Emily Quilter

Email: emily.quilter@bristol.ac.uk

LinkedIn: https://www.linkedin.com/in/emily-quilter-8953181b7/ 

ORCID ID: https://orcid.org/0000-0003-1302-9059

Project title: Assessing the acceptability and usability of the World Health Organisation’s SkinNTDs App as a Diagnostic Assistance Tool for Skin Neglected Tropical Diseases in Kenya

Supervisory team: Dr Amberly Brigden and Professor Kenton O'Hara

 

Project summary

My research focuses on the WHO Skin NTD (Neglected Tropical Diseases) app in Kenya, examining how AI-enabled mobile health tools are used by frontline health workers (FHWs) and experienced by patients in resource-constrained clinical settings. The app was developed to support the recognition, documentation, and management of skin NTDs and other common dermatological conditions. Initially intended to build capacity through educational content, newer versions incorporate convolutional neural networks (CNNs) that analyse images of skin lesions and generate AI-derived differential diagnoses, ranked by confidence levels, across 12 skin NTDs and 24 common conditions.

These AI outputs are designed to complement—not replace—clinical reasoning by supporting FHWs to refine diagnoses through integration with patient history and physical examination. The app is explicitly positioned as a clinical decision support tool to strengthen clinical confidence and capacity among non-dermatologist FHWs.

I led the first qualitative study to explore the AI component of the WHO app in real-world settings, conducting interviews and focus groups with FHWs across five counties in Kenya. Using qualitative methods and systems-thinking tools, we explored how FHWs interpret and engage with the app’s outputs, revealing important pedagogical, ethical, and systems-level dynamics surrounding AI implementation in primary care.

Building on these findings, I will soon undertake a four-month ethnographic study across government referral hospitals, nurse-led dispensaries, and community outreach settings. This next phase will involve observing the app in situ and conducting in-depth interviews with patients—recognising them as vital stakeholders in mHealth interventions. Understanding how AI-enabled tools are embedded into clinical workflows, and how they influence reasoning, referral patterns, professional autonomy, and patient experience, is essential to ensuring responsible innovation.

To support ethical deployment, I will co-produce professional guidance with national and global stakeholders—including FHWs and persons affected by leprosy—grounded in the lived realities of healthcare delivery in Kenya. This work aims to inform the responsible development, implementation, and governance of AI-infused mHealth tools in global health contexts. I have received funding from the WHO and L’Oréal for the app assessment and ethnographic fieldwork, and was awarded the CDT Impact Award to support the co-production of this ethical guidance.

Bio

My interest in digital health builds on a long-standing focus on leprosy and infectious disease research. After completing an MSc in Control of Infectious Diseases at the London School of Hygiene and Tropical Medicine, I worked in Tanzania, Bangladesh, and Nepal, where I saw first-hand both the potential and limitations of health systems delivering leprosy care at the grassroots level. These experiences cemented my belief that digital technologies — when designed and implemented ethically — can support clinical decision-making, strengthen health worker capacity, and improve care for underserved populations. I am especially committed to inclusive research approaches that meaningfully involve persons affected by NTDs (Neglected Tropical Diseases) in the design, delivery, and interpretation of research — not simply as participants, but as co-researchers and collaborators. I believe this kind of engagement is essential for ensuring digital health innovation is equitable, grounded, and accountable to the communities it aims to serve.

Research and activity