Mobile Phones in Health Care Delivery Can't Be Ignored

How the rapidly moving technology in mobile phones will impact on the Telecare industry, writes Tom Morton, CEO, Argyll.

The care industry has experienced significant culture changes following the drive to support independent living and provision of care in the community. These changes driven by the government have also placed significant challenges on our work practices.

As care provider organizations look to improve service delivery and provide the auditable evidence that satisfies national and local performance targets it is not surprising that many are now looking to increase deployment of mobile technology to further enhance service provision.

For many years, the mobile phone was excluded from the discourse about devices and platforms to deliver care services and as digital devices proliferated within the growing UK Telecare market, the mobile phone as a delivery device was somewhat ignored. By comparison care service providers in developing countries began to understand that the advantages of the mobile phone and the expansion of wireless networks offered the opportunity to deliver services to low – and middle income countries with handsets that were becoming increasingly sophisticated and affordable in geographies and environments that were uniquely challenging.

As of May 2008, 21.2% of the world's people were using the Internet, by comparison and more dramatically, the number of global mobile phone subscribers has grown to over 3.4 billion or approximately 50% of the world's population, with the greatest growth in Asia, the Middle East, and Africa. Mobile technologies therefore enable Telecare providers to decentralize and extend their reach to remote settings as well as to individual members with a comparatively smaller investment in technology infrastructure.

There are now almost 4 billion people using mobile phones, a number that is projected to grow to 5.2 billion by 2011. There are now more mobile subscribers in developing countries than in developed countries and the mobile phone has replaced the computer as the fastest growing technology on our planet.

As technologies go, mobile phones are flexible and familiar for the end user and currently GSM and 3G based CDMA networks provide coverage to homes, workplaces, and even remote rural areas.

In the short term questions still persist about the future form developing mobile technologies will take but there is no doubt that the capabilities of today's Smartphone's (e.g. the Apple iPhone or Nokia N95) to download applications when required will become more affordable and therefore more easily accessible over time. In fact, mobile phones are increasingly being viewed as connected computers incorporating powerful internet applications. GPRS, Edge, and even 3G data services, all previously restricted to high-end handsets and wealthy users, are now making steady inroads onto mid-prices mobile phones across the world. Furthermore the integration of the geographical mapping technologies GIS and GPS with mobile technologies lets users "tag" voice and data communication to a particular location or series of locations effectively providing the potential of extending Telecare and Lone Worker service delivery far beyond the confines of the home. New broadband access technologies (e.g. WiMAX) offering the mobile user and service provider enhanced web, e-mail and voice over internet (VoIP) services at as little as one-tenth the cost-per-bit of current 3G technology and Wireless Long Distance [WiLD] providing broadband over distances of up to 200kms from a single source.

Traditionally, mobile users have only been able to use those devices, content and services that were authorized by the network operators and therefore specialist applications development for care services has been severely restricted. Times have changed though and cash and resource strapped Mobile Network Operators are beginning to understand that partnering specialist applications providers makes good sense for their customers and, of course, their revenues. Our recent partnership agreements with O2 and CommonTime are testament to this trend.

As with most things in emerging technologies it's not that straightforward. We have already seen in the health care field that whilst mobile technology is facilitating data collection, both health providers and government are now facing the need to create back-end systems capable of aggregating and analyzing a wealth of new data. Systems are complex and multi-faceted and interventions in one area may require investments in others. In addition advances made possible through mobile technology demand more sophisticated back-end systems to run them effectively and securely within any given compliance framework and much of the published evidence about the use of mobiles in healthcare remain in the proof of concept stage. The challenge is how to move from proof of concept to larger scale implementations of promising projects. We are optimistic however that with increased investments in evaluating the health impact of using mobile technologies and, more importantly, in the scaling of projects that are shown to work, we will see significant progress in the use of mobile technologies within our industry.

In the meantime one challenge facing Mobile Network Operators everywhere is that management capacity is usually stretched to its limits just providing the basic service model in the face of very rapid network and customer growth in the context of a challenging economic landscape. Ironically it is the latter point that is driving the move towards lower cost outsourced mobile application development and what's needed now is a more concerted effort on the part of technology developers, industry groups and consulting organizations to identify innovative new applications developers or non-traditional network providers then find ways to support them financially and managerially as they pilot new applications.

A comprehensive report from the wireless industry (Wireless Healthcare, 2005) lists an astonishing 101 specific health-related activities that can be conducted using mobile phones; it highlights many of the newly emerging opportunities to take advantage of the health sector's increased access to mobile technologies. Among the many examples are reminders about appointments and medication, the use of a SIM card to hold medical data, peer support for patients via mobile phones, support for health professionals making a diagnosis, and many types of data collection, along with using phones to control inventory, and to contact emergency services.

While the UK health community might debate the future of the mobile phone within our industry, healthcare individuals around the world are already using mobile technologies to access care services provided by the software applications on mobile phones. As mobile phones become an integral part of everyday life it seems highly unlikely that they will not play a crucial part of care service delivery in the near future. Industry visionaries, like mobile industry expert, Jeffrey Sachs at Columbia University in the US, may well be right when he predicts; "the cell phone is the single most transformative technology for development."