Global Health Ideas

Finding global health solutions through innovation and technology

Archive for the ‘ICT’ Category

Vote for mHealth Project: ClaimsMobile in Uganda

Please vote for Ben’s mobile payment for health systems project. Voting closes Friday.

VOTE – NETSQUARED: By introducing a smartphone and web-application system for submitting and reviewing claims, we hope to reduce the delays and errors, increase clinics’ profitability and improve communication. Below is a related post by Melissa Ho who is working with Ben on this project which fills a critical gap. Cross posted from ICTDCHICK:

First HealthyBaby Birth

The mother receives the baby from the nurses at the clinic.

The mother receives the baby from the nurses at the clinic.

As I have been pre-occupied with writing lectures for my class, and setting up my research, my collaborating partners at Marie Stopes International Uganda have been busy launching a new phase of the output-based aid voucher program, financing in-hospital delivery of babies, in addition to the in-clinic treatment of sexually-transmitted infections (STIs). The new program, called HealthyBaby is eligible to mothers who qualify under a specific poverty baseline and covers four antenatal visits, the delivery, and a postnatal visit. Last week they just started distributing vouchers, and this past weekend was the delivery of the first baby whose birth was covered by the program.

Like the HealthyLife program, the mother purchases a voucher for 3000 USh (approximately 1.50 USD, the HealthyLife program charges 3000USh for a pair of vouchers treating both sexual partners). The voucher then can be broken into several sticker stubs, one of which is submitted with a claim form on each visit.

The first mother puts her thumb print on the HealthyBaby claim form

The first mother puts her thumb print on the HealthyBaby claim form

The hospital then submits the claim form with the voucher to the funding agency (my collaborating organization), who then pays the hospital for the cost of the visit – labs, any prescriptions given, the consultation fee, etc. You can see in the picture to the right the nurse filling out the paper form and the mother putting her thumbprint on it. Filling out the forms can be tedious and error prone – this particular clinic had almost 18% of their STI claims rejected for errors last October. In the same month another clinics had 38.6% of their claims rejected. I am trying to work on digital systems that can help improve communications between the clinics and the funding agency, and also decrease the cost and burden of claims administration.

The Claim Mobile project actually focuses on the HealthyLife program – the STI treatment program, rather than the HealthyBaby program, but I hope to demonstrate the sustainability and replicability of the system that I’m developing by training the engineers here to retool my system for HealthyBaby – so by the time I leave, I am hoping it will be in place for both programs.

By coincidence, this first birth occurred in one of the two clinics where I’m running the pre-pilot of the Claim Mobile system.

Written by Aman

April 8, 2009 at 10:07 pm

World Health Day: The Future of Global Health

The WHO has decided to focus this World Health Day on hospital infrastructure during times of emergency. The folks over at Global Health Progress have a good round of what some bloggers are saying and include health journalism folks as well as thoughts from the AvianFlu diary. I thought I would go off theme and briefly throw out some thoughts on the bigger picture and encourage you to use this day to think about what is the future of global health? In this context of thinking about the future in 10, 20 or 30 years, the world is in turmoil and we are questioning the fundamental nature of market driven economies, why not use this as an opportunity to do the same for global health in a forward looking way? Think about where we are and whether we are prioritizing the right things and moving in the right directions?

Approximately 10 (only TEN!) years ago there was no Google, Kiva, Gates Foundation or knowledge about the cost differences between generic and brand name drugs (see this great talk on the Future of Global Health by Jim Yong Kim and his discussion of how they reduced the price of treating MDR TB patients by 80-90% in 1999) amongst major care organizations (absolutely stunning). Mobile phone penetration was less than 1% in developing countries and social entrepreneurship wasn’t hot, the vast majority of us probably hadn’t even heard of that term.

Where we were ten years ago is arguably a profoundly different world from where we are today and per the video below “we are living in exponential times“. To give you further inspiration to think differently today definitely watch the below (via 2173):

The acceleration of technology for social change and global health is going to increase, in this decade alone the convergence of movements in philanthropy, entrepreneurship and technology all enabled by the internet and mobile phone revolution have allowed people to collaborate, innovate and communicate on an entirely different level. I don’t know what the future of global health is – but I wonder how open source collaborations will contribute to solutions and whether twittering for global health will be around in five years and for whom and what purpose? Or will we just be doing more of the same. I wonder if we will be doing entire marketing and health education campaigns via mobile phones and how this will evolve. Will there be convergence of people and ideas working on global and domestic health? Will the flow of innovation and products from “South” to “North” become the next hot topic? I wonder if we will have a TED just for Global Health?

We might face a global crisis in 2030 but we will also be better equipped to face that crisis.Today is a day we should be thinking about what all the possibilities are and how we can get there in the fastest way possible.  The last idea I will throw out as food for thought is to think about what have been the top 10 biggest developments in global health in the last decade and how will these shape the future?

Other thoughts on World Health Day:
UN Dispatch, link
Human Rights Watch, link
The Lancet Student, link
Global Institute Blog, link
Charity Navigator, link

Written by Aman

April 7, 2009 at 9:05 pm

Social challenges

Update: Voting opened Monday and will close Friday 3pm Pacific time. We are expecting a high turnout. Your support will be critical. To cast a ballot voters need to select three projects.

NetSquared has a new social challenge “N2Y4“. Voting opens Monday and Melissa and I submitted a proposal called “ClaimsMobile” to the new competition. “ClaimsMobile” is a mobile phone and web database application for management of patients’ medical and financial information in a Uganda output-based healthcare project. We have been working with partners at the Mbarara University, the NGO Marie Stopes International Uganda, and small private clinics in the region. Check it out. Voting starts April 6th (Monday) 11 AM California time and runs for five days. If you like our idea, vote for it… and be sure to look through the range of amazing proposals – everything from education to international justice to community programs. The word cloud says it all.

wordcloud

There seem to be a lot of “social challenges” these days. In the past nine months, I’ve been asked to vote for a Peace Corps projects photo idea at NameYourDreamAssignment, a girls’ tuition fund in Burkina Faso, a geotourism project in Ecuador, a women in sport challenge, as well as support a handful of ideas among the 7875 proposals submitted to the popular Ideas for Change in America campaign; all hosted on platforms like Ashoka ChangeMakers, GlobalGiving, NetSquared, and Change.org.

These challenges, like California ballot initiatives, work best if voters take the time to learn the issues. Spend some time to select projects from an area you know or have a great deal of interest – the NetSquare’s word cloud is a useful first step to sort ideas. If that fails, Stoltz at Web2…Oh Really recommends picking the project with the least votes… and I’ll close by suggesting “ClaimsMobile” for your short list.

Written by Ben

April 4, 2009 at 7:52 pm

CATER NYU Workshop on Technologies for Humanity (April 10)

I’ll be in New York attending the health portion of the following workshop. Please pass the word and if you are around and want to meet up send us an email (thdblog AT gmail).

“The CATER research group cordially invites you to attend the 2009 workshop on “Technologies for Development” which showcases our ongoing research efforts in the space of appropriate technologies that aid development in under-developed areas around the world.

Cost-Effective Appropriate Technologies for Emerging Regions (CATER) is a new multidisciplinary research initiative at NYU that focuses on developing appropriate, low-cost Information and Communication Technologies (ICT) for addressing pressing problems in developing regions. CATER is a joint initiative comprising faculty from Computer Science, the School of Medicine, the Wagner Graduate School of Public Service, NYU’s Economics Department, and NYU-Polytechnic.

This workshop will feature a combination of invited talks from accomplished researchers and short talks by student researchers within
CATER on their ongoing research efforts. The talks will cover four important areas:”

·         Technologies for improving access to communications in rural areas
·         Technologies for enhancing rural healthcare
·         Technologies for enhancing financial and commerce services
·         Technologies for enhancing rural education

FULL SCHEDULE

Written by Aman

March 18, 2009 at 8:16 pm

“Innovating for the Health of All” open for registration (Havana, November 2009)

Forum 2009
Innovating for the health of all
Innovando para la salud de todos
Havana, Cuba, 16-20 November 2009

Registration here

The letter:

Dear colleague,

Forum 2009: Innovating for the Health of All is this year’s milestone event in research and innovation for health. Organized by the Global Forum for Health Research, it will take place from 16-20 November in Havana, Cuba, at the invitation of the Ministry of Public Health.

What exactly is “innovation”?* How can decision-makers and practitioners work together to foster innovation for health and health equity? What can we learn from innovation policies and initiatives around the world? These questions will be answered in Forum 2009‘s interwoven discussions of social innovation and technological innovation.

This event will bring together some 800 leaders and experts from around the world to share ideas and forge new partnerships. It will include a unique mix of stakeholders from health and science ministries, research agencies and institutions, development agencies, foundations, nongovernmental organizations, civil society, the private sector and media.

As you expand your networks, you will also be able to learn from discussions on social entrepreneurship for health, public-private product development for neglected diseases, eHealth, knowledge-translation platforms, national health innovation systems, donor-country harmonization and coherence, and innovative financing strategies.

With the theme “innovation,” we are challenged to be innovative in the programme itself including new session formats that are more interactive, new ways to network and share information, and new opportunities for inclusion.

So please join us. Registration is now open on http://www.globalforumhealth.org. We very much look forward to seeing you in Cuba.

Yours sincerely,
Professor Stephen Matlin
Executive Director
Global Forum for Health Research

Google Flu Trends for developing countries?

A few days back Aman wrote a post about Google Flu Trends.  Thought I’d add a few thoughts here after reading the draft manuscript that the Google-CDC team posted in advance of its publication in Nature.

By the way, here’s what Nature says:  Because of the immediate public-health implications of this paper, Nature supports the Google and the CDC decision to release this information to the public in advance of a formal publication date for the research. The paper has been subjected to the usual rigor of peer review and is accepted in principle. Nature feels the public-health consideration here makes it appropriate to relax our embargo rule

Ginsberg J, Mohebbi MH, Patel RS, Brammer L, Smolinski MS, Brilliant L. Detecting influenza epidemics using search engine query data. Draft manuscript for Nature. Retrieved 14 Nov 2008.

Assuming that few folks will read the manuscript or the article, here’s some highlights.  I should say I appreciated that the article was clearly written.  If you need more context, check out Google Flu Trends How does this work?

  • Targets health-seeking behavior of Internet users, particularly Google users [not sure those are different anymore], in the United States for ILI (influenza-like illness)
  • Compared to previous work attempting to link online activity to disease prevalence, benefits from volume: hundreds of billions of searches over 5 years
  • Key result – reduced reporting lag to one day compared to CDC’s surveillance system of 1-2 weeks
  • Spatial resolution based on IP address goes to nearest big city [for example my current IP maps to Oakland, California right now], but the system is right now only looking to the level of states – this is more detailed CDC’s reporting, which is based on 9 U.S. regions
  • CDC data was used for model-building (linear logistic regression) as well as comparison [for stats nerds - the comparison was made with held-out data]
  • Not all states publish ILI data, but they were still able to achieve a correlation of 0.85 in Utah without training the model on that state’s data
  • There have attempted to look at disease outbreaks of enterics and arboviruses, but without success.
  • For those familiar with GPHIN and Healthmap, two other online , the major difference is in the data being examined – Flu Trends looks at search terms while the other systems rely on news sources, website, official alerts, and the such
  • There is a possibility that this will not model a flu pandemic well since the search behavior used for modeling is based on non-pandemic variety of flu 
  • The modeling effort was immense – “450 million different models to test each of the candidate queries”

So what does this mean for developing world applications?

Here’s what the authors say: “Though it may be possible for this approach to be applied to any country with a large population of web search users, we cannot currently provide accurate estimates for large parts of the developing world. Even within the developed world, small countries and less common languages may be challenging to accurately survey.”

The key is whether there are detectable changes in search in response to disease outbreaks.  This is dependent on Internet volume, health-seeking search behavior, and language.  And if there is no baseline data, like with CDC surveillance data, then what is the best strategy for model-building?  How valid will models be from one country to another?  That probably depends on the countries.  Is it perhaps possible to have a less refined output, something like a multi-level warning system for decision makers to followup with on-the-ground resources?  Or should we be focusing on news+ like GPHIN and Healthmap?

Another thought is that we could mine SMS traffic for detecting disease outbreaks.  The problem becomes more complicated, since we’re now looking at data that is much more complex than search queries.  And there is often segmentation due to the presence of multiple phone providers in one area.  Even if the data were anonymized, this raises huge privacy concerns.   Still it could be a way to tap in to areas with low Internet penetration and to provide detection based on very real-time data.

Google Flu Trends: Predicting the Future

In case you missed this in the NY Times today – fascinating experiment with a new Google tool on the frontiers of diseases surveillance and global health trends. Remains to be seen how useful this will be and lots of validation needs to be done, but this is yet another example of people outside of traditional health/public health communities who are on the leading edge of public health innovation:

“What if Google knew before anyone else that a fast-spreading flu outbreak was putting you at heightened risk of getting sick? And what if it could alert you, your doctor and your local public health officials before the muscle aches and chills kicked in? That, in essence, is the promise of Google Flu Trends.

“Google Flu Trends (www.google.org/flutrends) is the latest indication that the words typed into search engines like Google can be used to track the collective interests and concerns of millions of people, and even to forecast the future.”

googleflue

We have discussed before how data indexed on the web can used for all sorts of fascinating things. We had a previous posts on global health job trends and also on publications that use the terms global health and private sector. The graphs below show a large increase in both areas, however there are dozens of caveats with this kind of trend analysis and the below graphs have to be taken with a grain of salt:


1. Global Health Job Trends (see for full post)

2. Trends: Development/Global Health in the Business Press (see for full post)

jobgraph


scholargoogle_articles

Written by Aman

November 11, 2008 at 4:31 pm

M-Money Maturing

Russell Southwood had a short story (full report at balancingact-africa.com) on Kenyan banks crying foul with the rapid expansion of mobile money credits acting profitably as current account institutions without the same regulatory oversight.  From Southwood’s emailed summary:

“Currently, the two leading mobile phone service providers – Zain and Safaricom – are offering money-transfer services in the country under Sokotele and M-Pesa brands respectively… To avert undue competition with the banking fraternity … M-Pesa and Sokotele services have to meet the capitalisation requirement as stipulated in the Banking Act. According to the Act, a deposit taking institution should maintain a minimum capitalisation of Ksh250 million ($3.5 million). This is however expected to double come December next year before hitting Ksh1 billion ($14.2 million) by 2010 after capitalisation requirements were amended in this financial year’s budget.”

How small is too small for regulation?  As clear from Kenya, small transactions at scale can leverage significant economic activity and worry the big bank competition.

The question was raised elsewhere this week.  The World Affairs Council of Northern California and UC Berkeley are holding a roundtable dinner next Wednesday with space reserved for UCB students if they address, in 150 words, some of the industry challenges as microfinance and m-money mature.  So any UCB students reading this post, check out BalancingAct for a few ideas.  A few choice subjects:

- When is a bank account a bank account?
- Does the market want mobile phone enabled financial services?
- What’s makes a successful customer business model interface?

The growth of the mobile services in microfinance has been breathtaking and defining the space where traditional banking, microfinance and mobile services intersect will continue to be a challenge as the technology matures and demand continues to grow.

Written by Ben

October 17, 2008 at 1:06 pm

Global Health Council 2009: New Technologies + Proven Strategies = Healthy Communities

The Global Health Council has released the theme for their 2009 conference to be held in Washington, DC: “New Technologies + Proven Strategies = Healthy Communities”.  I’ve been helping them with development of their CFP over the summer months – the focus is largely on ICT, but there is consideration given to other technologies also.  This is an applied conference with significant international representation.  In terms of a broad global health meeting, this is the best I’ve attended.

Written by Jaspal

September 2, 2008 at 2:30 pm

Mobile Phones & Global Health III: Ultrasound, Imaging & ECG to Go!

1. Microsoft is funding research in Argentina and India into low-cost electrocardiogram (ECG) machines. The devices, which can cost less than $100, use cell phones to transmit data to a computer, where it can be analyzed and then conveyed to a doctor.

2. Using Rubinsky’s gear, a doctor could use a cell-phone screen to view a cross section of tissue. In this image, a doctor uses a cell phone to magnify a patient’s breast tissue and examine it for a tumor.
SOURCE: Business Week

==============================================================
This is our third post on mobile phones and international/global health (post 1, post 2). This post is largely imcomplete, but I wanted to get it up. The above pics and quotes below are based on a feature in Business Week:

“It’s not easy to lug an ultrasound machine into a remote village’s health clinic—much less keep it running. But a cell phone? No problem…”

“According to the World Health Organization, about half of the imaging equipment sent to developing countries goes unused because local technicians aren’t trained to operate it or lack the necessary spare parts. So researchers are stepping up efforts to employ wireless technologies to deliver crucial medical services, particularly in underserved areas…Scientists from the University of California, Berkeley, have just developed a prototype technology that uses cell phones to deliver imaging information to doctors.”

“The University of California professor says that by reducing a complex electromagnetic imaging machine to a portable electromagnetic scanner that can work in tandem with a regular cell phone and a computer, he has essentially replicated a $10,000 piece of equipment for just hundreds of dollars.”

Another source – Imaging technology could be useful in poor countries:
Some types of medical imaging could become cheaper and more accessible to millions of people in the developing world if an innovative concept developed by an engineer at the Hebrew University of Jerusalem fulfils its promise. The device uses cellular phone technology to transmit magnetic resonance images, computed tomograms, and ultrasound scans (PLoS One 2008;3:e2075; doi: 10.1371/journal.pone.0002075)

One other recent article in this area, from PC World -
Mobile Phones and the Digital Divide: Whether you’re building an application for the 3G iPhone in the United States or trying to figure out how to deliver health information via SMS (Short Message Service) to a rural community in Botswana, the mobile space is diverse and exciting in equal measure.

Also be sure to check out:
- Why people seek out health information, link

Written by Aman

August 27, 2008 at 9:58 pm

Aug 15 Deadline: $150,000 for Stories of Change

I keep forgetting to put up a post on this, so here it is, close to the deadline. It will be great to see the film(s) that come out of this (hopefully global health related!):

Stories of Change: Social Entrepreneurship in Focus Through Documentary
“The Sundance Institute Documentary Film Program and the Skoll Foundation have partnered in a three-year initiative to explore how independent feature-length documentary film can advance knowledge about social entrepreneurship.”

“The Stories of Change Fund will consider independent feature-length documentary projects in all categories of development, production and post-production. Completed films are note eligible. Film projects must be completed by 2010. Grant awards will be made on a case-by-case basis and may range up to $150,000 US per film.”

http://sundance.org/skoll/

Written by Aman

August 10, 2008 at 9:01 pm

Mobile Phones and International Health Links Part II

I missed a few links from our previous post on global health and mobile phones, so this is part deux, which will be followed by Part III later this week. As you can see from the frenzy of recent activity – the mobile phone for health revolution is moving ahead rapidly, where it will take us and how useful it will ultimately be will be known in due time. And as mentioned, this is a case where the “Third World is First”, innovation is happening far ahead of what we are seeing in the US. There are a several good links below. For those seeking more documentation beyond news items, see the report from the Bellagio e-health conference which I believe is being organized by the UN Foundation, Vodafone Group Foundation and the Telemedicine society of India.

CellScope: Mobile-phone microscopes, Link
Dan Fletcher, a professor of bioengineering at the University of California, Berkeley (Go Bears!!), has developed a cheap attachment to turn the digital camera on many of today’s mobile phones into a microscope. Called a CellScope, it can show individual white and red blood cells, which means that with the correct stain it can be used to identify the parasite that causes malaria.

Cellphones for HIV, Link

Mobile Phone Telemedicine Interview: Full Interview at MobileActive.org
(title and link via Drew – thanks!)

mHealth and Mobile Telemedicine – an Overview
Great links below and full news link here

  • Sizing the Business Potential (Link)
  • Relationship among Economic Development (Link)
  • mHealth: A Developing Country Perspective (Link)

Wireless Technology for Social Change: Trends in NGO Mobile Use, Link

Related to above: “Technology plays crucial role in vaccination distribution”, Link

The Pill Phone for US Markets. This kind of application was used long before in developing countries – now it is slowly entering the US market: “In a first-of-its-kind application, Verizon customers in the US can get information and set reminders regarding medication and dosage with “the Pill Phone”. Link

Managing Symptoms By Mobile Phone May Revolutionize Cancer Care For Young People, Link

New wi-fi devices warn doctors of heart attacks, Link
“The Bluetooth wireless technology that allows people to use a hands-free earpiece could soon alert the emergency services when someone has a heart attack…” How they will manage the data flow and response is a big question in my opinion.

Other Links:

  • Microtelecom for the Next Billion Mobile Users, Link
  • MobileActive08 is the only global gathering that is connecting leaders who are working at the convergence of civil society, mobile technology and social change. Link

Written by Aman

August 3, 2008 at 7:45 pm

Mobile Phones and Global Health Link Drop

Over the last year there I have noticed a tremendous up-tick in mobile phones for health/global health stories. The innovation in this area has been worldwide and the sense I get is that use outside the US and in developing countries is far more creative and wide ranging (I haven’t done the research, but this is probably a case where a country like the US will be taking lessons from less developed regions or the “South” as people love to say). We did a previous link drop on SMS/Text Messaging for Global Health that you should check out. Below I begin with two links about the power of mobile phones in general followed by recent links in a plethora of areas from countries around the world. Enjoy:

“Within the next three years, another billion people will begin to make regular use of cell phones, continuing the fastest adoption of a new technology in history” Taken from a very good post on “Mobile Phones for Development” over at CrissCrossed.

New NextBillion MIT Network: “Eventually there will be more cell phone users than people who read and write.” —Eric Schmidt, CEO, Google. The goal of the Next Billion Network is to deploy innovative mobile technologies that help people reduce friction in their local markets from the bottom up. (Link)

_____

  • Telemedicine and Monitoring AIDS Treatment in Africa (Link)
    “With software developed by Ericsson and phones donated… health workers can call up the medical records of pregnant women from an online database and then, by cell phone, tell care-givers what to do during an emergency…”

    • Another story on the above: A toll-free mobile service being launched in selected remote areas in Africa promises to save lives by connecting people with emergency medical cases to health personnel. (Link)
  • STOMP (STop smoking Over Mobile Phone): “Clinical trials have shown that using STOMP doubled reported quit rates from 13% to 28% after six weeks“. This would be of tremendous use in LDC’s as smoking is a serious global health issue. (Link)
  • Glucose (Diabetes) and exercise monitoring (Link)
    • Tracking chronic conditions remotely and sending info to clinicians (Link)
    • Managing symptoms for cancer care (Link)
    • Cardiomobile exercise and monitoring system: “The Cardiomobile system works by the patient attaching to their chests a mini ECG (electrocardiogram or heart signal) monitor and wearing a cap with a lightweight GPS receiver, both connected to a mobile phone via Bluetooth.” (Link) ; mini ecg picture (Link)
    • Mental Health Monitoring: Mobile phones and the internet will soon be used to help up to two million Australians manage their mental health problems. (Link)
    • India to develop their unique mobile phone health monitoring system (Link)
    • Erricson to offer mobile health services across India (Link) via Sneha
    • Review Article: Innovation in practice: mobile phone technology in patient care. (Link)

    OTHER

    • Solar Charger For Mobile Phones (Link)
      • Nokia Phones go Green: “Today Nokia chargers save 90% more energy, 65-80% of the phone components are recyclable and have reduced packaging by more than 50%…” (Link)
      • Kenya’s mobile revolution (Link)
      • iPhone health and fitness applications (Link)

      Written by Aman

      July 28, 2008 at 8:30 pm

      Global Health Video Makes Top 10 TED List

      Everyone I have spoken to loves TED videos. If you aren’t familiar with TED, you are missing out. The Technology Entertainment and Design (there is that word again! see Jaspal’s work in the area of global health design) outfit gathers some of the best people in their respective fields to share ideas . While their annual conference is extremely exclusive, they do post their videos online. The tag line: Inspired talks by the world’s greatest thinkers and doers. TED just posted on the their top 10 videos in the past 2 years. On first glance I found 2 things remarkable about this list:

      1. These videos have over 50 Million views (amazing)!

      2. There is a global/public health video in the top 10, debuting at number 7

      The numbers clearly display a strong appetite for for this kind of work – work that is innovative, connects and sometimes has great impact on the social good. What’s more – global health issues can garner a lot of attention and people do care about it (translation, there are ways to make it sexy and appealing). I would be very curious to get a age based demographic breakdown of who is watching these videos, specifically I want to see if there is a generational breakdown. The public health video has made its rounds and we did discuss it here at THD (I have posted it below again). From TED:

      Announcing the Top 10 TEDTalks

      “With 50 million views since we started posting video two years ago, TEDTalks have become a powerful cultural force. To celebrate this milestone, we’re releasing a never-before-seen list: the Top 10 TEDTalks of all time, as of June 2008.

      With speakers like neuroanatomist Jill Bolte Taylor and global health expert Hans Rosling, the list proves one of the compelling ideas behind TEDTalks: that an unknown speaker with a powerful idea can reach — and move — a global audience through the power of quality web video…”

      Hans Rosling (well worth watching):

      Written by Aman

      July 7, 2008 at 2:04 am

      Market Failure and the Clear Need for Electronic Health Records

      The New York Times reports that Most Doctors Aren’t Using Electronic Health Records. However, the New England Journal of Medicine study released June 18th notes paradoxically “doctors who use electronic health records say overwhelmingly that such records have helped improve the quality and timeliness of care.” The benefits are overwhelmingly positive: “82% [of doctors using electronic medical records] said they improved the quality of clinical decisions, 86% said they helped in avoiding medication errors, and 85% said they improved the delivery of preventative care.” Clearly, electronic medical records could be a tremendous aid in improving health outcomes, shifting the balance of care from costly medical intervention to relatively inexpensive prevention measures, and reducing medical errors.

      Yet fewer than one in five of the nation’s doctors has started using such records.” Only 4% of doctors surveyed were using “fully functional” electronic records that can record clinical and demographic data, results of lab tests, issue orders and inform clinical decisions (such as warning about drug interactions). 13% of respondents reported using a “basic” clinical system, which lacks clinical decision support and some order-entry capability.

      The barriers cited are largely economic, with doctors in small practices citing prohibitive capital costs for adopting a new system, lost income from not seeing patients, and no existing electronic medical record software that meets the needs of small to medium practices. In an attempt to speed adoption, the government has announced a Medicare program that will offer incentives to practices to transition to electronic medical records.

      What we see is a deficit in innovation, and that is something innovators and the capital markets can address,” said Dr. David J. Brailer, who leads a firm that invests in medical ventures, Health Evolution Partners.

      After conducting several retrospective folder reviews, I believe the conventional patient folder is actually an obstacle to good patient care. Folders are often lost or duplicated, and they take time to retrieve. Basic patient information is duplicated in every physician’s notes, handwriting is often illegible, there is no alert system for medication errors, guidelines for patient management, or flags for unusual findings or reminders on lab results. Despite a fully integrated health system in South Africa, the reliance on paper records causes fragmentation of patient information, and disrupts continuity of care.

      Why go with paper when you could have electronic medical records?

      Written by farzaneh

      June 21, 2008 at 9:02 am

      Posted in ICT, Innovation

      Global Health Council 4: Coming Full Circle with Aravind

      Aman already reported on the Aravind Eye Care System (AECS) being awarded the prestigious 2008 Gates Award for Global Health, which “honors extraordinary efforts to improve health in developing countries”.  And as Aman mentioned, three of us at this blog owe a big debt to the Aravind organization, first for allowing us to work with them starting in 2004 in studying the Aurolab model, and second for launching us into the arena of technology, innovation, and global health.  More than 4 years after we began our relationship with Aravind, I found myself at my poster talking with Dr. Nam and Dr. Ravi about medical licensing for recent graduates in India and Mongolia.  (Similar policies of requiring graduates to work in rural areas between medical school and residency.)

      The photo below is from after the awards ceremony on Thursday night.  L-R: Dr. R.D. Ravindran, Chief Medical Officer of the Pondicherry hospital, Dr. P. Naperumalsamy, me.  Thanks to Suzanne Gilbert, Director of the SEVA Foundation, Center for Innovation in Eye Care, for taking the photo.  She was also instrumental in getting us started in this field, so it was great to reconnect with her here in DC.

      Dr. Nam’s award acceptance speech on behalf of AECS followed up a short film about Aravind and a detailed telling of the Aravind story by William Gates, Sr.  Some new directions I learned from his speech:

      1. Aravind has signed an MOU with China to increase the number of cataract surgeries done there
      2. They have an increased emphasis on information technology for supporting and extending services
      3. They aim to provide 1 million cataract surgeries per year within 5 years (currently 280,000)
      4. On October 1st, they will dedicate a research institute named after Dr. V

      Dr. Nam closed by saying: “We have done something through Aravind, but there is much more to be done.”

      Mobile Phones for Global Health: Vodafone-UN Partnership

      The UN Foundation and the Vodafone Foundation released a new report this week – Mobile Technology for Social Change: Trends in NGO Mobile Use. Thanks to Mark over at the UN Dispatch blog for telling me about this in the first place. Credit for the below description goes to an email I recieved (thanks very much Adele!) from folks at the UN Foundation, which is reproduced below:

      Case studies exploring use of ‘mobile activism’ for public health projects include:

      Mobile health data collection systems ( Kenya and Zambia ): Collecting and tracking essential health data on handheld devices, in countries where statistical information was previously gathered via paper and pencil, if recorded at all.

      Monitoring HIV/AIDS care ( South Africa ): Using mobile devices to collect health data and support HIV/AIDS patient monitoring in a country with the world’s highest HIV/AIDS infection rates, and where rural populations often otherwise go unassisted.

      Sexual health information for teenagers (US and UK ): Connecting youth to important information on sexual and reproductive health via anonymous text messaging, to empower young people to make informed sexual health decisions.

      Continuing medical education for remote health workers ( Uganda ): Providing medical updates and access to vital information via mobile phones for doctors and nurses working in some of the most destitute regions, where continuing medical education services are lacking.

      A total of 11 case studies identify emerging trends in ‘mobile activism,’ and investigate both the promise and challenges of innovative use of mobile technology to meet international development goals.

      Written by Aman

      April 30, 2008 at 9:48 pm

      13 Cents a Month for BOP Health Insurance

      A C.K. Prahalad speech was recently profiled by a Wharton newsletter, in that lecture he spoke about Indian farmers paying 13 cents a month for health insurance which allowed:

      Narayana Hrudayalaya, a pediatric heart hospital in Bangalore, to operate upon 25,000 farmers and to offer free medical consultation to 85,000 more. “This year we have increased the monthly contribution by farmers to Rs 10 (25 cents) a month, but still, we hope to cover 13 million individuals using the world’s largest telemedicine network to deliver critical health services to rural areas…

      This displays the power of pooled community based insurance. The first thing that came to my mind is that this has a shot of working because India is a place with massive volume, human resources and technological capacity. These are sweeping generalizations, but they are worthing thinking about when comparing India to other developing regions that do not have the same capacity on these three fronts. Never-the-less this is a great example and experiment that may hold powerful lessons.

       ‘The Poor Deserve World-Class Products and Services’
      Published: January 24, 2008 in India Knowledge@Wharton

      Written by Aman

      January 28, 2008 at 10:16 pm

      World AIDS Day: Educational Breakthrough

      Tomorrow is World AIDS Day and instead of “barraging you with [another set of] statistics, gruesome photos, or heart-wrenching stories” (quote credit to Mr. Casnocaha), I want to alert you to something we prefer here – solutions, problem solving, technology, and creative thinking. Piya Sorcar, a doctoral student in Stanford’s Learning, Sciences & Technology Design program has used her considerable skills to figure out how to reach the minds of children in devleoping countries when it comes to HIV/AIDS education.

      Incorporating a variety of techniques from several disciplines Piya has generated an animation based educational technique and curriculum, the first of its kind in this area. The first results from this groundbreaking technique are in and they have been outstanding. The indefatigable Sorcar has plans to disseminate the educational curriculum free to schools and other organizations. She also has plans to launch the animation on social networking sites such as Orkut (very popular in some developing countries) and Facebook.

      This educational technique and curriculum has taken over 2 years to develop and as far as we know  no one else is using this animation based method. This work is truly inspirational, overcomes various methodological barriers and just as importantly political barriers (especailly in countries where sex education is banned). The early results indicate  tremendous success. I highly encourage you to read the full story below and visit the website where the animation can be viewed:  http://www.interactiveteachingaids.org/

      We previously covered Piya Sorcar’s work in a post last year and it has been the most read post on this blog with over 1700 visits. You can view that here for further background information.

      Lasly, there is much more to say about Piya’s work which we will save for another post. I have placed some links about World AIDS Day below this entry and as a side note – even rock group Queen is getting into the action with their first new recording in a decade to mark the event.

      Enjoy!:

      Doctoral student creates groundbreaking animation to teach HIV/AIDS prevention in developing countries

      To combat the stigma associated with discussing HIV/AIDS and sexual practices in India and other developing countries, doctoral student Piya Sorcar has developed a groundbreaking animation-based curriculum to teach HIV/AIDS awareness and prevention in a culturally sensitive manner to young adults around the world.

      Sorcar’s project, Interactive Teaching AIDS, is already being used in several countries…The animation emphasizes the biology of HIV/AIDS, presenting a storyline with a dialogue between a curious student and a friendly yet authoritative cartoon “doctor” on the biological facts about HIV,its spread, and its prevention.
       
      “What’s groundbreaking is that she’s shown that we can inform people about AIDS while respecting the culture,” said Communications Prof. Clifford Nass, an advisor to Sorcar’s Ph.D. project. “That’s an enormous accomplishment.”

      “The result was Interactive Teaching AIDS, an animation-based tutorial featuring a friendly cartoon doctor and patient who guide participants through the biological aspects of AIDS transmission. The tutorial is available online and on a CD.”

      RESULTS
      A recent study of the application in India by Sorcar with 423 students in private schools and colleges in North India, showed significant gains in learning and retention levels after interacting with the 20-minute animated tutorial. Prior to testing, only 65% knew that HIV was not spread through coughing; after the tutorial, this percentage increased to 94%. Students stated that they were comfortable learning from the tool, and more than 90% said they learned more about HIV/AIDS through the animated tutorial than any other communication method such as television or school. One month after initial exposure to the tutorial, students were rapidly seeking and educating others about HIV/AIDS prevention through their networks, with nearly 90% sharing information they learned from the tutorial with someone else.

      Full story and above sources from here and here

      More links:
      CNN Student Learning Activity, link
      MTV and KFF Partnership, link
      NPR story, link
      Reuters article, link

      Written by Aman

      November 30, 2007 at 10:54 am

      Using Virtual Online Worlds to Research Epidemics

      This is a fascinating idea that was sent to me by Cat Laine over at AIDG. I know I am always raving about their blog, but really if you haven’t managed to check it out – go over there right now. Onto the story which may or may not have benefits for modeling real world epidemics: “A fantasy plague that accidentally ran amok in the Internet’s most popular game world, populated by nine million flesh-and-blood players, may help scientists predict the impact of genuine epidemics…”

      This story is not only a case of researchers being very innovative but also yet another example of how the business world is getting invovled and make a contribution to solving global health problems. The company that makes World of Warcraft is Vivendi a, giant global media company, that has entered into dicussions to possibly provide scientific data for research.

      Online gamers rehearse real-world epidemics
      “Virtual playgrounds such as World of Warcraft, launched in 2004, could soon become testing grounds for the all-too-real battle against bird flu, malaria or some as yet unknown killer virus….As technology and biology become more heavily integrated in daily life, this small step towards the interaction of virtual viruses and humans could become highly significant.

      The unlikely path to a collaboration between hard science and hard-core gaming began in late 2005, when Blizzard programmers introduced a highly contagious disease — dubbed “Corrupted Blood” — into a newly created zone of the game’s Byzantine environment.

      World of Warcraft is a “multiplayer online role-playing game” in which players — numbering in the tens, or hundreds of thousands — use computer-controlled avatars to fight battles, form alliances, and dialogue simultaneously on the Internet. At first the “patch”, as new elements such as the disease are called, worked as expected: experienced players shrugged it off like a bad cold, and weaker ones were left with disabled avatars.

      But then things spun out of control. As in reality, some of those carrying the virus slipped back into the virtual world’s densely populated cities, rapidly infecting their defenseless inhabitants. The disease also spread — much like real influenza or the plague — via domesticated animals abandoned by players for fear of infecting their avatars, leaving the sickened pets to roam freely. Programmers tried to set up quarantines, but they were ignored. Finally, they resorted to an option not available in the real world: they shut down the servers and rebooted the system.

      This was the first time that a virtual virus has infected a virtual human being in a manner resembling an actual epidemiological event…To date, epidemiologists have relied heavily on mathematical simulations to forecast the spread of contagious diseases across large populations.” But crunching numbers has limitations, says Fefferman. “There is no way to model how people will behave” in a pubic crisis, she said.

      “How many will run away from a quarantine? Will they become more or less cooperative if they are scared? We simply don’t know.” Which is where the virtual netherworlds come into the picture. They can help scientists to “feed appropriate parameters into existing epidemiological models,” she said.


      Other video game uses for public health:
      1) The Wii (check out this review of the Wii for health, Nintendo’s Wii finds use in physical therapy)

      2) Public health games

      Written by Aman

      October 12, 2007 at 5:21 pm

      MTV Launches Activist Network

      Here is a new site by MTV – think.mtv.com. They have various videos and links that of course feature artists and also non-artist involvement. MTV can clearly be a powerful motivator, their engagement is interesting and a testament to the hipness of being involved in social causes or at least giving that perception. Let’s hope this does well and gets a younger generation mobilized, screen shots and description below (along with a Jay Z video of him at the UN, click on the picture):

      “NEW YORK (Reuters) – Viacom Inc’s MTV will launch a new Internet social network sponsored by foundations operated by the founders of Microsoft and AOL to encourage youth activism….It will let users create pages, as on other online social networks Facebook and MySpace, and upload photos and videos, some of which may be aired on MTV’s online or cable network.” Full story here: MTV to launch activism social network

      Jay Z on his issue – Water:

      The think.mtv.com web site:

      Written by Aman

      September 30, 2007 at 7:43 pm

      From KaiserNetwork: “Researchers Use GPS, PDAs for Malaria Prevention in Africa, Study Says”

      CDC researchers have developed new tools using GPS technology and PDAs to help prevent the spread of malaria in Africa, according to a study published in the August issue of the American Journal of Tropical Medicine and Hygiene, InformationWeek reports. Researchers used the devices to collect data on the use of insecticide-treated nets in homes in Niger and Togo.

      The researchers used sampling software for Windows Mobile devices to compile complete lists of households in the area and employed GPS systems to locate homes and interview a random sample of people. Study co-author Jodi Vanden Eng in a statement said, “Before we developed this method using these devices, it usually took days, or even weeks to complete the same task” that the researchers now can accomplish in one day.

      Full story summarized on KaiserNetwork.

      Written by Ben

      September 13, 2007 at 11:44 am

      AfriHealth 2007 ICT Conference

      The AfriHealth 2007 conference will be held from Sept 18 – 20th in Nairobi. There may still be panel speaker slots open, so if you are an expert in this area or know anyone who is, please let me know and please spread the word. The press release is here.

      afrihealth1.jpg

      Written by Aman

      August 7, 2007 at 7:58 am

      Humanitarian Relief and Mobile Phones

      The Economist last week published an article titled “Flood, famine and mobile phones“with this lead-in:

      “MY NAME is Mohammed Sokor, writing to you from Dagahaley refugee camp in Dadaab. Dear Sir, there is an alarming issue here. People are given too few kilograms of food. You must help.

      “A crumpled note, delivered to a passing rock star-turned-philanthropist? No, Mr Sokor is a much sharper communicator than that. He texted this appeal from his own mobile phone to the mobiles of two United Nations officials, in London and Nairobi. He got the numbers by surfing at an internet café at the north Kenyan camp.”

      The article touches on the benefits that modern technology can bring to humanitarian relief, citing examples as diverse as the UN’s ReliefWeb portal, Mukuru.com (an SMS-based voucher system for connecting the Zimbabwean diaspora community with relatives back home), and Sri Lanka’s tsunami “early-warning system which would send SMS messages to every mobile phone in an area at risk of flooding”.

      The most interesting portion of the article for me was about the potential drawbacks of the technology:

      “Oisin Walton of Télécoms sans Frontières has a different worry: e-mail may supplant aid workers’ conflict-avoidance skills; they may come to rely too much on e-mailed security warnings, and not enough on their instincts. And the Red Cross’s Florian Westphal fears satellite or mobile phones will make warlords even more suspicious of aid workers;
      it is now harder to eavesdrop than it was when aid workers used open radio frequencies.”

      Written by Jaspal

      August 1, 2007 at 8:24 am

      Creative Mapping for Global Issues and Google Mashup “Action Planet”

      I just discovered Maplecroft Maps that can filed under – awareness building via visual data representation. What is really cool about their maps, besides the tremendous breadth of issues they cover, are the additional resources linked to the map. For example, when you click on a map there are several tabs for: case studies, analysis and resources. Very cool stuff:

      Maplecroft maps is a highly visual, web-based resource which contains detailed country information for over 200 states and maps for key issues significant to business and society. This innovative tool is designed to raise awareness amongst corporations, government and non-governmental organizations, academics, students and the general public of how an organisation’s operations interact with wider society, and how the risks and opportunities generated can be responsibly managed through stakeholder engagement and partnership.

      maplecroftmaps.jpg

      “More than 30 different issues are already available…a number of the more recent maps were developed in partnership with the World Economic Forum’s Global Risk Network… Some of the maps are for:carbon resources, climate change, corporate governance, greenhouse gas emissions, natural disasters, pandemics, renewable energy use, aid, child labour, digital inclusion, displacement, education, HIV/AIDS, landmine risk, malaria, military expenditure, political risk, poverty, tuberculosis and water.” Check out their website.

      Second, from what I understand, students at Stanford’s Design school came up with ActionPlanet.org in four weeks, which is a mash up of Google maps and GlobalGiving. Action Planet connects your issue of interest with a project in need. If you want to see another kind of “mashup” check out CNN’s site IMPACT (Impact your world) which was recently covered by Lucy Bernholz (she coined this type of technology meets philanthropy as “cross platform embedded giving“). A description of Action Planet can bee seen below.

      [YouTube=http://www.youtube.com/watch?v=3fCu3g8rGbs]

      Written by Aman

      July 10, 2007 at 5:57 am

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