A call from the heart: mobile phones for health

Doctors in the developed world have access to a wide range of technological devices to help them diagnose and treat conditions such as high blood pressure. These are expensive and unavailable to health workers struggling to manage the burden of chronic disease in low-income countries. But now Professor Lionel Tarassenko and Dr Gari Clifford in the Oxford Institute of Biomedical Engineering (IBME) have hit on a way of exploiting a sophisticated piece of technology that is becoming ubiquitous – the 'smart' mobile phone – to provide cheap but effective tools for health surveillance and treatment.

Dr Clifford's students won the 2011 Engineering World Health award for the group's blood pressure monitoring device, a standard inflatable cuff attached to a small box containing cheap electronic sensors, which in turn plugs into a mobile phone via a USB port. 'The device costs between $5 and $10', says Dr Clifford. 'It connects dumb sensors with an intelligent phone; it needs no batteries, as it draws energy from the phone, and users are happy to keep their phones charged.'

IMBE researchers have previously designed mobile phone apps that enable local health workers to input health data and receive advice on managing patients, an approach known as m-health. Following a trial of this model of cardiovascular care in South Africa, Arvind Raghu, a student from Dr Clifford's group, is providing the technological input to a new study in the Indian province of Andhra Pradesh. The study is led by Dr Pallab Maulik, Dr Kazem Rahimi and Professor Stephen MacMahon from the George Centre for Healthcare Innovation, which opened in Oxford in 2010. 'Affordable health technologies are one of our main research priorities', says Professor Robyn Norton, Co-Director of the Centre, which is jointly funded by the Oxford Martin School and The George Institute for Global Health in Sydney, Australia.

The study is a randomised trial of the effectiveness of giving mobile-phone based systems to ASHAs (accredited social health activists) in 50 villages in Andhra Pradesh, and connecting their measurements to the national health records system. The George Institute's previous research in rural India suggests that 1 in 4 adults has high blood pressure, which leads to serious medical conditions including stroke, and that few are receiving treatment to keep it under control. The three-year study will evaluate whether using the technology helps to ensure that better management reaches the people who need it.

Meanwhile the IBME researchers have numerous other low-cost devices under development, targeted at conditions including rheumatic heart disease, breathing problems in premature babies, sleep apnoea and even mental health. Dr Clifford is also working with The George Institute in China and one of China's largest mobile phone providers to apply m-health to the problem of chronic disease in its vast population. 'Mobile phones have created an international standard communications pathway', he says. 'It's the way you exchange health data, as well as the way you store it, that matters.'