Oct 25, 2011 9:48 PM GMT
While others struggle to find jobs, it's highly admirable that those like Josh Nesbit - aged 24, create their own and have the potential to make a massive difference in the quality of life for millions.
There are now more than 5 billion mobile phone subscribers, and 90 percent of the world’s population is covered by a cell signal. Josh Nesbit, the 24-year-old CEO of Medic Mobile, is on a mission to use these far-reaching networks to change how patients and doctors interact. Can low-tech SMS programs revolutionize global health?
Josh Nesbit sees a bright future for the cellphones that most of us see as antiquated. The 24-year-old Nesbit is the CEO of nonprofit Medic Mobile, and this startup exec’s vision is to take those chunky Nokias and other phones of the recent past—the kind that most Americans threw out or relegated to the junk drawer long ago—and use them to radically change how health care is delivered in developing nations.
These old phones don’t have the touchscreens and slick software features of our shiny new smartphones. But they can text, and in Nesbit’s eyes, a simple technology like text messaging is a tool that can be used to track disease outbreaks, help first responders quickly locate victims after disasters, and more.
Nesbit and I first met on a drizzling Tuesday morning in New York, as he was getting ready to deliver a presentation to the United Nations Foundation’s mHealth Alliance about mobile health—more specifically, on what he calls the calls the marriage of “techies and healthies.” He knows that SMS and SIM card applications are not sexy technologies. For him, though, it’s the numbers that are so attractive. There are more than 5 billion mobile phone subscribers across the globe, while 90 percent of the world’s population is covered by a cell signal. In sub-Saharan Africa, an area plagued by public health woes and a lack of infrastructure, 50 percent of people now have access to a cellphone. Within two years, if not sooner, that figure will jump to 100 percent. “Ubiquity is the killer app,” Nesbit says.
The notion that SMS could revolutionize healthcare first entered Nesbit’s mind in 2007, when he was still a Stanford undergrad. He’d just met Dickson Mtanga, a community health worker in rural Malawi who was walking 35 miles to deliver handwritten patient charts to the nearest hospital. Nesbit biked out to Mtanga’s village one day, only to discover that his cellphone got a better signal there than it did on Stanford’s campus in Palo Alto, Calif. All those bars of service jumped from the phone’s screen and slapped him across the face: These far-reaching GSM networks, he realized, could connect doctors and patients like never before.
Armed with a $5000 grant, a backpack full of old phones, and a laptop running a GSM modem and the open-source group-texting software called FrontlineSMS, Nesbit started working with the hospital and community health workers to coordinate patient care. The system they put in place allowed Mtanga and others to text in the information on those medical charts rather than making the hours-long trek. Patients could text their symptoms to doctors, cutting down on unnecessary visits for minor ailments and freeing up space for those in need of serious care. Within six months of the system going live, the number of patients being treated for tuberculosis doubled, more than 1200 hours in travel time were eliminated, and emergency services became available in the area for the first time. The operating costs in those six months: $500, Nesbit says.
Malawi was the proof-of-concept he needed, but another challenge soon followed when a massive earthquake tore apart Port-au-Prince, Haiti, in 2010. Nesbit knew that group-texting could support the relief effort. Within a few hours, working with the U.S. State Department and with mobile operators in Haiti, he secured 4636 as a short code that any victim could text for free to request assistance.
The messages started coming in—but a tad too fast. “If you tell people to text their name and location, you’re going to get free-form messages in mostly Haitian Creole with vague references to locations,” Nesbit says. In order to help decipher these urgent texts requesting search-and-rescue teams, more water, or any number of other needs, Nesbit and his team recruited an army of 2500 volunteers over the Internet who spoke Haitian Creole and knew the logistics of Port-au-Prince. “They were essentially mapping, categorizing, and translating every single one of those texts, and we ended up processing 80,000 messages in the first three weeks after the earthquake.” When Nesbit’s team got actionable info, they forwarded it to the U.S. Army’s forces on the ground.
Volunteers came through to decipher messages in Haiti, but it’s unrealistic to rely on the good intentions of strangers as a filter for hundreds or thousands of texts. To improve how it processes texts, Medic Mobile recently handed a computational linguist at Stanford six months of free-form texts between community health workers and physicians in Malawi. The linguist developed an AI method that could differentiate the type of requests and then bump the most urgent messages, such as someone in need of emergency treatment, to the top of the queue for when the doctor checked the messages. It auto-categorized the messages with a 98 percent accuracy rate, even when words were misspelled, punctuation was erratic, and different dialects appeared.