It’s All Just Data: On Similarities and Disparities in Global Digital Health

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Reuters

Inside the newsroom at Bloomberg News in San Francisco, hundreds of screens are flashing with updates from around the world. A perfect setting for a recent seminar on how mobile technology is improving worldwide access to healthcare information, and how collection and usage of health data varies in different regions. So what on Earth is different?

World Affairs Council of Northern California and Bloomberg News hosted the gathering on mHealth: Impacts on Health Care with panelists from Medic Mobile, Digital Health Samsung, and World Policy Forum.
Ram Fish, Samsung’s VP of Digital Health, had the latest sensors on his wrist. In his visions of future health care, there will be a shift in how health data is analyzed, and ultimately how health care is delivered. The capability and expertise to interpret results will move away from physicians:
”Instead of mothers wanting their sons to become doctors, the doctors will come to me for advice.”
Time will tell if Fish is right, but we will certainly have to (re-?)define normal for everything we track. Big data has the innate challenge of interpretation, and it needs to be distilled down to something useful. Samsung has partnered with UCSF to evaluate their technology. Passion driven on how data can improve health, Ram Fish’s statement was clear:

“We’re going from small data to big data to small data.”

Digital health technology is expanding globally. Moderator Adam Satariano, technology reporter at Bloomberg News, wondered if we should think differently about mHealth data collection in developed vs developing countries.
Dianne Kane, Senior Designer at Medic Mobile, highlighted the importance of understanding what data healthcare workers would benefit from, and just deliver what is needed; no more, no less. To remove access to already released data is much more difficult.
Medic Mobile, a non-profit organization aiming to enhance coordination in healthcare, has projects on antenatal care, immunizations, and disease surveillance in over 20 countries. Human centered design, to go in and observe what the needs are among healthcare workers, is key to Medic Mobile.
Medic Mobile’s customers and users are not the same people. Dianne Kane emphasized the need to focus on the usefulness for the user only, not the buyer. The drawback is of course delay or lack of product feedback since the user is not paying for it. (I guess there’s no holiday season shopping pattern to analyze?)

Pam Dixon, Executive Director at the World Policy Forum, was the devil’s advocate this evening. What are the risks in digital health?
Data can always be used to hurt individuals, according to Dixon. Wrong info can fall into the wrong hands. This is a risk in both developed and undeveloped countries, whether it is a dictator or an insurance company wanting the information.
Confidentiality is a concern, as well as the voluntary aspect of tracking data. Pam Dixon argued that when data flies around, when there is a risk of secondary use outside healthcare, we need additional protection laws. What happens when an employer or insurance company requires wear of sensors? These risks needs to be planned for, be medicated for.

Digital health, for who is this technology? Who will be able to afford it? Will it cause inequality?
Ram Fish meant that even the most expensive devises generates large cost savings by improving health. Low-cost sensors will maintain a separate space, in all income settings.
“By maintaining a variety of systems, we will be able to avoid disparities,” Pam Dixon added.
Feature phones are still dominating the scene in low- and middle income countries. Dianne Kane argued that the smartphone revolution will get there eventually, but if you want to make an impact now using mobile phones, make sure the system works on a devise looking like the one you had back in 2002. Nothing will change just because the prices of smartphones get lower, but rather when the battery lifetime is solved. To charge your phone twice daily is just not an option if you have to walk to the next village to do so. (When my brand new phone dies by noon, I often want that Nokia 3210 back.)

So what is the impact of digital health on health care, and what are the similarities and disparities in a global setting?
Pam Dixon compared the systems of using feature phones vs sophisticated sensors, in some way here represented by her two co-panelists. What they have in common is that they create and send data, that’s all:

“It’s all just data.”

Numbers keep flashing on the screens inside Bloomberg’s newsroom. A total information overload. Unless these numbers are analyzed and distilled in tomorrow’s business section, none of it will make sense. The parallel to big health data is obvious.
Just data makes no difference.

This is a guest post by Johanna Sandlund, MD, PhD, Global Health Diagnostic Fellow, Stanford University. She can be reached at sandlund@stanford.edu

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