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Kanav Kahol, an expert on biomedical informatics, quit his teaching job in the US and came back to India to create a technology that would help the poor. He works with the affordable health technology department of non-profit Public Health Foundation of India and has recently created a new device called Swasthya Slate (health tablet-cum-app). It contains several health monitoring functions and can be used to monitor health in rural areas. Kahol talks to Dinsa Sachan about his latest innovation
How did the idea about Swasthya Slate occur to you?
When I landed in the country last year, I found most work in rural health technology was around telemedicine, creating electronic records and restructuring existing software for video-based interactions. In my several consultations with healthcare workers from Himachal Pradesh, Odisha, Andhra Pradesh and Karnataka, one thing was common: they all wanted systems that could help them perform better in their jobs. During consultations I found a major gap. There were no point-of-care diagnostics. If well-designed point-of-care diagnostics are available, rural health workers like ASHAs (Accredited Social Health Activist) and ANMs (Auxiliary Nurse Midwife) would be able to perform basic diagnostics in the village itself and give primary healthcare to people. This was the starting point for the Swasthya Slate.
What are the components of the Swasthya Slate and how does it work?
The Swasthya Slate or health tablet comprises sensors that detect physiological functions. It also contains software for patient records. Peripherals include digital thermometer, water-quality metre, three leads for ECG and heart rate sensor. The measurements taken by the sensors are sent to an android device using a Bluetooth connection. So, this is a purely wireless system. Swasthya Slate application also allows the healthcare worker to take demographic details, clinical information as well as the vitals of the patient. These can be stored in the tablet and uploaded to a central server when the Internet connection is available. This allows for remote monitoring and telemedicine applications.
Are you confident about the accuracy of your device?
While designing we have followed a well-defined scientific framework. We did compare the readings of high-end machines with our tablet. We found the readings were 99.94 per cent similar. We also tested the accuracy of the slate in labs. Swasthya Slate was able to achieve 99.93 per cent accuracy in experiments as well.
Does using a tablet require some proficiency with computers? Most people in villages are not computer literate. How will your device be of use then?
This is a major assumption which I have found not to be true. People will learn anything which adds value to their life like mobile phones. In our pilot study in Odisha, we found that the healthcare workers were able to learn how to use the system in five minutes. Usability was a major goal of our development and the pilot studies have shown that our goals are likely to be met.
What has been the outcome of your pilot studies?
We did some initial usability tests in Odisha and will continue to test this in Jammu and Kashmir, Andhra Pradesh, Punjab and Himachal Pradesh. Outcomes have been very encouraging in terms of systematic changes this device can bring. Reporting functions like loading data quickly in an automated manner on which otherwise ASHAs waste so much time have been appreciated and so has been the ability to offer diagnostics on the spot. We have also had good feedback on robustness and reliability of the device. One demand has been to add more diagnostics. The enthusiasm for use is very high. We will require more time to measure the impact at an epidemiological level.
Have you spoken to the government about incorporating the tablet into the health system?
We are in talks with state governments as well as the Centre. Initial response has been good. Our plan right now is to finish the blood pressure and blood sugar software in multiple languages. Then we will test the system focussing on maternal and child health. We want to finish all the work in six months and the device should then be ready to be commercialised.
What is the cost of the project?
Development costs have added up to around Rs 5.5 lakh. Cost per tablet is likely to be around between Rs 4,000 and Rs 7,000.