Thursday, May 30, 2013

Tracking healthcare innovation at the world's end

May 30, 2013 | Benjamin Harris, New Media Producer

Afghanistan doesn't come to mind when you ask me to list some of the top crucibles of innovation in healthcare right now. With a majority of the population living in incredibly remote areas and a dearth of basic necessities such as medications and supplies, one would be hard pressed to think that game-changing strategies and techniques are being developed there. Adversity, however, can be a prerequisite for change.
"Sometimes it takes going to the edges of the earth, as it were, to be able to develop stuff you can use at home," says Peter Killcommons, MD, CEO of MedWeb.
We spoke at the American Telemedicine Association’s annual trade show  a few weeks ago, where I saw his presentation on using mHealth to serve rural and isolated populations. By focusing on the bare bones, setting up jury-rigged and low-power satellite networks to link remote clinics with the world at large, Killcommons' efforts show the effects that even a basic cell phone connection can have.
In many ways, the problems to overcome in Afghanistan are a mirror of the problems in our own health care system.
"When patients go to the hospital, somebody gets sick in a village, they pretty much wait until they're almost dead," says Killcommons. "Then they'll throw them on the back of a bike or motorcycle... they wait until the last, last minute until they're really terrified that something bad is going to happen if they don't do something."
Sound familiar? There may not be donkey traffic jams in front of your local ER, but the space in our hospitals reserved for the most threatening situations is increasingly becoming the first point of contact for people with health questions. People access health care when they can, where they can. Killcommons looked at the situation in Afghanistan and realized that before breaking out the advanced surgical machines well-intentioned donors had given to hospitals in the region, some less fancy steps needed to be taken first.
That basic infrastructure was communication. Killcommons worked with locals to source and set up solar powered satellite and cell phone networks to bring telemedicine programs to remote areas of Afghanistan.
"A cell phone is like $5 from China. That's all they need really," says Killcommons. "There's some cell phones with a solar panel on the back, we wouldn't consider it reasonable to use that because it takes 30 hours in sunlight to give it a full charge. However, for them, that's freakin' perfect because the phone will last for two weeks - it's not like they're getting a hundred calls a day."
Getting people access to the information they need in a timely and sustainable fashion was his first priority, and it translates from the mountains of Afghanistan to anywhere in the world. Speaking about a telehealth program his company has developed for pregnant women, Killcommons sees the technology's potential to assist people anywhere.
"In the United States we have exceptional healthcare, but still it may be inconvenient if someone is living in a rural area and they can't get in to see their obstetrician as often as they would like, and a tool like this can be used," Killcommons says.
Access to reliable information is the first step in lowering costs and keeping patients more engaged in their care. In a world awash with resources (many not so reputable), communities, and the technology to link pretty much anything to anything else, providing robust and simple channels of access for some of the most remote and at risk will become an increasingly important mission in reforming health care.
"We need practitioners who can counsel us on how to be discerning readers of what we come across, to assist us as we wade through the snake-oil cures and the potential conflicts of interest, and who can help us put newly published research into context with what it mean for us as individuals," writes Laurie Edwards in a recent story on WBUR.
It's easy to lose sight of the little stuff. We like to get carried away over the newest and the flashiest technology. In the case of a remote village in Afghanistan or even America, though, having access to a cell phone and someone at the other end who can offer some educated advice can be worth more than the most advanced ER. The more you know, they say.
Benjamin Harris is Editor of Future Care, where this post was originally published. To learn more about the site read Harris' introductory post, Welcome to Future Care.

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