WHCC Affordable Health Innovations

The WHCC Affordable Health Innovations Blog recently spoke with Joel Selanikio, MD, the Washington director of DataDyne, creator of EpiSurveyor, a free mobile-phone-and-web-based data collection system that a user can set up in less than an hour. The simplicity has made EpiSurveyor the most widely-used mHealth software in the world, with thousands of users in hundreds of organizations — including 15 sub-Saharan African countries in conjunction with the World Health Organization’s African Regional Office.

Click here for a visual display of EpiSurveyor in action.

WHCC: Why is there a need for EpiSurveyor?

Dr. Selanikio: In every enterprise, there is a need for good data to establish priorities, determine baselines, and evaluate progress. International development and global health are no exceptions to this rule, and much of our essential data is obtained from community-based, or facility-based surveys on paper. EpiSurveyor takes this paper-based system and easily and inexpensively replaces it with one based on mobile phones.

Such mobile electronic data collection previously required expensive technical personnel, with costs per data collection activity ranging from tens to hundreds of thousands of dollars. EpiSurveyor makes mobile electronic data collection dramatically simpler, allowing program personnel to do it themselves, without expensive technical consultants (less than one percent of EpiSurveyor users ever require our technical support!). This drastically reduces the cost and difficulty of using the technology.

This is similar to the process that has taken place with other capabilities in our lives, aided by the Internet and now the mobile phone: establishing email service for an organization used to require the setup and maintenance of server computers and software, with dedicated staff and air conditioned rooms. Now it only requires a Hotmail, Yahoo Mail, Gmail, or other Web mail account. Setting up a Web site with your photos and comments used to require a web programmer’s skills: now it requires five minutes with Facebook or any similar site.

Likewise, EpiSurveyor takes a complex and expensive task and makes it simple, inexpensive, and accessible.

WHCC: What are the most significant barriers to collecting quality health data in many parts of the world?

Dr. Selanikio: There are too many significant barriers to list: from bad roads to poorly paid personnel to political instability and violence. Some of these are inherent (e.g., it is always going to be somewhat difficult to visit 20,000 rural households to examine the children of the household for malnutrition), while others are not. EpiSurveyor addresses one single significant barrier: we are eliminating the high level of cost and technical complexity involved in using mobile electronic data collection.

Who is the primary audience that would use EpiSurveyor?

Dr. Selanikio: The user population for EpiSurveyor is defining itself: although our primary concern has always been global health, because the software is accessible to anyone with a browser, we find users from the World Bank doing economic surveys in Latin America, individual researchers collecting data in Cameroon andCanadian veterinarians investigating swine disease at farms in Ontario.

Again, in every enterprise there is a need for good data.

It is our job at DataDyne to ensure that EpiSurveyor meets the needs of – and is accessible to – all these users and potential users like them: both well-resourced international organizations and the less-well-resourced individuals, healthcare providers, Non-Government Organizations, ministries and businesses that all need high-quality data.

The bottom line: if your organization is thinking of collecting data on paper and clipboard, you can use EpiSurveyor to collect that data more easily, inexpensively, and efficiently.

WHCC: Are there particular countries or regions where EpiSurveyor has been especially successful?

Dr. Selenikio: EpiSurveyor was originally focused in Africa, from its first beta test in Kenya in 2005 and the subsequent WHO program to expand its use in 10 other sub-Saharan Africa countries with funding from the UN Foundation and Vodafone Foundation (who have also funded most of the software’s development). Today, while EpiSurveyor is programmed almost entirely by DataDyne’s Kenyan staff in Nairobi, EpiSurveyor has become a global utility — used worldwide and available anywhere there is a browser and a mobile phone.

WHCC: What do you see as the long-term growth potential for EpiSurveyor?

Dr. Selanikio: Our goal is to make EpiSurveyor a self-sustaining public utility for data collection, analysis, and reporting. We are exploring additional services and features, beyond those of the free, basic version of EpiSurveyor, with the idea that larger organizations will pay for those services and features and in doing so subsidize the provision of the basic version to quite literally everyone else on the planet who needs to collect data.

This has never been done before in international development, though the model is widely used in the commercial software realm (Skype, Flickr, and many other software programs and websites have such a free + premium model), and we are keen to be the first. Our current projections indicate that if we can receive two more years of funding we will reach the break-even point at which we would no longer require grants or investment funding to continue to provide excellent data collection capabilities to anyone who requires them.

About Joel Selanikio, MD
Named by Internet Evolution to their 2010 IE100 list of key internet influencers, and by Forbes magazine as one of the most powerful innovators of 2009, Joel Selanikio is a winner of the 2009 Lemelson-MIT Award for Sustainability and the 2009 Wall Street Journal Technology Innovation Award for Healthcare IT. His work has been reported on by The Economist, The Wall Street Journal, the BBC, and the Washington Post, among others. He is a sought-after speaker, and a participant in the World Economic Forum in Davos, Switzerland.

The WHCC Affordable Health Innovations Global Initiative recently spoke with The Center for Health Market Innovation about its exciting new initiative. (CHMI) — www.healthmarketinnovations.org – is a new, publicly accessible, global knowledge platform that collects, analyzes, and disseminates information about Health Market Innovations in the developing world. CHMI is the first database of its kind, providing aggregate, standardized, searchable information about hundreds of programs with potential to improve how health markets operate. It is part of the Results for Development Institute.

WHCC: What is a health market?
CHMI: A health market is the part of the health system where decisions about health care are made by both consumers and providers of services. When consumers seek out care for their symptoms, they usually have options about where to receive it, including numerous private providers. These providers also have choices about the quality and type of care they offer. Markets exist in any sectors, but health markets have two primary challenges that set them apart from others. First, unlike consumers of other products such as food or clothing, health care consumers are often not well-informed about the type of health care they need, so they struggle to distinguish between high-quality and low-quality care. Second, societies around the world value equitable access to health care more than equitable access to most other products. Although these challenges exist, health markets have the potential to deliver better results for the poor if well-harnessed. When well-monitored and regulated, health markets can be a source of creative new approaches with the potential to achieve greater efficiencies, greater quality, and increased access to care for the poor.

WHCC: What was the impetus for starting CHMI? Where did you see a need that wasn’t being addressed?
CHMI: The idea for CHMI came about following a 2008 study funded by the Rockefeller Foundation on the role of the private sector in health. One of the products of the study was the identification of several interesting health models that were delivering care and financial protection to the poor in innovative ways. This quickly led to the realization that there were many such models in existence, but that information about them was sparse, a potential result of the relatively little attention given to market‐based approaches versus traditional public sector delivery models. Speaking with individuals from various professional backgrounds, we learned that many saw this lack of centralized and complete information as an obstacle in carrying out their work. For example, funders have had difficulty identifying and evaluating programs for support, policymakers did not have enough information about the scale, scope, and effectiveness of specific models to leverage their potential, and researchers were not able to obtain a wide enough sample of health market programs, precluding high-quality impact research. CHMI works to fill this gap.

WHCC: You mention that in many developing countries – including ones with large populations – financing for health services comes largely from private sources and individuals pay for care out-of-pocket. This seems especially problematic since many individuals likely can’t afford this. What is the result?
CHMI: The poor in developing countries often rely on private providers and pay out-of-pocket for health services. In India, for example, over 70% of total spending on health is out-of-pocket payments. The result of this is that, often, illness pushes poor individuals deeper into poverty and impoverishes families living just above the poverty line. Also important to remember is that “private providers” are not always registered facilities staffed by trained doctors and nurses. Quite often, the poor rely on informal providers for care. Although the service fees charged by these individuals may be lower than those found in formal private facilities, the quality of care provided can be inappropriate, substandard and even dangerous. CHMI also works to documents programs that work with these informal providers – organizing, training and accrediting them to deliver better care to the poor.

WHCC: CHMI includes governments, NGOs, community organizations, social entrepreneurs and companies as the innovators that are integral to the goal of dramatically improving health markets. Why is each a vital part of the plan?
CHMI: The market for health is complex and includes many actors, both private and public, that interact to deliver health services to the poor. NGOs and community organizations often serve areas and population groups that are out of the reach of government programs. They also leverage resources of the international community, as well as local resources (e.g., community heath workers, community risk-pooling arrangements), to provide care and financial protection. Social entrepreneurs are key to promoting new approaches and technologies for service delivery and financing, often offering new solutions to longstanding challenges in health care. Governments can play a critical role in stewarding the health market, engaging private providers to achieve broader health systems goals. Although these roles aren’t always cleanly defined and often overlap, each actor has a specific set of resources and expertise at their disposal and is able to play a critical role in improving the market for health.

WHCC: Part of your approach includes a “wiki”-style contribution platform. Why is this important?
CHMI: Although CHMI is striving to document all approaches that improve the health market in the developing world, we have made it a priority to capture lesser-known and home-grown programs. To achieve this, we are relying on “eyes on the ground” to identify and profile these initiatives. CHMI is going about this in two ways: (1) in country partners and (2) contributions from the community. Currently, CHMI partners are working to document health market innovations in India, South Africa and Vietnam, and new partners will soon begin work in the Andean Region of Latin America, Brazil, Indonesia, Kenya (including a mapping of Tanzania, Rwanda and Uganda), Pakistan, and the Phillipines. These partnerships are critical to the success of CHMI and in-country institutions will contribute greatly to data collection and analysis. We are also relying on input from the community to keep the CHMI database up-to-date and add programs not captured by our partners, including those that operate in countries where we do not have a presence. Users are able to contribute in two ways: submitting program profiles for initiatives not currently profiled in the CHMI database, and providing updated information on current profiles.

WHCC: What the next steps for CHMI? What are the short-term and long-term goals? CHMI is constantly growing, both in terms of the breadth and depth of the database, as well as the features and additional research that will build on and supplement the data currently available. Current plans for future CHMI products include expanding the CHMI database with the addition of 6 new partners and contributions from the community; developing metrics to identify promising programs and producing country profiles to provide a context for the innovative programs profiled in the database; and publication of in-depth program case studies and thematic studies on exciting health market topics. CHMI will also work to create linkages among CHMI’s various stakeholder groups, including matching innovative programs with potential funding. For a more extensive view of CHMI’s future goals and plans, visit the http://healthmarketinnovations.org/content/chmi-roadmap.

CHMI is funded by the Bill & Melinda Gates Foundation and the Rockefeller Foundation, and is managed by Results for Development Institute in collaboration with a network of partners. CHMI partners include Access Health International in India, BroadReach Healthcare in South Africa, the Center of Investment in Health Promotion (CIHP) in Vietnam, and the Global Health Group at the University of California, San Francisco (UCSF).

Join the WHCC Affordable Health Innovations Poster Exhibit at the Leadership Summit on Creating Global Disruptive Business Innovations.

The World Congress Leadership Summit on Creating Global Disruptive Business Innovations is pleased to welcome submissions for a special poster exhibit that highlights affordable health care solutions. As part of the WHCC Affordable Health Innovations Global Initiative www.whcchealthinnovations.org, the exhibit will feature disruptive health innovations poised to change the health care market.

Qualifying companies will be permitted to join our onsite poster pavilion at a specially designated price.

The World Congress Leadership Summit on Creating Global Disruptive Business Innovations in Health Care will focus on innovations that have begun to “disrupt” previously established business practices in the health care industry. These innovations are revolutionizing health care by increasing access, delivery and cutting costs. An entirely new population of consumers will gain access to services that they previously could not.

To submit an abstract for review, please visit our website. Include a description of your organization and a brief description of your disruptive innovations project. Submit abstracts by Friday, July 2 for consideration.

In Rajasthan, India’s driest region, social entrepreneur and innovator Dr. BP Agrawal believes a “River From the Sky” is the answer to providing arid villages with fresh drinking water.
After decades working in research and development for global companies such as General Dynamics, Dr. Agrawal turned his attention to his non-profit organization Sustainable Innovations. One of the company’s major initiatives is solving the dramatic water shortage problem in his native Rajasthan, a region in north eastern India with 56 million people and 40,000 rural villages. His efforts during the past five years earned him numerous awards, including the 2010 $100,000 Lemelson-MIT Award, presented by The Lemelson Foundation. Dr. Agrawal recently visited MIT to share insights on his work during EurekaFest, a mutli-day celebration designed to empower a legacy of inventors through activities that inspire youth, honor role models and encourage creativity and problem solving.
Dr. Agrawal also presented posters on innovations at the World Health Care Congress in April and the World Healthcare Innovation and Technology Congress last November.
The implications of inadequate access to clean drinking water are, of course, dramatic.
The World Water Development Report 2009 estimated 80 percent of health problems and 5 million deaths per year in developing countries are linked to inadequate water and sanitation.
“River From the Sky” is the English translation for Aakash Ganga, a project Dr. Agrawal developed that maximizes the use of rainwater by the channeling it from village roof tops into water tanks that can be used to supply villages with much-needed drinking and cleaning water.
Rajasthan suffers from a 10-month annual drought. While it rains considerably during the two-month rainy reason, the region lacks the infrastructure to capture water and maximize its use. The Aakash Ganga system channels enough rooftop rainwater to provide a village with a year’s worth of drinking water.
If the concept sounds simple, the project’s development and implementation is not. Dr. Agrawal explained that he must navigate economic, social political and logistical barriers to make Aakash Ganga sustainable.
Poor basic health and sanitation are constants in Rajasthan. While a lack of running water and medicine are contributors, the psychology of the villagers can also hinder progress.
“Health care is pretty much non-existent,” said Agrawal. “They have accepted diseases as the normal aging process. They don’t event complain about them.”
Under the Aakash Ganga system, a portion of the water collected on a home’s roof is channeled into a tank for the family’s personal use. The rest of the water is channeled into a community reservoir and used by homes with thatched roofs that cannot collect water and families that cannot afford personal water tanks. The large shared reservoir is 400,000 liters or more in capacity, costs about $0.05 per liter to construct and has an infrastructural investment of $2-$3 per person per year. The network is designed to provide 10-12 liters daily per person. So far, it has helped 10,000 villagers gain access to clean water, and Dr. Agrawal hopes to replicate the system in many other villages.
In order to help make the system self-sustainable, Sustainable Innovations rent the roofs from the villagers, which provides them with income. Seventy percent of harvested water is sold or used for individual families. The rest goes to horticulture.
Sustainable Innovations has received a $200,000 World Bank Development Grant and matching funds from the Rajasthan Association of North America. Dr. Agrawal hopes to secure several million more dollars from India’s Ministry of Rural Development, Department of Science and Technology, the National Rural Drinking Water Program and social investors.
In addition to Aakash Ganga, Agrawal and Sustainable Innovations has developed a kiosk-based health clinics that can provide care at $0.25 per visit. The clinics are operated by high-school educated young women and are designed to alleviate the shortage of trained medical staff and improve standardized treatment protocols for common ailments and preventable diseases in India.

The WHCC Affordable Health Innovations Global Initiative is pleased to welcome Children’s Hospital Boston, Harvard Medical School to the poster exhibit at the World Health Care Congress Middle East, December 5-7 in Abu Dhabi. Dr. Rana Sharara-Chami, assistant in critical care medicine, will present “Pediatric Intensive Care Unit Without Walls, a state-of-the-art Web site that would provide free and unlimited access to pediatric critical care resources for health care professionals around the world. The Web site features presentations by international experts in the field, hands-on practice by the experts and simulation-based talks. In addition, it has a health map to track incidence of disease and regional epidemiology of infections, clinical practice guidelines to all ICU topics and an interactive forum where health care professonals could contribute, comment and ask questions. A Middle East inititave is underway where the Web site’s usability is being tested in many centers. The project coordinators hope the knowledge will affect physicians’ behavior and eventually improve children mortality rates around the world.

To submit an abstract to present a poster at WHCC Middle East, please visit http://www.worldcongress.com/events/HR10004/posters.cfm?confCode=HR10004

Check out a recent blog post from Boston Biotech Watch on the health innovations on display at the 7th Annual World Health care Congress. The innovations were part of our Affordable Health Innovation Exhibit. The piece is co-written by Steve Dickman, CEO, CBT Advisors and writer Malorye Allison.

Following the success of the Affordable Health Innovation Poster Exhibit at the World Health Care Congeess in Washington D.C. this April, we are launching similar exhibits at our several of our upcoming conferences, including the World Health Care Congress, Middle East, December 5-7 in Abu Dhabi, United Arab Emirates.

The World Health Care Congress Middle East will gather 750 senior health care leaders from around the globe. We welcome poster submissions from all areas of the health care industry, including those focusing on hospitals and health systems, public and population health, health care financing and mobile health and telemedicine.

Click here to submit an abstract of your work for consideration.

Participants are invited to present a poster at the event. While we permit organizations to send just a poster for display, we strongly encourage participants to attend with the poster. It is a great opportunity to meet other people in the health care field.

In addition, we will display your work on our special Web site www.whcchealthinnovations.org. This year-round project is like a “virtual exhibit” for displaying posters as well as infromation about the projects.

If you didn’t catch it when it aired, check on the report CBS Evening News did on Vision Spring, a great non-profit that is helping the visually-impaired in developing countires see.  The organization does this through free eye exams and affordably-priced glasses. The report takes us to the rural village of Keharpura in Rajasthan, India, where Ranju Sharma, a local woman, finishes her daily choses and begins administering eye exams to other villagers. 

By providing the eye exams, Sharma can then sell glasses to those who need them four about $4 pair.  She keeps about $1 per pair for herself and the recipients of the glasses get something they otherswise likely would be without – the gift of good eyesight.

VisionSpring was foudned in 2001 by New York City eye doctor Jordan Kassalow.

Click the link below to watch the report

http://www.cbsnews.com/video/watch/?id=6463853n&tag=mncol;lst;2

The 7th Annual World Health Care Congress has come and gone, and with it the WHCC Affordable Health Exhibit and Awards. We are pleased to have welcomed 50 poster presentations to our exhibit hall. The organizations that either sent posters of their innovations or made the trip to Washington D.C.  are among the most interesting and exciting players in the health care field.

On the conference’s second morning, we had the pleasure of presenting awards to three of our innovators. Patrick Beattie, a scientist at the Cambridge-based non-profit Diagnostics For All, took home our top award for DFA’s work on a diagnostic tool that is produced on regular printing paper.  Used to detect a wide assortment of maladies, the pattended paper design uses microfluid channels and is about the size of a postage stamp.

We also awarded two honorable mentions. Harry Poliak accepted one of the awards on behalf of Safe Water Today, an organization that has developed the Siphon Water Filter. This low-cost device can be used in homes to remove harmful contaminents from drinking water. About 70,000 units are in use around the world.  Erik Douglas, a post-doctoral scholar at the University of California Berkeley took home an honorable mention for CellScope, a device that merges a microscope with a cell phone, allowing for high-quality images at the cellular level. This point-of-care diagnostic tool system is capable of on-site diagnosis and wireless transmission of patient and location data to clinical centers for remote evaluation, patient management, and epidemiological surveillance.

We are extremely thankful to Professor Muhammad Yunus, founder and and managing director of Grameen Bank and Grameen Health, and 2006 Nobel Peace Prize Laureate, for presenting the awards onstage at WHCC . Professor Yunus has done tremendous work around the globe to bring simple yet effective health solutions to the poor.

Thanks again to the many organizations who took the time to join us in Washington, D.C. We look foward to continuing to build the program.