mHealth Summit 2010: It’s not about the technology

This is one of  a series of posts on the recent 2010 mHealth summit. Previous posts include an overview, Patricia Mechael’s pearls of mHealth wisdom, mHealth and the evidence, mHealth in western vs global contexts and notable tweets.

This post briefly outlines various themes that emerged.

  • It’s not about technology – behaviour change is complex
    • RT @AudieAtienza:Vijay Vaitheeswaran “health depends on behavior & behavior is very difficult to change!” not about the technology… #mhs10
    • downeym “Bathroom scales have been around a long time, but we still have obesity.” –Vaitheeswaran at #mHS10
  • Partnerships and collaboration are key
    • RT@mHealthAlliance Dr. Mwenesi, Tanzanian Health Ministry: Collaboration btwn public & private only way to move #mHealth forward #mHS10
    • Text4baby was repeatedly cited as an amazing success story of a private public partnership.
    • Partners should be drawn from relevant stakeholders in the eco system: Private [telecom industries], NGO; open source developers; public health system; community health workers
    • Ministries of Health must be involved– interventions need to be health demand driven not technology led. There is a risk of letting the technology experts lead the enterprise and yet they don’t realize the complexities of health systems.
    • South–to–south collaboration is essential as a sustainable approach which can promote equity.
    • Rockefeller didn’t want to replicate the same old silos – built mHealth alliance
  • From pilots to full scale but where’s the funding?
    • The mobile technology landscape is characterized by many pilots with few scale-ups. Why? Lack of leadership and project management skills as well as sustainable funding models
    • The unrelenting criticism of pilotitis [ pilots that fail to scale into larger scope implementation]  was only matched by the scarcity of a clear strategy on a self sustaining business model that could evolve into a full scale, established service. The notable exception was text4baby which quickly became a nationwide project as a result of rare support from multiple partners and stakeholders including the White House. How easily can its success be replicated?
  • Caution: user needs must come first
    • EndoGoddess David Gustafson says high volume Internet info/mobile health info can be conflicting/confusing to patient and may not result in improved health outcomes. #mhs10
    • kwalser We haven’t addressed what patients and families need [for #mHealth] to be truly helpful. – Dr. Gustafson #mHS10#ux#design#usability
    • It is important not to bombard the clinicians with too many alerts – some are about minor issues while others contradict one another
    • RT @haddadda: we should be designing mhealth applications with rather than for patients and health workers. #mhs10
    • For mHealth, it’s the responsibility of app developers to maximize ease for users, taking into account language & literacy #mHS10
    • We must address the issues of tinfrastructure. Automating poor paper records leads to equally poor EHRs, Louis I. HochHeiser, Humana, Inc. 
    • Just giving cell phones will not accomplish much: first understand the needs of the people/health care providers, perceptions, values, cultures – systems are not always transferable; use ethnography to characterize the needs of the people; involve end-users at the beginning of the project using participatory design Walter Curioso
    • Smart phones are the exclusive domain of the rich; realistic technology should focus on simpler phones
    • Simple health solutions –  reminders can be text messages but should be carefully designed; beyond the message, think about the right context. In Peru, people with HIV prefer the subtle coded message: it’s time for your…life in order to mitigate privacy, security and stigma issues
    • mHealth helps collect data
      • mHealth outcomes can make an essential contribution to data collection which can support health system strengthening.
      • RT @mHealthAlliance: For CDC in Kenya, mobile data collection saves time and money. CDC now collects 20 times more health data than just a few years ago #mHS10
      • Michael S. Lauer cautioned that data collected naturalistically is not rigorous protocol – there will be missing information and it is hard to mine
        • a fad: it delivers real outcomes – real value across chain; 30% of consumers are willing to pay $2 on consultation
        • a technology game but change to business model and cultural behaviour worldwide – existing care regimens can be used
        • just about care delivery; can transform business model – for example how payors interact with patients submitting claims
        • a niche business: mobility is transforming many sectors around the world eg. in utilities, smart metering tech for consumption monitoring, retail and banking
        • a one solution fits all as models differ geographically
          • mature: delivery – where real savings are
          • emerging: reach – most rapid adoption of mobile health
        • Healthcare systems and institutions must change to improve performance
          • Interventions cannot take place in a vacuum.: Leadership Institutions Systems Technologies (LIST required)
            • Leadership: strategy, vision, political skills and ethical perspectives
            • Institutions: development only  possible thru the vehicle of institutions that mobilize the pursuit of goals – hospitals…needs long term investments against political pressures
            • Tech: Knowhow to deliver appropriate interventions – biomedical as well ICTs to improve performance
            • Systems design – procurement, info, personnel so that requisite structures can mobilize the necessary resources

          • Whether patients, providers, epidemiologists or policy makers…human oriented approaches are essential.
          Explore posts in the same categories: Global health, Mobile health


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          One Comment on “mHealth Summit 2010: It’s not about the technology”

          1. […] This is the fourth of a series of posts on the recent mHealth Summit. Previous posts include an overview, why reinvent the wheel, mHealth is not about technology, […]

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