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The Use of Mobile Phones to Improve Health. Marc Mitchell, M.D., S.M Harvard School of Public Health and D-tree International. What does a phone do?. send and receive voice data send and receive alphanumeric data - SMS run applications store data, voice
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The Use of Mobile Phones to Improve Health Marc Mitchell, M.D., S.M Harvard School of Public Health and D-tree International
What does a phone do? • send and receive voice data • send and receive alphanumeric data - SMS • run applications • store data, voice • take and show video or photos • use peripherals (diagnostics) • know where it is (GPS)
How does this affect healthcare? • decision support at POS • linked medical record • continuum of care • across time, place • communications between • community – hw – manager • enhanced diagnostics
Decision Support at POS for frontline HW • Facility • Integrated Management of Childhood Illness (IMCI) • Maternal and Child Health (Ante-natal, Post-natal, Neo-natal) • Active Management of Third stage of labor • Immediate Newborn Assessment • HIV triage • Severe Acute Malnutrition • Community • Maternal and Child Health • (Ante-natal, Post-natal, Neo-natal) • TB screening • Home based care • Orphans and Vulnerable Children • Family Planning • Community IMCI
Linked Medical Record running on phone Performance Report patient database patients lost to f/u 1. ali samuel 2. ben hasan 3. etc. Clinical Protocol Enable continuum of care • growth monitoring • immunizations • lab tests • pregnancy registration • referral tracking
Link CHW and clinic HW Nutrition
Link CHW and clinic HW neonatal antenatal and postnatal care
linking Community – HW – Manager client (basic phone) information alerts reminders surveillance (tweets) CHW (java phone) pt. registration pt. record protocols scheduling training alerts reminders msg to clinic clinic (smart phone) pt. registration pt record protocols scheduling training alerts reminders telemedicine supervisor (phone or netbook) messaging exception rules for supervision surveillance learning notifications alerts manager (laptop) exception rules for supervision surveillance learning data queries
What is needed to get there? Standards technology: interoperable, robust clinical: customizable but consistent Infrastructure technology: how to support data flows technology: how to manage equipment logistics (drugs, equipment) Financing models who pays for what what is role of telecoms, pharma, MoH, others
What is needed to get there? Leadership national: data policies, task shifting, funding global: need for international standards, etc. accountability across the entire spectrum Cooperation and humility donors must cooperate, not be so arrogant for profit and government must learn to work together and share responsibility Do not lose sight of the client the goal of mHealth is Health not phones
The Use of Mobile Phones to Improve Health Marc Mitchell, M.D., S.M Harvard School of Public Health and D-tree International