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 You've probably heard the term "E-health," used in this forum and elsewhere to refer to things such as electronic health records, but a possibly more interesting advancement from a public health standpoint is the burgeoning area of M-health. M-health is the use of mobile hand-held devices, especially text and web-enabled cell phones, for the delivery of health information and messaging. Some 3.3 billion people, one of every two people on the planet, owns at least one cell phone. In the rural and developing world, cell phones are the fastest growing means of communication. Market penetration in the developed world is around 90 percent, and in the developing world about one-third of that, and growing. Even among the poor, the cell pone is becoming ubiquitous. M-health collaborations are occurring in numerous countries, addressing a multitude of health conditions. Often they provide reminders about healthy activities, sources for disease-specific information. While high quality assessments of their effectiveness are still forthcoming, there is reason to be hopeful based on the limited data on outcomes and process that are available. For example, Project Masiluleke in South Africa sends out 1 million text messages a day encouraging people to be tested for HIV, and providing a phone number to call for more information. In the first five months of the program, the number of calls to the South African National AIDS Helpline quadrupled. The collaborations that are emerging around this technology development are also fascinating, with the potential to build technological and economic capacity as well as healthier populations. Coded in Country, for example, is a project that encourages local programmers to develop software solutions for local projects. "The closer the developers of solutions are to where the problems are, the more effective the solutions become and the more transferable they become to similar environments." Writes Walter Curioso, MPH, who studies m-health as part of his PhD research. "In many cases, local development is leading to more rapid trial and error with a goal of faster and greater success." Coded in Country was initiated by DataDyne, a non-profit sustainable information technology company, who now collaborate with non-profit D-Tree International, and the health care technology company Dimagi. Of course informatics giants such as Google are also involved, often bringing their substantial expertise and resources to the assistance of those local developers who understand their specific social, cultural and health contexts the best. Cell phones are also being explored as a means of tracking patient wellbeing or compliance with treatments, and for disaster preparedness-warning a population of an impending tsunami, for example. Hand-held devices of the "PDA" variety also hold promise for practicing health professionals that may not have access to large medical libraries, specialist consultancies, or other networks to provide informational assistance.  |
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