,
disease surveillance
Improve communication about health
• Patient data, interactive communication, media,
research, advocacy

10. Target beneficiaries
Direct and intermediary…
General public and health sector…
• International
• Regional
• National
• Provincial
• Local
Look at needs, capacity (including
literacy and language), location,
access
Additional burden? Or relief?
Participatory approaches
(beneficiaries, program
implementers, technology
developers)

11. Monitoring and evaluation
• Formal integration program- targeted application of
mobile technology to support a specific health
program
• Informal integration- mobile technology widely used
to support programming without consideration of its
specific contribution to program objectives
• Begin with documentation and internal learning and
standardization
• Expand to assessment of select interventions- and
the specific role and contribution of mobile
technologies (positive and negative)
• Learn from other ICT and Development Programs
(esp. Education and Commerce)

12. mHealth Challenges
• Limited documentation and
impact evaluation- effects of
integration lost within broader
programming – many case
studies and anecdotes
• Individual haphazard
integration without knowledge
of the range of possibilities,
standards for
implementation, or indicators
to measure success – internal
and external learning and
exchange

13. mHealth Challenges
• Differential access to mobile technologies and
capacity to maximize integration
• Increasing trends to focus on mobile health without
proper learning mechanisms from eHealth
• Rapidly changing technologies and environment
• Poor quality of health information and services
especially in rural areas

14. Key Lessons in mHealth
• Technology is a tool
• Successful integration requires full network
participation
• Local access and availability should drive integration
• Build on existing mHealth patterns
• Simple, user-friendly, and sustainable
• Creative combination of new and old technology
• Training and capacity development
• Regular monitoring and evaluation
• Clear planAssessment
Based on InfoDev for sustainability

15. The way forward…
• Identify key areas in which mobile technologies can
leverage international policy and programming objectives
[Develop a strategic framework…]
• Move from case studies and anecdotes to intensive
evaluation
• Develop standard protocols and indicators to assess and
compare the effects of improved telecommunications and
integration of mobile technologies on health
• Explore the role of various partners including industry:
Corporate Social Responsibility and social marketing of
technology