Step into the future

Picture this…

Imagine an outbreak occurring in a remote rural location or even in a city. The first indication may be from an AI-based programme tracking news stories based on the movement of people based on the SIM devices (information shared confidentially by the mobile phone network operators). This could be anything from a sudden clustering around a health post, a spate of school closures, or a poultry farm stopping production.

A smart phone-based survey could be used to help local public health representatives to ground truth the assumptions. Smart phones could be used for the continuous monitoring of vital signs of those affected or at risk. This data is overlaid on GIS systems to look at both people at risk and areas affected, from which simulations can be run to look at potential scenarios, and the cost effectiveness of different response strategies as part of a dynamic response.

Global experts can co-create guidance for both local experts as well as communities affected. Simulation based training can provide the relevant competences to people quickly and effectively, regardless of language and literacy. There is no need for international volunteers to fly in and international experts can do much of their work remotely.

The local people and organisations are empowered to respond to the crisis themselves. Where specialist knowledge is needed, virtual consultations can be carried out with experts from around the world able to provide 24hr monitoring and coverage of the event. Smart phone-based systems can leverage any local capacity streamlining the use of scarce resources and ensuring any triage is as transparent and effective as possible. These approaches all lead to an ongoing strengthening of health systems and a real legacy.

The use of drones can get samples back to labs for research programmes enabling research into better therapeutic regimens or vaccines to be carried out in real time within a framework with pre-agreed ethical guidelines.

Blockchain enables payment of people and for resources. It also permits the secure sharing of patient records which can be accessed from the cloud. Mobile phones provide updates to the people in the affected communities, so they understand the nature of the threat to their security and the response.

There are individual examples of all this happening. Woven together it could make the traditional humanitarian response redundant. This poses a huge challenge. Humanitarian organisations that have evolved over the years to support and run ‘international interventions’, as well as donor organisations with the kind of contractual arrangements designed to support the traditional programmatic approach and ensure a command and control structure to coordinate individual responses across a sector.

The new approach builds on technologies that most humanitarian agencies do not have in-house: blockchain, artificial intelligence, drones, sensors, Internet of things, and wearable devices. These all come together in the future of patient care and management, disease tracking, point-of-care support, health education, remote monitoring, diagnostics, and supply chain management.

This raises a number of questions. How do humanitarian agencies keep track of the broad range of innovations that are transforming the public health landscape? What are the emergent challenges surrounding patient privacy and security, limits to access, training and capacity building challenges, interoperability issues, regulation and policy hurdles and more? This is not just a one-off challenge for the start of 2018, but a continuing challenge to keep humanitarian responses fit for purpose in the fast-changing digital world.

This ‘Simulation-based training tools for Just-in-Time ( JIT) capacity building’ project has been an opportunity created by digital technology to re-imagine the humanitarian response to the future. It was built on the experience of ebuddi (see previous blogs), but also looked at related innovations in other sectors to see what might be possible. The result could be transformational but poses a considerable challenge to the humanitarian agencies and the funding agencies that rely on them to deliver humanitarian responses.

Just as Uber has revolutionised the cost and accessibility of personal transport, empowering anyone with a car to potentially become a taxi driver, serve their community and earn money, it has also threatened traditional taxi services. Similarly, digital technology and the virtual platforms it can create, can make many of the functions, processes and hierarchies of traditional humanitarian agencies redundant.

If you are interested in learning more about these challenges and the solutions health workers are devising for them, check out the newest TechChange course, The Future of Digital Health, beginning on February 26, 2018!

Many humanitarian agencies are going through an existential crisis. Short term they may face safeguarding issues, but longer term they have an even greater challenge. The Future of Digital Health and this project provide a snapshot to help re-imagine the humanitarian agency of the future.