mHealth Working Group Meeting
Wednesday April 20th, 9:30 am -11:30 am (Eastern US)
Held at FHI, 4401 Wilson Blvd, Suite 700, Arlington, VA
Dial in: 1-888-651-5908 (US) Participant code: 106181
Topic: mHealth for HIV/AIDS Service Delivery

• Mobile phone-based interventions to promote adherence to antiretroviral therapy: a randomized controlled trial of SMS reminders in Kenya, by Dr. Harsha Thirumurthy, UNC School of Public Health and the World Bank
   
• TxtAlert for antiretroviral therapy appointment reminders and rescheduling in South Africa, by Marcha Neethling, Praekelt Foundation
   
• Experience from Zambia using mobile phones in a PEPFAR-funded project to prevent maternal to child transmission of HIV through 1) early testing of infants (Results 160) and 2) getting HIV+ babies onto life-saving treatment as soon as possible (RemindMi), by Andrew Kumwenda, FHI/Zambia
   
• 11:20 Invitation for collaboration on the K4Health mHealth Toolkit
   
• 11:25 Closing Remarks
  New participants are also welcome to receive future group announcements by joining the listserv at http://my.ibpinitiative.org/mhealth [47]. If you have any questions, please email the co-chairs of the mHealth Working Group, Kelly Keisling, keisling.kelly@gmail.com [28] and Laura Raney,  lraney@fhi.org [27] 

mHealth Projects – Where are they now? The April 26th meeting hosted past presenters invited to discuss “where are you now.” Presenters discussed their ongoing progress and lessons learned in mHealth. As mHealth continues to evolve, we reviewed how these mHealth projects have evolved with the field. We also discussed lessons learned within an issues framework for implementing mHealth. mHealth Working Group meetingThursday, April 26th from 9:00am-11:30am EDT Presenters include: Pam Riley, Abt Associates; James Bon Tempo, Jhpiego; Neil Lesh, Dimagi; Heather Vahdat, FHI 360; Meredith Puleio, IRH Held at the Association of Reproductive Health Professionals,1901 L Street, NW, Suite 300, Washington DC 888-651-5908 , Code: 757731 (Toll free is US only, international please call by Skype)Please RSVP directly to Kelly Keisling (keisling.kelly@gmail.com [28]) and Laura Raney (LRaney@fhi360.org [49]) if you can participate in person or remotely. Meeting materials will be available at the mHealth Working Group [50] .Thanks for demonstrating your leadership in mHealth.The next mHealth Working Group meeting will be hosted by Save the Children to discuss organizational strategy for mHealth. The meeting will be held on Tuesday, May 22, 9:30 - 11:30 am EDT at 200 L Street NW, Suite 500. The meeting is available remotely: in the US or via Skype: 1-866-386-4210, international 1-433-863-6601, code 634 879 6591. Participant experiences with organizational strategy in e/mHealth is invited.

 April 6, 2011 Agenda: 

• Mobile Behavior Change Communication by Kelly Keisling, JHUCCP K4Health 
• Summary of ICT4D Webinar: Defining Requirements for mHealth by Carrie MIller and Dina Brick, CRS

 Interagency Working Group for mHealth Integration
Preliminary Planning Session- August 6, 2009
Meeting Notes
 
The Interagency Working Group for mHealth Integration was convened to discuss growing opportunities in mHealth. The Working Group was offered as a combined resource for developing effective and responsible mHealth programs at scale. The planning session served as a forum for sharing related achievements, ideas and questions. Discussion began by addressing how mHealth can be integrated with public health standards and within a larger public health strategy.
 
Recurring Themes
 
The preliminary session prompted avid discussion on a range of topics and recommended actions.
 
Defining Needs
 
The needs of a mHealth program require clearer understanding, given that “the technology is the easy part”. Members of a health organization should be in agreement on the needs and design of an application before mobile technology is implemented. To achieve this, public health and ICT staff should talk openly about the defined problems and range of solutions.
 
Framing and Synthesizing Information
 
A framework is needed to synthesize the diffuse information available on mHealth.
Creating a framework requires that health organizations clearly define what they want to know. Accordingly, “buckets” of information and cross-cutting issues can be identified. Any synthesis of mHealth information should expand beyond a brief “blurb”, yet focus on the most important details. It should also integrate information and aggregate data. Covered information could include program type, country, IT requirements, and challenges. Illustrative examples can also be drawn from mobile phone programs in other fields, such as agriculture and banking. Placing available information in a clear framework would define the role of the Working Group and its fit with other organizations.
 
Research and Data
 
A mHealth program requires evidence of efficacy before it can be scaled up. Nevertheless, rigorous evaluation of mHealth programs is uncommon. Even where research is performed, it is often difficult for a mHealth program to progress beyond the research stage. Formative research is first needed to understand the context of mobile phone use, including phone costs, privacy, ownership, and access. This effort could be supported by access to market data on mobile phone purchases and usage. Additional formative research is needed to determine cross-cutting issues in mHealth programs.
Mobile Technology
The roles of mobile technology and program design were emphasized. An interoperable technology platform would reduce redundancies. Interoperability could also enable a donor to support multiple mobile technology programs more efficiently. Further issues include whether to update systems for 3G or 4G technology and for particular smart phones in order to transfer large quantities of data. 
Sustainability
 
Funding mechanisms should be determined for the Working Group, in particular, and for mHealth programs, overall. The sustainability of mHealth programs is an important consideration. Related issues include how to collaborate with private sector ICT partners, and determining the willingness of mobile phone users to pay for mHealth services.
 
Working Group Cooperation
 
Any working group requires “giving and getting in return”. Presentations by member organizations on mHealth programs could disseminate methods used and lessons learned. Adding a Q&A session could increase understanding of member examples and contribute to the formation of mHealth standards. This cooperative arrangement is challenging because implementing agencies both partner and compete with each other. Nevertheless, implementing agencies are able to cooperate successfully in many established working groups. Members can discuss how far participation should extend within levels and within country programs of their own organizations. Opportunities also exist for cooperation with in-country working groups abroad.
 
Next Steps
A variety of actions were requested for the Working Group in the near and long-term.
 
Near-Term Goals for mHealth

•  Design a matrix to frame/synthesize available information, supported by member submissions.
•  Form subgroups on specified topics.
•  Host a full-day panel discussion, with separate sessions on subtopics.
•  Participate in the mHealth Summit, October 28-30, 2009.

 
Longer-Term Goals for mHealth

• Create an online platform or “mHealth toolkit” for knowledge management, education and collaboration.
• Establish an agenda for operations research.
• Establish ethical standards and codes of conduct.
• Establish best practices.
• Establish sustainability models.
• Coordinate with potential donors.
• Design mHealth applications.

August 6 Session Participant List
 

Participant

Organization

Email

Pamela Riley

Abt Associates Inc.

pamela_riley@abtassoc.com [53]

Niles Friedman

BroadReach Healthcare

nfriedman@brhc.com [54]

Kelly Keisling

Center for Communication Programs, Johns Hopkins

kkeislin@jhuccp.org [55]

Julia Blencowe

CORE Group

jblencowe@coregroupdc.org [56]

Heather Vahdat

Family Health International

hvahdat@fhi.org [57]

Kate Gilles

Family Health International

kgilles@fhi.org [58]

Kelly L'Engle

Family Health International

klengle@fhi.org [59]

Laura Raney

Family Health International

lraney@fhi.org [27]

David Cantor

ICF Macro

dccantor@gmail.com [60]

Meredith Puleio

Institute for Reproductive Health, Georgetown U.

mp447@georgetown.edu [61]

Victoria Jennings

Institute for Reproductive Health, Georgetown U.

jenningv@georgetown.edu [62]

Janna McDougall

International Center for Research on Women

jmcdougall@icrw.org [63]

Fletcher Perri

Jhpiego

fletcher.perri@gmail.com [64]

James BonTempo

Jhpiego

jbontempo@jhpiego.net [65]

Mulamba Diese

John Snow, Inc.

mulamba_diese@jsi.com [66]

Philippe LeMay

Knowledge for Health

plemay@jhuccp.org [67]

Kyle Duarte

Management Sciences for Health

kduarte@msh.org [68]

Piers Bocock

Management Sciences for Health

pbocock@msh.org [69]

Anton Luchitsky

PATH

aluchitsky@path.org [70]

Bonnie Keith

PATH

bkeith@path.org [71]

Cherie Carter

Population Services International

ccarter@psi.org [72]

Margot Mahannah

Population Services International

mmahannah@psi.org [73]

Mariah Preston

Population Services International

mpreston@psi.org [74]

David Isaak

Save the Children USA

disaak@savechildren.org [75]

Meegan McVay

The Elizabeth Glaser Pediatric AIDS Foundation

mmcvay@pedaids.org [76]

Adam Slote

USAID

aslote@usaid.gov [77]

Jewel Gausman

USAID

jgausman@usaid.gov [78]

Mihira Karra

USAID

mkarra@usaid.gov [78]

Patricia Flanagan

USAID

pflanagan@usaid.gov [79]

Peggy D'Adamo

USAID

mdadamo@usaid.gov [80]

 
 
For further information, please contact:
Kelly Keisling
keisling.kelly@gmail.com [28] 

 Dec. 1 Meeting of mHealth Working Group on National Strategy, Hosted by Deloitte The presentations and open group discussion will address development of a national mHealth strategy. WHEN: Thursday December 1st, 2011 from 9:00 - 11:00 am EDT WHERE: Deloitte Consulting, 555 12th Street NW, 5th Floor, Room 5001, Washington, DC THEME: Developing a National mHealth Strategy AGENDA: Development of National mHealth Strategy Framework: Tanzania Strategy Workshop Video [82] 

• Claud Kumalija, Head of HMIS for the Tanzanian Ministry of Health and Social Welfare 
• Dr. Mwendwa Mwenesi, mHealth Country Coordinator for the Tanzanian Ministry of Health and Social Welfare 
• Marcos Mzeru, Country ICT Manager- mHealth, for the Tanzanian Ministry of Health and Social Welfare 
• Jon Tigges and Nathaniel Clarke, Deloitte Consulting 
• Sarah Emerson, CDC Foundation 
• Steve Ollis, COO for D-tree International and co-chair of the Tanzania mHealth Community of Practice 

Working Group Activities before/at the mHealth Summit

•  Conference on mHealth and Information and Communication Technologies in the World of Small Enterprise Development, co-organized with the Aspen Institute and UNCTAD on November 29.
• Building Partnerships that Work: Designing for Success and Scale, a paper coauthored by the mHealth Working Group and GBCHealth. This supports the GBC panel on public private partnerships for mHealth at the mHealth Summit on December 7. 
• Open meet-up on global health perspectives at the mHealth Summit on Monday, December 5 from 1-2 pm in the Chesapeake Room #2. 

To participate by conference call, dial 888 998 2663; Code: 4182977. Webcast is available at https://www137.livemeeting.com/cc/dt/join?id=KQ9HMB&role=attend&pw=CfG23%3Fw [83] – select Join the Meeting. (Further webcast instructions at bottom.) Meeting materials will be available at mHealth Working Group [50]. Please RSVP if you are attending in person or remotely, to Kelly Keisling (keisling.kelly@gmail.com [28]). Deloitte Consulting is located 1.5 blocks south of Metro Center metro stop. Please take the elevator to the 5th Floor and the room is opposite reception. Please bring photo ID to access the building. Kelly KeislingLaura RaneymHealth Working Group Co-ChairsAbout the mHealth Working Group Founded in August 2009, the mHealth Working Group is a collaborative forum for sharing and synthesizing knowledge on mHealth, facilitated and supported by the K4Health Project.  Composed of more than 500 individuals representing over 150 organizations worldwide, the mHealth Working Group seeks to frame mobile technology within a larger global health strategy. By applying public health standards and practices to mHealth, we promote approaches that are appropriate, evidence-based, interoperable, scalable and sustainable in resource-poor settings. The Working Group holds regular meetings in Washington, DC to discuss promising approaches, challenges, and lessons learned. Minutes from previous meetings, as well as more information about the group, are on the mHealth Toolkit at /toolkits/mhealth/mhealth-working-group-0 [84]. Interested colleagues are welcome to receive future announcements by joining the listserv at knowledge-gateway.org/mhealth. To participate by webcast, install Office Live and accept the terms. Start Live Meeting client, and then in Voice & Video pane under Join Audio options, click Call Me. The conferencing service will call you at the number you specify (Recommended). Otherwise dial 888 998 2663; Code: 4182977. If you have problems, copy this address and paste it into your web browser: https://www.livemeeting.com/cc/dt/join [85]. Then Copy and paste the required information:  Meeting ID: KQ9HMB Entry Code: g\X6NTf Location: https://www.livemeeting.com/cc/dt [86] . If you still cannot enter the meeting, contact support [87] at http://support.microsoft.com/gp/cp_livemeeting2007_master?ln=en-us [88]. 

 mHealth Working Group Meeting Notes
Monday, December 13, 2010, 10:00 AM – 12:30 PM (Eastern US)
Held at Family Health International (FHI), Arlington, VA
 
 
Thank you to FHI for hosting this meeting. The next meeting will be on January 19, 2011 from 9 to 11 am at USAID. If your organization would like to host a future meeting, please contact either Kelly Keisling (kkeislin@jhuccp.org [55]) or Laura Raney (lraney@fhi.org [27]), mHealth Working Group co-chairs.
 
Meeting Discussion Items
1.      How health and ICT organizations partner in mHealth
2.      Developments in the mBCC Technical Group
3.      Recapping the best of the mHealth Summit
4.      Maternal mHealth Initiative
 
Notes and presentations are available on the mHealth Toolkit, filed by date, at:
/toolkits/mhealth/working-group-materials [90]
 
1. How Health and ICT Organizations Partner in mHealth
 
We invited presenters from both ICT and health partner organizations to share information on health-ICT partnerships including: 1) the partner process - how partnerships are selected, structured, and maintained; 2) the design process - how programs/systems are designed; and 3) the role of each partner.
 
The first speakers were Heather Vahdat, FHI, by videoconference from FHI’s Durham, NC office and Hajo van Beijma, Text to Change (TTC) via telephone from Amsterdam. Heather Vahdat, Associate Scientist in FHI’s Behavioral and Social Sciences Division, is the co-investigator for FHI's Mobile for Reproductive Health (m4RH) program. Hajo van Beijmaworks on new programs and partnerships and is the head of financeatthe non-profit organization Text to Change (TTC).  Text to Change specializes in interactive and incentive based SMS programs addressing a wide range of health issues such as HIV/AIDS, malaria and reproductive health.
 
Heather spoke about the steps that FHI went through first in developing the concept for a basic SMS system for the distribution of contraceptive knowledge, then finding a technology partner to work with. They solicited for partners, narrowed the list, and then chose Text to Change (TTC) based on the key decision points of flexibility, reliability, and sustainability. Flexibility was important for a pilot in order to refine it repeatedly during the development process. Other considerations in choosing a partner were: quality control in terms of checking the system and data; cultural considerations (having a partner in region is extremely helpful); and having a partner knowledgeable in public health. (See attached slides for further details.)
 
As nonprofits, both organizations have similar goals which made the affiliation easy to manage and grow. The partners also had a clear definition of roles. FHI developed and tested the system content, designed the research process, and undertook system usability testing. TTC provided programming, input on design and the proposed algorithm, and data monitoring. Working with TTC, FHI designed and developed the Mobile for Reproductive Health (m4RH) project, an interactive platform with text messages on family planning methods that users can access via their mobile phones. The launch was promoted by and integrated with a larger field program already in place. The project piloted nationwide in Tanzania and Kenya, see http://www.fhi360.org/en/Research/Projects/Progress/GTL/mobile_tech.htm [91].
 
The big considerations with regard to a pilot program are sustainability and cost. FHI offered three lessons learned:
1) Having a good IT partner is critical but finding a partner can be a daunting process. When all else fails, just ask!
2) Location, location, location. Regional expertise is a benefit.
3) Be clear in expectations regarding upfront and long-range costs.
 
During group discussion, questions were raised regarding messaging costs. FHI benefitted from reduced costs since TTC had negotiated lower rates to support expansion to a national level. Participant comments highlighted TTC’s negotiations for fixed price transmissions in 16 countries. Additionally, UNICEF is planning a report on case studies for negotiating agreements with local carriers. In the coming months, as FHI further explores additional programs and platforms, it will make available a global kit with how-to guidance and information on replication of the project. Another discussion item was the use of audio messages for countries with low literacy rates. Several organizations are exploring this option (Abt Associates, Johns Hopkins Center for Communication Programs and FHI). However, it was noted that audio costs are higher and some communities are not accepting of the technology or credibility of the information presented. The possible trend toward SMS in Africa and audio in India was mentioned, though it has not been measured.
 
Merrick Schaefer, a technical project manager at UNICEF, presented on types of partnerships and the institutional attributes that make potential partners want to partner. He drew on experiences his team had from a myriad of mHealth and other technical projects from the last three years. He used his current project as an example to contextualize various types of partnerships. He started by describing Project Mwana, a UNICEF initiative that uses mobile technology to strengthen services for mothers and infants in Zambia and Malawi. Thus far, the project has created, implemented and is scaling two tools: Results 160 that delivers infant HIV testing results and materials from clinics to cities with tracking capabilities; and RemindMi that allows community health workers to register child births and track the visits and care given to mothers and newborns see, http://projectmwana.posterous.com [92].
 
Project Mwana has benefitted from a series of different partnerships in the last year. With regard to partnering, Merrick said the most important factors for the ICT partnerships UNICEF has utilized are 1) having staff that can function as technology translators for the rest of the organization, and 2) adopting a project approach that is appealing to ICT and design firms. Merrick’s team is an Innovation Group inside UNICEF composed of software developers and designers who help the programmatic staff understand how technology can strengthen their work and convene partners to help them do it. The team “speaks” the same language as the teams they are working with and can take the programmatic goals of the UNICEF and present them as technological or design issues to groups they partner with. Having this type of expertise makes the partnership process much more effective. Additionally, the projects are designed with sustainability in mind. They work with local offices to further train local developers and managers allowing the projects to be more easily sustainable on a global level. This is appealing to partners as it demonstrates that the work they are contributing to will carry on after the immediate engagement is over.
 
The project approach that the team takes also makes partnering with UNICEF desirable. The team follows the current best practices for technology and software development including having a user-centered design approach, creating and using open source software and using agile and iterative development methodologies. Many private sector organizations utilizing these approaches in their own work are attracted to the idea of working with an organization which has already adopted this mindset.
                                                                                         
Further, Merrick explained 7 types of partnerships that are often used for collaboration including implementing, academic, informal, formal, open source and community, internship and fellowship, and telecom. For Project Mwana there were many implementing partners in country, including the Clinton Health Access Initiative, Boston University, Zambia Prevention, Care and Treatment (ZPCT) and Worldvision that either worked with the team on implementing or programmatic pieces or utilized the tools in their own pilots. Second was an academic partnership with Columbia’s School of International and Public Affairs program where four graduate students did a series of field visits and created a report that explored the clinics programs and cell phone use. Third was an informal partnership with a big 5 consulting firm, that wishes to remain anonymous, which dedicated consultants over 4 months to give weekly meetings and advise the team on how to effectively structure the project. The informal nature of the partnership allowed minimal overhead for both organizations. Fourth is a long-term, formal partnership between UNICEF and frog design which sent a team to do user research and help with the qualitative analysis of the project. Fifth, the tools were built using an open source platform, RapidSMS, and tapped into the 200+ member community and was able to reuse a fair amount of code from others projects which significantly reduced software development time. Sixth included internships and higher-level fellowships.
 
His last point was not to partner with telecom companies for pilots but rather think about such partnerships when it is time to scale.   This is partly because getting a reduced rate for the cost of data or messages at a pilot scale is much less important than at scale. If you can’t afford the messages when the project is small, it will make scaling difficult. You also lose leverage for corporate social responsibility funding by giving the telecom partner exposure for the pilot. Additionally, for projects to work at scale, it is often necessary to work with all of the telecom providers in country since some parts of countries are only covered by one. Being locked into a relationship with one can make partnering with the others much more difficult.
 
Convening many and different types of partners around Project Mwana allowed the small team to act as a bigger team, leveraging the experience and resources of many organizations for the success of the project. For a presentation about Project Mwana, see http://dl.dropbox.com/u/16799705/Project%20Mwana%20-%20for%20Malawi%20for%20IATT.v2.pptx [93]
 
Steve Ollis of D-Tree International was the next speaker on mHealth partnerships. Steve is a Project Manager for mHealth projects around maternal and child health in Tanzania and India. Steve spoke about D-Tree’s mobile applications for health care providers in clinics and communities and various partnerships that they have formed. Pathfinder and D-Tree are working together to assist community health workers in home visits for PLHA and chronically ill patients, guide management of patient schedule visits, and provide referral reminders for follow-ups all referred patients. With JHPIEGO, D-Tree has developed facility and community protocols for antenatal, neonatal and postnatal care in accordance with Tanzania MOH guidelines, as well as prototype applications ready for field refinement. With UNICEF, D-Tree developed protocols to support outpatient treatment of severe acute malnutrition in Zanzibar, and an application to support screening, registration, treatment and prescribing to be done at the health facility. With CARE, they have developed protocols for Individual Birth Planning and ANC, Active Management of 3rd Stage of Labor, Immediate Newborn Assessment and Postpartum follow-up for mother and child, and are establishing a server for integration of all patient data in OpenMRS.
 
The emphasis in partnerships for D-Tree is sharing a vision, reinforcing the government’s mission, finding key partners and local experts to provide subject matter expertise, and tailoring the tools to work within the context of the local environment. This includes clarifying vague clinical guidelines into discrete, specific and actionable steps, as well as working to ensure that the questions support the workflow and local cultural norms. It is important to be realistic when balancing local capacity (staffing, equipment, labs, etc.) with national guidelines for clinical protocols, when developing applications. D-Tree International uses a common process: Design of protocol and prototypes; Field refinement to start initial testing of the models; Training and pilot prep stage; Pilot program; and Assessment of the success of the pilot. Steve reiterated that scale and sustainability tend to be the most crucial factors in the development of these applications. D-Tree’s active engagement with partners is an iterative process, working together with partner organizations and field health workers, rather than a packaged, “out of the box”, solution. This engagement also requires champions within partners to ensure that the project is not just seen as a stand alone technology project but as part of the larger effort that the partner is engaging in. For further information about D-Tree, see www.d-tree.org [94].
 
In response to questions, Steve said that D-Tree uses Nokia phones, but that highly complex protocols can be difficult for even more expensive phones. Group discussion mentioned that Android handsets are scarce in Africa. Also, Android software has difficulty with text in Hindi. Both Merrick and Steve said it is difficult to find reliable solar chargers. Instead, local methods can be used for finding informal sources of electricity.
 
 
2. Developments in the mBCC Technical Group
 
A short update was given on the Working Group’s Technical Group on mHealth for behavior change communication (mBCC) by Stephen Rahaim of Abt Associates and Renald Fleury . The current focus continues to be on further development of the Field Guide (see www.mbccfieldguide.com [95]). All are welcome to contribute to the mBCC Field Guide through the website or further discussion. Please contact Kelly Keisling (kkeislin@jhuccp.org [55]) and Stephen Rahaim (Stephen_Rahaim@abtassoc.com [96]) if you would like to know more or be included in the Technical Group’s listserv and meetings.
 
 
3. Recapping the Best of the mHealth Summit
 
The brief recap of the mHealth Summit focused on identifying and expressing the main themes of the summit which included: “Pilotitis” and the effort to move toward scalable and evidence-based approaches, developing business models, use of mobile money applications for mHealth, and interdisciplinary collaborations. This year’s Summit brought in 2,400 attendees from 50 different countries, including 150 different speakers with keynote speeches by Bill Gates and Ted Turner. The 2011 mHealth Summit is set for December 5-7, 2011 in Washington, DC. Further information is available at mHealthSummit.org
 
 
4. Maternal mHealth Initiative
Cathryn Meurn of the mHealth Alliance spoke about the Maternal mHealth Initiative (MMI). Cathryn described their efforts to unite ICTs, especially mobile, with the expertise of maternal, newborn and child health practitioners, and deliver information-based interventions to reduce maternal and infant mortality and improve the health of mothers and babies.
The mHealth Alliance has launched www.healthunbound.org [97] as a forum for collaboration between sectors in mHealth. As a first step in the Initiative, the mHealth Alliance is encouraging all participants and organizations to register their projects that contain mHealth or eHealth components on HUB, with particular emphasis on maternal and newborn health. The goal is to develop a robust Mobile Maternal Health Innovation Commons to analyze gaps, and ultimately work to create digital health systems with the greatest impact on reducing maternal and infant mortality, using appropriate and scalable technology. The mHealth Alliance is pleased to announce the appointment of Jennifer Potts as Director, Maternal mHealth Initiative. Ms. Potts brings to the mHealth Alliance over 20 years of experience in the fields of reproductive and maternal health.
In addition, the mHealth Alliance is continuing to develop thought leadership pieces, advance on the infrastructure for phase two of healthunbound.org, and organize conference events.  
 
Joining the mHealth Working Group
 
The mHealth Working Group is a collaborative forum for sharing and synthesizing knowledge on mHealth. Over 250 participants and contributors represent more than 100 organizations from the US, Europe, Africa, Asia and Latin America. The Working Group seeks to frame mobile technology within a larger global health strategy. By applying public health standards and practices to mHealth, we promote approaches that are appropriate, evidence-based, interoperable and scalable in resource-poor settings. The Working Group holds regular meetings in Washington, DC to discuss promising approaches, challenges and lessons learned.
 
If you would like to join the mHealth Working Group and listserv, please go to http://knowledge-gateway.org/mhealth [14]. Listserv members are invited to share announcements and materials with the listserv by sending them to mhealth@my.ibpinitiative.org [98]. Information on the mHealth Toolkit is also available at /toolkits/mhealth [99].
 
 

Interagency Working Group for mHealth
Meeting Notes- December 3, 2009
 
mHealth Summit - Data Collection
The mHealth Summit was commended as the largest gathering on mHealth to date. Discussion covered several Summit presentations on data collection, including those using RapidSMS, Episurveyor, and Cell-PREVEN. Continuity of device operability can be challenging. Use of complementary paper forms can address this issue, and the Open Mobile Consortium has developed solutions such as storing data on mobile devices. Nevertheless, constant transmission ability is limited by transmission range, and procedures should be defined for periods when devices cannot transmit. “Near-time” was suggested instead of “real-time” to describe data collections speed, since intermediate steps are not as quick as data transmission. It was remarked that mobile data collection programs do not necessarily target health areas where real-time speed is most advantageous, resulting in “random acts of kindness”. Also, the disaster relief field may provide useful examples of mobile data collection.
 
mHealth Summit - BCC
 
In Summit presentations on BCC, Project Masiluleke was discussed as a large-scale effort to link text messages and a hotline. This mass messaging was compared to the individualized patient approach in the presentation on smart phones for diabetes self-management in China. Comments stressed targeting SMS for demand creation where adequate supply is available. Numerous calls for research on the efficacy of SMS were also mentioned at the mHealth Summit.
 
mHealth Summit - Program Development
 
A Summit attendee suggested that future presentations should explain their development processes in addition to their technological solutions. It was also suggested that mHealth programs should not rush scale up because more information is first needed from pilots. Scale up is also complicated by differences between markets or regions. A standard set of considerations would be helpful in adapting to these differences. AED Satellife mentioned their development of related guidelines for data collection.
 
Regulation
 
The possibility of a health ministry regulating mHealth programs attracted comments. A country with numerous mHealth programs risks redundancy and “pilot weariness”. Ownership and control of transmitted data and telephone numbers are also issues of concern. However, it is important that regulation not stifle innovation.
 
Public-Private Partnerships
 
Technology companies are possible partners and funding sources for mHealth projects,
potentially in cooperation with the USAID Global Development Alliance. Vodafone has separately announced a mHealth Alliance Award. It was suggested that public-private partnership would require the development of selection criteria for mHealth.
 
 
Working Group Goals
 
Next steps for the Working Group will address the needs of global health organizations in mHealth, including capacity building, collaboration, and knowledge management (see accompanying slides). Next steps include development of an online platform for collaboration and knowledge management, and 2) formation of a technical group on mobile data collection.
 
For further information on the Interagency Working Group for mHealth, please contact Kelly Keisling at kkeislin@jhuccp.org [55].
 
Meeting Participants
 
Pam Riley                    Abt Associates                         pamela_riley@abtassoc.com [53]
Holly Ladd                   AED Satellife                            hladd@aed.org [101]
Carrie Brown                ARPH                                     cbrown@arhp.org [102]
Ellen Cohen                 ARHP                                     ecohen@arhp.org [103]
Kelly Keisling                CCP                                        kkeislin@jhuccp.org [55]
Josh Nesbit                 FrontlineSMS:Medic                    josh@medic.frontlinesms.com [104]
David Cantor               ICF Macro                                dccantor@gmail.com [60]
Meredith Puleio           IRH Georgetown                       mp447@georgetown.edu [61]
Elliott Hoel                  Measure DHS                           elliot.hoel@macrointernational.com [105]
Thulani Mbatha            MSH                                       MMbatha@msh.org [106];
Katie Powell                MSH                                       KPowell@msh.org [107]
Annette Boyer            CECity                                    aboyer@cecity.com [108]
David Isaac                 SixBlue Data                            disaak@sixbluedata.com [109]
Rebecca Oser             BroadReach                             roser@brhc.com [110]
Daniel Anderson          BroadReach                             danderson@brhc.com [111]
Mihira Karra                 USAID                                    mkarra@usaid.gov [78]
Peggy D'Adamo          USAID                                    mdadamo@usaid.gov [80]
                       
  

This was a presentation/meeting that occurred at the mHealth Summit on Public Private Partnership in mHealth. The attached paper was co-authored by the mHealth Working Group.
Location: GBCHealth at the mHealth Summit
Topics: Paper on public private partnerships in mHealth
Panelists: Erin Mote (USAID), Paul Ellingstad (HP),  Sarah Sanders (Vodafone), Rodrigo Saucedo (Carlos Slim Health Institute), Jon Tigges (Deloitte), Vicky Hausman (Dalberg)

 
Meeting Agenda for the mHealth Working Group
Wednesday February 23, 9:00 am – 11:00 am (Eastern Standard Time)
Held at PSI, 1120 19th Street, NW Suite 600 Washington, DC
In the U.S. 866 -331- 0889, outside of the U.S. 803-477-2002, participant code 407684
 
 
 
9:00-9:20 Introductions 
 
9:15-9:30 Overview of mHealth Working Group – Kelly Keisling and Laura Raney, co-chairs
9:30-10:00 Ongea Zaidi na Salama: Using Mobile Phone Networks to Improve Condom Social Marketing in Tanzania - Daniel Crapper, PSI Country Representative for Tanzania
 
10:00-10:30 ILSGateway: mHealth Logistics Reporting System Designed to Strengthen the Integrated Logistics System (ILS) in Tanzania - Marasi Mwencha, Senior mHealth Advisor, John Snow, Inc.
 
10:30-10:40 Closing remarks
 
10:40-11:00 Social discussion among attendees
 
 
 
New participants are welcome to join the listserv of the mHealth Working Group for further announcements at http://knowledge-gateway.org/mhealth [14]. Further resources are available on the mHealth Toolkit at /toolkits/mhealth [99]. Presentations and minutes from past meetings are posted on the Toolkit under About the Toolkit tab, Working Group Materials. If you have questions please contact Kelly Keisling, keisling.kelly@gmail.com [28] or Laura Raney, lraney@fhi.org [27], Co-Chairs of the mHealth Working Group.

 
mHealth Working Group Meeting Notes
Wednesday, February 24th 2010, 10.00 AM – 12.00 noon (Eastern US)
Held at ARHP, Washington D.C
 
 
The meeting discussed the guide for mobile data collection, including needed resources and published evidence and challenges. Comments are invited on the attached Mobile Data Collection Guide and Resource Review by March 8th to kkeislin@jhuccp.org [55]. Recent mHealth events were also reviewed, covering the Health Affairs meeting on E-Health in Developing Countries, and the mHealth International Networking Conference.
 
The next meeting of the mHealth Working Group will be held:
 
April 6, 2010, 10.00 AM – 12.00 noon (Eastern US)
 
Mobile Data Collection Guide
 
For the Mobile Data Collection Guide, several suggestions were made.

• A gap analysis can clearly compare how mobiles compare to paper methods.
• A formal set of requirements is needed for translating public health needs into system requirements.
• Examples of mobile data collection can be drawn from similar examples in agriculture and the US census.

(Please email comments on the attached Guide and Resource Review to kkeislin@jhuccp.org [55] by Monday, March 8th.)
 
Increased speed, reduced error, reduced loss of data, and reduced costs are possible advantages of using mobile devices for data collection. Evidence for each of these advantages was reviewed, to prompt discussion of how mobiles are useful or challenging (see slides). Participant commented widely on mobile data collection and the draft Guide.

• How much evidence is needed to justify mobile data collection? Are the advantages obvious enough to replace paper methods without examining current or future studies on mobiles? Do potential users demand evidence? Is health data collection different from information in other fields? All data collection mechanisms have biases, and a clear understanding of the biases is required.
• Parallel use of paper and mobiles may reduce any data loss during startup. This temporary or ongoing measure could reduce any cost or time savings from avoiding paper, however.
• Training and role playing can reduce any social desirability bias introduced by mobile devices. An example of Bangladesh PDA training was cited, showing that cultural sensitivity can be maintained in similar situations.
• Surveyor fatigue may be greater for use of mobiles than for use of paper. Usability testing and interface design can be important for how well and how consistently a technology is used.
• Electronic consent forms can use the signature feature to potentially meet IRB requirements while avoiding this extra use of paper. 
• Introduction of mobiles may require staff changes. For example someone competent with working on paper-based surveys may not be competent with the use of PDAs. Technology can also shift the burden from one person to another, requiring task shifting.
• Involve all stakeholders in planning, since mobiles may benefit or burden staff members in varying ways. Also, different stakeholders may have different uses for data. Nethope can provide an example of broad stakeholder input.
• Staffs have various reasons for adopting technology. These may include productivity, ease, or upgrading skills for their resume.

 
Recent mHealth Events
 
The Health Affairs meeting on E-Health in Developing Countries and the The mHealth International Networking Conference were reviewed (see slides). 
 

• There are common sense opportunities for mobile HMIS. It is needlessly complicated for the nurses to note information on their hands or note pads and then to transfer that information on to a computer.
• Social media is faster or more popular than other forms of media. CDC’s  Facebook page receives more hits than its homepage on some topics. Twitter can be faster than broadcast media disseminating breaking news.
• Health consumer websites offer user control, as seen with Keas.

 
mHealth Working Group Meeting Notes
January 19, 2011 9:00 AM – 11:00 AM (eastern US)
Held at USAID, Washington, DC
 
We greatly appreciate USAID hosting the January 2011 meeting of the mHealth Working Group. The next meeting will be held on the morning of February 23rd, 2011 at Population Services International in Washington, DC. If your organization would like to host a future meeting, please contact either Kelly Keisling (kkeislin@jhuccp.org [55]) or Laura Raney (lraney@fhi.org [27]), mHealth Working Group co-chairs.
 
 
Meeting Discussion Items
1. Presentations on formative research in mHealth:
-Dr. Rajiv Rimal and Basil Safi of the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs   
-Meredith Puleio of the Institute for Reproductive Health, Georgetown University
2. mHealth literature review and future topics
 
Notes and presentations are available on the mHealth Toolkit, filed by date, at:
/toolkits/mhealth/working-group-materials [90]
 
 
1. Presentations on Formative Research in mHealth
 
There has been a popular call for mHealth to be patient-centered and user-centered, ensuring that technology is relevant and appropriate for local populations. This may be challenging as the pace of technology development and mHealth adoption accelerates. Formative research is a method for better understanding the needs of populations and their contexts. Use of formative research can reduce the uncertainties of mHealth by introducing a known method to the development process and by providing necessary information for proper design.
 
Dr. Rajiv Rimal of the of the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHUCCP)framed formative research on mHealth with a discussion of theories, methods and examples on formative evaluation. This approach was used in the Urban Health Initiative (UHI) in India. It includes an audience analysis through a variety of methods that focus on demographic and psychographic segmentation techniques.  The demographic profile illustrates basic characteristics like age, education, gender, and health literacy. The psychographic profile shows the attitudes, beliefs, perceptions and prior knowledge. Communication profiles show the density of the social network and level of interactivity, the media use trends, and access to information which all have implications for dissemination. Behavior profiles look at the prior behaviors as predictors for future behavior and the readiness to adopt new behaviors. The cultural profile determines the most prevalent and relevant social norms, traditions, and obligations. The last segment of the audience profile is the aspect of structure which evaluates the ability to access services and environmental contributing factors. Rajiv then went on to explain how these profiles are used in developing messages through targeting, tailoring, and segmentation. Targeting makes the messages available to the audience via the correct channels and allows for more exposure. Tailoring ensures that the messages resonate, inspire, and motivate the audience and in the case of the UHI project focus on facilitation and aspirations instead of persuasion because it was found that the audience knew the best outcomes but were unsure how to achieve these results. Segmentation groups the audience into meaningful clusters that are internally homogenous and externally heterogeneous allowing for better focus, which were determined to be newly married couples, couples with one child, and couples with 2+ children in the Urban Health Initiative study.
 
Continuing to speak on the Urban Health Initiative, Basil Safi of the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs (JHUCCP) presented formative research on using mHealth to promote significant increases in the prevalence of contraceptives in Uttar Pradesh. India is well positioned to support a mHealth program with widespread mobile phone ownership and one of the world’s largest telecommunications networks. In the UHI project, mHealth will play a role as part of a total communication strategy across various media channels for demand creation for family planning. The key issues revealed by formative research include limited mobile phone ownership among women, limited capabilities of women’s phones, and limited use of SMS by women. Mobile phones are used mainly by the men for work, as well as video downloads, since a large segment of the population is illiterate. Perceived association of mobile video with pornography is also a sensitive issue. Along the entire process of developing this mHealth intervention, JHUCCP is currently at the stage of data review and analysis. The implications of broader formative research indicate that mHealth can emphasize positive experiences and discussion with peers and spouses. mHealth can also support communication with men through mobiles and with women through community health workers with smart phones. Interactive voice response, games, and mobile-assisted interpersonal communication may be used where literacy is a barrier. The UHI pilot testing is set to begin in March in several slums to assess usability, comprehension, outreach, retention, satisfactions, and action. Following the pilot, scale up is planned for May 2011. The mHealth effort will then be introduced in Agra for comparison to another city to determine to measure general increase in contraceptive use.
In discussion afterward, the question was raised whether it would be possible to measure the impact of mHealth when it is packaged with other efforts. It was acknowledged that this would be difficult but possible given ability of JHUCCP researchers to conduct dose-response measures that can track the comparative behavioral impact of those reached by a package of interventions including mHealth activities versus those who were exposed to the same package of activities without the mHealth component. Also, the measurement of mHealth as an integrated package will be insightful since there are few previous studies on mHealth as an integrated channel of communication. It was mentioned that demand should be confirmed before resources are dedicated to scale up. Once the value is clear, JHUCCP intends to use the application as a way for specific cell phone providers to draw in clients, providing mutually benefit for all partners.
Meredith Puleio of the Institute for Reproductive Health, Georgetown University (IRH) discussed development of CycleTel™ in India from proof-of-concept to deployment. The concept behind CycleTel is to facilitate use of the Standard Days Method® of family planning via SMS. The program will be launched for testing in Dehli, focusing on higher income women who own cell phones and have interest in the application and method. Currently, the project is in the technology development phase and is in the process of building the test market group of 500 selected participants. The proof-of-concept was determined through focus groups, cognitive interviews, and manual testing which allowed for the results to consistently become more refined, creating the best possible message comprehension. Meredith explained that the value of formative research is that it provides a more established example of audience needs and demands. This determines a more conclusive product design prior to fully launching and investing in the program. This investigation illustrated the need for a close relationship with their technology development partner, ThoughtWorks. This allows a shared creative process of developing the final programming through engaging in communication and continual feedback, while also supporting the CycleTel project’s efforts in building other substantial relationships necessary for product launch. Meredith also advised on their future plans for scaling up the project, including establishing a technical advisory group, deciding ownership of the technology, considering potential business models, as well as monitoring and evaluating to minimize risk. Meredith cited the experience of CycleTel for tips on launching a mHealth application. Important tips include the value of partnerships, an in-depth understanding of the environment, the importance of seeking out information on new product development, and the overall value of formative research.
 
Discussion afterward highlighted that a target audience of higher income groups were chosen for the prior technology capabilities, though IRH would have preferred to study and focus on the lower incomes levels where the need is greater. Regarding challenges for scaling up, IRH is happy with their plan to use a technology company and application that can be used by customers of any mobile phone provider. IRH mentioned their plan to start in Dehli, and evaluate where to expand from there. IRH also hopes that demand will be generated as information about the program is disseminated through word of mouth (referrals). Delving into the evaluation plans of the program, a larger group of participants would be necessary to measure impact on unmet need. However, data on service use will be collected continuously by the technology, itself. The program will be further evaluated through phone surveys with users. When asked about IRH’s plans to provide a hotline and call center, Meredith explained that reinforcing information through another source could increase trust in the program.
 
 
2. mHealth Literature Review and Future Topics
 
Additional discussion covered future topics for the mHealth Working Group and the mHealth Toolkit. Management Sciences for Health is searching for informational resources for the data collection and health information systems tabs of the mHealth Toolkit. The mHealth Toolkit is a knowledge management site at /toolkits/mhealth [99] guided by the mHealth Working Group. Participant suggestions for future topics included case studies based on personal experiences, product development information, and specific examples of the steps and guidelines for creating a mHealth project. If you have suggestions or questions about the mHealth Working Group or the mHealth Toolkit, please contact Kelly Keisling (kkeislin@jhuccp.org [55]) or Laura Raney (lraney@fhi.org [27]).
 
 
Joining the mHealth Working Group
 
The mHealth Working Group is a collaborative forum for sharing and synthesizing knowledge on mHealth. Over 250 participants and contributors represent more than 100 organizations from worldwide. The Working Group seeks to frame mobile technology within a larger global health strategy. By applying public health standards and practices to mHealth, we promote approaches that are appropriate, evidence-based, interoperable and scalable in resource-poor settings. The Working Group holds regular meetings in Washington, DC to discuss promising approaches, challenges and lessons learned.
 
If you would like to join the mHealth Working Group and listserv, please go to http://knowledge-gateway.org/mhealth [14]. Listserv members are invited to share announcements and materials with the listserv by sending them to mhealth@my.ibpinitiative.org [98].

 
We hope you and your colleagues can join the next meeting of the mHealth Working Group on Tuesday, January 24th. This month's open meeting will be hosted by PSI. Discussion will cover the 2011 mHealth Summit, the 2011 International Conference on Family Planning, and mHealth plans for 2012.

WHEN: Tuesday, January 24th, 2011 from 9:30 - 11:30 am EST
WHERE: PSI , 1120 19th Street, NW, Suite 600, Washington, DC
CALL: dial 888 651 5908 [117], code 489386

Please RSVP if you are attending in person or remotely, directly to Kelly Keisling (keisling.kelly@gmail.com [28]) and Laura Raney (LRaney@fhi360.org [49]).
 

 Interagency Working Group for mHealth Meeting Notes- July 13, 2010 Meeting Discussion Items (see accompanying slides)

• Current Events
• mHealth Toolkit Feedback
• Introducing Planning Process
• Applying the Innovation Cycle to Mobile Health
• Capturing mHealth Requirements
• Recap of Conference on ICT for Education and Training
• Renaming the Working Group

               mHealth Toolkit Feedback The mHealth Toolkit is now openly available at www.k4health.org/toolkits/mhealth [99]. Working Group members are free to introduce the Toolkit to their colleagues. Suggestions for the Toolkit included adding a Google search feature find information on the Toolkit or other selected sites. Members discussed how to link the Toolkit to other sites addressing mHealth, such as MobileActive.org, the Open Mobile Consortium, and the anticipated HUB website. A recap of previous group feedback on the Toolkit addressed the need for a planning process in adopting mHealth. Need for Planning Process A planning process could address some common limitations of mHealth, including uncertainty about how to adopt mHealth, lack of evidence, and tendency to skip planning steps. Members mentioned the unpredictability of mHealth projects, because the lack of guidance means decisions are based on best guesses. More helpfully, the electronic monitoring can be built into mHealth programs for real/near time data. This combination of uncertainty and immediate feedback requires that M&E and adaptation be built into each stage of development. A generic planning model was presented to place in context the steps of formative research, concept development, and requirements definition, each to be addressed by presenters. Planning can also be supported by the planning sections on BCC, mLearning and data collection in the mHealth Toolkit. The discussed planning model is similar to other planning models in health. However, members suggested that the model include ongoing feedback loops, given the iterative nature of mHealth planning. “Does Information Technology Make a Difference” was suggested as a related article. Presentation by Dr. Aditya Dev Sood, Center for Knowledge Societies.  Aditya spoke on the CKS approach to formative research and concept development, “Applying the Innovation Cycle to mHealth: Understand, Develop and Enhance”. (No slides are available until the project is published.)

• CKS researched innovation for vaccine delivery in the state of Bihar for the Gates Foundation, including opportunities for mobile technology.
• Ethnographic research examined contextual issues at the organizational level (dissonance between the district, state and national level plans) and community level (traditional approaches to health and folk medicine).
• Cross functional teams worked in 5 districts, teaming solution designers with ethnographers.
• The field team recorded their ideas in a diary every day.
• 25 concepts for were grouped and presented to stakeholders and domain experts in a workshop for screening according to feasibility and potential impact.
• The process provides ongoing concept development and a routinization of the creative process.
• Concepts are summarized in a Concept Definition Template.
• The question was raised whether funders would be flexible or far-sighted enough to award funds to formative research. Technology companies recognize the importance of having designers on staff.

 Presentation by Janice Cunningham, Applied Innovation and Development Partners.  Janice spoke on the succeeding step supported by formative research, “Capturing mHealth Requirements: A Worksheet to Guide the Process.” (See attached slides and worksheet. A blank worksheet for general use will be made available on the mHealth Toolkit.)

• Requirements definition is an iterative framework to guide planning, trigger questions, and document and track the process.
• mDots was used as an example program illustrating the steps in requirements definition.
• The presentation and worksheet cover the steps: Goals & Objectives, Background, Scale, User Profiles,  Communication Patterns, and Operational Support.
• Functional User Needs translates needs into functionality. Functionality is not the same as IT solution, since various IT or non-IT solutions may provide a functionality.
• Use case scenarios provide the requirements for IT vendors.
• Members are welcome to use the requirements worksheet for development of other mHealth projects.

 Renaming the Working Group:

• Suggestions for a more succinct and representative name emphasized the following qualities of the group: international/global, strategic, non technological, mHealth for beginners/new adopters, implementation and practical rather than policy. 

 Recap of Conference on ICT for Education and Training, by James BonTempo, Jhpiego

• Mxit provided an interesting example of mobiles for education in South Africa.

http://www.thoughtleader.co.za/stevevosloo/2008/01/18/using-mxit-to-learn/ [119]

• Much of Conference focused on the educator as the end users, rather than the pupil.
• Educational management and information systems can track and organize mobile education.
• Conference discussion emphasized appropriate technology, but there is tension between appropriate and aspirational uses.

   Meeting Attendees July 13, 2010    NameOrganizationEmailGuy ChalkJHU/CCPgchalk@jhuccp.org [120]Aleya HornARHPaleyahorn@arhp.org [121]Nadja VielotPSInvielot@psi.org [122]Meredith PuleioIRH/Georgetownmp447@georgetown.edu [61]Ann Hendrix-JenkinsCORE Groupajenkins@coregroupdc.org [123]Angela Nash-MercadoJHU/CCP K4healthanashmc@jhuccp.org [124]Eric TylerPlaneric.tyler@planusa.org [125]Daniel AndersonBroad Reach Healthcaredanderson@brhc.com [111]Caytie DeckerABT Associatescaytie_decker@abtassoc.com [126]Aditya Dev SoodCKSaditya@cks.in [127]Emily BlynnMSHeblynn@msh.org [128]Adam SloteUSAIDaslote@usaid.gov [77]Laura RaneyFHIlraney@fhi.org [27]James BonTempoJhpiegojbuntempo@jhpiego.net [129]Janice CunninghamAIDPjanicecunningham@mac.com [130]             

We hope you can join us for the July meeting of the mHealth Working Group, hosted this month by John Snow, Inc. (JSI). The meeting will address coordination for mHealth.
Topic: Coordinating mHealth Within and Between Organizations in the Field
When: July 20th, Wednesday , 9:30 am – 11:30 am (Eastern US)
Location: John Snow, Inc. (JSI) 1616 N. Fort Myer Drive 12th Floor, Rosslyn, VA (directions below)Conference call: 888-651-5908, Participant Code: 757731
Agenda:
- Coordination for mHealth, by Michael Frost, Director, JSI Center for mHealth
- PEPFAR’s Health Informatics Public-Private Partnership, by Michael Gehron, incoming HIS Coordinator at OGAC, and John Novak, Office of HIV/AIDS at USAID
- Reflections on the Mobile Health Summit, by Margaret (Peggy) D'Adamo, USAID
- HUB Health Unbound website, by David Haddad, the mHealth Alliance

If you plan to attend or call, RSVP’s are appreciated by Kelly Keisling, keisling.kelly@gmail.com [28] or Laura Raney, lraney@fhi.org [27].

Directions:
The front of JSI’s building is on Fairfax Drive, although the address is N. Fort Myer. From the Metro take the Blue or Orange like, and get off at the Rosslyn Station. Walk up the stairs on the right rather than going out to the street. At the top of the stairs, make a left, you will be on N. Fort Myer Drive. Go 2 blocks; JSI is on the right.

Thanks for demonstrating your leadership in mHealth.
Kelly Keisling
Laura Raney
mHealth Working Group co-chairs

The mHealth Working Group, facilitated and coordinated by K4Health, is a collaborative forum for sharing and synthesizing knowledge on mHealth. The Working Group was created in 2009 with global health organizations to frame mobile technology within a larger global health strategy. By applying public health standards and practices to mHealth, we promote approaches that are appropriate, evidence-based, scalable and interoperable in resource-poor settings. The mHealth Working Group currently has over 400 members representing more than 150 organizations in 20 countries. The Working Group holds regular meetings in Washington, DC to discuss promising approaches, challenges and lessons learned. Meetings are hosted by member organizations, recently including the World Bank, FHI, PSI, USAID, MSH, AED and ARHP.
Minutes of past meetings and presentations are posted on the mHealth Toolkit at /toolkits/mhealth/mhealth-working-group-0. The Working Group has a moderated listserv for members to share announcements and discussions. You may sign up at http://my.ibpinitiative.org/mhealth [47].
 

March 16, 2012 mHealth Working Group Meeting
TOPICS: mHealth for behavior change communications and release of the mBCC Field Guide
PRESENTERS: Gael O'Sullivan, Abt Associates

WHEN: Friday, March 16th, 2012 from 9:30 - 11:30 am EST
WHERE: Abt Associates, 4550 Montgomery Avenue, Suite 800 North, Bethesda, MD
CALL-IN: US Toll Free: 1-888-232-0371 International Callers (not toll-free): 805-240-9832 Participant Code: 484046
You are welcome to view the comments on the mBCC Field Guide at http://www.mbccfieldguide.com [95].
Please RSVP if you are attending in person or remotely, directly to Kelly Keisling (keisling.kelly@gmail.com [28]) and Laura Raney (LRaney@fhi360.org [49]).
 
 
 
 

March 23, 2011
mHealth Working Group in Washington, DC.
Held at AED, 1875 Connecticut Ave. North Building, 8th Floor
March 23rd, 9:30 am -11:00 am (Eastern US)
 **Apologies for the technical difficulties with the call in numbers.  

• Upcoming Meetings
• Review of mLearning Literature & Discussion
• Mobile Health Information System (MHIS) by Holly Ladd, AED-SATELLIFE
• Mobiles for Quality Improvement (m4QI) by James Bon Tempo, Jhpiego, and Pamela Riley, Abt Associates
• Mobile Behavior Change Communication (mBCC) Field Guide by Shalu Umapathy, Abt Associates
• Potential Group Activities
  If you have any questions, please email the co-chairs of the mHealth Working Group, Kelly Keisling, keisling.kelly@gmail.com [28] and Laura Raney,  lraney@fhi.org [27] 
   

 
mHealth Working Group Meeting Notes
Wednesday, May 12th 2010, 9:00 AM – 11:30 AM (Eastern US)
Held at ARHP, Washington D.C
 
A big thanks to those that participated in the May 12th meeting of the mHealth Working Group. We discussed a guest presentation and the topic of mLearning. We also introduced a knowledge management toolkit for the Working Group’s resources.
 
The mHealth Toolkit was introduced as an online knowledge management platform for resources of the mHealth Working Group. The Toolkit is electronic reference library to organize and disseminate the knowledge shared at our meetings. Participants in the mHealth Working Group are invited to use and steer development of the mHealth Toolkit before its release. Modifications have been made to the Toolkit and your feedback is invited by June 8. Please include your comments on the site or contact me at kkeislin@jhuccp.org [55]. If you are a current member of the mHealth Working Group, you can access the mHealth Toolkit at www.k4health.com [151] before its launch. Simply login with your email address as login ID and the password “changeme”, then look for the mHealth Toolkit at the bottom of your account page. You can then add resources and comment on them by following the attached instructions. Organizations are invited to submit their own materials for selection in the mHealth Toolkit, so that their logos will be included in the public version of the Toolkit. Looking ahead to the coming public release of the mHealth Toolkit, this is an opportunity for the Working Group participants to support the appropriate adoption of mHealth throughout the developing world.
 
A presentation on Text4Health immunization reminders was given by Dr. Melissa Stockwell, an Assistant Professor of Clinical Pediatrics and Population and Family Health at Columbia University's College of Physicians and Surgeons and the Mailman School of Public Health. Dr. Stockwell discussed study of text reminders to improve adolescent immunization coverage. The study addressed a US Latino population, but addressed many universal issues such as language selection and cost effectiveness. See the attached slide for lessons learned in the Text4Health study. The full presentation cannot be disseminated while the study is in review for publication, but Dr. Stockwell is available to answer questions at mss2112@columbia.edu [152].
 
The Gates Foundation’s Grand Challenges Explorations was discussed at the meeting, and participants were encouraged to apply by May 19 for the grantto create low-cost cell phone-based applications for priority global health conditions. Participants commented on the difference between “best innovations” and “best, new innovations”, and well as the difference between innovations emphasizing health and those emphasizing information technology. The importance of interoperability was raised. Participants also questioned the definition of “low end” cell phones, such as whether Java-enable phones would be permissible. Comments framed the Grand Challenges Explorations as an opportunity to apply crossover applications for health programs, such as mBanking. The Grand Challenge was also mentioned as an opportunity for a collaborative joint proposal. 
 
mLearning was discussed as an mHealth area for new consideration by the Working Group. For the purposes of discussion, mLearning was defined as use of mobile technology to train health care providers- building the capacity of the provider rather than emphasizing of the capacity of the device or of remote experts, as with job aids or telemedicine (see attached slides). Participants reiterated that job aids and telemedicine might also be useful for training, but that learning only occurs if it is not merely rote dependence on the device. The precedence set by eLearning was addressed, but discussion emphasized the importance of not merely “cutting and pasting” trainings from another format into mobile devices. mLearning has different challenges and opportunities. The advantages and limitations of mLearning in reviewed literature was summarized. There was also discussion of the difference between self-directed learning vs. preset formats, and synchronous vs. asynchronous uses. The question was raised whether mLearning applications should be divided by type of device.
 
We are creating a technical group on mLearning. If you are interested in joining the subgroup to plan future efforts in mLearning, please express your interest to kkeislin@jhuccp.org [55]. You are also welcome to invite colleagues to receive the general announcements of the mHealth Working Group.
 
We appreciate the meeting space provided by the Association of Reproductive Health Professionals. They welcome feedback on their new initiative to provide an interactive maternal health mapping tool (see attachment).
 
For those of you that have not seen the announcement of the next mHealth Summit, see http://www.mhealthsummit.org/ [153].
 

 
May 12, 2010 Meeting Attendees In-Person
 
 

Name:

Organization:

E-mail:

Miguel Lara

Microhealth

Miguel@microhealth.org [154]

James Bontempo

Jhpiego

jbontempo@jhpiego.net [65]

Aleya Horn Kennedy

ARHP

ahorn@arhp.org [139]

Katie Powell

MSH

kpowell@msh.org [155]

Michael Rodriguez

JSI

mrodriguez@jsi.com [141]

Megan Noel

JSI

mnoel@jsi.com [156]

David Isaak

Six Blue Data

disaak@sixbluedata.com [109]

Robert Weierbach

mHealth Alliance

rweierbach@unfoundation.org [157]

Beth Robbins

ARHP

brobbins@arhp.org [158]

Mitali Thakor

Johns Hopkins SPH/ MIT

mitalithakor@gmail.com [159]

Luis Tam

Plan USA

Luis.Tam@planusa.org [160]

Laura Raney

FHI

lraney@fhi.org [27]

Meredith Puleio

IRH/Georgetown

Mp447@georgetown.edu [161]

Hillary Chen

OSTP

hchen@ostp.eop.gov [162]

Ann Hendrix-Jenkins

Core Group

ajenkins@coregroupdc.org [123]

Jeanne Koepsell

Save the Children

jkoepsell@savechildren.org [163]

Peggy D’Adamo

USAID

mdadamo@usaid.gov [80]

Philippe Lemay

K4Health

plemay@jhuccp.org [67]

Adam Slote

USAID

aslote@usaid.gov [77]

Organizational Strategy for mHealth
When: Tuesday May 22nd, 9:30 am -11:30 am EDT
Where: Save the Children, 2000 L Street NW, Suite 500
Call Info: In US or via skype: 1-866-386-4210 [165], International: 1-433-863-6601,
Conf. Code: 634 879 6591
AGENDA:
Organizational Strategy for mHealth, by Jeanne Koepsell, Save the Children
USAID/Bureau for Global Health Draft eHealth Strategic Framework, by Adam Slote, USAID Bureau for Global Health
WHO Bulletin articles on mHealth research and measurement, by Rebecca S. Levine, Save the Children/ MCHIP

 mHealth Working Group Meeting May 23rd: New Frontiers in Global Health: e/mHealth at the World Bank: Designs, Approaches and Emerging Trends
 
We hope you can join us for the May meeting of the mHealth Working Group. Hosted by the World Bank, this discussion on electronic and mobile health (e/mHealth) will bring provide an overview of the World Bank’s work in e/mHealth, highlighting the process of initiating projects (design, approaches and challenges), negotiating the scope, and implementation (capacity, technical needs, communications, relationship with IT, telecoms, other stakeholders, etc.). The first hour will be short presentations from the regional focal points of the World Bank (Africa, MENA, LAC, and ECA), followed by feedback, discussion, sharing and questions.
 
When: Monday, May 23rd, 10:00 am – noon (Eastern US)
Location: The World Bank, 1818 H Street, NW (Main Complex), Room 13-121 (directions below)
 
RSVP Required! Please contact Kelly Keisling, keisling.kelly@gmail [167] or Laura Raney, lraney@fhi.org [27]. In addition, please bring a photo ID. Refreshments will be served.
If you do not RSVP, be prepared to wait for security. We do not want you to miss any portion of the meeting!
Meeting Chair: Philippe Dongier, Manager, ICT Sector Unit
 
Presenters:

- Feng Zhao (Africa), Senior Health Specialist, Africa Region
 
- Akiko Maeda (MENA), Lead Health Specialist, Health, Nutrition and Population Network
 
- Zlatan Sabic, eHealth Consultant for Europe and Central Asia
 
- Fernando Montenegro-Torres, Senior Economist, Department of Human Development, Latin America and Caribbean Region (via VC from Guatemala)
- Carmen Carpio, Public Health Specialist, Latin America and Caribbean regional Health UnitDirections:
World Bank, 1818 H Street, NW, Washington, DC (Main Complex). By metro, 2 blocks from Farragut West (Orange line) or 3-4 blocks from Farragut North (Red line). The entrance is on 18th Street (intersection 18th and H Streets, just off Pennsylvania Ave.)
Thanks for demonstrating your leadership in mHealth.
Kelly Keisling
Laura Raney
mHealth Working Group co-chairs
 
The mHealth Working Group is a collaborative forum for sharing and synthesizing knowledge on mHealth. The Working Group was created in 2009 to frame mobile technology within a larger global health strategy. By applying public health standards and practices to mHealth, we promote approaches that are appropriate, evidence-based, scalable and interoperable in resource-poor settings. The mHealth Working Group currently has over 350 members representing more than 135 organizations in 20 countries. The Working Group holds regular meetings in Washington, DC to discuss promising approaches, challenges and lessons learned. Meetings are hosted by member organizations, recently including USAID, MSH, FHI, PSI, AED and ARHP.
The Working Group has a moderated listserv for members to share announcements and discussions. You may sign up at http://knowledge-gateway.org/mhealth [14]. Minutes of past meetings as well as the presentations are posted on the mHealth Toolkit at /toolkits/mhealth/mhealth-working-group-0 [84]

 
mHealth Working Group Meeting
Friday, November 18th, 2011, 9:30 - 11:30 am EDT
To be held at PAHO/WHO
 525 Twenty-third Street, N.W., Washington, DC  Room 1017
 
eHealth Strategy and Plan of Action for the Americas
Agenda
9:30     Opening and Group Introductions
  
10:10    eHealth Strategy and Plan of Action for the Americas and
eHealth for the immunization program by PAHO/WHO
Marcelo D’Agostino and Carolina Danovaro
 
10:40    Questions and Discussion with PAHO
 
11:10    The mHealth Toolkit, by K4Health
Kelly Keisling, Laura Raney
 
11:25    Closing Remarks and Networking
 
Where:
In person at PAHO/WHO 525 23rd ST NW Room 1017 -Washington DC 20037
Virtually in front of your personal or work computer anywhere in the world.
Please check the local time in your own town at  http://www.timeanddate.com/worldclock/meeting.html [169]
To Log in (To log in, simply type your name and organization) of participants at  
https://sas.elluminate.com/m.jnlp?sid=1110&password=M.A4FA308B5F1FA6CD60DB62C0137303 [170]

*** Translation into Spanish will be available
 
For more information, contact Lucia Ruggiero ruglucia@paho.org [171]
 
 

Information and Communication Technologies in the World of Small Enterprise Development
November 29, 2011, 9:00 AM – 12:30 PM
The Aspen Institute, 1 Dupont Circle, #700, Washington DC, 20036
ANDE, UNCTAD, and the mHealth Working Group are partnering to host a half-day meeting inWashington, DC centered on the role of information and communication technologies (ICTs) in private sector development. The event will feature highlights from UNCTAD’srecent report on the subject and a discussion with ANDE members and partners on the implications that these findings have for organizations working on small and growing business (SGB) development in developing markets.
9:00 AM - Welcome Remarks - Randall Kempner, Executive Director, ANDE
9:30 AM - Presentation of “ICTs in Private Sector Development” –Torbjörn Fredriksson, Chief, ICT Analysis Section, UNCTAD
10:00 AM-  ICTs and SGBs – Leveraging technology for small and growing business development
Panelists will discuss recent trends in the ICT field and their implication for SGBs and overall private sector development.

• Randall Kempner, Executive Director, ANDE (moderator)
• Xavier Faz, Senior Technology Advisor, Consultative Group to Assist the Poor (CGAP)
• Thao Nguyen, Newton Fellow and CEO Star Anise Foods
• Christine Phillpotts, Portfolio Manager, Grassroots Business Fund 

11:15 AM – mHealth and Private Enterprise Development
This panel will explore trends in mobile health technologies, opportunities and challenges for private sector development, and ways in which the private sector can be leveraged to promote local capacity and sustainability in mHealth. 

• Kelly Keisling, Co-Chair, the mHealth Working Group (moderator)
• Nate Barthel, Managing Editor, CodedinCountry.org
• James BonTempo, Thought Leader in ICT4D, Jhpiego
• Kristin Peterson, Co-founder & CEO, Inveneo

12:15 PM – Conclusion -Randall Kempner
 
Aspen Network of Development Entrepreneurs (ANDE):The Aspen Network of Development Entrepreneurs is a global network of organizations that propel entrepreneurship in emerging markets. The network's members provide critical financing and business support services to small and growing businesses that create significant economic, environmental, and social impacts in developing countries. 
United Nations Conference on Trade and Development (UNCTAD):UNCTAD promotes the development-friendly integration of developing countries into the world economy. As an authoritative knowledge-based institution, its work aims to help shape current policy debates and thinking on development, with a particular focus on ensuring that domestic policies and international action are mutually supportive in bringing about sustainable development.
 

Please join us Thursday, October 20th for the mHealth Working Group meeting from 9:30 am – 11:30 am at Jhpiego.  The topic of the open meeting is innovative methods for monitoring and evaluating mHealth projects.
When:  October 20th 9:30am – 11:30 am Eastern US
Theme: Innovative M&E of mHealth
Location: Jhpiego,  1776 Massachusetts Avenue, NW, Suite 300, Washington DC
Conference call at (202) 835-3159 (International) and (800) 835-3040 (US), ID 23147
Webcast available at: http://webcast.jhu.edu/mediasite/SilverlightPlayer/Default.aspx?peid=a21... [174]
 
Agenda:
 

• Mining the Data Exhaust: Extracting Behavior Change Evidence from Text Messages for Male Circumcision in Tanzania, by James BonTempo, Learning Technology Advisor, Jhpiego
• Embedding evaluation into mHealth activities: Challenges and Opportunities, by Dr. Kelly L'Engle, Scientist, Behavioral and Social Sciences, FHI 360
• Improved Response to Disasters and Outbreaks by Tracking Population Movements with Mobile Phone Network Data: A Post-Earthquake Geospatial Study in Haiti, by Dr. Richard Garfield, Schools of Nursing and Public Health, Columbia University

Please bring a photo ID to enter the building and please RSVP (in person or call-in) directly to either Kelly Keisling, keisling.kelly@gmail.com [28] or Laura Raney, lraney@fhi360.org [175].
 
Directions to Jhpiego
Jhpiego is located 2 blocks southeast of Dupont Circle, near the Dupont Circle metro stop on the red line.
 
About the mHealth Working Group
Founded in August 2009, the mHealth Working Group is a collaborative forum for sharing and synthesizing knowledge on mHealth, facilitated and supported by the K4Health Project.  Composed of more than 500 individuals representing over150 organizations worldwide, the mHealth Working Group seeks to frame mobile technology within a larger global health strategy. By applying public health standards and practices to mHealth, we promote approaches that are appropriate, evidence-based, interoperable, and scalable in resource-poor settings. The Working Group holds regular meetings in Washington, DC, to discuss promising approaches, challenges, and lessons learned.
 
Minutes from previous meetings, as well as more information about the group, are on the mHealth Toolkit at /toolkits/mhealth [99]. The mHealth Working Group is facilitated and supported by USAID’s K4Health Project. New participants are also welcome to receive future group announcements by joining the listserv at /toolkits/mhealth/mhealth-listserv [176].
 

 
mHealth Working Group Meeting Notes
Tuesday, October 26, 2010, 10:00 AM – 12:30 PM (Eastern US)
Held at Management Sciences for Health (MSH), Arlington, VA
 
 
Thank you to MSH for hosting this meeting. If your organization would like to host the next meeting, please contain either Kelly Keisling (kkeislin@jhuccp.org [55]) or Laura Raney (lraney@fhi.org [27]), mHealth Working Group co-chairs.
 
Meeting Discussion Items

• Summary of Technical Group meeting on mHealth Behavior Change Communication
• mHealth Toolkit Updates
• mHealth in Action in Malawi – program and technology
• HUB: Health Alliance Unbound
• mHealth Summit
• Renaming the Working Group

 
Notes and materials are available at:
/toolkits/mhealth/working-group-materials [90]
 
Summary of Technical Group meeting on mHealth Behavior Change Communication
 
Stephen Rahaim of Abt Associates summarized the meeting of our technical group on mHealth for behavior change communication (mBCC) which took place at Abt on October 12th. The objective of the group is to create a resource for BCC practitioners to apply mobile technology to BCC projects. The resource is also for those supporting projects in the field or home office as well as donors, as a way to think about how to integrate mBCC into program design or to be aware of the components. The 17 participants at the meeting discussed the structure, components and processes of an mBCC Field Guide. There was significant interest among participants in contributing. A web-based application will be used. A six month time frame was established for the creation and release of a first draft (beta version). The group will continue to discuss how to accept and incorporate comments from the larger mHealth and development community that would result in an mBCC Field Guide 1.0. A format and structure for the guide will be available in the next few weeks for contributions with content leaders who will filter and format the information. A separate listserv will be set up for the mBCC technical group. Please contact Kelly Keisling and Stephen Rahaim or Shalu Umapathy (kkeislin@jhuccp.org [55]; Stephen_Rahaim@abtassoc.com [96]; Shalu_Umapathy@abtassoc.com [178];) if you would like to be included. This group will report out periodically to the larger mHealth Working Group. Discussion on M&E followed, as well as data collection and HHIS.
 
mHealth Toolkit Updates
 
MSH is the tab champion for Data Collection and for Health Information Systems on the mHealth Toolkit (/toolkits/mhealth [99]). Natalie Campbell is the team leader and welcomes participation, contributions and/or feedback. 
 
FHI is the tab champion for the three topic tabs, HIV/AIDS, Reproductive Health/Family Planning, and Malaria as well as the tab on Events, Websites, Funding and Topics. Laura Raney is the team leader. Your contributions, participation and/or feedback would be most appreciated.
 
mHealth in Action in Malawi
 
Natalie Campbell of MSH and Josh Nesbit of FrontlineSMS:Medic each gave presentations about their work in Malawi. Natalie’s presentation, “Reaching Beyond the Grid: the K4Health Malawi Pilot”, discussed the challenge of supporting community health workers (CHWs) to deliver effective family planning and reproductive health (FP/RH) services. One component of the pilot project that MSH is piloting addresses their remote location, limited training and limited access to resources at the district and national level with mobile telephone networking using Frontline SMS in two districts. In addition to FrontlineSMS, MSH is partnering with the MOH, BASICS and other SMS network projects. Under the 13-month project, the SMS system consists of:
1.      SMS alert system (i.e., notification of community vaccination dates, trainings, etc.)
2.      Peer-to-peer-SMS network (ongoing support for CHWs; 100 in each of the districts)
3.      On-demand automated FP/RH info and tips (immediate info on dosages or other automated responses to FAQs)
A handout gave more information on how the system works and some results to date. The CHWs themselves asked for the pilot to be expanded to all CHWs in the districts, and made the case with examples of how it is having a huge impact on lives and money. Some examples: reporting drug stock outs so clients never miss their monthly supplies; report any side effects or difficult conditions and assist clients in time; get timely information about supervisory support visits; and avoid longer walks (30 km trip) to consult supervisors on difficult cases. Next steps: continue to track usage; continue training; increase use of key word messaging; explore expansion of program; and explore partnerships. For more information or questions, please contact Natalie Campbell, ncampbell@msh.org [179]
 
Josh Nesbit gave a presentation the work of FrontlineSMS:Medic, for which he is the Executive Director. The non-profit organization uses low-cost mobile technology to create connected, coordinated health systems that save more lives. Josh’s presentation included photos of community health workers with phones, the simple system that allows the connected health system (a laptop), a training sessions for health workers, examples of how the network, through SMS, assists with emergency care; patient tracking; training management; symptom monitoring; referrals; and stock levels. Throughout, the outputs in terms of time and money saved as well as number of clients reached, were shown. Josh then showed the countries where FrontlineSMS:Medic is working and FrontlineForms. Josh showed OpenMRS, an electronic medical records system designed for managing patient information in treatment programs (such as HIV or TB), as well as primary care. Then he showed PatientView, their new software for managing patient information anywhere there’s a mobile signal. PatientView has more limited features than OpenMRS and is much easier to use for minimally resourced projects. Josh showed a few screen shots of the Beta version of PatientView, which has just been released. TextForms and Resource Finder were also presented as are being used in Pakistan that allow mapping of the various health centers and hospitals along with key information on their capacity, services and availability. Josh also showed incident mapping as used in Haiti after the earthquake, an SMS-based emergency response system. The presentation also included current work on SMS capacity in local languages, and work on MMS and diagnostics, using a mobile phone. Using hardware that costs less than $10 and attaches to a mobile phone, this cell phone technology could enable doctors, or maybe anyone with a phone in the field, could use the system to make quick, cheap, and accurate assessments of diseases. See http://medicmobile.org/ [180] for more information about FrontlineSMS:Medic.
 
HUB: Health Alliance Unbound
 
Jessica Shull of the mHealth Alliance gave a presentation of the new HUB: Health Alliance Unbound (www.healthunbound.org [97]). HUB is a health information community – not just mHealth. Tabs feature: Action, Topics, Countries, Resources, Technology, Directory and Events. The site has many great features. Under resources, for example, you can find a list of projects and links to show how the project is connected to the rest of the community. You can also find research and reference material. Under Action, you can find Workspaces, including Evaluations Commons, which provides a discussion space, with the goal to “build a consensus around the various approaches and evaluation standards and metrics for mHealth Evaluations that can best serve this community’s needs.” Also check out the excellent calendar feature under Events. Jessica can be reached at jess.shull@gmail.com [138].
 
mHealth Summit
 
Taking place in Washington November 8-10, the group discussed how to share new information. In the end, it was decided to take good notes, highlight important issues, and share them. One was to set up a Google site with a rough table of contents for folks to do a data dump of interesting and new things they learn, with the idea of organizing it better later. Another is to mail notes to the co-chairs who will hash it out and summarize in a report to make available to the group. To reduce effort for participants, the co-chairs will simply send emails requesting comments on the most useful aspects of the Summit. The mHealth Working Group will be represented at the K4Health booth of the mHealth Summit.
 
Renaming the Working Group
Meeting attendees had a brief discussion about changing the name of the working group. Many options were put forward. However, the group voted unanimously on the namemHealth Working Group. With that, the meeting was adjourned.
 
 
Listserv members are invited to share announcements and materials with the listserv by sending them to mhealth@my.ibpinitiative.org [98].
 
If you would like to join the mHealth Working Group listserv, please go to http://knowledge-gateway.org/mhealth [14]

 
mHealth Working Group Meeting Notes
Wednesday, September 15th 2010, 10:00 AM – 12:30 PM (Eastern US)
Held at the Association of Reproductive Health Professionals, Washington D.C
 
 
Developments at the mHealth Working Group
The mHealth Working Group promotes collaboration and leadership in mHealth. In this spirit, we are announcing several examples of collaborative leadership by members. Management Sciences for Health (MSH) and Family Health International (FHI) will lead sections of the mHealth Toolkit. We are excited to have Laura Raney of FHI as the new co-chair of the mHealth Working Group. Laura is the co-chair of HIPNet, the Health Information and Publications Network. HIPNet is a USAID- fundedcollaboration among organizations that provide access to technical health information and innovative information technologies. We are also seeking interested partners for the mHealth Working Group and mHealth Toolkit as we expand to cover mHealth for health information systems. 
 
Management Sciences for Health (MSH) will host the next meeting of the mHealth Working Group on the morning of October 26th. MSH is located at 4301 N. Fairfax Drive, Arlington, VA.
 
Abt Associates will host the next meeting of our technical group on mHealth for behavior change communication (mBCC) at 10:00 am – 12:00 noon on October 12th. Preparations for the technical group were discussed, and level of evidence was suggested as an additional agenda item. Please find the draft mBCC Resource Kit Initiative at /toolkits/mhealth/2010-09-15-discussion-mbcc-resource-kit-initiative [182].
 
New methods for sharing information on mHealth were discussed. 

• News from the mHealth Working Group will be announced through our new listserv. Anyone interested is welcome to join the listserv at http://knowledge-gateway.org/mhealth [14]. Listserv members are also invited to share announcements and materials with the listserv by sending them to mhealth@my.ibpinitiative.org [98].  
• New materials are welcome for the mHealth Toolkit at www.k4health.org/toolkits/mhealth [99].
• To promote organizational access to information on mHealth, discussion covered the planned introduction of an eToolkits Window. The Window will allow you to link content from the mHealth Toolkit to your website. Employees can access the small window listing the most recent resources added to the toolkit of your choice. 

 
mHealth for Health Information Systems
 
Literature on mHealth for Health Information Systems (HIS) raises a number of practical opportunities and challenges, ranging from data customization to impact on workflow. At a more fundamental level, mHealth is vulnerable to a number of interoperability and standardization issues that can affect all HIS. These issues were raised in the August 18 conference call of our technical group on mHealth for HIS. Several groups are addressing health information systems and health information technology, such as WHO, HMN, and OpenMRS. The mHealth Alliance will also launch its HUB site soon.
 
A range of presenters were invited to examine the practical and overarching issues in HIS. For the September 15th meeting presentations and August 18th HIS conference call notes, please see /toolkits/mhealth/working-group-materials [90].
 
Thulani Mbatha of Management Sciences for Health presented on Using Cell Phones to Monitor Availability of Malaria Medicines. The pilots used EpiSurveyor to capture observational, survey and GPS data for supply chain management. The free software required little IT support. Updating and digitization of forms took one week and data collectors were trained in one day.  Challenges included a phone model that was chosen for its large screen and better keyboard feature, which had occasional difficulty obtaining GPS coordinates. Other challenges included limited internet connectivity for transferring data while still at the facility. It was recommended to upload later with internet connectivity. Data could be stored on the servers of the project or of Datadyne, the software producer. The Ministry of Health required that data be safeguarded with password protection. In the long run, it may be necessary for ministries to host data on their own servers.
 
Scott Ruddick of Mennonite Economic Development Associates presented on MEDA mHealth: Pakistan & Tanzania. The mobile system in Tanzania addresses bed net orders, shop signup, and net deliveries. Use of GPS mapping of data allows more efficient delivery routes for nets.
 
David Lubinski of PATH presented on Creating Stronger Health Systems Through Stronger Health Information Systems. The overview addressed the increasing complexity of HIS, and provided an approach for solution development. David emphasized the important role that health experts have in determining requirements. A report on the topic will be released soon, and feedback will be sought. Discussion raised the point that technology can make problems more visible, but technology, itself, often cannot solve the problem. Solving an identified problem requires human response and coordination. Furthermore, any health information system that does not lead to action will be abandoned for lack of use.
 
Current Developments and Events in mHealth
 
The mHealth Alliance recently launched its glossary, which can be found at
http://www.mhealthalliance.org/media_center/glossary-terms [183]
 
Events on mHealth can be found at /toolkits/mhealth/events-mhealth [184]. Members of the listserv for the mHealth Working Group are welcome to share event announcements at mhealth@my.ibpinitiative.org [98].
 
 
Lost & Found
 
A green notebook was left at the meeting. If you wish to reclaim it, please contact kkeislin@jhuccp.org [55].
 

 mHealth Working Group meeting
September 27, 9:30 am – 11:30 am
USAID Mezzanine Information Center (Library)
 
 
Agenda
 
Introduction – Margaret (Peggy) D’Adamo, USAID

Panel presentation on Mobile Alliance for Maternal Action (MAMA)  
Sandhya Rao, Senior Advisor for Private Sector Partnerships, USAID/GH/HIDN (Office of Health, Infectious Diseases and Nutrition)
Pamela Riley, Senior mHealth Advisor of SHOPS Project (Strengthening Health Outcomes through the Private Sector), Abt Associates
Cat Meurn, Program Associate, the Maternal and Newborn mHealth Initiative, mHealth Alliance
Health Unbound (HUB) – Soma Ghoshal, HUB Community Manager the mHealth Alliance
Review of the National mHealth Strategy Workshop in Tanzania - Jon Tigges, mHealth Initiative Program Manager,  Deloitte Consulting
 
 
Coffee and pastries available at 8:45
Web conferencing (via Adobe Connect): https://connect.johnshopkins.edu/mhealthwgmtg/ [186] and sign-in as guest. 
Dial-in number: 888-651-5908, Participant Code: 489386 (US only, international calls by Skype)
 

mHealth Working Group
Founded in August 2009, the mHealth Working Group is a collaborative forum for sharing and synthesizing knowledge on mHealth, facilitated and supported by the K4Health Project.
 
Composed of more than 500 individuals representing over 150 organizations worldwide, the mHealth Working Group seeks to frame mobile technology within a larger global health strategy. By applying public health standards and practices to mHealth, we promote approaches that are appropriate, evidence-based, interoperable, and scalable in resource-poor settings. The Working Group holds regular meetings in Washington, DC, to discuss promising approaches, challenges, and lessons learned.
 
Minutes from previous meetings, as well as more information about the group, are on the mHealth Toolkit at  /toolkits/mhealth [99]. New participants are also welcome to receive future group announcements by joining the listserv at www.k4health.org/toolkits/mhealth/mhealth-listserv [176].  
 
If you would like to host a future meeting, please contact either Kelly Keisling (keisling.kelly@gmail.com [187]) or Laura Raney (lraney@fhi360.org [175]), mHealth Working Group co-chairs.

 
Interagency Working Group for mHealth Integration
September 9, 2009 Meeting Notes
 
Agenda and Discussion Items
1. Synthesizing and framing information on mHealth
A variety of mHealth information sources and organizations are available. Synthesizing and framing available information can support development of public health standards in mHealth. It is important to avoid redundancy and add value by emphasizing public health standards to complement technology standards.
 
There were various comments on the differences between public health standards and technology standards for mHealth. It is often difficult to translate public health needs into ITC language. The technology standards of mHealth solutions are often “easier” or better defined than the cultural and subjective issues on which a projects depend. For example, introducing unfamiliar types of phones may cause social disruption, or the reliability of electricity can affect designs. Defining these user requirements can support selection of an appropriate technology solution. These issues can be addressed by business process analysis.
 
Guest speaker, Dr. Neal Lesh, compared a mHealth application to a “hammer in search of a nail”. Now that the hammer has been built, it is necessary to identify the right nail by integrating technology with health systems.
 
One way to synthesize and frame mHealth projects is to place them within the matrix of program categories and issues that was requested in the August 6 meeting. (See the September 9 Working Group presentation slides for the example contributed by the Institute for Reproductive Health, Georgetown University.)
 
2. Online knowledge management and collaboration
Online forums can increase productivity between meetings, facilitate collaboration, and invite broader participation. An online toolkit will also organize information by category and by issue. The toolkit’s organization and content will be determined by input from the Working Group.
 
Participants suggested that the digital library movement can provide useful examples. Maintaining member activity and member profiles are also important. There was a request for prioritizing online collaboration ahead of later toolkit functions.
 
3. Presentation on CommCare by Dr. Neal Lesh of D-tree International, Dimagi
CommCare is a mHealth program and application that supports and monitors the case management of community health workers to reduce neonatal mortality.
 
Based on Neal’s experience with CommCare and related programs, he offered five cautionary suggestions:
1. Open sourcing is complex:  it carries costs, challenges to tech support, requirements to “get by giving”, and opportunities for local ownership.
2. Design under the mango tree: participation by local users in the design process reduces the mistaken assumptions that can undermine mHealth programs.
3. Don’t automate broken systems. mHealth is a specific tool rather than a panacea for broken health systems. Process maps can help specify which parts of a system can be automated by phone.
4. Beware of unused data: less is more when designing data requirements for users.
5. Building local capacity:  capacity building takes time but creates opportunities for local innovation. Software could be labeled as “Coded in Country”, akin to a fair trade certification.
 
The importance of collaborative design was mentioned by Neal and attendees. The electronic forms and uses of the data should be discussed with users in the field.  Agreement on the ownership/accountability of an application is crucial, as well as agreement on the timeline for its development.  Collaboration can establish universal systems to prevent redundancy. Otherwise, a dozen programs with a dozen reporting systems could require a dozen different types of phones. However, it is important that universal tools not become “cookie-cutter”, since some aspects may have to be adapted to local needs. A mHealth “code of conduct” could support responsible efforts. Orderly development of mHealth systems requires country-level coordination, and ministries of health can play an important role.
 
Other comments by Neal and attendees covered the technical training that accompanies an application. Also, emphasis on program indicators can focus the development process. Most programs using parallel systems of transferring data by phones and paper. CommCare provides phones to community health workers but does not limit their personal use of phones. A question was raised whether mHealth generates enough return on investment in underserved areas.
 
Neal has played an active role in the OpenROSA Constortium with Cell Life, Makarere, DataDyne, SSI, UW, D-Tree, and Dimagi. They have created JavaRosa open source software for low-end phones.
 
4. Prioritizing issues, program categories and related subgroups
Prioritizing mHealth topics can define a starting point for knowledge sharing and collaboration within the Working Group. Participants voted to choose a program category and an issue to be addressed by subgroups. A later announcement will explain vote results and opportunities for participation in subgroups.
 
5. Preparation for  mHealth Summit
Future announcements will address the mHealth Summit on October 29-30. Participants are encouraged to express their expectations and needs for the Summit.

 
September 9 Meeting Participants
 

Eddie Kariisa

Abt Associates

Eddie_Kariisa@Abtassoc.com [189]

Daniel Anderson 

BroadReach Healthcare

danderson@brhc.com [111]

Kelly Keisling

Center for Communication Programs, Johns Hopkins U

kkeislin@jhuccp.org [55]

Neal Lesh

D-Tree International

neal@equalarea.com
[190]

Meegan McVay

Elizabeth Glaser Pediatric AIDS Foundation

mmcvay@pedaids.org [76]

Jill Mathis

Elizabeth Glaser Pediatric AIDS Foundation

Jmathis@pedaids.org [191]

Laura Raney

Family Health International

lraney@fhi.org [27]

Phil Rogers

Family Health International

progers@fhi.org [192]

David Cantor

ICF Macro

dccantor@gmail.com [60]

Meredith Puleio

Institute for Reproductive Health, Georgetown U.

mp447@georgetown.edu [61]

Victoria Jennings

Institute for Reproductive Health, Georgetown U.

jenningv@georgetown.edu [62]

Janna McDougall

International Center for Research on Women

jmcdougall@icrw.org [63]

James BonTempo

Jhpiego

jbontempo@jhpiego.net [65]

Adriana Andrade

Jhpiego/Johns Hopkins U.

aandrade@jhmi.edu [193]

Natalie Campbell

Management Sciences for Health

ncampbell@msh.org [179]

Charlotte Colvin

PATH

 ccolvin@path.org [194]

Mariah Preston

Population Services International

mpreston@psi.org [74]

David Isaak

SixBlue Data

disaak@sixbluedata.com [109]

Adam Slote

USAID

aslote@usaid.gov [77]

Mihira Karra

USAID

mkarra@usaid.gov [78]

Peggy D'Adamo

USAID

mdadamo@usaid.gov [80]

Patricia Flanagan

USAID

pflanagan@usaid.gov [79]

Given that privacy of the doctor-patient relationship is at the heart of good health care, and that the electronic health record (EHR) is at the heart of good eHealth practice, the question arises: Is privacy legislation at the heart of the EHR? The second global survey on eHealth conducted by the Global Observatory for eHealth (GOe) set out to answer that question by investigating the extent to which the legal frameworks in the Member States of the World Health Organization (WHO) address the need to protect patient privacy in EHRs as health care systems move towards leveraging the power of EHRs to deliver safer, more efficient, and more accessible health care. (Excerpt)