Short-message technologies are being used by hundreds of projects for a multitude of health related objectives. Most have adopted their own ad-hoc implementations for structured short-message communications. There is currently no known standard for adoption and implementation of short-message technologies within the healthcare domain. Due to the prevalence of these global ad-hoc efforts and the interoperability implications therein it is critical that a standard in this domain be developed.

Many healthcare settings, especially those within rural and low-income environments do not have the infrastructure needed to effectively support messaging payloads above a few kilobytes. This might be due to limitations of the mobile technology (e.g., low-end smartphone) or may be due to a lack of robust network connections within their area (e.g., sparse distribution of cell phone towers). Projects within these areas have frequently adopted short-message services as an intermediary way in which to communicate health care and public health services in a limited fashion. Most times, project-specific short-message structures are used in order to make ad-hoc standards for communicating essential information.

Short-message technologies are one of the most widely used mobile applications with estimates of over 3 billion active users and encompassing upwards of 80% of mobile subscribers. Short-message technologies are generally composed of approximately 160 characters depending on device, implementation and character library. Due to the broad penetration and adoption of texting by people world-wide and the low infrastructure implementation requirements it has been identified as a valuable method for communicating health information across all socio-economic health settings.