The Global Innovation Series is supported by BMW i, a new concept dedicated to providing mobility solutions for the urban environment. It delivers more than purpose-built electric vehicles — it delivers smart mobility services. Visit bmw-i.com or follow @BMWi on Twitter.

You text your friends, you call your mom, you use your smartphone to upload pictures of your day-to-day life. But did you know your phone has a higher purpose? Even if it's just a Nokia "candy bar" phone or a flip-phone, that handheld piece of machinery can save lives. And there are startups all over the world that are innovating and creating new technologies that will change the global health landscape in dramatic ways. Read on for two promising startups that are equipping health care workers in developing nations with souped-up cellphones, and helping them treat more patients, faster.

Medic Mobile







As an international health and bioethics student at Stanford, Josh Nesbit researched pediatric HIV and wrote his thesis on treatment initiation for HIV-positive kids in rural Malawi. His research inspired him to start FrontlineSMS:Medic out of his Stanford dorm room. It started with a pilot program in Malawi, in an area where two doctors were shuttling around to diagnose and treat 250,000 people. Nesbit provided Java-run $10 mobile phones to community health workers to decentralize the care and create an "SMS patient coordination network." In short, the phones helped medical workers efficiently gather health data and follow up with patients.

"In six months, our pilot in Malawi saved the clinical staff 1,200 hours of follow-up time and more than $3,000 in motorbike fuel," Nesbit says. Further, it doubled the number of patients who were treated for Tuberculosis (TB). Once treated, patient follow-ups were completed by SMS rather than an in-person exam, which saved time, transportation and money.

"We're looking at how mobile phones can make the health care system and the people working in it more efficient, with the end goal of saving more lives," says Nesbit. FrontlineSMS:Medic is now known as Medic Mobile and runs off open-source data from OpenMRS, Ushahidi, Google Apps and HealthMap.

Medic Mobile serves 4.5 million people in 11 countries, including northeast Africa, Honduras, Nepal and Colombia. But perhaps the most famous use of Medic Mobile was in the aftermath of the Haiti earthquake. Nesbit coordinated with the DigiCel Command Center on the ground in Haiti, and they created a 4636 database, where the 80,000 incoming texts to the number "4636" were tagged and mapped to help the rescue effort.







Aside from crisis situations, SMS messages are also in use by governments, ministries of health and NGOs like the Clinton Health Access Initiative, which tracks vaccines via mobile phone (see flow chart above). Facebook has even jumped in the mobile health care game and created a SIM app. Nesbit hopes that's only the beginning.

"It could be really exciting to have those health worker- and patient-focused apps developed so you can run them on $10 Nokia phones," Nesbit says. "On iPads and iPhones, the killer app is the cool app — but in public health, the cool app is the one that everyone can use."

And to that end, Medic Mobile just launched its first SIM app for global health organization PSI. Named Kuvela, it can operate on 80% of the world’s phones, whether it's a $15 handset or an Android smartphone. This means data collection can reach a new level of accessibility and affordability, especially as mobile phone penetration skyrockets in developing countries.

But Nesbit hopes this is only the first of many Medic Mobile apps that empower health care workers and patients alike. He envisions applications that help patients schedule appointments, access remote consultations and get in touch with health care workers during a medical emergency.

"We're getting close to that Walmart-like efficiency that we'd like to see in global health," Nesbit says.

To get even more mobile phones on the ground where they're needed, Medic Mobile has partnered with HopePhones. You can donate new or used cell phones by clicking the "Donate phones" button on the website. Just turn off and deactivate your phone, print a free shipping label and send the phone in. It will go to Medic Mobile and its affiliates around the world.

Mobile Diagnostics







UCLA Professor Aydogan Ozcan, 32, is also using mobile technology to improve health care in the developing world, but he's turning the phone into an actual medical device. Ozcan is creating portable and lightweight microscopes that affix to cellphones, thus transforming them into a platform for conducting microanalysis of blood, bodily fluids and water samples. In short, your cellphone can become a mobile medical lab that can diagnose life-threatening diseases.

The microscopes are small, thanks to an innovative lens-free technology known as LUCAS — Lensless Ultra-wide-field Cell Monitoring Array platform based on Shadow imaging. The lensless design was made possible by recent advances in computer science and physics that allow scientists to understand how light interacts with various bacteria. So lenses are replaced by algorithms and computer codes that examine how light plays off the cells in question. Using light, Ozcan's team can detect "digital shadows" of cells and bacteria and then compare them to patterns that are stored in a library of images to immediately detect TB, malaria, certain STDs, HIV and other diseases.

"With this toolkit, the patient will give the blood and the technician will prepare the microscope slide with the patients red blood cells on it, and our microscopes will quickly image it and enable remote and immediate diagnosis," Ozcan explains. Not only is it fast, but it's also "remarkably cheap," costing just 10 to 15 cents per test.

The technology works on almost any kind of phone. For a cameraphone, you can install an attachment to make use of the existing camera, or you can install a separate unit that uses the cell phone as a vehicle to transmit the MMS images via USB — the cell phone essentially acts as an intermediary between a patient and a central PC station in a remote hospital. With the promise of immediate diagnosis, health care workers in developing worlds who shuttle from village to village and see hundreds of patients can provide an immediate diagnosis and plan of action right then and there, and they can record data and keep a record of the patient. This level of organization and efficiency doesn't currently exist.

In Africa, one hospital might cover 1,800 kilometers — for a health care worker on a motorcycle, that's a lot of terrain to cover and a lot of patients to treat. But MMS-diagnosis will improve health care in remote locations and circumvent having to physically go to hospitals, and yet hospitals will have far more of an impact on the lives of its patients by implementing mobile technology that can diagnose and treat at any distance.

"The concept of a hospital will diffuse away," says Ozcan. It will no longer be a central hub where people come and go, but a central database that offers affordable, accessible and better quality health care.

Ozcan's research is funded by millions of dollars from the NIH, U.S. Office of Naval Research and the National Science Foundation. But Ozcan's group focuses on perfecting the technology, not manufacturing it for market. However, it recently received $400,000 from the NIH for commercialization, and it is working with a startup whose main mission is to commercialize Ozcan's technology. Once it does get mass-manufactured, Ozcan says the cost per microscope will be $10 to $15, a very affordable price for such a revolutionary tool.

"It’s a very exciting time for all the researchers who are aiming to provide new solutions for global health with cell phones and computers," says Ozcan. "They are creating a very interesting toolset for us to do cutting edge science and engineering at a fraction of the cost."

What other mobile innovations have you seen in health care? Let us know in the comments.

Series Supported by BMW i

The Global Innovation Series is supported by BMW i, a new concept dedicated to providing mobility solutions for the urban environment. It delivers more than purpose-built electric vehicles; it delivers smart mobility services within and beyond the car. Visit bmw-i.com or follow @BMWi on Twitter.



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Images courtesy of iStockphoto, milosluz, DNY59, and Josh Nesbit, Medic Mobile, Ozcan BioPhotonics Group at UCLA