How We're Democratizing Healthcare with Mobile Phones
"Democratizing healthcare”—those are two big words, and I don’t quite know what they mean. But what I know is that they evoke (vaguely but strongly) how things should be, and highlight what healthcare is not today. It is not personal, it is not preventative, it is not universally accessible.
In 2009, I could not have been further removed from healthcare community. In fact, I had not a single idea of anything to do with medicine. My background is in Electrical Engineering, which I studied as an undergrad in India. Then, a chance encounter with friends Abhishek and Yogesh, two doctors who were interning in the rural hinterlands of Maharashtra, a state in India, changed everything. They had to brave lack of infrastructure, lack of staff, political problems, local disbelief of scientific medicine, and other challenging conditions.
To compound matters, there was an acute shortage of appropriate medical devices available. This last part is really something to be worried about if you are a doctor. It is like telling a carpenter: go build without the right tools. Appropriate medical devices are in short supply in the developing world because historically, the whole medical device industry is based in, and caters mostly to, North American and European healthcare systems. Simple economics means that the technologies that do turn up in lower income countries are, in the best cases, refurbished, ill-fitting medical equipment or new but unaffordable. Or, they are inappropriate for many reasons: not rugged enough for field use; not simple enough for untrained non-medical personnel; needing power and other infrastructure; etc.
This is why a group of doctors, engineers, designers, and I set out to build a TouchHb, a medical device that addressed one specific problem: screening and monitoring for anemia, which is especially a problem for children and pregnant women. We learned a lot during the making of ToucHb—like any other med tech startup—only we were based in rural India rather than Silicon Valley.
We soon found another similar problem to tackle: routine urine analysis.
The machines we saw used in the West and in hospitals in Mumbai and Delhi were power-hungry lab machines, costing $1,000 and more. They work when a user dips a small paper test strip in the urine sample, and then it's placed in the machine. The paper contains chemical dots arranged in a sequence that change color over time, depending on the concentration of glucose, bilirubin, nitrites, etc., in the urine. The machine “reads” the strip and provides the test report.
We asked ourselves, “Why couldn’t a mobile phone do the same job?” We figured we could replicate what the $1,000+ lab-based urine analyzer did—basically imaging of test strips—with any cell phone that had a decent camera.