I've got 99 problems but a phone ain't one: Electronic and mobile health in low and middle income countries.
Mobile technology is very prevalent in Kenya-mobile phone penetration is at 88% and mobile data subscriptions form 99% of all internet subscriptions. While there is great potential for such ubiquitous technology to revolutionise access and quality of healthcare in low-resource settings, there have been few successes at scale. Implementations of electronic health (e-Health) and mobile health (m-Health) technologies in countries like Kenya are yet to tackle human resource constraints or the political, ethical and financial considerations of such technologies. We outline recent innovations that could improve access and quality while considering the costs of healthcare. One is an attempt to create a scalable clinical decision support system by engaging a global network of specialist doctors and reversing some of the damaging effects of medical brain drain. The other efficiently extracts digital information from paper-based records using low-cost and locally produced tools such as rubber stamps to improve adherence to clinical practice guidelines. By bringing down the costs of remote consultations and clinical audit, respectively, these projects offer the potential for clinics in resource-limited settings to deliver high-quality care. This paper makes a case for continued and increased investment in social enterprises that bridge academia, public and private sectors to deliver sustainable and scalable e-Health and m-Health solutions.
Institute of Healthcare Management, Strathmore Business School, Nairobi, Kenya Health-E-Net Limited, Nairobi, Kenya.
Pratap
P
Kumar
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Chris
C
Paton
KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
Doris
D
Kirigia
D040421:Cell Phone / Q000706:statistics & numerical data*; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D003906:Developing Countries; D004059:Diffusion of Innovation; D019983:Guideline Adherence; D054625:Healthcare Disparities / Q000191:economics; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D007630:Kenya; D010820:Physicians / Q000600:supply & distribution; D017410:Practice Guidelines as Topic; D019114:Remote Consultation / Q000191:economics; D017216:Telemedicine / Q000706:statistics & numerical data*
Evidence Based Medicine; Health Service; Information Technology