Bench Press

Singapore is a fascinating country – despite the lack of what most in the West would recognize as democratic freedom, it consistently ranks well in terms of lack of corruption and high and growing standard of living for its people.

It is also one of the boldest when it comes to instituting policies and reforms: they were the first to implement a congestion tax to help manage traffic. Unlike most countries, Singapore is open to competition and investment from foreigners in strategic areas like telecommunications, power generation, and financial services. Singapore has also been extremely active in attempting to build up its capabilities as a center for life sciences excellence.

So it shouldn’t surprise me that they are among the first countries to actively utilize social media applications like Facebook and Twitter to help deal with a public health risk like Dengue Fever (from The Jakarta Globe):

The city-state’s National Environment Agency (NEA) plans to roll out … providing information on the latest dengue clusters or areas that have been earmarked as high-risk – on these new media platforms within the next three months … Through Facebook and Twitter, the public will also be able to post feedback or provide tip-offs. For example, if Singaporeans notice an increase in the number of mosquitoes in your neighbourhood or find potential breeding sites, they can alert NEA officers by posting on the agency’s Facebook page or tweeting the NEA account. “We need to put more information out in the public space, so more people can be informed and take action,” said Derek Ho, director of the environmental health department at NEA. “Leveraging on new media channels such as Facebook and Twitter is a good way to do that.”

A refreshing understanding of the uses of social media by a government agency – more interesting than that, though, is the work Singapore’s NEA is doing to build image recognition capabilities into smartphone apps like the NEA’s iPhone app to help field workers (and potentially the public) track and identify mosquitos and mosquito larvae!

The NEA is also in the process of developing a mosquito-recognition program that can identify the species of mosquito from a photograph of its pupae or larvae. With such software, and with the help of a mini microscope that attaches to the camera on a personal digital assistant or cellphone, NEA officers will be able to take photographs of larvae or pupae found in mosquito-breeding sites and instantly find out if they belong to the Aedes species, which spreads dengue … When it is ready, the agency hopes to be able to integrate it with the NEA iPhone application, so that the public or grassroots members conducting checks around the neighbourhood can use the technology as well.
Early identification will allow the NEA to act more swiftly to curb the spread of dengue in potential high-risk zones.

Very cool demonstration of the power of smartphones and of a government that is motivated to try out new technologies to tackle serious problems.

With smartphones becoming more sophisticated and more popular, its only natural that there are a growing number of attempts to use them as a platform for scientific inquiry (pocket ultrasound, microscopy, and astronomy for example). This is especially useful in developing countries, where a relative lack of high-end computers and fixed broadband access make smartphones a very suitable alternative to the more expensive, bulkier solutions that are used in the developed world.

It should come as little surprise, then, that doctors in India are helping to pioneer a new “telemedicine” tool using the camera and processing capabilities of Apple’s popular iPhone to do remote diagnosis of Retinopathy of Prematurity (RoP), a condition which is more likely to afflict infants born underweight. While curable, RoP needs to be treated within days of detecting it as to prevent permanent damage to a child’s eyes, something which the iPhone’s camera, mobile broadband, and robustness of software and security platform allows pediatric eye surgeons to diagnose from remote locations, hundreds or even thousands of miles away.

But, the potential of smartphones to function as a tool for tele-medicine can probably go far beyond this. At least, that’s what i2i TeleSolutions, an Indian-based startup, is betting on. They provided part of the software solution for the RoP diagnosis tool, and are aiming to provide software and services to enable further telemedicine technology – mainly:

• Security – It is important that sensitive medical information is transmitted securely in a way such that only the appropriate medical professionals see the information.
• Data compression – As fast as 3G and the new LTE networks are (and will be), network coverage and data transfer rates will continue to be a limiting factor on the adoption of telemedicine. As such, a true telemedicine solution will require lossless compression techniques.
• IT support – Medical organizations are not especially well-suited for building sophisticated IT capabilities, nor do medical professionals necessarily have the time to learn an arcane user interface. For that reason, telemedicine solutions should aim to provide web-based access methods (in addition to any non-web based methods they may choose to push) to access and react to data.

i2i provides further details on the scope of their platform on their web page, but I think it represents a strong start for a solution. Going forward, I’d like to see them (and any competitors that emerge) provide support for:

• Additional types of data – i2i’s focus seems to be primarily on images, but the full range of capabilities on smartphones is massive – GPS, accelerometer, magnetometer, and even microscopy and other medical attachments – and I would hate to think that tele-medicine would be limited only to its imaging capability
• Deployment on more phones – The iPhone is unique in the maturity of the platform, but it would be nice to see similar applications on other operating systems like Android, Symbian, and Windows Mobile.
• Interactivity – The i2i platform appears to be very unidirectional: (1) take a picture, (2) send it to a remote surgeon. I think the true promise of telemedicine is something which allows for a greater level of flexibility and interactivity on both ends (to refine the view, or make a suggestion on some other place to scan, etc).
• Ability to tack on analytics – There is a significant amount of medical data that needs to be analyzed/processed before it can be acted upon. Building some sort of open protocol or extendability (a la Firefox or Salesforce or LinkedIn/Facebook model) would do a great deal towards enhancing the potential of a telemedicine platform

Anyone else have any other ideas?