emerging use cases for digital health in lmics relevant to ... · behaviour (e.g. nutrition) ......

InternationalTelecommunicationUnion

Document RSG1SG5-IoT-16/18-E

22 November 2016

English only

ITU Workshop on

Spectrum Management for

Internet of Things Deployment

(Geneva, 22 November 2016)

Emerging use cases for digital

health in LMICs relevant to

5G applications

Dr. Garrett MehlScientits

‹#›‹#›

EmergingusecasesfordigitalhealthinLMICsrelevantto5Gapplications

Dr.GarrettMehl,Scientist

ITUWorkshoponSpectrumManagementforIOTand5G

Geneva,Switzerland

22November,2016

UniversalHealthCoverage

“Allpeople,irrespec8veofsocioeconomicstatus,shouldhaveaccesstoqualityhealthservicestheyneed,withoutincurringfinancialhardship.”

GlobalStrategyforWomen's,Children'sandAdolescents'Health,2016-2030

GarreEMehl:[email protected]

“Fartoomanywomen,childrenandadolescentsworldwides8llhaveliEleornoaccesstoessen8al,good-qualityhealthservicesandeduca8on,cleanairandwater,adequatesanita8onandgoodnutri8on”

GlobalStrategyforWomen's,Children'sandAdolescents'Health,2016-2030

GarreEMehl:[email protected]

• InordertorealizetheandachievethevisiondetailedintheGlobalStrategy,InnovaSonwillbeessen8al.

ChildhoodInfancy

Maternal HealthPostpartum (mother)

Postnatal (newborn)

BirthPregnancyBefore Pregnancy

MaternalandchildconSnuum

PublicHealthIntervenSonsofknownefficacyexistandarewell

described

[email protected]

ChildhoodInfancy


Postnatal (newborn)

• Nutrition and lifestyle

counseling,

management of

inter-partum weight

• Prevention and

treatment of

maternal anaemia

Mother-child PNC Checklist

• Case management of severe

acute malnutrition and

treatment for wasting

• Management of moderate

acute malnutrition

(appropriate breastfeeding,

complementary feeding; and

supplementary feeding

where necessary)

• Care for children with

developmental delays

• Vitamin A supplementation

• Zinc Supplementation for

acute diarrhea

• Deworming drug treatment

in children

Identify/Prioritize at Risk Children


• Educate for risk

signs such as

severe anaemia.

• Automated

calculation of and

ability to flag high

risk pregnancies.

Identify/Prioritize Risk Pregnancies

• Prevention, detection

and management of

anaemia, especially for

adolescent girls

• Promotion of healthy

behaviour (e.g. nutrition)

• Pre-pregnancy detection

and management of risk

factors (nutrition,

obesity) and genetic

conditions

• Prioritize women based

on age, parity, and last

pregnancy for family

planning, services and

counseling.

Client Registration

• Assessment and

Management of Fetal

Health and growth

• Iron and folic acid

supplementation

• Dietary counseling for

healthy weight gain

and adequate nutrition

• Multiple micronutrient

supplementation

• Balanced protein-

energy

supplementation

Pregnancy Registration

•Early initiation of

breastfeeding (within the first

hour)

•Exclusive breastfeeding for 6

months; continued

breastfeeding and

complementary feeding from

6 months

•Dietary counseling for

prevention of undernutrition,

overweight and obesity

•Periodic vitamin A

supplementation where

appropriate

• Iron supplementation where

appropriate

Routine Services

• Healthy Home Care

and nutritional

support

Birth Notification

ImportantDigitalStrategiesAcrossConSnuum

[email protected]

WHO Essential Nutrition Interventions

ChildhoodInfancy


Postnatal (newborn)


counseling,

management of

inter-partum weight

• Prevention and

treatment of

maternal anaemia






acute malnutrition




where necessary)





acute diarrhea


in children




signs such as

severe anaemia.

• Automated

calculation of and


risk pregnancies.



and management of


adolescent girls





factors (nutrition,


conditions





counseling.

Client Registration

• Assessment and

Management of Fetal

Health and growth


supplementation


healthy weight gain



supplementation


energy

supplementation




hour)


months; continued

breastfeeding and


6 months






appropriate


appropriate

Routine Services


and nutritional

support

Birth Notification

NutriSonIntervenSonsAcrossConSnuum

[email protected]

WHO Essential Nutrition Interventions

ChildhoodInfancy


Postnatal (newborn)


counseling,

management of

inter-partum weight

• Prevention and

treatment of

maternal anaemia






acute malnutrition




where necessary)





acute diarrhea


in children




signs such as

severe anaemia.

• Automated

calculation of and


risk pregnancies.



and management of


adolescent girls





factors (nutrition,


conditions





counseling.

Client Registration

• Assessment and

Management of Fetal

Health and growth


supplementation


healthy weight gain



supplementation


energy

supplementation




hour)


months; continued

breastfeeding and


6 months






appropriate


appropriate

Routine Services


and nutritional

support

Birth Notification

mHealthNutriSonStrategiesAcrossConSnuum

[email protected]

ChallengesinreachingvulnerablepopulaSons

IntegrateddigitalsystemsforUniversalHealthCoverage

Quality

Coverage

Affordability

Measurement&Accountability

Digitally-EnhancedResponsiveAccountability

Knowingwhoisinneedofservices,havingthenecessaryhumanresourcesandcommodi8esinadequatesupply,andconnecSngthesetogetherattheright8meandplace.

TypicalCurrentSituaSon• Dominantpapersystemsareusedinasub-standard

manner;digitalsystemss8llemerging,butuncoordinated

• Limitedaccesstoandusabilityofresul8ngdata

• DatacollectedisoTennotusedtoguidehealthworkforcepointofcarecareserviceprovision,ordecision-makersupervisionorplanning

• Sta8s8calmodelinganddataes8ma8onsareusedtofillgapsforplanninganddecision-making

• Mostrou8nedigitalsystemsarenotnaSonallyscaled

• Fewdigitalsystemsinteroperatewithothertools,orusecommondatastandards

PaperRegisters

[email protected]

Inaccessiblelegacysystemswithconsiderableclient-leveldata

elementsonservicedeliveryandoutcomesbyprovider

Inaccessibledataforhealthworkers

[email protected]

DatacollecSon,screeningservicedeliveryandreporSngarefour

separatefuncSons

Households)are)expected)to)report)to)mul1ple)agencies)

CHW)

BBS)

EPI)

LG)

LAW)

HouseholdsarevisitedbyMulSpleNon-InteracSngHealthCadresRespondingtoPregnantWomen,ReporSngto

MulSpleAgencies

StatusQuo:LegacyBusinessProcesses

HealthSystemsareComplex

...butnotimpossibletoopSmize

Whatisneeded• Accuratemeasurementandeffec8ve

accountabilityrequiresstrongintegratedinformaSonsystems,drivenbycountryneedsanduses.

• Robustdigitaltoolsthatarecomplementary,offeringvalueatdifferentlevelsandacrosshealthdomainsinthehealthsystem,

• DigitaltoolsthatinteroperatethroughtechnicalandsemanScstandards,andsharethesame“denominators”-todefinetargetpopula8ons

PrioritypracSces• EnumeraSonofpopula8on,withdefinedcriteriafor

targetpopulaSons,andnutri8onstates

•Healthcadrespecificdigitaltoolswithevidence-basedcontentthatreflectsdomainsofnutri8onandexis8nginforma8on-andwork-flows

• Standardizeddataelementsandindicators,andrepor8ngframeworksforhealthandnutri8onstatus

• UseofindividualidenSfiersandrecordsthatarepersistentandensurecon8nuityofcare

• SystemaScandrouSnescreeningforiden8fica8onofdiseaseandnutri8onstates,andmechanismsforreferral

[email protected]

CommonUseCases

ChildhoodInfancy


Postnatal (newborn)



Client Registration

Pregnancy Registration Routine ServicesBirth

Notification

Enumeration


[email protected]

Screening and risk assessment Screening and risk assessmentHealth promotion and dietary counseling, including use of multimedia

Commodity management Commodity managementDiagnostics, decision support algorithms, to diagnose, refer

Treatment & client management Treatment & client managementWeight gain and growth chart assessment & monitoring

Reminders for service provisionMaintaining stock of nutrition commodities

Birth Registration

Digital Tools Relevant to Nutrition for Mothers and Children

...ensurethathouseholdsincatchementareasareenumerated

Enumeration

•biometricregistraSon•facialrecogniSon•clientlookuptoensureuniqueentry

Enumeration

Requirements

ChildhoodInfancy


Postnatal (newborn)



Client Registration


Notification


[email protected]

Enumeration

...ensurepregnanciesareregisteredanddiagnosScsidenSfythoseathigh-risk

Pregnancy Registration and Risk Factor Diagnosis

Credit:MarkLeongforWHO/HRP

Micronutrient supplementation and Pregnancy Registration

•low-energynetworkeddiagnosSctools•high-bandwidthconnecSvitytoexpertcare•real-Smecommoditystockchecks

Requirements

ChildhoodInfancy


Postnatal (newborn)



Client Registration


Notification


[email protected]

Pregnancy Registration and Risk Diagnosis, Commodities

Micronutrient supplementation

Enumeration

...toensureprovidersareabletoidenSfytheirclientswherevertheymightbe

Treatment & client management

...toensureprovidersareabletomanageclientsanddeliveressenSalintervenSonseffecSvely



WHOOpenSmartRegisterPlacorm

AntenatalCareView

[email protected]



•lowpowerconnecteddevices•augmentedrealitytolocateclients•connecSvityeveninremoteareas•clientlookuptoensureuniqueentry•persistenthealthrecordwithclinicalchartimages

Requirements

ChildhoodInfancy


Postnatal (newborn)



Client Registration


Notification


[email protected]

registration, diagnosis Micronutrient supplementation

Treatment & client management Treatment & client management

Enumeration

Clientsmaytravelconsiderabledistances

Personalized Information



...Clientsneedpersonalized

informaSontoensuretheyare

empoweredtoseekservices



•connecSvityeveninremoteareas•sensorsconnectedtoproviders•networkedlookupforrealSmestockandfacilitystatus•Abilitytoaccesspersonalizedrecord•AbilitytoaccesspersonalizedinformaSon

Requirements

ChildhoodInfancy


Postnatal (newborn)



Client Registration


Notification


[email protected]

Micronutrient supplementation Micronutrient supplementation


Enumeration


...canfacilitatedecisionsupport,treatment,and

referral

Credit:G.Mehl

Diagnostics, decision support algorithms, to diagnose, refer

Credit:G.Mehl


•connecSvityeveninremoteareas•machinelearningfrompaeernsofintervenSonsandoutcomes•linkedrecordstoensureconSnuityofcare

Requirements

ChildhoodInfancy


Postnatal (newborn)



Client Registration


Notification


[email protected]



Enumeration

Reminders for service provision

Birth RegistrationScreening and risk assessment Screening and risk assessment

Breastfeeding


...canhelpensurethatessenSalcommodiSesareofqualityandinstock

Credit:G.Mehl

Maintaining stock of commodities

Credit:G.Mehl


•connecSvityeveninremoteareas•real-Smeassessmentofstocksandqualitymeasures(temp)•smart-approachestoprevenSngstockoutandpredicSngneeds

Requirements

ChildhoodInfancy


Postnatal (newborn)



Client Registration


Notification


[email protected]



Enumeration



Breastfeeding


Maintaining stock of nutrition commodities

Health promotion and dietary counseling, including use of multimedia

...canremindmotherstoseekcarefor

themselvesandtheirchildrenwhenneeded

[email protected]


Credit:G.Mehl


•abilitytoaccessmulS-mediatailoredtoclientneeds•clientaccesstocontent

Requirements

ChildhoodInfancy


Postnatal (newborn)



Client Registration


Notification


[email protected]



Enumeration



Breastfeeding



Weight gain and growth chart assessment & monitoring


Coordination and Data Reporting

summit Institute of Developmentsummit Institute of Development

Client Centered Care Provision and Data Flow: Dynamic data driven task allocation and customization


FacilitatescoordinaSonamonghealthworkers

Credit:GMehl


CoordinaSonispossibleacrosscadresforservices,andforreporSng

Credit:GMehl


ChildhoodInfancy


Postnatal (newborn)



Client Registration


Notification

5GandIOTOpportuniSesAcrossConSnuum

[email protected]



Enumeration



Breastfeeding



Weight gain and growth chart assessment & monitoring



ValueofIOTand5GtoHealthinLMICs

• Lowlatencyprovidesopportunityfordiagnos8csandbiometrics

• High-bandwidthallowsforlargefiletransfersincludingmul8-mediaforprovidersandclients

• ConnecSvityincludingmeshwillprovideabilitytoensureinforma8onexchangecantakeplaceanywhere

• IOTwillfacilitateremotemonitoringtotrackvitalsignsandqualityofcommodi8es,equipmentmonitoring

• voicerecogniSoncansupportkeylessdataentryforevenlowskilledprovidersandclients

• Networkedsystemsallowforpersonalizeddiagnos8csandcomputa8onstobecarriedoutatthepointofcare,anywhere

Thankyou

Dr.GarreeMehlScienSst,DigitalInnovaSon

WHO,[email protected]

November22,2016

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emerging use cases for digital health in lmics relevant to ... · behaviour (e.g. nutrition) ......

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