One wonders whether we should invoke the serendipity or “karma” to explain the contents of the world's first telephone call, made by Alexander Graham Bell on March 10 1876: “Watson, come here, I want you,” a request for medical aid after spilling acid on himself — it was the world's first demonstration of mHealth! Little could Bell have foreseen that in December 2011, 3,500 people from 50 different countries would spend three full days in Washington, discussing just how a phone could indeed be the most disruptive innovation of the 21st century; with the potential to radically transform healthcare delivery to 7 billion.
With hundreds of mobile network operators, telecom specialists, software developers and manufacturers of mobile monitoring devices discussing the intricacies of providing mobile healthcare, the message was loud and clear — doctors of today could become an endangered species. After all, there is now a potential for five billion to have doctors in their pockets!
It is assumed that a doctor is in a hospital or clinic for a face-to-face encounter with a patient. With shortage of doctors and hospitals, this will be difficult for the 750 million Indians living in suburban and rural India. The exponential increase in the utilisation of mobile phones could perhaps bridge this divide. In keeping with Nobel Laureate Muhammad Yunus's observation that “the quickest way to get rid of poverty right now is to have a mobile phone,” the National Telecom Policy 2011 views the mobile phone as an instrument of empowerment.
With every sixth human and every fifth mobile phone on this planet in India, one would have thought that we would be the leaders in mHealth particularly when mBanking, mCommerce and mEntertainment are steadily increasing. With mHealth, we seem to have more pilots than in the Indian Air Force. Are we suffering from pilotitis? There are millions of educated diabetics with smart phones in India. Why are they not embracing mHealth applications? Is it because mHealth applications have to be culture sensitive, customised and cost-effective, using appropriate, need based technology? Making available WiFI and WiMax is not enough. The issue of WiiiFM (What is in it For Me) from every stakeholder's perspective needs to be addressed.
Today, mobile devices can revolutionise health care delivery by providing access to authenticated health information. Ensuring compliance with and adherence to medication, with SMS reminders, can go a long way in reducing relapses in chronic diseases. Tomorrow, the mobile phone could be a hand-held hospital functioning as a microscope and as a repository of your personal health record. Through wireless internet and 3G your doctor could “examine” you through videoconferencing, review your current ECG, compare it with your previous ECG and echocardiogram.
You can even look at the block in your pulsating coronary artery on your mobile screen, along with your cardiologist though he is far away. Doctor “anyone, anytime, anywhere” need no longer be a cliché. Mobile phones are no longer elitist. In an egalitarian society, millions of pregnant women can now go through virtual hand-holding with SMS reminders. Foetal heart rates can be continuously monitored in high risk pregnancies and using Bluetooth, information can be transmitted to a central monitoring unit, through a simple mobile phone which 37% of rural India now has.
The 13,500 mobile health applications include prescribing glasses for yourself. Bluetooth-enabled glucometers directly inform a dedicated server of your glucose level. Eventually, using non-invasive measurement of blood glucose with wearable sensors, a wireless command to your implanted insulin pump will release insulin, without your knowledge. Wireless-enabled wearable ECGs will detect arrhythmia trends even before you are aware of them. A chemical sensor on your phone could warn you of an impending asthma attack as well as remind you of your cholesterol levels when you are in a cafeteria. It can confirm whether your drugs are authentic or counterfeit.
According to Mckinsey, with 450 mobile internet users by 2015, India could become “the first truly mobile digital society.”
We must exploit this opportunity to bridge the health divide. Making available bionic contact lens where email could be seen is not the priority. Utilising the simple ubiquitous mobile phone to provide better quality, cost-effective health care everywhere is.
(The writer is a Chennai-based neurosurgeon, past president of the Neurological Society of India, President of the Indian Society for Stereotactic and Functional Neurosurgery and past president of the Telemedicine Society of India and is an mHealth evangelist. His email ID is: drganapathy@ apollohospitals. com)
