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On the ground experiences & challenges of a connected diagnostics GxAlert in Nigeria

Union Conference 2016 by KNCV

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On the ground experiences & challenges of a connected diagnostics GxAlert in Nigeria

  1. 1. On the ground experiences and challenges of a connected diagnostics-GX Alert in Nigeria 47th Union World Conference on Lung Health Liverpool, England Oct 26 - 29, 2016 Gidado M., Peter, N., Elom, E., Gabriel A., Rupert E., Useni S., Nkem C., Kuye J.
  2. 2. Acknowledgement & declaration of conflict of interest  All colleagues in NTP; Abts associates and system one; USAID.  I have no conflict of interest and I take responsibilities for the content of the presentation
  3. 3. Presentation outline  Summary  Introduction  Processes  Lessons learnt  Challenges/Way forward
  4. 4. Summary GxAlert connectivity is a laboratory management tool if implemented effectively. However “matching the right technology with the right problem can be challenging” (Lombardo, & Buckeridge, 2007)
  5. 5. Introduction--1  4th in-terms of Global TB burden  Highest TB burden in Africa.  TB incidence: 322/100,000 population  TB treatment coverage-CDR is 15%,  National HIV prevalence- 3.4%  TB/HIV co-infection 17%  Prevalence of MDR-TB among New Cases is 2.9%  Service delivery points: • >5,940 DOTS centers • >1,925 AFB centers • 245 GeneXpert sites • 8 TB culture labs
  6. 6. Introduction---2  Real time paperless data century – the role of internet. • “Chose technology that aligns with fiscal realities; technology that are flexible & scalable” • “Engage stakeholders in the entire processes” • “Implementing connectivity is a journey and should be Step wise” • “Who is the costumer, & what is/are the goals of the connectivity” • “Management of expectations” Lombardo, & Buckeridge (2007)
  7. 7. Lab connectivity in Nigeria GeneXpert Health Systems Connects the device via secure network. Allows automatic real-time reporting of test results. Routes the information so it can become “actionable” within the health system.
  8. 8. What are we connecting and why? GH Kumo Kwali GH IDH Kano Zankli Lab NIMR Yaba SMS Email Computer Other Systems: e-TB Manager DHIS2 GeneXpert
  9. 9. Why Connect GeneXperts? Connected via GxAlert
  10. 10. Implementation processes: Proof of concept Add a USB Modem Add a 3G Router <5 machines >200 machines
  11. 11. We always ask for more:
  12. 12. Results-example--1
  13. 13. Results ---2  Real time feedback to patients and clinicians on readiness of result  Real time notification/Alert to state program on MTB/Rif resistance case  Early alert: • Non functioning machine • Cartridge stock level • Warranty expiration • Error rates  Timely reporting of appropriate indicators
  14. 14. Challenges:  Variation/Availability of internet by states/lab sites  Quality of primary data-incompleteness of variables in request forms  Summary dashboard not available for the direct user  Lack of unique identification number with difficulties to link GxAlert with other electronic reporting system  Legal framework or enabling policy on electronic reporting  Security, privacy and confidentiality related issues (currently non connection among military sites)
  15. 15. What are we asking for now  How can we… • Sustain Connectivity • Have Patient Unique Identifier • Integrate with other systems (e-TB, DHIS) • Dedicated Staff to Train, Provide on Site Supportive Supervision, Monitor and Troubleshoot when a lab does not report • Connect system with other diagnostic tools
  16. 16. Acknowledgement  NTP  USAID  KNCV/CTB  Abts & System one  GeneXpert lab colleagues
  17. 17. Thanks Comments/Questions