Global Community Healthcare: Taking Health Technology Local

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In making tough decisions about healthcare it's important to have the right information and technology is giving us information, it's giving us more reliable information in real time. So the ability to use technologies to respond to crisis quickly and in more effectively whether it be a new outbreak in the community or whether it will be crisis a patient may have in their home with to a cardiac problem, I think what I'm excited about is the ability to intervene more quickly and more efficiently and earlier in a process.

It's not a completely preventive approach, but we're pushing that definition a little bit as we push the cost of care down as best as we can, push the point care out to the community. I was telling somebody recently in my own experience I use technology all the time to teach students all over the world, but when I want to teach how to care for patient at the bedside, I have my new screen rule, so when we go into a patient's room, with the students and the residents, I tell them all the screens get turned of, it's eyes on the patient, hands on the patient.

We don't want to have technology interfere with that trust. When I think about what matters is what's really killing people and when we think about children in the world less than five years old of course it's diseases of childhood vaccines propounded diseases like diarrhea and pneumonia, it's what we worry most about.

We also worry most about the health of their mothers so, maternal health issues and surviving child birth is a major challenge still. That's an example for instance of a challenge that's tough, you can't really fix that with a vaccine. To deliver a healthy baby and have a healthy mother, requires a trained healthcare provider.

Someone told me recently we spend 60% of our health dollars on the last six months of life. That's a choice, certainly not a choice a lot of other communities and societies either can or be willing to make. They choose to spend the resources more on preventative care, on helping mothers deliver the babies because that's their major challenge so, I think it's all about the choices we want to make as a society.

They're not easy choices, we're used to having these options, but I think it's maybe that's the lesson we can learn from other places. One of the things that happens is that, if you have a community that has few healthcare providers, don't have enough doctors and nurses, the ones that are there have to do more, and they have to become experts in everything.

So, a community health worker in a village in Africa has to be able to help deliver baby, deliver vaccines, treat malaria, treat HIV/AIDS, tuberculosis, and then maybe even hypertension over the next 20 years. So, finding ways to help those providers become able to multitask, it's really changed the way we view how we educate people.

If you look what happened in the United States, social media and access to the internet, it's breaking down the barriers between patients and providers, our patients are much better informed often because they are part of this community of patients, so they come into our offices asking a lot more questions and different questions than you would have 20 years ago.

So that's certainly going to happen in Africa, and I think that's a potentially powerful thing, if you empower patients, if you empower the community with information, they're going to be demanding better services and better health outcomes from their own governments, from their own community programs and hospitals and clinicians.