IAS 2017: Hold the phone — mobile “health wallet” could make prevention, care, and treatment cheaper, better, and accessible

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Science Speaks this week continues coverage of the July 23-26 9th IAS Conference on HIV Science.

Paris – Anyone here have their phone turned off?

Millicent Olulo asked that question before she started her presentation in a first day session here on mobile technologies and health, and was answered with predictable laughter. Does anyone turn their phone off anymore, or, for that matter take their eyes off it for long?

Other presentations during the session by then had showcased technologies, from text reminders to pills with ingestable microchips, that could improve and monitor treatment adherence.

According to Olulo, a cheap mobile phone can do more than that to revolutionize health care — cutting costs, improving quality, and increasing efficiency as well as access. All of that, she said, could come just by modernizing the way money to pay for health services and commodities changes hands.

The technology needed to do that was not only in the hands of everyone in the audience that day, but in an established — at least — 85 percent of people in Kenya, likely more (whether or not the statistic, already floated during the session, that more people own cell phones than toothbrushes, is verifiable).

Olulo knows this because Kenya (along with Tanzania) is home to M-Pesa — M for mobile, pesa the Swahili word for money — a ten-year-old mobile phone-based banking system now used by 85 percent of Kenya’s population, and responsible for 66 percent of electronic payments in the country. It works on any phone — important in a country where fewer than half the people who live there enjoy the luxury of a smart phone and its apps — speeds transactions, and has made banking services accessible to rural, remote, low-income and sick people for whom those services had previously been out of reach.

Based on all M-Pesa’s methods, aims and results, PharmAccess, the foundation Olulo works with, launched MTiba — M still for mobile, tiba, the Swahili word for treatment — in 2015 across five low-income Kenya neighborhoods, as a platform for saving, receiving, sending, and spending money and benefits  for health services. As of this July, 370 clinics in Nairobi and Kenya’s Central region use the system and link patients to it. Using funding for treatment provided by pharmaceutical companies, and other cell service providers, it could be expanded across Africa, Olulo said.

Aside from streamlining payments, and better ensuring they go where intended, use of the system has produced an unprecedented span of information on a patient level, Olulo said, allowing analysis of the data to “chart a patient’s journey from diagnosis to treatment to adherence to outcomes.” The system also provides data on testing and treatment access and uptake that can then be added to demographic health survey reports. In addition, the digital exchange of money for commodities eases the work of tracking supply chains and averting stockouts.

So she said, while she is glad to see the embrace of technology evidenced in an audience of people who don’t turn off their phones, it’s the willingness to do things differently in order to do them better that offers the most promise.

“People get excited about what new tool they’re using,” Olulo said. “But the question is not what tool, but what problem are you solving?”

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