How will mobile technology help in healthcare? Look to developing nations

BOSTON - When it comes to using mobile technology for healthcare applications, there is plenty developed nations could learn from activities going on in emerging nations.

That was the theme sounded during the closing session at the 3rd annual summit on mHealth held by the World Congress. That session, "An mHealth Prescription," suggested that all countries -- rich or poor, established or emerging -- have an opportunity to harness mobile communications as a means of reforming the healthcare system's dominant focus on reactive care and treatment, encouraging a shift to preventive strategies.

The motivation is simple: the cost of the current system is unsustainable both for developed and developing nations, said David Aylward, senior advisor for global health and technology with Ashoka, a 25-year-old organization focused on enabling "social entrepreneurs" around the world. For example, in India there are only 60 physicians and 130 nurses or midwives for every 100,000 people. That compares with about 267 physicians for every 100,000 people in the United States, he said.

"The focus should not be on healthcare, it should be on health," Aylward said.

The mobile phone offers an opportunity to help distribute healthcare responsibilities, with an eye to relegating hospitals more to their proper place as a last resort for care rather than the first stop, as is so often the case in the current system, he noted. The challenge is that the existing regulatory and reimbursement structure in places such as the United States must be refined in order to accommodate mobile technology, and that will take time.

Also offering practical perspective on mHealth was Kate Canales, creative director for Frog Design, which is working on a number of so-called mHealth initiatives in the developing world (some sponsored by business such as insurance companies, others backed by non-profits). mHealth refers to applications and care solutions that are supported by mobile phones, tablet computers and other mobile devices.

Canales focused on four "lessons" that the Frog Design team has gathered from its work on these projects in developing countries. She suggests that while these models might not map directly to established systems, they offer a creative jumping-off-point for mobile healthcare applications.

1. Get comfortable with non-clinical sources. Use technology to reinforce patient communities with accurate, relevant information. Canales cites the example of a community project where appointments are shared. That way, information has a better change of being disseminated accurately. She notes: "Information shared between patients is the most valuable information in healthcare." Even though doctors and nurses might not be comfortable with this idea, the fact is that more people than ever are sharing information about their conditions -- and mobile technology is at the center of that.
2. Build tools to support and extend existing "human infrastructure," not replace it. The example here: Frog Design allied its resources with an individual in one community who had a mobile phone, using that means to remind him of when people were due for vaccinations, check-ups or other preventive visits. In the United States, this same concept is emerging in an application called PatientTouch.
3. Find systems that are working to support people, then build on them. (And we need to remember to look outside of healthcare.) The example Canales discussed here actually comes from the United States, in the form of the organization Prostate Net. Funded by a cancer survivor, its focus is on education that encourages men to get screened, especially men from the African-American community. And believe it or not, one of the most successful "voices" for this cause has been barbers. That's because many of the targeted men tend to have longstanding relationships, and they are willing to view their advice favorably, Canales said.
4. Start small and learn your way to the right solutions through a deep understanding of patient and user context. One poignant example cited by Canales was an effort to encourage women to travel to birthing clinics by giving them a "mommy pack" of diapers and other care products. After some initial success, however, the clinic saw the number of participating mothers decline. The reason: the incentives in the mommy pack weren't big enough to offset the prospects of the hour long walk the women were forced to make during labor. "You can't design for behavior change if you don't undersand motivation and meaning," Canales said. The lessons learned through that project were later applied to the development of a mobile phone application and service to encourage HIV testing among men in South Africa. Anonymity, in particular, was key, she said.

Photo courtesy of Creative Commons

This post was originally published on Smartplanet.com