health care

Thanks to a tip from my colleague Beth Jenkins, I enthusiastically read The Harvard Business Review’s List: Breakthrough Ideas for 2010. The entire article is a nice, quick read that will get you thinking about a wide variety of issues – from how we can better license technology to manage people to financing energy alternatives. I immediately focused on the second idea on the list, “The Technology That Can Revolutionize Health Care”.

The author is Dr. Ronald Dixon, Director of Virtual Practice Management at Massachusetts General Hospital in Boston, MA shows how simple things like phone calls and email can have a dramatic effect on the care of patients – making it better, easier and ultimately cheaper.

While reading the piece, I was relieved to read his perspective – he knows that these tools can be very effective, but must wait until the rules change in order to fully capitalize on the system. The two main barriers -- a hospital’s need to be able to charge a fee for a doctor’s time (emailing, calling, etc.) and the inability of information from emails between a patient and doctor cannot be included in the patient’s health record – are significant. However, the examples of how these tools can really make a difference in a person’s care are significant.

Image Source: Gizmodo

Speaking of technologies being used for other purposes...  This story was passed along by Aaron Kao, a sharp new intern here at Ashoka.

The Wii Balance Board—a pressure-sensitive accessory you stand on to do yoga and play snowboarding video games—can apparently do the same thing for stroke victims that an $18,000 piece of medical equipment has traditionally done, at less than 1% of the cost and available for sale at your local mall. 

"When (University of Melbourne researcher) Ross Clark read in New Scientist (29 March 2008, p 26) that the US military considered the Nintendo Wiimote controller accurate enough to control bomb disposal robots, it set him thinking. Could the Wii's skiing and snowboarding attachment, the balance board, help rehabilitate people who have had a stroke?"

As the Healthcare Reform Debate rages on here in the US, in other countries healthcare is being transformed by a new crop of social entrepreneurs popping up around the globe. This trend, micro health clinics, boast high-quality, affordable and accessible healthcare in rural areas of countries where income and health disparities can have devastating effects on the population.

We have previously posted highlights of the Healthpoint Services E Health Points here on AshokaTech, and there are many other models doing similar work.
Here is a list of four other initiatives using innovative business models and technologies to increase access to basic healthcare services around the globe.

In this week's episode of the AshokaTECH Podcast, host Alex Budak interviews Ashoka Fellow David Green.  Green's work focuses on health care delivery to the developing world, enabling developing countries to produce, distribute, and service high-quality, affordable health care products. Having already directed the successful production and distribution of two products–intraocular lenses and surgical sutures, David is now launching an effort to manufacture and distribute top-of-the-line, cost effective, cosmetically acceptable, and locally maintainable hearing aids.  Alex asks him about his ongoing project, as well as what Green has termed "compassionate capitalism."

Be sure to follow Alex on Twitter, @TheBudak, for updates on the podcast and your chance to have your own questions answered in future interviews.

Listen and subscribe to the AshokaTECH Podcast on iTunes

Or visit the AshokaTECH Audioroom to listen to this and all AshokaTECH Podcasts.

Ashoka-Lemelson Fellow Rebeca Villalobos and her organization ASEMBIS (Asociación de Servicios Médicos para el Bien Social; or Association of Medical Services for the Common Good) have refined a financially sustainable model to offer high-quality medical care at affordable prices.  95% of ASEMBIS total budget is covered by patient fees; patients are drawn by promotional and discount programs, the possibility of financing through credit, and the affordable rates, even at full price.  26% of patients are considered low-income, many of whom receive 100% subsidies.  The other 5% of the budget comes from monetary or in-kind donations (technical training, medicine, equipment, etc.) from partner organizations, including Christoffel Blindenmission International, World Vision, and ASESA among others.  ASEMBIS constantly reassesses costs and prices through semi-annual market studies including considerations of inflation, minimum wages, market prices, inputs, and analysis of the competition. By segmenting the market, ASEMBIS has been financially self-sustainable for the past ten years.  They have served over 1,000,000 clients – 330,000 in the past year alone – and elements of her model have been adopted by organizations in Mexico, El Salvador, Honduras, and Panama.

This post contributed by Health for All's Urmila Srinivas.

A six-month waiting list for patients is never comforting for a doctor, much less for the patient. Such was the case with residents of New Mexico waiting to see Dr. Sanjeev Arora, a physician at the University of New Mexico hospital and one of the few hepatitis specialists in the area.

If patients near the hospital have to wait six months to see a specialist, what about the needs of other residents that have no means of physically getting to Arora or another type of specialist? Can the problem of location be solved? Will anything motivate specialists and physicians to pick up their established lives in hospitals, clinics, and private practices and move to rural, more remote areas?

Dr. Arora, an Ashoka Fellow, understood that having the ability to communicate is an essential element of healthcare delivery and arguably sets the foundation for healthcare delivery.  If you’re lucky, your specialist lives close by and you are a subway, bus, or car ride away from an appointment, diagnosis, or treatment. The problem arises when rural and underserved populations are unable to travel and communicate with specialists who are dispersed across a state, often times much farther than a day’s worth of travel.

The Disease Control Priorities in Developing Countries book has a chapter on Skin Diseases. The introduction states, “In assigning health priorities, skin diseases are sometimes thought of, in planning terms, as small-time players in the global league of illness compared with diseases that cause significant mortality, such as HIV/AIDS, community-acquired pneumonias, and tuberculosis. However, skin problems are generally among the most common diseases seen in primary care settings in tropical areas, and in some regions where transmissible diseases such as tinea imbricata or onchocerciasis are endemic, they become the dominant presentation.”

I admit that when I think about diseases and the need to diagnose these diseases, skin diseases don’t jump immediately to my mind. However, common skin diseases such as acne affect the quality of life just as much as other common conditions like diabetes, arthritis, and asthma. Often, skin diseases can lead to disfigurement and can result in social isolation and exclusion. One of the main problems is that primary care facilities in many developing countries simply don’t have the capacity to diagnose of treat these issues. Beyond skin diseases, diagnostic imaging is needed to diagnose conditions internally, like tuberculosis, for instance.

As the Ashoka Healthcare for All work moves forward, I have recently been spending time researching low-cost solar powered refrigerators. We need refrigeration to store medicines, vaccines, and certain reagents to perform diagnostic tests. These needs are similar to others who are working in resource-poor settings where there is ample heat but little or unreliable electricity to keep refrigerators operating.

Here is a short list of the technologies I found thus far. If you know of others, please let me know!

I spend a lot of time looking, searching, emailing, and asking for information on low-cost, health technologies designed for use in resource-poor settings. Though I mainly focus on health diagnostics for infectious diseases, I make it a point to try and find as many solutions in as many different health areas as possible, in hopes that we will be able to incorporate them into Ashoka’s Healthcare for All work. It is no surprise, then, that I was overjoyed and inspired when I stumbled upon the http://maternova.net website. Maternova is a “web-based media channel with a laser sharp focus on maternal/neonatal health in low-resource settings”. Laser sharp focus indeed! Founded by Meg Wirth, a public health expert with a focus on maternal and child health and social venture capital for financing global health, the site compiles innovative tools to save mothers and to save infants, based on whether or not they are on the market or currently in development. There is also a section for innovation in structure and systems (such as the vaccine refrigerator shown in the picture above). When I spoke with Ms. Wirth earlier this summer it was obvious she has a great vision for the site. Just check out their plan to use crowd sourcing to map maternal health clinics, connect professionals, accelerate innovation, and be a space to provide additional resources to us all.