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Qualcomm’s Wireless Reach mHealth Project to Improve Cardiovascular Disease in Resource Scarce China

Qualcomm’s Wireless Reach™ initiative, the strategic initiative of the wireless chipset manufacturer, has partnered with Life Care Networks and the Community Health Association of China to start a mHealth project focused on improving prevention and care of cardiovascular diseases (CVD) in rural China. The project, Wireless Heart Health, was launched back in September in community health clinics in three provinces (Shandong, Anhui, and Sichuan) and one municipality (Chongqing).

Photo Credit: Qualcomm

In the past, most mHealth projects in rural areas have focused on acute diseases. These diseases are easier to handle via treatment and/or prevention, which allows for numerous mHealth interventions including appointment and pill reminders as well as data collection and information dissemination. But chronic diseases are becoming a larger public health issue in rapidly developing countries. Within China, CVD is the leading cause of death. By leveraging mobile technology to reach the rural community clinics, patients and health workers in rural areas can be connected directly with trained medical personnel in an urban area. While this type of connection is common in many countries (see MTN CareConnect in South Africa), the level of technology sophistication in this project allows for more in-depth data to be gathered and transferred to trained doctors.

Project Details

Life Care Networks developed a cardiovascular monitoring system that uses China Telecom’s 3G network to send heart data to cardiac specialists, who can provide rapid patient feedback. The system includes an electrocardiogram (ECG) senor on a smartphone, electronic medical record software, and workstations at the community clinics. The ECG-enabled smartphone has a gold rim around the outside part of it which is the senor. The patient simply holds the top and bottom of the phone in order for it to read their heart data. The medical records software is web-based and includes all past data collected in the clinic. This allows for both the community health workers and the doctors in the call center to have access to historical data in order to provide better care to the patients.

Within the project, the community health clinics are connected via the 3G network directly to cardiac specialists in the Beijing Life Care Networks Call Center. Using the ECG sensor along with the software and workstations, the patient data is sent to the call center and allows for real-time feedback either by SMS or voice. The call center is open 24-hours a day, and their services range from monitoring and diagnosis to treatment and referral. Referrals are especially important in these clinics as the clinic staff often do not have the knowledge and expertise to treat complicated cardiovascular issues. Because the smartphone sends the patient information directly to a trained doctor, it allows for referrals to happen swiftly, cutting down the time it usually takes. Also the smartphones are available for patients to rent in order to monitor their cardiovascular information.

Partnership Model

By leveraging a partnership model, Wireless Reach has been able to expand many services into rural or resource scarce areas by working with both for-profit and nonprofit organizations. With the Wireless Heart Health project, Life Care Networks is a for-profit company that has a commercially available ECG monitoring service as well as products and services for personal care. They offer different levels of service, depending on the needs and desires of their clients. The other project partner, the Community Health Association of China, is a nonprofit organization that supports the efforts of the Ministry of Health in helping to strengthen the Community Health Clinics throughout China.

Wireless Reach’s partnership model does not only include bringing together for-profits and nonprofits to strategically work together. An important aspect of all Qualcomm’s Wireless Reach projects is that they tie directly to government policies and initiatives. For example, this project addresses one of the specific issues outlined in the recent 2009 Chinese Health Care Reform, which focuses on strengthening the country’s grassroots medical institutions to provide equitable health care for all citizens.By partnering with Community Health Association of China, Qualcomm is able to engage in a project that supports the Chinese government’s efforts to develop a primary health care system.

Sustainability and Scale

Another important aspect of Wireless Reach projects is the goal for them to sustain as well as reach scale. In some cases, the project and its products/services become commercialized. In other cases, they have been sustained by the relevant country’s government. Since this project is only months old, the long-term model has not been decided yet. But there is a plan to create sustainability in the short-term and answers the age old question of “who pays?” In the model, patients are charged a small fee to its patients to rent the specialized phone. This allows the clinics to generate revenue and creates incentives to actively use the products and services.

Current Results

As mentioned before, each of Qualcomm’s Wireless Reach projects are focused on reaching sustainability and increasing scale. For this project, Wireless Reach is focused on gathering information and creating best practices in order to keep the project sustainable and eventually scale up. New impact data has recently been received and ranges from September 2011 to the end of January.

46 community health clinic doctors have been trained on how to use the system.
A total of 1033 patients have participated in the project.
These patients have sent 2172 pieces ECG data.
Out of that data, 513 pieces were identified as abnormal.
Out of all of the patient participants, 208 were screened for serious cardiovascular conditions and referred to higher-level clinics for further evaluation and testing.

Wireless Heart Health is an interesting example of how creating strategic partnerships, utilizing current technology and infrastructure (both telecommunications and health), and tying the project goals to current government policies can create a sustainable and scalable mobile health model.

Please also find below a video of the project:

View More Qualcomm Videos

February 17, 2012/by actualize

Health, Originally posted on the GBI Portal

Made in Cameroon: Touch Screen for mHealth

Arthur Zang - Photo Credit: http://www.rnw.nl/africa

A 24 year-old Cameroonian has invented a touch screen medical tablet that enables heart examinations such as the electrocardiogram (ECG) to be performed at remote, rural locations while the results of the test are transferred remotely to specialists for interpretation.

The touch screen tablet – Cardiopad was invented by Arthur Zang, a young computer engineer born and trained in Cameroon at the Ecole Nationale Supérieure Polytechnique (ENSP) in Yaounde.

According to Zang, the Cardiopad is “the first fully touch screen medical tablet made in Cameroon and in Africa.” He believes it is an invention that could save numerous human lives, and says the reliability of the pad device is as high as 97.5%. Zang says he invented the device in order to facilitate the treatment of patients with heart disease across Cameroon and the rest of Africa. So far, several medical tests have been carried out with the Cardiopad which have been validated by the Cameroonian scientific community.

“The tablet is used as a classical electrocardiograph device: electrodes are placed on the patient and connected to a module that, in turn, connects to the tablet. When a medical examination is performed on a patient in a remote village, for example, the results are transmitted from the nurse’s tablet to that of the doctor who then interprets them, says Radio Netherlands.”

While doing his academic internship at the General Hospital of Yaounde, in 2010, Arthur Zang became aware of the difficulties faced by Cameroonians in accessing care related to the heart. The Central African country has an approximately 40 cardiologists for about 20 million population with almost all these cardiologists located in the two large cities of Yaounde and Douala.

Access to cardiologist by patients especially those living in remote cities is therefore a huge challenge. This severe deficit of medical personnel means that patients with heart ailments usually have to travel long distances to undergo heart examinations and consult with doctors. Even at that, it is still not easy. On some occasions, patients must make appointments months in advance, and some even die in the process of waiting for their appointment.

Photo Credit: Cardiopad

This is how the technology works. Both the cardiologist (in the city) and the nurse (in the remote community) need to have the Cardiopad. A patient in the remote community is connected to electrodes placed on his heart. These electrodes are connected to a module called Cardiopad Acquisition Mobile (CAM) via a Bluetooth interface, which transmits the heart signal to the Cardiopad after the signal has been digitized. The nurse can then read the heart beats, heart rate, and the intervals between each beat displayed on the Cardiopad, etc. All these data are then stored in a file and sent to the cardiologist’s Cardiopad via a mobile telecommunication network.

The Cardiopad is already generating a lot of interest in African tech and medical circles. Zang believes his invention will cut down the cost of heart examinations and he is currently looking for venture capital to commercially produce the device. Visit here for detailed information on the Cardiopad and its inventor.

February 14, 2012/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Weaving eHealth Into the Fabric of the African Health System

The 4th Afrihealth Conference, held in Nairobi, Kenya on Nov. 30 and Dec. 1, broadened the debate on the adoption of Telemedicine, mHealth and eHealth in Africa, and brought attention to the need to integrate and mainstream eHealth into the continent’s health system.

The theme of the conference was “consolidating the gains of technological innovation in healthcare through effective management,” and some debate sparked on what direction to take eHealth in Africa.

According to Science and Development Network reporter Maina Waruru, experts attending the conference argued that “a focus on high-tech healthcare solutions could come at the expense of basic prevention such as access to clean water and sanitation, good nutrition and hygiene, and health education.” Since 80 percent of illnesses in Africa stem from preventable infectious diseases, this focus on high-tech is a move in the “wrong direction.”

But the potential for using ICTs to continue to improve basic healthcare in Africa is great, and a focus should be on ensuring that appropriate technology is utilized and effectively delivered.

One concern attendees brought up was the lack of a legal framework to determine what qualifies a person to work as an “e-health” professional. E-health is often practiced by non-professionals such as ICT technicians and nurses, and many countries have not established what qualifications are needed to be certified as a professional.

In addition, physicians in many countries are of an older generation and received their degrees before the ICT explosion. Many are not comfortable with situations where they consult with patients remotely, without actually being in the room with them.

Image from Dr. Kwankam's powerpoint presentation at Afrihealth conference

From Dr. Kwankam's presentation at Afrihealth 2011 conference

To address some of these issues, Shariq Khoja, the coordinator of the e-health program at Aga Khan University, has suggested that laws should be put into place to “accommodate and mainstream [e-health].” According to Dr. Yunkap Kwankam of the International Society for Telemedicine and eHealth, “for eHealth to take root and thrive…it must itself be transformed…we must weave eHealth into the fabric of the health system.”

Dr. Kwankam claims that Africans can benefit from technology changes by effectively managing it and charting a course for ICT in health through an organized eHealth profession, national eHealth policies and strategies, and addressing large eHealth challenges, such as scaling up eHealth interventions.

Dr. Kwankam and other experts’ presentations from the conference are now available.

December 7, 2011/by actualize

Health, Health Systems, Originally posted on the GBI Portal

New telemedicine center in Nigeria aims to keep patients at home

A new telemedicine center opened last month in Lagos, Nigeria with the purpose of providing healthcare to local Nigerians. Designated as the Glo-Telemedicine Center, located on Victoria Island in Lagos, this center is a product of the collaboration between Nigeria’s Global Resources and Projects and healthcare providers in India, U.S., Egypt and other countries.

Photo Credit: Onche Odeh

The center is designed to minimize transportation concerns for Nigerians, especially those in isolated areas, to bring them expert healthcare from abroad. According to the executive officer of Global Resources Dr. Wale Alabi, “the Glo-Telemedicine Centre would bridge the gap between the poor and good health services by creating a simless [sic: seamless] communication between them and those with the expertise and facilities to help them.”

Dr. Alabi cited the high prevalence of Nigerians using life savings, and even taking out crippling loans to travel to foreign countries seeking expert healthcare. Dr. Alabi also claimed that over 60% of those who go abroad for services can get those same services in Nigeria, but often go abroad due to incorrect diagnoses.

The center will be used as a medical tool to reduce medical costs and substantially increase range of access to patients. The center is designed to offer specialty treatments to Nigerians at a low cost. It will also offer Continuing Medical Education to health professionals as a means to keep them informed of latest trends in health services.

The center’s capabilities are dependent on broadband fiber optics supplied by a Nigerian Telecommunication firm called Globacom. Their services take advantage of advances in ICT to transmit text, sound, video, image and other information from one location to another location.

Telemedicine is an application of medicine that takes advantage of electronic communications to transfer information from one location to another, often between health provider and patient, or between two health providers. Dr. Alabi noted that the success of telemedicine in African countries such as Kenya and Ghana is “transforming those countries.”

Similarly, Dr Alabi hopes the center will ultimately transform the way Nigerians think about accessing healthcare. However, this is not the first telemedicine project in Nigeria. Several years ago, the Nigerian government through the ministries of science and technology and health, commissioned a pilot telemedicine project that used satellite-based technologies. That project, called the NigComSat-1 Telemedicine pilot, was labeled impractical due to high costs and inapplicability. The Glo-Telemedicine center however, took note and addressed those issues, which is why it is now fully operational to Nigerians.

June 14, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Global Observatory for eHealth series – Volume 1

This publication presents data on the 114 World Health Organization (WHO) Member States that participated in the 2009 global survey on eHealth. Intended as a reference to the state of eHealth development in Member States, the publication highlights selected indicators in the form of country profiles.

The objectives of the country profiles are to:

describe the current status of the use of ICT for health in Member States; and
provide information concerning the progress of eHealth applications in these countries.

January 13, 2011/by actualize

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