"Re-engineering access to global health care with mobile technology" Nahush Katti at TEDxCoMo



so I'm not gonna be talking about nuclear fission today that didn't seem all that interesting to me but I will talk about something that might be a little bit more interesting so quick question how many of you have a smartphone just show Vin's all right so a lot of you what about a tablet okay fair number so as you can see mobile technology is everywhere we use their smart phones to take pictures and to listen to music we use our tablets to watch movies and read the news and our laptops for just about everything else they allow us to stay connected with one another regardless of geographical boundaries and they're involved in just about every aspect of our day-to-day lives all except what may be two of the most important our health and our 50 even now in the 21st century in order to get access ik diagnosis you need to call the doctor's office drive all the way to the office wait in the waiting room for what seems like forever only to be taken back and to be told that you have to eat more drink more fluids and get more rest and on top of that you're billed for it but we have to keep doing this because we really have no other option unless I guess you might consider WebMD to be an option but every time I use WebMD I'm told I'm dying of a new disease so I don't really like that too much so how can mobile technology solve this problem well mobile technology empowers the patient in the system we're currently only the doctor is empowered you the patient can input your symptoms and talk to a doctor when you want and while the doctor is getting a diagnosis back to you you can continue on with your life the era of driving to a doctor's office and waiting for waiting in the waiting room is slowly dying and after all if everything from shopping to banking is already online why not health care this lack of patient empowerment became especially evident to me about three years ago this is my grandfather three years ago he fell ill and he lived in a small rural village with my grandmother in India now this village had no health care and the closest hospital was about about two hours away and he had to make this trek at least twice a month and many times even more now the worst part about this was he would usually be at the hospital for just an hour but he would be commuting for over four hours I just thought that was ridiculous so I heard about this and I started talking to my friend Vikram Arun about it and a couple months later and after some more discussion we started dr. on a telemedicine company and at first we wanted to be able to do everything from the get-go we wanted to be able to diagnose everything it was going to be a telemedicine it was going to be a smartphone tablet app that would allow you to videoconference with the doctor closest to you but we soon realized that wasn't actually going to work out that well and so we decided to shift gears a little bit we decided to focus on one thing off the homology and we did so we decided to take a field test in India the home of the world's largest blind population and after we kept looking at it we realized that developing countries is what needs us the most apparently there's over 80 percent of all visual impairments and blindness could have been prevented in developing countries if they just had access to healthcare so if we think about this for a second that means that there are 230 million people worldwide in developing countries that are walking around blind simply because they didn't have access to the healthcare when they needed it not even that they couldn't afford it it's just that they couldn't have access to it Vikram and I immediately decided that this was going to be dr. Ahn's first goal and first product we were going to provide a method to allow these patients to have access to the ophthalmic care that they needed in order to do this we knew that we had to embrace the power of mobile technology in India like many other developing countries they jumped straight into the cell phone bubble it's estimated that right now 865 million cell phones for a population of 1.2 billion people and there's approximately 500,000 new lines signed daily next year they're saying that there's going to be a 97% prevalence of cell phones in India so we knew we had to use cell phones so while we're brainstorming how to bridge this gap between ophthalmology and mobile technology we decided to take a look at how how you're diagnosed today so if you go into an eye hospital today you're they're gonna do four basic tests to you first they're gonna do a visual test so just to see how your vision is then they're gonna do a slit lamp this is a slit lamp image so it looks at the front of your eye for cataract for cataracts and other lens lens disabilities then you do a fundus image which looks at the back of the eye or the retina and finally they look at the external image so Vikram and I were looking at this and we're like okay let's start with the slit lamp let's see if we can recreate this with our cell phone and so after three years of testing and a lot of help from the Columbia Career Center and the Public School District we were able to create a device that provides 92% accuracy compared to face to face diagnosis and the best thing about this it cost less than ten dollars it diagnosed cataracts the world's leading cause of blindness and the only other current way to do that is with a three thousand dollar plus machine now numbers sound great but the real thing that appealed to us was making sure that all these patients got the access to the care that they were needed and so on our first visit to Shanker Nathe raleigh at the eye hospital that we've teamed up with Vikram and I experienced something that stuck with us for a very long time after this image is rather graphic so please close your eyes if you're easily disturbed meat baby romkey I met him when he was 12 days old and he was suffering from a disease known as proptosis as he came he comes from a very poor family and his mother had to bring him to Shanker natalia via train once he got too shrunk her Natalia they immediately took him to a checkup room and they gave him a thorough check out he was then taken to an operating room and they operated on him luckily he got to keep his eye but I later learned that if his mother had delayed by even another couple of minutes he would not have been so lucky that really stuck with me I just could not help but think about how many other small babies there were around the world not only in developing countries but in rural parts of developed countries that were blind or were about to go blind simply because they didn't have the access to the health care that they needed so ophthalmology was cases like romkey is what keeps us going forward we know that in countries like India access tothe elma care is a necessity not a luxury but ophthalmology is just the beginning for us there's a huge field of medicine on top of that and not only medicine mobile technology has the power to make all of our lives for the better you can we can have kiosks set up in gas stations grocery stores and bus stations so everyone in develop in developing countries as well as rural parts of developed countries can go to these to get their basic diagnosis we hope that one day the only time you need to go to a hospital is for intensive care or extensive testing everything else can be taken care of in a kiosk like this medicine it's not even it doesn't even have to stop at medicine last summer Vikram and I went to an agricultural college in India the government there funds funds outreach centers similar to this so that farmers if they have a problem with their crop they can uproot it and take it over here and to get a diagnosis but oftentimes these outreach centers are ours or maybe even days away from where the farmer is and these farmers simply cannot afford to be losing that much time so we decided well why can't we apply the same principle that we did with ophthalmology to this and so we did we made a modified a device and gave it to a farmer and we were taking pictures like this and we were getting great accuracy but the thing the coolest thing that we can do with mobile technology is something I like to call disease tracking so I want all of you to think that you're a farmer and so let's say this side suddenly starts plants start to get a disease okay so five or six of you start to text the pictures of this for the Outreach Center and they're like hey I've never seen anything like this what is this what am I supposed to do to solve this why is this hurting my yield so much and the Outreach Center takes a look at it and they're like okay well I know where this is and this is what you do then a couple days later someone over here sends the same thing so now we suddenly have all these data points about how this disease is spreading we're able to do something that we've never been able to do before we're able to tell farmers when they're going to get hit by a by any sort of pesticide or virus so like maybe next week they realize it's coming over here and they know that it's going from right to left so I can warn you and say hey you're about to get hit with this pest you should probably put some of this on there so your yield doesn't get affected mobile technology has a power to do this now unfortunately my grandfather never got to see the healthcare system or the agriculture assistant put in his village but Vikram and I are working very hard every day to make sure that one day both of these things will become a reality next time you take out your phone to take a cool picture of a car or any weird thing that you want to take a picture of don't just think about the fact that it can do that also think about what else that could do because the mobile phone has a lot more potential than just that thank you you

4 Comments

  1. I'll share a journal link that shows over empowerment of patients with chronic conditions leads to poor or zero adherence to meds.
    Please take into account the emotional component when u suggest apps or tools etc

  2. What about the emotional barrier related to phones? I needed a diagnosis on a skin allergy, I'd magically move on after inputting symptoms? U have zero idea about emotional intelligence, sir.

  3. Impressive.  We hope you will consider applying to Weldon's School of Biomedical Engineering this spring.

  4. Look out world, Nahush Katti is about to shake you up!

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