Image courtesy of MGH CAMTech.

Health Hackathons Drive Affordable Medical Technology Innovation through Community Engagement

13th November 2017 – Aikaterini (Katerina) Mantzavinou and Bryan J. Ranger

Portions of this post were published as part of: Mantzavinou, A., Ranger, B. J., Gudapakkam, S., Hutchins, K. G. B., Bailey, E., & Olson, K. R. (2016). Health hackathons drive affordable medical technology innovation through community engagement.” In UNESCO Chair in Technologies for Development: From Innovation to Social Impact.

Successful medical innovation requires a process of co-creation among key stakeholders including healthcare professionals, end-users, scientists, engineers, and entrepreneurs (IDEO, 2015; Lee, Olson, & Trimi, 2012; Prahalad & Ramaswamy, 2004). This can be particularly challenging in low- and middle-income countries (LMICs), where political, financial, and cultural constraints often hamper innovation and crosstalk between the main players of the healthcare ecosystem (Chilukuri et al.; Sachs, 2003; Mauser et al., 2013). These players need to overcome communication and collaboration barriers, see beyond their discipline and approach a problem using a nontraditional way to generate effective and efficient healthcare solutions. One way to accomplish this is through ‘health hackathons.’

Health hackathons are 1- to 3-day events intended to bring together diverse stakeholders to solve pressing healthcare needs. One of the pioneers in developing this tool for healthcare transformation is MIT Hacking Medicine. MIT Hacking Medicine was founded in 2011 to energize the healthcare community and accelerate medical innovation by carrying out co-creation via health hackathons. The group has organized to date more than 40 health hackathons across 9 countries and 5 continents. Our hackathons have included multiple events in the limited-resource setting, primarily in partnership with the Consortium for Affordable Medical Technologies (CAMTech) of the Center for Global Health at the Massachusetts General Hospital (MGH). These hackathons have been focused on affordable medical technology for low- and middle-income countries (LMICs). Hackathon themes have specifically included reproductive, maternal, newborn, and child health; diabetes; telehealth; Ebola; and road safety.

fig1

Since our first joint hackathon, organized in Boston in 2012, MIT Hacking Medicine’s annual flagship event (the ‘Grand Hack’) has featured a global health track in collaboration with CAMTech. CAMTech further adapted the MIT Hacking Medicine health hackathon model to the LMIC health needs and innovation potential by bringing health hackathons to India and Uganda. In collaboration with MIT Hacking Medicine, CAMTech has organized 8 international events in these two countries over the past 3 years. Participants and mentors from the India and Uganda ecosystems created through these local events have then joined their U.S.-based counterparts at the Grand Hacks of 2014 and 2015 held in Cambridge, MA, giving a voice to the LMIC setting. CAMTech has also organized Boston hackathons with a focus on pressing global health challenges in partnership with MIT Hacking Medicine, including a Stop Ebola hackathon held in 2015 at MGH and a Global Cancer Innovation hackathon held in 2016 at MGH.

Though hackathons are continually growing in popularity on a global scale, they should not be viewed as a single event but rather a launching pad to spur sustainable innovations. With this goal in mind, MIT Hacking Medicine has focused much of its attention on generating a network of individuals compelled to make healthcare better by exchanging ideas, knowledge, and skills in the long-term. The group has piloted pre- and post-hackathon opportunities for networking, ideation, securing funds and progress follow-up. CAMTech has similarly extended the hackathon model in the LMIC setting to engage stakeholders after the event, provide resources, and educate on best practices for cost-effective medical innovation. It has set up Co-Creation Labs in India and Uganda, launched tools such as its Online Innovation Platform to offer mentorship and support to budding entrepreneurs after its events, and awards post-hackathon prizes to teams demonstrating the most progress after the hackathons. Both CAMTech and MIT Hacking Medicine track follow-up data from event participants and use it to continually assess the real-world impact of their hackathons on healthcare innovation in resource-rich and resource-constrained environments internally and through publications.

fig2a fig2b

The hackathon model presents a unique opportunity to accelerate healthcare improvement in LMICs. Solutions coming from local healthcare stakeholders inspire entrepreneurship and confidence in the community (C. Morel et al., 2005). By involving key figures of the local healthcare delivery and technology development chains in the medical innovation process, local talent and knowledge can be harnessed to generate solutions more easily adapted by the community. At the same time, power holders in LMICs such as investors, entrepreneurs, educational institutions or even governments take notice of the innovation coming out of these local hackathons, oftentimes opting to support this work financially or otherwise (Bailey, 2014). The hacking philosophy applied to affordable healthcare, engagement of the local community engagement and support of novel ideas toward long-term sustainability hold great promise for creating low-cost medical solutions that can improve healthcare outcomes globally.

Katerina and Bryan are PhD candidates in the Harvard-MIT Health Sciences and Technology Program, co-founders of MITCHI and instructors at the MIT D-Lab. They have collectively run more than 10 health hackathons with MIT Hacking Medicine. Katerina is a Tata Fellow.

Image:

https://www.dimagi.com/blog/mobile-applications-for-healthcare-workers/

The Impact of Mobile Phone Health Initiatives on the Lives of Rural Female Indian Health Workers

7th November 2017 – Niccolò Pignatelli

Building new technologies is a worthy and exciting pursuit, no doubt. However, builders should be mindful of the significant societal impact that their technologies have beyond their initial scope, both good and bad. In ‘Technology: The Emergence of a Hazardous Concept,’ (1997), Leo Marx claims that technology is often seen as the single chief causative factor for modernization and development. He worries many people fail to see beyond the ‘physical device’ to realize that a new technology becomes an active and shaping component of the complex social and institutional fabric of human life. These societal implications should be studied and curbed, or amplified, accordingly. Over two years of work, jointly at D-Lab and the Tata Center at MIT, I helped design mobile health tools that will eventually be given to rural health workers in India to screen for Cardiovascular Disease risk. Most of the rural health workers in India are women and here follow some examples of the societal impacts that the personal use of the mobile phones given to them may have.

Mobile phone health technologies often enable low-skilled women, in some cases even illiterate women, the possibility of taking on a meaningful job. This leads to significant societal elevation and also brings a certain level of financial independence previously unattainable. From being solely dependent on their husbands they are able to start making some household decisions. It has been shown in a paper published by Silva et al. in 2009, that mobile phone adoption is deeply dependent on how many people in one’s immediate vicinity own one. People close to these health workers may start to buy mobile phones and start reaping the benefits themselves. For example, many women in rural areas are employed as artisans such as in the batik printing trade and with access to mobile phones they may circumvent the middle-man selling their products, thus reducing information asymmetries and making more profit.

It has also been documented that mobile phones have effects on marriage life. In particular in northern India, many women leave their village of origin for marriage. In the absence of landlines mobile phones enable women to maintain their distant support groups thus alleviating possible loneliness and isolation. Overall, mobile phones give women a sense of empowerment and various case studies have found that women health workers are mostly proud of using mobile phone solutions as it increases their value in the eyes of their husbands and fellow villagers.

This new technology also enables women to be more independent and have a stronger voice within their community. They may start to take advantage of various networks that have started to promote local activism via mobile phones. For example ‘CG Net’ is an audio based network initially developed by Microsoft in the Central Gondwana Region that gives a political activist voice to local communities which are otherwise completely isolated.

These are just a few, and positive, examples which show that technologies are also ‘political instruments’. It is well known that the implications of deploying technologies into society are not always positive. Builders of technologies should not be blinded by the technological marvel they have created but strive to understand how it will affect society and then conclude whether they should pursue or alter their technology.

Niccolò is an alumnus of the MIT Technology & Policy Master’s Program and a Tata Fellow