Technology has great potential for improving maternal and child health, reducing the number of preventable deaths, and diagnosing and treating the diseases of poverty such as HIV/AIDS, malaria, and tuberculosis.

For decades, however, applying information and communication technology to address the world’s critical health problems has left much to be desired.

Proprietary legacy systems that do not communicate with other proprietary legacy systems and incompatible standards have not served global public interests.

These largely computer-based solutions are being challenged now by the overwhelming consensus that open standards at a minimum, and open source applications in an ideal world, are needed to fully appreciate all that technology has to offer the global public health community. Likewise, health ministries and NGOs the world over are realizing that mobile technology plays a critical role in public health services in developing countries.

Open source for health is important for the following reasons. Similar to principles inherent to public health, open source code is free (as in 'libre'); it can be modified, improved, and redistributed by any organization; it is part of a collective commons that can be built upon even if the original organization or company discontinues work, and it is often the collective work of many for a greater good that involves critical review by other programmers in a larger community.

These characteristics pose a powerful opportunity for developing countries to shift their focus to capacity building for customized solutions to national public health challenges and cultural nuances.

I have observed an overwhelming desire by Ministries of Health throughout the world to explore m-health applications using mobile technology to capitalize on the widespread availability and use of mobile phones and broadband infrastructure. There is also an increasing number of m-health open source software solutions, many of which are part of the Open Mobile Consortium (OMC).

Mobile technology, leveraged well, has the potential to increase access to health services and information, improve health outcomes, create efficiencies and cost-savings, and to engage citizens as active participants in their health.

As a public health specialist, my challenge is making sense of all of the tools that are now at my disposal. Each of them is at varying stages of development with the ability to be easily used by non-computer scientists- such as myself. For me, the OMC is a welcome contribution towards scalable and sustainable m-health systems.

Its work to minimize redundant programming, build functionality so that applications talk to each other, and advance user-focused design and documentation so that non-techies can download and use one or more tools within a toolkit, is already having a transformative effect on the work I do.

For example, in the Millennium Villages Project we are building an end-to-end solution that combines CommCare, RapidSMS, and OpenMRS to provide decision support at the point-of-care, capture patient information, manage workflow and provide alerts to community health workers and patients. T

he OMC is helping to close the loop and package such applications with the ability for customization for use by other NGOs and governments.

We are almost at a stage where we face no longer a technology problem, but one of making well-informed strategic decisions about what tool or set of tools can best be used to improve public health and well-being for all.

Below are some references that have helped me to articulate and frame my thoughts on this issue:
1. Reidpath, D.D., & Allotey, P. (2009). Opening up public health: A strategy for information and communication technology to support population health. The Lancet. 373, 1050-1051.
2. M-Health: Emerging Mobile Health Systems, Edited by R. Istepanian, S. Laxminarayan, and C. S. Pattichis. (2006). 624 p. 182 illus. 0-387-26558-9. Berlin: Springer, 2006.
3. Parry, D., Parry, E., Dorji, P., Dorji, J., Stone, P. Open Source Software: A Key Component of E-Health in developing countries. International Journal of Healthcare Information Systems and Informatics. 3:3, 1-15
4. Saran, C. Open source system helps health workers plan vaccinations in Africa. Computer Weekly; Apr 15, 2008; ProQuest Computing pg. 12
5. Iluyemi, A., Fitch, C., Parry, D., & Briggs, J. (2007). Health information system for community-based health workers: A case for mobile and wireless technologies. Paper presented at the IST-Africa, Maputo Mozambique.
6. Raento, M., Oulasvirta, A., Petit, R., & Toivonen, H. (2005). ContextPhone: A prototyping platform for context-aware mobile applications. Pervasive Computing, IEEE. 4:2, 51-59.
7. Allen,C., Biondich, P.G., Fraser, H., Jazayeri,D., Mamlin, B.W., Miranda, J., Tierney, W.M., and Wolfe, B.A. (2006). Cooking Up An Open Source EMR For Developing Countries: OpenMRS – A Recipe For Successful Collaboration. AMIA Annu Symp Proc. 2006, 529–533.

Many thanks to Hima Batavia for her help in gathering the background materials for this blog post.