World Bank Day @ mHealth Summit – Part 6

Notes from the eDevelopment Thematic Group event World Bank Day @ mHealth Summit – mHealth from policy to implementation.

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Session 6: Operationalizing mHealth: How do we translate mHealth applications into measurable health outcomes

Beyond the widespread global usage of mHealth applications, there remains a gap due to the lack of data and long-term impact assessments on health outcomes to validate the effectiveness of mHealth. Evaluation frameworks and studies are currently in process to fill this gap and this will be the subject of discussion between the panelists in this session along with the importance of monitoring and evaluation frameworks for this nascent sector.

Chairs: Armin Fidler, Advisor, Health, Nutrition and Population and Claire Thwaites, UN Foundation

This is an important question

  • how can outcomes be measured?
  • some people may even say it can’t be measured

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Panel Discussion

Patty Mechael, mHealth and Telemedicine Advisor for the Earth Institute

Unfortunately the evidence is quite thin

  • study on pilot projects
  • randomized control trials
  • but still developing this and figuring what works and what doesn’t

mHealth in Millennium Village project

  • bringing connectivity to villages
  • improving internal communication
  • toll-free emergency numbers

Several applications

  • child monitoring system

eHealth ecosystem

  • closed loop system
  • linking to the other systems – interoperable

Tested hypotheses:

  • mobile technologies can improve access to health access -> health outcomes
  • quality of care -> health outcomes
  • improving efficiency & lowering cost

Focus on your goals and work your way backwards

Gold standard in health research: randomized control trials

  • Also on mHealth solutions

Everybody who works on a project should think of how to evaluate it

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Julie Smith, Director of Public-Private Partnerships, CDC Foundation

Project: Phones for Health

Partnership with several organizations

Performance metrics – various areas of focus

  • also focusing on partnership performance
  • evaluating public-private partnerships

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Rachel Glennerster, MIT Poverty Labs

We run randomized control trials

What are the challenges?

  • patients behaviour – is generally irrational
  • health care workers – are acting irresponsible

Several measures to improve the behaviour

  • upfront incentives
  • deadlines

Implications – health worker reliability

  • reliable objective monitoring

Taking the result to existing evaluation to create an mHealth product which is working

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Andrew Stern, Partner, Dalberg Global Advisors

Evaluation – Theory of Change logic frame

Why do some projects work and some not?

  • differences between countries

Learnings

  • mHealth is not a solution to broken health care systems

Identifying critical challenges that constrain success

  • decision making & budget
  • lack of authority or money

Once again – data without action is worthless

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Q & A session

A lot of sessions mentioned that mHealth is not a fix for the health system – but particular aspects can be improved definitely

How do we get the results of the evaluation back to the policy?

Anybody experience in dealing with mental health with ICTs?

Aswers:

Rachel Glennerster:

  • There is definitely a role of ICT to fix the health system, not for every single mHealth project – but some are very helpful
  • Mental health? Really challenging for health systems in developing countries – no study seen so far
  • every sector says – we have no time to evaluate, we need to act now, but it’s not an excuse

Patty Mechael:

  • Getting systems to work can be very challenging
  • Even being able to study a situation before implementing a project is a way of getting to success easier

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Closing Remarks

Armin Fidler, Advisor, Health, Nutrition and Population, World Bank

Repeat what I heard during the day

  • Mobile phones are a cross cutting platform, it’s a means to an end
  • There is evidence that it can improve the functioning of health systems and also the outcomes – although it is hard to measure
  • It’s not only about scalability, also about sustainability
  • Funding has an implication on competition
  • eHealth policies can impede innovations – when is the right time?
  • How to creat good business models to create win-win for all stakeholders?
  • Leapfrogging

The way forward

  • maybe in 20 years eHealth will be just usual and be an integral part of health
  • exchaning information, how to collaborate – we should be doing more of that
  • evaluation – more concerted effort to disseminate lessons learned
  • scaling up – if we know something works, let’s make it big
  • we need to keep an eye about the next step of technology
  • it’s about health, it’s about people, it’s about change

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World Bank Day @ mHealth Summit – Part 6
was published on 28.10.2009 by Florian Sturm. It files under global
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