Field Of mHealth Research Articles

MHealth for Midwives: A Call to Action

The use of mobile phones has grown exponentially in the last decade including in some of the most remote and low-resource regions of the world. With the geographic expansion of mobile phone use, information and communication technology for development (ICT4D) was born, and innovative uses for mobile technologies in various fields including health care have emerged. This use of mobile technology in health care is known as mHealth. mHealth interventions are being used internationally to improve maternal and child health. Be it the use of a mobile phone to call for emergency transport, remote consultation, or large-scale short message service (SMS)-based community education programs, mHealth is demonstrating its utility in reproductive health programs throughout the world. This article describes the evolution and challenges of mHealth, discusses the role of mHealth in achieving Millennium Development Goals 4 and 5, and addresses the potential impact of mHealth for midwives. mHealth represents a new area of global health that warrants the attention of midwifery advocates. Midwifery leadership in the field of mHealth at this early stage of its development will ensure future health programming that is relevant to the needs of women and the midwives who care for them.

The promise and peril of mHealth in developing countries

The mHealth field understandably arose from a base of practice, developed a nascent, yet ever-expanding, body of inter-disciplinary scholarship, and currently hopes for recognition by, and establishment on, national and trans-national policy bodies and agendas respectively. However, to justify public investment, policymakers require a body of theoretically sound, methodologically rigorous, and generalizable, evidence on how mobile technologies can effectively improve basic healthcare service delivery for hard-to-reach, resource-poor populations in developing countries. This essay draws upon prior work, ranging from a review article, an mHealth intervention for Indonesian healthcare workers within the medical infrastructure, to a text-messaging project in Uganda focused on beneficiaries. The argument is organized around theoretical, methodological, and sustainability issues, and proposes suggestions for how the discipline of mobile communication studies can add value to the field of mHealth research in developing countries.

Capitalizing on the Characteristics of mHealth to Evaluate Its Impact

The field of mHealth has made significant advances in a short period of time, demanding a more thorough and scientific approach to understanding and evaluating its progress. A recent review of mHealth literature identified two primary research needs in order for mHealth to strengthen health systems and promote healthy behaviors, namely health outcomes and cost-benefits (Mechael et al., 2010). In direct response to the gaps identified in mHealth research, the aim of this paper is to present the study design and highlight key observations and next steps from an evaluation of the mHealth activities within the electronic health (eHealth) architecture implemented by the Millennium Villages Project (MVP) by leveraging data generated through mobile technology itself alongside complementary qualitative research and costing assessments. The study, funded by the International Development and Research Centre (IDRC) as part of the Open Architecture Standards and Information Systems research project (OASIS II) (Sinha, 2009), is being implemented on data generated by 14 MVP sites in 10 Sub-Saharan African countries including more in-depth research in Ghana, Rwanda, Tanzania, and Uganda. Specific components of the study include rigorous quantitative case-control analyses and other epidemiological approaches (such as survival analysis) supplemented by in-depth qualitative interviews spread out over 18 months, as well as a costing study to assess the impact of mHealth on health outcomes, service delivery, and efficiency.

Point of care in your pocket: a research agenda for the field of m-health

A frontier mindset fosters real and rapid innovation in mobile health. This fast, iterative approach should not be lost, especially given the speed with which mobile and wireless technologies evolve, but caution is warranted. Although well on track towards attaining its goal of reaching 1 million mothers by 2012, Text4Baby, a free mobile text service sponsored by Johnson & Johnson in the United States of America, is a case in point.

Moving mountains with mobiles: Spatiotemporal perspectives on mHealth in Nepal

Community healthcare workers (CHW) are an important component of rural healthcare service delivery to remote rural communities in developing countries. The field of mHealth proposes that mobile technologies will have a beneficial impact on rural healthcare development. Current analyses advance the proposition that the utilization of mobile technologies leads to the shifting of space and time (Ling & Campbell, 2009). The current research examined the potential for a sustainable mHealth system for CHW in Achham, Nepal. The community aspect of mobile usage was overlaid with a spatio-temporal lens to examine the information and communication needs and practices of stakeholders within the healthcare infrastructure. Fieldwork was conducted in conjunction with Nyaya Health, at the Bayalpata Hospital, in Accham, Nepal. Qualitative research methods, focus group discussions, and in-depth interviews included 57 respondents. The findings revealed that limited relevance and information-sharing, limited access due to individual ownership and low income, and ineffective training programs were key barriers to the delivery of rural healthcare services. The spatio-temporal perspective, particularly community communicative practices, revealed technological mHealth design solutions to alleviate the problems identified. The potential shifts in power relationships by using mobile technologies and hybrid fixed wireless technologies provide opportunities for further theoretical investigation.

Telemedicine in India: The Apollo Story

The challenges faced and the methods implemented by the Apollo Hospitals Group in introducing telemedicine in the Indian setting are discussed in this article. Using Information and Communication Technology (ICT) to make available secondary and tertiary medical expertise to suburban and rural India was thought of as early as 1997. In March 2000, the world's first Very Small Aperture Terminal (VSAT)-enabled village hospital was commissioned. Today, with 115 centers including 9 overseas, the Apollo Telemedicine Networking Foundation (ATNF) is the oldest and largest multispecialty telemedicine network. More than 57,000 teleconsultations in various disciplines, ranging from sexual medicine to neurosurgery, have been provided. Patients have been evaluated from distances ranging from 120 to 4,500 miles. A majority (85%) of these teleconsults were reviews. The successful proof of concept validation studies, carried out from 2000 to 2001 by Apollo, were instrumental in the Indian Space Research Organization (ISRO) including telemedicine as a major thrust area. The pioneering role played by Apollo is also discussed in using VSAT-enabled Hospitals on Wheels. The paper reviews the significant role played by ATNF in the growth and development of telemedicine in South Asia. Academic activities are also highlighted. The pioneering efforts in the field of m-health, home telecare, the Pan African e-Network Project, starting the first formal educational course in telehealth and various other e-initiatives are elaborated.

The M-Health Reference Model

The reference model presented in this article encourages the breakdown of M-Health systems into the following five key dimensions: (1) Communication Infrastructure: a description of mobile telecommunication technologies and networks; (2) Device Type: the type of device being used, such as PDA, sensor, or tablet PC; (3) Data Display: describes how the data will be displayed to the user and transmitted, such as images, e-mail, and textual data; (4) Application Purpose: identification of the objective for the M-Health system; (5) Application Domain: definition of the area in which the system will be implemented. Healthcare stakeholders and system implementer can use the reference model presented in this article to understand the security implications of the proposed system and to identify the technological infrastructure, business requirements, and operational needs of the M-Health systems being implemented. A reference model that encapsulates the emerging M-Health field is needed for cumulative progress in this field. Currently, the M-Health field is disjointed, and it is often unclear what constitutes an M-Health system. In the future, M-Health applications will take advantage of technological advances such as device miniaturizations, device convergence, high-speed mobile networks, and improved medical sensors. This will lead to the increased diffusion of clinical M-Health systems, which will require better understanding of the components that constitute the M-Health system.