Taking connected mobile-health diagnostics of infectious diseases to the field

New article in Nature on how internet-connected diagnostic devices might offer novel ways to diagnose, track and control infectious diseases and to improve the efficiency of the health system.

Nature.pdf (1.2 MB)

It will be great to have a discussion on any field experiences with such connected diagnostics.

Madhu

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Really nice, concise overview of the many technologies and interventions. I think at this point in history, we should be able to agree on the following:

  1. There are many different interventions created on mobile phones or using mobile-related technologies.
  2. A LOT of evidence has been generated on the effectiveness and efficiency gains made by some of them, proving at least that they’ve established it’s possible to generate fantastic results through their use (just reading the articles referenced in this article alone). Obviously, no guarantees that doing mobile = adding value, nor am I trying to suggest that most (or even “many”) of these interventions have been studied rigorously. But, it is now true that some have, and their evidence is compelling.
  3. Business models in the private sector, especially in the US, UK, Canada, and Europe are emerging and scaling rapidly. I’m not talking about selling ads inline with a free app, or being paid by global health to do software development with no business model around it. I’m talking about health care providers, insurers, and direct patients paying real money (not bitcoin) for proven health benefits.

Specifically, it’s worth looking at the revolution happening in diabetes, asthma, and COPD for chronic disease management. Over the past 6 months, I’ve met with Intermountain Healthcare, Public Health England, Propeller Health, Sickweather, Kinsa Health, Novartis, and MANY others now making millions-to-tens of millions in yearly revenues.

The question for global health though, where I cannot think of a single digital health intervention that’s gone to national scale or beyond with a truly sustainable business model is…why the heck aren’t these scaling in global health? I can’t help but point to the funding mechanisms of global health and how hostile they are to the digital health industry. Software-as-a-service is prevalent globally but absent in global health. Priced per user is the global standard but somehow impossible in global health. Monthly contracts for every single IT thing in the world but can’t seem to be done on a global health contract. This is crazy talk!

With all this evidence and hundreds, if not thousands, or highly valuable innovations and inventions…will the global health funders pay for performance? If not, why not? If so, it’s time to have a frank discussion about how Global Fund, USAID, DFID, and others’ grant and contract structures need to evolve. Doing so will enable us to FIND more patients, ENROLL them to the right regimen, ENGAGE with them so they complete treatment, and PREVENT relapse. Until the money gets fixed, these amazing innovations in the article will stay forever in “pilot mode”.

Here is another new paper on connectivity and diagnostics in the WHO Bulletin:

Best
madhu

Dear Jeff,

I share your sentiments, ’ why the heck aren’t these scaling in global health?', they should be scaled up in resource-limited and high disease burdened settings. I am one of the co-authors of this paper. We have highlighted the need for stakeholder involvement in the implementation of these intervention. I think there is also a real need for collaboration between researchers globally, to help solve this problem. I am open for collaboration.