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We need some balance in mHealth – and I don’t mean pilates.

Just over a week into the new year, one day in to CES and already I’m feeling guilty. I need to get mHealthed up. Shed some Christmad punds. Reform myself, detox, work harder, exercise more. Ohh, if only there were some technology innovations, some brilliant new gadgets that would monitor my activity, analyse me, poke and guide me.

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Just over a week into the new year, one day in to CES and already I’m feeling guilty. I need to get mHealthed up. Shed some Christmad punds. Reform myself, detox, work harder, exercise more. Ohh, if only there were some technology innovations, some brilliant new gadgets that would monitor my activity, analyse me, poke and guide me. Beacuase if there was, I’d be as fit as a thoroughbred race-horse in no time. Obviously though, I can’t be expected to do any of this on my own. I need guidance and motivation, and therein lies the premise for the mHealth industry. Not dissimilar to the the diet industry, for decades as consumers we’ve being coyly willing, to believe that there is a silver bullet that will cure all (inactivity) ills. Alas, not, who would have thought that it comes down to commitment and effort to get fit and stay as healthy as you can. This compliant delusion does give us a glipmse into how our world is adapting its frailty, fallibility and delusion to take advantage of tech as a new crutch.

We will certainly start to see more and more people using mHealth devices. The big winner I think will be the mid-prixed devices for $80 to $100. Products like the Jawbone Up and the Fitbit. Why mid-price? There’s a few reasons. The first reason: economics – consumers are more likely to get involved with mHealth at a moderate purchase price. Spend a weeks pay on a watch that you may not use? No. Buy a cheap pedometer? Unlikely. But $100 purchase that is neatly integrated with your PC, Mac or Smartphone. I think so. Secondly, there’s an element of the fitness mentality creeping in to the buying of one of these gadgets. A little pain – let’s not do a marathon on the first day – so a moderate purchase can be lived with, and also might motivate us to actually get out and run. In time, if we like the gadget, if we stick with the New Year program we might upgrade to a bells and whistles device, but for a start, wearable devices, wrist bands, shoe sensors, they are winner in this burgeoning market.

mHealth (mobile health) is a term used for the practice of medicine and public health, supported by mobile devices. The term is most commonly used in reference to using mobile communication devices, such as smartphones, sensor and tablets for health services and information, but also to affect emotional states.

So you’re all kitted out with new sensor shoes, new wistband, smart phone app, a whole bunch of Facebook friends willing, possibly even chanting for your shrinkage to perfection- it’s almost spiritual at this point. Add a wifi scales, a toaster with wifi that it shouts “Oi, Fatty!” so the neighbours can hear if you aren’t using wholegrain.

“You could add clever cutlery in the form of fork that essentially says stop, by vibrating if you’re eating too quickly. Useful to prevent the hiccups, as your fellow diners back away from you with a look of fear and disgust, as you have a table setting resembling the aftermath of a Roman feast laid for peckish centurions back from the Iberian peninsula. If all that isn’t a hint, Mr Clever Fork is just what you need, you slob.”

Maybe install a fridge that reads RFID tags on your food, and rats you out to your spouse/doctor/health insurer. You cannot fail to reach Magnificent on the fitness god & goddess scale. Incredible. We have now, or are about to, fix the entire obesity problem. Governments will cut taxes, health services globally will close hospitals and there will be just one nutritionist student in college, on the entire planet, next year. Technology has yet again, saved the world. And you were there, looking lean and slightly smug in Lycra, to see it.

Time for some balance I think, and not the pilates type. wifi scales from companies likeFrench maker Withings, pro appeal watches from Garmin, apps and websites from the Facebook of fitness, RunKeeper. It all connects, potentially, neatly together. More sophisticated oxygen, vital sign and health monitors are the really interesting element of this industry. Patients at risk from manageble illness or ailments should be the focus. Conencting home based monitors and networks to medical centres and medical staff is the real key. If we can improve the quality of life for those who would have previously been home-bound, then, technology can really make a differenc in health. Hype aside, the internet of everything is coming; we will be more connected, more informed and hopefully more aware, Awareness of our own health, and cognisance of those who battle illness everyday is important. With growing awareness comes responsibility and when we accept that responsibility as a society, we can use this new technology to improve not just world fitness, but world health.

External links & references

  1. What is mHealth? @ Wikipedia
  2. BBC report from 2010
  3. 10 key stats on mHealth: Axial
  4. Clinical mobility
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What is the Cello Phone microscope?

Dr. Aydogan Ozcan leads a research group who have done remarkable work on shadow imaging with a view to deploying low-cost cell-phones with cameras in low-resource communities in developing countries. Low-cost cameras used by personnel with a minimum of training could be used in disconnected communities to photograph fluid samples, capturing the micro-scale signature of cells, and transmit images to centralised clinics for analysis by infectious disease experts.

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Cellphone Microscope, UCLA

Aydogan Ozcan is a Professor of Electrical Engineering at UCLA’s California NanoSystems Institute. Follow him around UCLA’s campus as he discusses wireless health and demonstrates detecting malaria, tuberculosis, and other diseases with a cellphone! In August 2009, Technology Review magazine recognized Ozcan as one of the world’s top innovators under the age of 35 for his lens free imaging platform and its implications in wireless health.

While researching a blog post about Medic Mobile and their work with technology I came across references to Cello Phone and the work of UCLA Associate Professor Dr. Aydogan Ozcan.

He leads a research group who have done remarkable work on shadow imaging with a view to deploying low-cost cell-phones with cameras in low-resource communities in developing countries. Low-cost cameras used by personnel with a minimum of training could be used in disconnected communities to photograph fluid samples, capturing the micro-scale signature of cells, and transmit images to centralised clinics for analysis by infectious disease experts.

An inspiring project – it could assist in a global initiative to combat the spread of infectious diseases like Malaria and HIV, as well as improving general healthcare in under-resourced communities.

“We have more than 5 billion cell phone subscribers around the world today, and because of this, cell phones can now play a central role in telemedicine applications. Our research group has already created a very nice set of tools that can potentially replace most of the advanced instruments used currently in laboratories.”

Professor Aydogan Ozcan
UCLA’s California NanoSystems Institute.
  

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Medic Mobile : technology at the frontline

In 2010 a group of students from Stanford and Lewis & Clark in Oregon ran a pilot of the open-source software FrontlineSMS to co-ordinate community health workers at St Gabriel’s Hospital outside Namitete in Malawi.  FrontlineSMS allows community volunteers, medical personnel, patients and families to communicate more efficiently. Co-ordination of treatment has improved dramatically, particularly the palliative care offered by St Gabriel’s.

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In the technology business we’re hearing more great stories more often of innovation and entrepreneurship. Clever apps, connected devices, consumer mHealth embraced by the Lycra crowd, opportunities abound; tech’s winning, the world over. Undeniably, it’s fun for us as consumers. Entrepreneurs are being rewarded and the economy generally, is benefitting.

A growing number of people doing well, does not imply more people are doing good, but the story of Medic Mobile is inspirational because of their innovative use of technology and its impact on public health in remote regions of developing countries.

In 2010 a group of students from Stanford and Lewis & Clark in Oregon ran a pilot of the open-source software FrontlineSMS to co-ordinate community health workers at St Gabriel’s Hospital outside Namitete in Malawi.  FrontlineSMS allows community volunteers, medical personnel, patients and families to communicate more efficiently. Co-ordination of treatment has improved dramatically, particularly the palliative care offered by St Gabriel’s. 2010 was a big year at St Gabriel’s Hospital in Malawi. Founded in 1959 by the Carmelites , three years ago this small rural hospital got its first motorcycle ambulances – lessening the discomfort that patients would experience when being transported by the more traditional bicycle or ox-cart. Some accommodation was added for staff and the hospital got a new X-Ray machine and completed a new operating theatre. This year, St Gabriel’s will treat around 50,000 people.

Medic Mobile wasn’t started by software developers or even medical doctors—but by passionate people who ‘enjoyed tinkering’. Following that early successes in at St Gabriel’s, they have helped thirty or more organisations apply technology to improve health services in more than fifteen countries including Nepal and Bangladesh.

“Medic Mobile uses communication technologies to improve the health of under-served and disconnected communities. We see communication gaps through the eyes of community-based health workers and patients, guiding our partners towards low-cost technologies and efficient health services.”

— Our Mission, Medic Mobile

The Medic Mobile toolkit now includes software they have developed as well as open-source software from other organisations. In June 2010, they released a Beta plug-in of PatientView, which empowers hospital personnel to manage patient information via low-end devices in rural environments, requiring just SMS for communication – a crucial feature where broadband, wired or wireless, is limited. An incredibly light-weight EMR  or Electronica Medical Records system it runs on WIndows, Mac and Linux. It’s designed to manage patient information at small health centres who have limited resources and lack IT support to install and maintain a larger complex EMR. Clinicians and nursing staff can view aggregated patient data including appointments, past communications, test results and records. When a patient is due an appointment, clinics can now use PatientView to find the community health worker responsible for a specific patient and send them a reminder via SMS that a visit is needed. Its features reflect the environments where it’s deployed – stream matching algorithms help avoid errors when processing text messages from community health workers working with patients.

There are other tools in the Medic Mobile kit – Kujua, built on the Apache CouchDB which effectively works as a mobile health information hub for clinics, and more still – Professor Aydogan Ozcan at UCLA led a group that won the Vodafone Americas Foundation Wireless Innovation Project; CelloPhone, based on their LUCAS platform, uses a shadow-image process to capture images of cells and bacteria using simple mobile phones and a test process that could cost a dollar or less and  be carried out by people with a minimum of training. In tandem with Medic Mobile and partners, malaria and HIV analysis and treatment could be dramatically impacted in low resource communities.

Our team is committed to doing the kind of work that adds up to something. The kind of work you’d call home about. That you’d sacrifice a weekend for. We’re not here just to get ahead—we’re here to punch above our weight in the fight for global health equity. And we have an awful lot of fun working together.

Clever innovation is one thing, but clever innovation that’s scalable and at a low cost is key. SMS form filling, inexpensive testing and low-end devices – these are slim, elegant solutions in difficult environments.

The founders of Medic Mobile ‘enjoyed tinkering’ – a self-effacing phrase that makes you smile, but they  were people who clearly saw, and cared,  that technology could improve healthcare in the most challenging environments on our planet.

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