I just watched this YouTube video showing Dr Elizabeth Cote in Haiti with the Harvard Humanitarian Initiative and I found it a thoroughly ineffective use of mHealth technologies.
I found out about the video from a couple of rather glowing media accounts:
The situation in Haiti is in the most terrible state (at 1am this morning I heard directly from a Doctor who has arrived out there on a humanitarian effort) but is this the best that the Harvard Humanitarian Initiative can do? Why is no one challenging the value of what is being done here?
Before I made this post I questioned whether this was some uncoordinated activity by a member of staff – but no it’s to be found prominently listed on their news page:
So here I take a quick look at the issues as I see them (and please feel welcome to add your own thoughts in the comments):
What autonomy does a patient in a Red Cross shelter really have? Does the patient know what YouTube is? Does the patient know that Dr Elizabeth Cote will be sharing images of her and her personal data with a global audience?
I accept that if I was in this patients situation I’d probably have the same indifferent attitude and wouldn’t care about these small details… but this video shows a failure in the duty to care for this patient and a lack of respect for her dignity.
Apart from proving that you can collect data on an expensive mobile phone what benefit does this Doctor think there is from doing this activity? Why not spend the time/resources examining or treating patients? Cleaning the wound and changing her bandage? Failing that why not “talk to the patient”? Is this the best utilisation of a front line Doctor?
It always amazes me to see how hard it is to shift our first world mentality: Why isn’t the patient entering their own information? Do we think they are Poor AND Stupid?
What is the value of this information? Why aren’t they asking where did you live? Where are you living? Was your home knocked down? Do you still have a home?
I’d love to write about the clinical merit of this mHealth intervention but I’m sad to say I can’t see anything being actually done.
I’m not saying that everything being done in Haiti should be entirely altruistic, but the self serving nature of what we see in this video leaves me feeling that this is merely a Doctor proving something can be done. Trialling this technology in such a high profile disaster area doesn’t appear entirely ethical particularly in light of the myriad of other much more pressing and basic medical problems eg. Clean water, sanitation, shelter, food, clinical treatment etc.
Everywhere I look these days it seems the iPhone has invoked an “Emperors New Clothes” response from the media, sadly as this example demonstrates this is also now being perpetuated by Healthcare reporters. Amazingly there is no mention that this Doctor comes from a developed country (that has a $2.5 Trillion healthcare industry in which less than 25% of Doctors are using computers) and is using a $1000 mobile phone to document a few $’s worth of “care”.