1. mHEALTH- The Way Forward DR. WAQAR ALI 1

2. Introduction  In an mHealth environment, Information Moves rather than the Physician or the Patient mHealth creates an ePhysician - ePatient Scenario.  One of the most important things to remember always is that its all about the PATIENTS.  Patients should remain the center of focus for all stake holders as the ULTIMATE BENEFICIARY 2

3. WHY IN OUT SETUP? 3

4. Because: 1. Poverty 2. Insufficient number of Healthcare facilitates, Doctors and Paramedics available for increasing population 3. Large population of people living in remote areas without physical access to quality, or even basic, healthcare facilities 4. Uneven distribution of scarce resources limited to major cities 5. Limited resources available to the Government 4

5. Continue.. 6. Poorly trained Doctors in rural areas with no CME opportunities 7. Increasing Disease burden (DM/Metabolic Syndrome) 8. High cost of training & technology 9. Corruption & lack of commitment 5

6. When trying to understand the healthcare dynamics we need to consider the Increasing Trends in the following areas:  Need Population  Awareness Empowered Patient  Technology mobiles  Mobile phones being cost effective, easy to carry, personal in nature, less power dependent, easy to upgrade, and simple to operate with vast coverage prove to be the single most effective healthcare delivery tool. 6

7.  USES OF MOBILES ? 7

8. Uses of Mobiles include but are not limited to the following: 1. Education and Awareness 2. Remote Data Collection 3. Remote Monitoring 4. Communication and Training of Healthcare Workers 5. Disease and Epidemic Outbreak Tracking 6. Diagnostic and Treatment Support 7. Behavior Change / Remodeling 8

9. Continue..  Mobiles allow healthcare services to be delivered efficiently at the point of need.  It also allow information to be acquired from distant and remote locations which is then processed and evaluated at a central place like Hospitals.  One of the major impediments in the development of conventional Telemedicine was the issue of last mile which now has now been resolved by mobiles which, due to their unique nature, reach the remotest of places and serve the poorest of the people. 9

10. Applications of mHealth  The applications in mHealth range from the central service of a Medical Call / Contact Center to sms based health awareness campaigns which are used for behavior remodeling especially for AIDS, Smoking cessation or prevention of Hepatitis, Diarrhea, etc.  A Medical Call Center, which is the commonest application in mHealth, has established its diverse and significant utility in healthcare. 10

11. Continue..  Medical Call Center is an accessible, cost effective resource center where trained medical professionals (Registered Nurses or Physicians) take calls about medical issues.  The caller is then advised accordingly or redirected to the right care resource or information  It is the single best strategy to deliver the right care at the right time in the right setting with the right resources. 11

12. Continue.. Health Hot lines or call centers may be operated for  Hospitals / Emergency Departments  Private Clinics/Offices  NGOs/Associations running specialty services– HIV/Breast Ca/Hepatitis/Mother & Child/etc Urgent Medical Response Services  Poison control centers  Suicide prevention hotlines  Child abuse hotlines  Domestic Violence hotline. 12

13. Benefits of mHealth For Patients 1. Quality treatment is received when and where it is required 2. Cost and Time of traveling and work loss is saved 3. Compliance to treatment increases 4. Medical record is universally and permanently available allowing continuity in treatment 5. Empowerment is achieved where Patient starts taking responsibility of his own health 13

14. For Doctors 1. Consultants receive diverse patients from various locations 2. CME activities are organized riding the basic infrastructure of TeleMedicine 3. Epidemiological studies can be done 4. Second Opinion - Information could be shared in seconds with other colleagues any where in the world 14

15. For Government  Capability to deliver healthcare services to all  Efficient use of healthcare resources with cost saving  Cost cutting in traveling and administration expenses  Health education and awareness campaigns could be run through Audio Text Technology. 15

16. Operational Challenges in any eHealth or mHealth project  Training of Drs to conduct a “Telephone Triage”  Retaining trained Drs  High turnover  Availability of Drs in regional languages  Lady Drs are being focused to work from home  Maintaining the EMR / patient files 16

17.  Absence of regulation / standards  Maintaining quality  Maintaining the focus of Telecom operators towards delivery of healthcare & patient benefit  Getting the buy-in of independent Drs  Getting the buy-in of the Government  Measuring the outcomes “You cant Treasure what you cant Measure”  Infrastructure 17

18.  Mobile phones have revolutionized our Communication through a Disruptive Change and we should be prepared to capitalize upon the extraordinary benefits of mobiles in the healthcare scene 18

19. Thank you 19