mHealth and WHO By Jeremy Schwartz | 18 Oct, 2012

For those who haven't yet seen this...

Is anyone in this group invovled in mobile technology NCD work? Certainly, there is evidence in high-income nations that keeping patients connected to their providers and being sent digital reminders regarding certain health behaviors is one way to help keep patients motivated about their health. Given mobile tecnology's ubiquity throughout LMICs, it has the potential for meaningful use in the health arena. But, given the lack of a health care infrastructure in so many places that is currently able to support NCD care, the use of mHealth (I would suppose) will have to be much less patient-targeted and much more public health targeted. I could see it being used as a way of pushing some of the WHO population-based Best Buys such as tobacco control and dietary salt restriction.


Jeremy Schwartz, MD, FAAP
Instructor, Yale School of Medicine
Assistant Firm Chief, Waterbury Hospital, Yale Primary Care Internal Medicine Residency Program
Medical Director, Eastern Caribbean Health Outcomes Research Network (ECHORN-
Global Steering Committee, Young Professionals Chronic Disease Network (YP-CDN-
(203) 573-6246 (office) (203) 530-7261 (cell)



Shantanu Nundy Replied at 9:54 AM, 18 Oct 2012

Hi Jeremy- Thanks for sharing. I'm not involved with this group but have a couple thoughts. I definitely agree that mobile health has a large role to play in LMICs and I would even argue larger role in LMICs than HICs. In my work, largely in low-income settings in the U.S., we use mobile health to 'leapfrog' traditional care delivery structures. Existing delivery structures were built for acute illness, and in some ways it is easier to design a system with mhealth than to introduce it into an existing one. In settings where there is no primary health system population-level mhealth interventions seem appropriate but otherwise both individual and population-level interventions are complement even nascent primary health systems.

Kiti Kajana Replied at 10:14 AM, 18 Oct 2012

Is anyone from the network attending the MHealth Summit in DC -
It would be would be wonderful to have someone from YP there.

Joaquin Blaya, PhD Replied at 2:07 PM, 18 Oct 2012

Hi Jeremy,
In reading your comment, it's exactly what we do. A little introduction,
I'm a fellow at the Brigham & Women's Hospital and worked during my PhD
with the non-profit Partners In Health while we developed (along with other
organizations) the open source Electronic Medical Record (EMR) platform
OpenMRS ( since then I found that to have clinical
organizations use OpenMRS in Latin America it would require an organization
to actively promote and provide services to those organizations i.e. they
want to sign a contract with a company to ensure the system works. So I
co-founded an open source company in Chile eHS ( and our key
product is a system to do follow up and reminders to patients with chronic
diseases, starting with diabetes and hipertension. Here's a short video of
the system

Warm regards,

Gerente de Desarrollo, eHealth Systems <>
Research Fellow, Escuela de Medicina de Harvard <>
Moderador, <>

Kiti Kajana Replied at 2:11 PM, 18 Oct 2012

New UN initiative uses mobile technology to help fight non-communicable
17 October 2012 ? Two United Nations agencies today launched a new
initiative called ?m-Health? to use mobile technology, particularly text
messaging and applications, to help tackle non-communicable illnesses such
as diabetes, cancer, cardiovascular diseases and chronic respiratory
?Technological innovations are changing the landscape of disease
prevention and control. The widespread availability of mobile technology,
including in many of the least developed countries, is an exceptional
opportunity to expand the use of e-health,? said the Secretary-General of
the International Telecommunication Union (ITU), Hamadoun I. Touré.
Through the initiative, the ITU and the World Health Organization (WHO)
will provide evidence-based and operational guidance to encourage partners
worldwide, especially governments, to implement m-Health interventions to
address prevention and treatment of non-communicable diseases (NCDs) and
their common risk factors ? tobacco use, unhealthy diet, physical
inactivity and the harmful use of alcohol.
Non-communicable diseases are some of the leading causes of death and
disease in both developed countries and emerging economies alike,
according to a news release issued by the agencies. They dominate health
care needs and expenditures in most developed as well as most low- and
middle-income countries.
Of the 57 million deaths globally, NCDs contribute to an estimated 36
million deaths every year, including 14 million people dying between the
ages of 30 and 70. Using mobile telephone technology, m-Health practices
can help save lives, reduce illness and disability, and reduce healthcare
costs significantly.
?By joining forces, ITU and WHO will fight against debilitating
non-communicable diseases that can be controlled through the intervention
of m-Health solutions and services that are at once cost effective,
scalable and sustainable,? said Mr. Touré. ?In doing so, we will help end
a scourge that hinders economic growth and development around the world.?
The initiative will build on current projects, existing health systems and
platforms, and will involve partnerships between governments,
non-governmental organizations (NGOs) and the private sector.
?WHO is already using mobile devices to carry out surveillance of
non-communicable diseases and their risk factors,? said WHO?s Assistant
Director-General for Non-communicable Diseases and Mental Health, Oleg
?For example, the Global Adult Tobacco Surveillance system has used mobile
phones to capture data on tobacco use in 17 countries ? covering over half
of the world?s population. This experience of running population-scale
mobile projects will be vital to the initiative,? he stated.
WHO and ITU member countries are also testing mobile solutions for NCDs ?
ranging from providing assistance to help people quit tobacco, helping
people increase their activity levels, eating more healthily and helping
patients with non-communicable diseases better manage their conditions.
All of these experiences will feed into the new initiative.
The new initiative will initially run for a four-year period and focus on
prevention, treatment and enforcement to control non-communicable
It is currently being discussed in Dubai at ITU Telecom World 2012, where
leaders and pioneers in the corporate, research and academic sectors are
meeting with high-ranking policy-makers and regulators, with the aim of
sharing ideas on the future of global telecommunications.

Kiti Kajana, MPH | Non-communicable Disease Program Manager
National Home Office | American Cancer Society, Inc.
132 West 32nd Street, New York, NY 10001 Skype:kitikajana |

Carlos Joaquin Gonzalez Quesada Replied at 10:20 PM, 18 Oct 2012


Your work is very interesting. Do you currently have any project in Mexico. I would love to try something like this in the National institute of Cardiology. I am also working at BWH, I am one of the Internal Medicine and Global Health Equity Residents. Interested in collaboration projects?

Carlos J. Gonzalez Quesada, M.D.

Geneviève Bois Moderator Emeritus Replied at 11:31 PM, 18 Oct 2012

There was an interesting review of about a dozen mHealth projects around NCDs I read while I was working an diabetes education mHealth project in Gabon, it compares interventions in quite different settings, but was very interesting. Most of the projects I've heard of using mHealth and mHealth in NCDs were in LMICs actually, although MedicMobile has a very interesting paper on a research they've done with attendance to medical appointments in chronic disease management in vulnerable migrant groups in the Bay Area in California...

Thea Joselow Replied at 12:12 PM, 19 Oct 2012

Hi Jeremy,
We have a large mHealth text messaging project in India - named mDiabetes.
You can learn more about it here:
Here is some background:

Here is a piece by Nalini on

And here is a little video we made about the project:

All the best,

Thea Joselow
Arogya World

Steven van de Vijver Replied at 3:59 PM, 21 Oct 2012

Dear Genevieve,

Thanks for your post about an interesting review of about a dozen mHealth
projects arounds NCDs. As we (APHRC - African Population Health Research
Centre) are trying to involve mHealth aspects in our prevention program for
CVD in the slums of Nairobi I would be very much interested to read this
Could you send the link or name of the article or authors?

Regards, Steven

APHRC Campus
Kirawa Road, off Peponi Road
P.O. Box 10787-00100
Nairobi, Kenya

Tian Maoyi Replied at 4:40 PM, 21 Oct 2012

Our group is currently doing a project to manage the CVD high risk patients in Tibet, China and Haryana, India by using a smartphone-based electronic decision support system.

Interesting to see there are a lot of fellows interested in this field as well from this network.

I will be presenting in the mHealth summit in D.C. in Dec, anyone else will be going as well?


Tian Maoyi | PhD MSc Research Fellow The George Institute for Global Health | CHINA Room 1302, Tower B, Horizon Tower, No. 6 Zhichun Rd Haidian District | Beijing, 100088 P.R. China (北京海淀区知春路6号 锦秋国际大厦B1302室) T +86 (0)10 8280 0577 | M +86 186 1050 1623 E | W Legal:

Der-Ming Liou Replied at 8:41 PM, 21 Oct 2012

This is Der-Ming Liou from National Yang-Ming University, Taiwan. It's a very interested project. Where can I get more information?


Joaquin Blaya, PhD Replied at 9:03 PM, 2 Nov 2012

Apologies for taking this long to reply but yes I'd be very interested in
talking about a possible project. Can you email me at jblaya (at) to
talk further?

Gerente Tecnológico, eHS (
Fellow, Escuela de Medicina de Harvard

Marie Connelly Replied at 10:06 AM, 19 Nov 2012

I came across this article on SMS programs for smoking cessation and thought it might offer another interesting example of mHealth approaches being used for NCDs:

Full details of the study are available at:

Tian Maoyi Replied at 10:16 AM, 19 Nov 2012

Thanks. Very interesting article. Wondering if there is any study that uses mHealth technique for salt reduction intervention.

Tian Maoyi | PhD MSc Research Fellow The George Institute for Global Health | CHINA Room 1302, Tower B, Horizon Tower, No. 6 Zhichun Rd Haidian District | Beijing, 100088 P.R. China (北京海淀区知春路6号 锦秋国际大厦B1302室) T +86 (0)10 8280 0577 | M +86 186 1050 1623 E | W Legal: