The mHealth Opportunity: From Kamphaeng Phet to Capitol Hill

I'm working in Thailand and the Philippines for Dimagi, a Boston-based technology company that develops and deploys mobile phone-based solutions to public health issues around the world, particularly in developing countries. Here in Southeast Asia, Dimagi was hired to support a major vaccine trial for dengue fever, and I'm helping roll out a system that will use text messages to help keep the clinics running the trial in closer contact with their patients. Appointment reminders, health tips, and general encouragements to watch for fever symptoms will be automatically delivered on a mass scale to the patients who receive the trial vaccine.

How is it possible that we're running a high-tech project like this in off-the-beaten-path Thailand? All the system needs to operate is a central server with a good internet connection, and a network of patients with mobile phones. And everybody-- everybody-- has a mobile phone. With over 5 billion of them now in use around the world, we're simply leveraging a network that already exists to facilitate better communication between patient and doctor.

About two years ago, NDN helped promote the release of "mHealth for Development" a report jointly published by the UN Foundation and the Vodafone Foundation that describes the opportunity for mobile phones to be used to improve healthcare in the developing world, and includes a number of case studies of interesting projects already underway (a few Dimagi projects are included in the case studies). The report is a great starting point for beginning to understand this field and its potential.

But mHealth isn't just a developing world opportunity.  In the U.S. and other developed nations, the potential of the ubiquitous mobile phone network to help monitor symptoms and vital signs, faciliate remote diagnosis and treatment support, track epidemics, and otherwise improve the quality of care (while reducing costs) is huge. Particularly in the treatment of chronic diseases including diabetes, heart disease, and cancer-- which together account for 75% of healthcare costs in the U.S.-- mobile phone-based solutions can offer patients individualized monitoring and management of their health. 

Currently, only about 50% of chronic disease patients in the U.S. take their prescribed medication on time, which inevitably leads to their becoming sicker, requiring hospitalization and high-cost procedures. But even the most simple solutions can have a huge impact on that rate. SIMpill, a project piloted in South Africa, is a system that sends automated SMS reminders to tuberculosis patients to take their medication, and has led to an increase in compliance rates from less than 50 percent to over 90 percent. If simple solutions like SIMPill can help raise that rate in the U.S., Americans can all benefit from both improved medical care and greatly reduced costs.

What's more, applications that can successfully help manage chronic disease will have a huge global market. Dr. Darunee Tannitisupawong, a physician based here in Kamphaeng Phet, Thailand, has observed in the past decade a dramatic rise in diabetes and heart disease-- and she ranks those as the single greatest public health issues in this small provincial city today. Fifteen years ago, infectuous diseases like dengue fever were the greatest scourge of the population here, and while rates have remained steady (and will hopefully begin to decline if this vaccine trial proves successful), worsening eating and lifestyle habits have caused a dramatic rise in the incidence of chronic disease.

As KFC and McDonalds continue their conquest of every corner of the globe, chronic disease will be an increasingly large quotient of the world's illness. Fortunately, the best tool to combat that illness is already in the pocket of 70% of the people on earth.