In our September Technology Salon, we took on James BonTempo's pertinent question of What Does the "m" in mHealth Really Mean? in a spirited debate with technology and development practitioners.
We were seeking a better definition of mHealth than the current focus on devices, and specifically the hype around mobile phones. As one participant bemoaned, it seems that every health project with a mobile phone or PDA, no matter their usage, is now an mHealth project.
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So we sought to put parameters on what could be called an mHealth project, and through that, come up with a new definition for mHealth. After an hour of vibrant debate, we developed these four aspects for mHealth projects:
1. Field Mobility
First we all agreed that the "m" stood for mobility - health workers empowered with tools that allowed them to actually leave the clinic and visit with patients in the field. This concept of mobility could be as simple as a mobile community worker visiting clients with the original mobile data collection device: a clipboard. Yet, we felt that that was too basic - mHealth was more than just mobility, it had to include the collection of electronic health data.
2. Electronic Information
As much as mobility, we felt that the "m" in mHealth could just as easily stand for modernization - the digitization of health records systems. Its the storage and analysis of massive amounts of health data which is fostering a revolution in healthcare with Ministry and community worker alike. But more than just data, which implies numbers, we are really talking about health information - new treatments, activities, and practices shared with the community so they can improve health outcomes.
3. Timely Connectivity
Moving information means connectivity, but not necessarily constant connectivity. Asynchronous, store and forward or even sneakernet connectivity can be quite effective in remote locations. This led us to think of community health worker movement as more nomadic - many site visits between stints as a central health clinic - than always mobile all the time.
With nomadic movement, timeliness is relevant to location. In the health clinic, connectivity would be synchronous and aggregate information could be shared between clinician and Ministry, while in the community, connectivity could be asynchronous, with personal information shared between clinician and community.
4. Feedback Loop
Note the multiple mentions of information movement between Ministry and community. A real mHealth project must have bi-directional information sharing. No matter how important health data may be for Ministry-level decision makers, its even more important to have health data flowing back down to the very community health workers who are collecting it - for direct usage with patients.
As we looked at the four requirements listed above, we realized there needed to be one more change to the concept of mHealth, and that's the limitation of the word "health". We're really talking about a holistic approach to improving health outcomes, with an end-to-end communications infrastructure, so we're really talking about mHealthcare, not mHealth.
Yet even mHelathcare is still a subset of the more holistic eHealthcare, where these field-focused solutions tie into national electronic healthcare systems that can empower changes in people and policy at the country level.
Back down at the Technology Salon level, we concluded with a simple hope for our discussion. That this exercise would help each of us better discuss and explain what the "m" in mHealth means in our respective professions and promote a more inclusive and pragmatic concept of mHealthcare to the larger development and technology communities.