Social and Technical Challenges in Serving Preventive e-healthcare Services to Rural and Unreached People Ashir Ahmed Kyushu University & Grameen Communications
Agenda Can we trust the e-doctors? How to build a doctor-friendly telemedicine system? Consumer behavior: What is the response of the patients towards e-health services? (c) Ashir Ahmed, 2017 2
Knowledge on Social Issues Advanced Technology Grameen and Kyushu university initiatives SINCE 2007 Development of Technologies to achieve social goals 3
Approach to tackle social issues Create Instantly Usable Technologies Social Entrepreneurs Social Impacts Business 持続性 Technology Measure Efficiency Cost Effectiveness Universal / Mass Access 技術性 4
Power of ICT E-Service, U-Service Developed Countries Improvement of social services by using ICT based on existing infrastructure ICT ICT ICT Educatio n Healthcare Banking Transport Developing Countries Educ ation Energ y Redesign the social services based on ICT Applications come first, then infrastructure Healt h Banki ng ICT Govt. (c) Ashir Ahmed, 2017 5
7.5 Billion People 6 Billion Mobile Phones (SIM cards) Biggest Network in Human History (c) Ashir Ahmed, 2017 6
Industry-Academia-Government Joint Collaboration between Japan and Bangladesh Bangladesh Govt. TOP-Bottom Beneficiaries Dhaka University University (BD) Kyushu University University (JP) Bottom-UP Industry (BD) Grameen Industry (JP) Toyota, Sharp BD NGO/NPO/SB (c) Ashir Ahmed, 2017 7
Portable Health Clinic Preventive Healthcare Service at your Doorstep (c) Ashir Ahmed, 2017 8
Limited Resources in Rural Areas in Bangladesh Doctor, Nurses/ 10,000 patients 4doctors 2 nurses 70 60 50 40 30 20 67 42 24 21 10 6 3.5 0 Poor distribution of resources 20% of Doctorsin rural areas 73% population live in rural areas No. of Doctors Per 10,000 Patients in 2013 (Source: http://data.worldbank.org) (c) Ashir Ahmed, 2017 9
Reason of Death: NCD portion is increasing Stroke Diabetes Heart Failure Kidney Failure Non-Communicable Diseases (NCD) Can be prevented by regular health checkup and by following simple healthcare guideline Globally kills 36 million/year. >80% are low- and middleincome countries Threat to young people (c) Ashir Ahmed, 2017 10
Resource Sharing: Remote Healthcare? 2. Micro Entrepreneur 3. GramHealth DB 1. Portable Health Clinic Patient @Home 4. Telemedicine Center (Doctors call center) (c) Ashir Ahmed, 2017 11
Resource Sharing: One PHC box per community Research Challenges: User-Friendly, Modular Device Intelligent Screening System Patient Friendly, Doctor Friendly Interface BigData Analysis (c) Ashir Ahmed, 2017 12
Steps to turn an unemployed girl into an Entrepreneur Unemployed Girl 12-36 months training including internship Licensed Health Worker 1 month technical and entrepreneurship training Grameen Healthcare Entrepreneur (GHE) Resource Sharing: One Micro Entrepreneur in one Community (c) Ashir Ahmed, 2017 13
Portable Health Clinic: How it works Video File (c) Ashir Ahmed, 2017 14
ThreetypesofCustomers Type-1 Through micro entrepreneurs Type-2 Through our healthcare staffs Type-3 Through your staffs Individual Patients @Home (Rural, Urban) Patients @Orgs (Corporate Offices) Patients @Orgs (NGOs, NPOs) Individual Services (Regular On Demand) GramHealthcare Entrepreneur (GHE) Yearly Group Checkup, Regular Follow up Our Own Staffs Individual Services (Regular On Demand) We Train Your Staffs Provide PHC system training, Entrepreneurship Training Maintain the PHC Box Doctor Call Center (Support patients) GramHealth Database (Archives Patient History) (c) Ashir Ahmed, 2017 GramHealth Support Center in Dhaka 15
2. Chief Complaint 1. Measured Data with Triaged Results 3.Prescription 4. Doctor Contact (c) Ashir Ahmed, 2017 16
Service Delivery Statistics of Portable Health Clinic # As of Jan, 2018 Year Total Health Status Check-up Safe Cautious Affected Risky 2010 377 104 15 247 10 2012 6,412 1,056 4,035 1,084 237 2013 13,293 1,600 6,783 4,309 546 2014 5,384 1,037 2,299 1,680 345 2015 5,713 1,387 1,476 2,045 803 2016 7,008 1,875 1,614 2,255 1,070 2017 2,854 367 799 868 361 2018 300 34 117 77 44 Total 41,063 7,364 17,068 12,508 3,366 (c) Ashir Ahmed, 2017 17
Morbidity Reduced First Checkup n=8527 Remote Consultancy of risk cases (n=1635) Orange Affected Red Emergency Orange and Red cases are reexamined Two Months later Red and Orange (Appearance Rate= 1010/1635 = 62% ) Original count % Red (emergency) (12%) Orange (affected) (88%) Orange (16%) Red (2%) Green (16%) 1 Morbidity reduction after 2 months A decrease in Orange & increase Yellow and Green categories Red Green (healthy) (8%) (6%) Yellow (65%) Orange (affected) (38%) Yellow (caution) (48%) n=8527 Yellow Caution Green Healthy Not followed up n=1010 Health Status improved in two months (c) Ashir Ahmed, 2017 18
Overall Health Status by Triage (c) Ashir Ahmed, 2017 19
Wellness meter and Personalized Health Care Hypothetical Personalized Triage Illness / Wellness Meter (By using simple decimal scoring method) (c) Ashir Ahmed, 2017 20
PHC in Jaipur, India (c) Ashir Ahmed, 2017 21
Expansion 41,000 checkups in Bangladesh Trained 10 Health workers in India Maternal Health in Cambodia Trained 5 Staffs in Thailand (AIT) to be deployed in Pakistan (c) Ashir Ahmed, 2017 22
Challenges Can we trust the e-doctors? Doctor-friendly telemedicine system Consumer behavior. Response of the patients towards e-health services (c) Ashir Ahmed, 2017 23
Summary Creating Business (Entrepreneurs) in Rural Areas owned and operated by the poor Power of ICT in developing countries Opportunity to improve quality Big population, big market, big social impact Possibility of reverse innovation (c) Ashir Ahmed, 2017 24
Thank you (c) Ashir Ahmed, 2017 25