Doctors Ren Nianbao and Xie Guangguo have worked at the Lang Mao Shan Clinic in rural China for 20 years. Approximately one-fifth of their patients suffer from cardiovascular diseases (CVDs), one of the leading causes of death in China. In the past, the clinic relied on a conventional, 12-lead electrocardiogram (ECG) machine to screen for CVDs. The large, cumbersome machine and lack of specialist care in rural areas makes it less likely that patients with risk of acute CVD are screened, diagnosed and treated properly.
To help Dr. Ren and Dr. Xie better serve their patients, Qualcomm Wireless Reach and Life Care Networks collaborated on the Wireless Heart Health program to deploy mobile broadband-enabled ECG-sensing smartphones to conduct quick and accurate heart screenings as well as to connect community health care providers to heart experts at the Life Care Networks Call Center in Beijing for consultation. It takes less than five minutes for specialists at the call center to send back diagnosis and treatment recommendations.
Recently, I spoke on a panel at the Aspen Network of Development Entrepreneurs (ANDE) Metrics from the Ground Up 2016 conference in Washington, D.C. and presented this program as an example of how Wireless Reach uses monitoring and evaluation (M&E) to catalyze small and growing businesses. Diana Harbison, Director of the U.S. Trade and Development Agency’s Office of Program Monitoring and Evaluation, also participated in the panel. Genevieve Edens, Impact Assessment Manager for ANDE, moderated the session.
The Wireless Heart Health program aims to decrease CVD morbidity and mortality in rural, at-risk areas in China. Since the program’s implementation in 2014, 600 doctors and staff have used the ECG-sensing smartphone system, and more than 160,000 patients have benefitted from it.
This is all solid data, but to help ensure the program’s sustainability and develop a strategy for scaling the business model, we needed insight to the end-user experience. So in fall of 2015, with help from Vital Wave, Inc., we designed and implemented a use and satisfaction survey that asked questions such as: Does the device improve providers’ and patients’ experience? Are quality of care and doctor-patient trust improved by connecting rural providers and patients to experts via remote consultation?
The results showed that health care providers are very satisfied with the ECG-sensing smartphones and believe they are providing improved care and services to patients with CVD. These are some of our key findings:
- 97 percent of providers believe the ECG-sensing smartphone is more or equally reliable as the conventional machine.
- 78 percent believe their recordkeeping improved since they began using the ECG-sensing smartphone.
- Two-thirds of providers examined more patients than before by using the ECG-sensing smartphone, while around three-fifths report making more CVD diagnoses using the device and said the call center increased the accuracy of their diagnoses.
- Providers suggested some advances for the next iteration of devices, including more sensors for more leads (77 percent) and improved wireless connectivity (67 percent).
We also found that the cost reductions (US$0.43 for a smartphone ECG vs. US$5.19 for a conventional ECG) are a huge benefit to patients. These cost reductions, combined with the significantly improved quality and mobility of care show the potential for mobile broadband technology to create a sea change in CVD care across China.
Based on the data, we recommended that Life Care Networks create a sustainability and scale-up strategy that includes: 1) providing enhanced training for providers and education for patients, 2) furthering research and development on the sensors, 3) conducting periodic surveys to create feedback loops with providers, and 4) deepening collaboration with operators on improving connectivity.
We are truly excited that these research findings highlight the program’s success in supporting providers and government agencies to address the rising health burden of CVD. We hope that our M&E program’s recommendations will inform decisions on scaling Wireless Heart Health, giving more rural residents in China unprecedented access to specialist CVD care right in their own backyard, one mobile connection at a time.