Urban E-Health Project in Rio de Janeiro

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Information about Urban E-Health Project in Rio de Janeiro
Health & Medicine

Published on March 10, 2014

Author: stellarm_13

Source: slideshare.net


This is the pilot project of using ICTs to help people from the under-served areas in the world.

URBAN E-HEALTH PROJECTSanta Marta Community, Rio de Janiero


BACKGROUND • Low and middle-income countries are urbanizing rapidly • More processed foods, less exercise • Shift from communicable disease to non-communicable diseases • Communicable Diseases • Malaria, TB, Hepatitis • Non-Communicable Diseases ( Chronic ) • Long duration and not passed from individual to individual • Cardiovascular, Cancer, Respiratory Diseases, and Diabetes • In 2007, 72% of deaths in Brazil

STATISTICS • 1980 – 2008, 10-year increase in life expectancy of every baby • At 2050, life expectancy of every baby in Brazil is 81 • In 2005, 15% of Brazil’s population were 65 years old and older • At 2050, they would be 55% of Brazil’s population • Higher demand for health services

WHY RIO DE JANIERO? 1. A rapid-aging population • Highest ratio of elderly population 2. Changing dietary habits • Obesity also targeting the poor • Chronic diseases on poor neighborhoods 3. Public heath-care that are adjusting 4. Rise of real-estate prices • For new hospitals 5. Prevalence of underprivileged urban areas • 22% or 1.4 Million, Little or no access to healthcare

WHY SANTA MARTA? • Transportation is a problem • Slow and overcrowded cable car • Nearest public hospital, 6 km from Sta. Marta 1. Pacification Program • To reduce high level of violence and crime 2. Saude Presente ( 2009 ) • Expand health services to remote areas • Currently, Santa Marta’s Family Clinic • 1 doctor, 1 nurse, 1 nurse technician, 2 oral health teams, 6 community heath agents ( INFOMEDIARIES )


SCOPE • The Pilot Program • Portable e-health kit for Santa Marta’s Family Clinic • Measurements of blood pressure, glucose level, quickly and efficiently • Backpack can be transported easily • Can e-health technology reduce the cost of healthcare in a previously underserved community? • Does e-health technology help overcome barriers to healthcare in this type of community?

SCOPE • Directly addresses the gap in access to public services • Accelerates the process of health care


OBJECTIVES 1. Address current and future health challenges affecting major emerging cities 2. Tackle the economic, social and physical barriers to healthcare for underserved communities 3. Develop a new economic model of healthcare


TASK FORCE MEMBERS • The Pilot Project 1. City of Rio de Janeiro 2. Support of the Municipal Secretary of Health 3. GE • Founding member of the New Cities Foundation • Technology, strategic and financial support 4. Cisco 5. Department of Clinical Medicine at the State University of Rio • Independent research team


TARGET POPULATION • Elderly inhabitants of Santa Marta 1. Quality of Life 2. Good Nutrition 3. Physical Exercise 4. Rehabilitation • 100 patients over the age of 60 • Data collection: 7 months • August 2012 – March 2013


E-HEALTH BACKPACK • Problem • No equipment for blood analysis • Chronic diseases cannot be detected • Solution : E-Health Backpack • Detect an average of 20 diseases in minutes • Nurses can perform in-home visits • Cost : USD $42,000 or Php 19 000 000.00

E-HEALTH BACKPACK V-Scan • Pocket-sized ultrasound device for obstetric, abdominal and heart tests

E-HEALTH BACKPACK Tuffsat pulse Oxymeter • Blood oxygenation and heart rate

E-HEALTH BACKPACK Electrocardiogram • Electrical activity of the heart Picture taken from : sanwinmed.pp.alibaba.com

E-HEALTH BACKPACK Accutrend blood monitor • Monitors glucose, cholesterol, and triglycerides level


E-HEALTH BACKPACK Scale • Assess bioimpedance, weight, fat, and hydration • Bioimpedance – response to external electric current ( blood flow, fat content )

E-HEALTH BACKPACK Blood pressure monitor



TRAINING AND OUTREACH • The Team • 4 Doctors • 1 Nurse manager • 3 Nurses • 3 Nurse technicians • Doctors • Trained to use the V-Scan • Interpreting data collected from the backpack



DATA COLLECTION • 30 weeks of Data Collection • 200 visits with backpack • 6.6 visits per week • To diversify the data pool, the study included: • Pregnant women • Patients under 60 • Patients with disabilities



RESEARCH METHODOLOGY 1. Is e-health cost effective from the public healthcare perspective? • Economic Benefits • Based on the avoided hospitalizations • If patients condition can be prevented from advancing to the next stage • Avoided clinical outcomes

RESEARCH METHODOLOGY 2. Does the pilot improve access to healthcare services for underserved populations? • Clinical Impact • Patients in the pilot VS a control group • Difference in healthcare costs

RESEARCH METHODOLOGY 3. What is the end-user experience? • End-user Satisfaction • Patient’s and clinical staff’s satisfaction with the backpack • A questionnaire was used to survey the users


RESULTS Economic Impact • Significant positive impact • In-home visits were enhanced with the E-heath Backpacks • Early detection of chronic diseases • USD $200,000 per 100 patients per year • Decrease severity of cardiovascular illness • Reduction of 360 hospitalizations per 1000 patients • USD $135,876 per 1000 patients per year

RESULTS Clinical Impact • Lower prevalence of clinical conditions VS historical control groups

RESULTS Social Impact • Majority of the patients and health workers : POSITIVE • Reduction in time for medical results

RESULTS Terrible Poor Neutral Good Excellent Not Evaluated

RESULTS Terrible Poor Neutral Good Excellent Not Evaluated

RESULTS Terrible Poor Neutral Good Excellent Not Evaluated


CHALLENGES 1. Delays • Authorization process • Completion of the E-Health kit 2. Technical • Need for a medical specialist to interpret images 3. Process • Breaking the routine, using the backpack 4. Data Collection • Slow at the early stage because of the 3 previous challenges



CONCLUSIONS 1. E-Health kit benefits the patients as well as the healthcare professionals 2. Morbidity reduced for chronic disease suffering patients 3. The e-health project is worth the investment 4. High tech innovations can be used to improve healthcare in underserved communities

RECOMMENDATIONS 1. From m-health to e-health • Full potential of the backpack should be utilized • Use wireless technology within the backpack 2. Expand the type and location of patients • Other communities with fewer health services 3. Extend the analysis of measurements taken • Cost saved for patients ( fare, etc. ) • Carbon emissions reduced • Add another team member : social scientist

SOURCE New Cities Foundation (2013), An Urban E-Health Project in Rio, [online] Available: http://www.newcitiesfoundation.org/wp-content/uploads/PDF/Research/New-Cities- Foundation-E-HealthFull-Report.pdf


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