How is technology helping in access to healthcare?

SevagKechichian

How is digital technology (especially artificial intelligence) currently being used to increase access to basic health care in low- and middle-income countries?

Shashi

Hi @nothmany and @acowlagi - As you both have a background in technology, it would be nice to know from you how technology is used currently to increase basic healthcare. Please share your thoughts.

Shashi

Hi @Shabbir - It would great to have your thoughts on this discussion. Thanks.

SArora

Project ECHO exists to democratize life-saving medical knowledge — linking experts at centralized institutions with regional, local, and community-based workforces. The model leverages digital technology to engage local healthcare workers and public health officials in knowledge-sharing and case-based learning. Best practices are shared and adapted in both directions — between subject matter experts and those working in the field to get the right knowledge at the right place at the right time.
AI will play an increasingly important role as data gets collected at the Last Mile via cell/smart phones. This data can be analyzed and be used by health care workers. For example, a 29 year old patient presents with a fever, has a cough, and has two other family members that are sick. A health care worker that is attending to this patient can be guided by an AI system, enabling her decision making. Should she manage this patient herself, or send to a hospital, etc.? It's important to note that AI cannot replace people, but will play an important enabling role.

Shashi

Thanks Dr. Sanjeev for sharing your thoughts.
Hi @owen and @dzera - As you have experience in technology, you may have thoughts on how we can leverage technology to increase access to basic healthcare in LMICs. Please join the discussion. Thanks.

jordangiali

@SArora Thank you for the detailed feedback! We will look into Project ECHO!

bngejane

Beyond the incredible work done by Daniel Kraft, Dr Bertalan Mesko & Raymond McCauley you might want to also check out this presentation at AI for Good.
https://www.linkedin.com/feed/update/urn:li:activity:6686993478657839105
https://www.youtube.com/watch?v=FwcWiGMrKho&feature=youtu.be

NickOttens

@michalhemmo, @ymedan, @ross_d_king, you may have some ideas for us here.

This discussion is part of our Frontline Health Prize Design, which will seek to bring technology-powered frontline health systems to everyone, everywhere. We're interested in any and all initiatives that already use digital technology to expand access to frontline health in low- and middle-income countries.

ymedan

@NickOttens. Tanks for approaching me for comments.
Our first drive should be to move from HealthCare/Medicine to Health. Recent studies done during Covid -19 has hown to digital literacy was key for avoiding oneliness, distress and deterioration in health condition.
The other comment I wish to make is to look at Portugal. It is has the largest percentage of old popualtion in Europe but they managed to launch a nationwide digital literacy program in 2014. So now, all citizens, especially the elderly, have digital access to tele-healthcare services.

Bottom line - start with digital literacy.

Shashi

Thanks @ymedan for sharing your thoughts.

bngejane

Surgical:

As explained by the project's senior researcher, Dr. Philip Pratt, "With the HoloLens, we're now doing the same kind of [scan] and then processing the data captured to make it suitable to look at. That means we end up with a silhouette of a limb, the location of the injury, and the course of the vessels through the area, as opposed to this grayscale image of a scan and a bit more guesswork." Now an operating theatre of an under-resourced hospital in rural India has suddenly been upgraded to a state of the art facility with just a $3500 HoloLens 1.

From Peter Diamandis' Blog

bngejane

Diagnostics:

New medical devices allow non-invasive cancer diagnosis: India-based iBreastExam can detect breast cancer with tactile sensors, while French company Damae Medical uses a new optical technology for skin cancer detection. In the future, machine learning may allow US startups Grail and Freenome to detect cancer through liquid biopsies—like a simple blood test. A low-cost approach more adapted to developing countries, echOpen is an open-source echo-stethoscope (ultrasound probe) connected to a smartphone. It allows cheap and fast preliminary diagnosis, to support a better orientation for further medical care.

bngejane

last-mile delivery:

For instance, Living Goods (US) delivers life-saving products to the doorstep of the poor in East Africa, thanks to a network of local entrepreneurs called “health promoters”. Each of them gets basic medical supplies, as well as a smartphone loaded with diagnosis and pregnancy apps etc.

bngejane

Talking about healthcare v sickcare:
Nutrient deficiencies impair a third of the world population, especially in the poorest countries. While the diversification of local diets remains a priority, food and life sciences also enable products and ingredients with higher nutritional value. For instance, humanitarian food science pioneer Nutriset (France) has developed since 1993 a wide range of therapeutic food products for children and mothers affected by malnutrition.

Shashi

Thanks @bngejane for these insightful inputs.

bngejane

With the help of Mr Paul Epping we did a mindmap of the health tech, this is by no means a final version and I still await his review but you might want to check it out: https://mm.tt/1502648773?t=8HjFOaAR5K

tylerbn

Great DataKind post on data science and AI enabled frontline healthcare workers to address 3 critical delays to patient care. Post link: https://www.datakind.org/blog/strengthening-frontline-health-systems-with-data-science-ai-updates-from-our-first-cohort-of-project

Shashi

Thanks @tylerbn for sharing this insightful link.

tylerbn

The linked paper here summarizes the high clinical and performance quality improvements that can be achieved with AI-enabled technology. ThinkMD has developed an mHealth point-of-care clinical assessment, triage, treatment, and recommendation platform deployed across the world with frontline workers. The assessment logic is based on the clinical assessment approaches by health-care professionals including taking numerous clinical data points about past and current history, symptoms, vital signs, and physical examination findings, weighting for their clinical significance and severity compared with normal values, followed by a cluster-pattern data analysis as they pertain to specific clinical conditions (e.g., dehydration) and disease risk (e.g., dysentery), generating an integrated clinical risk assessment. Results so far indicate frontline workers make clinical and treatment decisions more in line with what a physician would choose, and increasingly adhere to WHO standards with regard to treatment pathways (in this paper, IMCI and iCCM standards).
Initial findings have been published in the American Journal of Tropical Medicine and Hygiene: http://www.ajtmh.org/content/journals/10.4269/ajtmh.18-0869

stephaniel

@Shashi - Why can't smartphones' full capabilities be harnessed to allow patients to better determine if they need to see a doctor? There is an app called Preventicus Heartbeats that is not available everywhere but has been shown to have ECG-comparable accuracy. This should be available to all everywhere and might produce measurable improvements in health statistics (and actual life preservation) among people who tend to be reluctant to seek medical care (whether due to distance from a hospital/doctor, cost, scheduling, or other reasons):

https://en.preventicus.com/en/about-preventicus/

This is especially important in the COVID-19 era, since it looks like even mild or asymptomatic cases can cause heart damage that lasts for months (78 out of 100 patients in a recent German study), which the patient might not know about. We don't know how long this damage takes to resolve, if it resolves at all. Study source:

https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916

Having an app like Heartbeats in regular use for all, not just for patients with known conditions, could catch these instances before they cause significant morbidity.

Shashi

Thanks @stephaniel for sharing these insights. I agree smartphone capabilities need to be better utilized. We will definitely take it into consideration in our final prize design, as the global mHealth market size was valued at USD 40.7 billion in 2019 and is projected to register a CAGR of 29.2% by 2027.