O×CAHT is a group of students, researchers and faculty at the University of Oxford working on projects realted to healthcare in resource-poor regions and is affiliated to Engineering World Health (EWH). EWH's mission is "To inspire and mobilize the biomedical engineering community to improve the quality of health care in vulnerable communities. ... [through] activities such as travelling to developing countries to work in hospitals, designing novel medical technologies appropriate for resource-poor settings, [repairing, maintaining and] building medical devices for use in developing countries, and promoting understanding and goodwill between the developed and developing world."
O×CAHT's approach is closely related to this mission, although we concentrate on the core strengths of Oxford's Institute of Biomedical Engieering (IBME), where we are based. These strengths include telelmedicine, mHealth, data mining, artificial intelligence and signal processing, which can be leveraged to improved automated or semi-automated diagnostics using low cost computational power readily available in billions of mobile phones and could computing environments. Moreover, we seek to use existing supply chains in resource-poor regions, rather than build new supply chains. We also consider education, sustainability and human factors, and therefore partner with public & primary healthcare specialists, anthropologists and business entitites.
In particular, our projects tend to focus on mHealth intiatives to provide rapid, high quality information transmission, and low-cost diagnsotic systems which utilize the almost ubiquitous global cellular networks. O×CAHT is closely affiliated with Dr Clifford's Intelligent Patient Monitoring Group at the IBME, which has similar goals to O×CAHT.
Costs of healthcare treatments are escalating due to chronic disease epidemics, ageing populations and rising expectations for more complex diagnostics and treatments. At the same time, most of humanity live in resource-poor locations without access to timely and affordable diagnostics and medical care. Key issues include a lack of skilled or semi-skilled health care workers for accurate screening and referral; absence of a permanent and portable record of a patient's medical history; a highly restricted supply of working medical diagnostic devices; poor supply chains for medical equipment consumables and repairs; poor treatment compliance; slow rates of information flow; and lack of quality auditing to identify bottlenecks and quantify health care improvements.
The recent global explosion of cellular telecom usage has provided an extensive supply chain for both hardware as well as rapid communication and data transfer. Over 4.5 billion mobile phone handsets are in circulation, and almost 90% of humanity is within range of cellular tower, with the poorest being amongst the most rapid adopters of mobile phone technology. The harnessing this 'leap-frog' effect presents an unprecedented opportunity for the delivery of healthcare to the most remote regions of Earth. The provision of an intelligent communication device to the relatively abundant untrained or semi-trained workers around the globe, allows for an integrated approach for capturing diagnostic data and enables experts to rapidly review and diagnose. Moreover, the creation of large expert-labelled databases of context-specific medical data provides the opportunity to leverage the computational power of back-end clusters and even mobile devices to provide automated decision support. In this way, it may be possible to scale up telemedicine from millions of experts to billions of autonomous agents. O×CAHT attempts to address the issues that must be solved to provide low-cost automated decision support in resource-poor locations through the mechanism of mHealth. In particular this includes the design of low-cost robust instrumentation which is resistant to artefacts and noise which are typical of resource-poor locations, the development of secure interchangeable medical records accessible from a mobile phone, multiple-expert anotation of data, the employment of standardized medical nomenclatures and sustainability models for open source solutions.
All O×CAHT's output is public domain, with software carrying an open source Berkeley-style distribution license so that third parties can develop competitive and sustainable service models around the delivery of healthcare. By making the central technology free, competition is more fierce, lowering costs. Moreover, the central technology becomes easily extendable, more flexible to local needs, more secure (e.g. Linux), and gains a community of committed people who want to contribute to something beyond pure profit. Moreover, it allows the user (clinical establishment or patient) to take control of their data, and prevents companies from locking in users to expensive and restrictive systems. The Berkeley Source Distribution (BSD) licenses are a family of permissive free software licenses and as such allow proprietary software to call BSD-licensed software. This enables companies to retain competitive advantages and build business models, but prevents practices that impede the use of patient data by the user. Therefore, integration between different systems, whether proprietary or free, become possible at relatively low cost and without negotiation with, permission from or payment to the software providers.