Monday, December 7, 2009

Appropriate Technologies

The primary goal of the iCons in Medicine program is to create a community of healthcare professionals, enabled by appropriate technology to build bridges and forge connections across geographic, social, cultural, and ideological boundaries to make high-quality medical knowledge available wherever medicine is practiced. Appropriate technology is not necessarily items that are high-tech or low-tech, and may not be commercial off-the-shelf items. Rather, appropriate technologies are those that best combine suitability to the task at hand with compatibility with the technological, cultural, and economic framework of the region where they are deployed. Groups of researchers, universities, and not-for-profit and for-profit companies have all begun making strides to create healthcare tools that can be utilized in areas that may lack trained medical staff, resources, and/or reliable Internet connectivity, as well as other regions worldwide.



Health IT advancements and web-based tools offer an opportunity for physicians and healthcare workers to use technology in ways that previously were not available. Mobile applications for iPhones are gaining popularity among healthcare providers in the developed world. The BBC reports that, per Manhattan Research, 64 percent of U.S. doctors currently own a smartphone, and this figure is expected to rise to 81 percent by 2012. Most popular smartphone-based apps are available for the iPhone, among these tools are those that allow for collaboration between healthcare providers working in country, and remote consulting physicians. Among these are the iStetho Adapter and iStethoscope Pro app, developed by RidRx, which allow for audio information to be captured via a stethoscope modified for use with the adapter to be translated into sound spectrograms.

For some physicians in the United States and other areas of the developed world, high-tech solutions provide an opportunity to provide the best quality of care. Dr. Dinesh Patel, iCons in Medicine Member and Chief of Arthroscopic Surgery at Massachusetts General Hospital, finds that in his practice, new imaging and lens technologies have had the greatest impact. Technologies, which are “constantly evolving as high-tech experts bring new ideas,” bring cost reductions and improved health outcomes, as well as reducing complications and insurance costs, according to Dr. Patel. President of the American Telemedicine Center Corp., Dr. Gildred Colon Vega, also utilizes computer-based solutions in her practice at the San Juan Health Centre. Dr. Colon has found that an electronic medical record technology known as Web (based) Disease Management Electronic Medical Record (WebDMEMR) has been especially useful for storing clinical trial information.

Areas of the developing world are also making use of many of these high-tech solutions, including smartphones, and computer-based and mobile applications. The lack of trained staff have led physicians at one eye hospital in India to employ the use of mobile technology to improve its reach in rural and semi-urban areas. By training individuals in rural areas to take retinal images that are then sent to doctors’ iPhones at the hospital in Bangalore, providers are better able to ensure that infants are treated quickly if Retinaopathy of Prematurity (ROP – a potentially blinding condition) is detected.

Life-saving solutions are also being created specifically for use in the developing world, both by researchers in more developed regions and healthcare providers working in-country. These appropriate technologies are often designed with an eye towards sustainability, and make use of the skills of local craftsmen with readily available materials. Diagnostic technology is one area that holds great promise for creating technologies that are both highly effective and inexpensive, and that will provide a global benefit. Additionally, prosthetic and wheelchair fabrication techniques, such as those developed by the Center for International Rehabilitation (CIR) provide low-cost alternatives to standard prosthetic and orthotic devices that can be used in areas where resources or highly-trained personnel may not be available.

These technologies, initially conceived for use in medically underserved and post-conflict areas, also have the potential to impact healthcare in the developed world. The World Health Organization (WHO) reports that chronic disease is now the major cause of death and disability worldwide. With issues like cardiovascular disease, diabetes, and obesity, as well as pandemic outbreaks of H1N1 and HIV/AIDS, the development and utilization of globally appropriate solutions is surely practical. Hector Casanova, CP and Yeongchi Wu, MD, both iCons in Medicine Members, have noted the importance of exploring these technologies as possible alternative treatment options to help lower healthcare costs while maintaining a high quality of care. To this end, many technologies that have been conceived for use in the developing world are now being applied in the United States as well in a process known as “reverse innovation.” Companies like General Electric have created technologies in emerging markets and then bringing them to more developed regions.

Through “reverse innovations” and the application of appropriate technologies conceived in the developed world for the developing world or for global application, healthcare worldwide can be improved. By utilizing appropriate technologies that best combine the task at hand with the technological, cultural, and economic framework of the region where they are deployed, connections can be forged to make high-quality medical knowledge available around the globe.

Discuss Appropriate Technologies and Other Global Health Topics in the iCons in Medicine Forums

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