Keeping focus on common goals
Now Mechael embraces the challenge of coordinating the Alliance’s various stakeholders around the mHealth Commons, which the Alliance’s website defines as “public goods that would accelerate the impact and mainstreaming of mHealth, which do not disproportionately benefit any one player, and are unlikely -- and often impossible -- to be undertaken by any individual stakeholder.” Encouraging the Alliance’s numerous partners/stakeholders to collaborate in developing the mHealth field by sharing ideas and resources, Mechael keeps the organization’s focus on the people for whom their work stands to provide the most needed support in accessing better healthcare information and services. In other words, she works to keep the Alliance’s focus on that which is common to all of its stakeholders.

She has been highly influential in this capacity, according to Alain Labrique, an associate professor at the Johns Hopkins Bloomberg School of Public Health and and director of the JHU Global mHealth Initiative, who has collaborated with the Alliance numerous times.
 
“She has done an excellent job in balancing the different perspectives and priorities of the diverse stakeholders that make up the landscape of mHealth from the private sector to telecommunications companies to donor agencies and academic research institutions,” said Labrique in a written statement released to Healthcare IT News. “What she brings to the table,” said Labrique, “is a very strategic yet personable way of identifying shared priorities across these stakeholders and moving the conversation forward without getting stuck on the less important parts of the conversation that can often be stumbling blocks.”

A key aspect of Mechael’s aptitude for centering the Alliance’s stakeholders on the common goal of advancing global mHealth is her keen understanding of the necessity for a considered, strategic approach to technological development.

“I probably now spend 60 percent of my time trying to bring people down to earth and 40 percent continuing to create catalytic growth, optimism, and movement in the field.  There’s a lot of hype around the use of mobile technology and that it will solve all their problems in the world and it’s just not the case”

Promoting mHealth without addressing its pitfalls would be counterproductive to the Alliance’s work because doing so elides the problems that implementers would need to address in deploying mHealth solutions, thereby ignoring the adverse impact such as oversights could have on users and freezing the field’s growth, perhaps even arousing doubt about the technology’s efficacy.

 Mechael has been prescient in stressing the issues attendant to mHealth development, noted Katrin Verclas, a prominent figure in the mobile for development industry and a friend of Mechael’s. “It’s one thing to sell, and it’s another thing to sell with a realistic understanding of what can be accomplished,” Verclas told Healthcare IT News. Impact studies, data privacy, and security, those are things she has brought up early on when nobody else was talking about them. Even within that field, there’s some pioneering work she’s doing even as that field has matured”

Managing the overoptimistic expectations for mHealth allows Mechael to refocus stakeholders’ attention on their common goal of using this technology to improve people’s health, not because its novelty seems to promise salvation. While she spends much of her time, as she said, bringing people down to earth, she’s “doing it in a way that provides some recommendations for how to do [mHealth] and doing it sensibly…there are things that we now know that work really well that can be applied in a way that can actually harness the benefit of mobile without betting the farm on it, and then learning as you go along”

As with any industry, the Alliance must address the economics of its situation, contending with competition over limited resources. While every implementer may have the interests of the people their work affects in mind, they also consider their individual finances, obtaining the resources they need to continue to fund their projects. Mechael faces the major challenge of balancing individual interests with maintaining neutrality and mobilizing interest in the Commons.

“Donors think the Commons is really important, but where they tend to put their money is in direct implementation, and I get that, I understand they want to see direct impact, but to me the incremental cost of investing in the Commons, which benefits all of their implementations, needs to be paired with direct investment in implementation,” she said. “I think some of the donors are really coming around to that, where they’re saying we can put aside some resources for looking at the Commons even though we’re much more interested in the direct impact of what we’re implementing on the ground. It’s taken time for people -- and it’s such a young field still -- to come to that conclusion”

[See also: Developing nations to garner mHELP.]

Millennium Villages Project
Heightened financial interest in mHealth has helped precipitate this change of mind. In 2007, when Mechael was working at Earth Institute on the Millennium Villages Project, the mHealth landscape was relatively barren. “If we look at the field in general, when Patty started working at the Earth Institute, GSMA wasn’t very active and there were not many providers who were even thinking about mHealth,” said Joanna Rubenstein, Jeff Sachs’ chief of staff and Mechael’s boss during her time at the Earth Institute.  Exceptional for the time, Ericsson, the multinational telecommunications operator, invested in providing connectivity for the Millennium Villages even though there wasn’t a clear business tie-in to that work.  Still, mHealth had hardly registered as a viable business avenue.

“It’s only been in the last year and a half or so,” said Mechael, “that we’ve really started to see much more collaborative, win-win efforts that are helping to move everything forward. I think in the beginning there was a lot of competition over resources because there were very limited resources going into the field … and now what we’re starting to see is much more collaboration, there’s much more funding going into this work”