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Monday, December 3, 2012

The Data Collection Revolution: How Remote Monitoring Is Transforming Health Care Business

By Mark Maples

An OttoClave instrument sterilization system at work. (Images courtesy of OttoClave)

Editor's Note: This week we're launching NextBillion Health Care, a new blog focused on deliverying medical services and products to low-income patients and consumers.

You shop for a new TV on Amazon.

You use a coupon at the supermarket.

You “like” a post on Facebook.

If you live in a developed country, these and other routine decisions and transactions are converted to data. Businesses are continually developing ever more sophisticated methods to use this information to improve their products and services.

But in the developing world, data is notoriously difficult to gather – especially in remote areas. Historically, data collection has involved hand-written surveys or in-person observations, both of which are incredibly expensive and frequently produce biased results. The resulting data gap has led to a decreased ability to innovate, and a loss in profits and competitive advantage among entrepreneurs and businesses focused on the base of the pyramid.

In the health arena, the consequences of this situation can be particularly dire.

To take just one example, 1.3 million people die each year from unsafe injections. Unsterilized reusable needles are responsible for a large portion of these deaths. Even though autoclaves (instrument sterilization systems) are present in many clinics, they sit gathering dust because health workers don’t know how to use them. Yet most autoclave providers don’t address this problem, because they lack the product usage data that would allow for design improvements or training initiatives. Having access to this kind of objective data is the first step toward ensuring proper usage of these and other medical devices.

Fortunately, there’s a solution to this data gap.

Between 2000 and 2010, the number of mobile phone users in developing countries jumped from 29 to 77 percent. Of the more than 6 billion cell phone subscriptions worldwide, 76 percent are in developing countries. The speed of this growth is unprecedented in the history of technology, and its implications for data collection are nothing less than revolutionary.

Remote data collection is now possible in most underserved communities, and this data can dramatically redefine products designed for these markets. During the design and pilot phases of product development, usage data can give insight that ensures that products meet the specific needs of users. This information fundamentally changes the way designers iterate, allowing for accelerated improvements and better overall design. And once products have entered the market, the ability to monitor how they are being used will help to measure and guarantee a sustainable impact.

The benefits of remote data collection are so compelling that some companies are designing it into their products.

Providers using an OttoClave instrument sterilization systemI currently work with a company called OttoClave, which has developed a monitoring system that builds sensors directly into autoclaves, using cellular networks to monitor device usage in the field. The project began as a master’s thesis by two entrepreneurs at MIT, who started the company after graduation and continue to receive scale-up funding from MIT’s D-Lab program.

The company’s decision to build a remote monitoring capability into its “OttoClaves” grew from the challenges faced during designing and prototyping. When OttoClaves were first distributed in remote areas in India and Nepal, accurate usage data was almost impossible to gather. Surveys designed to gain insight into real-world application scenarios were given to staff members at rural health posts. But months later, when the surveys were collected, falsified data made the data sets virtually unusable. For instance, one clinic had recorded information for OttoClave use before the clinic had even received the device.

Incorporating remote monitoring into OttoClaves provides us with objective usage information. The sensors tell us how regularly the devices are used, how often different functions (such as the tutorial feature) are accessed, and the frequency of successful sterilization processes. This data will drive decisions in designing a more appropriate sterilization system, allow for rapid product iterations, and provide a basis for measuring impact. In addition, the ability to monitor product usage in the field will enable future buyers to respond rapidly to adverse events, such as broken equipment, helping to ensure continued use and sustainable impact.

OttoClave’s monitoring system is part of a new wave of cell applications and sensor systems that promise to redefine how information is collected at the base of the pyramid, giving unprecedented insight into how products and services are being used.

For example, EpiSurveyor is an open-platform cell phone survey app that has been used in a variety of applications, from fighting polio in Kenya, to dealing with government corruption in Guatemala. Whereas in the past, researchers or entrepreneurs had to trek from village to village administering paper surveys, EpiSurveyor turns simple cellphones into remote data gathering clipboards. Surveys that are completed on the phone are pushed over cell networks to a central database where they can be analyzed in real-time. Rather than waiting months for insights from survey data, someone on the ground is now able to gather much more accurate and relevant information instantaneously.

On the product side, SWEETLab (Sustainable Water, Energy and Environmental Technologies Laboratory), based at Portland State University, has created a multi-purpose platform for developers to monitor a wide range of devices in the field. It features a physical box with sensors, which can easily be connected to a variety of products. The platform uses cellular networks to transmit real-time usage information from these sensors to a centralized database. The mobility of the platform makes it well-suited for measuring outcomes of a wide range of devices or interventions designed for developing markets.

One current application of SWEETLab is helping Mercy Corps gather objective data on water and sanitation programs. SWEETLab’s remote sensors are incorporated into both latrines and hand-washing stations, allowing Mercy Corps to understand how the two services are used, if they complement each other, and how external events (such as staff visits) affect usage. This data can be used as evidence to support a successful program, or to improve a less effective one. Identifying successful development projects and having evidence to support scaling them will improve design and reduce waste throughout the international development space.

The growth of cellular networks has sparked a revolution in data collection at the base of the pyramid. Whether they’re focused on health care or other needs, entrepreneurs and social enterprises must take advantage of these tools. Enhanced innovation through data collection has the potential to unlock tremendous benefits for social enterprises and their customers, and to improve the standard of living globally for those with the greatest need.

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