Mead Oliver offers a rather critical analysis of the report, addressing some of the pressing questions surrounding mHealth. Perhaps most importantly (at least from my humble perspective) is the question of how to design incentives for truthful data collection by cell phone:
The problem in using cell phones for flu surveillance is that of incentives. How does one induce the general public to accurately report outbreaks of flu? People might under-report for fear that an intervention would be draconian. This fear could be offset with a campaign describing the nature of the intervention and perhaps by rewarding those who report with free cell phone minutes. On the other hand, If one gives away cell phone minutes for reports of flu episodes, people might over-report. The [UN/Vodafone] report suggests that these incorrect reports were entirely due to a misunderstanding based on language, when intentional misreporting in hopes of receiving the promised reward may have instead been the problem.
Despite such persisting challenges, there are presently upwards of 50 active mHealth projects, the majority of which are in sub-Saharan Africa. Among the most promising of these is Project Masiluleke, a mobile health project started in South Africa in 2008 which uses text messages to reach people in the most remote areas of the country to encourage them to get information and counseling on HIV/AIDS. The project delivers approximately 1 million HIV/AIDS and tuberculosis texts each day to personal cell phones providing contact information for the national AIDS helpline:
Callers to the national helpline can ask questions about HIV, get information about where to get tested and receive counseling.The project takes advantage of a popular form of texting across Africa, called a "please call me" message, that can be sent for free from a phone even if it is out of pre-paid minutes. The empty characters on the free text are used to convey the health message.Future phases of the project will allow users to text health questions, if they prefer not to call the line, and will provide an internet portal of information accessible by cell phone for people to learn about HIV. The ultimate goal, says the group, would be to provide free home HIV testing kits that would be supported by mobile counseling, so that people who aren't willing to visit a clinic can find out their status.
For now, much of such mHealth programs appear quite confined to sub-Saharan Africa, with a few projects scattered throughout Latin America and Southeast Asia. It will be most interesting to track the success of these projects to uncover whether they might prove equally successful elsewhere. Jumping the gun a bit, Nokia Research has already begun working with humanitarian agencies in India and psychiatrists in China to identify the potential m-technology might hold for remote populations there.