After about a decade of attracting big philanthropic investment without enough measurable results, Uganda and South Africa have both put a hold on any new
mHealth pilots in their countries. And as the developing world closes its doors, some nonprofits are turning their sights to the U.S. for further study.
"While there is still much to do in low and middle income countries, there is a lot that can be learned and transferred from the experience of designing
and implementing mHealth systems in resource constrained settings here in the U.S.," explained Patricia Mechael, the executive director of mHealth Alliance
at the United Nations Foundation. If they can improve health outcomes through randomized control trials, they may be able to renew the philanthropic
sectors' belief in the viability of the field.
And the U.S. could profit as well. Mobile interventions in prenatal care and chronic diseases, like diabetes, have already proven particularly successful,
in large part because they are an easy way for people to take charge of their own health. Price Waterhouse Cooper estimates that mHealth
interventions in the U.S. could save $10,000 per diabetic patient per year. The U.S. current spends $218 billion on diabetes every year.
Text messages have a wildly high "open and read" rate -- 97 percent versus 5 to 20
percent for email. What began as a field that mostly tackled approaches to improving care for HIV and AIDS patients has expanded its scope widely in the
last few years. In 2011, a Lancet study reported that text
messages to remind health workers in Kenya about the proper guidelines for malaria management improved care by 23.7 percent immediately after intervention
and continuing to 24.5 percent six months later. One recent project even attempted to reduce
depression among teenagers in Auckland, New Zealand using a cognitive behavioral therapy approach gone mobile; over three-quarters of participants viewed
at least half of the uplifting text messages sent to them and 66.7 percent said it helped them in getting rid of negative thoughts.
Medic Mobile, a non-profit organization founded in 2009, has used technology -- like text messaging immunization reminders or providing apps with basic,
life-saving information about prenatal care -- in over 20 countries on a wide variety of projects. Their efforts, thus far, have reached 3,500,000 people,
or 700,000 households. This month and next, it will launch two U.S.-based initiatives.
One program, which will begin on April 18, aims to use text message reminders to increase appointment attendance among the largely immigrant, Latino
population served by the San Mateo Medical Center. Those who opt-in will be able to confirm and reschedule appointments via text message. "These kinds of
clinics currently have full-time staff devoted to calling and trying to track down patients," explained Josh Nesbit, the organization's CEO and co-founder.
"We're trying to harness the power of asynchronicity to interact with as many people as possible in an efficient way."