The effectiveness of mHealth technology

I admit that when I was first introduced to the concept of mHealth, I thought it seemed rather excessive: an instance of people using technology because it exists rather than because it serves some sort of productive purpose. As a resident of the United States, where most people can simply see a doctor if they have need of medical attention, the concept of needing a mobile phone to ensure one's health seemed somewhat unnecessary. But after Tuesday's lecture and after viewing the above video, I've become convinced of its merits.


The video depicts the proposed application of mHealth technology in an indigenous Amazonian region of Brazil. In Brazil, routine levels of immunization have just missed the standard set by the National Immunization Program. In order to raise these levels, a partnership between the United Nations Foundation, Vodaphone Foundation, the Pan American Health Organization, and the Brazilian Ministry of Health has set out to implement mHealth technologies in a remote indigenous Brazilian community in 2011.


In a press release from the United Nations Foundation, Adele Waugaman, the Senior Director of the UN Foundation and Vodafone Foundation Technology Partnership, says that mHealth technologies in Brazil will assist in three areas: quantity, quality, and timeliness of health care. 


According to Jody Ranck, who was an author of a report published about the study, "The ubiquity of mobile devices presents a unique opportunity to break through an often fragmented universe of health data." Though many indigenous Brazilians cannot provide themselves with basic human needs, they still own mobile phones, and this is a trend that is on the rise, with 55% of Brazilian consumers purchasing mobiles in the last year. Clearly, if a tool is to be used, it is the mobile phone: it is simply the best way to affect the largest volume of Brazilians.


In terms of quality, the best way that mHealth technology can make an improvement is in terms of simply providing more information. While transportation and infrastructure barriers often prevented medical professionals from knowing the true gravity of the situation in a population, mobiles make it possible for large quantities of data to be collected and analyzed. And in terms of timeliness, this analysis can be conducted at a much faster speed and solutions can be subsequently reached that much faster.


These are valid, albeit obvious, points in the favor of mHealth technology, and I would add two more: reduced economic cost of healthcare and increased accountability of medical professionals. As mobiles are continuously declining in price, and are so affordable that even the very poor can own them, they seem to be, in addition to universal and efficient, a cheap way of addressing a very large and complex problem. In terms of accountability, mobiles provide an indisputable record of, essentially, "who did what, and when, and where." This increases the pressure on medical professionals to do their jobs correctly and provide the best possible care to the indigenous population.


The vote is still out on the results of the Brazil project, though a paper is expected to be released this summer on its progress. However, I'm inclined to believe that the results will be in the favor of mHealth technology. In 2009, a report conducted by David Banta of the University of Maastricht and Rosimary T. Almeida of the University of Rio de Janeiro assessed health technology in Brazil, and concluded with a recommendation that the Brazilian government create a national agency specifically devoted to the field. Given that Banta's and Almeida's findings clearly showed the benefit of mHealth programs, one can only imagine that this need will have at least remained consistent, if not increased, in a world that has become increasingly reliant on technology.


While my view of it is not as disparaging as it originally was, I still don't believe that mHealth solves every medical problem. The largest issue that I can identify with mHealth technology is the fact that its capabilities may be somewhat glorified. In class, I asked Jody Ranck how he thinks that the role of doctors will change with the advent of mHealth technology; this led to a discussion in class in which it transpired that most people felt that doctors are irreplaceable. I would tend to agree.


The UN Foundation and Vodafone Foundation identifies seven application categories for the mHealth technology: education and awareness; helpline; diagnostic and treatment support; communication and training for healthcare workers; disease and epidemic outbreak tracking; remote monitoring; and remote data collection. While these areas are important, they are very general; they are not the equivalent of treating the woman with Parkinson's or the man with cancer. For specific cases, doctors are needed, and I am skeptical to believe that any technology can replace the necessity for that physical presence in certain instances.


Yet as I've learned more about mHealth technology, I wonder about their application potentially in the United States. In my senior year of high school, I conducted a statistical study that I presented at the national finals of an epidemiological research convention; my study centered on how lower-income areas of the United States tend to produce people with more health problems. It made me wonder if applying similar systems of mHealth technology, as done in lower-to-middle income countries throughout the world, might make a difference in the United States. It's true that problems in the US are not as severe as those in other countries: unlike in indigenous Brazil, there are few, if any, transportation barriers to receiving vaccines, for instance. But in an informational sense--using mobiles to transfer medical data or to communicate with a wide variety of medical professionals, especially those that poorer people may not have the means to see without proper insurance--mHealth in the US might be a worthwhile attempt. Though very few, if any, studies have been conducted in this area, I think it is a topic that can and should be explored.


mHealth technology has the potential to change healthcare in remote and poor areas of the world, and this could be seen in the coming weeks in Brazil. With few disadvantages, it is a fantastic way to use the resources that almost everyone has to improve quality of life on a global scale, regardless of socioeconomic status or privilege.