SMS Medicine: Revolutionizing Healthcare Delivery

through Mobile Technology

Md. Shafiul Alam Bhuiyan Md. Ziaur Rahman
ID: 012213015 ID: 012213022
MSCSE MSCSE
Department of Computer Science and Engineering Department of Computer Science and Engineering
United International University, United International University,
Dhaka, Bangladesh Dhaka, Bangladesh
shafiulalam.bhuiyan@gmail.com ziaurrahman5232@gmail.com

Abstract:
The integration of mobile technology into healthcare systems has opened new avenues for improving
patient care and accessibility to medical services. SMS (Short Message Service) has emerged as a powerful
tool in this transformation, facilitating effective communication between healthcare providers and patients.
According to WHO, health is not only without disease and weakness but also health in physical health,
mental and social welfare. Hence, health-related quality of life (HRQoL) refers to the effects of disease
and therapy in physical patients, psychological and social welfare as felt by the patient (1). The world has
evolved quite a lot, medical advancement is one of them, such as telemedicine in which SMS medicine is
a messaging based medicine (or other format) health care service. However, SMS medicine is a segment
of telemedicine. Anyone from anywhere now can easily access Medicare services through just sending a
simple message and getting feedback with proper prescriptions. SMS medicine care helps everyone to
obtain any sort of initial medical aid. People from anywhere and at any time can consult with specialists
through a message. The study will reveal a detailed discussion about SMS medicine health care and how
this SMS medicine works as well as all the advantages of SMS medicine.

Keywords: SMS Medicine, AI Based System, healthcare delivery, patient engagement, telemedicine.

I. Introduction:
In the present era, digital technologies have made everything easily graspable within a very short period,
especially in the medical sector. The virtue of advanced medical connectivity is one of the most approvable
if it helps the user of their demands. Telemedicine is one of the medical science advancements which refers
to a medical treatment or diagnosis system which can be done over telephones or using other devices from
long distant places. Short Message System(SMS) medicine is one of effective telemedicine since the
process of taking medical services is to deliver care from long distance using various mobile technologies.
In the account of rapid advancement in a lifetime, interactions, audio-visual as well as huge internet
capacity, telemedicine derived our medical services faster in many health care, whereas annual global
growth rate is 13% to 27% (waller and Stotler, 2018). Considering the outbreak of the covid-19 pandemic,
telemedicine was the only savior for every patient since physical treatment cannot be done. Conducting
the process of telemedicine many web applications are needed as well as mobile applications because of
more flexibility. Web applications such as Updox, Mend, Klara, On-call health, etc are more usable
whereas there are also some mobile applications such as MDLIVE, Lemonaid, Live health, Doctor on
demand, Talk space, PlushCare, etc which are more flexible. All these apps or other formats are used to
get directly connected to desired health care and some even get visual directions or prescriptions from
doctors. Traditionally, any moment corresponding with consulting doctors over the land phone is
telemedicine but the technology does a lot more than typical doctor consultation. Telemedicine allows
users lively to exchange text messages with healthcare professionals about symptoms or treatments.
Moreover, users can even enjoy the privilege of video chats if needs be. Especially, rural people with
emergency needs for medication can easily meet their desired doctors or any healthcare professionals
within a very short time through telemedicine applications. Patients can enjoy all these services where no
specific time and place is to bother. Thus, telemedicine helps every miserable forbearing with a sustainable
process and easy using process.

According to a report by the World Health Organization (WHO), mobile technologies, including SMS,
have become indispensable in improving healthcare access and outcomes, particularly in low-resource
settings where traditional healthcare infrastructure may be lacking (WHO, 2020). SMS, with its ability to
deliver timely information and reminders directly to patients' mobile phones, has emerged as a cost-
effective and scalable solution for enhancing medication adherence, chronic disease management, and
preventive care initiatives (Wald, Dube, & Kuhn, 2017). The concept of SMS Medicine encapsulates a
diverse array of applications, ranging from health education campaigns and remote patient monitoring to
emergency response systems. By leveraging SMS, healthcare providers can effectively bridge
communication gaps, empower patients with essential health information, and streamline healthcare
delivery processes (Peeters, Kasteleyn, Vos, & Mierlo, 2019). Despite its simplicity, SMS Medicine
presents unique challenges, including ensuring data privacy, overcoming technological barriers, and
addressing disparities in mobile phone access and literacy levels among diverse populations (Mbuagbaw
et al., 2018). These considerations underscore the importance of developing contextually appropriate
strategies that leverage SMS's strengths while mitigating its limitations. Looking ahead, the future of SMS
Medicine holds promise for further innovation and integration with advanced technologies such as
artificial intelligence (AI) and the Internet of Things (IoT). These advancements are poised to enhance the
capabilities of SMS in personalized medicine, real-time health monitoring, and population-level health
interventions (Liu, Lu, Hu, & Yang, 2020).

The purpose of this research is to explore the transformative potential of SMS medicine in healthcare
delivery. By examining existing literature, case studies, and current practices, this paper aims to provide a
comprehensive overview of how SMS technology is revolutionizing healthcare. It seeks to identify the
benefits and challenges associated with its use and offer recommendations for future advancements. This
investigation is crucial for understanding the broader implications of integrating SMS medicine into
healthcare systems, particularly in resource-limited settings where traditional healthcare infrastructure
may be lacking.

The significance of SMS medicine lies in its ability to bridge gaps in healthcare access and delivery. In
many low- and middle-income countries (LMICs), where healthcare resources are scarce and geographical
barriers hinder access to care, SMS medicine presents a viable solution to extend healthcare services to
underserved populations. The ubiquitous nature of mobile phones, even in remote areas, makes SMS an
accessible and practical tool for delivering healthcare information and services.

II. Literature Review:

Mobile technology has revolutionized healthcare delivery through the advent of apps-based or
other format SMS (Short Message Service) medicine, offering innovative solutions to improve
patient care, enhance disease management, and facilitate communication between healthcare
providers and patients. Mobile health (mHealth) applications, including SMS interventions,
leverage the ubiquity of mobile phones to deliver timely health information and support across
diverse healthcare domains (WHO, 2011). SMS-based medical applications have demonstrated
efficacy in addressing medication adherence challenges prevalent in chronic diseases like
HIV/AIDS, tuberculosis, diabetes, and hypertension, thereby improving treatment outcomes
(Free et al., 2013). Beyond medication reminders, SMS plays a crucial role in maternal and child
health by providing antenatal care reminders and vaccination alerts, ensuring timely healthcare
interventions (Tomlinson et al., 2013). Behavioral health interventions utilize SMS to deliver
motivational messages, behavioral prompts, and support for conditions such as depression and
smoking cessation, contributing to improved mental health outcomes (Free et al., 2013).

The technological infrastructure supporting SMS-based medicine includes mobile network

operators, short message service centers (SMSCs), and backend systems that enable reliable
message delivery and data management (ITU, 2019). However, implementing SMS-based
medical applications faces challenges such as scalability, data security, and maintaining user
engagement. Scalability requires robust infrastructure and partnerships across multiple sectors to
reach diverse populations effectively (Fjeldsoe et al., 2009). Data security concerns necessitate
compliance with healthcare regulations and implementation of encryption methods to protect
patient information. Furthermore, sustaining user engagement involves personalized messaging
and feedback mechanisms to ensure continued patient adherence and participation (Fjeldsoe et
al., 2009).
Looking forward, the future of apps-based other format SMS medicine holds promise with
advancements in artificial intelligence (AI) and the Internet of Things (IoT) expected to enhance
personalized healthcare delivery. AI can analyze patient data to tailor SMS messages, predict
patient behavior, and optimize healthcare interventions (Free et al., 2013). Integration with IoT
devices offers real-time health monitoring and feedback, further enhancing the precision and
effectiveness of SMS-based medicine applications (Free et al., 2013). In conclusion, SMS-based
medical applications represent a transformative approach to healthcare communication,
leveraging mobile technology to overcome traditional barriers and improve patient outcomes
globally.

III. Need for SMS medicine:

SMS medicine is a potential tool to reduce patients’ transport and time-consuming as well as efficient
medical services. Traditionally, medical care can be shown effective particularly in the management
system while it also adapts or utilizes the hospital settings. For primary treatment there are many obstacles
to deal with in case of emergency such as traveling to the hospital, getting a seat, talking to a specialist
according to patients’ needs, etc these all create a barrier to medications. So, SMS medicine systems can
play a vital role in initial treatment. However, it is possible to speak directly to the specialists and the
forbearing can visually and lively communicate to the doctors if the patient insists. Whereas there is no
need for going to a hospital, taking a seat, and all these obstacles to face. So in the case of primary
treatment, SMS telemedicine will provide a potential and effective solution to primary treatments. In the
emergency department, many digitized medical technologies have been implanted in many rural hospitals
to provide specific SMS health care and specialists to patients in critical time-sensitive situations. The
method in an emergency, the patient will study a large number of medicare centers around him and study
the specialist that he needs. Afterward, the SMS medicine will match with the hospitals needed. After that,
the primary door-to-door service is provided and if needed the transfer or other hospital's instrument will
be done either (4).

Source: https://tradingeconomics.com/bangladesh/physicians-per-1-000-people-wb-
data.html

Figure 01: Number of patients compared to a doctor in BANGLADESH

In the present time, evey doctor or specialist has to deal with 6 patients which came out of the recent
analysis done in 2018 in BANGLADESH. It is very difficult to handle 6 patients for a single doctor and
still increasing over time. Thus, to reduce the pressure SMS medicine would surely play a vital role since
the process is quite compatible with both doctors and users. The initial treatment can be helped through
the SMS. So, all-encompassing SMS-based medicine will be helpful in an emergency case to deal with
numerous patients in finding immediate medicare and other services since the doctors are comparatively
16% to the patients. On the contrary, the traditional method is banal and not that helpful as SMS based
medicine.
 Source: https://www.statista.com/statistics/820756/number-of-telehealth-visits-in-
us/

Figure02: Number of Users of SMS Medicine in US

The graph depicts the number of people using SMS medicine in the US from 2013 to 2021 and also the
possibility of 2022. At the beginning people did not use SMS medicine because they did not know the
simplicity of using as well as efficiency. But after the emergence, patients tend to use SMS medicine and
take advantage of time, cost, etc. At present, people consult with staying home with the specialist they
want. Since all the numbers are increasing rapidly the need for SMS medical will also enhance. One of the
quickest and simplest communication is done with SMS based medicine where everyone can access their
useful specialist within a very short period and they do not even need to go to their centers. So, these apps
or websites have made everything within the boundary of the patients. All these are just because of patients'
needs as well as reducing time consumption. Urgent care is made in SMS medicine now with better options
which make it possible to offer patients easy access to their comfort zone. Moreover, it also enables
everyone to get connected with their desired doctors easily and with very short formalities which make
the process very easier. Around the world, telecommunication has made everything easier in the medical
department which enables every needy person to enjoy their desired services and whatnot (5). Since SMS
medicine is easy to use, the service is mostly hassle-free. The patients do not need to do long critical
processes and other complex procedures. So, it is easy to use. On the other perspective, the patients do not
need to go to hospitals and other Medicare centers and do the usual trite systems, they are quite free from
this suffering.

IV. How SMS medicine works:

The SMS medicine process is the steps that are needed to follow to receive the service from any web or
mobile application. In most of the applications, the two most used methods are direct prescriptions by
doctors in the chamber or control room by direct SMS and another is automatic prescriptions generated by
AI based central system which is derived from the symptoms based message.
 Figure 02: Process of SMS Medicine

In using the first method, the patients have to provide SMS with all the symptoms; the central server
receives the SMS. Then, the server provides appropriate prescriptions from the specialist. Nevertheless, if
required, the doctor can be connected with the patient either in audio or in video and discuss the patient’s
issues, and prescribe medicines accordingly. So in this one patient connects with the specialists directly.
In using the other method, the patients have to provide SMS with the symptoms, that message is received
by a server that connects to the system which is developed to provide prescriptions according to the
symptoms. Thus, the system applies the symptoms to analyze with the designed medications and finally
provides some medication which is received by patients. Hence, in this second process, the patient gets
prescriptions from the central system, not from the doctors.

V. The Power of SMS in Healthcare

SMS (Short Message Service) has revolutionized the way healthcare providers communicate with patients,
leading to improved patient engagement, better health outcomes, and streamlined delivery of care.

1. Enhancing Patient-Provider Communication

SMS enables healthcare providers to stay connected with patients directly through text messaging. This
enhanced communication facilitates:
 Timely appointment reminders and medication adherence prompts
 Improved patient education and health literacy
 Shared decision-making and informed patients

2. Improving Patient Outcomes

By leveraging SMS, healthcare providers can:
 Increase patient engagement and satisfaction
 Optimize time management and efficiency
 Reduce costs for healthcare organizations

3. Boosting Appointment Attendance

SMS reminders have been show to increase scheduled appointment attendance by 67%. This highlights
the effectiveness of SMS in reducing no-shows and improving patient access to care.

4. Enabling Targeted Messaging

SMS allows for personalized and segmented messaging to various patient populations based on their
specific healthcare needs. This targeted approach enhances the relevance and effectiveness of patient
communication.
 5. Integrating with Existing Systems
SMS can be seamlessly integrate with existing healthcare systems, such as electronic health records
(EHRs) and telehealth platforms. This integration streamlines communication workflows and ensures
consistent patient data across multiple touchpoints.

6. Overcoming Barriers
SMS has the potential to overcome language and literacy barriers by providing accessible and easy-to-
understand health information. This is particularly beneficial for diverse patient populations. In
conclusion, SMS has emerged as a powerful tool in healthcare, revolutionizing patient engagement and
communication. By leveraging SMS, healthcare providers can enhance patient outcomes, optimize
operational efficiency, and deliver high-quality care that meets the evolving needs of patients.

VI. Advantages of SMS Telemedicine:

SMS medicine is one of the best tools to receive medical services in case of emergency because
traditionally the patient has to go to the hospital first if they need any medications or consultations. But in
SMS-based systems of medication, the patient does not even need to go anywhere the person can get
connected with any specialist he wants to meet and consult with while sitting in his room. Further, he can
visually contact the therapist and talk about symptoms. Thus, SMS medicine is far better than any
traditional way to consult with others where the patient can get instant primary treatment without any
delay. The time and the space barrier are nothing to consider in telemedicine since everything is done by
web or mobile application over the phone and other devices. Hence, instant primary medical provisions
are easily reachable through just a message. App based SMS medicine has another great advantage which
is less costly treatment. SMS medicine is far less costly than any other way. Considering the usual
treatments, we take, one has to go all the way to the hospital to meet with any specialist or any doctors to
consult with. In which one has to bear various expenses, the most dominant one is the consulting cost that
is to pay to meet with any consultant. There are also other expenses such as applicant expense, hospital
visit expense, traveling cost, etc. Thus, usual treatment becomes costlier, whereas in the SMS medicine
one has to pay the charge of being online and getting the app which is basic, and also the cost of sending
messages which is not even a cost if judged. so, the medical app is far more cost-effective than any other
treatment process. One of the most significant benefits of SMS medicine is that it can be used by anyone
from anywhere without any barricade of time, place, or money. Anyone from far from the city area can
also access this tell medication service through a message only. He just needs to possess the device and
the internet connection, and he can easily get services from the server. Considering the usual process of
taking medical healthcare or prescriptions, one has to go to the hospital and talk to the doctors or specialists
or other therapists but in the SMS medicine system, one can easily access the doctors or therapist through
a message and get what he needs. So, in that way, people from rural areas can also easily access the services
of the SMS Medicare. SMS system telecare is a treatment for all people without any class or status. Anyone
who needs basic treatment or any consultation can possess the privilege of the application. In a basic way,
not all the people could obtain medical consultations for various ways such as some could not afford the
medical expenses so they do not take the service, some could not go outside the area so they were unable
to pursue medical care, there are also other reasons for why they could not make it to hospital and take
their service they need. But in the SMS medical care anyone can take the advantage of medical health
care. Thus, it is for most of the people of our country since the majority of the people can access this
service and anyone can utilize the advantage of application-based medication. The important pros of SMS
medicine are that it is a time-saving tool that saves time for not only patients but also doctors. The SMS
medication is used over telephones or other devices so one does not need to go to the hospital or any other
center which saves travel for both patient and doctor, hence it saves time for both of them. But traditionally,
people have to go to the hospital and wait for their turn and other procedures which eventually leads to a
waste of a lot of time. Furthermore, they often could not get the desired specialist. So, it is not worth it
compared to SMS-based medicine. Because the app-based Medicare helps save time for both patient and
doctor. Most significantly, SMS based medication will eventually change the face of our traditional
primary health system with a new face.
VII. Challenges and Considerations

While SMS medicine offers numerous advantages in enhancing healthcare delivery, it also presents several
challenges and considerations that must be address to ensure its effectiveness and sustainability. These
challenges span technical, socio-economic, privacy, and regulatory domains.

1. Privacy and Security Concerns:

SMS messages often contain sensitive health information, necessitating stringent measures to ensure
privacy and security. Healthcare providers must comply with regulations such as GDPR (General Data
Protection Regulation) in Europe or HIPAA (Health Insurance Portability and Accountability Act) in the
United States to safeguard patient data. Encryption of SMS transmissions and secure storage of
information on servers are essential to prevent unauthorized access and breaches (Mbuagbaw et al., 2018).
Implementing policies for data minimization, retention periods, and secure deletion of messages after they
are no longer needed helps mitigate risks associated with data privacy.

2. Technological Limitations:
Access to reliable mobile network coverage and smartphone penetration varies globally, posing challenges
for widespread adoption of SMS-based interventions. In regions with poor connectivity or limited access
to smartphones, the effectiveness of SMS in delivering timely health information or supporting remote
monitoring may be compromised (Peeters et al., 2019). This limitation underscores the need for alternative
communication strategies or hybrid approaches that combine SMS with other technologies to ensure
continuity of care.

3. Health Literacy and Language Diversity:

Effective communication through SMS requires messages to be comprehensible to diverse populations,
including those with varying levels of health literacy and linguistic proficiency. Tailoring messages to be
culturally sensitive and using simple language improves understanding and adherence to healthcare
instructions (Leon et al., 2019). Healthcare providers should consider employing multilingual SMS
platforms and providing educational resources to support patient comprehension and engagement.

4. Integration with Healthcare Systems:

Integrating SMS into existing healthcare systems presents logistical challenges, including interoperability
with electronic health records (EHRs), clinical workflows, and administrative processes. Ensuring
seamless integration requires collaboration between IT departments, healthcare providers, and SMS
service providers to streamline communication channels and data exchange (Wald, Dube, & Kuhn, 2017).
Overcoming resistance to technological change and aligning SMS interventions with organizational goals
are critical for achieving sustained adoption and effectiveness.

5. User Engagement and Behavior Change:

Effective engagement and behavior change through SMS depend on the relevance, timing, and
interactivity of messages. Personalizing SMS content to individual patient preferences and health goals
enhances motivation and adherence to treatment regimens (Peeters et al., 2019). Implementing feedback
mechanisms, interactive features, and behavioral nudges within SMS platforms can promote active
participation and long-term behavior modification among patients.

6. Regulatory and Ethical Considerations:

Compliance with regulatory guidelines and ethical standards is paramount in SMS Medicine. Healthcare
providers must obtain informed consent from patients for SMS communications, ensuring transparency
about the purpose, frequency, and potential risks associated with messaging (Mbuagbaw et al., 2018).
Respecting patient confidentiality, maintaining data security, and adhering to legal frameworks governing
telemedicine practices are essential for building trust and upholding ethical principles in healthcare
delivery.

7. Evaluation of Effectiveness and Impact:

Assessing the effectiveness and impact of SMS interventions requires robust evaluation methodologies
and metrics. Healthcare organizations should conduct rigorous studies to measure outcomes such as patient
adherence, health outcomes, and healthcare utilization rates (Wald, Dube, & Kuhn, 2017). Quantitative
analysis of SMS delivery metrics, patient surveys, and qualitative insights from healthcare providers and
 patients contribute to understanding the impact of SMS Medicine on healthcare delivery and patient
outcomes.

VIII. Future Directions

Future directions for SMS Medicine encompass several exciting possibilities that could further enhance
its impact on healthcare delivery. Firstly, advancements in artificial intelligence (AI) could revolutionize
SMS interactions by enabling more sophisticated chatbots capable of providing personalized medical
advice and interventions based on patient data and trends. Integrating blockchain technology could address
security concerns by ensuring robust encryption and data integrity in SMS healthcare communications.
Additionally, deeper integration with telemedicine platforms could extend SMS Medicine's capabilities,
allowing seamless transitions from text-based consultations to more comprehensive virtual healthcare
services. Behavioral insights derived from SMS data analytics could enable tailored interventions that
better address patient needs and preferences. Lastly, expanding SMS Medicine globally requires
addressing regional disparities in mobile phone access and healthcare infrastructure, while also
considering cultural sensitivities to ensure effective implementation across diverse populations. These
advancements promise to make SMS Medicine an indispensable tool for improving healthcare access,
efficiency, and patient outcomes worldwide.

IX. Conclusion:
Telemedicine is a broad section where patients use various techniques to communicate with doctors such
as video calling, audio calling etc. SMS medicine is one of the most used healthcare in recent days since
everyone around is available with mobile phones. Through SMS medicine anyone can enjoy the privilege
of healthcare from anywhere by just sending a message only and can be connected with a specialist. SMS
medicine helps any patient to take initial treatment with less time consuming and without any place barrier.
Moreover, it is convenient to use and a very simple process. People who are far from any medical centers
can use SMS medicine to prevent any serious situation by taking primary health care from any specialist
they need. Hence, the SMS medicine is easy to use and less costly as well as less-time consuming.
However, all encompassing, SMS medicine is really helpful to use and convenient for everyone even far
from any medical center.

References

1. World Health Organization. (2020). WHO Guideline: Recommendations on Digital Interventions

for Health System Strengthening. Retrieved from
https://www.who.int/publications/i/item/9789241550505
2. Wald, D. S., Dube, A., & Kuhn, L. (2017). Text message reminders to improve outpatient therapy
adherence among adolescents: A pilot study. Journal of the American Board of Family Medicine,
30(4), 491-494.
3. Peeters, J. M., Kasteleyn, M. J., Vos, R., & Mierlo, L. D. (2019). MHealth technologies for chronic
diseases and conditions management: a systematic review. Healthcare, 7(3), 86.
4. Mbuagbaw, L., van der Kop, M. L., Lester, R. T., Thirumurthy, H., Pop-Eleches, C., Ye, C., ... &
Smieja, M. (2018). Mobile phone text messages for improving adherence to antiretroviral therapy
(ART): an individual patient data meta-analysis of randomised trials. BMJ Open, 8(4), e021942.
5. Liu, W., Lu, Y., Hu, H., & Yang, S. (2020). The application of artificial intelligence in healthcare:
A systematic review. International Journal of Environmental Research and Public Health, 17(12),
4414.
6. Waller, M. and Stotler, C., 2018. Telemedicine: a primer. Current allergy and asthma reports, 18(10),
pp.1-9. Received from: https://pubmed.ncbi.nlm.nih.gov/30145709/
7. Yellowlees, P.M., 2005. Successfully developing a telemedicine system. Journal of telemedicine and
telecare, 11(7), p.331. Received from: https://pubmed.ncbi.nlm.nih.gov/16238833/
8. Saputri, G.Z., Akrom, E.D. and Darmawan, E., 2017. Improving Outpatient’s Quality of Life
Through Patient Adherence of Antihypertensive Therapy Using “Mobile Phone (SMS) and Brief
Counseling‑5A” in Polyclinic of Internal Medicine at PKU Muhammadiyah Bantul Hospital,
Yogyakarta. Indonesian Journal of Clinical Pharmacy Volume, 6(2). Received from:
https://jurnal.unpad.ac.id/ijcp/article/view/20486
9. Mohr, N.M., Young, T., Harland, K.K., Skow, B., Wittrock, A., Bell, A. and Ward, M.M., 2018.
Emergency department telemedicine shortens rural time-to-provider and emergency department
transfer times. Telemedicine and e-Health, 24(8), pp.582-593. Received from:
 https://europepmc.org/article/med/29293413
10. Mulgrew, K.W., Shaikh, U. and Nettiksimmons, J., 2011. Comparison of parent satisfaction with
care for childhood obesity delivered face-to-face and by telemedicine. Telemedicine and e-Health,
17(5), pp.383-387. Received from: https://psycnet.apa.org/record/2011-13562-008
11. Hashiguchi, T.C.O., 2020. Bringing health care to the patient: An overview of the use of telemedicine
in OECD countries. Received from:
https://www.oecd.org/officialdocuments/publicdisplaydocumentpdf/?cote=DELSA/HEA/WD/H
WP(2020)1&docLanguage=En
12. Free, C., Phillips, G., Watson, L., et al. (2013). The Effectiveness of Mobile-Health Technologies to
Improve Health Care Service Delivery Processes: A Systematic Review and Meta-Analysis. PLOS
Medicine, 10(1), e1001363.
13. Fjeldsoe, B. S., Marshall, A. L., & Miller, Y. D. (2009). Behavior Change Interventions Delivered
by Mobile Telephone Short-Message Service. American Journal of Preventive Medicine, 36(2), 165-
173.
14. Tomlinson, M., Rotheram-Borus, M. J., Swartz, L., & Tsai, A. C. (2013). Scaling Up mHealth:
Where is the Evidence? PLOS Medicine, 10(2), e1001382.
15. WHO. (2011). mHealth: New Horizons for Health through Mobile Technologies. Geneva: World
Health Organization.
16. ITU. (2019). Measuring Digital Development: Facts and Figures 2019. International
Telecommunicatio link: https://www.itu.int/en/ITU-
D/Statistics/Documents/facts/FactsFigures2019.pdf.