What is mHealth?

Together with Videographer Ethan Goldwater MobiHealthNews have produced a great video report asking delegates from the mHealth Summit in Washington DC “What is mHealth?”

These are a great challenge to the definition of mHealth as the leverage of Mobile (the newest and least understood mass media) for Health. But I find that each of them either merely describes a part of it or is taken out of context. As a recap here are the 8 already identified unique attributes of Mobile as the newest mass media (as described by Mobile Industry Guru Tomi Ahonen):

1st – mobile is personal
2nd – mobile is permanently carried
3rd – mobile is always on
4th – mobile has a built-in payment channel
5th – mobile is available at the point of creative impulse
6th – mobile is most accurate at measuring its audience
7th – only mobile can capture the social context of consumption
8th – only mobile can offer augmented reality

As an exercise I thought it would be interesting to give my opinion on the validity of the definitions put forward by each of the participants in the Video:

“…5 billion connections going up really fast”
David Aylward, mHealth Alliance

This is a indication of the popularity of mobile devices but it could never be considered a definition…

“…a catalogue of things …doing anything related to your health on your cellphone, so whether you’re doing a personal health record, whether you’re checking your glucose level or you just want to know how far you walked”
Dr Philip Olla, Mobile Diagnostic Services

Yep, Philip has appreciated it’s a wide range of things. I think the 8 already identified unique attributes incorporate these and many more. I also think that as mHealth services become more automated patients won’t think of them as “doing” eg. the pedometer that runs in the background on my Nokia N8 (similar to what you can find in Japan for years now) requires me to DO nothing.

“…personalised medicine or personalised health”
Chris Wasden, PriceWaterhouseCooper

I don’t think this is going to hold much water as some sections of our society have been fortunate to have had personalised health care for years before the mobile was even invented eg. the British Queen enjoys an entire Medical Household…

“…takes the right information & access to the service providers & puts it right in the patients pocket”
Dr Peter Hudson, Healthagen

Definitely these are key to what mHealth lets us achieve – but they are somewhat dismissive of the impact mobile devices are having when they’re in the pockets of carers…

“…technology to deliver an intervention to a patient, in other words how you can change the paradigm to have a patient centered approach”
Rodrigo Saucedo, Instituto Carlos Slim de la Salud

Well it’s certainly transformational when you can eliminate the barriers of time and space, at 3G Doctor everytime we bring a Patient & an informed Doctor together we see this, but it can’t really be considered a definition…

“…happens when you’re on the move, whether you’re a physician, a clinician or a consumer patient”
John Moore, Chilmark Research

Not so sure about this definition, mobiles themselves aren’t always on the move (most lie dormant for at least 7-8 hours a night) and this trend is going to be magnified in mHealth use cases as they increasingly serve immobile patients who are rarely “on the move”…

“…people are mobile and wireless brings mobility, so it’s not about the mobility it’s about the connectivity”
Rob McCray, Wireless Life Sciences Alliance

I find this definition misses the mark a good bit. I have lots of evidence that suggests an important mHealth service will be smart sleep monitoring and obviously people aren’t typically mobile when they’re asleep so the premise of “people are mobile” fails for me to shed any light on what mHealth is…

“…you can do anything along the healthcare spectrum from really complex telemedicine, telehealth, teleradiology to basic services such as getting an SMS about sexual health & reproductive services”
Alison Bloch, mHealth Strategist

Some great examples of the types of services that mHealth can support but not really a definition…

“…health content on SMS, health content on mobile web even original health videos”
Nandu Madhava, mDhil

Healthcare content on a personal unshared device is without doubt transformational but it’s not an all incompassing definition as it doesn’t even begin to include the communicative abilities that this mass media natively offers…

“…meeting people where they not just geographically but also emotionally”
Margaret Morris, Intel

Knowing of Margaret’s research work with the Mood Monitor App I’m assuming this is another out of context comment…

“…is really a platform, it’s in your hands it’s in your pocket it goes with you wherever you are and it’s a new way to reach the last mile”
Josh Nesbit, FrontlineSMS:Medic

A description of some of the 8 already identified properties of mobile as the newest mass media but again not a definition…

“…improving the access dramatically to health services, leveraging the phone in the pocket we can extend health services the way we couldn’t before”
Matt Berg, Millennium Villages Project

This neatly summarises the advantages of mHealth but again it’s not a definition…

“…disruptive, low cost, it’s all about the potential”
Don Casey, West Wireless Health Institute

Again these are advantages of mHealth…

“…it has luckily become an inclusive technology which has crossed all classes and all barriers and has reached even the poorest of communities”
Dr Ilmana Fasih, ZMQ Technology

I think this comment is referring to mobile phones…

“…is always on the go healthcare”
Susannah Fox, Pew Research

As with my response to John Moore’s definition above I’m not so sure about mobiles being on the go all the time eg. the mobile based sleep monitoring service I use actually requires me to not be on the go.

“…is something that is more of a revolution”
Mehul Shah, CTIS

Mehul is acutely aware of the transformation that is being seen, but this again isn’t a definition…

“…there’s going to be a convergence between mHealth and eHealth”
Trishan Panch, Sana Mobile

I’m not so sure it’s valuable to consider this to be convergence. More patients already use mobile phones for their health than use computers eg. even if we ignore the numbers isn’t it obvious that when we need advice or assistance we instinctively grab a phone rather than boot up our computers and go online?

A few years back the music industry thought that the same would happen with mobile content eg. that ringtones would be something that was controlled by the music industry. But it turned out that the ringtone industry generated billions of dollars for a completely new market entrant (mobile operators).

I’m betting that eHealth/mHealth convergence will seem absurd as mHealth entrepreneurs begin to capitalise on a mass market media that is available at the point of creative impulse and can accurately measure its audience and their social context. When we start leveraging Augmented Reality to help patients and carers everyone will sit up and realise this is transformational and has a reach that eHealth could never attain.

“…eHealth, mHealth – whatever you want to call it, I think the greatest need is in the rural populations of Africa and that’s why I want to make a difference”
Dr Morello Molefi, Telemedicine South Africa

Whatever you want to call it? Might I suggest that if you want to make a difference forget about eHealth and focus on mHealth as this leverages the only electronic device that has a greater distribution in emerging markets. 20% of GDP in Kenya is already passing through a mobile payment service (mPesa) and soon it is inevitable that we will be able to say something similar about healthcare (eg. “20% of rural african healthcare is being served by mobile phone based content and care services”). If you think this is unimaginable just think for one moment about the potential there is already today for invaluable health information to be accessed through the mobile operator portals that run on low cost WAP enabled devices…

“…they can actually be diagnosed on a remote basis and I just think it’s a great tool because it can provide access”
Thandi Ramathesele, IZWI Multimedia

Rather than a definition I feel this again gives us another good explanation of what mHealth can offer…

“…providers need to learn that they can get in there and be willing to interact in ways that are uncomfortable and in ways that we’re not traditionally used to doing. And I’m hoping that we’ll rise to that challenge and be a part of this wave of improved health”
Dr Enoch Choi, Palo Alto Medical Center

Not so sure about “be willing to interact in ways that are uncomfortable”. Sadly I’ve seen lots of this before and it really isn’t something I think patients deserve. Doctors work best when they’re comfortable because (as I’m sure Enoch knows well) this isn’t a profession that lends itself well to a “Jack of all Trades” approach. Obviously get yourself educated about the opportunity to effectively consult with patients remotely but if working with patients on the Phone or 3G Video Call is something you’re not comfortable with leave it to someone else – Doctors aren’t all the same and there are some out there who are really good at it. In my opinion there’s more than enough to do without Doctors feeling the need to do something they don’t want to do…

So what do you think? What is mHealth? Your turn, answers in the comments…

About David Doherty

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2 Responses to What is mHealth?

  1. Pingback: “Don’t immediately believe the mhealth hype – Dave Clifford” « mHealth Insight: the blog of 3G Doctor

  2. Pingback: What’s the value of mHealth? | mHealth Insight: the blog of 3G Doctor

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