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Day 2_Global Health Workshop_Wimbush
 

Day 2_Global Health Workshop_Wimbush

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  • i&#x2019;m going to be talking about how <br />
  • One way of looking at mHealth is by considering how these distinct forms of technology connect to one another. <br />
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  • preventable factors such as proper drugs and medical treatment <br /> <br /> deficit of 2.4 million over 57 countries <br />
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  • - providing health information and diagnoses in regions where access to providers is scarce <br />
  • mHealth innovates via... <br />
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  • Example of a provider-based mobile phone app <br /> <br /> Basically a mini mobile electronic medical record <br /> <br /> can guide community health workers, prompt them to do certain things, complete certain questionnairs, and sends everything back to a centralized data repository <br />
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  • http://blog.ushahidi.com/index.php/2010/01/22/the-nuts-and-bolts-behind-4636-in-haiti/ <br /> <br /> In brief, Dalila asked to know an address written in one of the texts she was translating and 2 minutes later she had the latitude and longitude, even though no map showed it, thanks to the local knowledge of Apo. This has been *typical*. <br /> <br /> Text volumes vary from one every 5 seconds in the day to every 5 minutes overnight. The average turn-around for us receiving a text and having it translated, categorized and back on the ground with coordinates, message and return # is about 10 minutes. <br />
  • These are from the ~1000 people who have stepped in so far (my guess from IPs). <br />
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  • Create and join in chat groups by SMS, email, or web browser. <br />
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  • allows information to flow between established applications (like Excel, Access, GoogleEarth, MySQL, Oracle and many others), and between devices (laptops, smartphones, PDAs, and servers) <br /> reliably, selectively, and securely in a distributed "data mesh" <br />
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Day 2_Global Health Workshop_Wimbush Day 2_Global Health Workshop_Wimbush Presentation Transcript

  • Mobile Health Technology for Global Health in Action Julian Wimbush, PhD Research Fellow CIDER, UC Berkeley April 15, 2010
  • mHealth is…
  • …use of mobile communication devices for health services and (multimedia) information via: • Mobile phones • Smartphones • Patient monitoring devices • Mobile telemedicine/telecare devices • MP3 players for mLearning • Microcomputers
  • Information Flow • Moving community and clinical health data between • Practitioners • Researchers • Patients • E.g.: real-time monitoring of patient vital signs, • E.g.: direct provision of care (via mobile telemedicine)
  • UN Millennium Development Goals: 2001-2015 For health: • Reduce child mortality by 2/3 • Improve maternal health • Reduce mortality / morbidity by 3/4 • Combat HIV and AIDS, malaria, and other diseases • Halt and begin to reverse the spread
  • MDG: Strategic Objectives • Improvement of the access to emergency and general health services • Improvement of the efficiency of health service delivery • Improvement of the clinical practice for enhanced health outcomes • The reduction of child and maternal mortality and morbidity in MVPs
  • Reality • A child born in the developing world is 33 times as likely to die within the first 5 years of life • Higher maternal mortality and morbidity rates (1M and 10M per year) • High HIV infection rates (2.5M new cases) • Prevalence of avoidable, communicable diseases (TB, malaria) due to preventable factors • Shortfall of medical workers (Def = 2.4M)
  • The Promise of Mobile Ubiquity IBM & World Bank, 2006
  • Developing World Context: Ripe for Growth • 3 billion+ mobile phone users (64% in developing world) • Biggest growth in Asia, Middle East, Africa • Mobile phones (plus) as a leapfrog technology • Bypassing fixed-line subscriptions • 90% of the world now lives within a mobile reception area • 2012: 50% of all remote populations will have mobile phones
  • Ease of Adoption: Low Cost • Cost of deployment continues to decrease • Cheaper infrastructure technologies (CDMA) • Cheaper phones (e.g., Java phone $50-100) • Availability of free and open-source software (FOSS) / apps
  • Ease of Adoption • Breaking the literacy barrier • Direct voice communication • Communication and coordination with people in remote, rural areas • Tracking migrant populations
  • Emerging trends in mHealth • Emergency response systems • Mobile synchronous (voice) and asynchronous (SMS) telemedicine diagnostic and decision support to remote clinicians • Clinician-focused, evidence-based formulary, database and decision support information available at the point-of-care • Clinical care and remote patient monitoring • Health services monitoring and reporting • Health-related mLearning for the general public • Training and continuing professional development for health care workers • Health promotion and community mobilization • Support of long-term conditions
  • Distribution of mHealth Programs by Location and Application Area
  • Mobile Health • Information as a provider
  • Decentralized Health Care Delivery
  • mHealth: Care Delivery • screenshot
  • CommCare
  • Information Flow: Crowdsourcing Data
  • FrontLine SMS • Screen shot
  • Frontline SMS • enables users to send and receive text messages with large groups of people through mobile phones • does not require an Internet connection • works with existing plan on all GSM phones, modems and networks
  • FrontLine SMS • Reminders / Adherence • Coordination / Communication • Simple SMS-based forms
  • Situational Awareness • Communication (plus Geospatial Awareness?) • Surveillance vs. Disaster Response
  • Situational Awareness • Perception of: • environmental elements in time and space • comprehension of their meaning • projection of their status in the near future • Vital for emergency responders & surveillance
  • Situational Awareness: Haiti
  • How it works 1. Put word out that people on the ground can send [Name, location, status/message] 2. SMS submitted, with varying levels of structure/detail 3. Enters database 4. Passed to a mechanical turk-type outfit of volunteers for structuring 5. Message is structured in the database 6. Gets passed off to orgs (via Sahana) that can do something about the issue
  • 4636 in Action
  • 4636 in Action
  • Messaging Category Distribution Chart
  • Geospatial Situational Awareness
  • Geospatial Situational Awareness • Geospatial presentation of situational data related to incidents and resources • Real-time • Can be viewed simultaneously or in layers
  • GeoChat
  • GeoChat • Evolved from a simple concept • Can I send an SMS message and see it on a map? • Automated! • Collaboration / communication platform designed to meet the needs of humanitarian aid, international health and disaster response workers
  • Situational Awareness: GeoChat
  • GeoChat Capabilities • Create and join in chat groups. • Translates location names sent by users to a position on a map • Can broadcast one or more RSS feeds. • Twitter-enabled. • SMS gateway supported by 96% of the world’s mobile carriers.
  • Implementation Settings • Mekong Basin Disease Surveillance network • Laos, Thailand, Cambodia • Thai Hospital Surveillance System • Tied to national EHR system rollout in 600 public hospitals
  • Geospatial Situational Awareness (USHAHIDI)
  • Data Analytics: RIFF-Evolve
  • Combining Data: Data “Meshing” with Mesh4x • Microsoft Access Database + Java XForms application + online Google spreadsheet. • = Combined, then centralized • Allows disparate orgs to share data while retaining local applications
  • Mesh4x
  • The Future? • Bigger crowd + more media = better filters? • Refined Data Acquisition and Analysis • Predictive Analytics • Automated Triaging
  • Thank you! Questions?