Kopernik: on-line store of innovative technologies designed for the BOP

Posted by | Posted in Access to Health, Design, Finance, Food for thought, Health Systems, Infrastructure, Innovation, Medical Devices | Posted on 21-02-2010

Kopernik: Connecting Innovative Technologies with Poor Communities
We are lucky to have a guest post today by Ewa and people like her in general who are doing what they can for global health. She and her team have just launched a new web platform connecting you with poor communities and technologies that might be needed there via an online store. I cannot emphasize enough that is this is long long overdue and that we should all be embarrassed that this hasn’t happened before. So major kudos to Ewa and her team for pulling this platform together and giving it a shot. Please visit their website and spread the word (you can also read there Tech for development blog here):

Guest Post by Ewa Wojkowska, a former UN worker, is the co-founder of TheKopernik.org.
As the rubble is cleared in Haiti, as a measure of stability comes to Sudan, as Sri Lanka holds a bitter peace and as Burundi faces its first election in the wake of massive civil war, a new development opportunity presents in some of the world’s poorest and most troubled places.

Online social entrepreneurship for the poor is one of the most compelling ways to fight poverty—and to reshape our development practices. Examples like Kiva and Global Giving are already leading the way, linking people anywhere in the world to better assistance and real results. The internet has created the opportunity for a transparent virtual marketplace: communities in developing countries identify their local needs, individuals anywhere in the world directly respond. Today our site—www.thekopernik.org—joins the force, connecting breakthrough technology to the poor through an online marketplace. It’s a simple, direct idea for real assistance to people in need.


Here’s our idea: Registered local organizations provide short proposals explaining their needs—simple water filtration in Freetown, Sierra Leone, self-adjusting eyeglasses in Manado, Indonesia. Any visitor to the site, anywhere in the world, can review the proposals and make donations to fund the plan of his or her choice. We connect these breakthrough technologies—water filters and drums, self-adjusting eye glasses, and solar lights, just to name a few—to the people who need them most.

What sets us apart is the focus on technology and a review mechanism for local organizations, or ‘technology seekers’, to rate the products. By including a feedback mechanism on the effectiveness of these technologies, Kopernik gives voice and choice to local communities and organizations – simple elements that are so frequently missed in international development efforts. We’re looking to take out the delays and to spark new ideas in international aid, one click at a time.We believe this is the new face of development.

If more people everywhere have safe, unfettered access to clean water, more efficient means of transporting that water, clear eyesight, and reliable light, how would their choices change? How would they see the world and their place in it? What could their empowerment achieve?

We now have the technology to improve everyone’s lives, and the internet is the window to get these life-changing technologies into people’s hands, directly and efficiently. We’re building a resource that those in need can access for themselves.

Ewa Wojkowska, a former UN worker, is the co-founder of Kopernik.org. The website launched this past week.

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Forum 2009, No. 6: A Physical Therapist Headed to Tecate (#GFHR09)

Posted by | Posted in Access to Health, Conferences, Design, Global Health, Government, Health Systems, ICT, Innovation, Leadership & Management, Mobile Phones, Private Sector, Public Private Partnerships, Research, Social Entrepreneurship | Posted on 17-12-2009

The Global Forum for Health Research Forum 2009: Innovating for the Health of All took place in Havana, Cuba from 16-20 November. This is the sixth and final in a series of posts from the conference.

It’s now been a month since Forum 2009, so it’s time to wrap up any remaining thoughts from the meeting. My intention with these posts was never to provide a comprehensive view of the conference. If you’re looking for that, or simply additional insights into the meeting, I recommend the following resources:

  1. Priya Shetty’s coverage of Forum 2009 for the SciDev.Net blog, five posts
  2. TropIKA.net comprehensive coverage of Forum 2009, including daily reports and session reports

On my Cancún-bound flight out of Havana, on the morning of the 20th, the woman sitting next to me asked me for help with her Mexican immigration forms. As I was helping her, I asked what she did. “Terapista”. She asked what I was doing in Cuba. Attending “un congreso de investigaciones de salud pública”. She was a Cuban physical therapist going on a three month medical mission to Tecate in the Mexican state of Baja California, via Cancún, Mexico City, and Tijuana. I spent most of the short flight asking about her experiences on previous missions, all to Mexico, and probing for more details about the Cuban health system. Most memorably, she was quite proud of a unique surgical treatment the Cubans have developed for Parkinson’s disease.

I spoke about the medical assistance Cuba lends to other countries in an earlier post. The photo below of the 20 convertible peso note reinforces this. It touts Operación Milagro (Wikipedia link in Spanish), a joint program between Cuba and Venezuela with official aims similar to Cuba’s other medical mission efforts.

20CUCNote

While I was speaking to this terapista on the plane, it occurred to me how important the setting of the conference was given the innovation theme. I don’t think that this was lost on many of the conference participants given external interest in the Cuban system, Cuban participation on panels, and various site visits. Still, there were three circumstances that limited knowledge exchange between the visitors and the Cubans:

  1. Language barriers. There wasn’t very much communication between the several hundred Cuban participants and the external participants, especially those from outside Latin America. This was due in no small part to language barriers. Simultaneous translation took place during the larger sessions (UN-style headsets), but the smaller sessions didn’t have any and the informal exchange was visibly limited between the two groups.
  2. An apparently flawless system. The Cuban health system may have been the talk of the week, but it was presented without fault. Even though it may be one of the best systems on the planet, it is not immune to needing improvement. Without a realistic understanding of the challenges, it was hard to understand the true effectiveness of the system. (In comparison, Minister of Health Chen Zhu was frank in talking about elements of the Chinese health system that need improvement, for example indicating in his plenary talk that many public clinics in China operate like private clinics.)
  3. No U.S. government employees in attendance. There were certainly Americans at Forum 2009, but because of the restrictions associated with the U.S. embargo – it’s a bloqueo the Cubans said, since an embargo implies wrongdoing – there were almost no representatives of U.S. government institutions. I didn’t realize this myself until a colleague from the WHO pointed it out to me. He cited the example of his colleagues from the CDC who were not permitted to attend. Looking through the participant list, I only spotted one, someone from USAID. It’s unfortunate because there was a big opportunity for learning in both directions. In any case there were strong suggestions that we are months away from ending the embargo/bloqueo. Time will tell.

And here’s a post Aman wrote for Global Health Ideas about the Cuban health system two years ago: Lessons from Cuba: Healthcare Infrastructure and Information Systems.

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Forum 2009, No. 5: Innovation for Remote Populations/mHealth (#GFHR09)

Posted by | Posted in Access to Health, Conferences, Data, Design, Education, Entrepreneurship & Microfinance Blogs, Franchise, Global Health, Government, HIV/AIDS, Health Systems, Human Resources, ICT, Infectious Diseases, Infrastructure, Innovation, Leadership & Management, Malaria, Mapping, Maternal and Child Health, Mobile Phones, Non Profit, Private Sector, Public Private Partnerships, Research, Social Entrepreneurship, Stats, Supply Chain, Surveillance | Posted on 08-12-2009

The Global Forum for Health Research Forum 2009: Innovating for the Health of All took place in Havana, Cuba from 16-20 November. This is the fifth in a series of posts from the conference. Only one or two more after this one.

My reason for attending Forum 2009 was to participate in a session title “Innovation for Remote Populations”. This post is a about that session. What follows is taken from my recent report to the Global Forum for Health Research – edited only slightly.

Innovation for Remote Populations

Thurs-19-Nov-2009, 14:00-15:45, Global Café, Palacio de Convenciones, La Habana, Cuba

Coordinators/Facilitators:
Patricia Mechael, mHealth and Telemedicine Advisor, Millennium Villages Project, Earth Institute, Columbia University, USA & Egypt (organizer & facilitator)
Tim Hurson, Facilitators Without Borders (facilitator)
Charles Gardner, Global Forum for Health Research (focal point)
Speakers (alphabetical order):
Simon Adebola, NEPAD Council Global Health Commission, Geneva
Najeeb al-Shorbaji, Director, Knowledge Management and Sharing, WHO
Caren Serra Bavaresco, Student, Epidemiology, Universidade Federal do Rio Grande do Sul, Brazil
Karl Brown, Associate Director, Rockefeller Foundation
Arul Chib, Assistant Professor, Wee Kim Wee School of Communication, and Assistant Director, Singapore Internet Research Center, Nanyang Technological University
Dziedzom Komi de Souza, Ph.D. Student and Research Assistant, Parasitology, Noguchi Memorial Institute for Medical Research, Ghana
Bastiaan Hoefman, co-Founder, Text2Change
Bernardita Labarca, Project Coordinator, Zoltner Consulting Group, Chile
Claire O’Neill, Chairperson, Cell-Life-South Africa
Ravi Ram, Head, Monitoring & Evaluation, African Medical Research and Research Foundation (AMREF), Nairobi Kenya
Marco Salmen, OHR-GMCP Initiative for HIV/AIDS, Global Micro-Clinic Project, United States
Jaspal S. Sandhu, Design Researcher, College of Engineering, University of California, Berkeley, USA
Joel Selanikio, co-Founder and Director, Datadyne.org, USA
Garance Upham, General Secretary, Direction, Safe Observer International, France

Coordinators/Facilitators:

  • Patricia Mechael, mHealth and Telemedicine Advisor, Millennium Villages Project, Earth Institute, Columbia University, USA & Egypt (organizer & facilitator)
  • Tim Hurson, Facilitators Without Borders (facilitator)
  • Charles Gardner, Global Forum for Health Research (focal point)

Speakers (alphabetical order):

  • Simon Adebola, NEPAD Council Global Health Commission, Geneva
  • Najeeb al-Shorbaji, Director, Knowledge Management and Sharing, WHO
  • Caren Serra Bavaresco, Student, Epidemiology, Universidade Federal do Rio Grande do Sul, Brazil
  • Karl Brown, Associate Director, Rockefeller Foundation
  • Arul Chib, Assistant Professor, Wee Kim Wee School of Communication, and Assistant Director, Singapore Internet Research Center, Nanyang Technological University
  • Dziedzom Komi de Souza, Ph.D. Student and Research Assistant, Parasitology, Noguchi Memorial Institute for Medical Research, Ghana
  • Bastiaan Hoefman, co-Founder, Text2Change
  • Bernardita Labarca, Project Coordinator, Zoltner Consulting Group, Chile
  • Claire O’Neill, Chairperson, Cell-Life-South Africa
  • Ravi Ram, Head, Monitoring & Evaluation, African Medical Research and Research Foundation (AMREF), Nairobi Kenya
  • Marco Salmen, OHR-GMCP Initiative for HIV/AIDS, Global Micro-Clinic Project, United States
  • Jaspal S. Sandhu, Design Researcher, College of Engineering, University of California, Berkeley, USA
  • Joel Selanikio, co-Founder and Director, Datadyne.org, USA
  • Garance Upham, General Secretary, Direction, Safe Observer International, France

Additional participants – from the audience:

  • Elmer Zelaya – Fundación Chica/Nicaragua
  • Timothy Dye – SUNY Upstate Medical School/USA
  • Jane Kengeya – WHO
  • Oyewale Tomori – Redeemer’s University/Nigeria
  • Lishandu/Zambia (full name/affiliation not available)
  • Vargas/USA (full name/affiliation not available)

Summary:

  1. Diverse users and uses: The speakers presented a variety of mHealth/eHealth applications involving a wide variety of users, including both the health workforce and community members, e.g. educating teenagers about HIV/AIDS in South Africa (O’Neill), Internet access in western Kenya to improve uptake of HIV VCT (Salmen), mobile emergency response systems in Aceh (Chib), electronic IMCI in Tanzania (Brown), text-based health education and health service promotion in Uganda (Hoefman), training for health workers as a downloadable game package for phones in Kenya (Ram), telemedicine to improve the skills of health workers at primary levels in Brazil (Bavaresco), delivery of health information to communities in Chile (Labarca), a general set of tools for mobile data collection being used worldwide (Selanikio), and handheld computers to support rural healthcare delivery in Mongolia (Sandhu).
  2. mHealth/eHealth is about enabling access: A common theme across diverse applications was that information and communication technologies are being used to enable access to health information and services in places where access is difficult because of remoteness and/or cost.
  3. Coordination among the various players: Coordination among donors and projects is necessary to avoid unnecessary duplication of effort and to share what works. This is the role of the mHealth Alliance, supported by Rockefeller Foundation among others (Brown). While there were questions from the program side as to what data donors want (Chib), there was a simultaneous sentiment that donors need “stepwise” guidance (al-Shorbaji).
  4. De-emphasizing technology: The mHealth Alliance has recently been discussing development of an “mHealth Toolkit”, to provide a common technical architecture and platform for those planning to implement mHealth programs (Brown). The existence of free technology platforms – in this case DataDyne’s tool – enables programs to focus on developing health content (Labarca). It is important to have a generalizable tool, as DataDyne has done, that can be used by anyone; if individual governments must approve technology “you’ve lost the battle” (Selanikio). Programs must focus on understanding people and applications more than technology; in response to a question from Dye about the use of ethnography in this field, three examples were given: ethnography of teen chat rooms in South Africa (O’Neill), multi-year ethnographic fieldwork as the basis for the program in western Kenya (Salmen), and design ethnography of the information management practices of rural health workers in Mongolia (Sandhu).
  5. Defining good evaluation: There are challenges to seeing change in population health outcomes (Chib). It is difficult to measure behavior change (Hoefman) and to evaluate systems that provide health content to people (Labarca). Ethnography should be considered more seriously as a complementary evaluation strategy in mHealth (Sandhu). In evaluation, the metrics should match the intervention – mHealth is another intervention; in addition, we want to see the unintended effects of technology (Ram).
  6. New modalities of engaging people: Mobile phones enable fundamentally new ways of engaging with people. As opposed to mass communication that is often used in social marketing, phones allow for interpersonal communication that can be tailored and cost-effective (O’Neill). There are two modalities, moving messages out to people and demand-driven services, where people demand the information that they need (Ram). Salmen lent his support to the importance of demand-driven services and argued that phones will bring more equity. This is all supporting the shift to citizen-centered healthcare (Mechael).
  7. Cautions moving forward: In natural disasters, the cellular network is the first to go (Zelaya). An open question: Who owns the data? (al-Shorbaji). Nobody is thinking about “real sustainability” (Adebola). Reliable phone networks are a challenge (Lishandu). We should be careful that we don’t become too dependent on one tool (al-Shorbaji).
  8. Need to think more creatively: We should be bolder with approaches; if we are, poor countries “could leapfrog” in health and development terms (Upham). Many of the applications discussed focused on SMS and telephony capabilities; we should think about leveraging more advanced capabilities of mobile phones (Kengeya).
  9. Who should design technology? There is an assumption that Africans cannot develop software, but that is not true (Adebola). DataDyne software was already developed by Africans (Selanikio). Africans should develop software, but they shouldn’t redesign what has already been built (Brown).

Conclusions/Recommendations:

  1. There is a need for increased knowledge-sharing about mHealth/eHealth within the global health community. This should definitely include policymakers. As Prof. Tomori elegantly stated, while we are thinking about how to reach remote populations, we should think about “hard-to-reach” African leaders.
  2. While there was discussion of both eHealth and mHealth, the discussion focused primarily on the latter.
  3. There is a need for a continuing dialogue about mHealth. It is unrealistic to expect policy recommendations to come out of this meeting given the state of the field (many open issues) and the limited engagement at the meeting.
  4. Major mHealth topics to be discussed at future meetings: definitions; standards, including how to conduct evaluation; and successes and failures from the field.
  5. The value of the meeting was threefold: (1) it helped extend the network of those working in mHealth; (2) it provided those outside the field with an understanding of the opportunities and challenges of using mobile phones to improve population health; and (3) it placed a much-needed emphasis on prioritizing people and applications over technology.
  6. Mechael suggested reviving the Mobile Metrics and Evaluation Group as a means of maintaining an active mHealth community discussion outside of official meetings.

Other observations:

  1. The fishbowl format was successful in eliciting relevant commentary from a large group of speakers as well as from the audience. Time was an issue, though, as several invited speakers only spoke once and several audience members had comments or questions that they were unable to share.
  2. One key issue that was not explored – as I stated at the end of the session – was the link between social entrepreneurship and mHealth. This is especially relevant to issues of demand, incentivization, and sustainability.
  3. There is a need for an ongoing discussion of these issues at Forum 2010 and beyond – while the conversation will continue in other settings, the Global Forum for Health Research should continue to be involved because of its systems focus, its emphasis on actionable research, and the unique mix of parties (policymakers, donors, implementers) it brings together.
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Forum 2009, No. 4: Public-Private “Debate” Redux (#GFHR09)

Posted by | Posted in Access to Health, Conferences, Global Health, Health Systems, Innovation, Pharmaceuticals, Philanthropy, Private Sector, Public Private Partnerships, Social Entrepreneurship | Posted on 02-12-2009

The Global Forum for Health Research Forum 2009: Innovating for the Health of All took place in Havana, Cuba from 16-20 November. I was in Jamaica the week following the conference and completely offline. Now that I’m back in the U.S., I’m planning at least two more posts about Forum 2009. This is the fourth in a series of posts from the conference.

In early 2009, Oxfam released a report Blind Optimism critical of the private sector’s role in healthcare in poor countries. It drew attention to the cause of those who believe that any private involvement in healthcare in these countries is harmful. The arguments, evidence, and position of the report were flawed in numerous ways; sound responses to the report were provided by April Harding and the World Bank:

The reasonable conclusion one would come to from working in the field and from studying health systems is that a mix of private and public approaches will be most effective – and that the need for different approaches should be dictated by local context. Ideological extremism – pro-private or pro-public – doesn’t serve anyone, most especially the people who need access to health.

At Forum 2009, there was much stronger representation of the private sector than at the previous meetings. In addition to pharma and biotech, there were several sessions and plenary speakers dedicated to talking social entrepreneurship. One of these speakers was Al Hammond, Senior Entrepreneur-in-Residence at Ashoka. Al spoke during Wednesday’s plenary - Enhancing national environment for innovation: perspectives on low- and middle-income countries (TropIKA.net post about the session) – about Ashoka’s Healthcare for All pilot Punjab, India.

During Q&A Claudio Schuftan of the People’s Health Movement criticized Dr. Hammond and Ashok [sic] for: (1) bringing electronics to people where there is no electricity or way to repair devices, (2) supporting the interests of multinational corporations, and (3) making people dependent on products. Dr. Hammond began his response by saying, “We are aware that there is hostility towards private sector approaches”. He explained that they use market approaches to achieve efficiency and that all the programs he presented are social enterprises started by NGOs. Based on the success of the three pilots so far, the Punjabi government has requested 600 additional units. “Take what you will from that”, he ended.

Dr. Schuftan’s comments are well-aligned with the Blind Optimism ideology. Such comments attempt to polarize policymakers, donors, and implementers. In doing so, they actually keep us from thinking critically about the private sector and social entrepreneurship. Fortunately, this was not the overall tone of the meeting.

At the end of a session examining the role of governmental policy in supporting social entrepreneurship, Julius Mugwagwa of the Open University (UK) asked a question about the “backlash” that might occur if something went very wrong with one of these social entrepreneurial models. This is the type of balanced discussion we really need.

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Highlights of Clinton Global Initiative 2009

Posted by | Posted in Conferences, Finance, Food for thought, Global Health, Government, HIV/AIDS, Health Systems, Innovation, Leadership & Management, Maternal and Child Health, Philanthropy, Private Sector, Social Entrepreneurship | Posted on 28-09-2009

Nota bene: These are a few highlights from CGI – please do add your inspirations/ideas in the comments!

Clinton Global Initiative – Making things happen through Commitments

Action speaks louder than words. At CGI, you’ve got to commit – and that has an amazing impact.

Education that Pays for ItselfSafe Drinking Water for ChildrenLighting a Billion Lives

What will your commitment be?

CGI was the birthplace, in past years, of projects like Matt Damon’s water program (water.org, expanding this year to Haiti), the Goldman Sachs 10,000 Women Initiative, and so many more. In the five years of CGI, there have been 1,400 commitments made (participants are required to make commitments to existing projects or commit to creating new projects), valued at $46 billion dollars, and impacting the lives of 200 million people in 150 countries. This year’s meeting will give birth to 30 more of these programs – more by Andrew Mersman over at Passport Magazine/ Change by Doing blog.

Check out CGI Commitments here.

Innovation!

Business Week highlighted innovation as a top priority for the global economy, and President Obama announced a new strategy for innovation: A Strategy for American Innovation: Driving Towards Sustainable Growth and Quality Jobs. Download white paper.

Judith Rodin of the Rockefeller Foundation identified innovation strategies that could be applied to social problems – user-driven innovation, crowd sourcing and collaborative competitions reported here by Alexandra Cheney at Fast Company.  And Innovate Today: 8 Ways Business can End Poverty - superb post by Steve Enders over at tonic.

A few people – including Muhammed Yunus and Ngozi Okonjo-Iweala of the World Bank at CGI had an Innovation Wish List. Yunus talked about the edible yogurt pot, and Judith Rodin announced a new initiative to help the poor – the Global Impact Investing Network. This gets my vote for one of the most exciting developments to come out of CGI – read the Economist article.

Investing in Women and Girls

Women make up half of the world’s population, but do 2/3 of the world’s work, produce 50% world’s food, earn 10% world’s income, own 1% of world’s property.

Read the rest of this entry »

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Accountability, AIDS and Africa – Stop the Stockouts, Financial Oversight (BEMF)

Posted by | Posted in Access to Health, Finance, Food for thought, Global Health, Government, HIV/AIDS, Health Systems, ICT, Infectious Diseases, Innovation, Malaria, Mapping, Mobile Phones, Pharmaceuticals, Research, Supply Chain, TB | Posted on 24-09-2009

In my work in the field, I am no longer surprised to see test stockouts, essential medicines stockouts, supply stockouts, broken or missing diagnostic machines, or patients who are afraid of healthcare workers. It is a complete tragedy, and as I work to help, I think of all the people who are sick or die because of failures of the healthcare system, who cannot tell anyone their stories. For those who do not work in the health system, or haven’t had an experience of health system failure, transparency and data on implementation is practically invisible – so there’s no public awareness of the issues.

So I was thrilled to see recent developments in accountability – the Stop the Stockouts campaign, and the creation of the Budget and Expenditure Monitoring Forum in South Africa.

Power to the People: Stop the Stockouts

Stop the Stock-outs , a multi-country Africa campaign, is using text messages sent by activists and members of the public to expose stock-outs of essential medicines at public health facilities and put pressure on governments to address the issue. It was launched in Kenya, Uganda, Malawi and Zambia by Health Action International (HAI) Africa. During Pill Check week in June, facilities were surveyed, and a map of stockouts was created. The image below incorporates July 2009 data. It was found that many government health facilities were routinely running out of, or just not stocking essential medicines to treat common diseases such as malaria, pneumonia, diarrhoea, HIV and tuberculosis (TB).

“We were finding availability levels in rural, lower-level health facilities of 40 or 50 percent for essential medicines,” said Christa Cepuch, a pharmacist at HAI Africa. Read more from IRIN here

intromap

Show me the Money: HIV Policy AND the Budget and Expenditure Monitoring Forum in South Africa

With a new government in South Africa as of May, there have been some very positive signs. Read the rest of this entry »

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Innovation at the Clinton Global Initiative Meeting – Watch Online!

Posted by | Posted in Conferences, Global Health, Government, Health Systems, Innovation, Leadership & Management, Maternal and Child Health, Philanthrophy, Public Private Partnerships, Social Entrepreneurship | Posted on 22-09-2009

Clinton Global Intiative Meeting 2009

This year’s Clinton Global Initiative takes place from 22 – 25 September 2009, where heads of state, government and business leaders, scholars, and NGO directors work together to analyze, discuss, and debate possible solutions to urgent global issues. Each participant is then asked to take action on one or more issues by making a Commitment to Action.

The Economist calls the meeting ‘an important part of the global elite’s calendar’, so join online and watch the live webcast!

As noted in our post on Girls Count: The Girl Effect, one of the major themes this year is Investing in Girls and Women. The four focus areas are Innovation, Human Capital, Infrastructure, and Equitable Futures.

Read the rest of this entry »

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Mayo Clinic, Global Health and Design Thinking: Innovations in Healthcare Experience and Delivery

Posted by | Posted in Access to Health, Chronic Disease, Conferences, Design, Food for thought, Global Health, Health Systems, ICT, Infectious Diseases, Innovation, Pharmaceuticals, Private Sector | Posted on 21-09-2009

TimBrown_DT_Mayo

Mayo Clinic, Global Health and Design Thinking. You might be wondering what those three terms have to do with each together. This is my partial recap on time spent at the Mayo Clinic this past week where I saw one potential vision of what the future of healthcare might look like. It was a great privellege to hang out at the Mayo Clinic for what was the best conference I have attended in a long long time or maybe ever (Amy Tenderich at Diabetes Mine also has a recap that I encourage you to read). The Mayo Center for Innovation hosted a TED style event – Transform, a collaborative symposium on innovations in health care experience and delivery, all the videos are online (highly recommended viewing). It is going to take me a few months to digest what happened there and wrap my mind around everything I heard. There were over 430 people from 23 states, 7 countries and over 1,350 tweets. The caliber and just genuine niceness of every person I interacted with was on some other level, the conversations were rich, deep and thoughtful. The conference organizers *created an open purposeful environment* that led to an incredible experience. The folks at Mayo certainly shaped and designed a great space to achieve the symposium goals (this all reminded me of the Winston Churchill quote – “We shape our buildings and afterwards, our buildings shape us”).  Let me stop before you think I have joined a cult. The direct connection to global health here – it was discussed by keynote speakers and my first tweet from Mayo was “this place reminds me of Aravind (Aravind Eye Care System). Jaspal, Mahad and I have written several articles and cases studies on Aravind and I continue to believe it is a premiere model for innovation and care delivery. More on this in a bit.

The Global Health Convergence: “Design Thinking” and Innovation
There were many things that made this event great, however, in terms of extending your horizons and making you think, one of the most refreshing things was to see some convergence of disciplines and people from a variety of backgrounds. This is very hard to do and cannot be underrated. We all live in a sea of fragmentation,  in systems, in professions and fragmentation in how we solve problems. This is even reflected on a micro level – look at the mainstream peer reviewed journals in healthcare where you see severe fragmentation amongst the physician, nursing and pharmacy focused journals (some of this is for good reasons and some of it’s not). This conference was in part about ditching that fragmentation and about a convergence of ideas, people and relationships working collaboratively. In addition to innovative projects, new models of delivering care and how the process of innovation can be conceptualized, managed, and enabled was discussed. Much of this was encompassed under the umbrella of Design Thinking (innovating and problem solving using various methods). Tim Brown, CEO of IDEO, was a headliner on this front and re-emphasized a call for design to big, an ethic of design for social impact/change, which Jaspal and I have covered on this blog before (see our previous post – 8 Links for Design and Global Health).

If you were too look at the methods of design thinking you would see an amalgamation and convergence of mostly existing methods from a variety of disciplines (from engineering to ethnography to epidemiology to psychology to health services research to name a few examples). As Tim Brown said in his talk: Design thinking begins with integrative thinking which is the ability to hold opposing constraints and opposing ideas and from those create  new solutions…this means balancing societal needs (desirability) with what’s possible (feasibility) and what’s sustainable (viability)“. When Tim Brown said “Design should not be left in the hand of designers” he hit the nail on the head – design thinking can be incorporated by non-”designers” to help innovate and solve problems. What we do has to be a participatory, collaborative effort. Tim Brown wrote more about this participatory perspective (How to Design a Participatory System in a post crisis economy world). There are many critically important reasons why this is a key factor, one of which goes back to Paulo Freirean educational tenets – people who participate in their own education, become engaged in the transformation of their own world. The other reason is because even though as brilliant as Tim Brown is, (and all the people working at organizations like his) he doesn’t have all the answers, or even the correct ones (read his other piece at FastCompany on HSAs where his point is highly debatable about the solution and at best has over simplified the problem).

The bottom line that I took away is that we need more of a participatory system, we should be open to new ways of approaching problems (“design thinking”) and we can provide some structure to the process of innovation. Besides design thinking the other major theme I want to point to is global health – as I said above in the keynote presentations global health made an apperance. Both Clay Christensen and Tim Brown mentioned the Aravind Eye Care System and Jaspal spoke entirely about global health. We have said on this blog before that there are many lessons that can be learned from outside our system where innovation is taking place due to extreme necessity, it’s not a choice (a lot of this is taking place over the web and with mHealth – mobile phones for health). In Global Health, there are hundreds, maybe thousands of innovative experiments going on using a wide area of technology (devices, drugs, the web, mobile phones, etc.), however, how we track these experiments, talk about failure, and share what has been learned seems to be highly inefficient and lacking.  We have covered a lot of this ground over the past three years, the easiest summary of examples can be found in this post:

42 “Extremely affordable” Innovations in Global Health

Clay C, Tim B, and Jaspal all pointed to global health as a place we can learn from. While there are some serious limitations, there is a ton to learn from the use of mobile phones in developing countries and how that might apply here – because overseas usage of phones is far beyond what is being done in the US. The other area to keep an eye on is chronic diseases. In some places, there is going to be an explosion of chronic conditions and new models will have to be devised to handle that tidal wave. I would love to see Amy Tenderich and her community do a brainstorming session on design for diabetes in developing countries. On this front see two previous posts:

1. Reverse South to North innovationBorrowing innovation: health services, financial services, and clean tech
2. A massive wave of chronic disease in India and China

Let me leave you on a note of caution, a “design thinking” approach (remember using existing methods) can offer some powerful alternatives. However, there can also be something seductive about design thinking and a rapid approach (we’ve cautioned this on the graphics/visual side before). If you fall into that seduction, then this is just a fad for you, it’s on us to be rigorous, thoughtful and corrective when need be:

“The myth of innovation is that brilliant ideas leap fully formed from the minds of geniuses. The reality is that most innovations come from a process of rigorous examination through which great ideas are identified and developed before being realized as new offerings and capabilities.” IDEO website.

I have many more thoughts on this, if I get the time I’ll jot down a few more notes and quotes from the conference, in the meantime, it is well worth watching the videos from Transform.

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Is YOUR water safe? Toxic Waters – The New York Times Interactive Database of Water Pollution Violations

Posted by | Posted in Conferences, Data, Global Health, Government, Health Systems, ICT, Mapping, Media, Water | Posted on 13-09-2009

In a chilling expose today, Toxic Waters – Clean Water Laws are Neglected, at a Cost to Health, Charles DuHigg of the New York Times covers the impunity of polluters and lax regulation of clean water laws. The NYT then goes a step further – creating transparency through a public database of violations which is ‘more comprehensive than the states or the EPA‘, that you can access to find polluters near you on an interactive map. There is also a nice interactive graphic of the Clean Water Act enforcement record in all 50 states. Deep cuts were made in government funding, and now clearly our Environmental Health Monitoring system needs repair. Democracy needs a strong, free media who reports and then acts. Who knew the NYT would be a key environmental health policy innovator overnight?

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Mobile Phones for Global Health Links (VI)

Posted by | Posted in Access to Health, Food for thought, Global Health, Health Systems, Mobile Phones | Posted on 27-07-2009

Time for some more desk clearing, here are recent items on mHealth, many are worth skimming.

1. Bringing mHealth back to earth, link
2. Using sports to teach about AIDS, climate change and recycling, link

3. Interview with Frontline SMS and Kiwanja.net founder, link
4. mHealth data collection pilot in India – Mobile-SCDRT, link
5. Health Education Response ( HER ), software distributes health information on major topics, link

6. Mobile phone that recognises objects will aid the blind (SeeScan), link

7. Driving mobile activism adoption, Ashoka crowd sourcing ideas, link

8. Another example of learning going South TO north -Text message finds nearest AIDS test center, link

9. MIT Groups Use Mobile Phones To Boost Health in Developing Countries, link

10. Cell phone towers can help predict the next big flood, link

11. How Uganda’s health care problems can end with a phone, link

12. MOH Zambia, UNICEF join with mobile phone companies for Child Health Week, link

13. Harnessing Both Sun and Cell Phone to Close Gaps in Local Health Care, link

14. MTN, Google and Grameen partner in Uganda, link

15. CNN covers EpiSurveyor – weapon against epidemics, link
16. Consortium Collaborates on Mobile Technology for Social Good, link
17. We’ve covered this before, but some early results are back: A mobile phone microscope to diagnose disease, link

Update, add at least one more to the list:
18.
Via Pulse + Signal EXCLUSIVE: Video Footage of FrontlineSMS:Medic in Action, link

BONUS:
See #2 the Bamboo Green Concept Phone, link
Is Mayo Clinic leading the way in the US? check out their strategy, link

IBM ploughs $100 million into mobile research, link

Mobile phone chip that diagnoses disease at your bedside ‘available in five years’, link
Mobile phones ‘more dangerous than smoking’, link

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*Previous Links on mHealth*
Mobile Phones for Global Health Link Drop V (May 19, 2009)
Mobile Phone & Development Link Drop (Mar 10, 2009)
Mobile Phones & Global Health III: Ultrasound, Imaging & ECG to Go! (Aug 27, 2008)
Mobile Phones and International Health Links Part II (Aug 3, 2008)
Mobile Phones and Global Health
Link Drop (July 28, 2008)

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