Bobby Jefferson, Senior Health Informatics Advisor, Futures Group• Principal Investigator CDC HMIS Grant Kenya• Senior HMI...
Global Organizational Structure•   Founded in 1971                                 Futures Group Global, LLC•   Headquarte...
mHealth Informatics ChallengeNigeria, Kenya, Uganda, Tanzania, Rwanda, Zambia, South Africa, HaitiGuyana, Ethiopia , 10 Co...
Health IT Solutions          Collectively referred to as IQSolutions1.   Electronic medical records     1.   IQCare - Revi...
Health IT Solutions   Use of freely available, reusable, tools, “coded in     country” Creative commons approachReusable s...
demohttp://173.203.65.108/iqcare/frmLogin.aspx Username: user1 Password: 1 Facility/Satellite: 001-01-01-Demo Site
IQSMS – Mobile Phone Reporting by Health Workers
IQSMS PMTCT ReportsPMTCT Currently consists of 4 types of monthly reports1. PMTCT Antenatal Clinic (ANC) Monthly Summary F...
PMTCT Report                                         Data Quality ChecksMust Pass All Data Quality Rules,                 ...
NUMBER OF CLIENT HAD HIV TEST AT ANC
technology isn’t the barrier to scale up•   Nurses and community health worker receive per diem or transports costs    for...
Tanzania                                        Distance from   Time spent toFacility Name               District    Facil...
• Delays with data flow and information reporting from the District and  Regional level to the National level• Inaccuracy ...
   Instruction on   Any problems with                                    Swahili critical to    small buttons on the    ...
IQSMS Instructions in Swahili
   Barriers to implementing               • Anything that can be    mobile phone reporting for               improved on ...
Health IT Solutions*EMRS – Electronic Medical Records System
Health IT Solutions        Tanzania mobile phone coverage and mobile penetration            Vpdacom Tanzania•    *EMRS – E...
M&E Electronic Reporting System                                                                     Solar Power Cell phone...
For more information     Contact        Bjefferson at futuresgroup.com        Lburrows at futuresgroup.com       For mo...
Futures  crs mhealth demo sep 23
Futures  crs mhealth demo sep 23
Futures  crs mhealth demo sep 23
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Futures crs mhealth demo sep 23

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  • Bobby JeffersonSenior Health Informatics AdvisorICT4 Development SummitWEBINAR 5th March
  • Describe the main types of challenges that your ICT solution is addressingWe provide ICT solutions to rural, remote regional areas, lacking in constant power or only intermittent power , lack of computers, internet, skilled IT staff, Program managers, decisions makers, need information from health, patient, financial and program data Several existing technology systems in field, not interoperable, cannot exchange or transfer information, cannot create linkages with other programs, Communication, sharing, reports, data from field to HQS and HQS to field
  • Give example of a successful deploymentDescribe what went well (provide any supporting evidence), describe positive unintended consequences/innovationsAnnunciation Hospital in Nigeria, efirst hospital, eClinic, success storyIQCare can be used for PMTCT, Well Baby Care, Diabetes, Health indicators
  • Identify how to decrease that gap to ensure all pregnant mother’s are tested during ANC
  • IQCare Captures, organizes and presents information in a manner superior to the physical recordsMaintains automated patient histories(registration, lab tests & results, rx plans, appointment schedules and exits); the records are stored, retrieved, and cross-referenced more efficientlyDesigned for use even in countries with under-developed infrastructure
  • IQCare Captures, organizes and presents information in a manner superior to the physical recordsMaintains automated patient histories(registration, lab tests & results, rx plans, appointment schedules and exits); the records are stored, retrieved, and cross-referenced more efficientlyDesigned for use even in countries with under-developed infrastructure
  • Futures crs mhealth demo sep 23

    1. 1. Bobby Jefferson, Senior Health Informatics Advisor, Futures Group• Principal Investigator CDC HMIS Grant Kenya• Senior HMIS Advisor - AIDSReliefAbby Clay, Senior Business Development Associate, Futures Group
    2. 2. Global Organizational Structure• Founded in 1971 Futures Group Global, LLC• Headquartered in Chris LeGrand, MS Chief Executive Officer Washington, DC USA• 467 staff Operations worldwide Ed Abel, MPA Senior Vice President & Chief Operating Officer Human Resources Organizational Dev Benefits• Operating in 30+ Recruiting countries Finance & Administration Employee Relations Timothy Schur Chief Financial Officer• Largest country presence, USA Technical India Farley R. Cleghorn, MD, MPH Afghanistan Senior Vice President & Kenya Chief Technical Officer South Africa Tanzania Center for Policy & Center for Health Advocacy Systems & Solutions Sarah Clark, PhD Shannon Hader, MD, MPH Vice President Vice President
    3. 3. mHealth Informatics ChallengeNigeria, Kenya, Uganda, Tanzania, Rwanda, Zambia, South Africa, HaitiGuyana, Ethiopia , 10 Countries, 244 Hospital Facilities + 112 SatellitesClinics , 535 Antenatal Care - PMTCT sitesSupporting rural, remote, faith based mission hospitals “serving poorest ofpoor”Lack power, intermittent power, No IT staff, No internet, Sparse mobilecoverageNurses, Health workers need to report health indicators, M&E program data onmonthly basisCost effectiveness and sustainability -- no funds for proprietary licenses, oryearly maintenance fees
    4. 4. Health IT Solutions Collectively referred to as IQSolutions1. Electronic medical records 1. IQCare - Reviewed by CDC, WHO, USAID 2. IQChart - French language2. Mobile Phone solution (SMS technology)3. Site Capacity Assessment Dashboard (SCA)4. Monitoring & Evaluation Electronic reporting5. GIS and GPS related IQGeo6. SQL Training, Virus Remediation Training
    5. 5. Health IT Solutions Use of freely available, reusable, tools, “coded in country” Creative commons approachReusable software and technology across countries and programsOffline Solutions, Disconnected modelLocal programmers, all IT staff in country (Africa) Low costs, Inexpensive $200-$350 NetbooksSamsung Solar netbooksSolar mobile phones, SMS instead of SmartphonesUse of inverters to address power
    6. 6. demohttp://173.203.65.108/iqcare/frmLogin.aspx Username: user1 Password: 1 Facility/Satellite: 001-01-01-Demo Site
    7. 7. IQSMS – Mobile Phone Reporting by Health Workers
    8. 8. IQSMS PMTCT ReportsPMTCT Currently consists of 4 types of monthly reports1. PMTCT Antenatal Clinic (ANC) Monthly Summary Form2. PMTCT Care Register Monthly Summary Form3. PMTCT Maternity (L&D) Monthly Summary Form4. PMTCT Mother - Child followup SummarForm
    9. 9. PMTCT Report Data Quality ChecksMust Pass All Data Quality Rules, District Office Monthly and Quarterly Reports
    10. 10. NUMBER OF CLIENT HAD HIV TEST AT ANC
    11. 11. technology isn’t the barrier to scale up• Nurses and community health worker receive per diem or transports costs for picking up or bringing their list and reports back and forth to health facilities, district offices, etc.,– they’re not interested in losing out in reimbursement;• After early adopters, health care workers not keen sending message unless they have free airtime and toll free number available from their mobile telecom provider ; we increase use by 50% when toll free is available• The older staff have more difficulty using mobile for messaging and reporting;• Often other people have access to the phones (25% share phone vs. Own) and often those text message can be forwarded to others• Staff in rural areas want their SMS messages in Swahili or local language; Detailed instructions in Swahili to how to do reporting and use phones for reporting
    12. 12. Tanzania Distance from Time spent toFacility Name District Facility to Deliver PMTCT Bus Fare (Tsh) District (KM) Report (Hrs) MWANZA Region NYAMAGANA DISTRICTMwamashimba Health Centre Kwimba 50 1.30hrs 10000Malya Health Centre Kwimba 25 1hr 5000Kikubiji Dispensary Kwimba 102 4hrs 20000Kiliwi Dispensary Kwimba 100 4hrs 20000 KWIMBA DISTRICTNyakalilo Health Center Sengerema 46 2 HRS 8000Mwangika Health Centre Sengerema 98 4 HRS 10000Sengerema Health Centre Sengerema 10 20MIN 3000 SENGEREMA DISTRICTKharumwa Health Centre Geita 115 3HRS 20000Nzera Health Centre Geita 48 2HRS 8000Katoro Health Centre Geita 50 45MIN 6000Nkome Dispensary Geita 80 2HRS 6000Nyanghwale Health Center Geita 85 2HRS 7000Kasamwa Health Centre Geita 25 30MIN 4000Bukori Health Centre Geita 60 1:30HRS 6000
    13. 13. • Delays with data flow and information reporting from the District and Regional level to the National level• Inaccuracy of reports being received thus requiring further on site data verification• High cost of supervision and sending report to district in regards to travel costs to access the 535 health facilities • Ever used the phone for SMS services No 52.17% Yes 47.83% Total 100 – All staff own the telephone handset and share it in daily personal uses
    14. 14.  Instruction on Any problems with Swahili critical to small buttons on the using IQSMS phone?  Response Freq % Response Freq %  No 6 17.14 No 30 85.71  Yes 29 82.86 Yes 5 14.29  Total 35 100 Total 35 100 • Reasons For Not Sending Monthly Report – Majority said they don’t understand English language – Need message understandable in Swahili language
    15. 15. IQSMS Instructions in Swahili
    16. 16.  Barriers to implementing • Anything that can be mobile phone reporting for improved on report submitting all four reports submission to make each month report to be on time  Mobile Network Problem/failure • Response Freq %  Server don’t respond on time • No 14 40.00  PCR report type is hard • Yes 21 60.00  It have been found that free • Total 35 100 Airtime is critical for scale up
    17. 17. Health IT Solutions*EMRS – Electronic Medical Records System
    18. 18. Health IT Solutions Tanzania mobile phone coverage and mobile penetration Vpdacom Tanzania• *EMRS – Electronic Medical Records System
    19. 19. M&E Electronic Reporting System Solar Power Cell phonesOrphans Vulnerable Children PDA device(OVC), Most At RiskPopulation (MARPS),Maternal Child Health (MNH) Ms Access Database Excel PMTCT MONTHLY REPORT PMTCT Antenatal Clinic (ANC) Monthly Excel Only Summary Form Web Internet 118 Desktop ANC 01. New ANC clients this month 8 ANC 02. Previously known to be HIV positive 17 ANC 03. Total number tasted 574 ANC 04. Number of new client had HIV test at ANC 277 ANC 05. Tested HIV-Positive 37 ANC 06. Post-test counseled for positive and negative 574 ANC 07. Number of partners tested for HIV 16 ANC 08. Tested HIV-Positive 4
    20. 20. For more information Contact  Bjefferson at futuresgroup.com  Lburrows at futuresgroup.com For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: www.atsdr.cdc.gov
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