20 September 2011

Josh Nesbit on mHealth

This session just ended, so please forgive if it is a bit of a hasty post. I want to be a bit more rapid with some of my coverage. This is a primer of sorts that I hope to use as a springboard for conversation about mHealth and lead to further discussions with Josh.

mHealth, as Medic Mobile CEO Josh Nesbit sees it, can be a collaboration between what he calls the 'techies' and the 'healthies.' In his presentation, Nesbit laid out the various ways that mobile technology can support global health. "We need to understand the needs and the capacity first before working on solutions," he said while stressing the importance of listening first to make sure that the collaboration between the two groups is appropriate and effective.

The examples he shared, some of the standard fare, included MPESA, charging phones through bikes, electronic medical records, SMS reminders and phone applications. Of note, he stressed that the most boring applications are often the ones that have higher use rates. "I am more concerned with ubiquity of applications," Nesbit said.

The rush to get mobile solutions has led to some great practical innovations as well as a few that overreach such as an iPhone applications meant to be used by the Haitian poor. So, hearing a ICT leader discuss the need for solutions that are actually used was a positive sign. Better yet, Nesbit is looking to randomized evaluations to look for solutions. He is currently running trials in Ethopia and India by partnering with the World Bank and DMF respectively.

While RCTs have been coming under some well deserved scrutiny as of late, mHealth may be a place where the evaluations can mesh well. The behavior changes are easier to measure when comparing how women access health services when provided SMS reminders verses those who do not. The drive to scale would lead many to want RCTs to lead to immediate growth, but Nesbit cautioned that scale would be in the context of the trial and where it happened.

It was evident through his remarks that listening is one of Nesbit's priorities. It is how he sees technical advocates like himself as linking up with health advocates to maximize the interaction between the two.