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For the first time the World Health Organization’s (WHO) Global Observatory for eHealth (GOe) has sought to determine the status of mHealth in Member States; its 2009 global survey contained a section specifically devoted to mHealth. Completed by 114 Member States, the survey documented for analysis four aspects of mHealth: adoption of initiatives, types of initiatives, status of evaluation, and barriers to implementation. Fourteen categories of mHealth services were surveyed: health call centres, emergency toll-free telephone services, managing emergencies and disasters, mobile telemedicine, appointment reminders, community mobilization and health promotion, treatment compliance, mobile patient records, information access, patient monitoring, health surveys and data collection, surveillance, health awareness raising, and decision support systems.

The survey shows there is a groundswell of activity.  The majority of Member States (83%) reported offering at least one type of mHealth service. However, many countries offered four to six programmes. The four most frequently reported mHealth initiatives were: health call centres (59%), emergency toll-free telephone services (55%), managing emergencies and disasters (54%), and mobile telemedicine (49%). With the exception of health call centres, emergency toll-free telephone services, and managing emergencies and disasters, approximately two thirds of mHealth programmes are in the pilot or informal stage.

The survey results highlight that the dominant form of mHealth today is characterized by small-scale pilot projects that address single issues in information sharing and access. There were only limited larger mHealth implementations (primarily supported by public-private partnerships). While it is anticipated that large-scale and complex programmes will become more common as mHealth matures, strategies and policies that integrate eHealth and mHealth interoperability into health services would be wise. mHealth is no different from other areas of eHealth in its need to adopt globally accepted standards and interoperable technologies, ideally using open architecture. The use of standardized information and communication technologies would enhance efficiency and reduce cost. To accomplish this, countries will need to collaborate in developing global best practices so that data can move more effectively between systems and applications. 

Efficient electronic medical record (EMR) storage and retrieval
systems for treating the millions of HIV/AIDS and tuberculosis
(TB) patients in the developing world is largely an unsolved
problem. One attempt at addressing this need is the Open Medical
Record System (OpenMRS) – a framework that provides a free
and flexible EMR system for resource-constrained environments.
Although OpenMRS is a step in the right direction, implementers
of such systems face a question that is largely unanswered by
previous work. Where in the existing paper-based workflow can
such plastic technology be injected and how does one evaluate the
efficacy of this intervention?

In this paper, the authors describe the role manual processes have played
in a rural hospital in Rwanda and how they determined where to
implement appropriate technology solutions of these challenges through an open source framework that provides a free and flexible electronic medical record system
(EMR) for resource-constrained environments. In this
paper, the authors describe the role manual, paper-based processes have
played in a rural hospital and how they determined where to
implement appropriate technologies.