Mobile phone technology’s potential for healthcare

Sam Surka
Senior Scientist, Telemedicine and mHealth Unit, Medical Research Council
MMed in e-Healthcare: Use of mobile phone technology in enabling community health workers to screen patients for cardiovascular disease

Under the microscope

Dr Sam Surka is helping to organise the first Inclusive Health Innovation Summit at the UCT Graduate School of Business, as part of the work being done by the Bertha Center for Social Entrepreneurship and Innovation, http://gsbblogs.uct.ac.za/inclusivehealth/. When not trying to wrestle his mobile phone from his 18-month-old daughter, he smashes squash balls to relieve stress or takes to the road on his bicycle.

Mobile phone technology holds heartening possibilities for healthcare in South Africa says enthusiast Dr Sam Surka.We know we should but we don’t. It’s a common human failing, particularly when it comes to taking responsibility for our health. We know, for example, that chronic diseases of lifestyle, HIV and some cancers can to a large extent be prevented, yet they’re on the rise. One of the most effective ways of reducing disease burden and its economic consequences is through preventive screening, and it is this area of human behaviour over which Dr Leegale Adonis has focused her microscope.

Her fascination with the human condition goes back to childhood. “My mother was a community nurse in the small town I grew up in. I spent a lot of time in the clinic, helping her out and seeing the interaction she had with people. This intrigued me and spurred my interest in medicine. My mother feared that medicine was a trying career and she tried to dissuade me, but I loved the sense of helping people in need and seeing their sincere gratitude and appreciation.

Now, as a public health specialist, Dr Adonis will try to unravel why preventive screening rates are low. “Knowing how to get more people to screen would have a positive impact on morbidity, mortality and cost outcomes,” she says. Her population of study is the Discovery Health-insured population from 2005 to 2011.

“This work is the first of its kind and will contribute to our understanding of incentivising health seeking behaviour, some of which could be transferable to the larger South African population,” says Dr D Basu, the acting head of the Public Health Unit in the Department of Community Health at Johannesburg’s Charlotte Maxeke Academic Hospital. “This important area of medicine has unfortunately and incorrectly been set aside for other competing priorities. My hope is that I can convince policy makers to incorporate health screening policies and targets as an integral part of the National Health Insurance,” Dr Adonis says.

Her dreams don’t stop there. “I dream of a South Africa with a health profile not inextricably linked to inequality and not marred by poverty, mismanaged health systems and poorly implemented policies.”

As a senior scientist in Telemedicine and mHealth at the Medical Research Council, Dr Sam Surka is an ardent proponent of mobile technology as an aid to community health workers.

“The ubiquity of mobile phones, cutting across all socioeconomic sectors of society, makes it a very exciting platform to leverage for the purposes of improved healthcare delivery,” he says. Mobile phone technology, including apps and connected devices, are already being used to screen for various medical conditions such as respiratory disease, mental health disorders and diabetes and Dr Surka wants to expand this to include cardiovascular disease, which is a leading cause of death worldwide and, in particular, in developing countries. Though there is a large amount of interest in this form of technology there is, as yet, little evidence of its impact on health outcomes. But Dr Surka believes that enabling community health workers to screen for cardiovascular disease using low cost technology like mobile phones offers significant relief to communities where health professionals are scarce. “I think it has the ability to meaningfully impact on the delivery of healthcare in South Africa. Community health workers have already been identified by the Department of Health as a potential workforce that can contribute in addressing the many challenges we face and mobile phones have been shown to be a useful job aid,” Dr Surka says. His hope is to develop a mobile phone version of the cardiovascular disease risk assessment tool developed by Gaziano et al. and to ensure that evidence-based solutions are adopted and integrated into the health system. Dr Surka is pursuing his studies at the Centre for Online Health at the University of Queenland in Brisbane, Australia, which is one of the first institutions to develop an e-Health degree and it offers a comprehensive e-Health programme. His research project will be done in collaboration with the Centre for Chronic Disease Initiatives in Africa at the University of Cape Town and Harvard Medical School in Boston.