Point-of-Care Support & Diagnostics

Librarians and physicians are teaming up in order to improve accessibility of clinical information in Guatemala and thus improving care. In a first step it wlll provide physicians in Guatemala with access to electronic medical information in databases and e-journals via smart phones; in addition they will have the possibility to contact Penn physicians in order to obtain diagnostic advice. In a next step Guatemalan physicians will in turn train community health workers in rural health posts in finding relevant digital medical resources. 

The Rwandan RapidSMS application was designed specifically to support maternal, neonatal and early child health at the community level and to save mothers and newborn lives. The tools help community health workers (CHWs) to track pregnant women, monitor antenatal care, identify and refer women at risk, and improve communication with health facilities in the case of emergencies. The system was also designed to help CHWs to identify and address reasons why women and young children die at the community level. The programme was initially modelled in the district of Musanze, with the plan for national scaling following the results of the model.

After a successful 2009 pilot, Mozambique has nationally rolled out SMS printers in 2010. The results of infant HIV tests are electronically transmitted from two central reference laboratories in Maputo and the northern provincial capital, Nampula, to more than 275 health centres. This reduced the time it took for clinics to receive test results from reference labs from an average of about three weeks to about three days.

Medical personnel of a cancer centre and two hospitals in India have started screening high-risk individuals for oral cancer using smart phones with camera. The condition is either diagnosed by using the pre-loaded software on the phone, or by uploading the data to the hospital's EMR (electronic medical records) system for specialist feedback. The patient can either be advised on treatment through interactive videos on the phone or referred to a specialist.

Clinical officers use mobile phones to take pictures and notes of patients in remote areas of Tanzania. The information on complex medical cases can be shared with specialists from Dar es Salaam and abroad via the iPath telemedicine platform. Specialists view the information and provide advice remotely.

The Africa Teledermatology Project, initiated in 2007, operates in six African countries, using ICT to capture and send images of patients to specialists in other African countries, Austria and the United States. These provide diagnostic and treatment support to local physicians, dermatologists, and health care workers in hospitals and clinics in underserved regions. Due to inconsistent access to the internet, mobile applications were tested to provide wireless connectivity for the transfer of patient history and photographs, focussing on the diagnosis of cervical cancer, HIV, and skin diseases.

In this pilot (started in July 2009), a mobile application based on RapidSMS was used by 100 community health workers (CHWs) in Sauri, Kenya, to actively monitor 9,500+ children under five. ChildCount supports the delivery of CMAM (community-based management of acute malnutrition) programmes; home-based testing for malaria using Rapid Diagnostic Test (RDT) kits and immediate dispersal of treatments; and home-based treatment of children with diarrheal illness. CHWs used SMS messages to register patients and sent in their data with the ultimate goal of improving child health and empowering community health workers. The more recent ChildCount+ added support for maternal health.

In the video below, Matt Berg provided an overview of ChildCount and how it was set-up at PopTech 2010.

Th mobile-phone based application aims to assist community health workers in managing household visits and planing their day, while at the same time collecting and reporting data to monitor and evaluate community health programs. It was piloted in several projects in Tanzania and the target is to have 1,400 health workers using CommCare by 2014. In 2011, Dimagi launched a cloud-based, enterprise level platform to deploy CommCare globally.

The region of Kedougou has the highest maternal mortality rates in Senegal, due to poor quality and limited availability of obstetric health services. In order to improve access to skilled assistance during delivery, the project aims to improve communication links between villages and health centres by donating prepaid mobile phones and working on a network of community workers who call the nearest health centre in case of an emergency. A motorbike ambulance can be called to transport women to a health centre or hospital.

A web-based application delivered on PDAs was developed and tested in 2007 to collect patient risk assessment data, and deliver counseling protocol training and evaluation to nurses involved in HIV care.