By The Center for Global Women’s Health Technologies Staff
The old adage “necessity is the mother of invention” holds true now more than ever. We are seeing this in the way individuals are social distancing to ensure the well-being of others, where vendors in street markets are taking on new roles as community health providers, and where digital technologies are being leveraged more than ever by health professionals for telemedicine, businesses for operations, and students for completion of their studies.
Although our world is in the midst of challenge and tragedy, we are also seeing great opportunity and triumph. Under the pressure to save lives, people are thinking fast and developing new technologies at unprecedented rates to address COVID-19. We’re seeing inventions that allow ventilators to be used for multiple patients, N-95 masks to be sanitized for reuse, and production lines to be converted from making perfume, whisky, and jeans to hand sanitizer, ventilators, and masks.
In addition to spurring new technologies, COVID-19 highlights the importance of accessibility. When practicing social distancing, Americans feel the strain of missing components of our daily lives. Whether that be the simple pleasure of a Friday night spent at a restaurant with friends, visiting grandparents living in care facilities, taking your kids to a playground, working in an office, or attending a sporting event, pieces of our normal lives are missing.
Yet, there is something more important to consider. If you have been ill during this time, you will notice that non-COVID healthcare has become inaccessible in many places across the United States. Many of us reading this article live in places where this is a mere irregularity, a temporary inconvenience. For women across the globe, however, sexual and reproductive healthcare is regularly inaccessible for any number of reasons: cultural stigma, financial barriers, geographic challenges, and more. One thing we all have in common right now is the need for self-care and home diagnostics.
As researchers working in the area of global women’s health and technologies, our team is constantly thinking about health disparities and how we can address them. We deliver low cost, effective care to marginalized populations. Services like telemedicine, rather than brick and mortar facilities, and community health providers, rather than physicians, often come to the forefront of our conversations. This is a big departure from norms followed in countries like the United States.
We now see our country pivoting in a direction that could serve a broader spectrum of beneficiaries. This change could transform the efficiency and accessibility of health care, and pave the way for broader preventative health coverage at significantly lower cost. While this is speculation, we firmly believe now is the time for big and bold change to happen.
Telemedicine and community-based health services alone can only go so far in preventative health coverage. These services must be bolstered through innovations that allow individuals to perform tests without physically visiting a healthcare provider. These tests can then be assessed by an expert for further decision making. There is perhaps no better example than what is now a ubiquitous at-home diagnostic: the home pregnancy test.
A name that not many know, but should, is that of Margaret Crane. In 1967, she was working at a pharmaceuticals lab when she observed the information flow of pregnancy tests: patient gives sample to doctor, doctor ships sample to lab, lab analyzes sample and sends results to doctor, doctor delivers results to patient. She considered what it would be like to relocate this test from the physician’s office and the lab into a woman’s home. “It was a way for a woman to peer into her own body and find out about her status, without anyone else — husband, boyfriend, boss, doctor — getting in the way.”
But as is the case with all radical ideas, Ms. Crane’s were debunked by higher ups in the company. The doctors felt threatened that if the women did the tests, that would take away their services. The managers were afraid that if women found out they were pregnant they would become distraught and kill themselves. And yet, she persisted. Ms. Crane’s at-home pregnancy tests became available in 1977. “Today, eight out of 10 women learn they are pregnant from a drugstore device.” Most are probably unaware of the test’s torturous history and Ms. Crane’s drive and passion for her innovation.
Story Source: The New York Times
Our team thinks about women’s health from a perspective not unlike that of Ms. Crane. We see modern technology’s potential to disrupt centuries old status quo. There is probably no better example of an archaic medical tool that still persists to this day than the duckbill speculum, used in every gynecologist’s office. This instrument reflects old-fashioned cultural attitudes and anxieties about female bodies that unfortunately still persist today.
As an alternative, we have created the Callascope, a device that allows a woman to perform her own gynecological exam without the need for a speculum or a doctor, and provides access to life-saving solutions when experts and equipment are inaccessible. This is a first for women. We have developed this technology specifically for women to test themselves for cervical cancer. The woman uses the device to take a picture of her cervix and send it to an expert who examines the image and renders a decision.
We now ask ourselves, how could the Callascope do more than cervical cancer testing at a time when people around the world are huddled in their homes?
It could allow a woman to take pictures of her cervix during labor so a health provider could assess its dilation rather than relying solely on the frequency of her contractions.
It could allow a woman to see her cervix change over her menstrual cycle and identify the best time to conceive.
Perhaps it could be used remotely by an obstetrician to monitor a pregnant woman for signs of pre-term labor.
When this crisis is over, what lessons will we take with us?
We hope that the importance of at-home care is never again underestimated and undervalued. It is during this time that we have the ability to reshape the face of patient care, outside of the clinic.
The tale of the home pregnancy test is not unique. Breakthroughs that give patients control over their bodies are often resisted as was the case for example with in-home HIV testing. Time and again, the same concerns arise: Are patients smart enough? Can they handle bad news? And do they have the right to private information about their bodies? We believe they are and they do, as has been amply demonstrated with the home pregnancy test and our own interactions with women in the U.S., Ghana and Peru who have embraced using the Callascope and the opportunities it provides.
As we wonder how long we will have to self-isolate to drive down the spread of COVID-19, it is important to ask: how can we innovate to give patients more control of their health and, in doing so, create more accessible health care for all?