Februaury 2009

mHealth mobile connectivity for healthcare : Susan Thomas, eHEALTH Bureau

Humanitarian calls such as ‘healthcare for all’ require care to be available over a much larger area than covered presently, and also allow greater mobility these are challenges easily tackled by the already available mobile telephony. The medical community is limited by only their imagination.

After taking the telecom sector by storm mobile phones are set to change the way healthcare is delivered. Be it sending an SMS to track down the closest healthcare facility, or an attempt to track truant government doctors who neglect their official duties by practising privately on the side, or even a more evolved form of a cell phone that can monitor the condition of HIV and malaria patients and test water quality at disaster sites and undeveloped areas.

The virtual encyclopedia ‘Wikipedia’ defines mHealth as “a term for medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, PDAs, and other wireless devices. mHealth applications include the use of mobile devices in collecting community and clinical health data, delivery of healthcare information to practitioners, researchers, and patients, real-time monitoring of patient vital signs, and direct provision of care (via mobile telemedicine).”

Lets explore some innovative ways how the mobility of cellular phones are been capitalised upon in the field of medicine today.


Mobile phones to track doctors

In a recent news the Bihar State Health Minister Nand Kishore Yadav announced that the state government has decided to give free mobile phone services to its doctors in an attempt to reduce truancy. Many government doctors neglect their official duties by practising privately on the side. The main purpose of the move is to be able to get in touch with the doctors at any time. Their movements will also be tracked by a system. The doctors have been given instructions to keep their mobile phones switched on permanently, even if not on duty.

It is hoped that this will help to improve the functioning of the government hospitals in the state. The Indian state mobile provider, BSNL has already provided about 800 connections. According to the plan, doctors will have unlimited talk time among themselves but there will be a bar on making outside calls. This will also let them know where the doctor is serving – at his place of posting or doing private practice. In which case stern action will be taken.

SMS for the nearest healthcare facility

A government project named ‘Dr SMS’ in the southern Indian state Kerala’s Kozhikode district, has implemented a system allowing citizens to obtain information about the nearest healthcare facility anytime of the day by sending an SMS.

The individual seeking medical attention anywhere in the district has to SMS a prescribed format including his pin code to 9446460600, the same number which returns information on government files in the district collectorate. The system extracts information from a database prepared by the government machinery under the district medical centre. Within seconds, a message containing the nearest hospital’s whereabouts will be sent back to the user.

Mobile penetration is very high in the developing world, and the technology available today is most accessible and not complicated at all. Even those who are not proficient in English can send a simple SMS in English. “Since reality shows are able to exploit SMS in a big way, we decided to explore it for life-saving purposes,” said Kozhikode district collector A Jayathilak, at the inauguration of the project, which will be gradually extended to the entire state.

The system also gives pointers to blood banks, diagnostic centres, private hospitals, speciality centres, facilities for surgery and ventilators and the list of specialist doctors in the district.

Mobile penetration is very high in the developing world, and the technology available today is most accessible and not complicated at all.

Mobiles to monitor patients’ conditions

Scientists at the University of California, Los Angeles (UCLA) have created a cell phone that can monitor the condition of HIV and malaria patients and test water quality at disaster sites and undeveloped areas.

UCLA electrical engineering professor Aydogan Ozcan has constructed the new innovative imaging technology, which has been miniaturised by researchers in his lab to the point that it can fit in standard cell phones. The imaging platform, known as LUCAS (Lensless Ultra-wide-field Cell monitoring Array platform based on Shadow imaging), has now been successfully installed in both a cell phone and a webcam. Both devices acquire an image in the same way as using a short wavelength blue light to illuminate a blood, saliva or other fluid sample. LUCAS captures an image of the microparticles in the solution using a sensor array.

As red blood cells and other microparticles have a distinct diffraction pattern, or shadow image, it becomes easier to identify and count them almost instantaneously by LUCAS using a custom-developed “decision algorithm” that compares the captured shadow images to a library of training images. Data collected by LUCAS can then be sent to a hospital for analysis and diagnosis using the cell phone, or transferred via USB to a computer for transmission to a hospital.

This technology will not only have great impact in healthcare applications, it also has the potential to replace cytometers in research labs at a fraction of the cost. A conventional flow-cytometer identifies cells serially, one at a time, whereas tabletop versions of LUCAS can identify thousands of cells in a second, all in parallel, with the same accuracy. In the current study, Ozcan described an improvement in the LUCAS system – this improvement allows for identification of smaller particles such as E. coli that were not previously possible.

‘Doctor on Call’ on your mobile

For the first time in India, a mobile phone doctor-to-patient service called ‘Doctor on Call’ was launched. The 9 to 9 service that provides live interaction was pioneered by BPL Mobile, Mumbai’s leading mobile service.

BPL Mobile has launched this Value Added Service to provide a virtual channel that will give subscribers instant access to quality medical assistance. The service will provide a first time telephonic consultation, where the doctors will diagnose the patient’s problems under three categories depending on the condition of the patient, ‘Acute’, ‘Chronic’ and ‘Emergency’. While the Doctor who attends the call will try to understand the present condition of the patient on the phone, and will offer some palliative home remedy to the subscriber under the type: ‘Acute condition’, the attending doctor will suggest a future course of action in terms of lifestyle change, preventive measures and specialist to be consulted for further management of the chronic condition. In the case of an Emergency, the doctor will suggest if the patient needs to be rushed to the nearest hospital.

The service will cost the users an amount they would otherwise spend on travel and so on. Using this would not require them to take time off from work or schedule an appointment. More so, the aged or the frail would not need to worry about their mobility.

This service is in fact being provided with assistance from HealthcareMagic.com, a Bangalore-based company providing healthcare consultation over the Internet. This is also another example of how the Internet is itself becoming more accessible through mobile phones and Blackberries!

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