Improving Standards of Care with Mobile Applications in Tanzania

Posted by EKStallings on Nov 01, 2011
Improving Standards of Care with Mobile Applications in Tanzania data sheet 777 Views
Bogan, Molly, Jan van Esch, Gayo Mhila, Brian DeRenzi, Caroline Mushi, Timothy Wakabi, Neal Lesh, Marc Mitchell
Publication Date: 
Apr 2009
Publication Type: 
Report/White paper

In this paper, we present D-tree International’s work with medical algorithms and mobile applications to improve the standards of care in clinical and community settings. In particular, we present a mobile phone-based application called CommCare which helps community health workers (CHWs) to provide home-based care and social support to HIV, tuberculosis and other chronic patients. The application guides the CHWs through a series of questions which they answer using the phone’s number pad. The data then can be submitted directly to a central database over a cellular GPRS network.

We report on our experience developing and testing the application in Tanzania, including the iterative development process with the CHWs and training them to use the program. We include an account of some of the hardware and software issues encountered and resolved during the process, and some initial reactions from the first CHWs and clients to use the program. While the formal evaluation of the program is still in progress, initial findings show that the phonebased system is generally viewed positively by the users and by the clients as more discreet and better for privacy than the paper-based system.


CoolComply: Using Wireless Tech to Monitor Medication Storage and Adherence

Posted by AnneryanHeatwole on May 17, 2011
CoolComply: Using Wireless Tech to Monitor Medication Storage and Adherence data sheet 2234 Views

Many medications lose efficacy if stored outside their optimal temperature range, but in rural settings it can be difficult to maintain a steady cooling level. A new solar-powered refrigeration device called CoolComply is working to solve this problem by creating a more stable means of home medication storage, and improving patient adherence along the way.

Developed in partnership by the Massachusetts General Hospital, Innovations in International Health at MIT, and the Global Health Committee, CoolComply uses wireless technology to relay readings to local healthcare workers so they can remotely monitor patients being treated for Multiple Drug Resistant Tuberculosis (MDR-TB). spoke with Stephan Boyer (a student of Electrical Engineering and Computer Science at MIT), Anna Young (the R&D Officer for International Laboratories of Innovations in International Health at MIT), and Aya Caldwell (Program Manager at CIMIT’s Global Health Initiative) about their work developing CoolComply.

Basic Information
Organization involved in the project?: 
Project goals: 

The project goals are two-fold:

  • To create a system that keeps medications cool and that monitors the medications' temperatures
  • To monitor medication adherence of patients with multiple drug resistant tuberculosis
Brief description of the project: 

CoolComply is a cooling device that monitors the temperature of MDR-TB medication and wirelessly transmits data about the temperature of the medication and patient adherence levels to community health workers through SMS. 

Target audience: 

The target audiences are community health workers in Ethiopia and patients with multiple drug resistant tuberculosis. 

Detailed Information
Length of Project (in months) : 
Under Development
Anticipated launch date: 
2011 Aug
What worked well? : 

The project is still under development, but so far the group has built and tested a cooling device that transmits SMS alerts.

What did not work? What were the challenges?: 

The group has worked around designing for limited connectivity and limited electricity access, as the device needs to function off the grid while maintaining steady temperatures and regular wireless updates for commuity health workers. 

Mobile Direct Observation Treatment for Tuberculosis Patients

Posted by MohiniBhavsar on Oct 11, 2010
Mobile Direct Observation Treatment for Tuberculosis Patients data sheet 2015 Views
Jeffrey A. Hoffman, Janice R. Cunningham, Andrew J.Suleh, Aaron Sundsmo, Debra Dekker, Fred Vago, Kelly Munly, Emmy Kageha Igonya, Jonathan Hunt-Glassman
Publication Date: 
Jul 2010
Publication Type: 
Journal article

Growth in mobile phone penetration has created new opportunities to reach and improve care to underserved, at-risk populations including those with tuberculosis (TB) or HIV/AIDS.

This paper summarizes a proof-of-concept pilot designed to provide remote Mobile Direct Observation of Treatment (MDOT) for TB patients. The MDOT model combines Clinic with Community DOT through the use of mobile phone video capture and transmission, alleviating the travel burden for patients and health professionals.

Three healthcare professionals along with 13 patients and their treatment supporters were recruited from the Mbagathi District Hospital in Nairobi, Kenya. Treatment supporters were asked to take daily videos of the patient swallowing their medications. Patients submitted the videos for review by the health professionals and were asked to view motivational and educational TB text (SMS) and video health messages. Surveys were conducted at intake, 15 days, and 30 days. Data were collected in 2008 and analyzed in 2009

All three health professionals and 11 patients completed the trial. All agreed that MDOT was a viable option, and eight patients preferred MDOT to clinic DOT or DOT through visiting Community Health Workers.

MDOT is technically feasible. Both patients and health professionals appear empowered by the ability to communicate with each other and appear receptive to remote MDOT and health messaging over mobile. Further research should be conducted to evaluate whether MDOT (1) improves medication adherence, (2) is cost effective, and (3) can be used to improve treatment compliance for other diseases such as AIDS.

X out TB: Mobile Phones for Combatting Tuberculosis

Posted by CorinneRamey on Jun 20, 2008

The numbers should speak for themselves. In 2006, there were 9.2 million new tuberculosis (TB) cases and 1.7 million TB deaths. Of these cases, 5.3% were a tough strain of TB that is resistant to treatment (known as MDR-TB, or multiple drug resistant tuberculosis). The total cost of TB control programs in high burden countries is estimated to be about $2.3 billion in 2008. A team of students and faculty at the Massachusetts Institute of Technology has come up with an innovative response to this problem that uses mobile phones as both a reporting mechanism and incentive program.