Archive for the ‘Mobile Phones’ Category
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:
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 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.
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
Two recent awards were given out in the area of technology for humanity. The first was a generic “best of 2008″ in technology PopSci award. It was great to see PopSci pick a technology for developing countries as one of their top products, the CellScope, which we covered in a post on mobile phones for global health (hat tip BOPreneur). Additionally there was the annual Tech Museum awards which you can read more about over at CNET (the Star Syringe was their health awardee).
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.
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
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
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.
- 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
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)
- Review Article: Innovation in practice: mobile phone technology in patient care. (Link)
- 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)
- Solar-powered GSM towers (Ethan Zuckerman)
- Kenya’s mobile revolution (Link)
- iPhone health and fitness applications (Link)