INSIGHT. DIALOGUE. ENGAGEMENT. ACTION. SCALE.
by Rachel Gehr and Romika Kotian
In this discussion, Pallavi Gupta, engages in a dialogue with Gopi Gopalakrishnan, Founder and President of World Health Partners (WHP), and Jacqueline Linnes, Assistant Professor of Biomedical Engineering (BME) at Purdue University, to discuss existing challenges and gaps between R&D and on-the-ground implementation processes in the sector of healthcare.
As part of the IDEAS discussion series, Pallavi Gupta, Assistant Director of Programs, Shah Lab, engages in a dialogue with Gopi Gopalakrishnan, Founder and President of World Health Partners (WHP), and Jackie Linnes, Assistant Professor of Biomedical Engineering (BME) at Purdue University. This discourse brings to light existing challenges and gaps between research and on-the-ground implementation processes in the sector of healthcare, and how these processes will need to be adapted in the light of disruptions such as the COVID-19 pandemic.
Founded in 2008 by Gopi Gopalakrishnan, World Health Partners, is a non-profit organization that primarily seeks to deliver health and reproductive health services tailored to the needs of populations that reside in rural and semi urban areas. Leveraging his experience from having founded one of the first large-scale rural social franchise programs to provide reproductive health services in a low-resource setting in India, Gopi envisioned a similar program augmented with telecommunication capabilities to meet the needs of the current times through WHP.
“Establish a similar network of providers… who could also benefit from the rapid expansion of telecommunication technologies in the world”
– Gopi Gopalakrishnan
WHP has now come a long way in providing healthcare services to over 26 million patients by creating digital solutions through technology enabled networks, collaborative efforts with public and private sectors, training and investment in local entrepreneurs, providing critical healthcare to women, children and the poorest section of the society, and caring for the community as a whole.
While WHP facilitates the availability of various reproductive health services in remote areas by creating a tailored healthcare ecosystem, researchers at Purdue’s Biomedical Engineering (BME) department work towards developing rapid diagnostic devices and tools based on human-centered design to help address healthcare challenges across the globe.
Jackie describes the fascinating research that her own lab, the Linnes Lab, as well as other labs at BME such as the Kinzer-Ursem Lab, Cardiovascular Imaging Research Lab, and the Natural and Biological Photonics Lab are conducting in the field of point-of-care diagnostics for healthcare. The Linnes Lab and Kinzer-Ursem Lab have developed a tool to detect the presence of V. cholerae in water in field settings, paper test strips for accurate point-of-care cervical cancer detection, rapid HIV RNA detection in low-cost tech similar to a pregnancy test, and rapid, low-cost detection of neo-natal sepsis. Along with other labs at BME, they are developing several innovative aids in the form of hand-held or wearable devices, and mobile-based or paper-based devices, to deliver valuable information that can assist with rapid diagnosis and informed decision-making in relation with diseases such as cholera, malaria, HIV, cervical cancer, neo-natal sepsis, preeclampsia, anemia and Sickle Cell Disease (SCD).
One of the major gaps between developing ideas in a research environment and implementing the resulting technologies in the field is how the end user decides to interact with what they have been provided. This is out of the control of both the creator and provider of the technology, requiring both parties to continuously redesign and adjust to meet the actual needs of the user and not just what is assumed.
“How can you create a product that cannot be manipulated and will not cooperate with the user if it is not properly utilized? In a different scenario, if the user knows how to use the product but is not motivated, how can incentives be provided to correctly utilize what has been offered?”
– Gopi Gopalakrishnan
While the team typically works with people who have basic training, Gopi and Jackie explored the idea of a healthcare entrepreneur who had not been trained on medical devices – can the technologies be made simple enough for volunteer workers with limited experience? Can the technology replicate the processes and human interactions as they exist instead of forcing a new way of operating? Can the tech solution, assist healthcare workers, amplifying their strengths and alleviating the roadblocks that they face while interacting with the community, instead of requiring them to learn new skills just to be able to operate the technology? Here Gopi recounted an experience where a handheld technology failed in creating desired impact, just because it required the frontline workers to enter text information in the app which they weren’t particularly skilled at. All it took, was to design the execution strategy so that, that particular requirement was fulfilled elsewhere – via call center.
“All the possible things that could go wrong, no matter what causes them – the device, the user, a secondary system – you have to consider all of those things and how you will mitigate them.”
– Jackie Linnes on Engineering Failure Mode Effects Analysis
Many similar examples that were discussed during the session, showed that careful design of the implementation and execution strategy of such technologies, are as important as the technology itself, and that a functional tool doesn’t automatically mean an impactful tool. Another critical point in the design of the execution strategy was highlighted by Pallavi where she highlighted the importance of the iterative process accounting for learning in the field that needs to reflect in the design and execution of the technology.
“It has to be iterative, and account for exiting processes, systems, partner and implementer feedback for it to be truly impactful in the field”
– Pallavi Gupta
As challenges continue to arise, the Purdue and WHP teams work to adjust and redesign methods of creating and distributing products to provide safe, reliable, and straightforward opportunities to community members.
While this partnership has already made great progress in offering vital healthcare opportunities to underserved community members, there are still various translation gaps that provide avenues for future collaboration. Four key opportunity areas were articulated during the conversation between Gopi, Jackie and Pallavi:
1) Acquiring insight into appropriate local technology needs, existing processes and available solutions in the local market
2) Assessment of strengths and capabilities of local stakeholders to guide the design of the solution and its implementation strategy; and interpretation of data outputs and its effect on workflow
3) Iterative implementation of technology and acquisition of feedback from frontline workers and implementing partners
4) Scaling of device manufacturing for relevant communities, by relying on the strengths and networks of the local partners.
This partnership between WHP and Purdue University has the potential to make great progress in their goal of providing healthcare opportunities to community members without access to vital resources. The complimentary skills and expertise of WHP and Purdue university can ensure that not only the appropriate technology get developed but also that it gets implemented in a way that can empower the local partners and communities to deliver those services in equitable fashion.
Purdue College of Engineering and Shah Family Global Innovation Lab