> Tuesday, September 8th at 11:45 AM
> Lucky Gunasekara                             
> Enabling Electronic Medical Records in Developing Countries
> Lucky Gunasekara is a second year Stanford medical student
> and co-founder of FrontlineSMS:Medic, a team committed to
> empowering community health workers in the developing world
> using appropriate mobile technology.
> Lucky will be discussing their use of a free, open-source, short
> message service (SMS) software package, Patient View - built on
> a popular piece of free and open source software - FrontlineSMS,
> for healthcare applications to vastly increase the access and usage
> of electronic medical records by rural community health workers
> and improve patient monitoring and follow up, with correspondent
> health improvements. The system enables large-scale, two-way text
> messaging using only a laptop, a GSM modem, and cell phones to
> enable better patient management, electronic medical records via the
> cell phone, cheap mobile diagnostics, and mapping of health services.
> Lucky will also be sharing his experiences this summer building a
> 500-strong community health worker SMS program with the Clinton
> HIV/AIDS Initiative, and plans to scale further in 2010 in Malawi and
> Rwanda. As part of FrontlineSMS:Medic's Hope Phones campaign,
www.hopephones.org, Lucky is hoping each attendee brings one of
> their old mobile phones to donate to be recycled for use by a clinic
> overseas.

Lucky began his talk by pointing out that there are 300,000,000 people with tuberculosis, AIDS, or malaria on this earth. Because of this, 11 million of them die preventable deaths every year. Many of those deaths occur in Africa, where large parts of the country have very little infrastructure of the kinds Americans are used to. He explained that because of the difficulties and expense, land lines are almost unobtainable there, but with $50 you can get a cell phone, some minutes, and the card that connects it to the available grid. Nokia is the leading provider there, and there is an adequately stocked supply chain all over the continent. Coverage is expanding rapidly.

Lucky then explained that his parents are big in the cell phone business, so he grew up around the technology and came onto the scene with a surprisingly detailed understanding of the network and how it operates. When the tsunami devastated Indonesia his relatives in the area were hurt, so he did a fundraiser to help them in Boston, where he was at school. Over break he went back to see how they were doing, and he found out a lot about the health care system there. When he came back he wrote a ten page e-mail and sent it to Nokia's head of development, who sent back a polite "thanks for the idea but stay in school" type response. Lucky shelved it until he met Josh, a fellow Stanford student who was just back from doing health care work in South Africa and had lots of ideas about how to make things better there.

They set about making a medical records system that is compatible with what works there, starting in Malawi. Since the health care system there is based around a volunteer community healthcare worker in each village, they designed and built a system that would work around that person's cell phone and the hospital in town's data center. The healthcare worker would input information into text messages and upload it when the phone smells network availability. Also the system does things like remind people to take their pills and go in for checkups. It is free and open source, making it very scalable. In the two years since they first went live, the system has grown very popular with the users. Now they are expanding coverage as fast as they can finance the growth. Malawi has about a quarter of the country on the system now, and there are some users in Cameroon, South Africa, and other places. A lot of the money for growth is coming from Clinton and organizations like the Gates Foundation.

Since installing it, they have upgraded it to be the African version of a 9/11 system. Before that ambulances would occasionally grope around the countryside looking for people in trouble, but usually people too sick to walk to the hospital were sunk. Calling for help has made a huge difference, saving a lot of fuel and lives.

Lucky is asking everybody that can to donate old cell phones, working or not, to the cause. Ones that can't be used directly will be mined for their Colton and other recyclables and the money used for the cause. Each cell phone donated gets five villages on the network. Visit hopephones.org to get a free mailing label to send them in with. UPS donates the shipping.

During Q&A much more came up:

Malawi is about the size of California, with a population of 11 million people.

Livingston was the first european explorer of Malawi, and he exploited it to.

Africans are developing igneous ways of exploiting minimal connect time for maximum information sharing. Things like dialing a phone and hanging up after a set number of rings to share a message.

Tian Harter