Over the past years, the number of mobile phone subscribers in China has been increasing at an exponential rate. By the end of 2015, there was approximately 202.47 million cell phones produced in China1 along with 1,033.6 million mobile users registered in China, with the number of users expected to grow to 1,086.8 by 2019.
This is an opportunity for the Chinese healthcare system to provide mobile health (mHealth); a service that includes communicating and/or informing patients or their family members via mobile phones, patient monitoring devices, personal digital assistants (PDAs) and other wireless devices about health related issues/topics. Additionally, mHealth offers distinct opportunities to monitor a patient’s progress, receive personalized messages and support, collect ecologically valid data and much more.
Globally, mHealth systems have been implemented and utilized throughout various countries. The World Health Organization (WHO) conducted a global survey consisting of 114 nations and found that many countries have incorporated mHealth initiatives1. Table 1 conveys the most utilized mHealth services on a global scale.
Table 1: mHealth services utilized as a percentage.
| mHealth service | Percentage |
| Health call centres (respond to injuries) | 38% |
| SMS appointment reminders | 25% |
| Using telemedicine | 18% |
| Accessing patient records | 18% |
| Measuring treatment compliance | 17% |
| Raising health awareness | 10% |
| Monitoring patients | 8% |
| Physician decision support | 6% |
A recent report predicts that Europe and the Asia-Pacific will have the largest markets, followed by North America – with Latin America and Africa having the smallest markets. Furthermore, within the Asia region, China and Japan will account for the largest percentage of the mHealth market – 37% and 21% respectively.
From the data gathered, SMS appointment reminders and raising health awareness are two of the most utilized mHealth services. Mobile phones/enabled devices are able to assist patients and physicians by providing ways to deliver medical reminders and diagnostic information through digital technology. For instance, patients who forget to take or do not take their medication at the prescribed time or dosage can ultimately affect their treatment. The use of text messaging or voicemails, reminds patients when to take their medicines and advise them of the correct dosage. This improves the efficacy of drug therapies and may reduce the risk of further serious illnesses in the future.
This was evident in a study conducted in Australia, by The George Institute (TGI) – TEXT ME – which helps promote behaviour change and reduce cardiac risk in patients with coronary heart disease through a simple text messaging reminder system. The study found that the group who received the text messages were nearly 2.4 times as likely to exercise, 44% of patients more likely to control their blood pressure and 33% more likely to quit smoking.
Further to reducing risk of added illnesses, mHealth improves administrative efficiency by streamlining medical processes and reducing errors. Similarly, utilizing digital technology within China, can increase and improve accuracy when prescribing medicines/medical treatment. Doctors who are able to prescribe medication electronically, saves money by cutting error rates and can increase the number of patients seen.
Patients and physicians are able to benefit off video chats and conferencing. Those who reside within rural areas in China or a long distance from medical facilities may still be able to draw on the expertise of health providers, gain access to health care and receive early stage diagnosis and treatment that can ward off further costly illnesses. Similarly, TGI has conducted a study in India – SMARTHealth – a technology based primary care ecosystem that harnesses mHealth to provide high quality healthcare by a low cost re-engineered workforce. The primary outcome of the study is to determine whether the application of a mobile based system in rural areas will reduce death, disability and catastrophic healthcare expenditure. The study’s methods and results may have some application in China.
Conclusion
With the world’s largest and fastest growing mobile user population and a wide range of mobile needs and habits – China is in a unique position for a potential mHealth revolution. The mHealth initiatives TGI have implemented have seen significant results, which has improved the quality of lives of patients in rural communities and given them access to high quality healthcare. By leveraging the digital telecommunications system and the widespread use of smartphones, mobile phones, tablets and IT groundwork already in place, mHealth can bring high quality healthcare efficiently and effectively with reduced costs.
