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Petra Wilson Global Challenges #MWC14 #mHealth
- 3. Global&challenges&[3&of&3]&
Data*innovation*today*is*very*siloed*
3"
Siloed&data&systems&cannot&talk&to&
each&other…&
!
1. Huge!complexity!for!buyers!
2. Market!cannot!put!a!price!to!a!
product!
3. Reinventing!the!wheel!
4. Increased!development!costs!!
5. Limited!market!size!
6. Limited!data!aggregation!
Results'
Uptake'
• >650,000&unique&patient&IDs&issued&in&Malawi&
• >6,000&patients&with&diabetes&
• Enthusiastic&clinicians&response&
&
Health'outcomes'
• Lower&patient&drop=out&and&death&rates&
• Reduction&of&drug&errors&
Scalability'
• Fully&open=source&system&
Additional'benefits'
• Automated&diabetes®istry,&enabling&
– More&accurate&government&drug&
forecasting&&
– Better&referral&and&planning&of&surgically&
necessary&treatments&(amputations,&foot&
ulcers&etc.)&
• Low=cost&power&backup&systems&&
• Hardware&for&information&storage&and&
transfer&
Background'
&
• Data&critical&for&high&quality&patient&care,&
programme&monitoring&and&evaluation,&
preventing&drug&stock=outs,&etc.&
• Manual&paper=based&aggregation&of&data&
and&compilation&of&reports&now&unfeasible&
Approach'
&
• User=friendly,&graphics=based&touchscreen&
incorporating&(in&one&shot):&
1. Basic&patient&medical&history&&
2. Clinician&alerts&and&decision&support&
3. Fully=automated&reports&for&M&E&
4. Data&collection&for&secondary&uses&
Examples'we’ve'explored:'Baobab&A'Harries'
11"
Source' &Douglas&GP,&Gadabu&OJ,&Joukes&S,&Mumba&S,&McKay&MV,&Ben=&Smith&A,&Jahn&A,&Schouten&EJ,&Lewis&ZL,&van&Oosterhout&JJ,&Allain&TJ,&Zachariah&R,&Berger&SD,&Harries&AD,&Chimbwandira&F&(2010=.&&
Using'Touchscreen'Electronic'Medical'Record'Systems'to'Support'and'Monitor'National'Scale?Up'of'Antiretroviral'Therapy'in'Malawi.'PLoS&One&Medicine,&August&2010,&Volume&7,&Issue&8&
&Allain&TJ,&van&Oosterhout&JJ,&Douglas&GP,&Joukes&S,&Gadabu&OJ,&Darts&C,&Kapur&A,&Harries&AD&(2011).&&Applying'lessons'learnt'from'the'‘DOTS’'Tuberculosis'Model'to'monitoring'and'evaluating'
persons'with'diabetes'mellitus'in'Blantyre,'Malawi.&&Tropical&Medicine&and&International&Health,&volume&16&no&9&pp&1077–1084&
Results'
Uptake'
• 13#centres#already#use#eHealth#
• System#consolidation#underway#for#others#
#
Health'outcomes'
• XX#
Scalability'
• XX#
Additional'benefits'
• XX#
Background'
• 24#centres#for#MCH/Diabetes#with#>200,000#
patients/year#attend#them#
#
#
Approach'
• Possibility#of#using#eHealth#to#monitor#
mother#and#child#care#and#take#more#
detailed#medical#records,#and#also#the#
organisation’s#desire#to#expand#the#services#
surrounding#diabetes#and#hypertension#
• Mobile#health#initiative##
Examples'we’ve'explored:'Jordan'A'Harries'
12#
Source' #XX#
Results'
Uptake'
• 94%$eligible$population$within$<18$months$
• >190,000$
$
Health'outcomes'
• Discovered$‘silent$killer’$risk$factors$
– 1/3$diabetes$=$11,000$
– 1/2$high$blood$pressure$=$27,000$
– 2/3$high$cholesterol$=$$
• 24%$increase$in$patient$engagement$with$care$
• 18%$increase$in$good$control$of$diabetes$
• 20%$increase$in$good$control$of$cholesterol$
Scalability'
• Fully$openKsource$system$
Additional'benefits'
• Secure$patient$access$web$portal$
• CloudKbased$
• Multimedia$(web,$call$centre,$mobile,$smartphone$
apps,$etc.)$
• Rockefeller$implementation$OpenHDD$
• Platform$Health$ITU$standard$(H.MEDX)$
Background'
$
• UAE$second$highest$prevalence$of$type$2$
diabetes$in$the$World$
• Comprehensive$health$reform$with$universal$
health$insurance$
Approach'
• Innovative,$lowKcost,$secure$eHealth$system$
(Shafafiya)$
• Pioneering$eHealthKenabled$population$NCD$
programme$(Weqaya)$
• Weqaya$logo$on$healthy$products$
• Open,$secure$mobile$Cloud$
• API$creates$market$for$Weqaya$apps$
• Disease$Management$Programme$market$
Examples'we’ve'explored:'Abu'Dhabi'O'Harrison'
13#
Source''Podolak$I,$Vetter$P,$and$Harrison$O$(2012).$$Measuring'Health'Data'Management'Maturity'in'Abu'Dhabi'Health'Policy'and'Technology.$$Health$Policy$and$Technology$
$Hajat$C,$Harrison$O,$Al$Siksek$Z$(2011).$Weqaya:'A'Whole'Population'Cardiovascular'Screening'Programme'in'Abu'Dhabi.$$AJPH$2011,$22$September$
$Hajat$C,$Harrison$O$(2010).$The'Abu'Dhabi'Cardiovascular'Program:'The'Continuation'of'Framingham.$$Prog.$Cardiovasc.$Dis.,$Vol$53,$Issue$1,$JulyKAugust$2010,$pp28K38$
$See$http://www.jointlearningnetwork.org/content/openhdd$and$http://www.jointlearningnetwork.org/content/dayKoneKsiteKvisitKabuKdhabi$
$Weqaya$materials$available$online$at$URL$www.weqaya.ae$$
Source!!Estrin!D,!Sim!I!(2010).!!Open!mHealth!Architecture:!An!Engine!for!Health!Care!Innovation.!!Science,!Vol!330,!pp759T760!
- 9. Data&innovation&remains&siloed&
9"
Siloed&data&systems&cannot&talk&to&
each&other…&
!
1. Huge!complexity!for!buyers!
2. Market!cannot!put!a!price!to!a!
product!
3. Reinventing!the!wheel!
4. Increased!development!costs!!
5. Limited!market!size!
6. Limited!data!aggregation!
Results'
Uptake'
• >650,000&unique&patient&IDs&issued&in&Malawi&
• >6,000&patients&with&diabetes&
• Enthusiastic&clinicians&response&
&
Health'outcomes'
• Lower&patient&drop=out&and&death&rates&
• Reduction&of&drug&errors&
Scalability'
• Fully&open=source&system&
Additional'benefits'
• Automated&diabetes®istry,&enabling&
– More&accurate&government&drug&
forecasting&&
– Better&referral&and&planning&of&surgically&
necessary&treatments&(amputations,&foot&
ulcers&etc.)&
• Low=cost&power&backup&systems&&
• Hardware&for&information&storage&and&
transfer&
Background'
&
• Data&critical&for&high&quality&patient&care,&
programme&monitoring&and&evaluation,&
preventing&drug&stock=outs,&etc.&
• Manual&paper=based&aggregation&of&data&
and&compilation&of&reports&now&unfeasible&
Approach'
&
• User=friendly,&graphics=based&touchscreen&
incorporating&(in&one&shot):&
1. Basic&patient&medical&history&&
2. Clinician&alerts&and&decision&support&
3. Fully=automated&reports&for&M&E&
4. Data&collection&for&secondary&uses&
Examples'we’ve'explored:'Baobab&A'Harries'
11"
Source' &Douglas&GP,&Gadabu&OJ,&Joukes&S,&Mumba&S,&McKay&MV,&Ben=&Smith&A,&Jahn&A,&Schouten&EJ,&Lewis&ZL,&van&Oosterhout&JJ,&Allain&TJ,&Zachariah&R,&Berger&SD,&Harries&AD,&Chimbwandira&F&(2010=.&&
Using'Touchscreen'Electronic'Medical'Record'Systems'to'Support'and'Monitor'National'Scale?Up'of'Antiretroviral'Therapy'in'Malawi.'PLoS&One&Medicine,&August&2010,&Volume&7,&Issue&8&
&Allain&TJ,&van&Oosterhout&JJ,&Douglas&GP,&Joukes&S,&Gadabu&OJ,&Darts&C,&Kapur&A,&Harries&AD&(2011).&&Applying'lessons'learnt'from'the'‘DOTS’'Tuberculosis'Model'to'monitoring'and'evaluating'
persons'with'diabetes'mellitus'in'Blantyre,'Malawi.&&Tropical&Medicine&and&International&Health,&volume&16&no&9&pp&1077–1084&
Results'
Uptake'
• 13#centres#already#use#eHealth#
• System#consolidation#underway#for#others#
#
Health'outcomes'
• XX#
Scalability'
• XX#
Additional'benefits'
• XX#
Background'
• 24#centres#for#MCH/Diabetes#with#>200,000#
patients/year#attend#them#
#
#
Approach'
• Possibility#of#using#eHealth#to#monitor#
mother#and#child#care#and#take#more#
detailed#medical#records,#and#also#the#
organisation’s#desire#to#expand#the#services#
surrounding#diabetes#and#hypertension#
• Mobile#health#initiative##
Examples'we’ve'explored:'Jordan'A'Harries'
12#
Source' #XX#
Results'
Uptake'
• 94%$eligible$population$within$<18$months$
• >190,000$
$
Health'outcomes'
• Discovered$‘silent$killer’$risk$factors$
– 1/3$diabetes$=$11,000$
– 1/2$high$blood$pressure$=$27,000$
– 2/3$high$cholesterol$=$$
• 24%$increase$in$patient$engagement$with$care$
• 18%$increase$in$good$control$of$diabetes$
• 20%$increase$in$good$control$of$cholesterol$
Scalability'
• Fully$openKsource$system$
Additional'benefits'
• Secure$patient$access$web$portal$
• CloudKbased$
• Multimedia$(web,$call$centre,$mobile,$smartphone$
apps,$etc.)$
• Rockefeller$implementation$OpenHDD$
• Platform$Health$ITU$standard$(H.MEDX)$
Background'
$
• UAE$second$highest$prevalence$of$type$2$
diabetes$in$the$World$
• Comprehensive$health$reform$with$universal$
health$insurance$
Approach'
• Innovative,$lowKcost,$secure$eHealth$system$
(Shafafiya)$
• Pioneering$eHealthKenabled$population$NCD$
programme$(Weqaya)$
• Weqaya$logo$on$healthy$products$
• Open,$secure$mobile$Cloud$
• API$creates$market$for$Weqaya$apps$
• Disease$Management$Programme$market$
Examples'we’ve'explored:'Abu'Dhabi'O'Harrison'
13#
Source''Podolak$I,$Vetter$P,$and$Harrison$O$(2012).$$Measuring'Health'Data'Management'Maturity'in'Abu'Dhabi'Health'Policy'and'Technology.$$Health$Policy$and$Technology$
$Hajat$C,$Harrison$O,$Al$Siksek$Z$(2011).$Weqaya:'A'Whole'Population'Cardiovascular'Screening'Programme'in'Abu'Dhabi.$$AJPH$2011,$22$September$
$Hajat$C,$Harrison$O$(2010).$The'Abu'Dhabi'Cardiovascular'Program:'The'Continuation'of'Framingham.$$Prog.$Cardiovasc.$Dis.,$Vol$53,$Issue$1,$JulyKAugust$2010,$pp28K38$
$See$http://www.jointlearningnetwork.org/content/openhdd$and$http://www.jointlearningnetwork.org/content/dayKoneKsiteKvisitKabuKdhabi$
$Weqaya$materials$available$online$at$URL$www.weqaya.ae$$
Source!!Estrin!D,!Sim!I!(2010).!!Open!mHealth!Architecture:!An!Engine!for!Health!Care!Innovation.!!Science,!Vol!330,!pp759T760!