A mother in Tanzania walks for three days with a sick child on her hip, only to arrive at a rural clinic whose inventory of malaria medicine is depleted.
It's a matter of life and death for the mother and child. But from a business standpoint, it's a straightforward supply chain issue. Antimalarial medicines -- with a 96% cure rate -- are available. Yet far-flung clinics have a hard time keeping them in stock. Having adequate supplies when and where they are needed is critical, because the medication isn't fully effective unless patients take it within 24 hours of contracting malaria.
Novartis -- a company whose innovations include micro-chipped pills that can track whether patients take their medication on schedule -- resolved the crisis in Tanzania by relying on, of all things, SMS text messaging.
Similarly, OhioHealth in Dublin, Ohio, is using text messaging to deliver health and wellness information to patients subscribing to its OH Mobile app. The app can alert obstetric patients of upcoming tests and procedures or remind pre-operative patients to refrain from eating and drinking after midnight the day before their surgery.
"A very important component of patient care delivery is dependent on patient engagement. That idea and the fact that the vast majority of patients had smartphones gave us the idea for the app," says Dr. Mrunal Shah, vice president of physician IT services at OhioHealth. "We wanted something easily deployable and easily updatable," he notes. The result: "Patients are leaving wonderful feedback. They're just hungry for more information, which is a fantastic problem to have," says Shah.
Novartis and OhioHealth are among dozens of 2012 Computerworld Honors laureates that are leveraging low-cost, consumer-oriented technologies to create and deploy systems and applications designed to greatly benefit society, especially in the areas of education and healthcare.
The Computerworld Honors program, now in its 24th year, recognizes organizations that create and use IT to promote and advance public welfare. Award winners will gather at an event in Washington on June 4 to celebrate their achievements.
Read more about all 200 Computerworld Honors Laureates for 2012.
Necessity Drives Innovation
Usability and affordability are the heart and soul of these innovations, many of which are being deployed in poverty-stricken and remote areas of developing nations where life's basic necessities -- much less state-of-the-art IT and ubiquitous Internet access -- are not readily available.
But what is available is SMS, which in remote areas performs more efficiently than costlier, more complex options, according to Rob James, CIO at Novartis. Working with IBM and Vodaphone, Novartis IT came up with a simple idea: Have each remote clinic text four numbers, representing the inventory levels of four different medicines, to distribution facilities in major cities that ship supplies. The application is known as SMS for Life.
"The idea was to take that information centrally and look at inventory levels overall so we could do a better job of forecasting stock-outs," says James.
Initial results of a pilot test at 20 sites across Tanzania were daunting: More than 25% of remote facilities were totally out of stock on all medications.
"The good news is that once we had that data, we could reduce stock-outs to less than 1% in a very short time," James says. "That led to a rollout across Tanzania, then through Kenya, and we're now in the planning stages for Cameroon and the Republic of the Congo," he adds. Over the past decade, Novartis has provided more than 500 million malaria treatments for adults and children.
Developed by an IT team at Novartis, the SMS system comprises an SMS management tool and a Web-based reporting tool. The SMS app stores a single registered mobile phone number for one healthcare worker at each facility. Once a week, the system automatically sends a text message to each of these phone numbers asking for the current stock of medicines at their facility. Stock data is then returned using a short code number at no cost to the healthcare worker.
"This is one of those unique programs and one of our favorite programs in IT," James says, adding that everyone who worked on the project did so as a volunteer.
Low-Cost Literacy Tools
Keeping user costs low was also a major driver in the development of an application known as Mobile and Immersive Learning for Literacy in Emerging Economies, or MILLEE for short. Designed as a series of English literacy games that are played on cellphones, the application aims to improve English as a second language among poor children living in rural villages and urban slums in the developing world.
Matthew Kam started the project in 2004, when he was a graduate student at the University of California, Berkeley. When Kam moved to Carnegie Mellon University to become an assistant professor in human-computer interaction, he expanded the project with the idea of having students rewrite the software from scratch so that it would operate on very low-end cellphones.
"Before CMU, the application was running on higher-end phones," Kam explains. "What we were really trying to do with the expansion is to target the most affordable phones out there, so as to perform research pilots that reflect more realistic cost conditions. We were looking for the lowest common denominator," he says.
Specifically, Kam and his team were targeting Java Micro edition (J2ME) phones, which are significantly cheaper than high-end smartphones. Technical barriers included optimizing the application for use on low-resource devices with limited memory and organizing the English-language learning content, including graphics and voiceover files, on the phone's storage system so that file input and output remained efficient.
There were cultural challenges as well. The earliest game designs weren't intuitive to children in rural India.
"This forced us to take a step back and study 28 of their traditional village games and contemporary Western video games," Kam says. The analysis provided the team with a set of guidelines on how to design educational games for non-Westerners.
MILLEE team member Ashton Thomas, who graduated from CMU in May 2011, developed a game called Word Catch, in which a player is presented with an English word and four images, one of which corresponds to the meaning of the word. "You had to stop a ball over the correct image, and the speed of the ball would change. As the words got harder, the speed of the ball got faster," he recalls.
Thomas, who has since launched a fitness software company called Acrinta, recalls that one of the challenges for his MILLEE team was that it was geographically dispersed, with some members in India and others at CMU's campus in Pittsburgh.
"The time zone difference, the physical distance and the communication barriers were all challenges," he says. "The students in India would help maintain the code base and do some development. They would also take the phones and install the games and go to the learners to get feedback and relay all of that information back to us."
As Thomas sees it, one key to the value of the MILLEE project is that "it's a game, and as the students are playing, they're having fun." But he points out that the students are also learning, "and that is creating opportunities that could lead to serious social change" -- an observation confirmed in a recent report from the British Council, which estimates that the salary gap between professionals with and without English skills in some developing countries is as high as 20% to 30%.
Enabling a Livelihood
Improving the economic prospects of villagers in India is the goal of MicroGraam, a project that taps mobile and Internet technologies to enable urban professionals to find, select and provide microcredit to underprivileged borrowers in rural India.
MicroGraam co-founder Sekhar Sarukkai notes that the concept of microfinance isn't new. But as he and co-founder Rangan Varadan saw it, it could be improved.
"A few years ago, Rangan went back to India to run the banking and finance practice for Infosys, and he saw that microfinance was a great model, but borrowers were struggling," he recalls. "They had to start repaying the next month after they borrowed the money," he explains. But it could take several months before a newly launched venture paid enough to begin repaying the original loan.
The two men decided to apply the principles of venture capital to the microfinance market. Rather than having borrowers start to pay back their loans immediately, lenders would begin to receive payments -- plus an agreed-upon amount of interest -- when the new venture became more solvent.
The model required transparency between lender and borrower, which MicroGraam addressed by developing a marketplace platform using open-source technology, including integration with online payment gateways. A key feature of the system is that micro-fund transfer costs are less than 0.5%, compared to the industry-standard 5%.
"Complete transparency is one of the most important ways technology can help these low-cost transactions. But you need to do it in a very low-cost manner," Sarukkai notes. "Open source helps a lot. This is a fully open-source application."
MicroGraam lenders can search through a database that includes descriptions of borrowers, photographs, and information about the purpose of and terms of the loan. Lenders also receive updates about the progress of the businesses they fund. In addition, the system provides scheduled reminders to MicroGraam's nongovernmental organization (NGO) partners that administer the loans on the company's behalf.
"MicroGraam doesn't have any field offices, so we go to select NGOs who are already working in villages and partner with them so we don't have any overhead on our end," explains Sarukkai. "It's the NGOs that go and collect the money, so it's very important for us to have visibility into that."
What has become equally important is providing transparency to the borrowers. This is done via SMS technology.
"Borrowers are very interested in visibility into their progress, and almost all of these people have phones, because they are very low cost," he explains.
In the past two years, MicroGraam has facilitated 836 loans totaling about $230,000. The repayment rate is 98%. A woman in the province of Trichy in India, who borrowed 1,500 rupees (about $50) to buy a mixer to grind flour, is typical of MicroGraam's borrowers, who are mostly women.
"She started making batter and selling the batter to others in the slum," Sarukkai says. "You could think it's not a big deal, but by selling batter she was able to share in profits. It took her a year and a half, but now she gets more than 1,000 rupees a month from selling batter."
"It's amazing how $100 can change lives so substantially."