mHealth: Tending the garden of 1000 flowers

At #mHS10, we heard funders talking time and time again for letting “1000 flowers bloom” in mHealth pilots, and programs talking about pilots leading to more pilots. This was fine the first few times it came up, but by the last day, the syndromes of the pilot-itis pandemic were clear.

This reeks of desperation. The funders are not finding clear winners in their projects, and the various implementers are casting about with local solutions that they either can’t or won’t scale, trying to find an idea so powerful that it will break through this lock.

We need to focus more energy on innovations which are dealing with core problems in health and in using mobiles for health, and thin out some of these 1000s of flowers. The soil is too fertile for this approach, and the many duplicated, repeated pilots will crowd out new, creative and gamechanging ideas. We need to move past these more basic mhealth applications - reminder messages for drug adherence, pre-natal checkups and so on are great - but simply using a new communications method to address an old problem. Let’s replicate and scale those to more sub-sectors and keep them funded, but let’s not dwell on them.

On scale – this is not something that’s eay to do. There are many barriers in mobile and in health, from cultural concerns to be dealt with which limit scaling of health projects, to many technical ones inhibiting good mobile projects from being re-implemented in other regions. There are many good meta-solutions to the technical side - open data standards and open source, both praised often at MHS10, are paving the way by creating a variety of tools which can work together.

We need more.

The platforms and networks need to become more open. Projects have been able to thrive where they rely on the lowest common denominators in phones - voice and SMS. Even still, a lack of global short-codes and improved cross-carrier and cross-border functionality hinders scaling. Beyond voice and SMS, it becomes a difficult maze of twisty passages dealing with the various featurephone systems, vendor lock-downs, and even more capable smartphones, which are even more locked down and difficult to get custom applications loaded.

The building blocks are there – open source tools and open data standards abound; focusing on those is a big first step. Banding projects together, connecting at events like the mHealth summit, and increased best-practice sharing is another. Not being shy about where the real blockers are to scalable solutions is the elephant in the room. Do we need to engage the GSMA and ITU to work on better cross-connection solutions among the many global connectivity providers? Cell phone manufacturers to improve standardized access to their devices? These aren’t the low-hanging fruits, but they might be the keys.