Scaling Up mHealth: Where Is the Evidence?

Abstract

Mark Tomlinson and colleagues question whether there is sufficient evidence on implementation and effectiveness to match the wide enthusiasm for mHealth interventions, and propose a global strategy to determine needed evidence to support mHealth scale-up.

A roadmap for the implementation of mHealth innovations for image-based diagnostic support in clinical and public-health settings: a focus on front-line health workers and health-system organizations

“…Beyond acceptability and usability, some put forward not only seamlessness but also added value, in particular as regards front-line users. This is in line with the necessity expressed by a number of participants to meticulously conceive the solutions/applications envisaged and come up with solid proof of cost-effectiveness [7]. There is indeed a paucity of cost-utility and cost-effectiveness studies available within the field of mHealth [19].…”

“…Some of them cover a wide span of applications (the bulk of which remain behavioural ones) [7] and others have a more specific focus, like those related to non-communicable diseases (NCDs) [8]. Studies are reviewed for their theoretical underpinning, their methodological qualities, the state of advancement of the ‘solution’ proposed and their actual results.…”

“…Studies are reviewed for their theoretical underpinning, their methodological qualities, the state of advancement of the ‘solution’ proposed and their actual results. There is a general sense that there is an increasing gap between what could be an interesting mHealth application (pilots) and what actually is implemented and sustained; the criticism as to how research helps understand this gap is severe [7,8]. Understanding how, why, for whom and in what circumstances mHealth interventions improve treatment and care is important [8].…”

‘M-TRACK’ (mobile phone reminders and electronic tracking tool) cuts the risk of pre-treatment loss to follow-up by 80% among people living with HIV under programme settings: a mixed-methods study from Gujarat, India

“…Some reviews have noted potential challenges for scale-up and detailed the elements necessary for successful scale-up in developing countries [24,25]. These have to be factored in before planning a scale-up of M-TRACK across the state.…”

“…In general, there is limited evidence on the cost-effectiveness of mHealth interventions [24], and we did not undertake a formal analysis of costs (of call charges, internet charges and other indirect costs). This could be a topic for future research.…”