GHIC 2020: Global Health & Innovation Conference
April 4-5, 2020
Yale University, New Haven, CT

Unite For Sight's 2011 Global Health & Innovation Conference

Blog Report by Catherine Thomas, Unite For Sight Global Health Leadership Intern

Mobile Potential Conference Session

In the burgeoning field of mHealth, mobile technology is being used to provide rapid diagnostics, collect public health data, improve patient adherence to drug regimens, influence patients to adopt healthier behaviors, and increase the efficacy of community health workers (CHWs), among other healthcare services.  At the conference, we had the honor of seeing some of the pioneers of this field.

Matt Berg, one of Time’s 100 Most Influential People in the World in 2010, has developed a system called ChildCount+ that has been used by community health workers in Kenya to improve healthcare services for vulnerable children.  This mobile system is used to monitor health in the communities, and it is also used in immunization campaigns, as well as rapid interventions for those in need.  Berg acknowledged, “For a child to count, they must be counted.”  In order to receive health benefits, such as vaccinations, from the government, children need to be registered and too many in non-industrialized nations are not.  Through ChildCount+, all children in the target villages are registered and given identification numbers. With the ID numbers and a list of codes, community health workers are able to report and help treat malnutrition, malaria, and diarrheal disease in each child.  For example, CHWs can deliver Malaria Rapid Diagnostic Tests, send in a child’s status and symptoms, and then receive medical directions from the project’s headquarters for medication administration.  After identifying and treating conditions in ill children, CHWs send updates to the headquarters about the patient’s health status via text messages.  It can also be used to monitor the course of pregnancy for expecting mothers.  This technology renders live-saving healthcare much more accessible to those living in removed areas. Not only is this technology useful for providing immediate therapy to rural patients but it also can be applied to gathering such epidemiological information as incidence of malaria, number of  newborns, malnutrition prevalence, etc.  Moreover, it can be used to assess health infrastructure and access to healthcare.  The potential for mHealth is boundless.

Rich Fletcher is a research scientist at MIT Media Lab who is also working in the field of mobile technologies for health interventions.  He noted that mobile phones can be (and are being) used to identify patients and keep electronic medical records, to power and analyze the results of low-cost medical instruments, to deliver the results of printed diagnostics, and more broadly to provide telecommunication between patients and healthcare personnel.  He and others have been developing mobile-phone based devices to take physiological measurements such as blood pressure, pulse, weight, glucose levels, and body temperature.  For example, the lab has developed a USB-powered sonogram tool and an auscultation device to hear heart and lung sounds.  As another example, for those with chronic diseases wireless biosensors can be attached to the patient’s body and then convey physiological information to the mobile phone-based software; the software can then deliver interventions with texts, images, sound files, and social networking elements.  A similarly designed device can be used to monitor the physiological states of infants and to alert parents to changes in sleep, arousal, distress, or discomfort.  Furthermore, patients or community health workers can take printed diagnostic tests and then send in the results via text messages with certain codes.  Although there will certainly be many obstacles to its implementation, telemedicine could serve as an excellent temporary solution to healthcare shortages in many non-industrialized countries. 

A member of Futures Group, Bobby Jefferson discussed his work on monitoring and evaluation (M&E) of prevention of mother to child transmission (PMTCT) of HIV through the use of SMS messages. Similarly to ChildCount+, IQ SMS enables reporting of such measures as the number of new HIV-positive clients, patients tested, and patients counseled.  It also enables the creation and usage of electronic medical records for each patient with records of various test results, treatment regimens, immunizations, and maternal health status. Jefferson noted the benefits of this SMS system including its low cost, its ability to connect the most inaccessible populations to healthcare facilities, the money saved from transportation costs, and its familiarity for users. 

Lastly, Jessica Haberer, a research scientist at the Harvard Global Health Institute, discussed various mobile inventions for adherence monitoring.  She notes that currently adherence is monitored based on retrospective self-reporting and is often inaccurate.  Moreover, problems are detected weeks or months after they occur.  Mobile phones could be the answer to reducing barriers to monitoring and increasing adherence.  One way to use cell phones is through self-reporting via SMS or calls.  Another is with Wisepill™ which is a pill container that electronically monitors the opening of the container.  A more invasive technology, wireless ingestion monitors use microchips or other wearable devices to detect the presence of the medication in the body.  These technologies, of course, present with many limitations including difficulties learning to use mobile communication, high costs, and privacy issues.

It is essential that new technologies are made available to developing countries so as not to exacerbate existing global inequalities in wealth and health.  All of these presenters are inspiring vanguards directing technological design to benefit the BOP.  Hopefully they will prompt other researchers and companies to devote resources and expertise to those who need them most. However, the development of devices is not all that must be done.  John Gage of Sun Microsystems aptly notes that “Technology is easy. People are hard.”(1)  The implementation of high-tech devices in low-resource areas will certainly be the greatest hurdle.  Such systems of thought as design thinking will be required to ensure the devices are actually used and are effective.

(1)  Haqqani, Abdul Basit, ed. The Role of Information and Communication Technologies in Global Development: Analysis and Policy Recommendations. Geneva: United Nations, Department of Economic and Social Affairs, 2005. GoogleBooks. 22 February 2011.