From a shaky start a few years ago, mobile healthor mHealth has grown up as a sector, and today has many companies Plying innovative healthcare solutions. ENNs Rajesh K Sharma takes a telescopic view of the industry and talks to a few industry movers about the journey of mHealth

The healthcare scene in India is one of extremes. : while we have internationally well -known premier institutes that make India a popular medical tourism destination, vast sections of Indian dont have access to even basic healthcare. Rural India still lacks basic healthcare. Even in urban areas, while the rich can afford the best treatments, the poor have to contend with overcrowded hospitals and a creaking infrastructure. The Government of India allocated `3,00,018 crore towards its various health schemes in the 12th Five Year Plan in 2012. Though the total spending on healthcare by the government and private players has been rising steadily, it is still not enough to meet the demand.

But while the government struggles to meet the challenges of universal healthcare, technology has made it increasingly possible. Technologies like telemedicine and mHealth are giving a fillip to the demands for healthcare. Though the two terms may sound similar, they have different connotations. As Dr Ruchi Dass, CEO of HealthCursor, explains, mHealth encompasses acquisition, transport, storage processing and securing the raw and process data to deliver meaningful results. Telemedicine, on the other hand, is the science of using similar wireless channels and networks to provide clinical healthcare at a distance.

mHealth, plainly speaking, is the delivery of healthcare services or information on mobile phones. It began in its earnest around 2008-09, in the form of mobile carriers giving medical advice on their networks as a value added service, for a fee. Later, SMS services were also added to the mix and people could have their queries answered by a doctor. The introduction of 3G services around that time provided more avenues for the disbursal of medical services, with mobile websites and later apps doing the needful. This belief in the power of mobile-based solutions was powered on the basis of Indias increasing mobile coverage. However, TRAI later had to correct its numbers, when it was found that the number of active connections was less than what it had earlier stated. But in spite of this corrections, the faith in mHealth remained, and the sector still showed a growth.

“Maturing of the mobile environment has led to the players offering a bouquet of solutions over the cell phones that have become ubiquitous in their presence”

Flash forward to 2014, and the mobile health scenario is abuzz with activity. In addition to mobile carriers, newer players are providing mHealth services through voice, SMS, mobile websites as well as apps. The maturing of the mobile environment has led to the players offering a bouquet of solutions over the mobile phones that have become ubiquitous in their presence. Starting from basic services like finding a doctor or a specialist nearby to fixing up an appointment with a doctor, there are solutions available that allow the patient to connect to a doctor immediately, irrespective of the location. mHealth solutions have made it possible for persons seeking a second opinion to get it from specialists. The government too has been actively hitching on the mHealth bandwagon. It has launched Dial a Doctor services in states like Kerala, which connect rural people to doctors in urban areas under its National Health Mission (NHM) scheme. This has proved to be beneficial to the rural people. Some notable innovations in mHealth are mDhil, a start-up that provides healthcare information through SMSes, mobile web and apps; Sana, that enables community health workers on how to screen and diagnose patients and link that data to doctors through OpenMRS via open source mobile apps; mPedigree, a mobile platform to track and check the validity of medicines to combat drug counterfeiting; E-Health Points, that provide families in rural villages with clean drinking water, medicines, comprehensive diagnostic tools, and advanced tele-medical services; World Health partners, a multi-level service delivery network which leverages the latest in telemedicine and point-ofcare diagnostic technology to improve access and quality of care; and ZMQ software systems, that develop mobile games to combat HIV in India. In addition, there are players like the Bangalore- based HealthcareMagic that provide mobile based healthcare solutions to corporate clients. Such is the belief in the promise of this sector that a PricewaterhouseCoopers (PwC) report has predicted that the mHealth market will eventually be worth Rs 3,000 crore.

mHealth is also promoted as a means to combat epidemics. Though the mHealth service providers agree that they may not be able to provide treatment in case of a spread, their services are very useful in disseminating information to the people so that they can entertain caution and prevent a sudden outbreak. Dr Dass adds that mHealth leveraged applications can help in disease surveillance, tracking, monitoring, prevention as well as management. Shekhar Sahu of HealthcareMagic adds that if a service like mHealth is available to even a small portion of people and they get regular tips, then it will make a lot of difference in their understanding and taking of precaution against the disease.

But while there is optimism about mHealth, a few words of caution are to be noted here. Though the mobile penetration has been growing, the uptake in mHealth services has not been proportional. In fact, such services are still seen as a value added service rather than a necessity. A common complaint among mobile healthcare providers is that people dont have enough money on their mobile phones, and as a result, very calls get connected in spite of a huge volume of people calling.

mHealth also faces a problem of perception, as in India, the majority of calls received are from rural areas, leading to many associating it as a service for the poor, which it is not. In fact, mobileenabled services can be used by urban people to solve minor ailments, thus saving a trip to the doctor. At the same time, mHealth is also a suitable way of reaching out to the urban poor, who may not have the money to visit the swanky new hospital or clinics in their areas.

As things stand today, mHealth, after a shaky start in 2008-09, has managed to deliver on its initial promise. The introduction of 3G services only aided in its growth. A patient wishing to use such a service today would be spoilt for choice. The exuberance being witnessed in the sector today is a culmination of the vision of universal healthcare by the early adopters. Though the uptake remains low in comparison to mobile penetration, it is being readily accepted by the people, and the prediction by PwC may soon become a reality.

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