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  • Time to get mHealth moving

Using mobile devices to collect and share health data can make healthcare cheaper, faster and more equitable, argues Jody Ranck.

You can't see health data as they flow from clinic to decision-maker — but they are absolutely critical for informing good policies and allocating resources appropriately.

Countless lives are lost each year because of limited access to health information. If an infectious disease breaks out in a remote village, for example, it can take weeks for surveillance data collected on paper to reach central systems — and in that time, the outbreak could have become an epidemic.

But equipped with a mobile phone, a health worker in a remote area can send real-time data on symptoms observed in an outbreak to the health ministry. 

Using mobile phones in this way, known as mHealth, can dramatically reduce the damage caused by disease. It can also prevent drug stock-outs and improve patient care.

Developments in modern ICT — moving beyond the computer, fax and landlines to mobile devices — are key to improving the ease and efficiency of health data flows, ultimately giving people greater and more equitable access to health services.

The mobile solution

In the past decade, a mobile communications revolution has swept the globe. Nearly 90 per cent of the world's population now has access to a mobile-phone signal, including 80 per cent of people in rural areas.

Mobile phones promise to benefit people in remote areas by making it easier — and cheaper — to diagnose diseases such as malaria and tuberculosis. A recent trial in Nairobi, Kenya, showed that healthcare workers' use of mobile phone technology can help HIV patients adhere to treatment.

The benefits aren't limited to managing patients. The flexibility of mobile communications is shifting the landscape of health information-sharing, playing an increasingly important role in strengthening health systems.

But as the range of donors funding global health has expanded since the early 1990s, so too has the number of data reporting systems — resulting in a fragmented structure where separate systems can't 'talk' to one another.

Well-designed ICT systems that are interoperable and use open standards can harmonise systems and transform the way we use data to make policies and deliver healthcare.

In most cases, it will take decades to develop and expand such systems. But some smaller countries, such as Belize and Rwanda, have already had success in implementing robust systems to track inventories on rolling out anti-retroviral treatment programmes.

And FrontlineSMS:Medic's use of SMS in Malawi has saved local health centres money and time by reducing visits for routine health problems.

A tool for maternal health

Improving data collection and sharing has particularly great potential for strengthening maternal and newborn care.

For example, by tracking inventories mHealth and eHealth (healthcare supported by electronic communications) systems can help to ensure that life-saving drugs are available when patients — such as a woman who arrives at a rural clinic haemorrhaging from childbirth — need them.

A pilot project in Senegal — supported by the UN Foundation and Vodafone Foundation Technology Partnership — used a free, open-source data collection tool for mobile devices called EpiSurveyor to collect maternal health data across ten districts. 

In partnership with the WHO and the social enterprise DataDyne, the Senegalese Ministry of Health used EpiSurveyor to identify a shortage in the use of partograms (a set of measurements used by midwives to enable healthy births). 

The ministry distributed partograms more widely and encouraged midwives to use them for every delivery. Follow-up surveys revealed that partogram use increased by almost a third across the ten districts, compared with a one per cent increase in areas outside the pilot area.

Not just about technology

The rapid rise of mobile devices in the developing world is a unique opportunity to improve the flow of health information, whether through simple phone calls, SMS messaging, wireless data transmission or the burgeoning wireless internet.

New applications can help with decision support, collection of more accurate and timely data, inventory management and disease surveillance — capabilities that are essential for sound policymaking and planning.

And the next generation of mHealth applications in the developing world may include peer-to-peer applications for communities to collect their own data, or engage in peer support for healthcare. 

Mobile money networks and mHealth are also converging in ways that may drive innovative health financing mechanisms such as micro-insurance.

But to make this promise a reality, key stakeholders — from ministries and nongovernmental organisations to the private sector — must prioritise mHealth training for healthcare workers so that they understand both health systems and modern ICT technologies.

mHealth is not purely a question of technology. For mobile devices to work at their best, health systems will have to be transformed, and the changes will require managerial and organisational innovation.

Front-line health workers to policymakers and donors must start to facilitate data-sharing through ICT and mobile technologies now. The future of healthcare for the world's most vulnerable population depends on it.

Jody Ranck is the lead author of 'Health Information and Health Care: The Role of Technology in Unlocking Data and Wellness', and director of thought leadership, policy and advocacy for the mHealth Alliance, an organisation hosted by the UN Foundation.