Tai­wan shares its health care know-how


Weekday morn­ings in Mthatha, a com­mu­nity on South Africa’s Eastern Cape, 40 health care work­ers em­bark on a jour­ney past fields and rugged cliffs. Their goal: to reach the small painted homes that sparsely dot the land­scape.

John­son Huang ( ), head of a Tai­wanese team that de­vel­ops mo­bile ap­pli­ca­tions for the con­ti­nent, said that find­ing the homes can be tough be­cause Mthatha has no road signs.

“For a com­mu­nity health worker go­ing into a fresh as­sign­ment, it can be hard sim­ply to lo­cate the pa­tients,” said Huang, who leads the re­search and de­vel­op­ment of a new por­ta­ble so­lu­tion.

“The no­ta­tion for a spe­cific home might be some­thing like this, ‘Go down along this road and then you’ll see a tree. Turn right at the tree and you’ll see a lit­tle vil­lage, and in this vil­lage there is one house that looks like that,’” he said.

The Com­mu­nity Health Care App

Like many res­i­dents in re­mote parts of the world, the peo­ple of Mthatha rarely visit med­i­cal clin­ics. In­stead, they rely on trav­el­ing healthcare work­ers for ba­sic ser­vices and re­fer­rals to hos­pi­tals when their con­di­tion is se­ri­ous.

In a pi­lot study that runs to Oc­to­ber, 20 of the 40 healthcare work­ers are go­ing to work in the morn­ings with a mo­bile app de­vel­oped by Huang’s team at Tai­wan’s Bjor­gaas Foun­da­tion (

). Pro­vi­sion­ally named CHC (Com­mu­nity Healthcare), the app is still in beta test­ing, though most of its fea­tures are com­plete.

The app solves the prob­lem of lost healthcare work­ers by pro­vid­ing steady and de­pend­able GPS nav­i­ga­tion to ev­ery pa­tient’s lo­ca­tion.

But the real beauty is that the app is con­nected to a cloud data­base, which al­lows healthcare work­ers to do much more than track down pa­tient homes.

For one, CHC lets work­ers down­load pa­tient forms on their smart­phone, spar­ing them from car­ry­ing heavy boxes and the prob­lems of not hav­ing cor­rect forms on hand.

Work­ers can also col­lect data and au­to­mat­i­cally sub­mit it to the cloud, a con­ve­nience that cuts down on hu­man er­ror when han­dling pa­per records.

“For ex­am­ple, healthcare work­ers have a blood pres­sure mon­i­tor and ther­mome­ter. Via Blue­tooth, the read­ings are wired di­rectly to the phone and to

the cloud data­base,” he said.

A South African Na­tional Health Bank

Huang said that over time, the cloud stor­age could be­come some­thing sim­i­lar to Tai­wan’s na­tional health in­sur­ance data­base: a com­mon repos­i­tory of pa­tient in­for­ma­tion from work­ers and hos­pi­tal staff all over the coun­try.

In South Africa, pa­tient records are still mainly pa­per-based, not shared be­tween hos­pi­tals and prone to go­ing miss­ing.

If an AIDS pa­tient goes into a hos­pi­tal he has not vis­ited be­fore, the doc­tor has no way of look­ing up his pa­tient history. Even if the pa­tient vis­its a fa­mil­iar hos­pi­tal, his record may be in­com­plete, and his physi­cian may make mis­takes.

Maybe the medicine a doc­tor pre­scribes to you de­pends on whether you re­ceived med­i­ca­tion in a cer­tain month af­ter your di­ag­no­sis. You may have built up an im­mu­nity that re­duces drug ef­fi­cacy,” Huang said.

With the CHC so­lu­tion, a doc­tor can scan the pa­tient’s fin­ger­print and re­ceive a com­pre­hen­sive pic­ture of the pa­tient’s med­i­cal history.

“What I mean is that in­for­ma­tion and tech­nol­ogy sys­tems can help med­i­cal ser­vice providers pro­vide long-term care. In coun­tries where this med­i­cal in­for­ma­tion is not avail­able, the qual­ity of healthcare tends to be poor,” he said.

Find­ing His Way

Huang, a na­tive of Ping­tung County, is in his early 30s but looks younger. With his thick arms and wide chest, he is built like a top-flight ath­lete, but when he speaks he has the air of a pro­fes­sor.

“Tai­wan hap­pens to have ex­pe­ri­ence in tech so­lu­tions for med­i­cal care,” he said.

“Since the na­tional health in­sur­ance pro­gram was formed in 1995, hos­pi­tals have been re­quired to sub­mit their pa­tient data elec­tron­i­cally and firms have worked with them and the state to cre­ate an elec­tronic so­lu­tion that is now quite ma­ture.”

As a boy in South­ern Tai­wan, Huang had wanted to be­come a doc­tor, but was di­ag­nosed with a form of at­ten­tion deficit dis­or­der that caused his hands to trem­ble. Told he would be un­able to use a scalpel, he took a dif­fer­ent path and is now chief in­for­ma­tion of­fi­cer for Bjor­gaas, a so­cial wel­fare non-profit that works over­seas.

Mo­bile health so­lu­tions are par­tic­u­larly suited for un­der­de­vel­oped coun­tries due to the para­dox that they of­ten have ex­cel­lent tech­nol­ogy in­fra­struc­ture, he said.

“South Africa’s med­i­cal in­for­ma­tion ser­vice sys­tem is not so com­plete. You could say that they do not have one,” Huang said.

“But the in­ter­net cov­er­age is roughly 76 per­cent. And it’s 3G.”

By year’s end, Huang and his team will look at the test run’s data qual­ity and de­cide where to take the app from there.

“We may tweak the app, or if we find it is suc­cess­ful, we can repli­cate the study else­where. Maybe some­day we can use it in South­east Asia - any coun­tries that have an in­ter­est in this so­lu­tion,” he said.

“The idea with CHC is to pack­age some of Tai­wan’s strengths and of­fer them to the world.”

Photos pro­vided by the Bjor­gaas Foun­da­tion

A view of the Mthatha, South Africa, where res­i­dents rely on trav­el­ing work­ers for ba­sic health ser­vices.

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