In class on Tuesday, March 18, we spoke about the difference between front office and back office in terms of the potential for ICTs in education. On Thursday we spoke of ICTs for health. This article is about technologies that keep you away from the office altogether—the doctor’s that is. Most of these technologies are mHealth technologies, defined by Meredith on her blog here. There are eight initiatives: “smart” pill bottles, health tracking briefs, ThriveOn for customized mental health help, wearable fall protection underwear, baby monitor clipped to clothes, smart footwear, smartphone thermometer, and Scandu Scout to analyze vitals on your smartphone. These are all new concepts that were on display at a recent South by Southwest conference. I am going to analyze the two types of technological underwear. Pixie Scientific is the company that created the health tracking briefs, smart diapers that contain an indicator panel that tracks UTIs and monitors hydration to prevent disease. These diapers sound like a great idea for public health, more so than the ActiveProtective underwear with 3-D motion sensors to detect falls.
However, if Pixie Scientific and ActiveProtective could combine the two? How amazing! They would be preventing UTIs by tracking hydration, injury with micro-airbags in the underwear, and a call for help. The cons to these undergarments would be cost—Pixie Scientifics briefs are disposable and the infant version has been around for a while. ActiveProtective must be brand new, because there is not any information online yet, but I can’t imagine micro airbags and whatever “call for help” technology is, is cheap. Pixie Scientific seems to still be in its research stage. I found a funding project for the program on indiegogo. The company claims they will use the $21,491 raised to “fund manufacturing, a data-gathering study at UCSF Benioff Children’s Hospital, and another study meant to collect data for FDA registration”. Mainly these diapers will screen for: urinary tract infections, prolonged dehydration, and developing kidney problems. According to UrologyHealth, approximately 40 percent of women and 12 percent of men will experience at least one UTI in their lifetimes. I’m a big fan of these diapers because I’m a public health major, and if they can reach their stretch goals: to search for endemic diseases and screen for early signs of type 1diabetes, that would be a huge deal in terms of promoting higher quality of life through disease prevention.
mHealth, an abbreviation of mobile health, is a broad term generally used to describe health programs and initiatives operating primarily through mobile devices. Mobile device use is on the rise, and it is now estimated that up to 85% of the world’s population is covered under some mobile subscription. In rural areas with limited access to physical clinics, doctors, and resources this type of program can have far-reaching benefits. Because of the nature of mobile devices, applications, etc. mHealth initiatives are able to cover a wide range of health topics including general health information, diagnosis, and disease tracking.
To me, mHealth has a huge potential for use in developing nations. While researching the topic, I came across MAMA (Mobile Alliance for Maternal Action). This program operates mainly through SMS messages and simple voice reminders. MAMA currently operates in 69 countries and reaches nearly 141 million women. Their messages are based on WHO and UNICEF guidelines and provide information about what to expect from their babies at certain ages and reminders to get checkups or vaccines. To learn more about MAMA, check out their website below.
This is just one of many examples of mHealth initiatives focusing on developing nations. Of course maternal health has always been a focus, but what other ares do you think mHealth could have a major impact in? Do you see any challenges for these initiatives in the future? I think they are a wonderful example of just how much potential technology has in developing nations.
Colorimetrix, a new smartphone app, could serve as a health care game changer in developing nations. The app, which was developed by researchers at the University of Cambridge, measures color based saliva or urine tests through the phone’s camera. The user takes a picture of a test strip that has been placed in the solution, and the app uses an algorithm to transmit the results into a readable number. Results can then be sent to healthcare providers or specialists for analysis in real time.
This app has the potential to transform the current means of patient screening. It provides quick, low-cost and portable diagnostics that can be transferred to medical professionals around the globe within seconds. Patients are also able to monitor chronic conditions, such as diabetes, with this app. Also, because patients are able to transmit results information so quickly, Colorimetrix may be able to slow or limit the spread of pandemic diseases by communicating with community healthcare professionals. “This app has the potential to help in the fight against HIV, tuberculosis and malaria in the developing world, bringing the concept of mobile healthcare to reality,” said Ali Yetisen, a PhD student in the Department of Chemical Engineering & Biotechnology.
There are some major strengths to this app, the main one being how quickly it can connect patient data to physicians to interpret the results. This would cut down on hospital expenses, empower patients, and allow for less waiting time in health clinics. On the other hand, systemic healthcare problems and technological capacity within many developing nations may inhibit this app from reaching its full potential. Lack of trained healthcare providers to interpret results and low bandwidth in developing countries may pose barriers to the adoption of this app.
Linda Raftree’s article is a great resource for delving into the world of ICT4D professionals. In it, Jonathan Donner is mentioned for a debate in his post titled More letters, more problems, which seems to be a very fair response to the debate regarding the term used to describe this field. In this post he concludes that in the multifaceted field that is ICT4D, there should be frequent discussion of improvement. Reflection is key in making the practitioners of the field reflective, careful and precise in how they use terms to describe what they all work to do.
Jonathan Donner currently researches in the Technology for Emerging Markets group at Microsoft Research India, and specifically focuses on economic and social implications of the spread of mobile telephony in developing countries. He is also a visiting academic at the Hasso Plattner Institute for ICT4D Research at the University of Cape Town. His Ph.D was earned at Stanford in Communication Theory and Research, and he has been a post-doctoral research fellow at the Earth Institute at Columbia. His book, Mobile Communication (part of a Digital Media and Society Series) is about how the mobile phone has grown so popular in almost every society on earth, and are very useful tools, especially in the developing world. Additionally, he has a book titled mHealth in Practice. His blog is very pertinent to our ICT4D class and he can be followed as @jcdonner on Twitter.
This PBS article discusses the challenges involved with text messaging programs designed to spread health information in developing countries. Many of the problems discussed are issues that we have brought up in class.
Some of the problems include:
- The difficulty of charging cell phones in isolated areas.
- Is the information provided relavent and useful?
- Will people follow the advice given in text messages?
- How will cultural differences across countries affect how people respond to the text messages?
- Early data did not look at whether or not text messages actually cause behavior change.
- Governments need to be on board for large scale projects.
This article discusses several ways mhealth can be utilized in the developing world. In India and South Africa, text messages are being used to give pregnant women advice during each stage of pregnancy. In Bangladesh, text messages are being used to inform parents about when to vaccinate their children. Even in the United States mhealth is being used for smoking cesation programs.
We discussed other issues in class that the article did not include. For example, would text messages be too expensive for some people? Does everyone with a phone know how to send texts? How can you encourage people to sign up for the text messages? How can you make sure information is clear and relevant and that people will actually read the texts? These are all problems that future mhealth programs must address.
Plan to save lives and reduce costs agreed at ITU Telecom World 2012
“Of the 57 million deaths globally, NCDs contribute to an estimated 36 million deaths every year, including 14 million people dying between the ages of 30 and 70.” This is extremely sad that there are such large statistics concerning deaths due to NCDs. These are preventable diseases! The burden of non-communicable disease is now greater than the burden of communicable diseases across all income groups. People are living longer and their lifestyles create a higher probability of developing chronic, degenerative diseases. People can control the risk factors for non-communicable diseases, but yet heart disease, neoplasm, cardiovascular disease, diabetes, hypertension, myocardial infarction, and cancers still are the top killers in the US and other countries. Despite affecting so many people, some non-communicable diseases can be prevented or controlled at relatively low cost, such as type II diabetes. Major risk factors for many non-communicable diseases are tobacco use, diet, physical activity, and environmental exposures. If these risks factors can be reduced, the percentage of people developing non-communicable diseases will decrease.
Utilizing mobile phones to save lives, reduce illness and disability, and reduce healthcare costs significantly would be very innovative of ICTs. In addition, the idea that this mHealth initiative is building on current projects and existing health systems and platforms, and will involve partnerships between governments, NGOs, and the private sector is perfect for sustainability and working with what is available rather than trying to do something completely new. Similar to the Txt4Health campaigns, this larger scale initiative will most likely bring positive impact. Perhaps with this new m-Health initiative by the ITU and WHO, we can find ways to reduce the rate of non-communicable disease not just in developing countries but also developed countries like the US.
This article discusses the results of a Harvard School of Public Health study which was released this month regarding the use of mobile phones in tracking malaria in Kenya. In this study, researchers tracked the timing and location of calls and texts from 15 million mobile phones in Kenya between June 2008 – June 2009 and compared this data with data on malaria prevalence by region. By studying the movements of people relative to the movement of the disease, the researchers were able to identify primary sources of malaria, as well as those most at risk for infection. They concluded that the most significant amount of malaria transmission in Kenya is from travel from Lake Victoria to Nairobi, Kenya’s capital.
This study differs from some of the others we read about and discussed this week in that it does not use mobile technology to directly communicate with mobile phone users. It is interesting to see how the prevalence of mobile phone use, particularly in Africa, can be utilized for development in ways other than direct communication. Because this was a large scale study, rather than using mobile phones for direct communication within a smaller population, these results might be immediately applicable to policy decisions. In addition they can be applied to mHealth efforts more similar to the ones we read about this week, which directly engage and interact with their target populations to help more effectively educate about, prevent, and treat malaria. One of the researches associated with the study suggested warning texts to travelers to and from malaria hot spots.
While this study has the potential to provide a great deal of insight regarding patterns of malaria transmission, the data is biased due to the digital divide, and population differences between those who have mobile phones and those who do not. Younger, wealthier, male, and urban populations are more likely to have mobile phones and therefore be reflected in this data, so initiatives and policy based off these results may disproportionately benefit those groups. These results, and this method of data collection, may be less effective particularly in terms of helping rural, female, lower-income, and less geographically mobile populations. Of course, any knowledge which can promote health, even disproportionately, should be considered and used to implement public health initiatives – however hopefully there will be other measures taken to make up for disparities in data, as not to further disadvantage already disadvantaged groups within the population.
A recent surge in m-Health and e-Health ICT4D initiative are popping up in Egypt and the Middle East. Many of these projects focus on smartphones, 3G networks, wireless internet, and apps to improve health services throughout the region.
Qualcomm, a technology company, is is leading a pilot program in Egypt to see if eHealth and mHealth initiatives will be successful in the region, and there are bigger plans to overhaul the health care system in Egypt (and other North Africa and Middle East countries) to rely more heavily on ICT. Here’s an article about one pilot project (focused on utilizing 3G mobile network to diagnose skin conditions remotely) that is a small piece of the overall vision for the region. According to this article: “The Ministry of Communications and Information Technology has facilitated the integration of ICT in health services and the provision of telemedicine to the remote and rural areas of Egypt,” said Dr Hoda Baraka, first deputy to the Minister of ICT. “The Egyptian Teledermatology initiative, using mobile health technology, is inspired by pursuing equal opportunities for health services anywhere in Egypt and expanding medical insurance to all citizens. E-health programs bring better diagnostic and health services to a wider segment of the Egyptian society.”
In researching this pilot project more, I’ve found another article that points out an overall vision of mhealth for the region. Apparently, ” Qualcomm is working with regional governments and mobile operators in the Middle East to create country-wide mobile health systems within the next three to five years, according to a report in Reuters. Qualcomm is currently looking into opening offices in both Saudi Arabia and Egypt in mid-2011.” This is a very ambitious ICT4D initiative that could revolutionize health in the region. However, it is important to focus on possible limitations, infrastructure, environment, and usage of ICT in the region to assess the plausibility of such projects. The same article that sites the plan for implementing a country-wide mobile health system that relies heavily on smart phones, apps, wireless internet, and 3G network access also noted a very important piece of information: Egypt only has 6-7% smartphone penetration. This seems like a very large problem for the m-health project. A national health plan that relies on patients having access to smartphones may lead to many unintended consequences. Digital divide that exist among the target populations may turn into to major divides in access to health care, which could exacerbate cycles of poverty and exclude already marginalized populations. I think this project deals with many of the topics we have discussed in class and relates to many of the readings. I am interested to see what classmates think about the positives and negatives of these initiatives. Will these mhealth efforts help improve medical care in rural areas or will it widen inequalities?