04 MarFiled under blog
I just returned from a long weekend in Palo Alto, my first face to face meeting with most of the FrontlineSMS:Medic team. It was fun! If you’re surprised that we hadn’t met in person before, you might be interested in how we learned about each other and decided to work together.
- Spring 2007: Josh Nesbit, an undergraduate at Stanford University, meets Ken Banks.
- Summer 2008: Josh begins using FrontlineSMS at St. Gabriels Hospital in Namitete, Malawi.
- Summer 2008: Lucky Gunasekara is working as a researcher in mobile and web media for a consulting company in Tokyo, Japan. In his free time reads about mobile phone penetration in developing countries and begins to dream of connecting community health workers and patients to electronic health records via SMS on mobile phones.
- Early Fall 2008: Isaac Holeman plans to work with a friend at a clinic in East Africa after he graduates from Lewis and Clark the following May. Having no clinical training but some tech experience, he begins planning to integrate OpenMRS into mobile phones using SMS.
- November 2008: Dr. Wayne Centrone of Health Bridges International wants to set up a health records system at their clinic in Peru and contacts Daniel Bachhuber (who has more tech experience) to ask for help.
- Daniel and Isaac are friends; they randomly share their ideas and decide to join forces under the name MobilizeMRS and apply for the NetSquared USAID Development Challenge. Their proposal is to merge FrontlineSMS with OpenMRS. Their project becomes a finalist.
- Early 2009: Through a series of emails and phone calls, Josh, Daniel, and Isaac team up.
- Josh meets, by chance at lunch, Lucky, who now studies at Stanford Medical School. Lucky joins the team, and invites his friend Nadim Mahmud to join on and help develop a 500,000 patient mHealth impact study in Bangladesh for the summer of 2010.
- Lucky is selected as one of 10 featured announcements out of 700 student commitments at the 2009 Clinton Global Initiative University. At CGIU, Lucky meets Ken Banks and pitches connecting FrontlineSMS, OpenMRS, and a revolutionary cell phone-based diagnostic technology, developed at UCLA. Ken agrees to formally give his support and former President Bill Clinton makes the announcement.
- February 23rd: They relaunch the venture as FrontlineSMS:Medic. The Medic team is currently beginning software development and already have firm implementation plans with over 15 partner clinics in Africa, Asia, and Latin America
Daniel and I both flew down from Oregon to Palo Alto on Friday, and got to know Josh, Nadim, and Lucky at a noodle bar down town. The real work began Saturday morning with a massive 11 hour team meeting. The five of us spent a lot of the morning working on our application for the Dell Social Innovation Challenge. That application is now posted, so we’d appreciate your feedback and your votes!
After a short break for burritos, we met with a handful of other Stanford med students to discuss our plans for the next year. We’re still working out the details about who will help set up where, and we decided it was useful to place the various upcoming implementations of FrontlineSMS:Medic into three categories.
Research Studies: These sites will conduct randomized controlled trials or prospective impact studies on a stable, accepted build of medic.
Innovation Pilots: These sites will innovate, experiment, and provide feedback on the latest features as soon as possible.
Implementer Partners: These sites will receive tech support, may receive hardware, and will have a FrontlineSMS:Medic team member on site for a short time or not at all.
We definitely have our work cut out for us with all these sites. We’ll introduce you to each project individually as things progress.
Technical details absorbed the next chunk of our meeting. Every exchange was good-natured, and yet the rapid back and forth was so intense it felt almost like an argument. For hours upon hours. I thought many times of something Clay Shirky recently said about innovation: “Don’t look at crowds and don’t look at individuals, look at small groups of smart people arguing with each other.”
Our discussion of features and interfaces led us to be empathetically and anthropologically about the community we hope to serve, and it exposed a truth that had quietly undergirded many of our earlier conversations. We are taking a grass roots approach to scalability. Many people will read the word “scalability,” and think of massive, efficient hospitals serving many hundreds of thousands of patients. They might think of organizations that have a large, university trained technical team to work on medical informatics. That’s scale, right? In contrast, by focusing on grass roots scalability we are thinking first and foremost about the small or medium sized clinic or hospital where perhaps no one has an awful lot of training with technology. Most of them will find one computer and some phones a lot less daunting than complex computer networks, servers, and complicated software installation. These organizations probably have just one person to work on medical informatics, and chances are this person is doubling as a TB officer, nurse, or janitor. If our project achieves significant scale, it will be first because we expand our simple approach to many resource constrained organizations, and secondarily because any one organization may implement FrontlineSMS:Medic at significant scale.
We’ll post more about the fruits of this discussion soon. In the mean time why don’t you check out Nadim’s post about the visit he and Lucky made to UCLA to discuss integrating FrontlineSMS:Medic with Professor Ozcan’s LUCAS technology.
Cross-posted at Isaac Holeman’s Weblog.