Technical Environment for an mHealth Implementation in Ghana - Outline Example

Dear I must commend you for your effort. It is a good effort and I did not really have much to do (especially as editing is not supposed tochange content, subject matter or ideas) except to reconstruct few sentences, check punctuations and check subject verb agreement. Your topic is also interesting. After this first part, which contains the edited work, you will find the editing process. Texts in red ink are new ideas and corrections. Areas that needed to be omitted have also been crossed out. Edited Version Technical Environment for an mHealth Implementation in Ghana Executive Summary /Abstract CONTENT I. EXECUTIVE SUMMARY II. DEDICATED III. AUTHORS IV. CONTENT V. ACKNOWLEDGE VI. ACRONYMS AND ABBREVIATIONS 1. INTRODUCTION 2. BOUNDARY CONDITIONS FOR THE WORK, METHODOLOGY 3. LITERATURE REVIEW 4. RESULTS AND DISCUSSION 5. CONCLUSIONS AND OUTLOOK 6. BIBLIOGRAPHY/ 9. REFERENCES LIST OF FIGURES LIST OF TABLES APPENDIX Acknowledgement Acronyms and abbreviations 3G Third generation mobile telecommunications AIDS Acquired immunodeficiency syndrome DataCol Data Collector eHealth Electronic health EHR Electronic health record EMR Electronic medical record EMRS Emergency medical response systems HIV Human immunodeficiency virus ICT Information and communication technologies IMCI Integrated Management of Childhood Illness ITU International Telecommunications Union mHealth Mobile health MDGs Millennium Development Goals MMS Multimedia messaging service GMA Ghana Medical Association GDP Gross domestic product GNI Gross national income GOe Global Observatory for eHealth GPRS General packet radio service GPS Global positioning system OECD Organisation for Economic Co-Operation and Development PDA Personal digital assistant RFID Radio frequency identification SIM Subscriber identity module SMS Short message service UN United Nations WAP Wireless application protocol WHO World Health Organization 1. INTRODUCTION 1.1 Area of interest The decision to undertake a research related to mHealth was because of my interest in Healthcare and strong believe that simple steps can be taken to make a difference. Being a medical doctor and having worked in Ghana, which is deficient in healthcare personnel, I have first hand experience in how a project related to mHealth will help to improve the health outcome of Ghanaians. This was thus believed to be an area that will sustain my interest and enjoy the time spent in doing this project. Mobile phone usage in developing countries is increasing (See figure 1.0) and with this increase comes several innovative projects that aims at improving the lives of the subscribers. Mobile telecommunications operators have expressed interest in being socially responsible by sponsoring several life improvement programs. Speaking to some of the employee of such companies, one senses the will of these companies to improve the lives of its customers. 1.2 Ghana, mHealth and Mobile Telecommunication The Millennium Development Goals by the United Nations highlight targets for improving global health, but in many parts of the world key health challenges and lack of healthcare personnel continue to be a major hindrance. It is said, “For example, Sub-Saharan Africa has 11% of world’s population and 24% of the global burden of disease, but only 3% of the world’s health workers. In areas facing these odds, the explosive growth of mobile communications is paving the way for innovative mHealth solutions to help reach health goals.” [1] How Will mHealth help achieve these targets? The answer lies in how innovative health informatics personnel and policy makers harness their capabilities of new and improved mobile telecommunication infrastructure to develop solutions targeted at solving various problems in global health. An example of innovative project s is one in Ghana called MDNet, which was started by a group of doctors from New York University and the Ghana Medical Association (GMA). This project was as a result of a deal stroked with Ghana Telecom (now Vodafone) -- one of the leading telecommunication communication companies in the country in 2008. The MDNet offers free mobile-to-mobile voice and text services to all the physicians in Ghana who are members of the association as well as a one-way bulk SMS which allows GMA to send information to doctors about national emergencies and meetings, as well as to contact doctors within a particular specialty. A recent publication in the Global Observatory for eHealth (GOe) volume 3 in 2011 highlights some of the successes chalked up by the MDNet project. According to the publication, a 2009 survey of MDNet users conducted by Switchboard reports that users of MDNet are of the opinion that MDNet has improved communication about patient management among physicians throughout Ghana’s health delivery system. Additionally, physicians in the rural areas generally agreed that MDNet has made it easier to reach their experienced colleagues for specialist advice as well as soliciting information regarding specialists, bed availability, and clinic times, facilitating the referral of patients to higher levels of care. According to Vatsalan et tal (2010), mHealth (also called mobile Health) revolves around the use of wireless technologies such as Bluetooth, GSM/GPRS/3G, WiFi, WiMAX, etc to send and receive various eHealth data contents and services. They went on to say that mHealth and eHealth are intimately linked; that is, both are used to improve health outcomes and their technologies work hand in hand [2] Mobile phone usage is increasing at an amazing rate: at a world rate of about 78 per one hundred inhabitants and about 70 per one hundred inhabitants in the low-income world (See figure 1.0). Mobile phones are indeed becoming part of us and their capabilities with regards to device functionalities are also increasing. As usage and functionality increases, it is generally agreed that innovation and for that matter, innovation in mHealth will increase and the result of this will be an improved global health outcome. Figure 1.0 Mobile cellular subscriptions per 100 inhabitants. 1.3 Problem Statement Most mHealth are implemented as a stand alone; , vendor locked in project in various countries in the low-income countries. This makes it very difficult to replicate the project in other districts/town/villages in the same country. The problem we believe results from inadequate information on the technical environment available in these countries, hence the need to conduct a research to find out the technical environment available in the Ghanaian setting for the successful implementation of mHealth project. 1.4 Research Aim As can be deduced from the problem statement, the main aim for which the researcher carried out this research work was to find out the technical environment present in Ghana for the implementation of a mHealth project. To achieve this aim, which is very broad in nature, the researcher came out with a number of specific objectives. It must be noted that the research aim will be attained based on the achievement of the various specific objectives. Specific Objectives 1. To identify the reliability of mobile networks in Ghana 2. To research into the signal strength of mobile networks in Ghana 3. To find the cost of mobile phone usage in Ghana. 4. To identify factors that constitutes the cost of mobile phone usage in Ghana 5. To identify means by which mobile phone networks in Ghana can help in the improvement of healthcare in Ghana. 1.5 Research Questions The following research questions were asked in line with the specific objectives set by the researcher. They are: a) What is the reliability of mobile networks in Ghana? b) What is the signal strength of the mobile networks? c) What categories of mobile phones are used in Ghana? d) What is the cost of mobile phone usage? e) What categories of mobile network exist in Ghana? f) What other means of mobile communication exist besides mobile telephony? 1.6 Structure of Dissertation This paper begins with the introductory background of mobile phones and how they might help to improve health outcomes as well as the main research questions and the significance of the research in section 1. Section 2, which is the methodology section describes and tries to justify methods used in this project work. Section 3, which is the literature review section, goes on to identify the key debates in the mHealth sectors, evaluates the ideas in the mHealth and analyses some assumptions of other players in the mHealth sector. Section 4, the Results and Discussion section, outlines the results of the data collected and tries to link the data to the research questions and the views of other researchers in the field. Lastly, section 5, which is the conclusion and outlook section will look at overview of mobile telecommunication infrastructure in Ghana and draw some conclusions on the research. METHODOLOGY AND IMPLEMENTATION 2.1 Research Design Saunders et al (2003) explain that there are several forms of research approach or design that can be employed by a researcher in his or her research work. The selection of a research design however depends on the type of research being conducted and the general outcome expected by the researcher. To this effect, Saunders et al mention “experiment; survey; grounded theory; ethnography; action research and case study” as the major examples of research design. For the sake of the research aim for this research, case study has been chosen as the research design. This is because case study seeks to analyze an existing situation or phenomenon. “case study research aims at understanding a bounded phenomenon by examining in depth, and in a holistic manner, one or more particular instances of the phenomenon.” In this research, the phenomenon being examined is the technical environment present in Ghana for the implementation of a mHealth project. 2.2 Population and Sample Size and Sample Selection The population of the research work refers to all people who have some level of probability of becoming part of respondents to be used for the research. The sample size on the other hand refers to the people who would eventually become participants/respondents in the research during the data collection stage. Having said this, the population of the research can therefore be defined to be all mobile phone users in Ghana, the National communication Authority of Ghana and all telecommunication companies in Ghana. The sample was also made up of the chief information officer of the National communication Authority of Ghana, two hundred and twenty-two (222) mobile phone users and one information officer each from all five communication networks in Ghana namely MTN, Tigo, Vodafone, Expresso and Airtel. Sampling selection refers to the technique used in getting the sample size. To get the sample size, the researcher adopted two major forms of sampling procedures namely purposive sampling and random sampling. Purposive sampling was used to select the information officers from the National communication Authority of Ghana and information officers from the communication networks in Ghana. Purposive sampling was used on these individuals because they were perceived by the researcher to be the people with right and appropriate kind of information that needed to be collected for the research work. Random sampling was however used in selecting the two hundred and twenty-two mobile phone users. In random sampling, all people in the population have an equal chance of becoming part of the sample size and there is no bias in the selection of respondents. This type of sampling technique was used on the mobile phone users because the researcher wanted to a fair representation of as many mobile phone users from different networks and socio-economic background as possible. 2.3 Research Instructions A research instrument refers to the materials that aided the researcher in collecting data from the sample size. The researcher used questionnaire in the collection of data from mobile phone users whiles he used interview for the information officers. 2.4 Data Collection Procedure With the main project work being about what the technical environment is for an mHealth project in Ghana, the project was mainly to retrieve data, which already existed from the mobile telecommunication companies, conduct survey of users of mobile networks and to collect existing data from mobile telecommunication regulators in the country. This means that the major data collection approach used was primary data collection. Primary data collection entails a situation whereby the researcher collects data from the field of research himself without depending on ready-made data or information from sources such as books, internet and new items. 2.5 Data Collected The main project question -- “What are the technical environment available for an mHealth project in Ghana?” was subdivided in five questions. A general overview of the mobile telecommunication networks with regards to subscribers was obtained from the National communication Authority of Ghana, which is the regulatory body for issues related to Telecommunications in the Ghana. This data will help to get an idea of the number of subscribers to the various networks, the official number of mobile telecommunication companies and the services that they provided. The first subdivision was “What is the reliability of mobile networks in Ghana?”. To answer this question and the question “What categories of mobile phones are used in Ghana?” a survey questionnaire on page 13 was developed. A question like “what kind of mobile phone do you used?” was intended to specifically retrieve the brand of phone as well as the model. This was going to aid us in categorizing the different type of phones in existence. It was carried out both online in the cities and in the towns and villages, a print out was given out. An idea of their mobile signal strength was obtained by asking “how many bars of network connection do they see on their phones at work and at home?”. This question made the assumption that all respondent will have noticed the number of bars of network connections on their phones. The questionnaire yielded 222 responses in total. To further answer the question the reliability of the networks, 200 calls were made to the various networks and those that went through were recorded. This method of measuring reliability assumed that if a network is very reliable that subscribers should be able to receive call everywhere they are. A limitation of this could be that some people will be in an environment where is physically impossible to receive a network connection. In addition, data on collected by the national communication Authority on call connection times were also obtained. With the subdivision “What are the signal strength of the various mobile networks?”, a new Nokia N3 was purchased and software called Phoneinfo.sisx was installed on it. Whiles making a journey from Accra (capital city of Ghana) to Kumasi (second biggest city) and from Kumasi to Tarkoradi (the capital of the western region), signal strength was measured in every town or village along these main roads using the phoneinfo software on a Nokia N3 and recorded. The category of mobile network in Ghana were obtained by contacting the providers. And with regards to the question other means of mobile telecommunication data was obtained from the regulators i.e. the National Communication Authority. 3. LITERATURE REVIEW / STATE OF THE ART It is generally agreed that Mobile Health, also known as mHealth, is a component of eHealth. According to a Wikipedia.org article, eHealth is a term that can encompass a range of services or systems that are at the edge of medicine/healthcare and information technology. These are Electronic health records, Telemedicine, Consumer health informatics, Health knowledge management, Virtual healthcare teams, Medical research using Grids, Healthcare Information Systems and mHealth. [3] At the 2010 mHealth Summit of the Foundation for the National Institutes of Health, mHealth was define as “the delivery of healthcare services via mobile communication devices.” [4] This rather simplistic definition does not specify what kind of devices nor does it indicate which means of communication these mobile devices use. A much more comprehensive definition is one which was published in the GOe series volume 3 in 2011 which defines mHealth as “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices”. This document went on to say that “mHealth involves the use and capitalization on a mobile phone’s core utility of voice and short messaging service (SMS) as well as more complex functionalities and applications including general packet radio service (GPRS), third and fourth generation mobile telecommunications (3G and 4G systems), global positioning system (GPS), and Bluetooth technology.”[5] mHealth appears to achieve a more remarkable result in low-income countries where infrastructures such as transportation, electricity and Hospitals seem to be lagging behind the mobile telecommunication infrastructure. A recent publication by the United Nation Foundation on the impact of mHealth highlighted successes recorded by the mHealth project. For example in Uganda HIV/AIDS awareness quiz via short message services (SMS) led to an overall increase of nearly 40% in the number of people coming in for free HIV/AIDS testing. Similarly, in the Philippines, TB patients were given mobile phone and were called daily to remind them to take the TB medications, which led to about 90% compliance rate. And in Peru, Health workers use mobile phones to send SMS messages with real-time data on symptoms experienced by clinical trial participants. This enables quick response to side effects of the trial medication. [6] A critical review of these reports of successes seems to be biased towards low-income countries alone; even though the GOe reports of higher percentage of mHealth initiatives in high-income countries [5]. It is generally agreed that if mHealth advances, its impact will be much more needed in low-income countries where accessibility to healthcare is generally very difficult. In the mHealth for Development (2011) publication by the United Nations Foundation and Vodafone Foundation, they tried to give a generally agreed overview of the current technology in existence today and what services these technologies provided. In addition to that some key technological advancement issues as well as how future technologies would look like and the kind of services that is going to be provided in future were also reviewed. In this publication with regards to current technology picture with slight country variations: The hardware technologies in usage are: 1. Mobile phones carry range of features suitable for basic mHealth services. 2. Most new handsets access the web mostly with GPRS connection and few 3G connections, to download pictures and images. 3. Speed limits applications 4. Most latops, handhelds, PDAs easily access wireless networks where available. Current software picture is: 1. Widely available for laptops and handhelds. 2. Only recent availability for handsets as vendoes open architecture. Network Access picture is: 1. Cellular common in urban, less so in rural areas. 2. Broadband, Internet access limited geographically and where available, it costs a lot. And with regards to standards, the broadband standards may require decisions. These current technological picture renders services such as a) Education/awareness programs. b) Medication monitoring. c) Data collection services. d) Disease tracking. e) Remote monitoring. With these technological pictures, if certain key technological advancements issues such as: a) WiMAX-type chipset standard for PCs (intel, others) becomes standard. b) Java Virtual Machine and other open systems are used. c) Greater bandwidth for new applications becomes available. d) Spreading IP access for standards, licensing decisions. are dealt with we might see a future technology picture where there is a) Increased intelligence blurs distinction between cell phones and mobile computers. b) Solar chargers. larger displays. c) Acceptance of open source systems accelerates application development and reduces cost. d) Network transparency e) Wireless networks create near universal internet access. f) Greater range of services, provides partnerships permitted These future picture may lead to a situation where a) More sophisticated diagnoses/consultaion, e.g. teleradiology, teleopthamology. b) More effective use of health workers. c) More ‘personal’ mHealth services. d) Services for travel-restricted. Source: mHealth for Development. Retrieved on: August 6, 2011 From: http://www.globalproblems-globalsolutions-files.org/unf_website/assets/publications/technology/mhealth/mHealth_impact_needs.pdf 4. RESULTS AND DISCUSSION 5. CONCLUSIONS AND OUTLOOK 6. BIBLIOGRAPHY/ 9. REFERENCES 1. http://www.globalproblems-globalsolutions-files.org/unf_website/assets/publications/technology/mhealth/mHealth_for_Development_Report_1Pager.pdf 2. Mobile Technologies for enhancing eHealth Solutions in Developing Countries. Dinusha Vatsalan, Shironi Arunatileka, Keith Chapman, Gihan Senaviratne, Saatviga Sudahr, Dulindra Wijetileka and Yvone Wickramasinghe. 3. http://en.wikipedia.org/wiki/EHealth#E_Mental_Health: August 4, 2011 4. Torgan, Carol (November 6, 2009). "The mHealth Summit: Local & Global Converge". caroltorgan.com. Retrieved August 4, 2011. 5. GOe Series Volume 3 2011 6. http://www.globalproblems-globalsolutions-files.org/unf_website/assets/publications/technology/mhealth/mHealth_impact_needs.pdf 7. Saunders, M., Lewis, P. and Thornhill, A. 2003, ‘Research Methods for Business Students’. Harlow: Pearson Education Limited. 8. TESOL, ‘Qualitative Research: Case Study Guidelines’, available from http://www.tesol.org/s_tesol/sec_document.asp?cid=476&did=2153 2011. Web. August 9, 2011 LIST OF FIGURES LIST OF TABLES APPENDIX EDITING PROCESS 1. INTRODUCTION 1.1 Area of interest The decision to undertake a research related to mHealth was because of my interest in Healthcare and strong believe that simple steps that can be taken to make a difference. Being a medical doctor and having worked in Ghana, which is deficient in healthcare personnel, healthcare personnel deficient environment as Ghana, I have a first hand experience in how a project related to mHealth will help to improve the health outcome of Ghanaians. This was thus believed to be an area that will sustain my interest and enjoy the time spent in doing this project. Mobile phone usage in developing countries is increasing (See figure 1.0) and with this increase has comes several innovative projects that aims at to improving the lives of the subscribers. Mobile telecommunications operators have expressed interest in being socially responsible by sponsoring several life improvement programs. Speaking to some of the employee of such companies, one senses the will of these companies to improve the lives of its customers. 1.2 Ghana, mHealth and Mobile Telecommunication The Millennium Development Goals by the United Nations highlight targets for improving global health, but in many parts of the world key health challenges and lack of healthcare personnel continue to be an important a major hindrance. It is said, “For example, Sub-Saharan Africa has 11% of world’s population and 24% of the global burden of disease, but only 3% of the world’s health workers. In areas facing these odds, the explosive growth of mobile communications is paving the way for innovative mHealth solutions to help reach health goals.” [1] How Will mHealth help achieve these targets? The answer lies in how innovative health informatics personnel and policy makers are in harnessing harness their capabilities of new and improved mobile telecommunication infrastructure to develop solutions targeted at solving various problems in the global health. An example of innovative project s is one in Ghana called MDNet, which was started by a group of doctors from New York University and the Ghana Medical Association (GMA). This project was as a result of a deal stroked with Ghana Telecom (now Vodafone) -- one of the leading telecommunication communication companies in the country in 2008. The MDNet offers free mobile-to-mobile voice and text services to all the physicians in Ghana who are members of the association as well as a one-way bulk SMS which allows GMA to send information to doctors about national emergencies and meetings, as well as to contact doctors within a particular specialty. A recent publication in the Global Observatory for eHealth (GOe) volume 3 in 2011 highlights some of the successes chalked up by the MDNet project. According to the In that publication, a 2009 survey of MDNet users conducted by Switchboard reports that , users of MDNet are of the opinion that MDNet has improved communication about patient management among physicians throughout Ghana’s health delivery system. Additionally, physicians in the rural areas generally agreed that MDNet has made it easier to reach their experienced colleagues for specialist advice as well as soliciting information regarding specialists, bed availability, and clinic times, facilitating the referral of patients to higher levels of care. According to Vatsalan et tal (2010), mHealth (also called mobile Health) revolves around the use of wireless technologies such as Bluetooth, GSM/GPRS/3G, WiFi, WiMAX, etc to send and receive various eHealth data contents and services. They went on to say that mHealth and eHealth are intimately linked; that is, i.e. both are used to improve health outcomes and their technologies work hand in hand [2] Mobile phone usage is increasing at an amazing rate: , at a world rate of about 78 per one hundred inhabitants and about 70 per one hundred inhabitants in the low-income world (See figure 1.0). , Mobile phones are indeed becoming part of us and their capabilities with regards to device functionalities are also increasing. As usage and functionality increases, it is generally agreed that innovation and for that matter, innovation in mHealth will increase and the result of this will be an improved global health outcome. Figure 1.0 Mobile cellular subscriptions per 100 inhabitants. 1.3 Problem Statement Most mHealth are implemented as a stand alone; , vendor locked in project in various countries in the low-income countries country. This makes it very difficult to replicate it the project in other districts/town/villages in the same country. The problem we believe results from in adequate inadequate information on the technical environment available in this these countries, hence the need to do conduct a research to find out the technical environment available in the Ghanaian setting for the successful implementation of mHealth project. 1.4 Research Aim As can be deduced from the problem statement, the main aim for which the researcher carried out this research work was to find out the technical environment present in Ghana for the implementation of a mHealth project. To achieve this aim, which is very broad in nature, the researcher came out with a number of specific objectives. It must be noted that the research aim will be attained based on the achievement of the various specific objectives. Specific Objectives 6. To identify the reliability of mobile networks in Ghana 7. To research into the signal strength of mobile networks in Ghana 8. To find the cost of mobile phone usage in Ghana. 9. To identify factors that constitutes the cost of mobile phone usage in Ghana 10. To identify means by which mobile phone networks in Ghana can help in the improvement of healthcare in Ghana. 1.5 Research Questions The following research questions were asked in line with the specific objectives set by the researcher. They are: a) What is the reliability of mobile networks in Ghana? b) What is the signal strength of the mobile networks? c) What categories of mobile phones are used in Ghana? d) What is the cost of mobile phone usage? g) What categories of mobile network exist in Ghana? h) What other means of mobile communication exist besides mobile telephony? 1.6 Structure of Dissertation This paper begins with the introductory background of mobile phones and how it they might help to improve health outcomes as well as the main research questions and the significance of the research in section 1. Section 2, which is the methodology section , describes and tries to justify methods used in this project work. Section 3, which is the literature review section, goes on to identify the key debates in the mHealth sectors, evaluates the ideas in the mHealth and analyses some assumptions of other players in the mHealth sector. Section 4, the Results and Discussion section, outlines the results of the data collected and try tries to link the data to the research questions and the views of other researchers in the field. Lastly, section 5, which is the conclusion and outlook section , will look at overview of mobile telecommunication infrastructure in Ghana and draw some conclusions on the research. 3. LITERATURE REVIEW / STATE OF THE ART It is generally agreed that Mobile Health, also known as mHealth, is a component of eHealth. According to a Wikipedia.org article, eHealth is a term that can encompass a range of services or systems that are at the edge of medicine/healthcare and information technology. , These are Electronic health records, Telemedicine, Consumer health informatics, Health knowledge management, Virtual healthcare teams, Medical research using Grids, Healthcare Information Systems and mHealth. [3] At the 2010 mHealth Summit of the Foundation for the National Institutes of Health, mHealth was define as “the delivery of healthcare services via mobile communication devices.” [4] This rather simplistic definition does not specify what kind of devices nor does it indicate which means of communication these mobile devices use. A much more comprehensive definition is one which was published in the GOe series volume 3 in 2011 which defines mHealth as “defined mHealth or mobile health as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices”. This document went on to say that “mHealth involves the use and capitalization on a mobile phone’s core utility of voice and short messaging service (SMS) as well as more complex functionalities and applications including general packet radio service (GPRS), third and fourth generation mobile telecommunications (3G and 4G systems), global positioning system (GPS), and Bluetooth technology.”[5] mHealth appears to achieve a more remarkable result in low-income countries where infrastructures such as transportation, electricity and Hospitals seem to be lagging behind the mobile telecommunication infrastructure. In A recent publication by the United Nation Foundation on about the impact of mHealth , it highlighted successes recorded by the mHealth project. like For example in Uganda HIV/AIDS awareness quiz via short message services (SMS) let led to an overall increase of nearly 40% in the number of people coming in for free HIV/AIDS testing. Similarly, in the Philippines, TB patients were given mobile phone and were called daily to remind them to take the TB medications, which lead led to about 90% compliance rate. And in Peru, Health workers use mobile phones to send SMS messages with real-time data on symptoms experienced by clinical trial participants. This enables quick response to side effects of the trial medication. [6] A critical review of these reports of successes seems to be biased towards low-income countries alone; , even though the GOe reports of higher percentage of mHealth initiatives in high-income countries [5]. It is generally agreed that if mHealth advances, and its impact will be much more needed in low-income countries where accessibility of to healthcare is generally very difficult. In the mHealth for Development (2011) publication by the United Nations Foundation and Vodafone Foundation, they tried to give a generally agreed overview of the current technology in existence today and what services these technologies provided. , and In addition to that some key technology technological advancement issues as well as how future technologies would look like and the kind of services that is going to be provided in future were also reviewed. In this publication with regards to current technology picture with slight country variations: , The hardware technology technologies in usage are: 5. Mobile phones carry range of features suitable for basic mHealth services. 6. Most new handsets access the web mostly with GPRS connection and few 3G connections, to download pictures and images. 7. Speed limits applications 8. Most latops, handhelds, PDAs easily access wireless networks where available. Current software picture is: 3. Widely available for laptops and handhelds. 4. Only recent availability for handsets as vendoes open architecture. Network Access picture is: 3. Cellular common in urban, less so in rural areas. 4. Broadband, Internet access limited geographically and where available, it costs a lot. And with regards to standards, the broadband standards may require decisions. These current techological technological picture renders services such as f) Education/awareness programs. g) Medication monitoring. h) Data collection services. i) Disease tracking. j) Remote monitoring. With these technological pictures, if certain key technological advancements issues such as: e) WiMAX-type chipset standard for PCs (intel, others) becomes standard. f) Java Virtual Machine and other open systems are used. g) Greater bandwidth for new applications becomes available. h) Spreading IP access for standards, licensing decisions. are dealt with we might see a future technology picture where there is g) Increased intelligence blurs distinction between cell phones and mobile computers. h) Solar chargers. larger displays. i) Acceptance of open source systems accelerates application development and reduces cost. j) Network transparency k) Wireless networks create near universal internet access. l) Greater range of services, provides partnerships permitted These future picture may lead to a situation where e) More sophisticated diagnoses/consultaion, e.g. teleradiology, teleopthamology. f) More effective use of health workers. g) More ‘personal’ mHealth services. h) Services for travel-restricted. 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