Healthcare // Mobile & Wireless
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8/25/2014
01:22 PM
Neil Polwart
Neil Polwart
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Mobile Health Apps Have Role In Ebola Crisis

Mobile health apps could play a bigger role than they have to date in speeding the response to a global health crisis.

As mobile technology takes a more prominent role within our healthcare systems and the ability to manage and track one's own wellness shapes the mHealth marketplace, it is fair to question how these technologies can help in times of international crisis.

The Ebola virus is dominating global headlines and causing widespread panic across the African continent, not only because of its shocking mortality rate (over 55% so far in this outbreak) and growing death count (currently standing at 1,229, according to the Centers for Disease Control & Prevention), but also due to propaganda and hysteria related to claims of government conspiracies and punishment from God. More rational anxiety is spreading among intergovernmental organizations and aid agencies that understand that with no proven treatments this has the potential to become a much bigger problem than it already is.

The Ebola virus. (Source: Wikimedia Commons)
The Ebola virus.
(Source: Wikimedia Commons)

The importance of traceability
What I find most disturbing as I follow this global crisis -- usually via Twitter or one of many news apps on my smartphone -- is the lack of coherence surrounding traceability. With cross-border and cross-continental travel becoming readily available to the African population, more must be done to track those who may have come in contact with the virus. In the absence of any effective treatment, traceability is key to containing Ebola's spread -- from understanding where the outbreak started and where infected patients are located (many of whom have fled quarantine) to obtaining up-to-date information on the spread of the virus and the 21-day patient monitoring process.

[Do electronic health records need a design overhaul? Read EHRs Must Fit Into Doctor-Patient Relationship.]

So how can mobile health technology help improve this situation, which Médecins Sans Frontières projects could take six months to control?

Availability of mHealth apps
There are several key requirements to ensure that mHealth applications are available and usable in sub-Saharan Africa. The technology must be at hand, the applications affordable or free, and importantly, connectivity must be available. With Africa boasting the fastest growth in mobile subscribers in the past decade -- predicted to reach 1 billion by 2015 -- technology requirements shouldn't be a restriction. In addition, many leading mobile and service providers are offering low-cost smartphones and broadband to encourage usage.

GSMA, the trade body representing mobile operators, has recently appeared in in the press touting its Mobile for Development mHealth program, which aims to help African countries reach many of the United Nation's millennium development goals. This program is a shining example of how mobile applications and smart technology are being used today to facilitate, track, and share healthcare information in resource-poor areas.

This begs the question: Why are these technologies not being fast-tracked to assist in the Ebola outbreak? With rapid point-of-care manufacturers pushing to develop tests that identify Ebola without the need to send patients and samples to off-site labs -- a risk in itself -- shouldn't mobile technology that reads, shares, and tracks results and offers medical advice also be implemented?

A handful of applications already exist that allow users, aid workers, and other medical practitioners to test and share results for illnesses such as HIV, malaria, and flu using only a smartphone. Why are such technologies not being used to test and track Ebola? Geo-referenced, real-time maps of infected patients could be key to tracking and controlling the spread of the virus. In a potential global crisis such as this, the World Health Organization has already called on governments to use exceptional measures, and the US FDA has bypassed its normally rigorous approval processes to fast-track military technology for civilian use.

Clearly barriers to deploying new technology can be overcome, especially when doing so can help reassure citizens and legislators that everything is under control. Perhaps the reason that real-time mHealth tools haven't yet been embraced in this outbreak -- nearly nine months after it started -- is that they would highlight just how out of control the situation is.

Unless action is taken imminently, the time for proving the strength and ability of mHealth applications in a global crisis will have passed. I believe we must first understand the collaborations and alliances required to promptly ensure that the most up-to-date technology is available. By working together, smartphone providers, mobile networks, application developers, and global health organizations can plan and prepare for events such as this, and educate those in resource-poor locations. Only then will mHealth lead the way in global healthcare.

Rather than worrying about how long it will take to control of this outbreak, governments should focus on whether they will ever be able to fully contain it if they don't manage it within that six-month window. Recent outbreaks of SARS and influenza should have served as warnings about the globalization of emerging disease threats. A global Ebola outbreak would have previously unimaginable consequences, not just for healthcare but all economies and humanity in general. Only by quickly understanding the dynamics of disease spread can we have any hope in winning the fight.

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Neil Polwart combines 15 years' biosensor development experience with an interest in software to find mobile health solutions that help the diagnostics industry. He is an innovator, startup founder, and commercially aware technologist operating with companies and partners ... View Full Bio
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Alison_Diana
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Alison_Diana,
User Rank: Author
8/25/2014 | 2:21:15 PM
Paper Processes
I wholeheartedly agree that we should use some of the affordable technologies available today to do a better job tracking and treating diseases like ebola. At the beginning of the ebola crisis, Dr. David Agus of CBS Morning shared his immunization record -- a long, long yellow sheet of paper that detailed all his innoculations for a recent trip to Africa. It reminded me of the record I have, tucked away, of the shots I got as a kid, before we moved to Venezuela. Each weekend (or so it seemed), we headed to Manchester for injections against malaria, yellow fever, and who knows what else. Decades later, the US continues to use the same approach the UK used back then (and may well still use today...). We've come so far in many other areas of government and health; surely we can digitize this important facet of protecting populations? 

That snippet from CBS is here: www.cbsnews.com/videos/ebola-outbreak-whats-happening-on-the-ground-in-west-africa/
Gary_EL
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Gary_EL,
User Rank: Ninja
8/25/2014 | 2:59:19 PM
Putting the Cart Before the Horse
This region doesn't need high tech solutions. What good will any of this sort of stuff do in a situation in which the people believe that disease is a punishment from God? What they need is running water, toilets and electricity. Start with the basics!
David F. Carr
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David F. Carr,
User Rank: Author
8/25/2014 | 5:05:24 PM
Re: Putting the Cart Before the Horse
There's certainly more than one problem to solve, but I do know that some of the government and nonprofit agencies responding to the public health crisis are frustrated by a lack of good data from the field, and anything that would help with data gathering would be helpful.
vcole829
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vcole829,
User Rank: Apprentice
8/26/2014 | 1:56:58 PM
And, they are filling that role!
When I saw this headline, I was expecting to find a write up about how mobile health apps are being used to help deal with the Ebola outbreak.  What I found was an article on how they ought to be used for that -- meaning that the author did not realize that his hopes were being fulfilled even as he was writing about them. 

Within days of the discovery of an ebola-infected individual here in Nigeria, work began on an Emergency Operation Centre in Lagos to co-ordinate all data and planning to deal with the crisis. My employer, eHealth Africa, was contracted to set up that facility. [We have constructed seven such centres for polio.] Pictures of the construction were posted on our Facebook page.

Before all of the paint in the new EOC was dry, there was one of the postulated "Geo-referenced, real-time maps of infected patients" -- and people who may have been exposed by those patients -- projected on the wall.  Data for that map (and its accociated planning reports) is coming in via Internet from smart phones, and via SMS where more elegant solutions are not available. The information is being retrieved by scientists and doctors world wide. (Due to the confidential nature of the data, access is restricted.) I don't speak for eHealth Africa, I just work here, but I am rather proud that what we are doing is new enough that IW writes about it in future tense.

[eHealth Africa is a non-profit Non-Governmental Organization based in Kano, Nigeria.]

 
NovarumDX
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NovarumDX,
User Rank: Apprentice
8/26/2014 | 3:17:17 PM
Re: And, they are filling that role!
vcole829,

You are right to be proud.  The work you are doing sounds like exactly the sort of opportunity I was referring to, but its far from universal across the region.  As the opening paragraph says - there is the opportunity for a bigger role, and with an international problem it needs a cross-border approach.  The next stage beyond your sort of offering though is directly linking the diagnostic tests to databases such as yours to automate that link - the underlying technology exists to do this, and indeed is already being used in Africa for other applications.

If you think there's an opportunity where we can help you raise the profile of your project, add functionality or extend its reach then get in touch - or pass on my details to the right people in your organisation.  We are keen to help.
impactnow
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impactnow,
User Rank: Ninja
8/26/2014 | 3:22:40 PM
Day to day behavior change

While I welcome any help in fighting this health crisis I don't know that mobile technology can have the greatest impact yet. So many of the individuals that have gotten Ebola need education about the disease in their language from their trusted advisors to stop the disease. There is still vast misunderstandings about the disease and its transmission process. Stopping the consumption of bush meat and addressing the handling of bodies will probably go further to stem the new cases at this point.

tzubair
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tzubair,
User Rank: Ninja
8/28/2014 | 5:24:53 PM
Much use?
I think Mobile technology would not be as much help in spreading awareness about epidemics as other measures of public health. As the target population of epidemics are usually  the people who do not have access to good health measures let alone fancy mobile apps. At least in the developing nations.
NovarumDX
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NovarumDX,
User Rank: Apprentice
8/28/2014 | 5:33:03 PM
Re: Much use?
Actually mobile penetration in Africa is actually better than many people realise - much of Africa has missed out landlines and gone directly to mobile.  mHealth solutions are already being used in Africa to track and record treatments and medications; and any centralised reporting would not be in the hands of patients but rather Healthcare Workers.  In order that aid agencies know where and what resource to deploy they need information back from the field - this relies on rapid communications and tracking tools.
tzubair
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tzubair,
User Rank: Ninja
8/31/2014 | 10:48:38 AM
Re: Much use?
@NovarumDX: I agree that mobile health systems can play an important role but what I meant was the fact that you need to have a solid mobile penetration first before you can achieve the desired results. People, especially the poor ones need to be given access to smartphones at affordable costs as well as cheap internet access so they can make use of it.
JacquesD308
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JacquesD308,
User Rank: Apprentice
10/15/2014 | 8:54:04 AM
Re: And, they are filling that role!
We are fighting Ebola in west Africa using our mobile health telemedicine platform since the begining of october.

The deadly Ebola virus is spreading around the world, and Singapore startup Health2i is trying to help contain it. It has launched a new version of its teledoctor app, Doctor Gratis, in West Africa.

Doctor Gratis lets Android and Blackberry users consult with doctors online through the app, as well as access information about health issues. This edition of the app features content about Ebola. Telemedicine may be a weapon against the disease in that it lessens contact between doctors and patients.

Health2i debuted its app in Indonesia a couple of years ago, and to date has about half a million downloads. Besides its online push in Africa, the startup is also working with Nigerian doctors to promote the app, which is free to use.

"We are targeting the middle class, as they are the ones who are traveling the most in the region," says Dr Jacques Durand, medical director of Health2i.

The company is focusing its efforts on these countries as a start: Liberia, Guinea, Sierra Leone, Ghana, and Gambia.
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