Global Health Care Equity

xTENDING POWER TO REACH with mHealth, eHealth, Telemedicine

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Background

Access to health is a human right [1, 2]. Part 1 of Article 25 of the Universal Declaration of Human Rights stipulated that everyone has “the right to a standard of living adequate for the health and well-being of himself and of his family” [3]. To ensure access to health by everyone requires a high level of creativity in developing processes with potential to reach places where motor vehicles and similar expensive technologies cannot reach [4]. Viable alternatives remain unclear without firm leadership in addressing inadequate access to health of the poorest populations around the world [5].

Human beings work hard to create products and services for disease prevention, diagnosis and cure. In spite of this hard work, human health industry has not thrived in many countries of the world to meet health needs of the local people effectively. Because of this problem preventable diseases continue kill millions of people around the world.

Emerging technologies in information, communication, and medical fields are rapidly converging to produce new platforms for health delivery. Health information, for example, can be transmitted through portable or mobile devices to extend the reach of health services to remote locations.Portable devices have the capability to create, store, retrieve, and transmit health data in real time among users [6]. From technological standpoint, health information can be loaded on a portable device such as a cellular telephone (cell phone) fitted with software applications for managing patient data. The patient information so loaded then flows over wireless networks, from one portable device to another. mHealth is the name used to refer to the concept of delivery of health care services over mobile devises.

Portable devices enabling transportability of software applications that can manage patient information could increase the reach and power to deliver health care services to the remotest areas possible. Because of ease of portability, mHealth has the potential to reach people living in most rural conditions where paved roads are scarce or do not exist [7]. This power-to-reach creates major opportunities to deliver high quality health care services to millions of people who would otherwise never have access to care. This power also ushers in potential for wealth generation for local people living in developing countries and for international investors [8].

The specific problem is that reaching the underserved people in rural areas is a difficult challenge because of the paucity of health care providers in these countries [9]. These factors enhance the feasibility of mHealth as an ideal mechanism for delivery of health care services in remote locations.

The business potential of mHealth encompasses the 2.4 billion mobile subscribers [10, 11]. This number of mobile subscribers is projected to increase to three billion by the end of 2009, connecting one-half of the global population [12]. Much of this growth will come from new subscribers in countries such as India, China, Africa, and Latin America. The number of mobile subscribers dwarfs any other means of reach. For example, there are only 11 million hospital beds in all developing countries [13]. The number of mobile phones even dwarfs the 305 million computers in Africa that would serve as a platform for telemedicine services. The ubiquity of the mobile phone renders it a powerful device for extending healthcare to the most rural areas of the planet [14].

The Problem

Despite this tremendous power-to- reach, the general problem is that we are not close to achieving the health-related targets of the Millennium Development Goals (MDGs) set for 2015 [15]. The fact that each year, millions of children die from preventable diseases is disheartening, but at the same time illustrates the magnitude of opportunity to do good with appropriate investment and use of mobile technology. Many children continue to die due to lack of access to routine immunization programs, education programs, and health campaigns. Hundreds of thousands of women die because of complications at childbirth. Millions succumb to infectious diseases. Maternal mortality has stagnated for two decades, child mortality is not declining fast enough, HIV/AIDS still infects people faster than the pace of distribution of antiretroviral treatment;  health inequality is widening within and across countries [16]. Insufficient resources, lack of adequately trained staff, and frequent shortages of critical vaccines and medicines characterize much of the health care system in the developing world [16].