We live largely in a SMS-centric world as far as mobile health is concerned. So many of the services that have achieved widespread penetration on a global basis are SMS-based. That makes sense. Along with voice it’s the only certain way for every mobile user in the world to be able to access a service. Call it the lowest common denominator in unflattering terms. Or if one is feeling more positive, it’s a means of democratising a mobile health service so everyone can enjoy access to it. That's the way I feel about SMS.

SMS-based services have other advantages too. They are less likely to attract regulation. For instance, an interesting new report by US research firm GigaOm calculates that the US Food and Drug Administration’s draft guideline on regulating mobile health apps (published in July this year) will likely capture less than 15 percent of all apps in use now globally. That’s because most are too low tech to be covered by the regulation, which will, however, become increasingly relevant in the future as the trend moves towards more advanced functionality.

“Areas where this will happen include applications involving electrocardiograms and tablet applications that involve MRI and other radiographic scans (the resolution of different screens may cause errors in diagnoses if not up to regulatory standards,” according to the GigaOm report). And the falling prices of smartphones and tablets combined with their growing multimedia and processing capability might mean these types of services could become commonplace as soon as a 12-month timeframe according to some of the interviewees in a new Mobile Heath Live video.

This idea cuts across a big news story this week which is the death of Steve Jobs. Some articles have discussed Jobs’ legacy in the healthcare sector, focusing on the take-up of Apple’s iPhone and iPad. Certainly the company’s tablet has high penetration among top US hospitals, according to figures released by Apple last week. But outside the US would that be so true? Probably not. And in many developing countries, the likely penetration of iPads in the healthcare sector is understandably close to zero.  Want an example of a global product with an influence on mobile health? Well, SMS of course. But a second answer might be the app for which Apple's App Store takes a lot of credit. As more apps are written for conventional handsets (and penetration of smartphones grows) then the app will grow in importance for mobile health services. Potentially apps could prove as significant in the future as SMS is today. Now that’s not a bad legacy.

Richard Handford

The editorial views expressed in this article are solely those of the author(s) and will not necessarily reflect the views of the GSMA, its Members or Associate Members.