Telemedicine and HIT In Developing Nations

We tend, particularly at the time of our momentous health reform debates, to be focused solely on problems in our health system.  Those problems pale in comparison to the lack of access to the most basic of health care for many in the developing world.  Given the relative lack of hard-wired infrastructure in much of this geography, mobile health technology can be very helpful.  Health Affairs provides several articles discussing the use of mobile technology and other health information capabilities to address health needs in poorer countries.  (Health Affairs Article) (Health Affairs Table of Contents) Although the developing world has a significant shortage of both medical providers and facilities, many people, and most health care professionals, have cell phones.

One of the articles discusses potential use of mobile health in the developing world.  Functionality includes social networking to provide warnings of public health issues, text messaging of health reminders or aid for self-care of chronic disease and providing information for centralized health record repositories.  Some benefits are extending the reach of health care providers and facilities; faster acquisition and sharing of important health information, better follow-up on needed care and more continuity of care.  There are risks, largely associated with transmission of erroneous information.

Another article reviews studies of use of health information technology in the developing world.  These studies examined HIT such as EHRs, lab information management, pharmacy information management, patient monitoring and tracking, patient reminders and clinical decision support.  The authors evaluated the quality of the studies and found a number on use of these systems in the developing world.  As in the developed world, this technology tended to reduce errors, improve communication, and sometimes improve productivity.  Patient reminder and monitoring systems increased follow-up and compliance.

Both articles emphasize the need for further rigorous review of health and cost outcomes for mobile and health information technology applications, but there is little question that significant benefit is being provided to areas that need great improvements in health care.