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How do you develop a patient centred healthcare system that serves vast numbers of transient poor people? India has an answer: Rashtriya Swasthya Bima Yojna (RSBY), which has won plaudits from the World Bank and the United Nations as one of the world's best health insurance schemes.

RSBY combines state-of-the-art technology and incentive structures. It is paperless, does not use cash and provides affordable health insurance to millions of people. The overwhelming majority of who, are illiterate, transient people living below the poverty line.

RSBY employs cost effective, scalable technologies to help satisfy the health needs of a significant proportion of India’s poor. Enrolment of families into the scheme, biometric smart card generation, pre-authorization of admissions, as well as claim submission and approval, all occur electronically. Beneficiaries can use their smartcards in any empanelled hospital across India and therefore travel is no barrier to receiving healthcare. Patient data are transferred electronically between empanelled hospitals and insurance companies and claims are settled automatically. The scheme lowers costs, increases efficiency and reduces fraud.

A postnatal care program using biometric identification has been developed in Cross River State, Nigeria. Since power supply in that region is quite unreliable, the electronics to run it is powered by solar panels. This is a relevant example of how new technology can be transported and used in rural areas and in environments that we would normally consider difficult.

Technology can't do everything to help poor countries manage their disease burden, but it could enable more efficient systems that can be built around individuals. A good example is the tracking system developed in some African states for patients who follow treatment regimes for tuberculosis.

In Chad digital biometrics are being used to monitor the health status of nomadic populations, who might not keep or understand any form of paper ID. Official identification in most developing countries is relatively low: overall something like 50% and in Zambia only 9% of the population have official birth certificates.

 Although developing countries are low on traditional official identifications such as birth certificates, they are one of the biggest uses of biometric identification. The comparative advantage of developing countries is that they have fewer legacy systems, relative to the developed world, and can therefore implement and benefit from emerging technologies far more easily.

 Africa is the fastest-growing mobile telephone market in the world and the biggest after Asia. Over the past five years the number of subscribers on the Continent has grown some 20% each year. By the end of 2012 it is projected that Africa will have 735 million mobile subscribers.The nature of Africa’s mobilemarket is also changing. Today, smart phone penetration rate in Africa is estimated to be about 18%: almost one in five and projected to reach 40% by 2015. While patchy, mobile penetration rates in Sub Saharan Africa, where the disease burden is greatest, are not low and the rate of smart phone penetration is estimated to be about 20%.

 In 2007 Sarafaricom, a leading mobile phone network in Kenya, launched M-Pesa, a mobile phone‐based payment and money transfer service for people too poor to have a bank account. M-Pesa spread quickly and has become the most successful mobile phone‐based financial service in the developing world. Today there are some 17 million registered M-Pesa accounts in Kenya. It is only a small step to offer a mobile health information service for all M-Pesa account holders.

 Africa’s new highways to carry healthcare information are virtual rather than physical. They already exist, they are extensive and, over the course of the next five years, are projected to rapidly expand and improve. With such an infrastructure one teacher can educate millions of people, which is significantly more cost effective and sustainable than traditional healthcare programmes.

Biometric identifiers are the distinctive, measurable characteristics used to label and describe individuals. In many developing economies health delivery systems are inefficient and subject to high level of losses or fraud. A way to function better would be to have a clear digital identity for those who are being treated. This would be beneficial for running health insurance programs or monitoring patients' adherence to regimes and treatments.

Recent advances in biometric identification technology offer a possible mechanism for poor countries to leapfrog traditional paper-based identity systems. Over the past five years, there has been a proliferation of biometric identification projects in developing countries. We have identified about 154 such systems covering over 2 billion people throughout the world, many in Africa, South America and South Asia.

When used smartly, technology can improve the delivery of health programs. It shifts the cost curve of program administration, giving implementation better results for their money. Technological innovations offer developing countries a way to leapfrog past and often fragmented and inefficient healthcare systems.