By David Schafran
As 3G sweeps a nation with over 670 million mobile phone connections, and Android phones become increasingly available, the opportunity for high value mobile enabled services is tremendous. Two industries that have already tapped into the ubiquity of mobile phones in a big way are entertainment and financial services, with applications ranging from music downloads to banking that are attracting swaths of users and investments. But there is a third category that has only scratched the surface in India, which has potential to benefit a billion, especially when combined with the other two: mHealth.
Mhealth (aka Mobile health) leverages mobile devices and information communication technology (ICT) to deliver health services and information exchange which can increase access, affordability, and quality of healthcare significantly.
One of the first major mHealth interventions was introduced by Apollo Hospitals, using telemedicine to make secondary and tertiary medical expertise available to rural and peri-urban India through an audiovisual enabled delivery system. As qualified doctors are scarce in these areas, telemedicine has filled an important need. From the year 2000 to 2009, over 57,000 tele-consultations were performed across various disciplines, from sexual health to neurology. Apollo is now offering 24/7 consultations for just Rs 45, the equivalent of $1, and has 71 telemedicine centers across India. Due to the success of the program, the Delhi government is looking to expand the program in the near future in a public private partnership.
This work has paved the way for other mHealth initiatives, but is far from serving the country of 1 billion.
Why has Indian mHealth not picked up steam like mEntertainment and mFinance? Do Indians value fun and money over health? Sounds provocative, but that would be brutally simplistic and is probably untrue. Is the technology not there yet? Maybe, though plenty can be done with existing technology as evidenced through telemedicine’s start with relatively simple audiovisual equipment and wireless networks.
Dr. Krishnan Ganapathy, one of the architects of Apollo Hospital’s telemedicine program, recently said at the mHealth Summit in Washington DC that mHealth in general has only scratched the surface in India because there is a lack of awareness among patients and doctors about what mHealth is and what benefit it can provide. In business terms, the demand for mHealth is not there yet. Where as mEntertainment and mFinance create stand alone products supported by lots of advertising dollars, mHealth remains more of a value added service.
Additionally, mHealth has not been practiced in an organized, regular way, and thus has not produced enough definitive evidence and science that mHealth produces concrete beneficial health outcomes. Nor has it been advertised enough to doctors as something that can save them time and money.
But Ganapathy’s main point was that there just plainly needs to be more companies doing work in the space, and making noise about what they do so doctors and the public buy in. Allow me to make some noise on their behalf – the following are some innovative companies, non-profits, and university research that are paving the way for Indian mHealth:
mDhil – This Bangalore start-up provides healthcare information to the general Indian public mainly through text messaging, but increasingly through mobile web and digital content. With a paid subscriber list of over 250,000 users, mDhil is becoming somewhat of a WebMD for the Indian market.
Sana – Based out of MIT, Sana’s team of students and volunteers creates open source mobile apps to guide community health workers on how to screen and diagnose patients and link that data to doctors through OpenMRS, the open source medical records system which is widely used in the developing world.
mPedigree – Started in Ghana and now also operating in India, mPedigree has created a mobile platform to track and check the validity of medicines in order to combat the rampant practice of drug counterfeiting.
E Healthpoints – Operating currently in Punjab, E Healthpoints is creating a network of modern clinics that offer telemedicine, clean water, diagnostics, and safe drugs to peri-urban Indians. They recently partnered with Proctor & Gamble to scale 2000 E Healthpoints across five north Indian states.
World Health Partners – This non-profit has created a multi-level service delivery network which leverages the latest in telemedicine and point-of-care diagnostic technology to improve access and quality of care to rural and peri-urban India. They are scaling from Uttar Pradesh to Bihar through funding from the Gates Foundation.
ZMQ Software Systems – This technology for development company has developed mobile games to combat HIV in India by trying to change adverse health behaviors. This fusion of digital entertainment, specifically games and health has massive growth potential to influence healthy behaviors and change adverse ones.
NETRA – Still in the research lab at MIT’s Media Lab, NETRA (Near-Eye Tool for Refractive Assessment) combines an external eye piece with software loaded on a smart phone to measure refractive conditions (ie near/far sightedness and astigmatism) on site at an extremely reduced cost. Optometrists in the US pay up $8000 for a similar device, and which is always located in optometrists’ office. This technology could be a game changer for rural India.
Along with the growth of mHealth entreprenuership in India, groups like the mHealth Alliance, which is a partnership between the Rockefeller Foundation, United Nations Foundation, Vodafone Foundation, GSM Association, and PEPFAR, plan to spread the mHealth gospel by setting up an India branch, as well as lead specific projects related to maternal health that already in the planning stage. Health 2.0, which puts on conferences in the US around the latest IT-enabled health solutions has plans to come to India in the next year to start stoking the Indian mHealth flame. Mhealth India is gaining momentum.
Moving forward, I am convinced that a major growth area for mHealth as well as mEntertainment and mFinance is to integrate the three. MHealth solutions that are more centered around fun, entertaining experiences using game mechanics, and incorporate easy payment options will both increase positive health outcomes and drive consumer demand more than any amount of press or conference attention. While technology will play a key role in making mHealth a success in India, user centric design and awareness of improved health outcomes plus cost savings for doctors (and payers) will be the key drivers of growth.
David Schafran is a design strategist focused on creating and implementing scalable user-centric systems that benefit broad audiences. After a year working with early stage social enterprises in Chennai, India through a Rockefeller Foundation fellowship, he is currently based in San Francisco where he works as a consultant and entrepreneur. He is currently focused on healthcare innovations and leveraging game dynamics for behavior change