Developing mHealth Systems to Improve Quality of Care
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This document discusses how developing mHealth (mobile health) systems can help improve quality of healthcare, especially in low and middle income countries. It describes D-tree International's work developing decision support tools for frontline health workers using mobile phones. An example from Malawi helped community health workers better identify and treat childhood illnesses like pneumonia through a guided mobile app for assessments, referrals, stock management and reporting. Lessons learned stressed the importance of involving local stakeholders, adapting to existing systems, and ensuring technology supports - rather than drives - health programs.
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Developing mHealth Systems to Improve Quality of Care
- 1. Developing mHealth Systems to improve quality of care Steve Ollis D-tree International sollis@d-tree.org www.d-tree.org @DtreeInt
- 2. Mobile Trends Mobile phone penetration has drastically increased over the last decade especially in developing countries.
- 3. Global Health Challenges Shortage of almost 4.3 million doctors, midwives, nurses and support workers worldwide, especially in low and middle income countries. Obstacles to Good Healthcare - Limited number of healthcare providers - Heavy client load - Limited training - High burden of disease - Limited financial resources - Paperwork
- 4. • Provide decision support tools for use by frontline health workers – Design, Test and Deploy systems – Partner with MOH and other health NGOs • Focus areas: – Maternal and Child Health – Chronic Disease What D-tree does
- 5. Types of mHealth interventions mHealth systems not apps!
- 6. CCM Malawi
- 7. The challenge • HSAs do not always follow guidelines – 56% asked about 3 danger signs – 37% assessed for 4 physical danger signs – 57% provided correct referrals and pre-referral treatment – Major gap in identification of fast breathing • Stock management • Data flows for monthly reporting
- 8. CCM in Malawi • Phase 1 – cIMCI tool on Nokia phones • Phase 2 – integrated CCM on Android • Vaccinations • Commodity tracking/reporting • Monthly reports • Dashboard • Supervisory application • Phase 2a – modification to allow for mRDTs • Phase 3 – integration with CBMNH
- 9. Patient history HSA can review patient history
- 10. Sick child form HSA guided through sick child protocol
- 11. Counting breaths Uses phone for time measurement Absence of such measuring device had been major reason for referral
- 12. Outcome of assessment Referral Home Treatment
- 13. Vaccinations
- 14. C-stock Integration HSA reminded when monthly stock report is due Entering new stock levels
- 15. Web Dashboard
- 16. Lessons learned • Fast pace of technological change • Change Management essential • Encourage data driven management • Field refinement is critical • Users must feel application supports them • Don’t let technology push the program – Sometimes a phone is just a phone – and that’s great!
- 17. Recommendations • Involvement with mHealth working group in each country • Look for existing projects to leverage • Adapt each project around the in-country m/eHealth ecosystem • Partner with MOH and consider the entire health system • Plan for integration with HMIS from the start • Leverage mFinance, mAgriculture, other e/mDevelopment initiatives
- 18. What’s next • Improved integration of facility and community • Integration of across domains • Improved dashboard analytics • Continued usage of mobile money • Exploration of integration with point of care diagnostics / unique identifiers
- 19. Thank you! For more information: Steve Ollis sollis@d-tree.org www.d-tree.org @DtreeInt