A few years ago, I had the honor of being invited to the biggest annual mobile technology conference in Barcelona. I was on a panel to take questions related to mobile health, which was a very young field at the time (even though I had been using mobile tools to send and give consults for years).
I was interviewed at the time by Mr Jonathan Marks, a fascinating and dynamic gentleman. The video can be seen here. I am very proud of this interview. It reflected the status of technology I had been working on, and also my hopes that I could advance a project for providing healthcare across Kenya. I actually got very far, having received the OK from the Kenyan Minister of Health at the time. Unfortunately, the project stalled due to lack of funding from the World Bank. But the principles of how to provide care over wide distances still hold true today.
As the westernized world struggles with issues of insurance coverage and the appropriate number of CTs per capita, the situation is very different in the developing world. Even in Kenya, which is relatively advanced in comparison to most other African countries, there still is a lack of basic services for many millions of people. There is no question that the single most critical change in Kenyan healthcare has been the very widespread adoption of mobile phones. These phones are being turned into the foundation for many types of testing as well as communication portals between patients, health workers, nurses and physicians.
In Kenya, similarly to other developing nations, the number of nurses and physicians is very limited. That is why it is so important to empower the general population as well as moderately trained health workers, with mobile devices. With a bit of code and simple interfaces, already established written guidelines for providing care in such areas, can be transformed into mobile applications that can simultaneously service millions of users.
The type of testing that is possible with cell phones is expanding very quickly. AliveCor allows a patient to record a simple ECG and to have this transmitted to a remote location for review. A patient with chest pain can use such a device to rule out critical abnormalities in their heart. This single device is not a replacement for a full scale cardiac evaluation in the hospital. But it is unquestionably a first step in establishing remote cardiology as an option for millions without regular healthcare. A device like Oto converts an iPhone into an Otoscope which can then be used to view and photograph the inner ear of a patient. This would allow for a remote doctor to confirm a diagnosis of a middle ear infection, also called Otitis Media. Mobile phones can also be used to assess the health of our lungs. SpiroSmart is a mobile app that can evaluate a patient for signs of Asthma and other lung disease.
This is by no means an exhaustive list of tools that attach to or link to a mobile phone in order to provide medical testing. I do not think that anyone will be surprised to see,in the near future, mobile phones acting as the plug-in key to a shell that offers many lab functions. This kind of technology will revolutionize care in the developing world.
As these technologies advance, their cost will continue to fall. It is often thought that it should cost billions of dollars to provide healthcare in remote areas around the world. But as the mobile phone and other mobile tools become more powerful and more available, it will be possible to provide even advanced care for a fraction of today’s costs. Part of the proposal that I had submitted to the Kenyan Ministry of health was for setting up modular clinics and surgical suites, that would be distributed across the country. The intent was for these clinics to be close enough to the entire population such that people would not literally die while walking days to reach a hospital. By concentrating resources in these clinics, it would have been possible to bring high-level care to the masses. The funding required was relatively small when considering that this was a countrywide solution. Nevertheless, as I noted above, the funds did not come through. The idea, however, lives on. And it is definitely my hope that someone else will manage to take my ideas and those of many others and turn them into realistic and practical heatlhcare solutions.
Thanks for listening