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Mhealth Model- Dr SMS in India- The Success Story


The... patient should be made to understand that he or she must take charge of his own life. Don't take your body to the doctor as if he were a repair shop. -Quentin Regestein
The World of “Speed- Living”! as simple, easy and compact as a mobile phone. Reminds me of Aircel’s popular advertisement “Pocket main Rocket hai”… I think”pocket main Rocket hai” is the right definition of Mhealth today! Many mobile projects struggle with scale and impact. While a mobile health project may run well with a small number of patients in one hospital, expanding the scope of a project until it is large enough to have real impact takes money, time, and widespread support of key stakeholders in a given community. And that is one of the biggest reasons why Mhealth is not keeping too well now-a-days and is suffering from “Pilotitis”.
Therefore, KSITM took this initiative to launch DR SMS in Kerala, aimed at improving health of the citizens of Kerala by improving access to health care resources by making available authentic information, providing timely information on medical and diagnostic facilities and providing informational alerts about emerging diseases. Kerala was also prompted to launch this m-Health project as it ranks as one of the leading States in India on mobile penetration. According to Telecom Regulatory Authority of India, in March 2008, Kerala has a tele-density of over 72 per cent as against the national tele-density of 32 per cent.
The project was piloted in Kozhikode (Calicut) in the district of Kozhikode in Kerala. The choice of Kozhikode was based on the fact that it is the third largest city in Kerala with a population of approximately 20 lakhs. Kozhikode was also chosen for the project piloting because it has the highest rates of mobile penetration in the State. Kozhikode also attracts huge migrant population/tourists, who are also one of the main targets of this project. The pilot project met with overwhelming success. The service was especially lapped by the large numbers of tourist population who did not know whom to contact in case of a medical emergency. During the pilot phase, an average of 200 daily transactions took place through the Dr. SMS facility.
The project has a credible and sound database on hospitals and emergency health centers drawn from a large data from the Health Infrastructure Survey, conducted by the National Commission on Macro economics and Health (NCMH), Ministry of Health and Family Welfare, Government of India. The system is supported by the National Informatics Centre and the State Information Technology Department. Encouraged by the success of the pilot project, the Government announced the launch of the project in all districts of Kerala.
What should be the Step 2 now?
I personally feel that Dr SMS can be very well linked with NRHM objectives for the State of Kerala. We actually have a lot to learn from a similar concept which Matt Berg described, during my visit to London. It’s called the ChildCount health monitoring system.
The project provides mobile phones to community health care workers who then use SMS to coordinate activities such as registering patients, transferring data to a central database, automatically alerting health workers to patients’ needs and facilitating communication among members of the health system. Roughly 100 community health workers at the Kenya site are equipped with mobile phones to monitor registered children for malnutrition and malaria.
The project’s five goals are to register every child under five in a given community into the ChildCount database, screen those children for signs of malnutrition every 90 days, monitor the children for the three major causes of death in children under five (malaria, diarrhea, and pneumonia), group all children into age groups in order to streamline immunizations, and record all local child births and deaths. The program has been meeting these goals with considerable success; for example, when the program incorporated a measles immunization awareness program, over 8000 children were vaccinated within seven days.
What will be the Business Model?
Though I am all set to pop a bill for this, I believe that NRHM should seek external funding as well. The ideology should be- “If the ultimate Goal is the same, Let us not work in silos, Let us work towards the common goal together”.Some of the Initiatives that could be of Interest to NRHM to collaborate with are:
Bill & Melinda Gates Foundation, Intel Digital Health Group,Robert Wood Johnson Foundation, McKesson Foundation, World Bank, UNICEF, UNFPA, European Commission, John Hopkins NCCC/GIAHC, U.S. Agency for International Development (USAID), Vodafone Americas Foundation, West Wireless Health Institute.
Reproductive & Child Health-II (RCH) program has already got funding from World Bank and the European Commission and We all know that the Rural Health Mission in Bihar recently got funding from Bill Gates Foundation.
According to the MoC, the Foundation will provide technical, management and program design support via NGOs in the areas of maternal, neonatal and child health; maternal and child nutrition; vaccine-preventable diseases, tuberculosis, pneumonia and Kala-azar, among others. While the MoC applies to all 38 districts in Bihar, the Foundation will initially start work in the nine districts of Patna, Banka, Khagaria, Begusarai, Gopalganj, Saharsa, Samastipur, and East and West Champaran. ..
To accelerate this momentum and fully unleash the potential of mHealth applications, dynamic multi-sector collaboration between groups as diverse as governments, multilateral organizations, and the private sector is needed.

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