Tuesday, 24 February 2015

Telehealth Can Make a Difference in Bangladesh

Appdragon is about to launch its SmartMed HomeCare telehealth service into Bangladesh after several month's of successful piloting.  Telehealth services can make a real difference in developing countries like Bangladesh, where mobile networks are typically much better than fixed telephony networks, with greater reach and data rates.  This is generally because of foreign and local government investment in what is regarded as one of the key infrastructure components, but also because there are relatively fewer and smaller copper wire networks to maintain, so funding can be directed straight at the newest mobile technologies.  Also, mobile network infrastructure is less costly and quicker to deploy, requiring less below ground work and cable laying.

The availability of mobile technology isn't the only factor that makes Bangladesh the perfect place to deploy telehealth solutions though.  You only need to look at the demographics of the country to realise that the provision of suitable healthcare, to all, is problematic.  There is a total population of 156.6m with an annual growth rate of over 6%.  However, life expectancy isn't on a par with other developing nations at 69 years for females and 71 for males.  This means a larger middle and old-aged population, a group of society who are traditionally heavy users of health care services.

Then consider the geography.  There are several major cities, with Dhaka the largest of the all counting for about 7m people, with a total of 29% living in urban areas. This is low compared to the region where the average is 34% and globally the average if 54%. This all means a large majority of the population are spread out across the rural lands, with relatively poor transport connections and challenging terrain including mountains, rivers and jungle.  Getting to and from hospitals which are entered around the big four cities is therefore challenging, time consuming and expensive.

If we look at the availability of health care professionals in Bangladesh, again the stats suggests a very strained infrastructure with only 3.6 physicians per 10,000 people (the regional average is 5.9 per 10,000).  Nurses and midwives are even more scarce at 2.2 per 10,000 (15.3 regional average).

High blood pressure affects 27% of those aged 25 and over, higher than the 25% regional average.  9.9% of females (9.8% of males) have diabetes, again higher than the regional average. In real terms, that means that over 42m people have blood pressure issues and around 30m have diabetes related health issues.  Obesity, though relatively low compared to the West (just 1% of the population are affected) is growing at an alarming rate and 1% still means 1.6m are overweight to an extent where it can affect their health (source: WHO website).

So we have the factors that lay the foundations for the need for telehealth: 1) good technological infrastructure, 2) poor transport infrastructure, 3) a large, dispersed rural population and 4) significant health problems and 5) very low availability of health services and qualified clinical personnel.



SmartMed HomeCare will start to address this by enabling patients, initially in the suburbs of the major cities, to monitor their own conditions from home whilst SmartMed's qualified physicians monitor the patient's progress remotely from the Dhaka based SmartMed Telehealth Centre.

This not only means the patient doesn't need to struggle across the busy, traffic choked city to attend a clinic thereby improving their quality of life and reducing the strain on busy clinics and hospitals, but it also means more regular checks and timelier interventions.  Ultimately this will result in fewer escalations and complications of the illness, requiring less in- or out-patient attendances.  

In Bangladesh we have teamed up with local, well-respected doctors who were trained in the NHS in the UK but have practiced in Dhaka and Bangladesh for many years.  Our intention is to use local knowledge and expertise to deliver services usually reserved for the wealthier end of Western society to as many people as possible across Bangladesh.

Our next launch will be the HealthWorker proposition, which addresses the needs of the 300,000 or so community based healthcare workers across the country.  Providing them with SmartMed's Android based apps and Bluetooth medical peripherals will allow them to see more patients in a shorter space of time, have qualified, experienced clinicians analyse the results and advise them on any interventions and it will enable them to deliver a broader level of services, addressing a greater number of illnesses and conditions.

It's clear that telehealth isn't the ultimate solution to healthcare problems in the developing world but in Bangladesh, we sincerely believe that telehealth and SmartMed in particular will make a big difference to the quality of care many thousands (and hopefully millions) of people can receive. Wherever they are...

For more information on our Bangladesh offerings, please visit our localised web-site at www.smartmedbd.com or check out or video of how SmartMed HomeCare works in the UK market .


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