Challenges

Millions of people in developing countries in Africa, the Arab States, Asia, and Latin America and the Caribbean have little access to qualified physicians. The reasons for this situation range from lack of physical access (patients having difficulty reaching a doctor in remote or even urban communities) and lack of funds (patients cannot afford the high cost of health care and governments are unable to subsidize underserved populations) to lack of medical resources (most countries face severe shortages of trained health-care professionals, especially medical experts).

Toward a Solution

ClickMedix, founded in 2010 by faculty and students of the Massachusetts Institute of Technology and Carnegie Mellon University, has been bringing affordable, quality health services to underserved patients in the developing world. It does this by enabling health organizations to reach more patients through mobile phones or tablets, using an application for remote diagnosis: wherever the patients are, doctors are able to discuss a patient’s care and prescribe a course of treatment in real time. The platform also offers the possibility of remote training and staff supervision, thereby building physician capacity while reducing costs. This global interconnected service is a prime model of triangular cooperation that is changing the way in which health-care systems and professionals across countries interact with one another, share data and offer their patients quicker, affordable, quality health-care services.

Building on a three-year pilot, ClickMedix created a highly reliable, secure, user-friendly tele-health, disease management and care coordination system that is compliant with the Health Insurance Portability and Accountability Act (HIPAA) and that can be deployed quickly to health practitioners and connect patients with medical experts worldwide. ClickMedix collaborates with local health enterprises such as the Jodhpur School of Public Health, whose health workers collect information from visits, including risk screening and triage, using smartphone applications, which ClickMedix customizes to the local context. The programme administrator can then view real- time data and patient progress in any preferred format. ClickMedix obtains doctors’ contact information from local enterprises and sets up remote consultations to enable local health-care workers to send patient information to a remote consulting doctor who provides a course of treatment that the local health-care worker administers and updates in the application, all available in real time. If a remote consultation is not available, the health workers refer the patients and help them to set up appointments with locally appropriate doctors based on the patient’s condition.

ClickMedix has been used to reduce patient waiting time from months to less than 72 hours, has enabled doctors to serve 4 to 15 times more patients without spending more time, and has created a more skilled workforce as well as new jobs for community- based and home-based health-care services. It has treated more than 200,000 patients, trained over 1,000 health professionals and saved more than $10 million globally. For example, by utilizing the ClickMedix platform, community health workers in New Delhi and Hyderabad were able to record basic patient data, conduct a physical ear screening with a Medtronic otoscope, and refer patients to ear, nose and throat specialists at hospitals. Those specialists confirm diagnoses and issue treatment plans remotely or suggest to patients that an outpatient treatment appointment is available. At health camps, small infections were treated while complex cases were referred to a hospital for further treatment. ClickMedix worked together with Medtronic to implement a screening process that took no more than three minutes, screen more than 200,000 patients with just nine health workers, double the number of treatments performed in partner hospitals, and extend service to in-hospital and patient counsellor follow-up care.

The ClickMedix-connected mobile health platform (called mHealth) connects health providers, reduces costs of service delivery and uses tiers of a country’s existing health-care system for patient care. Community health-care workers or clinic nurses with ClickMedix-enabled mobile phones or tablets can treat a patient thanks to their connection to the mHealth platform and to the entire health system. Once established, ClickMedix promises reliable transmissions (even where data connectivity is weak or intermittent), secure data processing, easy user interface, cell/tablet/laptop accessibility, integration into other information technology systems, and user control. It can be replicated in any country with mobile technology infrastructure, and it is easily scalable with more smartphones/tablets. A single device with a health worker or nurse can serve more than 1,000 patients per month.

Partners include global health organizations, health ministries, academia, medical professionals, public health practitioners, technologists, development activists, entrepreneurs and, of course, patients. More specifically, ClickMedix receives technical and financial support from an array of actors, including Medtronic, Ashoka, Western Diabetes Institute, Tata Trust, Cartier, Toyota, Grameen Health and Research, and Harvard University. These institutions have used mobile phone technology applications (e.g., Mobile Tele-Diabetes, Mobile Tele-Cardiology, Mobile Tele-ENT (Ear, Throat, Nose) and Mobile Tele-Dermatology) to treat diabetes, heart failure, skin and cervical cancer, Hansen’s disease and HIV/AIDS, among others, and have assisted with improving patient outcomes in countries such as Ghana, India, Mexico and the United States.

Sustainable Development Goal targets: 3.8, 3.9, 3.d