The central African country of Cameroon is slightly larger than California, and home to more than 20 million people. But for the entire population, there are only 30 heart surgeons available to help those suffering from cardiovascular disease and virtually all of them are located in the two largest cities. For those patients with heart conditions living in remote areas, they must endure arduous treks to reach a specialist doctor, sometimes exacerbating the patient’s health condition. The Cardiopad is a device inventor Arthur Zang developed to help reduce the risk to such patients.
An edited transcript of the conversation follows.
Arabic Knowledge at Wharton: Can you tell us what the Cardiopad does?
Arthur Zang: The Cardiopad is an embedded system for medical use. It’s a medical tablet PC with several features. It can perform electrocardiography (ECG) examinations of patients to acquire cardiac signals from the patient and then to filter, process, display, and print a report of the examinations. It also provides the transmission of test results from the ECG examinations via the GSM network to the remote cardiologists. There is also a presentation of an intuitive user interface to the cardiologist for computer-assisted diagnoses. This task is to process the ECG signal to extract the information for diagnostics and present this information to the cardiologist via a man-made machine and user-friendly interface. In addition, there is also data storage capabilities and management of ECG exams [to provide notification when a patient’s exam is due].
The Cardiopad will be able to store information related to ECG examinations in a database with messages and notifications, which will be sent to the cardiologist through the GSM network to inform him or her of the presence of a new examination to interpret.
There is also remote and real-time monitoring of patients. The Cardiopad will allow for remote monitoring of patients by the cardiologist whereever he is. The cardiologist may consult the current state of a patient’s health in real time.
Arabic Knowledge at Wharton: How does it work?
Zang: The Cardiopad is very simple to use. Suppose that we are in a district hospital where there are no specialists in cardiology. What happens is the patient arrives in a district hospital where there is no cardiologist. Using the Cardiopad, the nurse performs an ECG examination. The ECG examination data is then transmitted to the national data center where the data is stored in a server.
The cardiologist who follows the patient is notified by a message on his Cardiopad that there is a new examination data available. The examination results are then downloaded from the data center to the cardiologist’s Cardiopad.
The cardiologist interprets the examination using Cardiopad’s computer-assisted diagnostic embedded application. The diagnosis of the cardiologist is uploaded to the national server through a GPRS connection.
The diagnosis and prescriptions of the cardiologist are downloaded from the center to the Cardiopad of the nurse, who is then notified of this by the software program. The nurse communicates the results to the patient and the treatment required.
In order to do a cardiac examination with the Cardiopad, it requires two accessories to acquire the patient data. There are four electrodes that acquire the cardiac signal from the patient and an ECG wireless sensor transmits the signal to the CardioPad where the examination is done by a set signal processing operation applied on the signal.
This method has advantages because cables don’t get tangled up, multiple tests can be performed simultaneously, the patient won’t risk an electric accident and it allows the patient to move without stopping the recording so the patient has mobility.
Arabic Knowledge at Wharton: Can you tell us about some of the challenges of getting an ECG in a heart specialist’s office in Cameroon?
Zang: In Cameroon, there are very few specialists in cardiology, and they reside only in the biggest towns and work only in central and general hospitals. In Cameroon, there are fewer than 40 cardiologists for more than 20 million inhabitants and these cardiologists only work in the two major cities of the country, Douala and Yaoundé.
The consequences of this problem are disastrous both medically and economically. Indeed, patients living in rural areas must often make long trips to reach experts resulting in greater risk, time and money. The costs of examination and treatment are compounded by the cost of transportation and housing. All this contributes to a deteriorating quality of patient monitoring by specialists, which possibly increases the mortality rate for cardiovascular disease.
Arabic Knowledge at Wharton: How did you become interested in medical uses for your invention?
Zang: It was in 2009 when I was a student in my fourth year in the Polytechnic National High School of Yaoundé that I did an internship in a hospital and I discovered that there were only 30 cardiologists for all of the country. From that day onward, I have worked on a solution that will help cardiologists monitor their patients remotely to facilitate the work of the cardiologist and [improve the] life of the patients living in rural areas.
Arabic Knowledge at Wharton: What are the differences between the Cardiopad and the traditional electrocardiograph?
Zang: The differences between the Cardiopad and other electrocardiographs in order to perform an ECG exam with the Cardiopad, the patient is not physically connected to the device because the Cardiopad use a Bluetooth wireless connection to connect with the patient.
The result of the examination can be sent to a remote device from remote diagnosis using a GSM/GPRS/EDGE/3G wireless module, which is integrated inside the Cardiopad.
The Cardiopad can also be used as a scope, or electrocardioscope, to monitor a critical patient and it can also perform an ECG. The Cardiopad also has an embedded digital cardiology encyclopedia named Cardiopedia. It’s a 5,000-word-encyclopedia in a software program that can be used by the nurse or the cardiologist for a computer-assisted diagnosis.
Arabic Knowledge at Wharton: In some parts of Cameroon, there is the challenge of electrical supply. How does the Cardiopad cope with that issue?
Zang: The Cardiopad has a seven-hour autonomous battery that can be used economically. An ECG examination can be performed on a patient in just five minutes.
Arabic Knowledge at Wharton: What is your next step?
Zang: In order to manufacture our products in industrial quantities and deploy our solution on a national and continental scale effectively, it is obvious that it is absolutely necessary to have an industrial-sized hand coordinator. This is why I created a company called Himore Medical.
Himore Medical is a company that designs and manufactures medical-embedded systems, such as autonomous electronic and computer systems, for use [in the healthcare industry]. It also provides medical services to hospitals by providing the necessary equipment to perform remote examinations at low prices.
This business consists of several engineers and specialists of all stripes working together in order to find technological solutions to the problems that are the most devastating public health [issues] in Africa, such as malaria, cardiovascular disease and many more. We have four employees who are essentially researchers and engineers.
In addition to product development, the Himore Medical Team provides technical support services to Cardiopad users.
Arabic Knowledge at Wharton: What are some of the challenges of inventing in Cameroon?
Zang: There are several difficulties in Cameroon when it comes to invention. One of them is that first of all, there are no funds for the research and no venture capital. Also there isn’t a culture of risk. People want to see the things work before [they] believe and participate [in the projects]. And that is why it is very difficult. People here are must interested in the realization [of a project rather] than the idea.