MHealth

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The title of this article should be mHealth. The initial letter is capitalized due to technical restrictions.

mHealth (also written as m-health or sometimes mobile health) is a recent term for medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, PDAs, and other wireless devices. mHealth applications include the use of mobile devices in collecting community and clinical health data, delivery of healthcare information to practitioners, researchers, and patients, real-time monitoring of patient vital signs, and direct provision of care (via mobile telemedicine).

Definitions

Mobile eHealth or mHealth broadly encompasses the use of mobile telecommunication and multimedia technologies as they are integrated within increasingly mobile and wireless health care delivery systems and is part of a movement towards citizen-centered health service delivery. Mobile technologies by nature lend themselves to more decentralized health service delivery. Although Ministries of Health in low and middle income countries and policy makers are eager to explore the use of mobile phones and other ICT to promote health, the lack of a comprehensive model, knowledge base, and published data on the health benefits poses significant barriers.

The most widely cited and definitive definition is by Istepanian et al. as 'emerging mobile communications and network technologies for healthcare.’

Other later citations include Bardram et al. as m-health is focused on embedded wireless devices that track health-related parameters:

"The recent advances in information and communication technologies (ICT) enable technically the continual monitoring of health-related parameters with wireless sensors, wherever the user happens to be. Small, low-power sensors can, in principle, be embedded in almost anything in our surroundings: furniture, vehicles, wearable devices, and even clothes. Mobile phones or personal digital assistants (PDAs) with wireless networking capabilities may serve as gateweays that process, store, and transfer measured parameters to clinicians for further analysis or diagnosis. This technology trend, also called mHealth (mobile health), is already visible in the market."

Low and middle income countries

There has been a growing interest within the health sector to capitalize on the rapid uptake of mobile communication technologies and the overall improvements in telecommunications within the general population throughout the world. Characterized as a ‘leapfrog technology,’ mobile phones have allowed developing countries, even those with relatively poor infrastructure, to bypass 20th century fixed-line technology and jump straight to 21st century mobile technology. The number of global mobile phone subscribers in 2006 was estimated at 2.5 billion of an estimated global population of 6.6 billion (37.9%). These figures are expected to grow to 3.3 billion or approximately half of the world’s population by 2010 with the greatest growth expected in Asia, the Middle East, and Africa. In many countries, the number of mobile phone subscribers has by-passed the number of fixed-line telephones, this is particularly the case in developing countries.

The cost of mobile technology deployment is increasingly going down, with vendors such as Nokia developing cheaper infrastructure technologies (CDMA) and cheaper phones (sub $50–100, such as Sun's Java phone). Cost may not be much of an issue in the near future, especially compared to PC-based solutions. The increasing functionality of phones enables SmartPhone-capability in relatively inexpensive phones. It is worth noting that the capabilities of mobile phones in low and middle income countries has not reached the sophistication of those in high income countries, which now enable web browsing, GPS navigation, and email through what are being called smart phones. In spite of these differentials, the basic SMS text functions and real-time communication capacity of devices available in low and middle income countries offer a broad range of potential benefits to the health sector. Increased availability and efficiency in both voice and data-transfer systems in addition to rapid deployment of wireless infrastructure will likely accelerate the deployment of mobile-enabled health systems and services throughout the world.

The trends towards mHealth in developing countries are largely due to the overwhelming uptake of mobile phones within the health sector and by the general population as well as the increased uptake, however limited, of smart phones within the health sector for retrieval of web-based information and patient data in decentralized health management information systems (HMIS). In addition, wireless-enabled laptops and specialized health-related software applications are currently being developed, tested, and marketed throughout the world. This "high-end" work is happening primarily in high income countries; however, with broad advocacy campaigns for free and open source software (FOSS), applications tailored to local contexts may soon become available in low and middle income countries. Another route to increasing local capacity has been pioneered by EpiSurveyor.org [2], which is the first tool to use a Web 2.0 approach to providing useful software (specifically adopting the cloud-based, software-as-a-service model in order to broadly scale, following the example of commercial proprietary-but-free software such as Gmail, Facebook, et al), in this case to create mobile-phone-based data collection systems . Efforts to provide resources and training for the localized development of applications and technologies ought to be encouraged in low and middle income countries.

Mobile technologies offer direct voice communication (of particular value due to literacy and language capacity in many countries) and information transfer capabilities. The appeal of mobile communication technologies is that they enable communication in motion, allowing individuals to contact each other irrespective of time and place. This is particularly beneficial for work in remote areas where the mobile phone, and now increasingly wireless infrastructure, is able to reach more people at a more rapid rate. As a result of such technological advances the capacity for improved access to information and two-way communication hence becomes available at the point of need.

A two day conference was organized in Lagos, the purpose was to drive the health sector with technology tools in the area of telemedecine, mhealth and ehealth.

Improving health outcomes and efficiencies

Technology integration within the health sector has great potential to promote healthy lifestyles, improve decisions by health professionals as well as patients, and enhance healthcare quality by improving access to medical and health information and facilitating instantaneous communication in places where this was not previously possible. The increased use of technology can help reduce health care costs by improving efficiencies in the health care system and promoting prevention through behavior change communication (BCC). It also has the potential to advance clinical care and public health services by facilitating health professional practice and communication and reducing health disparities by applying new approaches to improve the health of isolated populations.

The Millennium Development Goals (MDGs) that specifically address health as set forth by the United Nations Millennium Declaration in 2000 include reducing child mortality; improving maternal health; combating HIV and AIDS, malaria, and other diseases; and increasing access to safe drinking water. A progress report published in 2006 indicates that childhood immunization and deliveries by skilled birth attendants are on the rise, while many regions continue to struggle to achieve reductions in the prevalence of the diseases of poverty including malaria, HIV and AIDS and tuberculosis (TB). Increasing attention has also been drawn to the critical shortages in trained healthcare personnel throughout the world whereby there are now 57 countries with critical shortages in health work force density with a global deficit of 2.4 million doctors, nurses, and midwives. Investing in the training and ongoing development of the healthcare work force is considered among the most effective means of improving health. Three key areas in which early and rapid gains can be achieved through technology design and integration are in the areas of Safe Motherhood, routine immunization and integrated management of childhood illness, and in addressing the diseases of poverty, namely HIV and AIDS, malaria, and TB- where significant resources have been mobilized to reduce the disease burden in low and middle income countries.

Efforts are ongoing to explore how a broad range of technologies, and most recently mHealth technologies, can improve such health outcomes as well as generate cost savings within the health systems of middle and low income countries. The specific potential of mHealth lies in its ability to offer opportunities for direct voice communication (of particular value due to literacy and language capacity in many countries) and information transfer capabilities that previous technologies did not. This is particularly beneficial for work in remote areas where the mobile phone, and now increasingly wireless infrastructure, is able to reach more people at a more rapid rate. As a result of such technological advances the capacity for improved access to information and two-way communication hence becomes available at the point-of-need and for healthcare workers at the point-of-care. Mobile communication technologies are tools that can be leveraged to support existing workflows within the health sector and between the health sector and the general public.

Some of the MVP strategic objectives for m-health are:

• Improvement of the access to emergency and general health services
• Improvement of the efficiency of health service delivery
• Improvement of the clinical practice for enhanced health outcomes
• The reduction of child and maternal mortality and morbidity in MVPs

Program areas

Mobile devices have been used in a number of different settings, but most applications can be classified as follows:

• Education and awareness
• Helpline
• Diagnostic support, treatment support, communication and training for healthcare workers
• Disease surveillance and epidemic outbreak tracking (malaria, HIV/AIDS, TB, Avian Flu)
• Treatment support and medication compliance for patients, including chronic disease management (such as diabetes)

Education and awareness

Country	Name	Inception	Program size	Major services	Insights and Outcomes	Sponsors	Charges	Telcom partner role
Mexico	Vidanet			Vidanet gives People Living With HIV (PLWHIV) the ability to register to receive messages to help improve their adherence to their specific treatment. The main objective of this Project for ICS is to develop a strategic model of educational communication by promoting projects involving a telecommunication revolution in favor of health. With these tools they can generate changes in attitude towards a self-health care, health risk prevention, and adherence to specific prescribed treatments assigned to PLWHIV.		Voxiva has partnered with the Instituto Carso de la Salud (ICS)
Mexico	Cardionet			Voxiva, along with ICS, has developed CardioNet, a solution in self-health care, health risk prevention, and adherence to prescribed treatments. Individuals complete a questionnaire asking them questions such as sex, age, weight, height, other health problems they have (i.e. diabetes or smoking) as well as blood pressure and cholesterol if known. Based on these answers, the individual is evaluated according to the standards set by the World Health Organization (WHO). From this assessment the individual begins receiving educational messages encouraging him/her to exercise and eat healthy. Examples of health foods and exercise are given to increase the messages effectiveness.		Voxiva has partnered with the Instituto Carso de la Salud (ICS)
India	Freedom HIV/AIDS	2005	In the first phase, ZMQ launched four games on Reliance Infocomm - one of the largest mobile operators of India and was able to reach out to over 9 million handsets. Later, the games were made available on other mobile carriers taking to 30 million handsets. In a span of 15 months, there have been a download of 10,3 million game sessions	Freedom HIV/AIDS comprises four mobile games targeting different mindsets and psychology of mobile users. The games are deployed on low-end black/white to sophisticated high-end colored devices.		Freedom HIV/AIDS is a social initiative of ZMQ Software Systems. The initiative is supported by Delhi State AIDS Control Society and was launched by Chief Minister of Delhi Shrimati Sheila Dikshit.	Games are free for download through the corporate social responsibility program of ZMQ
South Africa	Project Masiluleke		276 Million text messages –one million per day –being sent (2008-2009). 1,060,000 calls answered. Messages in local languages are especially well received.	Build awareness of HIV status, encourage HIV/AIDS testing and treatment and halt the disease’s spread. Stigma is a major barrier, causing people to only seek care very late in the illness.	SMS message campaign promoting HIV/AIDS awareness resulted in nearly a tripling of call volume to a local HIV/AIDS helpline.	Praekelt Foundation, iTeach, National Geographic, Nokia Siemens Networks, MTN, Ghetto Ruff, Children of South African Legacies, Aricent, PopTech!, frog design and National AIDS Helpline	‘Please Call Me’ service -free text messages. 95% of South Africa uses prepaid cellular plans, and can send “please call me” message. There is 120 empty characters left in a “please call me” SMS message.	MTN has allowed program to use total inventory of “please call me” messages.
Uganda	Text to Change		15,000 mobile phone subscribers in rural Uganda sent the quiz in the three month pilot test	HIV/AIDS awareness via an SMS-based multiple choice quiz in exchange for free airtime; correct answers provided; participants encouraged to come in for testing (fee waived for participants)	40% increase in the number of patients who came in for HIV/AIDS testing. Actionable insight: Many quiz takers did not think AIDS testing was accurate nor anonymou.	Celtel, AIDs Information Centre (AIC), Merck, and the Dutch Ministry of Foreign Affairs	SMS-based quiz in exchange for free airtime
Uganda, Tanzania and Kenya in Eastern Africa, and Malawi, Mozambique and Namibia in Southern Africa	Freedom HIV/AIDS Africa Reach Program	2006	In the first phase, ZMQ launched four games on Reliance Infocomm - one of the largest mobile operators of India and was able to reach out to over 9 million handsets. Later, the games were made available on other mobile carriers taking to 30 million handsets. In a span of 15 months, there have been a download of 10,3 million game sessions	Freedom HIV/AIDS introduced two HIV/AIDS awareness games to countries in Africa. Apart from English, the games have been developed in local languages - Kiswahili and Shen.		Freedom HIV/AIDS is a social initiative of ZMQ Software Systems. Africa Reach Program supported by Hivos, a leading Dutch development organization, and KPN, the largest Dutch telecom company, under the "Star Programme"	Games are free for download through the corporate social responsibility program of ZMQ
Many countries	FrontlineSMS			Free open source software that turns a laptop and a mobile phone into a central communications hub that enables users to send and receive text messages with large groups of people through mobile phones, without requiring an internet connection
	UNICEF/Georgia
	Mobile4Good

Helpline

Country	Name	Inception	Program size	Major services	Insights and Outcomes	Sponsors	Charges	Telcom partner role
Australia	National Health Call Centre Network or healthdirect	2007				Government-sponsored
Australia	HealthDirect (Western Australia)	1999				Government-sponsored
Australia	HealthDirect (Northern Territory)					Government-sponsored
Australia	Nurse-on-Call (Victoria)	2006				Government-sponsored
Australia	HealthDirect (South Australia)	2006				Government-sponsored
Australia	Health First (Australia Capital Territory)					Government-sponsored
Bangladesh	Healthline	2006	10000 Calls per day	Phone consults, information on facilities, drugs, test result interpretation, discounts on hospital visits. Mission: be a first reference point to complement conventional health solutions.	Top health complaints: Chronic diseases (40%), ENT, early pregnancy, malaria, pneumonia (each 8%), diarrhea (7%)	MNO-sponsored: Telemedicine firm and MNO	For profit. Service is US$ 0.21 (BDT 15) for 3 minute call	Marketing and promotion, Billing and revenue collection, Voice bearer
Canada	Fonemed (for USA callers)	1999				Government-sponsored
Canada	Telehealth (Ontario)	2001				Government-sponsored
Colombia	Telemedic					Independent
Dominican Republic	Telemed					Independent
India	HMRI	2007	50000 Calls per day	Phone consults, counseling and complaints, information on facilities, drugs, mobile health clinics (vans). Mission: create platform to enable 1 billion virtual and 1 billion physical service contacts.	Top health complaints: Recurring abdominal pain (13%), back pain (9%), knee pain (8%)	Government-sponsored: Government and a private charity	Not for profit. Service is free.	Voice bearer
Mexico	Telemedic					Independent
Mexico	MedicallHome	1998	10000 Calls per day	Phone consults, information on facilities, drugs, discounts at clinics, pharmacies. Mission: be the first choice in private health services.		Independent: Call center entrepreneurs	For profit. Subscription: unlimited calls for US$ 5.00 monthly	Shareholder, Billing and revenue collection, Voice bearer
New Zealand	Healthline	2006				Government-sponsored
Pakistan	Teledoctor	2008	1000 Calls per day	Phone consults, information on facilities, drugs. Mission: provide cheap, easy access to experienced doctors.	Top health complaints: Diarrhea and vomiting (gastro-enteritis), Gynecological ailments and obstetrics, Fever (usually associated with respiratory tract infections)	MNO-sponsored: Telemedicine firm and MNO	For profit. Service is US$ 0.30 (PKR 24) for 3 minute call	Marketing and promotion, Billing and revenue collection, Voice bearer
Philippines	Fonemed Asia-Pacific	planned				Independent
South Africa	Eastern Cape Health Call Centre	2007				Government-sponsored
Trinidad and Tobago	MedStar Health Information	2004				Independent
United Kingdom	NHS Direct	1999				Government-sponsored
United States	MedicareBlue PPO					Healthcare provider-sponsored
United States	FirstHelp Nurse Advice Line					Healthcare provider-sponsored
United States	Telemed (Puerto Rico)					Independent
United States	Informed Health Line (Aetna)					Healthcare provider-sponsored
United States	Teladoc	2007				Independent
United States	MedicallHome USA					Independent

Diagnostic support, treatment support, communication and training for healthcare workers

Country	Name	Inception	Program size	Major services	Insights and Outcomes	Sponsors	Charges	Telcom partner role
India	Tele-Doc	2003	Launched as a pilot project in 15 villages in Haryana in April 2003	TeleDoc provided handheld mobile phone devices to village health workers in India, permitting them to communicate with doctors who use a web application to help diagnose and prescribe for patients.		TeleDoc was a project of Jiva Institute, an India-based non-profit. Supported by the Soros Foundation.	The approximate cost of the entire TeleDoc process was 70 rupees (US$1.50) per consultation.
Peru	Nacer			Nacer is a phone- and web- based information and communication system for maternal and child health that allows health professionals in remote locations to communicate and exchange critical health information between themselves, medical experts, and regional hospitals. All reported data is recorded in a central database, and is available to health officials in real-time for analysis and decision-making. Health workers in locations without Internet connectivity can access the system using any phone (satellite, fixed-line, mobile, or community pay phone).		The USAID-funded Pathfinder International program and Voxiva worked with the Regional Health Directorate of Ucayali and the Peru Ministry of Health
Rwanda	TRACnet			TRACnet is Rwanda’s dynamic Information Technology solution designed to collect, store, retrieve, and disseminate critical program, drug, and patient information related to HIV/AIDS care and treatment. The system was implemented to support the Rwandan Government’s vision of rapidly scaling up HIV/AIDS clinical services in a variety of health care settings. Under the leadership of the Ministry of Health and the Treatment Research and AIDS Centre (TRAC), TRACnet is being deployed to increase the efficiency of Rwanda’s HIV/AIDS program management, and enhance the quality of patient care.		Voxiva and The Rwanda Ministry of Health
Uganda, Mozambique	AED Satellife			Information and communications technologies (ICT) initiatives through the USA-based not-for-profit Academy for Educational Development providing support for HIV/AIDS, malaria, child and maternal health, and health systems management programs.

Disease surveillance and epidemic outbreak tracking (such as malaria, HIV/AIDS, TB, Avian Flu)

Country	Name	Inception	Program size	Major services	Insights and Outcomes	Sponsors	Charges	Telcom partner role
Brazil	Name?		400 test results gathered by 20 field professionals in two days, all with GPS information	Containing the spread of the Dengue virus. Customized questionnaires distributed to field health agents’ mobile phones. Health data and GPS location information are integrated to enable immediate analysis and identification of areas with high infection levels.	Data collection times dramatically reduced (paper-based system would have taken 2–3 months for lesser information). End-user acceptance very high.	Nokia, Amazonas State Health Ministry
	AESSIMS			AESSIMS is designed to build health capacity at the field level by enabling front-line health workers to report disease incidence through an innovative combination of telephone and web based technology that leverages available infrastructure. AESSIMS enables health officials to better understand the scope of disease impact and strategically allocate resources to areas with the highest prevalence and need.		PATH, Voxiva, and the Government of Andhra Pradesh (GoAP)
	Voxiva Health Watch			Voxiva HealthWatch is an integrated surveillance platform used by public health agencies around the world to support integrated disease surveillance, syndromic surveillance, and coordinated response.
	InSTEDD

Treatment support and medication compliance for patients, including chronic disease management (such as diabetes)

Country	Name	Inception	Program size	Major services	Insights and Outcomes	Sponsors	Charges	Telcom partner role
Mexico	Diabediario			Voxiva, along with ICS, has developed Diabediario, a solution for changing diabetics’ lifestyles and for controlling and improving their adherence to their diabetic treatment. Any diabetic person, who has a TelCel cell phone, can participate in the program. Diabediario uses telecommunication to generate changes in attitude towards risk prevention and adherence to prescribed treatments. Diabediario does not replace doctor’s visits or pills but is meant to act as a supplement to outside care. This system empowers the patient to take control of their health by taking all the necessary steps to control their diabetes.		Voxiva has partnered with the Instituto Carso de la Salud (ICS)
Peru	Cell-Preven			Cell-Preven health workers use mobile phones to send SMS messages with real-time data on symptoms experienced by clinical trial participants. This enables immediate response to adverse symptoms		Powered by Voxiva
Thailand	Name?			TB patients were given mobile phones and called daily with a reminder to take their TB medication	90% of patients took their medication.
United States	mCare	2009		US Army Medical Department mobile phone messaging application for the case management of reintegrated wounded soldiers. SMS-based wellness tips, appointment reminders for US service members returning from duty. Ported content from "afterdeployment.org" to a cell phone. HIPAA compliant.		US Army Medical Department
?	DIMA Dietary Intake Monitoring Application	2009	6-week pilot study with 20 participants.	Mobile health application for dietary insight for a chronically Ill, low-literacy diabetic population	The device has a voice recorder and a bar code scanner. By the end of the study the participants were only using the voice recorder. Patients use "beam" bar code scanner more easily than pen bar code scanner. The device was not stigmatizing, rather seen as a status symbol.
United States	Web-based Mobile Support for the Washington D.C. Tobacco Quitline	2009		Currently updating the system to take real time patient smoking cessation data and "close the loop" feedback to improve adherence. Adding web interface to integrate with telephone quitline	Many behavior change things are characterized by success and relapse. Measuring real time behavior, along with context and psychological factors. "Are you feeling happy?"	Legacy Foundation
United States	MAHI Mobile Access to Health Information	2009	49 participants, recently diagnosed with diabetes. 5 month study.	Each time a diabetic patient used a glucose meter the phone would give them a call to gather data on why they were using it. Nokia or any java-enabled cell phone. Used bluetooth glucose meter. ndividuals record several messages per day. Data that were typically collected: pictures of food, pictures of confusing food labels, voice notes with specific problems.	Outcomes: significant fraction of participants switched from "external" to "internal" locus of control, which meant they felt more in charge. Participants became better problem solvers with the condition, and better achieved dietary goals.	Georgia Tech, CDC, Google Health, Siemens Corporate Research
	Virtual Health Pet
	On-Cue
	SIMpill			SMS appliance that monitors medicine compliance by sending a text message when the patient takes medicine.
	Cell-Life			SMS data gathering applications

Applications and Tools

Country	Name	Inception	Program size	Major services	Insights and Outcomes	Sponsors	Charges	Telcom partner role
	The Africa Health Infoway
	EpiHandy			Set of tools for collection and handling of data using mobile devices: mobile phones, smart phones, PDAs, and handheld computers
	RESCUER
	EpiSurveyor.org			Free, web- and mobile-based software to allow non-technologists to very easily create mobile phone data collection systems. Notable as the first Web 2.0 software for international health and development, with nearly 1000 users worldwide (since release of the website in July 2009 -- go to website for current stats) and winner of the 2009 Wall Street Journal Award for Technology Innovation for Healthcare IT, the 2009 Lemelson-MIT Award for Sustainability, and the Tech Museum Award and the Stockholm Challenge Award. Also notable for having largely been developed by Kenyan programmers under the direction of project director Joel Selanikio, co-founder with Rose Donna of DataDyne.org		Created by DataDyne.org, a USA/Kenya not-for-profit organization ("We build capacity, not pilots")
United States	SAFEVAX			SAFEVAX was designed to meet DoD’s requirements for actively monitoring, recording, and analyzing responses to smallpox vaccination. Voxiva developed SAFEVAX, an adverse event reporting solution that enables rapid identification of vaccine reactions, analysis of reaction patterns and trends, and automatic alert and notification. Criteria can be specified that results in an automatic telephone or e-mail notification being sent to the appropriate person		Voxiva and the United States Department of Defense

Technology

Key mobile communication technologies relevant to mHealth include:

• Mobile phones
• PDAs and smart phones
• Patient monitoring devices
• Mobile telemedicine/telecare devices
• MP3 players for mLearning
• Microcomputers

mHealth Technology capabilities:

Voice

Voice is usually personal two-way communication although automated systems may provide voice recorded information as well.

Data

Data access is primarily focused on visualizing static text but can also extend to interactive decision support algorithms, other visual image information, and also communication capabilities through the integration of e-mail and SMS features. Integrating use of GIS and GPS with mobile technologies adds a geographical mapping component that is able to “tag” voice and data communication to a particular location or series of locations. These combined capabilities have been used for emergency health services as well as for disease surveillance, health facilities and services mapping, and other health-related data collection.

Emerging trends and areas of interest in mHealth

• Emergency response systems (e.g., road traffic accidents, emergency obstetric care)
• Human resources coordination, management, and supervision
• Mobile synchronous (voice) and asynchronous (SMS) telemedicine diagnostic and decision support to remote clinicians
• Clinician-focused, evidence-based formulary, database and decision support information available at the point-of-care
• Clinical care and remote patient monitoring
• Health extension services
• Health services monitoring and reporting
• Health-related mLearning for the general public
• Training and continuing professional development for health care workers
• Health promotion and community mobilization

According to Vodafone Group Foundation on February 13 2008, a partnership for emergency communications was created between the group and United Nations Foundation. Such partnership will increase the effectiveness of the information and communications technology response to major emergencies and disasters around the world.

See also

• eHealth
• Health Informatics
• Health 2.0
• Open source software packages for mHealth
• mLearning
• Telehealth
• Telemedicine

Further reading

• "Technology plays crucial role in vaccination distribution" Computer Weekly: April 2008. [3]. Discusses use of handheld electronic data collection in managing public health data and activities.
• "A world of witnesses" The Economist: January 2008. [4] Discusses use of EpiSurveyor open source software in public health monitoring in Africa.
• "Globally, deaths from measles drop sharply" The Washington Post: November 2007. [5] Describes role of EpiSurveyor mobile data collection software in contributing to the highly successful fight against measles mortality.
• Kaplan, Warren. "Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries?" Globalization and Health 2 (2006): 9. [6]
• Olmeda, Christopher J. (2000). Information Technology in Systems of Care. Delfin Press. ISBN 978-0-9821442-0-6
• United Nations. "Compendium of ICT Applications on Electronic Government, Volume 1: Mobile Applications on Health and Learning." United Nations: 2006. [7]
• Economist "The doctor in your pocket [Medical technology: Nearly everyone in the developed world carries a mobile phone- so why not use it to deliver health care?]" The Economist: 2005. [8]
• Mechael, P. "Exploring Health-related Uses of Mobile Phones: An Egyptian Case Study." Public Health & Policy (p. 264). London: London School of Hygiene and Tropical Medicine 2006. [9]
• Mechael, Patricia (2009). The Case for mHealth in Developing Countries. Mobilizing Markets: Special Edition of MIT Innovations Journal for the GSMA Mobile World Congress 2009. Cambridge: MIT Press, pages 153-168.
• Mechael, P and D. Sloninsky. Towards the Development of an mHealth Strategy: A Literature Review. New York: Earth Institute at Columbia University: Working Document.
• Istepanian, R. "Introduction to the Special Section on M-Health: Beyond Seamless Mobility and Global Wireless Health-care Connectivity." IEEE Transactions on Information Technology in Biomedicine: 2004. 8(4), 405-413.
• Istepanian, Robert et al., eds. (2006) M-Health: Emerging Mobile Health Systems. Springer Verlag. ISBN 0-387-26558-9
• UNICEF and Women's Net (2007). Rapid Assessment of Cell Phones for Development. Written and compiled by Sally-Jean Shackleton.
• UN Foundation and Vodafone (2008). mHealth in the Global South: Landscape Analysis. [report by Vital Wave Consulting]
• Vital Wave Consulting (February 2009). mHealth for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World, United Nations Foundation, Vodafone Foundation.
• Anta R., El-Wahab S., and Giuffrida A. [Mobile Health: The potential of mobile telephony to bring health care to the majority.]http://www.iadb.org/document.cfm?id=1861959 Inter-American Development Bank. February 2009.
• Adesina Iluyemi, [Community-based health workers in developing countries and the role of m-health. In Telehealth in Developing Countries]http://www.idrc.ca/en/ev-137420-201-1-DO_TOPIC.html

External links

Research, coordination and strategy

• m-Health NZ Conference on mobile health in the Pacific region
• mHealth Alliance Formed in February 2009 by the Rockefeller Foundation, United Nations Foundation and Vodafone Foundation to facilitate global innovation and ensure maximum impact in the field of mobile health (mHealth)
• mHealth Initiative Boston USA-based not-for-profit organization, the successor to the Mobile Healthcare Alliance (MoHCA)
• Columbia University, Center for Global Health and Economic Development: Global eHealth Program Academic center conducting training, research and implementation for technologies to meet global health challenges
• MobileActive A resource for activists using mobile technology for social purposes
• Open-Mobile Consortium Promoting cooperation on open source development, testing, program implementation, and evaluation of mobile technology for social good.
• Grameen Foundation Mobile Technology for Community Health (MoTeCH) Launched in November 2008, the first project of the Mobile Technology for Community Health is to determine how mobile phones could be used to improve antenatal and neonatal care in rural Ghana
• West Wireless Health Institute The West Wireless Health Institute identifies, validates and accelerates the use of innovative and cost-effective wireless technologies for health needs.
• Carso Health Institute (Mexico/LATAM) Funded by Carlos Slim, the Carso Health Institute is focused on researching and finding innovative solutions to priority health issues in Latin America. TelSalud, an intervation based-programme, seeks to harness the power of the telecommunications for health.
• Wireless Life Sciences Alliance

News and information sources

• [10] Wireless Healthcare News
• mobihealthnews The mHealth industry monitor
• iPhoneMedicalApps The iPhone Medical Apps and News monitor
• Mobile WellBeing Mobile digital devices in service of human wellbeing
• Android Medical Apps The Android Medical Apps and News monitor

Technology and applications developers

• Cell-Life (South Africa) SMS data gathering applications
• Cinterion (Germany) Medical Device M2M enabler
• DataDyne.org A US and Kenyan not-for-profit consultancy creating mobile data collection applications to serve public health and international development. DataDyne created EpiSurveyor (DataDyne's EpiSurveyor.org), a free, very easy-to-use software suite to collect, analyze, map, and report data using handheld computers and cellphones.
• EpiHandy Set of tools for collection and handling of data using mobile devices: mobile phones, smart phones, PDAs, and handheld computers
• Free and/or Open source software packages for mHealth
• FrontlineSMS Free open source software that turns a laptop and a mobile phone into a central communications hub that enables users to send and receive text messages with large groups of people through mobile phones, without requiring an internet connection

Program implementers (may also be applications developers)

• AED-Satellife Information and communications technologies (ICT) initiatives through the USA-based not-for-profit Academy for Educational Development providing support for HIV/AIDS, malaria, child and maternal health, and health systems management programs in Uganda and Mozambique
• D-Tree (USA) In Partnership with Harvard School of Public Health, D-Tree develops treatment protocols for the most commonly diagnosed illnesses based on best field practices. The protocols are programmed into inexpensive handheld computers and mobile phones for use by frontline health workers in both clinical and community settings. These devices are augmented with a system of patient-held data cards with embedded computer chips that record individual medical information needed for diagnosis and treatment. D-Tree has projects in Tanzania.
• Freedom HIV/AIDS Freedom HIV/AIDS, a social initiative of the Indian firm ZMQ Software Systems, comprises four mobile games promoting HIV/AIDS awareness messages. The games have been introduced in India, Uganda, Tanzania, Kenya, Malawi, Mozambique and Namibia.
• eConsult India’s largest non-profit telemedicine initiative serving approximately 100,000 subscribers, with 10,000 healthcare partners
• InSTEDD (USA) An acronym for Innovative Support for Emergencies, Diseases and Disasters, InSTEDD is a California, USA based organization with programs in southeast Asia. InSTEDD has developed applications including GeoChat, which integrates SMS messaging and mapping, and tools for information sharing and decision support.
• MPedigree (Ghana)
• Phones for Health (USA)
• SexEdText (Philippines)
• SexInfoSF (USA)
• Text to Change (The Netherlands)

Private Sector

• 3G Doctor (Worldwide)
• German mHealth Project Inprimo
• GlucoMON-ADMS by Diabetech (Worldwide-GSM/GPRS)
• IBM mHealth wireless solution (USA)
• IQMax Mobile Healthcare Solutions
• Mobile Healthcare Industry Summit (London)
• Polka (USA/Worldwide)
• Sinovo (Germany/Worldwide) Diabetes Management with SiDiary
• Voxiva (USA/Worldwide) Interactive Health Engagement

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