mHealth killed the radio store … ah, I mean, Ebola

Once again, after a very short time, I find myself writing a post related to Ebola. As I said in my last Ebola related post, it is not specifically Ebola which is the focus of my discussion, but rather the medical and technological response to it.

In the following article, there is a description of how Nigeria used mobile health technology to track, control and eventually eradicate Ebola from the country. This is of course a tremendous success, especially when one considers all of the limiting issues that exist in the developing world. Whereas in the United States, it seems that dealing with Ebola has become the basis for serious attacks against the establishment, Nigeria has effectively “shown the world how to do it”.

What I find particularly fascinating about this article is that when you actually analyze the technologies used, there is nothing groundbreaking. No new heavily mathematical algorithms had to be developed in order to help the local health officials deal  with the spread of the disease. These days, when you can include in an app an entire mapping system, with a few lines of code, creating solutions becomes much more like fitting the pieces of a puzzle together.

By making use of established systems for communications, locating, recording critical notes, scanning information and more, the time necessary to develop an appropriate app is a fraction of what it would have been just a few years ago. As time goes on, more and more functionality is being wrapped up into units of code that are relatively easy to access and use. In a previous post, I spoke about the Lego like assembly of various software packages, in order to create a new product that is customized to the needs of the users. So, as more and more of these packages become available, and as those in the developing world get access to such new applications, we may very well be seeing the beginning of a revolution in healthcare in areas with the greatest need.

I remember having a meeting with a representative of the Ethiopian government, who was asking for information about potential  solutions for the medical needs of his country. I explained to him how even the institution of an SMS-based communication network, could go very far in improving healthcare services. He looked at me somewhat strangely and then insisted that something much more complex [and expensive] would be needed for his country. I explained to him that it is always possible to develop more and more advanced tools  to solve a given problem. But I wanted him to understand that the key to improving healthcare is first and foremost communication. If you can get information to move back and forth between patient and healthcare worker, healthcare worker and doctor, doctor and hospital staff, and all the way back again, then you could already have a solution for many of your health needs.

I remember speaking to a representative of an Israeli hospital’s IT department who was asking how I managed to provide my previous place of employment with a complete solution for imaging needs. Using free open source software along with code that I wrote, I was able to link up multiple imaging devices [x-ray, ultrasound, cardiac echo, regular photos] used by the technicians and physicians, with the company’s EMR. The hospital representative told me straight out that the solution being used by his hospital had cost millions. More so, he also told me that his hospital had purposely picked the most expensive solution on the market, on the principle that the most expensive option “must be the best”.

My point is that high level solutions for major medical needs can cost very little, and can even be relatively easy to design and implement. This by no means indicates that the solution is underpowered or ineffective. The medical world needs to learn how to take advantage of all of the existing applications and systems, in order to save costs and increase automation. There are plenty of programmers out there who can assemble the systems that doctors need. And there is inherently no reason why a solution, even for a country, needs to cost many millions if not billions of dollars.

Thanks for listening

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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