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CONNECTIONS (continued): Our work and partnerships are focused on developing prehospital emergency care systems -- work which regularly brings us and our partners into contact with individuals with new, short- and long-term disabilities, particularly resulting from road traffic injuries. Nonetheless, there are always other local organizations with deeper involvement working with PWDs with whom we could work to build and run inclusive response networks -- just as we work with ambulance agencies and fire departments to build and run prehospital emergency response systems.

With support through the Amplify program, we would be open and willing to establish new partnerships with other disability organizations in any country, including in Tanzania where we have existing programs.

Thank you OpenIDEO for the encouraging feedback as well as the additional comments and questions.

CONTEXT: Please see our reply to the "Feedback" question above. In short, caretakers requesting assistance on behalf of a PWD could use the software as is -- all that's required is to make a phone call to a call center. For PWDs to request assistance through Beacon on their own behalf would depend on the type and degree of the disability.

WHY HASN'T THIS OCCURRED YES?/OBSTACLES IN EXISTING SERVICES: This idea is very common in wealthy countries owing to robust communications infrastructure and formal response services: PWDs are able to request specialized services through public emergency response systems, as well as through private and non-governmental services. The obstacles that have prevented this from occurring in resource-limited settings primarily include a lack of formal response systems which are due in large part to a lack of appropriate communications technology: Emergency response technologies used to coordinate efforts in the wealthiest countries are typically developed for landline-based communities; prior to the proliferation of mobile phones, available emergency response technologies were inappropriate and/or unaffordable to most resource-limited communities. With Beacon, we've circumvented these outdated technologies to design a fully automated dispatching system that can be used on any mobile phone, with or without internet, and can be scaled for a fraction of the cost. https://trekmedics.org/wp-content/uploads/2017/03/white-paper-beacon_-final_trek-medics.pdf After Beacon has been implemented, the main obstacle in scaling is ensuring that appropriate and adequate patient transport vehicles are available where necessary (ambulances and other patient transport may not always be necessary when services can be rendered in the home - e.g., community-based rehab; quality of life care; in-home care)

LIVING CONDITIONS OF PWDs: Beacon was designed to be effective irrespective of socio-economic status. We have seen firsthand how Beacon can be of benefit to an epileptic patient in NYC as much as it could in rural Africa - rapid response by trained caretakers is needed in both cases. Because the platform can be used on any mobile phone, responders involved in the network could be advanced paramedics in ambulances with lots of training and equipment, or they could be an untrained community member who has a van available to transport PWDs to a rehab appointment, or they could be a caretaker who needs some extra help in turning a bed-ridden patient to prevent bedsores; the callers could be professionals or family members, or it could be the PWD requesting assistance on their own behalf (i.e,. if a person in a wheelchair fell out of their chair and needed help to get back in). Our platform enables communities to leverage the resources they have to meet the specific needs they are faced with.

USER-CENTERED DESIGN: We developed Beacon to be accessible to responders who may have limited literacy and who may/may not have formal vehicles (like ambulances) equipped with high-tech dispatching technologies, so that anyone with training and a mobile phone can actively participate in local response networks. The area where we see definite room for improvement is in how persons with significant physical, cognitive and/or psychological disabilities could access the platform to request assistance on their own behalf. This would largely entail adding features that could only be utilized through a smartphone - e.g., voice-initiated prompts (like Siri), Morse Code plug-ins, video calls and sign language, color contrast and character size, WACG2.0 et al.)

MODEL: People join the network as responders because they are motivated to take an active role in their community's public health and safety; they often tend to be individuals who come into direct contact with beneficiaries on a regular/daily basis through work and/or family; they tend to be young adults who are active and eager for new opportunities to develop their skills and gain professional experience; they generally place great value in community service and supporting people in need. Incentives offered are typically non-financial (e.g., free phones and credits; uniforms and prestige; professional development; health insurance et al).

LITERATURE REVIEW: We've done extensive research focused on the role and impact of time in delivering care to patients with acute medical conditions. Given the higher risk vulnerability for PWDs, we see inclusive services as a natural next step in community-based response networks. We think that our approach is unique because it's focused on leveraging available resources, and not dependent on solutions used in wealthy countries.

CONNECTIONS: We function as an NGO with a SaaS model, providing access to our software and technical advising for established partners, but not assuming control of local operations.

Hi Kieran Hanrahan Thank you for your feedback. I'd be very happy to speak more with you. I"m afraid you're correct about the challenges for universal accessibility, but given the high costs of developing apps there's got to be a way to find a closer-to-universal-accessibility-than-not solution. We have toyed with things for several different cohorts, like you said, going from push notifications to even morse code for blind/deaf/mute persons, but I'd be very glad to speak with you more about your work, definitely. Thanks for the offer!
And yes, we can set you up with a demo too - you can check out some of the materials here: http://trekmedics.org/beacon/how-to/ This is for the responders, not for reporting parties, so accessibility isn't as much of a concern there. The way we do it now is that caretakers/family/friends simply call the local fire station (or hospital) and make the request on behalf of the individual needing assistance. Would love to talk about it more. Please send me an email at jfriesen - at - trekmedics dot org and we can find a time then! Thanks again for reaching out!