One of the great advances in making patient medical information mobile was the fax machine. Hospitals first starting installing them to fax and receive lab orders and results - no more waiting for a human courier to do the job. When I was running a cardiology group some 12 years ago, the physicians, all community based, put fax machines in their homes so that the ER could fax the EKG over, allowing the physician to initiate treatment before they left their house. 

Today it's the cellphone that has emerged as the platform for portable, inexpensive data transmission. In Tono, Japan, a rural village miles from a hospital with a maternity service, a cellphone is being used to transmit fetal monitor readouts, while the patient, midwife and obstetrician can converse and see each other using internet telephony. It doesn't take much to envision existing technology and new applications routinely sending BP, diabetic monitoring and other patient monitoring data to physicians.

In February, the international mobile phone association GSMA announced that they had joined with the U.S. government to fight HIV/AIDS and other health challenges in 10 African countries. Named "Phones for Health", the project is a $10 million public-private partnership bringing together the industry with Ministries of Health, global health organizations, and other partners to use the widespread and increasing mobile phone coverage in the developing world to strengthen health systems. For example, cellphone service currently covers approximatley 60 percent of Africa, and coverage is projected to rise to 85 percent by 2010. "Health workers will also be able to use the system to order medicine, send alerts, download treatment guidelines, training materials and access other appropriate information," said Paul Meyer, Chairman of Voxiva, the company that has designed the software. "Managers at the regional and national level can access information in real-time via a web based database."

Cell phone based services have already seen success in Rawanda - that's right, Rawanda - in tackling HIV/AIDS and other diseases. Dr. Agnes Binagwaho, Executive Secretary, Rwanda's National AIDS Control Commission, said in the GSMA press release, 

Rwanda is the first country in Africa with a national-scale, real-time information system to manage its HIV and AIDS programme. We believe this can be a model for scaling up HIV and AIDS programmes across Africa and can be extended to TB, malaria and other diseases.

"The explosive spread of mobile phone networks across the developing world has created a unique opportunity to significantly transform how countries can tackle global health challenges," said Dr. Howard Zucker, Assistant Director-General of the World Health Organization (WHO), representing the WHO at the Partnership's launch at the 3GSM World Congress in Barcelona. Using existing technology and a mix and existing and new applications, the cell phone can become another tool to capture key measures of health conditions and transmit these to physicians. The promise of electronic health systems is the ability to manage and present data in a systematized format that is a valued tool for decision making by physicians.

This is not boosterism by someone with vested interests - this is seeing that the only way to effectively manage data in an effective and efficient way for the benefit of patients is information technology. The time is now - and we are seeing new companies and old jumping in, this time with an understanding of the realities of caring for real patients.