The document discusses how mobile tools can help with disease surveillance in low-income countries. It notes that timely, complete, and high-quality surveillance is difficult to achieve simultaneously. Mobile phones provide opportunities for more complete surveillance, but also challenges like usability, technology types, training costs, and pilot projects that don't scale. The organization InSTEDD has used mobile tools like GeoChat to help health workers during disasters and develop other solutions that don't require digital literacy. Effective surveillance requires clear goals and a balanced portfolio approach using mobile tools as part of broader systems and addressing issues like integration, data quality, and incentives.

1. © InSTEDD , CC BY-NC-SA
“New tools in LDCs using IT”
Mobile tools
for disease surveillance
in low income countries
Ed Jezierski, ND*
CTO, InSTEDD
@edjez

2. © InSTEDD , CC BY-NC-SA

3. © InSTEDD , CC BY-NC-SA
Tradeoffs
Timel
y
Complete
High Quality

4. © InSTEDD , CC BY-NC-SA
You can’t have it all!
Timel
y
Complete
High Quality
?

5. © InSTEDD , CC BY-NC-SA
Balanced portfolio
Timel
y
Complete
High Quality

6. © InSTEDD , CC BY-NC-SA
Mobiles give unprecedented
opportunity
Complete
Timel
y
High Quality

7. © InSTEDD , CC BY-NC-SA
But also new challenges
• Usability
• “Reach vs. Rich”
– Voice, SMS, smartphone, J2ME, USSD
• Bad designs
• Training costs
• Working with operators
• Pilots, pilots everywhere! that can never scale
• Community health worker (dis)incentives
• …

8. © InSTEDD , CC BY-NC-SA
Knowledge  Action

9. © InSTEDD , CC BY-NC-SA
Supporting group collaboration

10. © InSTEDD , CC BY-NC-SA
As Storm
Ketsana struck
Thailand,
health workers
using InSTEDD
GeoChat
alerted each
other of floods,
how to avoid
injuries and
rescuing
villagers

11. © InSTEDD , CC BY-NC-SA
Information technology doesn’t
need to be digital – at InSTEDD
we’ve had to work on tools that
simplify data reporting and
interpretation across the literacy

12. © InSTEDD , CC BY-NC-SA
Machine to Machine communication
e.g. Cepheid GeneXpert
Cepheid GeneXpert
Usage and issue monitoring
Disease trending for all tests
Aggregate data for reports
Granular data for analysis
No patient data uploaded

13. © InSTEDD , CC BY-NC-SA
Population Interaction
Screening and referral with PopCouncil BabyMonitor

14. © InSTEDD , CC BY-NC-SA
System … or archipelago?
The Other Ministry of Health
App That Only Keeps Running
Because WHO pays perdiems
for support
Some useful Ministry of
Health SMS App
The SMS app used that
has been piloted in ___
district ONLY over the last
3 years
The expensive SMS and IVR
solution some vendor did but
no one can get to the data
Remember that
summer when there
was this intern that was
Mary’s nephew and he
was kind of a geek and
he programmed a
system and then he left
but then a supervisor
That data reporting app that
was built by the university CS
intern; no one knows who uses
it but they sure tweet about it!

15. © InSTEDD , CC BY-NC-SA
Bringing it back together

16. © InSTEDD , CC BY-NC-SA
Bringing it back together
Global
Household
Village
District
Province
National
Regional
Events Indicators
Outcomes?
Incentives?
Sharing Policy?
Data Quality?
Technology?
Challenges for Integration:

17. © InSTEDD , CC BY-NC-SA
International Data (MBDS Regional
Network)
Spatiotemporal visualizations and analysis

18. © InSTEDD , CC BY-NC-SA
Tracking H1N1 in Real Time

19. © InSTEDD , CC BY-NC-SA
Client Registry
Shared Health Record
Facility Registry
Provider Registry
Terminology Service
Health Process Integration
Medical Record
Systems
Lab Mobile
Health Information Systems
as health surveillance enabler

20. © InSTEDD , CC BY-NC-SA
• Resource constrained environments can
foster efficient, creative, leapfrog approaches
• Effective surveillance starts with clear goals
• Mobile tools are just one part of a portfolio
• Mobiles bring unprecedented opportunities for
disease surveillance – if done well

21. © InSTEDD , CC BY-NC-SA
Thank You!
Ed Jezierski
CTO, InSTEDD
@edjez
edjez@instedd.org

22. © InSTEDD , CC BY-NC-SA
Cloud-based
Aggregator
Sifting, cleanup
and 1st phase of
analytics
WWW
ICD9
Prescriptions
Essence
2nd Phase
Analytics
Early Sensitization
Context
Prevalen
ce UI &
DB

23. © InSTEDD , CC BY-NC-SA

24. © InSTEDD , CC BY-NC-SA
will bring 365 opportunitiesOur field reports show 2013 to make the right choices