Real Time Assessments

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Stuart Thomson has put up a great site Desire Lines for Change showing how the  Smap software can be used to contribute to community discussions and decision making.  This fits well with one of the principles on which the software has been developed.

The idea came from when I worked at Rolls Royce aero engines R&D labs back in the early 80’s. Royces had this concept of assessing in real time whether or not an engine test was successful,  real time was defined as 20 minutes.  Within this time it had to be possible to decide if the test was successful and whether or not we could move on to the next test.  The totality of the data from the test, which could be very large,  would however be analysed over weeks, months and even years in order to contribute to engine design decisions.  If this data was going to be useful then we had to know if we had done enough cycles and the engine was run within the required parameters.  The diagram below shows the principle.

real time

The Smap mobile phones software is intended to contribute to this sort of real time assessment shown as the green 20 minute cycle in the picture above.  The data is collected and can then be analysed in the dashboard which may result in requests for more data.  Once the data is assessed as sound it can then be exported and analysed in a statistical analysis package or a GIS system over much longer periods of time.

Similarly as described in Desire Lines for Change, an initial assessment with the mobile phones can be made.  The data can be analysed and checked using the dashboard.  It can then be posted into a community forum to prompt an ongoing discussion, the results of which can be used in subsequent design decisions.

A report released today stated that 43% of Australians received sub-standard (below best practice) care at each visit to a general practitioner.  http://www.abc.net.au/news/2012-07-16/healthcare-system-failing-australians/4132056. Apparently this is largely due to GPs not being up to date with the latest treatments and practices.  Smart phones were suggested as a way to improve the situation.

I recently spent a couple of weeks in Africa looking at ways to increase the effectiveness and reach of mHealth initiatives.  Its customary to emphasise the importance of low cost devices in developing countries.  Applications that only require SMS or voice can be used by the widest number of people on the lowest cost phones with the longest battery life. Which is absolutely true if you are creating an application to be used by the general population or community health workers then this is almost certainly the sort of phone technology that should be your first preference.  To some extent this is also still true in developed countries.  If SMS works for your app then you should probably use it.

However I think you can make a strong case that doctors in developing countries can benefit just as much from smart phones as GPs in developed countries, if not more so.  Just as mobile phones leap frogged land lines, supplying a developing country doctor with a smart phone or tablet connected to a cloud based server can be much simpler than equipping the clinic with PCs and associated medical software.  It is also cost effective if that phone becomes an integral part of treating scores of patients per day and reporting health informatics.

The following diagram attempts to illustrates this.

Phone cost versus ease of use, flexibility and capability

No future for j2me phones?  There does not seem to be much development happening on these phones in developed countries nowadays.  I don’t think that it should be so different in developing countries.  So maybe applications should either be aimed at low cost devices over SMS / Voice, or smart phones, or both.