Cancer and mHealth: A Case Study in India
The World Health Organization (WHO) defines “mobile health,” or mHealth, as a subset “electronic health” that is concerned with the “use of mobile and wireless technologies to support the achievement of health objectives.” It covers things such as health call centers, emergency tool-free telephone services, mobile telemedicine, mobile patient records, decision support systems, and other services.
It’s clear that mobile technologies, particularly cellular phones, are becoming cheaper and gaining in popularity globally including in poorer countries. One statistic from the International Telecommunication Union puts the number of wireless subscribers at around 5 billion with over 70 percent living in low and middle income countries.
The international healthcare community is finding ways to use these technologies to its benefit. According to the WHO, in a survey completed by 114 member states, 83 percent of respondents offered at least one type of mHealth service with many offering between four to six programs. While currently, the bulk of mHealth activity related to oncology is concentrated in higher income nations, the cancer burden in developing countries is growing and will demand increased attention from the global community in the years to come.
Currently, there are some ongoing mHealth projects in these regions. One example is a partnership that began two years ago between India’s Narayana Hrudayalaya Hospital and Harvard/MIT to use the latter’s Sana platform to screen at-risk individuals for oral cancer in rural and semi-urban regions in India.
Sana is an open-source software system that supports audio, images, location-based data, and text. It can be downloaded to the phone so that decision support is available even when the connection is poor or non-existent.
As of last summer, the tool had been used to screen up to 6,000 patients and they plan to scale that number up to 1.5 million people this year. In addition to screening individuals, the project investigators are training health workers and general physicians to use Sana to screen and manage oral cancer and other diseases. They are also studying the cost-effectiveness, scalability, and sustainability of their program. The Sana software promises to bring much needed help to the healthcare infrastructure of developing nations.