That increased financial backing has helped the mHealth field grow does not diminish the pivotal role Mechael and the Alliance have played in stimulating this progress.  Resources, however much, go to waste, if not subjected to effective coordination. Such seems to be the case for eHealth and mobile for development, two areas that Mechael recounted lacked in coordination, and have been outstripped by mHealth.  

“I think the reason why mHealth is way ahead is because we had this Alliance, this neutral broker body that could help catalyze things, but that was not tied to any one player or institution. When I look back at the whole state of the field and where we’ve fit into all these ecosystems, the story of mHealth and the Alliance is quite a remarkable story because it was the field that never should have been, but became, and is now taking the health sector by storm in a way”

Long before the field’s dramatic upswing in popularity, Mechael was one of the first to recognize its potential.

Early influences
In 2000, Mechael was working at a dotcom in New York. She had recently returned from working in Sudan, where she had realized, from witnessing the use of two-way radios, that better tools to facilitate access to care were required to improve access to emergency services and access to health information. She began to wonder about the possibility of using new telecommunications technologies in healthcare settings, an investigation that stems from her exposure to technology during her upbringing.

Both of Mechael’s parents led careers related to computers and information technology. Her father studied agriculture while living in Egypt during the ’60s, simultaneously studying statistics and computers. He decided he wanted to work with computers, not agriculture, and he applied for immigration to the countries he thought would allow him to do so. He moved to New York and got a job working in data processing, after which he spent his entire career in the technological sector, including working on the team at Bank of New York that developed the prototype for ATM. Mechael recounted going to work with her father during this time and watching the newly-fashioned machine spit out monopoly money.  

Mechael’s mother had her first child at 19, Mechael at 20, and Mechael’s younger sister at 25. Between her second and third children, she decided she didn’t want to be a stay-at- home mom. At Mechael’s father’s suggestion, she studied electrical engineering and computer science by distance learning, eventually obtaining an associate’s degree.  She went on to have a career in the technological sector.    

“I grew up in a family where my parents were like ‘If you can think it, you can do it with technology’ and so I was then applying that thinking to healthcare”

Many people were researching digital divide issues concerning the Internet. Mechael had previously worked in isolated rural areas where none of the residents had electricity or access to running water, let alone Internet connectivity. Cell phones had begun to take hold in the U.S. Mechael had also noticed, during her work in Egypt, based out of the American University in Cairo, that some of the wealthy students already had cell phones.  She decided to do her PhD research on this emerging technology as a means to support health programs. In 2002, she began perhaps the first PhD on mHealth.

“At the time, she was incredibly ahead of her time,” said Mechael’s PhD adviser, Simon Carter, a science and technology sociologist at the London School of Hygiene and Tropical Medicine, in a recent interview with Healthcare IT News. “She wanted to look at how people were using mobile phone technology for health purposes, and I think that this was incredibly innovative for the time. There was very little research done on how people use mobile phones at all, and that goes for both developing countries and the West. This was a really interesting idea, something I thought could bear a lot of fruit”

Mechael began tackling the issue of researching a topic no one had worked on before and on which there was next to nothing written. Her initial ambition was to profile mobile phone usage in Bangladesh. However, she found that the uptake of phones was too low to sustain research and eventually settled her research in Egypt.

“The whole incident with Bangladesh and coming back, some people might have been really put off by that and worried about carrying on with the PhD,” said Carter. “She never gave me the impression she had any doubts about doing the PhD.  She just looked at it as a problem we needed to talk about and then solve.”

The level-headed perseverance, the apparent conviction with which Mechael responded to this and other challenges in her career in mHealth belie the fact that she herself, while conducting pioneering research in the field, did not anticipate her own, pivotal involvement in the mHealth industry.

“I never thought I’d actually work on mHealth. I had been working on mostly global health, primary healthcare programs, maternal and child health, HIV/AIDS programs. I was really just doing my PhD to teach, I wasn’t intending to actually make a career of it.  And now, when I look back on it, I think it’s been 13 years since I started researching and writing about the use of cell phones to support health programs, and as a friend likes to say to me you had an entire career in mHealth. I don’t know that anybody else has done that quite from start to finish.’ And I never really thought about it in that way, but it’s kind of true.”

Mechael came on as the Alliance’s executive director in 2011. According to Rubenstein, Mechael was the only person offered the job, “testimony to her experience working with others and their positive experience working with Patty, and her knowledge and her expertise working in the field."