Using Mobile Devices to Aid Global Health

I attended Global Health Council's annual global health conference this week and attended an interesting panel on "Better Service Through Better Information."

One of the more useful stories -- for my work anyhow -- was from Marc Mitchell of Harvard's School of Public Health. Dr. Mitchell explained how the availability of antiretrovial therapies is not the only constraint when it comes to saving the lives of millions suffering from HIV/AIDS. There's a critical shortage of medical staff as well. WHO reports that 4.3 million staff are needed -- doctors, nurses, midwives, and support staff.

His project developed a rather innovative way to use technology to serve more patients with fewer staff. It's based on the premise that most patients at clinics don't actually need to see a doctor or nurse every single time they visit. Instead, you can train "counselors" to screen the patients by asking them a series of specific yes/no questions. The counselors then can decide whether they should be referred to a doctor.

This "task shifting" approach is not new, Mitchell pointed out. What's new is the technology approach. Previously, they would take three weeks to train the counselors and then send them into the clinics with paper-based protocols. Paper has its limits as the question logic can get quite complicated. Instead, they equipped the counselors with Windows Mobile devices. The counselor asks the yes/no questions to the patient and taps the responses on the screen. At the end of the process, the computer replies with either "patient is doing fine" or "refer to doctor."

Ease of use was a extremely critical key to success. The interface is extremely easy and obscures some rather complex logic being computed by the underlying software. Yet, the new screening process takes less than ten minutes, which can be critical as some clinics see over 200 patients a day. Plus, the interface will soon be available in six languages. Even the informed consent form is online.

The program is still being piloted. Initial tests involved blind experiments to make sure that that the software-based referrals match what a human medical professional would have done.

This is yet another innovate way that technology can have real impact. In this case, it's helping to save lives.