ICT Developments in Mobile Technology for Global Public Health

1. ICTDevelopments in Mobile Technology FORGlobal Public Health: InSTEDD Collaboration Tools Channe Suy, MCA Product Manager Taha Kass-Hout, MD, MS Director, Global Public Health and Informatics Mekong Basin Disease Surveillance (MBDS) Information Communication and Technology ForumApril 2nd–3rd, 2009Mukdahan Province, Thailand Photo credit: IRMA (Integrated Risk Management for Africa) Innovative Support to Emergencies, Diseases, and Disasters

2. Late Detection and Response Opportunity for control CASES DAY

3. Early Detection and Response Opportunity for control CASES DAY

4. Public Health Measures Representativeness Completeness Predictive Value Timeliness Background

5. Public Health Measures 50 Malaria notifications (5%) Specificity / Reliability Urge frequent reporting: Weekly  daily  immediately 1000 Malaria infections (100%) Get as close to the bottom of the pyramid as possible Sensitivity / Timeliness • Main attributes • Representativeness • Completeness • Predictive value positive

6. Public Health Measures Health care hotline • Main attributes • Timeliness Signal as early as possible Time

7. Making Mobile Technologies Work for Health One of four major initiatives of the UN Millennium Action Plan (2000) mHealth for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World (2009)

8. Growth of Mobile Technologies Dzenowagi, WHO, 2005

9. Internet Penetration in Asia Pacific Countries Internet penetration levels among the population as a whole India 5.2% Malaysia 59.0% Thailand 20.5% Myanmar 0.1% This compares to about 73.6% for North America As we'd expect other countries in Asia are also shown to be high such as Japan, S. Korea, Taiwan and Hong Kong Nigel Collier, BioCaster: http://biocaster.nii.ac.jp http://www.internetworldstats.com/stats3.htm#asia

10. Urban – Rural Population, SE Asia (2002) UNCTAD Handbook of Statistics 2004 Dzenowagi, WHO, 2005

11. Making Mobile Technologies Work for Health Infrastructure affordable, reliable, high-speed connectivity Technology and tools designed, developed and deployed cheap and rugged access devices people who can install and support them Education skills to find, use and manage information Dzenowagi, WHO, 2005

12. Making Mobile Technologies Work for Health Policies and standards for information representation and exchange affordable rates, tariffs and services Evaluation evidence & experience to guide development Coordination vertical systems impede real progress interaction: what is used in one place should work in another Dzenowagi, WHO, 2005

13. Current Challenges Costs of data transmitted over mobile phone are greater than voice costs Language and illiteracy barriers Patient privacy and security Other challenges include the physical components of a telephone (headset or network)are not isolated but are part of an entire business model that includes pricing plans and other incentives which can provide leverage employed by public health agencies and policymakers Kaplan, Globalization and Health 2006, 2:9 doi:10.1186/1744-8603-2-9, 2006

14. The InSTEDD TECHNOLOGY Platform Open source software for closing the global collaboration gap InSTEDD GeoChat: Take Decisive Action in Response GeoChat lets you engage and coordinate with everyone who needs to be involved, linking headquarters, field, and the local community InSTEDD Mesh4X: Share Data Across All Boundaries Mesh4x lets you integrate applications, devices, and information into a shared, synchronized, distributed data mesh InSTEDD Evolve: Synthesize Data into Actionable Information Evolve lets you and your team monitor and collaborate around diverse data streams to detect, analyze, triage and track critical events as they unfold

15. How It Works – All Team Communication A field team member sends a message… it reaches the entire team…

16. Or… Field to HQ Communication Need supplies All is well 3 dead chickens Out of syringes

17. You Can Use GeoChat over Mobile Phone or Web

18. And these messages appear on a map… Filters: click here to show all the groups you are a member of.  the groups you want to view on the map. Messages: on the left panel are all of the messages coming into GeoChat from all the groups you have  , with the most recent at the top. Which group? At the bottom of each message, it tells you WHEN the message was sent and from which group it was sent.

19. And from here you can communicate with the team You can view the messages from one person by clicking on their message on the left panel (A) or by clicking on their icon on the map (B). • Click on a message or an icon and a conversation bubble will appear. • From here you communicate to an individual or to the entire team.

20. Least and worst case pandemic scenario played by Dr. Sovann Ly, Deputy Dir., Cambodia MoH Geochat Training conducted by the InSTEDD Team GeoChat Avian Influenza Exercise: Stung Treng Province, Cambodia, October 13-15, 2008

21. The Komphun rural Health Center serves over 7000 population in the Stung Treng and neighboring provinces. SE Asia Region (Source: Wikipedia) GeoChat Avian Influenza Exercise: Stung Treng Province, Cambodia, October 13-15, 2008 Cell phone use during the Avian Influenza Exercise: Stung Treng Province, Cambodia, October 13-15, 2008

22. GeoChat Avian Influenza Exercise: Stung Treng Province, Cambodia, October 13-15, 2008 Total Messages (exercise only) Exchanged during the morning of the AI Simulation Exercise, October 15, 2008, Stung Treng, Cambodia General messages exchanged among field workers, first responders, authorities, and government officials at CDC and provisional levels.

23. Examples Using GeoChat Connect a group of remote health centers ongoing team communication ask questions of each other Monitor a public health problem in a community with feedback from the field Create a support network for health issues, youth, women, etc. Other ideas?

24. Acknowledgements

25. Through funding from

26. Thank You! InSTEDD 400 Hamilton Avenue, Suite 120 Palo Alto, CA 94301 USA +1.650.353.4440 +1.877.650.4440 (toll-free in the US) info@instedd.org Cambodia, Photo taken by Taha Kass-Hout, October 2008 “this pic says it all- our kids are all the same- they deserve the same”, Comment by Robert Gregg on Facebook, October 2008

27. Back Slides

28. GeoChat Features: • Create, join, and participate in chat groups using SMS, email, or a web client on the surface of a map • Location information in messages is automatically extracted, so that you can see who said what, when, and where • International SMS gateway, Twitter gateway, and local gateway options • Full SMS command line interface • Public, private, and anonymous group configurations • Broadcast alerts to the entire team • Relay RSS/ATOM feeds of critical data over SMS Gateway Settings Setup RSS Feed

29. GeoChat Ideas for the Future Features: • Import additional data layers • Upload your own KML layer and combine with GeoChat conversations [e.g., flooded areas, destroyed buildings] • Sync structured data onto the map via HTTP or SMS • Group management via SMS for field • Gateway with plugged-in phone support for international characters /if the phone supports them/ • A US short code in summer (we cant promise dates)

30. GeoChat Ideas for the Future Features: • Offline client for disconnected operations • Pluggable encryption • Sensor integration • PDA client • Social Networking • Integrated Analytics – tag clouds, machine learning, entity extraction, clustering, etc. • Radio integration? Voice? Video?