Back in Bellagio

This is not where I expected to be, back at Rockefeller’s Bellagio Center for the third week of the eHealth conference. I made a mistake regarding my Indian Visa (as in not having a valid one), so my flight to Delhi is now delayed for at least seven days and the conference organizers here at Bellagio were kind enough to invite me back for this week’s discussion on “mHealth and Mobile Telemedicine.”

If you are going to get stuck somewhere, this isn’t a bad place to do it.

Projects and Partnerships

There is a much different dynamic to this week’s mHealth group compared to the group focused on access to information last week. While the access to information group was mostly comprised of representatives from international multilateral organizations (WHO, BIREME, etc.), this week we’ve got a lot of representatives from ‘industry’ (that is, mobile phone manufacturers and service providers) as well as groups looking for market-based solutions to social problems like CGAP, the GSMA Development Fund, and Voxiva.

There is another, probably related, difference. The end goal of last week’s meeting seemed to be forming partnerships. While this suited many of the participants, others were frustrated by the lack of concrete actions coming out of the week. Rather, the week ended with a concluding document declaring broad statements like “health information and knowledge are social determinants of health since inequities in access to information and knowledge generate and/or increase health inequities.” And: “The implementation of global eHealth initiatives should be based on partnerships involving various national and international players.”

The first couple day’s of this week’s mHealth session, on the other hand, has largely been focused on thinking through very specific projects. How can mobile phones be used in treating depression? What lessons from mobile banking should be applied to mobile health? What were the specific lessons learned in a public-private mHealth partnership in Vietnam?

On day one, the emphasis on all of these case studies was centered on implementation of the projects. Day two mostly dealt with scaling a project up after it has already been implemented.

As you can probably tell, I am a much bigger supporter of focusing on projects than partnerships. While manifestos and declarations garner a lot of signatures and media attention, it’s the projects that actually make change. I felt like there was a great opportunity to walk away from last week with a committed project that could put to test the enthusiastic presentations made here about eHealth. For example, if a hospital in Angola had expressed a desire to take advantage of communications technologies to improve their service, then all of the various groups that could make that happen where gathered here last week. Cisco could install wi-fi throughout the hospital. Zilics Health Information Systems from Brazil could help implement an electronic health records system. The School of Medicine at Oregon Health and Science University could offer medical training via teleconference. Nurses could be trained by fellow Portuguese-speaking nurses from the Federal University of Sao Paulo. The list goes on and on.

Even if the project itself did not come to fruition, it serves as a useful exercise to think through what some of the major obstacles are to implementing eHealth services in, for example, Angola.

I have to wonder if the mHealth group is more focused on implementation and scaling up rather than partnerships and declarations because there is money to be made in mHealth whereas business models regarding content and information have always been about restricting access, not increasing it.

I am curious what this mHealth group is going to come up with by the end of the week. One of their main goals is to develop a ‘road map’ for mobile health. We will see if that road map takes the shape of broad statements or focused projects. My guess is somewhere in between.