Public health initiatives are few are far between in Pakistan. You hear a few whispers of a national health scheme here and there and NGOs and charities do what they can but the magnitude of the problem far exceeds manpower and funding available. Disruptive innovation in healthcare exists which yields massive data for historical trends and future prevention and combines greater efficiency and economical access to tests and results. If the healthcare professionals know more, faster, they can do more, better.
iSTOC was created by former Nokia Health employees. Together, they developed an app that analyzes blood samples for infectious diseases like HIV and Hepatitis. The biggest challenge in blood tests is the time and cost factor; it takes too long and costs too much. While they succeeded in establishing themselves in 2012, they had to go through a lot of red tape such as European Conformity (CE) standards and the Food & Drug Administration (FDA) as well as the patent office. Umair Azam stumbled onto them when they launched their program in 2016.
Azam is the founder and managing partner of Integration Xperts, a company that provides technology solutions to its clients. Together they approached Secretary of Health in the Sindh Govt, Fazlullah Pechuho who was appreciative of their efforts and allowed them to set up the technology in a testing capacity within the province.
WHO Rapid Test Kit
The basis of the initiative is the Rapid Test Kit issued by the World Health Organization. The kit allows rapid blood tests to identify diseases visually, which has a human error of 20%. To improve this, the app made by iSTOC digitizes the process.
The Rapid Test Kits are now tagged via QR codes specific to the disease that is being tested for so that the app can automatically scan them and search for that particular disease in the blood sample. The Rapid Test Kit takes approximately 2 minutes to take the blood sample and test it. The smartphone app then analyzes the blood sample and identifies the disease markers within 30 seconds. It records the test along with the patient’s personal details and uploads it to a local database. This record can be linked to the NADRA database as well.
After the test, the app connects to a physician that can offer feedback. This can be a suggestion for further detailed testing, for medicine and nearby clinics or hospitals that can provide the best treatment. The blood sample report is printed on the spot and handed over to the patient.
The app is designed to gather bulk data to help identify at-risk areas. The success of the app is based on big data. It creates heat maps where a large concentration of individuals having a specific disease such as HIV or Malaria are, to track for treatment and help with future prevention. The app is tuned to scan for Malaria, Dengue, Chikungunya, Hepatitis B, Hepatitis C and HIV. If an area is identified as at-risk, the app can signal for an emergency response. This helps to arrange real time dispatches and rapid mobilization of response teams.
Umair says, “Urban areas such as Karachi are most affected by Dengue, Malaria and Chikungunya while the rural areas in Sindh are mostly affected by HIV and Hepatitis B and C. These markers help to send out warnings for the surrounding population to take precautions.”
The app has also tested effectively within prisons. “Across Sindh, approximately 1200 prisoners are brought into jail every month. The app will allow testing upon admission so that in case of a positive result for any disease, the prisoner can be isolated from the rest of the group.” To give you an idea of the present scenario in Sindh, there are 20,000 prisoners in Sindh housed in 25 jails and there is only one lab which allows for tests which is in Karachi.
At the moment this is a pilot project. Almost 125,000 people have been tested within the province, which is less than 1% of Sindh’s 48-50 million population. Umair believes that this number has to grow to at least 10% before any significant insights can be gained from the data. However, he believes that the simplicity of the technology and support from the provincial government will allow this initiative to have a great impact on healthcare.