ISO/TR 19231:2014

TECHNICAL ISO/TR
REPORT 19231
First edition
2014-11-15
Health informatics — Survey of
mHealth projects in low and middle
income countries (LMIC)
Informatique de santé — Étude de projets de santé mobile dans les
pays à revenu bas et moyen
Reference number
©
ISO 2014
© ISO 2014
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ii © ISO 2014 – All rights reserved

Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Symbols and abbreviated terms . 2
5 mHealth survey around the world . 3
5.1 Africa. 3
5.2 Asia . 4
5.3 South America . 6
6 mHealth use cases in LMIC . 7
6.1 Education and awareness . 7
6.2 Remote data collection . 7
6.3 Remote monitoring . 8
6.4 Communication and training for healthcare workers . 8
6.5 Disease and epidemic outbreak tracking . 8
6.6 Diagnostics and treatment support . 9
6.7 Sharing a medical image annotated with a region of interest . 9
7 Interoperable mHealth frameworks survey for LMIC . 9
7.1 ISO 14639 (all parts). 9
7.2 SA (Standards Australia) Handbook 137, 138 .10
7.3 HL7 Services-Aware Interoperability Framework (SAIF).11
7.4 HISA (Health Informatics Service Architecture) ISO 12967 .11
Bibliography .13
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
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The procedures used to develop this document and those intended for its further maintenance are
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different types of ISO documents should be noted. This document was drafted in accordance with the
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Attention is drawn to the possibility that some of the elements of this document may be the subject of
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to Trade (TBT), see the following URL: Foreword — Supplementary information.
The committee responsible for this document is ISO/TC 215, Health Informatics.
iv © ISO 2014 – All rights reserved

Introduction
Mobile Health (mHealth) is a hot topic in the health information technology (IT) industry because it can
make a big difference in healthcare services. The United Nations (UN) and World Health Organization
(WHO) are interested in mHealth technology to help overcome the current low quality healthcare
services in low and middle income countries (LMIC).
The UN describes use cases that are applicable to mHealth in LMIC: Education and Awareness; Remote
Data Collection; Remote Monitoring; Communication and Training for Healthcare Workers; Disease and
Epidemic Outbreak Tracking; and Diagnostics and Treatment Support. WHO also describes use cases:
Health call centres/Healthcare telephone help line; Emergency toll-free telephone services; Treatment
compliance; Appointment reminders; Community mobilization and health promotion; Raising
awareness; Mobile telemedicine; Public health emergencies; Health surveys and surveillance; Patient
monitoring; Information Initiatives; Decision support systems; and Patient records. For more use cases,
see References [1] and [2].
There are several eHealth frameworks already developed by a number of organizations such as
Health Level Seven (HL7), ISO/TC215, CEN/TC251, and Standards Australia (SA). Before suggesting
an interoperable mHealth framework, currently available eHealth frameworks are surveyed and
investigated to recognize how suitable each eHealth framework is for mHealth.
TECHNICAL REPORT ISO/TR 19231:2014(E)
Health informatics — Survey of mHealth projects in low
and middle income countries (LMIC)
1 Scope
This Technical Report surveys ongoing national mHealth projects in LMIC, to which some emerging
technologies such as zero configuration and proximity computing are applicable, especially when the
information and communication technology (ICT) infrastructure is not established in those countries.
The scope is constrained to mHealth use cases and technologies for information and communication
infrastructures that are useful for LMICs. In addition, the purpose of this Technical Report is to survey
not only national mHealth projects in LMICs, but also possible mHealth frameworks that might be used.
2 Normative references
There are no normative references in this document.
3 Terms and definitions
For the purposes of this document, the following terms and definitions apply.
3.1
clinician
health professional who delivers health services directly to a patient/client
3.2
patient
individual person that is a subject of care
3.3
HIV/AIDS
human immunodeficiency virus infection
acquired immunodeficiency syndrome
disease of the human immune immunodeficiency virus
3.4
SIM card
subscriber identity module
subscriber identification module
(SIM)
integrated circuit that securely stores the international mobile subscriber identity (IMSI) and the
related key used to identify and authenticate subscribers on mobile telephony devices (such as mobile
phones and computers)
3.5
infrastructure
basic physical and organizational structures needed for the operation of a society or enterprise, or the
services and facilities necessary for an economy to function
3.6
confidentiality
property that information is not made available or disclosed to unauthorised individuals, entities, or
processes
[SOURCE: ISO 7498-2:1989]
3.7
standard
document, established by consensus and approved by a recognised body that provides, for common and
repeated use, rules, guidelines or characteristics for activities or their results, aimed at achievement of
the optimum degree of order in a given context
[SOURCE: ISO/IEC Guide 2:2004]
3.8
solution
successful resolution to a medical problem
3.9
service
ability of a system to provide a set of output information based on a defined set of input information
[SOURCE: ISO 12967-1:2009]
3.10
healthcare
activities, services, or supplies related to the health of an individual
3.11
healthcare worker
healthcare professional involved in the direct provision of healthcare
3.12
organization
unique framework of authority within which a person or persons act, or are designated to act,
towards some purpose
[SOURCE: ISO 6523-1:1998]
3.13
subject of care
person scheduled to receive, receiving, or having healthcare
[SOURCE: ISO/EN 13606-1:2008]
3.14
use case
textual and graphical depiction of the actors and operations that address information exchange in the
context of a set of specific tasks performed by different systems or devices
4 Symbols and abbreviated terms
mHealth Mobile Health
LMIC Low and Middle Income Countries
SMS Short Message Services
PDA Personal Digital Assistant
2 © ISO 2014 – All rights reserved

UHI Universal Health Identifier Service
NASH National Authentication Service for Health
NPC National Product Catalogue
CADA Chinese Aged Diabetic Assistant
AESSIMS Acute Encephalitis Syndrome Surveillance Information System
SARS Severe Acute Respiratory Syndrome
TCD Trinity College Dublin
ATNF Apollo Telemedicine Networking Foundation
5 mHealth survey around the world
Mobile devices have been reaching more people in many developing countries than power grids, road
systems, water works, or fibre optic networks. Mobile services offer a way for the public and private
sectors to reach these communities, and one of the most important spheres for this interactive contact
[3]
is health. As a result, this report survey mHealth projects which are conducted nationwide around the
world. Furthermore, several use cases of mHealth are illustrated in the next chapter in order to classify
the possible mHealth services.
5.1 Africa
5.1.1 Project: Masiluleke
Country: South Africa
Participants: Pop! Tech Accelerator, Parakeet Foundation, iTeach, frog design, MTN, Nokia-Siemens
Networks, National AIDS Helpline, National Geographic Society, Ghetto Ruff Records, Children of South
African Legacies, Aricent
Application Area: Education and Awareness
Description: Project Masiluleke was proposed and this project is in progress to harness the power of
mobile technology as a high-impact, low-cost tool in the fight against HIV/AIDS. The project provides
a suite of interventions targeting the entire HIV/AIDS care continuum under the guidance of an
international, multidisciplinary team. The project contributes to HIV/AIDS care by promoting testing,
treatment connection/adherence, and, ultimately, improved access to testing through an innovative
home HIV test kit supported by mobile counselling. Project Masiluleke is encouraging people who are
scheduled to be tested and treated for HIV/AIDS in South Africa by sending one million text messages
per day. Capitalizing on the ubiquity of mobile devices in even the most resource constrained areas
makes the potential for this project to revolutionize the public health response to HIV/AIDS in South
Africa and other parts of the globe. The model is designed
...