MIT OpenCourseWarehttp://ocw.mit.edu ��MAS.965 / 6.976 / SP.716 NextLab I: Designing Mobile Technologies for the Next Billion UsersFall 2008 For information about citing these materials or our Terms of Use, visit: http://ocw.mit.edu/terms.Design of Health Care TechnologiesDesign of Health Care Technologies for the Developing World Robert A. Malkin••DefinitionsDefinitions • Developed World:Developed World: Nations that the United Nations Considers to have High Human Developmenthave High Human Development. Human Development:Human Development: A numerical measure of a Nation by the UN, based on indicators as Life Expectancy Adult based on indicators as Life Expectancy, Adult Literacy and GDP (Gross Domestic Product).-g , p p , )"Health for All by 2000"Health for All by 2000 • International effortInternational effort • Specific areas of need (oral re-hydrationSpecific areas of need. (oral re hydration solutions, food supplements, antibiotics, vector control agents, water pumps, latrines). • Technology was known, effective and cheap.g g y pTechnologyTechnology • Money should be spent in other areas. (socialMoney should be spent in other areas. (social services, basic needs). • Out of context equipment.qp• A new scanner won’t change the outcome, diagnoses or the length of stay of the patient in the hospital. • No one to repair or maintain the equipment. • It goes only to main cities and private hospitals.BarriersGeneral BarriersGeneral Barriers • Training of StaffTraining of Staff – Reluctance to change – Language BarriersLanguageg gEWHEWH •Engineering World Health – 4 year study on Medical Equipment in Developing Countries. – On-site equipment analysis and staff interviews.ee••Interview ((technical staff,, doctors,, nurses,, and admin. staff)). – 1st round, Basic Questions. • How many technical staff does the hospital have? • How have they been trained? • What is the spare parts budget and equipment budget of this hospital? • What % of equipment is donated?What % of equipment is donated? • What % of equipment is working? • What is the averagge agge of yyour medical equipment?•• InterviewInterview – 2nd round, In depth Questions. • What is the most difficult technical obstacle you need to overcome in order to do your job more need to overcome in order to do your job more effectively? • What healthcare technologygy on the current market meet this need? • What are you currently using to solve this problem?problem? • What equipment do you most need at this hosppital?COSTgypResultsResults • Equipment Data from 33 hospitals in 10 countries. • Interviews in additional 21 hospitals in 6 countries. • COST • SPARE PARTS – Not available in the countryNot available in the country – Not available in the market. • CONSUMABLESCONSUMABLES – Laboratory test strips, ECG Electrodes, electrosurgery tips, etc.or–Other BarriersOther Barriers • Lack of technical staffLack of technical staff. – poor literacy rate. “Brain Drain” “Brain Leak”Brain Drain or Brain Leak • Lack of reliable power and water. – Bundled with poor public infrastructure (roads).R b l dMisconceptionsMisconceptions •“Instruments must be simple”Instruments must be simple – The few users that are trained, are successfully trained. – Simple instrumentation is dependant on vendors andmanufacturersmanufacturers. • “Cost is always a main Barrier” – Resources can be pooled. – Equipment can be afforded but not maintainedmaintained.–Possible Blueprints for Successful DiDesign • Duke University-EngineeringDuke University Engineering World Health Competition for Underserved and Resource PoorUnderserved and Resource Poor Economies (CUREs) Business plan competitionBusiness plan competition • Need finding through on-the-ground market research • Nonprofit business development • Prototype development–pg, pPossible Blueprints for Successful DiDesign • Program for AppropriateProgram for Appropriate Technology in Health (PATH) LargeScale CollaborationLarge-Scale Collaboration • Clearly defined need. Where public and private sectors can work in harmony. • Consensus among the public health communitycommunity. • Public-Private collaboration to fund, design, field test and promote the product.can youQuestionsQuestions • If the projects that we are addressing areIf the projects that we are addressing are going to be based on cell phone technologies how affected will they be totechnologies, how affected will they be to such external factors as the ones discussed?discussed? • How about factors not discussed in this presentation? think of any? presentation? can you think of