Editor’s note: We kick off regular and in-depth coverage of how mobile is transforming health care and treatment in developed and developing markets with Dr. Phillip Olla, a visionary and entrepreneur creating an ecosystem that leverages mobile devices and networks to improve diagnosis and treatment.
The mobile revolution has been hailed as the enabling force for emerging markets and developing countries to become more active participants in the global economy. Given the right tools and environment, people can harness mobile technology to leapfrog more developed countries, creating services that address local problems and issues, and ultimately close the digital divide.
MoDiSe (Mobile Diagnostic Services) understands the power of mobile and is harnessing it to improve diagnosis and data collection. The goal is to create a collaborative platform that can be leveraged for clinical research and best practice health care delivery for underserved urban and rural populations in developing countries.
To this end the organization is working to invent and integrate a suite of key low cost medical devices into robust cloud architecture for rapid and remote diagnosis of neglected diseases.
Mobile medical diagnostics
I caught up with Dr. Olla to talk about work in progress at MoDiSe and learn more about his bold and brave approach to mobile health. A central focus of this work is Mobile Lab on a Chip (MoLOC), an innovation in mobile medical diagnostics.
“As with any mobile application, mobile health systems, including Mobile Lab on a Chip (MoLOC), require a committed ecosystem to work,” Dr. Olla observed. After speaking with colleagues, non-profits, software developers, device manufacturers, network operators and government representatives, Dr. Olla has realized that (even with the simplest, proven and ultimately super cost-efficient solutions) it is necessary to orchestrate all the moving pieces to get market traction.
“Even though our focus is to develop a MoLoC that can be used to test for multiple conditions, we decided to focus in on one disease to get started – and that is tuberculosis.”
If you thought (as I did) that we won the war against tuberculosis decades ago, then think again.
Wikipedia tells that roughly a third of the world’s population has been infected with M. tuberculosis, and new infections occur at a rate of one per second. In fact, tuberculosis is the world’s greatest infectious killer of women of reproductive age and the leading cause of death among people with HIV/AIDS. What’s more – in 2007 – an estimated 13.7 million people had active tuberculosis disease. There were also 9.3 million new cases and 1.8 million deaths
Fortunately, tuberculosis cure rates are dramatically higher when the disease is diagnosed early and accurately. Dr. Olla’s MoLOC solution enables rapid, low-cost point of care diagnosis using a microfluidic chip integrated with a mobile device and electronic medical record.
“For the system to work, and to scale, we are rallying partners across all the domains in the ecosystem to create a critical mass of cooperation so that we can get to the ‘silicon economics’ required to produce the chips and devices en masse,” Dr. Olla says. “We are also simultaneously developing the distribution system through clinics in the geographic regions hit hardest by TB, which coincide with those areas hit hardest by HIV-Aids.”
Open innovation benefits
What is progress to date? “With our partners we are creating a new model for open innovation and working out the economics — including cost and sponsorship for the point of care readers, the disposable chips, the managed services subscription for the providers on the ground, the operations cost for diagnosis through the cloud.” Another focus is funding sources. “This can come from the immense value of the data we can collect and aggregate in order to understand how diagnosis and treatment is working, and where there may be new migration patterns of the disease and so forth.”
Through this initiative, Dr. Olla has learned that the key to success and traction is 2011 is a robust business model – and a healthy ecosystem. “Competition we create amongst ourselves to secure scarce funding and resources are undermining the work we’re trying to do in places like Africa, India and in the developing world,” Dr. Olla said, referring to NGOs (Non Governmental Organizations).
His approach – one that perhaps provides a blueprint for other mobile health efforts — lies somewhere on the middle.
“Competition within the for-profit enterprise world is expected and healthy. We are now merging these two models, and creating an environment within which everybody can win. For-profit manufacturers of devices and chips, mobile networks and health services companies can make money, while also helping us scale to the volume required to keep the actual deployment costs low, on a per-patient basis.”
The ideal model might be one that involves the peoples of the world in the development of mobile heath care treatment and technology. “In my view the best model to really get things moving would be an open innovation competition.” Indeed, the key obstacles in the development of point-of-care tuberculosis tests are the lack of biomarkers and of suitable platforms for use in remote areas.
A way forward this year might be an open competition that would expose good ideas and innovators. “We know that the X Prize, Knowledge Ecology International, and Médecins Sans Frontières (MSF), have all independently proposed prizes for improved TB tests ranging from $5 – $100 million. This is the type of competition we need and we hope that at least one of these competitions is launched in 2011.”
Progress in Africa
When Dr. Olla and his team spoke with clinics in Africa, they were enthusiastic about providing distribution and service associated with the MoLOC project, initially focused on TB. “They did make it clear that the infrastructure, or backbone for the program, needs to allow for multiple tools and the support of multiple disease applications. The clinics in countries throughout Africa are for-profit themselves, and are not reliant on NGOS – but recognize that the NGOS and business ecosystem can help accelerate the development of the initial platform.”
However, a potential obstacle is the brain drain and the slow pace of capacity building in Africa and other developing nations. According to the World Health Organization (WHO) – the authority for health within the United Nations system — only 1.3 percent of African medical professionals practice in Africa. Put another way, there are more nurses from Malawi in Manchester, U.K than there are nurses in Malawi. And there are more Ethiopian doctors in Chicago than there are in Ethiopia.
Even though Africa does gain from funds sent home by African professionals living abroad, the negative consequences by far outweigh the benefits. A few data points to note: Africa now lacks the capacity to adequately train new health care professionals. For example, Zimbabwe spends about US$200,000 to train one doctor.
It’s an issue that Dr. Olla feels mobile can help solve. “We aim to address this problem by providing the ability to bring mobile health services to them and connect these graduating young doctors to colleagues through mobile network technologies to stem the loss and ensure there are live resources available who are able to leverage these global, mobile solutions.”
To this end Dr. Olla and his colleagues are working to bring together all the elements and players — governments, operators, for-profit enterprises, and non-profit organizations. They are also actively forming strategic partnerships with universities and research organizations that stand to benefit from the enhanced collection of data made possible by mobile. “This will take a bit longer,” Dr. Olla notes, “but our ability to create a very rich and committed ecosystem, focused on a single disease like TB as a starting point. It is the only way that will allow us to build a sustainable, flexible architecture that can then be leveraged across many needs.”
Dr. Olla’s noble purpose and global vision – on the ground and in the cloud – is about connecting the worlds of for-profit and non-profit for good. It’s an ambitious plan and Dr. Olla is taking practical steps to achieve this objective. Specifically, the aim is not to hit mass market — yet. “Instead, we are focusing instead on entrepreneurs in Africa and India who are creating urban clinics. These are smart people, already using SMS with regular cellphones. We can lease a smart phone to them for $50 a month set up with this diagnostic functionality, and they can develop their local businesses by tapping into the cloud using increasingly better 2, 3 and eventually 4G networks.”
Dr. Phillip Olla is a mobile telecom advisor with over 15 years experience working at the leading edge of mobile innovation. Dr. Olla is a Chartered Engineer with a Ph. D. in Mobile Telecommunications from Brunel University in the UK. He is also an accredited UK Press member. He has published numerous peer-reviewed articles in journals, and authored 3 industry reports along with 7 book chapters and 3 books. Dr. Olla is a member of the W3 Mobiles for social development group MW4D and the chair of research for the New Economic Partnership for Africa’s Development (NEPAD) Council. He serves on the advisory board for IGI Publishing and is the Associate Editor for the Journal of Information Technology Research. In addition, Dr. Olla is a worldwide speaker on mobile technology innovation and a member of MOCOM 2020 a non-profit open mobile media think tank.