Mobility, race, gender, relationships

Posted July 26, 2010 at mHealthNews.com

In the U.S., Pew recently reported "African-Americans and English-speaking Latinos continue to be among the most active users of the mobile web. Cell phone ownership is higher among African-Americans and Latinos than among whites (87% vs. 80%) and minority cell phone owners take advantage of a much greater range of their phones’ features compared with white mobile phone users. In total, 64% of African-Americans access the internet from a laptop or mobile phone, a seven-point increase from the 57% who did so at a similar point in 2009."

This year Pew asked for the first time and found about the following:

  • 54% have used their mobile device to send someone a photo or video
  • 23% have accessed a social networking site using their phone
  • 20% have used their phone to watch a video
  • 15% have posted a photo or video online
  • 11% have purchased a product using their phone
  • 11% have made a charitable donation by text message
  • 10% have used their mobile phone to access a status update service such as Twitter

In low and middle-income countries (hat tip MobieActive Mobile Minute – Daily m4Change News), a study on the mobile phone gender gap by the Cherie Blair Foundation for Women and the GSMA Development Fund, Women & Mobile: A Global Opportunity, finds the 300 million fewer female than male subscribers equates to a US$13 Billion opportunity; from US$740 Million in Latin America to US$4 Billion in East Asia.

Because mobiles can help increase female literacy, they are also natural allies to development efforts.

Concerning India, NPR’s Michel Martin interviewed New York Times and the International Herald Tribune reporter Anand Giridharadas about the explosion of mobile technology occurring there. Giridharadas noted that, while it is likely that more "people in the world have access to a cell phone today than have access to a flush toilet around the world" (for more on that, see Current TV Vanguard correspondent Adam Yamaguchino’s series from India and Indonesia about the world’s toilet crisis) in India cell phones are disintermediating traditional power relationships and are transformative for folks at the bottom of the power pyramid.

Open source healthcare, mobile banking

Posted on Mon, Jul 19, 2010 – 05:17 am at mobilehealthwatch.com | mhealthnews.com

Back in the early days of the HIMSS Medical Banking Project’s Cooperative Open-source Medical Banking Architecture & Technology (COMBAT) Initiative, the late John Hardin and I began exchanging emails with Tim O’Reilly, a bastion of the open source movement, arguing the case for the intersection of open source, open standards and medical banking technologies. Today, healthcare is a major theme of his open source connection, OSCON 2010, which runs July 19-23, 2010. Andy Oram has an excellent track summary over at his O’Reilly radar blog which I will not recreate here.

Those interested in mHealth will note from the healthcare track especially that Teddy Bachour will address Microsoft clinical documentation and patient records sharing APIs and open source tool kits, and Roni Zeiger will report on how Google Health’s API facilitates interactions with mobile devices. In addition, there is a track dedicated entirely to mobile sessions, where, in part, one will learn "why Android is so important, and the crucial role that web standards will play in mobile." The track covers Android and iPhone, as well as others.

The adoption rate of the Google open source handset operating system, Android, is still dwarfed by that of the iPhone, but Javelin notes that it "is growing at an astronomical rate."

"Android and iPhone owners by far are the biggest users of mobile banking. They are typically younger, on-the-go consumers who use smartphones as their primary tool for communication – including monitoring their bank accounts and making mobile payments," said James Van Dyke, Javelin President and Founder. “While mobile banking stalled in 2010 as consumers expressed concerns about security and financial institutions focused their attention on the fallout from the economy, the increase in smartphone usage bodes well for the future of mobile banking."

Of interest to Cisco fans is that while Android does not factor into its HealthPresence offering, it does in regard to the recently announced Cius.

The mobile social credit card

Posted on Mon, Jul 12, 2010 – 05:09 am at mobilehealthwatch.com | mHealthNews.com

MoneyGram International announced the expansion of its mobile transfer service to approximately 40,000 agent locations in the United States. The global money transfer company offering expansion follows its pilot program of select California and Hong Kong agent locations to 40 million Philippines SMART phone users.

By the end of this year, all of (the National Irish Bank’s) remaining 33 branches will be cash-free. About a fifth are already cashless, offering only financial advice. Concurrently, the European Central Bank wants a single electronic-payments system across all member states and with a phasing out of checks.

Some recent Javelin research points out:

  • The number of U.S. adults who own mobile phones dropped markedly in 2010, falling to 74%, down from 85% in 2009.
  • About 20% of all U.S. adults now tote a smartphone, as do 27% of mobile phone owners.
  • One in five consumers now using mobile banking.
  • Only 18 of the top 40 U.S. banks now offer mobile banking.

However, 20% of 1.5 billion with mobiles but without bank accounts will use mobile money by 2012 according to Economist in 2009.

I’m always whining about the fact that federal taxes don’t adequately account for hours donated to Non-Governmental Organizations and Non-Profit Organizations, so I suggested to Ideablob awhile back what I thought was a cool approach to track social capital–"The Social Credit Card". A (now mobile) credit system whereby one’s charitable activities such as volunteer hours are tracked and compensated. Every time one makes a social contribution (helping a neighbor, volunteering at a homeless shelter, donating to charity, etc.) they accumulate points. A social contribution’s value would be set at the rate a federal employee would be compensated to complete the same or similar task. Accountants would volunteer their time to help track these things.

Similar to frequent flyer miles, these points would be redeemable, for the purchasing of goods or services (e.g., healthcare services). The points could also be used to pay down debt or donated to other individuals or charities as a financial contribution. By combining social with financial capital we would create incentives for good works and a more comprehensive picture of one’s net worth–and provide an excellent way to do a census of how much healthcare related volunteerism goes unnoticed and uncompensated.

mHealth and maternal and newborn mortality

Posted on Tue, Jul 06, 2010 – 05:21 am at mobilehealthwatch.com | mHealthnews.com

A call for collaboration by international groups to reduce maternal and newborn mortality by employing mobile technologies includes a joint statement with five primary action areas:

  • Identify how technology can help enable known interventions that address maternal & newborn health needs
  • Design and build the first models of information and communications technologies (ICT) systems to do this, and the content and policies to go with them
  • Create new metrics for evaluating programs, using the enormous amount of data ICT-supported programs will produce
  • Test these integrated, end-to-end, scalable solutions in a variety of countries to learn what works best
  • Share activities in all four of the above, and lessons learned and best practices, with the global maternal health communities through a variety of communications channels

The initial supporters include the Family Care International, the GSM Association, Johns Hopkins School of Nursing and Bloomberg School of Public Health, mHealth Alliance, Partnership for Maternal, Newborn and Child Health, PATH, and the White Ribbon Alliance. PMNCH is spearheading the development of the Joint Action Plan.

Fabiano Teixeira da Cruz, Inter-American Development Bank in How Mobile Phone Technology Can Fight Maternal Mortality recounted the causes of high maternal mortality:

  • Poor access to the health care system
  • Access to family planning – counseling, services, supplies
  • Low coverage of antenatal care (e.g. missing appointments)
  • Inability or difficulties to communicate with providers and health-care team in case of emergencies and when needed
  • No access to lab results
  • No health care-related information easily available

Mobile phones have already played a part in women’s health issues by targeting human trafficking and infectious diseases.

Rich data at the point of care

Posted on Mon, Jun 28, 2010 – 05:04 am at MobileHealthWatch.com | mHealthNews.com

Recently, Keith Kleiner of singularityhub.com posted on the Xprize promotional video for an AI physician on every smart phone. Artificial intelligence at the point of care will benefit from the kinds of IT advancements featured at the June 2010 Semantic Technology Conference. Semantics and linked data have already helped to revolutionize healthcare and life sciences research, enabling the querying of complex biomedical data sets and their visualization, the construction of knowledge sharing databases and repositories, and networking between researchers.

Semantic applications demonstrated at the Conference in healthcare, life sciences and related included electronic medical records, biomedical ontologies, disaster response and emergency management systems, disease monitoring, earthquake and water systems recovery, first responders building floor plans, horizon scanning, public health monitoring, and even cost management and accounting. To learn more about the field you can attend XML Summer School in September at Oxford.

Regarding interrelationships of data, the HIMSS Health Wealth Task Force was recently chartered. According to John Casillas, Senior Vice President, HIMSS Business-Centered Systems, this group will likely be affiliated with the futuristic thinking of HIMSS Medical Banking Project since the "Health-Wealth Platform looks at the boundaries of where we are going – linking mHealth with mPayments to meet the needs of the underserved, linking online banking with PHRs for the everyday household, linking customized genomics with a secure vault accessible with a digital ID stored at your bank (an area under review by the White House today), using a card for multiple financial and healthcare functions, including kiosk functions at local doctors’ office…and much more."

Concerning the continued convergence of medical and mobile banking, David Aylward, Executive Director, mHealth Alliance, has recently "commissioned a discussion starter paper on the intersection of mHealth and mPayments," which he is hoping will be completed in several months time.

Building the mHealth Mesh

Posted on Mon, Jun 14, 2010 – 05:10 am at mobilehealthwatch.com | mHealthNews.com

The Federal agency tasked in bringing telecommunications to rural America is the U.S. Department of Agriculture’s (USDA) Rural Utilities Service (RUS). Its June 7, 2010 Round One Awards Report, Connecting Rural America, summarized the state of the projects (68 funded thus far) of the Broadband Initiatives Program (BIP), part of the American Recovery and Reinvestment Act of 2009.

"Broadband provides connectivity for efficient delivery of not just those programs, but for access to many goods and services needed by rural residents, including healthcare, education, and financial services", wrote Jonathan Adelstein, program administrator. "These will not only benefit rural areas but will enhance our overall economic growth nationwide."

In its analysis the Fiber-to-the-Home (FTTH) Council noted that more than half of the 62 last-mile initiatives "will involve end-to-end fiber optic solutions, with the reminder divided over other access technologies including wireless, DSL and coaxial cable."

"There are already more than 700 companies deploying fiber to the home networks in communities across the U.S., most of them in rural areas," remarked Joe Savage, President of the FTTH Council.

The report categorizes the projects as: Wireless Terrestrial Fixed (23), Wireless Terrestrial Mobile (5), Wireless Satellite (1), Wireless Hybrid System (3), Wireline Fiber-Optic Cable (48), Wireline xDSL (14), and Wireline Coaxial Cable (2).

The report highlighted these projects with at least some wireless component:
    •    Alaska: Copper Valley Wireless’s middle-mile project.
    •    Iowa: Eastlight, LLC, wireless broadband to 144,000 rural residents, 111 communities project.
    •    Ohio: Consolidated Electric Cooperative, Inc. Delaware, Morrow, Knox, and Licking counties middle-mile project.
    •    Oregon: The city of Sandy, Ore., (SandyNet, its own municipal Internet service provider) wireless Internet service expansion project.

mHealth in action

Posted on Mon, Jun 07, 2010 – 05:15 am at mobilehealthwatch.com | mhealthnews.com

Recently Rwanda’s President Paul Kagame made good on a promise and over 2,200 health workers received free phones in hopes of improving health services delivery.

In Kenya, NPO Text to Change and the telecommunications company Zain are using SMS mobile quizzes to keep Zain’s employees informed about the latest HIV/AIDS information.

Booz & Company’s Chris Bartlett, Klaus Boehncke, Andrew Johnstone-Burt, and Vanessa Wallace attempt the customization of the Booz E-Health Investment Model for Australia in Optimising E-Health Value Using an Investment Model to Build a Foundation for Program Success. Their abstract reads:

“Electronic health (e-health) initiatives that apply information technology to the delivery of healthcare services for patients and management of clinical information are an essential weapon in the battle against the rising costs and other systemic problems in healthcare. A customisable investment model can help guide policymakers as they seek to define, implement, and gain acceptance of viable e-health programs.”

They make the point that “Costs and benefits are often misaligned in healthcare: Stakeholders that are required to invest significant resources in e-health may only reap a smaller portion of apparent benefits, and those with the most to gain may incur fewer costs.”

The Policy White Paper: Barriers and Gaps Affecting mHealth in Low and Middle Income Countries by the Center for Global Health, Economic Development, the Earth Institute, Columbia University and the mHealth Alliance was released in May.

The 2010 mHealth Summit seeks abstracts from the public and private sectors to highlight ground-breaking health research, information and communication technologies, systems architecture and global partnerships that leverage mobile technology to improve global health outcomes. This year’s submission deadline is July 1, 2010.

Leveraging technologies to fight healthcare fraud, abuse

Posted on Mon, May 24, 2010 – 05:38 am at mobilehealthwatch.com | mHealthNews.com

I saw a job announcement this week from a supplier of revenue and payment cycle solutions requiring the desired M&A strategist to relocate to the city of the company’s headquarters. I immediately thought, "Why?" I reviewed the duties, and they can be completed anywhere. It dawned upon me that mHealth will never advance beyond the vision of the HR department.

NACHA — The Electronic Payments Association is advancing anywhere payments (see their PAYMENTS 2011 Call for Presentations for your future suggestions). Alternative mobile payments continue to spring up everywhere. Banks are seeing the trend that one in five adult mobile phone owners is  paying mobily. The PCI Security Standards Council released a new version of its Personal Identification Number Transactional Security requirements (the first of three new modules, Open Protocols, applies to internet protocol or to wireless enabled devices). HIMSS is promoting its Transformational Approaches for Achieving Meaningful Use virtual conference. We produce documents (for example, the Tennessee Office of e-Health Initiatives Operational and Strategic plans for Health Information Exchange) that talk a good game about "Telemedicine and Telehealth Initiatives" but ultimately these will be implemented by folks who have been screened by human resources thinking from the 80s.

This not to say that the HR technology community is standing idly by. The HR-XML Consortium fairly recently announced the availability of its new XML standards, the HR-XML 3.0 Release, its schemas aligned for human resources interoperability applications with the Open Applications Group implementation of UN/CEFACT (United Nations Centre for Trade Facilitation and Electronic Business) core components, making them more universal than ever. This modernization should greatly improving data and knowledge transfer.

What are your thoughts about how to bring HR to a worldview which supports and encourages mHealth?

Is HR holding back mHealth?

Posted on Mon, May 24, 2010 – 05:38 am at mobilehealthwatch.com | mHealthNews.com

I saw a job announcement this week from a supplier of revenue and payment cycle solutions requiring the desired M&A strategist to relocate to the city of the company’s headquarters. I immediately thought, "Why?" I reviewed the duties, and they can be completed anywhere. It dawned upon me that mHealth will never advance beyond the vision of the HR department.

NACHA — The Electronic Payments Association is advancing anywhere payments (see their PAYMENTS 2011 Call for Presentations for your future suggestions). Alternative mobile payments continue to spring up everywhere. Banks are seeing the trend that one in five adult mobile phone owners is  paying mobily. The PCI Security Standards Council released a new version of its Personal Identification Number Transactional Security requirements (the first of three new modules, Open Protocols, applies to internet protocol or to wireless enabled devices). HIMSS is promoting its Transformational Approaches for Achieving Meaningful Use virtual conference. We produce documents (for example, the Tennessee Office of e-Health Initiatives Operational and Strategic plans for Health Information Exchange) that talk a good game about "Telemedicine and Telehealth Initiatives" but ultimately these will be implemented by folks who have been screened by human resources thinking from the 80s.

This not to say that the HR technology community is standing idly by. The HR-XML Consortium fairly recently announced the availability of its new XML standards, the HR-XML 3.0 Release, its schemas aligned for human resources interoperability applications with the Open Applications Group implementation of UN/CEFACT (United Nations Centre for Trade Facilitation and Electronic Business) core components, making them more universal than ever. This modernization should greatly improving data and knowledge transfer.

What are your thoughts about how to bring HR to a worldview which supports and encourages mHealth?

Tennessee flood brings mHealth insights

Posted on Mon, May 17, 2010 – 05:33 am at mobilehealthwatch.com | mHealthNews.com

While I strive to be data-driven in my blogging, I think being a participant in the Tennessee Floods of May, 2010 may have taken the testing of the eHealth paradigm a bit too far. The experience comes with priceless wisdom.

What I’ve personally confirmed:

1) If a heavily residential area loses its landlines, residents will transfer their communication tasks over to the cellular infrastructure, and that infrastructure will likely prove insufficient due to sheer volume of data and voice transmitted. If there is additional capacity which can be brought online, it is not the current practice of the cellular providers to do so, so far as I have been able to ascertain.

2) If cell towers do not have backup electricity generation capability, the cellular network will fail any place the normal electric utility supply is interrupted. It is also possible that local cellular headquarters will require backup electricity generation capability. Since the towers share the public grid, if the power is kept off by the utilities while rubble is inspected and disaster clean up is on-going, this communication outage can continue for some time, or the bandwidth may be severely curtailed. While rural localities can apparently look forward to 4G service in the future, that was of little help to the 42 counties in Tennessee which will be receiving federal disaster relief funds to aid in their rebuilding efforts.

3) Local nonprofits can agree to cooperate in ad hoc manner in a very rapid manner. In the case of Nashville, Hands On Nashville (HON) was chosen to be the task management point by local government, NPOs, houses of worship, private commerce, etc. Thousands of volunteers were coordinated through it.

4) Social media (Facebook, Twitter) was extremely helpful in alerting rescuers about victims needing help, even by persons outside of the disaster areas.

5) A lack of an easy to find/use web cam directory hindered understanding of where water was flooding. Local TV news and radio were able to report well where their crews could reach, and radar covered rain fall, but many areas whose water levels were rising were left uninvestigated. The growth in the number of mobile phones with cameras made citizenship journalism a potential source of reporting.

6) When the elderly and persons with disabilities evacuate (for example, via boat) they often must do so without any of their supportive technology. The UCP Nashville Used Durable Medical Equipment Exchange program is asking for help to replenish so that it can continue to meet the increased calls they are receiving. Coincidentally, HHS recently awarded ARRA funds for a Disability Research Center on Disability Services, Care Coordination and Integration.