In this TechChange Podcast Patty Mechael, Executive Director at the mHealth Alliance and Adjunct Assistant Professor of International and Public Affairs at Columbia University, describes a bizarre history of mobile and mHealth:
“So mobile phones have been around probably since the first automobiles so I think since the 1920’s or 30’s and so but they didn’t really gain traction say until the mid to late 90’s where in the 80’s be started to see them in films like Wall Street as things like very large brick phones and then over time the technology became smaller, sleeker and more affordable so that the general population particularly in developed countries. In parralel what we saw in developing countries was the deployment of mobile network towers in urban areas that then started to move out into rural areas and so by the early millenium, so in around you know 1999, 2000 we started to see more robust telecommunications infrastructure in the form of cellphone towers .
Now mobile health itself actually began in the biomedical engineering field and really started with looking at wireless technologies and sensor technologies and how sensor technologies could be incorporated to monitor peoples health at a distance. And so what we saw in the very early days were things like remote cardiac monitors that then have like since evolved to start to look at things like diabetes monitoring and other types of sensor technologies.
At the same what we saw, particularly in developing countries was this new found access to mobile communications infrastructure(s) and basic handsets themselves that now enabled people in areas of the world that were never really had access to fixed line telephones now having access to a communication and information channel.
And so many of the early say mHealth implementations really came out of work in developing countries out of neccessity because they didn’t previously have access to really basic communication and or information tools or channels in rural end of use areas and so in at the same that that was happening on the communications side so now people were able to access emergency medical transportation services, they are more able to contact their healthcare providers with questions healthcare providers could coordinate their work togehter much more effectively using mobile technology there is a movement to use Personal digitlal assistants to do data collection and so some of the early mHealth implementations related to information or related to doing surveys on PDAs on various health issues whether it was immunnisations or the demographic health inforamtion surveys and some of those things.
And a lot of that work happened predominantly in the early millenium what we then saw over time was a real systematic movement in the mHealth space to start to develop mobile health applications for cellphones and so what you ended up having were things like Frontline SMS which was basically a SMS based service very broadbased service that can be used for anything being systematically applied to health or some of the early work of the UNICEF Innovations Group out of which came Rapid SMS that provided a framework for engaging and SMS based structured interactions and data collection and messaging. And so some of these early programs were applied to providing support tools for health workers to manage their client base more effectively or you know using them for things like supply chain management so one of the early UNICEF implementations was around the supply tracking of Plumpy’Nut which is like a nutrition supplement for children who are suffering from severe malnutrition and then since then things like Frontline SMS or Rapid SMS has been applied to address a whole range of health issues whether it’s early infant diagnosis for HIV, to support the prevention of transmission of mother to child transmission, to birth registrations, to providing rapid diagnostic support tools for community health workers as well as for like clinic based structured reporting as in the case of Uganda where they are now are having a nationally deployed program where basically the clinics track their case loads and their supply chain and provide a structured SMS based report at the end of each week that then goes into a national database that enables much more effective decision making in terms of where do they have supply shortages? where is the case load higher for malaria? or tuberculosis? or different types of health issues and so you can imagine that the possibilities are just exponential once we start to think about the use of smarter phones”
“mobile phones have been around probably since the first automobiles so I think since the 1920’s or 30’s”
It wasn’t until 1976 that mobile phones first appeared in Japan. The Ford Model T was rolling off Detroit production lines from 1908.
“Now mobile health itself actually began in the biomedical engineering field and really started with looking at wireless technologies and sensor technologies and how sensor technologies could be incorporated to monitor peoples health at a distance… …And so what we saw in the very early days were things like remote cardiac monitors that then have like since evolved to start to look at things like diabetes monitoring and other types of sensor technologies”
It continues to amaze me how many technologists can’t see beyond their excitement for this narrow M2M medical device part of the mHealth market. I think it’s helpful to remind ourselves of the successful mHealth applications and services that were already widespread before these mobile connected sensor technologies are even starting to get adopted.
Perhaps a look at the impact that car phones and pagers were providing to Healthcare Professionals in the 1990’s would be a good starter (in developed countries like the USA the telephone networks have largely evolved from pager networks).
“And so many of the early say mHealth implementations really came out of work in developing countries out of necessity”
When you appreciate that a region like Africa only got its first mobile phone network in 1995 – 15 years after the first one was launched in Japan – long after countless thousands of medics had acquired mobile phones and put them to use in the care of patients.
What do you think?