Faster Internet = Better Healthcare: Video Review

There are tons of examples of how technology is transforming global health, including this recent video from The World Bank.

The Pacific region contains many countries with populations spread across large distances and the Kingdom of Tonga is one of them. Containing 170 islands, Tonga has unique development challenges. According to the video, there are only about 55 doctors in Tonga serving a population of 100,000. Medical assistants and nurse practitioners serve the areas outside the main islands, thus access to doctors is limited. Also, Internet in Tonga is very expensive and provides limited bandwidth.

To address these two issues, The World Bank, along with its partners, constructed an 827 kilometer underwater fiber optic cable that connects Tonga to the Southern Cross Cable Network via Fiji and helps improve Internet services. So what impact does this have on healthcare? Increased bandwidth allows hospitals and health professionals to get what they need, improves information collection, leads to better diagnoses, and allows them to liaise with partners overseas to ensure best treatment for patients.

We all recognize that technology has a strong impact on many aspects of our lives (for better or worse). The benefits associated with the intersection of technology and healthcare is very interesting and becomes even more interesting when you examine the effects it has in rural versus urban areas. This video clearly highlights work done in rural areas where access is a huge problem. Watching it reminded me of an article I read in the New York Times last year about a failed MNCH project. The project failed because researchers took a model that was successful in rural areas and tried to replicate it in an urban setting.

That said, when it comes to global health, some people believe there are greater gains to be had in rural areas where successes are “easier” to achieve and measure. What is your opinion?

mHealth for Mothers: Video Review

mHealth, defined as the use of mobile technology to support healthcare, is arguably one of the hottest global health trends right now. With rapid advances in mobile technologies and applications, along with the continued growth of cellular networks, mHealth has the potential to address some of the biggest healthcare challenges in the world, including access and affordability. It’s becoming more and more integrated into healthcare systems as it can significantly cut costs and increase the reach of healthcare services in both middle- and low-income countries.

This video, released last month at the Social Good Summit during UN General Assembly Week in New York City, provides the following example of the kind of impact mHealth can have in developing countries:

  • Challenge – Most women around the world only have one prenatal visit with a healthcare worker. However, one billion women in developing countries have access to a mobile phone.
  • Solution – Use SMS and voice messaging to provide mothers with important information in their native language at each stage of pregnancy and throughout the first full year of the child’s life.

During my last trip to Nigeria I had my first personal experience with mHealth. Upon arrival, I purchased a basic Nokia bar phone and SIM card. While playing around with the phone, I stumbled upon the Nokia Life Tools app which is a standard, built-in feature on some models of Nokia bar phones. The app provides healthcare, entertainment, agricultural, and educational information. The healthcare section peaked my interest as it includes sections for MNCH advice, men’s health, women’s health, and chronic disease information. First, you enter basic details about yourself (sex, age, language, etc.), then you scroll through and subscribe to whichever topics you’re interested in. The MNCH advice section parallels the example in the video above. It delivers weekly developmental information during pregnancy via SMS and continues with child development tips for the first few years after pregnancy. The only costs associated with the app are standard text messaging fees.  

In addition to patient education, health workers and providers also use mHealth for data collection, disease surveillance and management, treatment support, direct care, and more. Developing countries are definitely embracing the movement and driving innovations in mHealth, making it an exciting field with the potential to transform healthcare all over the world.

APHA Mid-Year Meeting, Day 1: Technology and Socializing

Greetings from APHA’s Mid-Year meeting in Chicago!  This year’s meeting is on healthcare reform, which is fortunate for me – with so much focus on international health news and topics, I unfortunately do not know much about the intricacies of the new healthcare reform legislation, or how it is being implemented on the ground.  I think many Americans are in the same position, however, so hopefully I will gain a better understanding of reform and be able to pass it on to you, the reader!

Upon checking in, I was given a flash drive in addition to a program and a badge holder.  This is such a great resource – it contains speaker bios and (most of) the PowerPoint presentations from each session.  After I arrived this afternoon, I attended one of the first break-out sessions of the conference, “Technology Implications of Health Reform.”  The panel was made up of a representative from CDC, the Kentucky state health commissioner, and the CEO of the Cabarrus Health Alliance (which, believe it or not, is actually a county health department!).  Each one gave his perspective on implementing electronic medical records and building a health information exchange on the federal, state, and county level, respectively.  While I appreciate the excitement surrounding the possibilities of electronic health records (EHRs), I pointed out that even clinicians and health institutions that have them are not able to use them beyond searching for records by patient name or consultation date, plus whatever queries have been pre-programmed into the software by the vendor so that the practice can get the “Meaningful Use” dollars from the government.  I have experienced this in my public health surveillance work – providers have no idea how to pull the information that we are looking for from their records.  We have a long way to go before EHRs are useful on a large scale to public health surveillance and research.

Later in the evening, I had a chance to meet some of the APHA section representatives that were given the same opportunity as I was to attend the meeting.  This is apparently the first year that APHA has been able to bring section representatives to the mid-year meeting, so it is exciting to be a part of it.  The challenge will be thinking about how the information at this meeting can be applied to the activities of the IH section.  What do you think?