• mHealth
  • Vula Eye Health app's improving eye care in rural areas

    mHealth uptake in Africa is expanding. During the last 12 months we’ve seen solutions helping to tackle a variety of challenges, tracking Ebola, combating malaria and HIV, and detecting counterfeit drugs. Now, South Africa has an app to help improve eye care in rural areas.

    Dr William Mapham’s the inspiration for the Vula Eye Health App. It combines his clinical experience in rural clinics with an interest in mobile phone apps.

    The idea first came to Dr Mapham when he was working at the Vula Amehlo Clinic in Siteki, Swaziland. Vula Amehlo means Open your Eyes in a number of African languages, including Siswati, Zulu and isiXhosa. He later moved to the Uitenhage Hospital Eye Clinic in South Africa’s Eastern Cape Province, where in 2012 he received help to develop the app further with a Flash Grant from the Shuttleworth Foundation.

    Dr Mapham also got in touch with Flow, a company specialising in improving users’ experiences of technical products, to collaborate on the app’s design. Deloitte Digital recently acquired Flow.

    Debre Barrett, a Flow director, was inspired by the idea and offered Flow’s services at no charge. Since then, Flow has donated ZAR200,000, about US$17,000 worth of design and user expertise, and helped to develop the first demo version. Dr Mapham also approached Prof Kovin Naidoo of the Brien Holden Vision Institute, who agreed to partner with Mr Mapham and his team to help raise more funds, improve the app and roll it out through their network of offices in 53 countries. Prof Kovin Naidoo won the World Council of Optometry’s International Optometrist of the Year Award for 2007.

    Dr Mapham has recently moved to Stellenbosch University’s Ophthalmology Department, where he works today. Together with Prof Naidoo he submittedthe Vula Eye App to the SAB Innovation 2013 Awards , and it was awarded the top prize of ZAR1million, about US$85,000.

    The Vula Eye App is simple enough to use without special training. It creates a patient record and guides users through steps which enable them to perform an on-site eye test. The app uses the light on the phone to test patients’ pupil reactions. Users are prompted to take a photo of the patients’ eyes, and the app then connects to the most appropriate specialist in the area. There’s an option to chat to a specialist about concerns, and deal with any questions. The app contains a section on eye conditions to help identify common disorders.

    The app is built on a platform that enables other health specialities to build on top of it too. The team has already been approached to build apps for orthopaedics, tuberculosis, occupational health and HIV/AIDS patients.

    November 2014 was an exciting month for the Vula team. The Red Cross War Memorial Children’s Hospital launched the app, supporting faster, better ophthalmology referrals. Earlier that month, Vula was awarded a second Prize in the GAP ICT innovation competition where it received ZAR195,000, about US$16,500 funding.

    Vula is available on Android and iOS operating systems, and is being used in five hospitals across South Africa, as well as one hospital in Swaziland. It currently connects 252 nurses and healthcare workers with 26 eye health specialists across these six hospitals, and 485 referrals have been made using the app.

    Given the shortage of health workers and specialized doctors across Africa, Vula Eye App has the potential to help address some of these shortcomings and provide a useful reference for other speciality app developers, considering similar work. While it’s currently only being implemented in South Africa and Swaziland it will soon be available in Ghana.

  • 10 mHealth apps savings lives in Africa

    As mobile penetration and smartphone proliferation increase in Africa, so does the number of mHealth solutions. They extend to combating malaria, HIV, and detecting counterfeit drugs. It’s claimed that mHealth solutions are saving thousands of lives. A 2013 report by PricewaterhouseCoopers (PwC) estimates mHealth initiatives in Africa could save a million lives by 2017.

    Ventures Africa has a post on the top ten life-saving mHealth apps in Africa. They include:

    Hello Doctor is an app that provides free essential healthcare information that is updated daily. It’s currently available in ten African countries and provides access to healthcare advice, answers to health-related questions in live group chat forums, confidential one-on-one text conversation with a doctor in local languages, and the ability to receive a call back from a doctor within 60 minutes. mPedigree is a mobile app that allows pharmaceutical retailers and users to verify the authenticity of a drug. This is done for free by texting a unique code found on the product to a universal number. This helps protect underprivileged people who are vulnerable to purchasing fake drugs and is also helping to restore confidence to the healthcare system. MomConnect provides information and advice for pregnant women in South Africa. The information is adapted to the stages of pregnancy. The app also provides post-natal medical information to mothers for up to a year after the baby is born. The information during this time is mostly centred on child vaccination. Matibabu is a smartphone app that diagnoses malaria without having to take a blood sample. Patient simply insert a finger into their device to diagnose and the results are viewed on a smartphone.  Most malaria tests require blood samples, which are then sent to laboratories, tested and the results sent back. This can take days and is costly. Matibabu has changes all that, with patients now receiving their results within minutes. The test is fast, effective pain free and cuts down on costs. MedAfrica helps people in rural areas diagnose and monitor symptoms of diseases. The app provides directories of Doctors and hospitals, gives advice on treatment, authenticates possible counterfeit drugs and direct users to the nearest hospital. mRamadan was launched during the Ramadan season in Senegal. The app helps diabetic patients manage their health while fasting. Users receive free, daily text messages with recommendation before fasting, and tips for staying healthy during the fasting period. Smart Health app focuses on providing accurate baseline information resource on HIV/AIDS, TB and Malaria. The app is currently available in Tanzania, Nigeria, Kenya, South Africa, Angola, Ghana, and Senegal and embedded in all Samsung phones. Sehatuk is Arabic for your health. It provides a huge data base of drugs available in Morocco, along with their prices and dosages. It also provides useful information calling up an ambulance as well as news on the medical insurance. Omomi means my child. It’s an app that informs mothers and another relatives on immunization dates, baby’s growth pattern and general infant health tips. DrBridge is an app for Egyptians to make appointments with a doctor online. Doctors can use it to access patients’ medical records.

    The steady expansion of mHealth in Africa is an encouraging sign of improving healthcare. While there’s still a long way to go, it’s the right journey.

  • HealthKit identifies 137 Apps

    MobiHealthNews has a post on the 137 health and wellness apps that connect to Apple’s HealthKit. Some pull data from HealthKit, while others push data into HealthKit. Some do both. It’s not the final list, as new apps are added to HealthKit almost everyday, and Apple is slowly adding new fields to its platform.

    Based on their analysis, a summary of some of the most popular data types being pushed and pulled from Healthkit is:

    Apps pushing various kinds of data to Apple HealthKit include:

    34% are pushing active calories data 20% are pushing weight data 18% are writing heart rate data 15% are sharing walking and running distance data 10% are pushing out sleep analysis data 9% are sharing nutrition data 8 are pushing out blood pressure.

    Apps pulling various kinds of data from Apple HealthKit include:

    23% are pulling weight data 16% are integrating step count data 12% are using active calories data from the platform 10% are using heart rate data pulled from the system 10% are pulling down blood pressure data 9% make use of walking and running distance data 9% are pulling nutrition data.

    As the Healthkit platform expands and the data it collects diversifies, the potential value of the platform increases. It provides a long-term source of data for African countries planning to invest in and promote mHealth for better health.

  • Malawi's new HIV app is now available

    According to a report in Avert, in 2011 more than 10% of Malawi’s 15.9 million people were living with HIV and AIDS, which was also the leading cause of death in the country.

    Since then, the Malawi government has taken a number of positive steps to fight HIV. It now has a large number of initiatives actively seeking to minimise the spread. These include:

    Expanding voluntary HIV testing and counselling (HCT/ VCT) Prevention of mother-to-child transmission services Condom promotion and distribution Voluntary Medical Male Circumcision (VMMC) Blood safety measures Mass media campaigns Life Skills Education (LSE) for young people.

    Using mHealth is the latest initiative to help combat HIV in the country. Airtel Malawi and UNAIDS has signed a Memorandum of Understanding (MOU) to develop a HIV app. ITWEB Africa has the full report. The app will enable people living with HIV and AIDS in the country to access and share information about their medication. Airtel Malawi managing director, Heiko Schlittke, believes that “this mobile phone application will escalate the power of mobile technology in a bid to help reverse the HIV and AIDS crisis in Malawi by reaching out as many infected people as possible.”

    The UNAIDS country director for Malawi, Amakobe Sande, said the app would enable those affected and infected with the virus to access information about supplies of medication as well as experiences at healthcare points across the country. We hope that the mHealth app together with the ground work the government has already done will help to drastically reduce the spread of the disease.

  • mHealth supports mothers and children in Mali

    Mali’s infant and maternal mortality rates are among the highest in the world. They’re 196 per thousand people and 464 per hundred thousand live births. On average eight women die every day from pregnancy complications. Part of the Ministry of Health’s response is the use of mobile phones to reinforce the health system in favor of the mother and child unit and to improve the National Health System generally.

    The development of Mali’s communications sector has helped to provide a platform for support. Mobile customers increased 14-fold between 2005 and 2011, reaching more than 69%, million by the end of 2011. Mali went from 12th out of 14 countries in the West African Economic and Monetary Union (WAEMU) to 8th, and from 41st in Sub-Saharan Africa to 28th.

    Today, we tweet, we send SMSs, and we are on Facebook. We experience the indisputable advent of social media in our daily lives, and international experience shows that ICTs, especially mHealth, can help countries’ harmonious development.

    This is why Mali’s Ministry of Health, through the Telehealth and Medical Informatics National Agency, deployed a mobile fleet infrastructure of more than six hundred mobile phones, available to health workers in the periphery to support health services. Projects include Pesinet, for malaria, MédiMobile, and other pilot projects.

    The projects include monitoring the health of children below the age of 5 and better information sharing on maternal and child deaths. Between January 2012 and March 2013, 11 maternal deaths and 162 child deaths were reported, 73% of these at home, and 27% in health facilities. Over 24,000 cases of malaria in pregnant women were reported, with 670 deaths:  522 children below the age of 5, 145 children over 5 years of age, and 3 pregnant women.

    There is a significant improvement of about 91% in data accuracy and completeness compared to data from the National Health Information System that has an equivalent rate of about 40% and doesn’t use mHealth yet.

    Mali’s Ministry of Health is keen to extend these positive results and is a key partner in the joint WHO-ITU project on the use of mHealth for Non-Communicable Diseases (NCD). Diseases like diabetes, breast or cervical cancer, hypertension control related to other cardiovascular diseases, prevention of acute attacks in sickle cell and asthma could all benefit from mHealth, to improve care for patients, strengthen the capacity of health professionals, and make the right information available to health authorities to ensure decisions are based on evidence, is the path for all developing countries.

    Despite the positive results, challenges remain. Financial resources are limited, managing change is difficult, and there are substantial interoperability issues between the various technology platforms. Mali does not face these challenges alone and values collaboration to learn and share its experiences for the benefit of Africa’s rapidly expanding eHealth and mHealth opportunities.

  • La mSanté soutient le couple mére-enfant au Mali

    Les taux de mortalité infantiles et maternels du Mali comptent parmi les plus élevés du monde. Ils s’élèvent à 196 pour mille personnes et 464 pour cent mille naissances vivantes. En moyenne, huit femmes meurent chaque jour de complications de la grossesse. La réponse du Ministère de la Santé consiste notamment en l’utilisation de la téléphonie mobile pour renforcer le système de santé en faveur de l’unité dédiée au couple mère-enfant et pour améliorer le système de santé national en général.

    Le développement du secteur des communications du Mali a contribué à la fourniture d’une plateforme de soutien. Le parc mobile a été multiplié par 14 entre 2005 et 2011, atteignant plus de 10 millions fin 2011. Le Mali est passé de la 12e place sur 14 pays au sein de l’UEMOA (Union économique et monétaire ouest-africaine) à la 8e place, et de la 41e place en Afrique sub-saharienne à la 28e.

    Aujourd’hui, nous tweetons, nous envoyons des SMS et nous sommes sur Facebook. Nous vivons l’avènement incontestable des médias sociaux dans nos vies quotidiennes et l’expérience internationale montre que les TIC, particulièrement la mSanté, peuvent contribuer au développement harmonieux de nos pays.

    C’est pour cette raison que le Ministère de la Santé du Mali, via l’Agence nationale de télésanté et d’informatique médicale, a déployé des infrastructures de flotte mobile de plus de 600 téléphones mobiles, mis à disposition des agents de santé au niveau périphérique pour soutenir les services de santé. Les projets incluent Pesinet pour le paludisme, Médimobile et d’autres projets pilotes.

    Les projets prévoient notamment le suivi de la santé d’enfants de moins de 5 ans et un meilleur partage d’information sur les décès maternels et infantiles. Entre janvier 2012 et mars 2013, 11 décès maternels et 162 décès infantiles ont été signalés, 73 % d’entre eux à domicile et 27 % dans des structures de santé. Plus de 24 000 cas de paludisme chez les femmes enceintes ont été rapportés, dont 670 décès : 522 enfants de moins de 5 ans, 145 enfants de plus de 5 ans et 3 femmes enceintes.

    Une amélioration significative d’environ 91 % a été observée en termes de précision et d’intégralité des données, en comparaison avec les données issues du Système national d’information sanitaire dont le taux équivalent est d’environ 40 % et qui n’utilise pas encore la mSanté.

    Le ministère de la Santé du Mali cherche à étendre ces résultats positifs et est un partenaire clé du projet conjoint OMS-UIT concernant l’utilisation de la mSanté pour les maladies non-transmissibles. Des maladies comme le diabète, les cancers du sein ou du col de l’utérus, le contrôle de l’hypertension artérielle en lien avec d’autres maladies cardiovasculaires, la prévention des crises aiguës de drépanocytose et d’asthme pourraient toutes bénéficier de la mSanté pour améliorer la prise en charge des patients, renforcer les capacités des professionnels de la santé et mettre les bonnes informations à la disposition des autorités sanitaires pour assurer des décisions prises sur des bases factuelles. Ceci constitue la marche à suivre pour tous les pays en développement.

    En dépit de résultats positifs, des défis persistent. Les ressources financières sont limitées, la gestion du changement est difficile et des problèmes importants d’interopérabilité entre les divers plateformes technologiques existent. Le Mali n’est pas le seul pays confronté à ces difficultés et valorise la collaboration visant à enseigner et à partager ses expériences pour saisir les opportunités croissantes en télésanté et mSanté en Afrique.

  • Two health apps solving real African problems

    This years’ DEMO Africa event was in Nigeria on 24 September. Forty young startups from across the continent pitched their innovations to investors, hoping to secure financial and technical support from leading global technological companies. This kind of funding has the potential to catapult their innovations onto the world stage and to positively impacting thousands of lives in Africa. IT News Africa has the full report.

    “Africa is full of problems. But these problems present opportunities for innovation and what we are seeing is local developers shaping technology for the world,” says Fernando de Sousa, General Manager of Africa Initiatives at Microsoft, which under the 4Afrika Initiative was a Platinum sponsor for this year’s DEMO event.Through Microsoft’s continuing work with developers, the company has come across several applications which are spearheading local innovation, two of which focus on supporting and strengthening healthcare:

    access.mobile: ClinicCommunicator Matibabu

    ClinicCommunicatoris a web-based application that allows hospitals and clinics to automate communication to their patients through SMS. This includes appointment and medication reminders, updates on test results, health alerts and tips to stay healthy. Eight prominent East African hospitals have already signed on to trials of the service. Entrepreneur Kaakpema Yelpaala developed the app. He was a recipient of a Microsoft 4Afrika innovation grant. “ClinicCommunicator eases difficulties of patient scheduling, feedback and follow-up, saving on lost revenue, costly patient communications and other inefficiencies in patient engagement for African hospitals and medical practices,” says Kaakpema. “We hope to build additional healthcare products that are relevant for more people across Africa.”

    Matibabu is an app that detects malaria. It was developed in Uganda. Using a Kinect sensor and a mobile device, Matibabu detects a person’s malaria status without blood samples or a laboratory. The standard method for determining whether someone has malaria is drawing blood and viewing it under a microscope, which requires health workers and facilities that are scarce in many low-income countries. Now there is a simple, cost effective and pain free way to determine someone’s malaria status. The device the team developed can be plugged into a smartphone and can detect malaria using only light. Results are available in seconds and the smartphone can email them and map them for epidemiological purposes. In 2013, the app competed in the Microsoft Imagine Cup competition and won the United Nations Women Empowerment Award.

  • mHealth needs rigorous risk assessments

    How secure is your mHealth app? Security vulnerabilities of mHealth need addressing with rigorous risk assessment, says a study by researchers at Warwick University in the UK, and published in the Journal of Medical Internet Research (JMIR). While medical apps offer clinicians the capability to access medical knowledge and patient data at points of care, some apps could compromise patient safety and are potentially dangerous. There are different kinds of risks, and specific measures are needed to deal with them, especially their accuracy and reliability.

    The team proposes four main types of risk, each with different responses needed for regulation and with different regulators, ranging from individual clinicians for low risk apps, such as Body Mass Index (BMI) calculations, to independent, statutory regulators for higher risk apps with more complex mathematics.

    Many risk management methods are still in early development stages, so the initiative will roll on. The current status is still extremely valuable for eHealth regulators. For African countries, the model offers a faster start to mHealth regulation.

  • Asthma apps are about breathing

    For most of us, breathing isn’t difficult. I certainly don’t spend much time thinking about it, except for the occasional scary sea-swimming moment, caught clutching the sand after diving beneath an unexpectedly large wave. For asthmatics though, breathing can become impossible and the signs of deterioration are often small and subtle and only noticed by patients and their families once the patient is already in trouble, ‘trapped below the surface’ of a tight chest, needing urgent rescue through medical care, and often hospitalization, to avoid death. Keeping these patients out of the dangerously deep water of a serious attack is about helping them to identify danger signs long before they are serious, to take action, or to identify and avoid triggers that accelerate a plunge into the abyss.

    Open mHealth says that mHealth is about making “health data as useful and actionable” for patients and clinicians. The growing industry around mHealth is equally interested in reducing costs and the burden of care faced by health workers by reducing hospital visits. For asthmatics, both will sound like good news and they are no doubt pleased that innovators are not sitting idle.

    A number of companies now offer Apps and sensors to monitor breathing and help manage Asthma. Three quite different examples, sharing the same aim, are AsthmaMD that offers a Peak Flow Meter to measure lung function, iSonea that gauges adherence by monitoring wheezing, and Propeller Health’sapp and sensor, which attaches to a standard inhaler. All focus on helping asthmatics manage their condition and reduce the number of visits to healthcare providers. Ephraim Schwartz provides more detail in his June piece in mHealth News.

    AsthmaMD uses a Peak Flow Meter, a device that measures the force with which the patient breathes out, a key aspect of breathing particularly reduced in asthmatics. The meter syncs with an App via Bluetooth. When patients blow into the meter, a value is transmitted to the App, which then explains to the patient what the value means. The App will also track lung function over time and produces easy-to-read, color-coded peak flow charts, which provide healthcare providers with information to use to tailor treatment plans. They’ve reported a 10% improvement in lung function for active users, compared to a control group, and reduction in hospitalization and readmissions. It’s available over the counter in the US for $20.

    AsthmaMD apparently has 100,000 users and its developers have begun thinking about how to use their growing data source to answer questions about how to improve asthma care.

    iSonea’s device is called iSoneaAir. It records wheezes, a characteristic sound associated with obstructed airways. By measuring the wheeze rate, health workers are able to monitor patients’ progress outside of the clinical environment and assess how effective medications are before and after inhaling. “Doctors as well as insurers are looking at our application because it gives them a disease management focus,” said Ross Wilson, senior clinical manager at iSonea.

    The solution consists of an iPhone or Android App and the wheeze monitor, which is placed against the throat. The device syncs with the App via Bluetooth and wheeze recordings can be sent to health workers or stored in the cloud.

    The Propeller Health App, along with its sensor, tracks exact location, time and frequency of medication taken.

    Africa’s health challenges need solutions of their own, and the mHealth community in Africa is expanding its capacity to deliver. There’ll be lessons to learn from projects that gain traction elsewhere. Though probably none that will help me avoid the next big wave, or hold my breath longer when I get it wrong.

  • AliveCor is a life-saving mobile App

    These days, there’s an app for just about everything, from maps, to games, to mobile banking. Health’s part of the craze with numerous health and healthcare apps now available. These can track the number of steps you take, help document your food intake and even monitor your sleep. While these are all interesting up to a point, the extent that they change lives is debatable. An article in WNDU.com says there is now an app that not only changes lives, but can help save them.

    The AliveCor app works with the AliveCor Heart Monitor and records and saves single-channel ECG’s onto its server. The Heart Monitor is available for US$200 and can be used to track your heart rate anywhere. It is available for both Android and iOS. The technology can be downloaded for free by anyone with an app store on their phone.

    The technology uses electrical impulses from the user chest and turns them into ultrasound signals that are transmitted to the phone. The high reliability tracings it produces are very similar to LEAD I on regular ECG machines. These recordings are then saved into the cloud, where the information can be accessed at any time under confidentiality. The information can immediately be sent to a doctor who can make an informed decision without having to see the patient. The technology also allows you to save the readings as a PDF or send it as an email.

    Most international funding in Africa is devoted to child and maternal mortality, HIV, TB and malaria. Cardiovascular disease is often overlooked. According to the World’s Health Organization, the burden is increasing rapidly in Africa. Findings in a Cardiovascular Diagnosis and Therapy journal article show that in 2012, cardiovascular diseases accounted for 9.2% of total deaths in Africa.

    This technology has the potential to save countless lives. Hopefully, the inventors will continue to develop ways in which the heart tracings can be used and that the monitor will be available to African countries soon.

    eHNA covered a study of AliveCor in Sydney 2013.

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    Image from AliveCor website