I have a strong interest in the use of mobile phones in healthcare in both the US and in Africa, in particular. In mid-2008 I was a convenor in the last session of the Rockefeller Foundation’s Making the eHealth ConnectionSummit. The Rockefeller Foundation convened the summit in order to bring some of the leading practitioners of eHealth together for a month to think through how we could collectively address the barriers to the creation of a robust eHealth market in the Global South. An important sector of the Global eHealth market is the mobile space. In fact, innovation in the mobile space is occurring at a much faster rate in Africa than we see at the present time in the US due to a variety of reasons. The Rockefeller Foundation and others are attempting to coordinate activities in this space in order to avoid the situation we have in the US; a plethora of competing, fragmented technologies and ehealth systems that do not communicate well together, lack open standards that enable innovations and growth in the mobile health space, and all of this amounts to a missed opportunity to potentially provide better care at a lower price point.
Therefore a group of us are going to attempt to put together something called the Mobile Health Collaboratory over the coming months. What we’re doing is building a network ecosystem of the most important stakeholders in the mobile health space to develop a consensus around the market architecture needed to catalyze the mobile health space. In some respects this resembles the notion of the “Entrepreneur Commons” put forth by Marc Dangeard. Below is an illustration of Dangeard’s concept:
What we’ll be doing is creating a collaborative market that includes health plans, mobile entrepreneurs, handset manufacturers, back-end technology providers, telcoms, etc. Eventually our program will be a global mobile health collaboratory. We’re currently seeing a rapid growth in iPhone aps in the health and wellness space but we see relatively few that we think truly have the potential to shift health outcomes. This is partly due to the current state of the field–strong interest in the mobile device but application development is rarely informed by robust theories of behavioral change. Furthermore, the theories of behavioral change frequently deployed in fields such as public health and disease management are dated and demonstrating declining returns on investment. What is needed is more innovative thinking in the social technologies that influence behaviors, more anthropological and design thinking into the development of the applications, mining of the fields of persuasive technologies and persuasive games, social networking theory and perhaps behavioral economics all brought together in a way that engages individuals and networks rather than practicing the age-old game of Victorian-era moralizing that public health cherishes, oppressive regimes of self-surveillance, and blaming people for their poor health outcomes. The status quo in thinking about health in these terms needs to change. People no longer engage with this form of “health-ism” and any form of “consumer-driven” health that works to isolate ‘responsibility’ on the individual is bound to fail. If we don’t critically examine the complex assemblages around the mobile phone we’re going to miss a great opportunity to engage in a more robust practice of producing better health outcomes at a price point that is sustainable rather than the current modus operandi that is bankrupting the economy. This does not mean that mobiles are the answer to what’s ailing the system. They aren’t. In some of the posts that follow I’ll be explaining in more detail our thinking about mobile health commons and collaboratories as well as the social technologies that I think will make a difference.