The UK and India reflect the stark differences between developed and emerging markets in mHealth. For the latter, mHealth can address pressing healthcare needs; for the UK, it is simply an added luxury.

The healthcare landscapes of each country create different motives for using mHealth. Indians cover about three-quarters of their medical expenses out of their own pocket, and adequate care is beyond the financial reach of many. The country has only 0.6 doctors per 1,000 people, the vast majority of whom are concentrated in urban areas that encompass just 30% of India’s 1.2 billion inhabitants. Rural residents usually receive care from accredited social health activists rather than more trained medical personnel. Given the degree to which specialists concentrate in metropolitan areas and semi-urban towns, “telemedicine and mHealth methods will have to be adopted”, according to Sunderrajan Jagannathan, Head of Strategy at Siemens Healthcare India.

The UK, meanwhile, is reasonably well served by the National Health Service (NHS). Life expectancy of 80.4 years is above the developed world average (78) and far above that of India (67.1). Moreover, the NHS’s free service at the point of need removes the economic burden of care from most of the population. Instead, the currency British patients tend to pay in is inconvenience, with waiting lists a continuing problem.

The drivers of mHealth in each country are thus different. For Indian respondents, the three biggest attractions are cost reduction (cited by 58%), convenience of access (55%) and ability to obtain otherwise unavailable information (40%). Convenience is the biggest consideration of British patients (49%), but this is followed by a desire to take greater control of their own health (43%). Cost reduction (25%) is far down the list.

Cost is also the leading driver of mHealth for payers and doctors in India, followed by the opportunity to provide new services and to reach previously inaccessible patients. These considerations are much less important in the UK, where reduced administrative time is a leading concern. Indeed, UK payers were twice as likely to say that encouragement by regulators (34%) was a leading impetus for greater use of mHealth than improved outcomes (17%).

Even the people whom mHealth users are seeking to help differ between countries. In the last two years users in India were slightly less likely than British respondents to have acted on their own behalf (74% to 79%), but more than twice as likely to have done so for other family members (54% to 24%) and ten times more likely to have done so for friends and neighbours (29% to 3%).

The barriers to mHealth also reveal a telling difference in perspective. While cultural and medical attitudes are as much a problem in India as elsewhere in the world, the third-biggest barrier for British payers is that other areas need investment first.

The results are predictable. Among patients, 48% of British respondents do not engage in any mHealth-related activity, compared with just 12% of Indian respondents.

A glance at headline projects tells the same story. India has a range of substantial mHealth activities. The Aravind Eye Hospital System’s mobile health vans are an often studied use of wireless technology. The Apollo Telemedicine Networking Foundation has over 70 telemedicine centres in the country that allow contracting parties to serve rural areas. The government has announced plans for a variety of national telemedicine networks, including in oncology and disease surveillance. Still, Mr Jagannathan characterises India’s progress in telemedicine and mHealth as “baby steps—it has a long way to go, but has big potential.”

In Britain, meanwhile, progress is far less steady. Numerous mHealth projects exist, and stakeholders in Manchester are experimenting with the creation of a broadly based ecosystem of organisations to support the field. Nevertheless, after ten years and investment of £6.4 billion (US$10.3 billion), the largest eHealth project—the creation of electronic health records across the country—was abandoned as unfit for modern needs. In order to save money, the largest national telemedicine programme—NHS Direct—is also being replaced by a series of local facilities that will probably have less skilled personnel, potentially a setback in healthcare provision.