The document discusses using text messaging to improve healthcare in rural developing areas by bridging communication gaps. It describes several studies and programs that have used text messaging to track patients, monitor symptoms, manage care, and save costs. One program in a rural area saved $3,500 and 2,100 staff hours over six months by using text messages to coordinate care.
2. There is a 4.4 million global health worker shortage - WHO
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14. 73% of all mobile users are in the developing world By 2012, 50% of individuals living in remote areas in the world will have mobiles The fastest growth is projected to occur in Asia and Africa
27. Injury Emergency Care CHW alerts the clinic Clinic dispatches resources Mahmud N, Rodriguez J, Nesbit J. A text message-based intervention to bridge the healthcare communication gap in the rural developing world. Technol Health Care. 2010 Jan; 18(2): 137-44. 150 patients over 6 months
29. Patient misses appointment CHW receives alert CHW locates and checks in with patient CHW reports patient’s status Mahmud N, Rodriguez J, Nesbit J. A text message-based intervention to bridge the healthcare communication gap in the rural developing world. Technol Health Care. 2010 Jan; 18(2): 137-44. 2,100 hours saved Patient Tracking
30. 2x number of TB patients Mahmud N, Rodriguez J, Nesbit J. A text message-based intervention to bridge the healthcare communication gap in the rural developing world. Technol Health Care. 2010 Jan; 18(2): 137-44. Symptom Monitoring
31.
32. Mahmud N, Rodriguez J, Nesbit J. A text message-based intervention to bridge the healthcare communication gap in the rural developing world. Technol Health Care. 2010 Jan; 18(2): 137-44. Management
33. Impact in six months: 1. Saved $3,500 in motorcycle fuel 2. Saved 2,100 staff hours 3. Doubled enrollment in Tuberculosis treatment program Mahmud N, Rodriguez J, Nesbit J. A text message-based intervention to bridge the healthcare communication gap in the rural developing world. Technol Health Care. 2010 Jan; 18(2): 137-44.
56. “ My name is J___ ____ my brother is working in Unicef and I live in ____ I have 2 people that is still alive under the building still ! Send Help!”
64. ndimmafuna manthwala (‘I currently need medicine’) ndimafuna mantwala ndi-ma-fun-a man-twala ndi -ma- fun -a man - twala ndi -fun man-twala (“I need medicine”) Category = “Request for aid” 1) Normalize spellings 2) Segment words 3) Identify predictors Auto-categorization – the process 1 in 5 classification errors with raw messages 1 in 20 classification error post-processing. Improves with scale.
65.
Notes de l'éditeur
Use low-cost mobile technology to create connected, coordinated healthcare systems that save more lives.
Countries with health worker shortages
AIDS prevalence (proportionality map)
Tuberculosis
Malaria endemicity map. These maps overlay very well with those countries that have health worker shortages.
Countries with health worker shortages
The 5 billionth cell phone subscriber was recorded in July, btw. In stark contrast to access to Internet at ~10% in Malawi. Computer literacy is also very much lower than mobile literacy in Malawi.
Our flagship pilot was in Namitete, Malawi
Started work in Malawi at St. Gabriel’s Hospital where...
2 doctors serve 250,000 people spread 100 miles in every direction. St. Gabe’s typifies the struggle of the health worker shortage.
Around St. Gabriel’s 500 community health workers work in remote villages to help decentralize care, but volunteers like Dickson walk 40 miles each way to hand-deliver updates on patients. adherence rates suffer, clinicians are unaware of patient statuses, immobile patients cannot receive emergency care, remote health workers lack support, new illnesses are not identified
CHW empowerment - when they aren’t paid with money…
Expanded to 75 CWS during next 2-3 weeks. Will expand to 50 more in next 2 months.
Impact -- Patients with urgent needs receive emergency care.
Impact -- More patients remain in treatment programs, emergency transport and home-based care teams respond to priority cases, less resources are spent following up on defaulting patients.
And the cost to run the program was only $500 (SMS text messages)
Qualitative outcome: empowerment
Translated into 15 languages thus far.
Impact -- Fewer patients ‘fall through the cracks,’ referral clinics are prepared for referred patients, more patients begin and remain in treatment.
Impact -- Fewer stockouts, less waste, more patients receive vital drugs.
Medic has expanded since our inception to 11 countries.
Light-weight medical records system that can accept forms!
How is it being used? Being piloted in Mali as a full-fledged records system for the patients. Also used to automate SMS reminders for vaccines in India.
Vaccine project in Kurnool, India
Crisis mappers based out of boston, montreal, and other places. Mapping and communicating information. 4636 was the channel that people could use to communicate what was happening/needed.
80,000 SMS messages processed in 1 month
1500 people all over the world helped translate messages from Haitian creole. Translated, categorized, and geomapped messages. Then these structured tags were passed onto Patrick Meier’s crisis mapping team for secondary processing and distribution.
There was no 911 system. 4636 was the way to communicate urgent needs.
Received about 200 text messages in a day from this IDP camp (~2500 people here). Needed food and water.
Get involved at Hope Phones- you can donate your old cell phones to us- they get refurbished, resold, and we use the proceeds to buy appropriate phones for our pilot sites.
