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Informational Briefing Futures Group eHealth and mHealth
<ul><li>Bobby Jefferson, Senior Health Informatics Advisor,  Futures Group  </li></ul><ul><li>Manage 36  Programmers  Indi...
<ul><li>502 Staff  </li></ul><ul><li>30+ countries </li></ul><ul><li>Multi-disciplinary  </li></ul><ul><li>Majority doctor...
CHSS Geographic Focus Latin America and the Caribbean: Guatemala Guyana Haiti Honduras  Africa: Kenya Lesotho* Mozambique ...
Informatics Solutions  <ul><li>IT Database related to Poverty Reduction </li></ul><ul><ul><li>Social Cash Transfer </li></...
<ul><li>We are working across 15 Countries,  1,033 Hospital Facilities  + Satellites Clinics ,  Antenatal Care – 535 PMTCT...
 
Results <ul><li>Internet </li></ul><ul><li>Mobiles, SMS </li></ul>Rural, Remote  City # of Facilities <ul><li>Sparse  Mobi...
<ul><li>Nurses, Clinicians, Adherence Counselors, need  health data, M&E program data in knowledge repository  </li></ul><...
<ul><li>Approach </li></ul><ul><ul><li>Use of freely available, reusable, tools, “coded in country” Creative commons  appr...
Rajketu Singh Amit   Kumar Naveen Sharma Sanjay   Rana Piyush   Khanna , Jayanta Kr. Das:  Deepika Saini – no  photo  IT T...
 
 
Collaborators and Users ICAP  Columbia University 44 sites Intra Health International  17 sites Elizabeth Glaser EGPAF  16...
Health IT Solutions <ul><li>Collectively referred to as  IQSolutions </li></ul><ul><ul><li>Electronic medical records </li...
 
Clinicians able to review individual patient histories <ul><li>*Clinicians review patient histories, prescribed drugs, ord...
demo <ul><li>http :// 173.203.65.108/iqcare/frmLogin.aspx </li></ul><ul><li>Username: user1 </li></ul><ul><li>Password: 1 ...
 
Mobile Phone Reporting by Remote Workers
<ul><li>PMTCT Currently consists of 4 types of monthly reports  </li></ul><ul><li>1. PMTCT Antenatal Clinic (ANC) Monthly ...
Monthly  and Quarterly Reports  PMTCT Report Must Pass All Data Quality Rules, District Office Data Quality Checks
NUMBER OF CLIENT HAD HIV TEST AT ANC
Orphans Vulnerable Children  (OVC),  Most At Risk Population (MARPS), Maternal Child Health (MNH) Ms Access Database PDA d...
UNICEF Social Cash Transfer  Application Futures Group International
 
 
 
STEPS OVC <ul><li>STEPS OVC =  S ustainability  T hrough  E conomic  S trengthening,  P revention and  S upport for  O rph...
STEPS OVC Login
STEPS OVC Beneficiary Search
 
District Health Training - Mobile Phone Survey using SMS
 
Held Training of 600 District Health Officers in Kenya On New District Health Reporting Tool  Ministry of Health NASCOP   ...
Mobile Phone Survey Architecture  Assessment Database (Excel) Valid? SMS Provider service (Zain/Safaricom) survey data sen...
8 provinces involved in the survey, a total of 388 interviewees sent some reply;  101 interviewees completed the survey  G...
Response duration and times  Table 5: Time in minutes to complete the survey Province N = 131  Minimum 25th Percentile Med...
Response duration and times  <ul><li>Most of the respondents attended to the SMS after 5pm </li></ul><ul><li>Sending multi...
 
 
Informationl briefing feb 2012
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  • Global: GMS, SEARCH, WB IDU
  • How you deploy Where are you operational? Target beneficiaries…… Scale of operations Deployment partners Cost of deployment.. Large footprint, # of sites, clinics,# of patients managed listed below
  • IQCare Captures, organizes and presents information in a manner superior to the physical records Maintains automated patient histories( registration, lab tests &amp; results, rx plans, appointment schedules and exits ); the records are stored, retrieved, and cross-referenced more efficiently Designed for use even in countries with under-developed infrastructure
  • Identify how to decrease that gap to ensure all pregnant mother’s are tested during ANC
  • Give example of a successful deployment Describe what went well (provide any supporting evidence), describe positive unintended consequences/innovations Site Capacity Assessment Tool (SCA)
  • Transcript of "Informationl briefing feb 2012"

    1. 1. Informational Briefing Futures Group eHealth and mHealth
    2. 2. <ul><li>Bobby Jefferson, Senior Health Informatics Advisor, Futures Group </li></ul><ul><li>Manage 36 Programmers India (10) , South Africa (10) , Kenya (10), Tanzania (2), Nigeria (1), Guatemala (1) , Uganda (2) </li></ul><ul><li>U.S. Government President AIDS Relief Program $15 Billion – 10 Countries HIV, Prevention Mother to Child Transmission, TB, OVC </li></ul><ul><li>Principal Investigator– National Health Informatics System (HMIS) Kenya Datawarehouse , National Electronic Medical Records 6,000 hospitals </li></ul><ul><li>Lead IT Project Manager- Community Level Orphans and Vulnerable Children (OVC) electronic data system (World Vision, UNICEF, CRS, Africare) – Zambia, Tanzania </li></ul><ul><li>Health IT Advisor - 5 Central Asia Republics (CAR) Consortium for AIDS Strategic Information in Central Asia (CASICA) </li></ul><ul><li>Kazakhstan, Kyrgyz Republic, Tajikistan, </li></ul><ul><li>Turkmenistan, Uzbekistan </li></ul>Implementing eHealth and mHealth for Low Resource Communities
    3. 3. <ul><li>502 Staff </li></ul><ul><li>30+ countries </li></ul><ul><li>Multi-disciplinary </li></ul><ul><li>Majority doctoral and masters-level </li></ul>Staff Profile
    4. 4. CHSS Geographic Focus Latin America and the Caribbean: Guatemala Guyana Haiti Honduras Africa: Kenya Lesotho* Mozambique Nigeria Rwanda Tanzania Sierra Leone South Africa Swaziland Uganda Zambia Zimbabwe* Asia and the Middle East: Afghanistan China* India Pakistan* Europe & Eurasia Georgia* Ukraine
    5. 5. Informatics Solutions <ul><li>IT Database related to Poverty Reduction </li></ul><ul><ul><li>Social Cash Transfer </li></ul></ul><ul><ul><li>Household base assistance, community empowerment, </li></ul></ul><ul><li>Mobile Surveys </li></ul><ul><li>Monitoring and Evaluation system </li></ul><ul><li>PPP </li></ul><ul><li>Capacity Building, Knowledge Transfer, </li></ul><ul><ul><li>Site Capacity Assessment (SCA) tool </li></ul></ul>
    6. 6.
    7. 7. <ul><li>We are working across 15 Countries, 1,033 Hospital Facilities + Satellites Clinics , Antenatal Care – 535 PMTCT sites </li></ul><ul><li>Rural, remote, hospitals “ serving poorest of poor ” and Ministry of Health (MOH) facilities, Rural health facilities serving BPL, marginalized and most vulnerable populations  </li></ul><ul><ul><ul><li>Intermittent power, </li></ul></ul></ul><ul><ul><ul><li>Lack IT staff, </li></ul></ul></ul><ul><ul><ul><li>Lack internet, </li></ul></ul></ul><ul><ul><ul><li>Sparse mobile coverage </li></ul></ul></ul><ul><li>Lack of referrals, or linkage between HIV, PMTCT, TB, </li></ul><ul><li>Cost effectiveness and sustainability -- no funds for proprietary licenses, or yearly maintenance fees </li></ul>Low Resource Environment
    8. 9. Results <ul><li>Internet </li></ul><ul><li>Mobiles, SMS </li></ul>Rural, Remote City # of Facilities <ul><li>Sparse Mobile Coverage </li></ul><ul><li>No Internet </li></ul><ul><li>Intermittent Power </li></ul>Online Solutions Mobile Solutions Offline, Disconnected Solutions <ul><li>Smartphones </li></ul>
    9. 10. <ul><li>Nurses, Clinicians, Adherence Counselors, need health data, M&E program data in knowledge repository </li></ul><ul><li>Lack of referrals, or linkage between HIV, PMTCT, TB, or to existing technology systems </li></ul><ul><li>Cost effectiveness and sustainability -- no funds for proprietary licenses, or yearly maintenance fees </li></ul>Low Resource Environment
    10. 11. <ul><li>Approach </li></ul><ul><ul><li>Use of freely available, reusable, tools, “coded in country” Creative commons approach </li></ul></ul><ul><li>Reusable software and technology across countries and programs </li></ul><ul><li>Offline Solutions, Disconnected model </li></ul><ul><li>Local programmers, all IT staff in country (India, Kenya, South Africa) </li></ul><ul><li>- Offer Programmer training SQL, Agile process, Virus Remediation </li></ul><ul><li>Low costs, Inexpensive $200-$350 Netbooks , Solar netbooks </li></ul><ul><li>Solar mobile phones, SMS instead of Smartphones </li></ul><ul><li>- </li></ul>
    11. 12. Rajketu Singh Amit Kumar Naveen Sharma Sanjay Rana Piyush Khanna , Jayanta Kr. Das: Deepika Saini – no photo IT Team in India 2012 Paritosh Mishra Seema Verma
    12. 15. Collaborators and Users ICAP Columbia University 44 sites Intra Health International 17 sites Elizabeth Glaser EGPAF 16 sites Family Health Inter FHI 45 sites Catholic Relief Services 13 sites Catholic Relief Services - 32 Pathfinder International Gertrude Children Hospital DOD Walter Reed - 28 Mount Kenya University MOH Kenya Sites AIDSRelief John Snow International Rakai Health Services Vaccine Research Intra Health International Mennonite Christian Charities AIDSRElief 35 sites PMTCT , ANC sites 535 sites Elizabeth Glaser EGPAF Ministry of Health Ministry of Education Users World Vision Clinton Foundation Columbia University UNICEF DFID
    13. 16. Health IT Solutions <ul><li>Collectively referred to as IQSolutions </li></ul><ul><ul><li>Electronic medical records </li></ul></ul><ul><ul><ul><ul><li>IQCare   </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Independent Technical Evaluations Performed </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>WHO, USAID, CDC Atlanta, CDC in-country, Ministry of Health </li></ul></ul></ul></ul></ul><ul><ul><li>Mobile Phone solution (IQSMS technology) </li></ul></ul><ul><ul><li>Visual Dashboards </li></ul></ul><ul><ul><li>Monitoring & Evaluation Electronic reporting </li></ul></ul><ul><li>  </li></ul>
    14. 18. Clinicians able to review individual patient histories <ul><li>*Clinicians review patient histories, prescribed drugs, ordered tests and results, and progress on care and treatment during the exam </li></ul>
    15. 19. demo <ul><li>http :// 173.203.65.108/iqcare/frmLogin.aspx </li></ul><ul><li>Username: user1 </li></ul><ul><li>Password: 1 </li></ul><ul><li>Facility/Satellite: 001-01-01-Demo Site </li></ul>
    16. 21. Mobile Phone Reporting by Remote Workers
    17. 22. <ul><li>PMTCT Currently consists of 4 types of monthly reports </li></ul><ul><li>1. PMTCT Antenatal Clinic (ANC) Monthly Summary Form </li></ul><ul><li>2. PMTCT Care Register Monthly Summary Form </li></ul><ul><li>3. PMTCT Maternity (L&D) Monthly Summary Form </li></ul><ul><li>4. PMTCT Mother - Child followup SummarForm </li></ul>IQSMS PMTCT Reports
    18. 23. Monthly and Quarterly Reports PMTCT Report Must Pass All Data Quality Rules, District Office Data Quality Checks
    19. 24. NUMBER OF CLIENT HAD HIV TEST AT ANC
    20. 25. Orphans Vulnerable Children (OVC), Most At Risk Population (MARPS), Maternal Child Health (MNH) Ms Access Database PDA device Web Internet Desktop Excel Only M&E Electronic Reporting System Solar Power Cell phones Excel PMTCT MONTHLY REPORT     PMTCT Antenatal Clinic (ANC) Monthly Summary Form     ANC 01. New ANC clients this month   1188 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
    21. 26. UNICEF Social Cash Transfer Application Futures Group International
    22. 30. STEPS OVC <ul><li>STEPS OVC = S ustainability T hrough E conomic S trengthening, P revention and S upport for O rphans and V ulnerable C hildren </li></ul><ul><li>Program provides </li></ul><ul><ul><li>Support for HIV prevention and behavior change initiatives </li></ul></ul><ul><ul><li>Reducing HIV transmission </li></ul></ul><ul><ul><li>Support for OVC, at-risk youth and adults, and other vulnerable populations </li></ul></ul>
    23. 31.
    24. 32. STEPS OVC Login
    25. 33. STEPS OVC Beneficiary Search
    26. 35. District Health Training - Mobile Phone Survey using SMS
    27. 37. Held Training of 600 District Health Officers in Kenya On New District Health Reporting Tool Ministry of Health NASCOP   SMS 1: Have you entered /Imported data into the new tool ? Yes or No    SMS 2: Have you run reports using the new district tools ? Yes or No   SMS 3: Have you discussed the new district tools and reports with other members of the district health team ? Yes or No   SMS 4: In what district do you work? Your answers are confidential and a Ksh 20 refund will be given for each valid reply
    28. 38. Mobile Phone Survey Architecture Assessment Database (Excel) Valid? SMS Provider service (Zain/Safaricom) survey data sent via frontline SMS SMS archived in frontlinesms application DB Survey responses/corrections via SMS FrontlineSMS Assessment Application Survey questions and acknowledgement via SMS Get SMS data Save Yes No Acknowledge (Reimburse airtime) Request for correction Convert SMS content to DB data
    29. 39. 8 provinces involved in the survey, a total of 388 interviewees sent some reply; 101 interviewees completed the survey Graph 1: N Participated = 165; N completed = 101 Percentage participation/completion in the DHPT text message survey by province
    30. 40. Response duration and times Table 5: Time in minutes to complete the survey Province N = 131 Minimum 25th Percentile Median 75th Percentile Maximum Mean Central 12 11.00 22.00 27.00 59.00 5861.00 999.33 Coast 12 5.00 9.00 27.00 54.50 969.00 106.75 Eastern North 5 15.00 17.00 25.00 30.00 31.00 23.60 Eastern South 20 3.00 9.00 18.00 480.00 9703.00 1202.10 North Rift 17 15.00 34.00 50.00 262.00 17561.00 2512.06 Nyanza 22 9.00 19.00 27.00 152.00 17534.00 1722.05 South Rift 19 2.00 15.00 35.00 1623.00 27553.00 3162.63 Western 24 4.00 768.00 1372.50 19012.50 30063.00 9424.38 Graph 2: N: 131 interviewees who responded to at least 2 questions Median times (in minutes) participants used to complete the SMS survey
    31. 41. Response duration and times <ul><li>Most of the respondents attended to the SMS after 5pm </li></ul><ul><li>Sending multiple questions drastically reduces the response rate </li></ul><ul><li>Re-sending an answered question does not guarantee a response </li></ul><ul><li>Contact (physical, by mail or otherwise) significantly increases the  response rate </li></ul><ul><li>The longer the duration between a response and the next question the lower the chances of getting the next response </li></ul>
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