Ladies and gentlemen,
Good afternoon and welcome – and a very warm thank you to my good friend Klaus Leisinger, who has created this opportunity for us to be here in Basel together today.
As you may know, Klaus and I co-chair the Digital Health Initiative, which is a multi-stakeholder initiative aimed at sharing information on m-health projects for development and looking at ways in which such projects can be scaled up in the real world.
Klaus is also a very active Commissioner on the ITU/UNESCO Broadband Commission for Digital Development, which recognizes that broadband will be absolutely essential in helping us accelerate progress towards meeting the MDGs.
Klaus and I have also been busy this year with the Commission on Information and Accountability for Women and Children’s Health. This was set up by ITU and WHO to propose a framework global reporting, oversight and accountability – essential activities in ensuring that targets are met and goals are achieved.
This Novartis Symposium therefore fits in very well with our other activities, and I welcome this opportunity to discuss m-health and telemedicine opportunities with you today.
In a world of seven billion people, it is absolutely clear that information and communication technologies – ICTs – will play a key role in social and economic development.
With a growing, ageing, population in the 21st century, it is equally clear that one of the areas where ICTs can help make the greatest difference is in the provision and delivery of healthcare.
I firmly believe that m-health applications in particular will be key in providing affordable, sustainable, quality primary health services – especially to patients in rural areas.
Ladies and gentlemen,
As Secretary-General of the ITU – the United Nations Specialized Agency for ICTs – I am often asked how I think the world will look a decade from now.
And I have to confess that it is impossible to answer – because ICTs change everything, so quickly.
Imagine, at the beginning of the Millennium, being able to predict how the world would look today.
Back then, around half the people in the world’s richest countries had a mobile phone. Mobile penetration in Africa was under 2%.
Today there are almost six billion mobile phone subscriptions globally. Mobile penetration in Africa is close to 50%.
At the beginning of the Millennium, around 280 million people used the Internet worldwide. In a decade that figure has grown eight-fold to reach 2.3 billion people, or around a third of the world’s population.
In the past decade we have seen the arrival of iPods, smartphones and tablet computers. Almost any smartphone today has better power and graphics capabilities than a graphics card costing a million dollars in the year 2000.
So we can’t even begin to make serious predictions about the shape of the world a decade from now.
That said, we can already see many areas where ICTs – and in particular m-health – are already clearly making a difference, and I expect to see extraordinary progress, revolutionary progress, in the years ahead.
Among many examples where a difference is already being made, we can include:
- Access to health advice: people can access information on the internet, either directly or through health centres. Mobile phone applications can convey information in local languages or in pictures to reach illiterate patients.
- Training for healthcare workers, especially in remote areas: ICTs can deliver distance education, up-to-date information and help upgrade skills.
- Patient monitoring: patients with heart monitors can send regular data to their doctors and elderly people can be supported while they continue to live at home.
- Patient information: patients can be sent reminders via mobile phone messages to take their medicines, or bring their child to the local clinic for vaccination.
- Telemedicine/remote consultation: patients far from hospitals or clinics can receive remote diagnosis or specialist advice through video conferencing, avoiding delays and the need for travel or to take time off work.
- Disease surveillance: information systems linked to mapping capabilities can improve disease surveillance, epidemic tracking and responses.
- Data collection: health workers can use ‘smart’ hand-held devices and mobile phones to send data through to processing centres or add to health records, improving speed and reliability of data collection and processing. A pilot project in Senegal reported that data that took two weeks to collect on paper was now being collected in just one hour.
- Access to emergency services such as ambulances and paramedics can be facilitated through better communications systems.
- Management of patient records: ICTs enable patients to carry their own records on mobile phones or allow health workers to access online patient records, speeding information exchange and improving the quality of treatment.
- Transparency and accountability: health data and information can be made more accessible to the public as well as policymakers, researchers, healthcare providers and professionals. Social networking offers further opportunities for strengthening accountability.
I know I said it was impossible to predict the future, but I do think it is possible to identify some trends on the basis of what we already know.
I think for example that it is clear that we shall continue to see an increasing move from narrow-band to ever more data-centric and real-time applications, especially on mobile devices.
Indeed, in the very near future, more people will be accessing the Internet from mobile wireless devices than they will from fixed-line computers.
There are already some 1.2 billion mobile broadband subscriptions worldwide, and companies like Ericsson and Nokia expect that number to rise to over five billion in the next decade.
This will allow some services – notably consultation and diagnosis – which were previously available only in clinics or hospitals, to become available in the home, on-demand, through affordable low-tech solutions.
This will all be facilitated by the move to next-generation all-IP networks and devices.
As of September there were 663 million Skype users – giving Skype a bigger population than every country in the world except China or India. Already, most mobile devices have a camera included. So with all-IP networks, this allows for free, or ultra-low cost, real-time video-conferencing – from the home, or even from the ambulance.
I think we all know young people with mobile devices who use smart new technologies like Skype and FaceTime to make free video calls to their friends and family.
In hospitals and clinics we’ll see a huge increase in the use of visualization technology – such as advanced CAT scans, for example.
These are already available – and if you haven’t seen it, I can highly recommend a TED talk entitled ‘Visualizing Medical Data’, which was given by Swedish visualization expert Anders Ynnerman in Göteborg at the end of last year.
Increasingly, consultants and surgeons will be able to see – and even experiment virtually on – clear working 3D models of a patient’s heart, before operating in reality; or see exactly where a brain is malfunctioning, without the need to open up the skull.
On a much simpler level, we are already seeing smartphone apps that can make a real difference on the ground, even when there isn’t an Internet connection available.
Some of you may have seen news stories earlier this year about an app which can be used to diagnose malaria on the spot. The app processes a picture taken by the phone of a blood sample; detects malaria parasites; quantifies how much malaria is in the sample; and even points out the parasites in the photo. Once the data stored in the phone is uploaded, it can be used to spot and monitor disease trends.
Across every sector we will also see a massive proliferation in machine-to-machine communications, and we will see the Internet of Things become a reality. Companies like Cisco and Ericsson expect there to be 50 billion interconnected devices by 2020, and that doesn’t seem like an impossible prediction to me.
In terms of the health sector, this means that we will see personal and home-based sensor devices playing an increasingly prominent role – so that remote patient monitoring and telemedicine become an everyday reality.
It makes so much more sense to move some care to the home, instead of moving patients to clinics or hospitals – especially for elderly people and patients with chronic diseases.
For all parties concerned, including healthcare specialists and patients – and not to forget health insurers – it also makes more sense for routine data, such as blood pressure, or blood sugar levels, to be collected, sent and analyzed automatically, than it does to use up valuable specialist or patient time.
And when medical needs or emergencies dictate, then automatic alerts – including the patient’s location – can be sent straight through to a doctor or clinic.
Ladies and gentlemen,
Another effect of the massive proliferation of ICTs and the ubiquity of publicly-available information will be greater consumer awareness and increasing patient empowerment.
Patients – and of course healthcare professionals too – will be able to use personalized online applications to obtain first-level diagnoses, based on vital signs, images, and navigating through diagnostic decision-aid tools.
They will be able to seek a ‘second opinion’ within a few clicks online or via their mobile phones. Broader access to medical knowledge and resources are changing the relationship and expectations of patients vis-à-vis medical professionals – and this of course creates new challenges as well as new opportunities.
I am convinced that we will also see a whole range of new ICT applications that provide a new emphasis on health and wellness, and not just on responding to sickness or illness.
We all know that prevention is much better than cure, and we are already seeing amazing wellness apps becoming available – covering everything from basic sanitation and disease prevention, to balanced diets and healthy lifestyles.
ICTs will also continue to play a beneficial role in delivering equitable communications for all – including the one billion people worldwide who live with a disability.
At ITU we are doing a lot of work to facilitate access to ICTs for people with disabilities, notably in the area of standardization.
We are also working hard on coordinating the development of a set of open global standards for e-health and m-health applications – because interoperability will be absolutely crucial in a hyper-connected world.
ITU just recently approved a new protocol to relay biometric information, connecting medical practitioners with the real-time medical data of patients in remote locations.
We are now working in collaboration with other organizations on further standards and recommendations to help ensure the continuing proliferation of m-health and telemedicine applications.
In closing – and in the context of the ‘New Media’ subtitle of this Symposium – I would like to say a few words about the UN Wired meeting which ITU will be helping to organize next March at the United Nations in New York.
UN Wired 4.0 will bring together the world's thought leaders and technology innovators for two days of high-level forums on actionable technology solutions to Millennium Development challenges.
The goals of UN Wired are to:
- Identify areas that are succeeding in one area and transfer them innovatively to another;
- Build connections between the public and private sectors;
- And to showcase innovative ideas and trends in mobile telephony and social media.
I am expecting e-health and m-health applications to be very much part of the picture at UN Wired, and I am looking forward enormously to participating in this event.
I think we all recognize that in the 21st century we will depend on e-health and m-health to deliver affordable and sustainable healthcare solutions to the peoples of the world –not just in developing countries, but in the developed world too.
And as an optimist, I expect us to witness the arrival of many, many new and positive developments in technology which we simply won’t have seen coming.
We are witnessing the fastest changes in human history – and I believe that we have within our grasp the greatest opportunities for social and economic development ever known.
So let’s seize those opportunities!