This document discusses the use of mobile health (mHealth) technology for improving global health. It describes how mHealth uses mobile devices like phones and monitors to provide health services and information. This includes real-time patient monitoring and mobile telemedicine. The document outlines how mHealth can help achieve UN Millennium Development Goals by improving access to healthcare and reducing child and maternal mortality, especially in developing areas. It highlights how the widespread adoption of mobile phones has made mHealth a promising solution, as mobile infrastructure is low-cost and accessible even in remote locations. Several specific mHealth platforms and tools are described that enable information sharing, emergency response coordination, and geospatial situational awareness.

1. Mobile Health Technology for
Global Health in Action
Julian Wimbush, PhD
Research Fellow
CIDER, UC Berkeley
April 15, 2010

2. mHealth is…

3. …use of mobile communication devices for
health services
and (multimedia) information via:
• Mobile phones
• Smartphones
• Patient monitoring devices
• Mobile telemedicine/telecare devices
• MP3 players for mLearning
• Microcomputers

6. Information Flow
• Moving community and clinical health data
between
• Practitioners
• Researchers
• Patients
• E.g.: real-time monitoring of patient vital
signs,
• E.g.: direct provision of care (via mobile
telemedicine)

7. UN Millennium Development
Goals: 2001-2015
For health:
• Reduce child mortality by 2/3
• Improve maternal health
• Reduce mortality / morbidity by 3/4
• Combat HIV and AIDS, malaria, and other
diseases
• Halt and begin to reverse the spread

8. MDG: Strategic Objectives
• Improvement of the access to emergency
and general health services
• Improvement of the efficiency of health
service delivery
• Improvement of the clinical practice for
enhanced health outcomes
• The reduction of child and maternal
mortality and morbidity in MVPs

9. Reality
• A child born in the developing world is 33
times as likely to die within the first 5 years
of life
• Higher maternal mortality and morbidity
rates (1M and 10M per year)
• High HIV infection rates (2.5M new cases)
• Prevalence of avoidable, communicable
diseases (TB, malaria) due to preventable
factors
• Shortfall of medical workers (Def = 2.4M)

10. The Promise of Mobile Ubiquity
IBM & World Bank, 2006

11. Developing World Context: Ripe
for Growth
• 3 billion+ mobile phone users (64% in
developing world)
• Biggest growth in Asia, Middle East, Africa
• Mobile phones (plus) as a leapfrog technology
• Bypassing fixed-line subscriptions
• 90% of the world now lives within a mobile
reception area
• 2012: 50% of all remote populations will have
mobile phones

12. Ease of Adoption: Low
Cost
• Cost of deployment continues to decrease
• Cheaper infrastructure technologies
(CDMA)
• Cheaper phones (e.g., Java phone $50-100)
• Availability of free and open-source software
(FOSS) / apps

13. Ease of Adoption
• Breaking the literacy barrier
• Direct voice communication
• Communication and coordination with
people in remote, rural areas
• Tracking migrant populations

14. Emerging trends in mHealth
• Emergency response systems
• Mobile synchronous (voice) and asynchronous (SMS) telemedicine diagnostic
and decision support to remote clinicians
• Clinician-focused, evidence-based formulary, database and decision support
information available at the point-of-care
• Clinical care and remote patient monitoring
• Health services monitoring and reporting
• Health-related mLearning for the general public
• Training and continuing professional development for health care workers
• Health promotion and community mobilization
• Support of long-term conditions

15. Distribution of mHealth Programs by
Location and Application Area

16. Mobile Health
• Information as a provider

17. Decentralized Health Care Delivery

19. mHealth: Care Delivery
• screenshot

20. CommCare

21. Information Flow:
Crowdsourcing Data

23. FrontLine SMS
• Screen shot

24. Frontline SMS
• enables users to send and receive text
messages with large groups of people
through mobile phones
• does not require an Internet connection
• works with existing plan on all GSM phones,
modems and networks

25. FrontLine SMS
• Reminders / Adherence
• Coordination / Communication
• Simple SMS-based forms

27. Situational Awareness
• Communication (plus Geospatial
Awareness?)
• Surveillance vs. Disaster
Response

28. Situational Awareness
• Perception of:
• environmental elements in time and space
• comprehension of their meaning
• projection of their status in the near future
• Vital for emergency responders &
surveillance

29. Situational Awareness: Haiti

30. How it works
1. Put word out that people on the ground can send
[Name, location, status/message]
2. SMS submitted, with varying levels of structure/detail
3. Enters database
4. Passed to a mechanical turk-type outfit of volunteers
for structuring
5. Message is structured in the database
6. Gets passed off to orgs (via Sahana) that can do
something about the issue

31. 4636 in Action

32. 4636 in Action

33. Messaging Category Distribution Chart

34. Geospatial Situational Awareness

35. Geospatial Situational Awareness
• Geospatial presentation of situational data
related to incidents and resources
• Real-time
• Can be viewed simultaneously or in layers

36. GeoChat

37. GeoChat
• Evolved from a simple concept
• Can I send an SMS message and see it on a map?
• Automated!
• Collaboration / communication platform designed
to meet the needs of humanitarian aid, international
health and disaster response workers

38. Situational Awareness: GeoChat

39. GeoChat Capabilities
• Create and join in chat groups.
• Translates location names sent by users to a position on a
map
• Can broadcast one or more RSS feeds.
• Twitter-enabled.
• SMS gateway supported by 96% of the world’s mobile
carriers.

40. Implementation Settings
• Mekong Basin Disease Surveillance network
• Laos, Thailand, Cambodia
• Thai Hospital Surveillance System
• Tied to national EHR system rollout in 600
public hospitals

41. Geospatial Situational Awareness (USHAHIDI)

44. Data Analytics: RIFF-Evolve

47. Combining Data: Data
“Meshing” with Mesh4x
• Microsoft Access Database + Java XForms
application + online Google spreadsheet.
• = Combined, then centralized
• Allows disparate orgs to share data while retaining
local applications

48. Mesh4x

49. The Future?
• Bigger crowd + more media = better filters?
• Refined Data Acquisition and Analysis
• Predictive Analytics
• Automated Triaging

50. Thank you!
Questions?