The document discusses the application of computer and mobile health technologies. It first identifies existing health technologies such as operating systems, internet browsers, and new technologies. It then discusses mHealth, noting that the mHealth ecosystem is created through the intersection of health, technology, and finance sectors, influenced by government policies. It provides an overview of the different entities involved in mHealth including health systems, patients, financial institutions, technology developers, and governments. It also includes frameworks for mHealth impact and examples of mHealth applications such as emergency response, data collection, health financing, disease prevention, and treatment adherence.

1. Apply Computer and Mobile Health
Technology

2. IDENTIFY THE EXISTING HEALTH TECHNOLOGIES
• OVERVIEW
1. Introduction to computers operating system
2. Internet browsers
3. Existing new technology

3. MHealth
• The mHealth ecosystem is created through the
collision of three sectors
1. – health
2. technology
3. Finance
– with the backdrop of government policy and
regulation

4. 4
Source: Dalberg research and analysis
Health
Health system
Health care workers
Medical supply chains
Patients
Finance
Banks
Insurance
companies
Private investors
Philanthropists
Donors
Technology
Software
developers
Mobile
operators
Handset
makers
Government
Legislators
Regulators
Legal system
Ministries
mHealth
Service delivery
Mobile
platforms
mHealth
applications
Health
funding

5. Introduction to computers operating system
• An Operating system is software that creates a relation
between the User, Software and Hardware.
• It is an interface between the all.
• All the computers need basic software known as an
Operating System (OS) to function.
• The OS acts as an interface between the User,
Application Programs, Hardware and the System
Peripherals.
• The OS is the first software to be loaded when a
computers starts up.
• The entire application programs are loaded after the OS.

6. Types of computers operating system
• An Operating System can be of Three Types:
1. Single User MS-DoS
2. Multi User UNIX, Linux..
3. Network,

7. • Single User: If the single user os is loaded in
computer’s memory; the computer would be able
to handle one user at a time.
• Multi user: If the multi-user os is loaded in
computer’s memory; the computer would be able
to handle more than one user at a time.
• Network:If the network os is loaded in
computer’s memory; the computer would be able
to handle more than one computer at time.

8. Purpose of computers operating system
• The purpose of the OS is provided an
environment in which the user can execute
programs. The primary goal of an OS is thus to
make the computer convenient to use. A
secondary goal is to use the computer hardware
in an efficient manner.”
• Computer Hardware – CPU, memory, I/O devices
provide basic computing resources.
• Operating System – Controls and coordinates the
computing resources among the system and
application programs for the users.

9. Operating System Components
– Operating System Components
• Main components are
1. process, memory
2. File
3. I/O system
4. secondary storage management

10. Responsibilities of operating system
• Process Management responsibilities.
1. Creation and Deletion of user and system
processes.
2. Suspension and resumption of processes.
3. Provision of mechanisms for process
synchronization.
4. Provision of mechanisms for process
communication.
5. Provision of mechanisms for deadlock handling.

11. • Main Memory Management responsibilities
1. Keep track of which parts of memory are
being used and by what processes.
2. Decide which processes are to be loaded into
memory when memory space becomes
available.
3. Allocate and de-allocate memory as needed.

12. File Management responsibilities
1. Creation and deletion of files.
2. Creation and deletion of directories.
3. The support of primitives for manipulating
files and directories.
4. Mapping of files onto secondary storage.
5. Backup of files onto stable storage media.

13. I/O System Management
• I/O System Management – hides the
peculiarities of specific hardware devices from
the user

17. MHealth
• The mHealth ecosystem is created through the
collision of three sectors
1. – health
2. technology
3. Finance
– with the backdrop of government policy and
regulation

18. 18
Source: Dalberg research and analysis
Health
Health system
Health care workers
Medical supply chains
Patients
Finance
Banks
Insurance
companies
Private investors
Philanthropists
Donors
Technology
Software
developers
Mobile
operators
Handset
makers
Government
Legislators
Regulators
Legal system
Ministries
mHealth
Service delivery
Mobile
platforms
mHealth
applications
Health
funding

19. Framework for mHealth impact
Outcomes
Intermediate
outcomes
Multipliers
Outputs
Inputs
ICT literacy
Health literacy
Health training
M&E
Financing
Health system
needs
Health care
best practices
Procurement &
Supply chains
Cultural attitudes
Network installations
Distribution channels
Research & Development
mHealth
service
delivery
Policies &
Strategies
Related
Infrastructure
Regulation &
Standards
Leadership &
Governance
Communication &
Education
Complementary
mServices
Complementary capital
investments
ICT maintenance and
repair capacity
Access, affordability, quality, matching of
resources, behavioral norms
Better
health
Source: Dalberg research and analysis
19

20. WORKING DRAFT – FOR DISCUSSION PURPOSES ONLY
Supply Chain Management
Health Financing
Source: Dalberg research and analysis 20
Treatment Adherence /
Appointment Reminders
Data Collection / Disease
Surveillance
Health Information
Systems & Support Tools
for Health Workers
Disease Prevention and
Health Promotion
Emergency Medical
Response Systems
Health services
1
2
3
4
5
6
7
Description of mHealth usage and applications
Emergency response tools , including creation of EMR via mobile
phones, and ambulance services whose reach is extended with mobile
usage in remote areas
Collection and analysis of patient data, particularly at clinics or related to
call centers that are used to triage services and treatment; information to
help health worker prioritization; information on inventory (Note: overlaps
with supply chain management)
Use of smart-cards, vouchers, insurance and lending for health services
linked to mobile platforms (e.g., m-Pesa) or otherwise enabled using
mobile
Usage of mobile handheld devices to collect data remotely (e.g., by
community health workers); additionally, use of remote diagnostic tools
for disease surveillance and treatment; includes civic participation in
reporting outbreaks and disease information
Management of inventory and supply chain steps by mobile tracking and
communication; includes advocacy informed by supply chain
information
Use of mobile and SMS-based health information and education to
inform individual patients of preventive care and treatment
Utilization of messages and voice to communicate treatment and
procedural reminders to patients (e.g., automated SMS reminders to
patients on chronic medication)
Example Cases
Examples of mHealth interventions

21. Adherence
•Adherence is a huge issue in treating patients who
are HIV-positive and taking antiretroviral therapies
(ART), thus, WelTel provides weekly SMSes from
clinic nurses to patients, inquiring regarding their
treatment, and patients are required to respond
within 48 hours; if no response is received, the
nurse follows up with a call and referral if needed
•Social-enterprise model, funded by PEPFAR and
CDC
•Founded in 2007

22. Advantages:
• With reminders, patients adherence improves, leading to better outcomes in
terms of suppressed viral loads
• Cost-effective means of extending health system reach where roads are bad and
travel expensive, but mobile service is inexpensive and reliable; basic handset is
required (rather than a smartphone); utilizes existing clinic nurses
• Cost of the offering decreases with scale; also reduces overall health system
costs by estimated 1-7% due to ability to more efficiently following patients, and
keeping patients healthier via improved compliance, meaning they use less
emergency health services and avoid development of drug resistance and need
for 2nd line medications
• Potential to move “horizontally” beyond HIV given simplicity of system
• Results:
• In recent RCT, patients receiving SMSes had better adherence and suppressed
viral loads
• Beneficiaries and willingness to pay:
• Patients receiving antiretroviral therapies (ART), primarily in
the pastoral Masai communities of Kenya; ART funders who can
receive better return on investment
• Patients at Kajiado and Pumwani Health Centre receiving ART
indicated a willingness to pay up $0.50 to $1 USD.

23. •Current scale: Pilot and RCT in 273 patients
•Costs/revenue: Budget for RCT was $719k
•Estimated costs to scale:
oScaling to 400k PEPFAR patients on ART
would result in 26,000 additional patients
with suppressed viral loads
oAt $8/patient, this would cost $3.2M, which
is