Patricia N. Mechael, co-founder and Policy Lead at HealthEnabled, charts mHealth’s 20 year evolution
I began my PhD studies on ‘Health-related uses of mobile phones in Egypt’ at the London School of Hygiene and Tropical Medicine in 2001 when the mobile subscription rates in most low and middle-income countries (LMICs) were 2-3%. Neither I, nor most of my fellow public health classmates to whom I was known as the “the mobile phone chick”, would have thought that it was the start of a 20-year journey.
A key finding in my PhD research, which has not changed in the years since, is that people use their mobile phones to access health services and health information anytime and anywhere through both formal and informal channels. There are just so many more of them now, than there were then. Another was that the benefit that mobile phones can provide to health is only as good as the information, the services and the people they connect. mHealth’s greatest contribution has been its ability to increase reach of services and information to those who were previously unreachable – especially in LMICs – which did not have the infrastructure to enable internet access in the way envisioned by the Digital Revolution of the 1990s.
In the early days, through the pioneering efforts of mostly female colleagues like Holly Ladd at Sate-Life, Rose Donna at the Red Cross and Data Dyne and Deb Levine at YTH – mHealth fought hard to establish itself as a separate field from eHealth, which at the time was largely focused on electronic medical records and telemedicine. It distinguished itself as both an extension of eHealth with mobile phone support and case management tools for health workers and as a direct-to-consumer mobile messaging service. In its evolution, mHealth added wearable technologies to its suite and range of offerings and has since journeyed through the full Gartner Hype Cycle.
It started upwards from the Innovation Trigger with the creation of the mHealth Alliance and mHealth Summit in 2007/2008 to the Peak of Inflated Expectations in 2010/2011 when it was estimated to be worth $700 million USD – a significant amount at the time – and when over 5000 people attended the mHealth Summit. mHealth was described as having a cult following, and it was around that time that I remember no longer knowing everyone working in the field. There were also more mobile phone subscriptions than people on the planet.
With this milestone, individuals continued to use their mobile phones to access health services and information – but it was accompanied by an innovation boom with a proliferation of mHealth apps, services, and platforms. Many early mHealth efforts failed, but the lessons they taught us from Chile to Ghana to India and South Africa, some of which are captured in mHealth in Practice: Mobile Technology for Health Promotion in the Developing World (2013), endured and led to future successes.
In late 2014, mHealth and I found ourselves in the Trough of Disillusionment with the winding down of the mHealth Alliance (I was the executive director) to make room for the emergence of digital health. At the time, it made sense that mHealth needed to be better integrated with eHealth and the umbrella of digital health was the right path for it to take.
But mHealth never really disappeared and, now more than ever, has come into its own, with growing generations of digital natives throughout the world innovating on mobile platforms and taking a more active role in their own health, prioritizing the convenience of digital self-care and virtual visits. To my pleasant surprise, in 2021 mHealth has found itself on the other side of the hype cycle in the Slope of Enlightenment where it is now valued at over $50 billion USD.
The Covid-19 pandemic has also shown us all just how important mHealth is for Covid and non-Covid-related health promotion, disease surveillance (passive and active), health service delivery, telemedicine, vaccine distribution, and wellness/ mental health. The pairing of mHealth with AI and big data analytics is now opening even more possibilities with AI fueling mHealth applications and services, and vice versa, to improve health and well-being.
If someone asked me in 2001 where I saw the field in 20 years, I would have shrugged my shoulders and asked, “What field?” Now, when I look ahead to the next 20 years, I can say with great confidence, “We haven’t seen anything yet!”