The notion that SMS could revolutionize healthcare first entered Nesbit’s mind in 2007, when he was still a Stanford undergrad. He’d just met Dickson Mtanga, a community health worker in rural Malawi who was walking 35 miles to deliver handwritten patient charts to the nearest hospital. Nesbit biked out to Mtanga’s village one day, only to discover that his cellphone got a better signal there than it did on Stanford’s campus in Palo Alto, Calif. All those bars of service jumped from the phone’s screen and slapped him across the face: These far-reaching GSM networks, he realized, could connect doctors and patients like never before.

Armed with a $5000 grant, a backpack full of old phones, and a laptop running a GSM modem and the open-source group-texting software called FrontlineSMS, Nesbit started working with the hospital and community health workers to coordinate patient care. The system they put in place allowed Mtanga and others to text in the information on those medical charts rather than making the hours-long trek. Patients could text their symptoms to doctors, cutting down on unnecessary visits for minor ailments and freeing up space for those in need of serious care. Within six months of the system going live, the number of patients being treated for tuberculosis doubled, more than 1200 hours in travel time were eliminated, and emergency services became available in the area for the first time. The operating costs in those six months: $500, Nesbit says.

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