Discussion about entry: Mobile Technology To Improve Health Service Delivery Within Government

Our back-end system is extensively rules based and capable of initiating an intelligent chain of activities to deal with situations such as those described in your comments. For example one would write a rule that says in the event of a particular input in the TB outbreak field, select this text message, to send to all registerd clinicians and patients with this identifier on their master file (the identifier could be for a particular area)....hope this makes sense!

Thanks Jessie.

Supposedly, there was an outbreak of TB in homeless shelters in San Francisco California during months before September 2007 that involved five city funded homeless shelters and about 50 shelter (or respite) residents may have had to have been located and notified for additional screening. Their locations are likely scattered over a large number of locations.

If it had been the XDR-TB: Outbreak of a Drug-Resistant Tuberculosis (from Digg.com) then time would be a critical factor and notification in a densely populated area with highly mobile residents time is of the essence for notification. It can save a life.

I think SMS Messaging sent to every resource center, homeless shelters, medical centers, etc. and all homeless clients registered could have been alerted in hours or a day instead of who knows how long. I think SMS could also be back linked to email, pagers, faxes (digitally).

Good comments on these uses.

Thank you for your comments. To answer your questions: (A)What is it (the system) capable of doing right now? 1) Real time data & transaction exchange - the system allows for interactive online information management/ sharing and real-time processing for cost of services/medication to a particular cost centre for a specific patient. 2) Capacity building - for example, the clinician's question could be answered for a paticular patient taking into account his/her full medical history, as captured initially and updated in real time on the back-end system 3) Authorisation - requests for authorisation of particular treatment may be made, should there be a need for such an authorisation system. For instance, based on the latest pathology results of a patient, a new medication regimen may be authorised electronically. Authorisation may be linked to practical administration, in the form of stock control and or delivery of medication. 4) National Patient tracking & surveillance - Dokoza is able to update registered patients from interfacing with all existing hospital information systems. Patients who access care across facilities, may receive appropriate care as the clinicians in different facilities are aware of key treatment already provided to patients. Lack of information about treatment already provided may significantly hamper protocol compliance. 5) Common Platform - For example, Dokoza was able to interface with the local hospital information system and the laboratory system which would allow both parties to exchange information efficiently in order to perform key functions more effectively. 6) Confidential communication with patients - capacity for automatic patient reminders to take medication, or of appointments, or encourage generally with short education messages. (B)What are the plans for making it more functional and user friendly to people who lack computer or phone literacy? User feedback on our software version was extremely favourable and supports the case that entry level SMS is accessible and user-friendly. This is an unedited response from a user " The system is very helpful - easy to use because we are (more) used to cell phones than computers. Can be used at anytime - easily available, no waiting for someone to finish using the computers - only one computer in department. Less paperwork. Can get lab results immediately and can also get subsequent result. Not easy to make (a) mistake with result because (one) will be looking at the figures unlike taking (verbal) result on the phone". (C) What is the exact evidence that patients using these phones were able to adhere to their medication? There is no way to ensure compliance, one can only remind patients and the reminder itself assists patients to remember to take meds for example.

Thanks, Jessie.

Hi Deb,

Thank you for your comments. It's interesting that you talk about providing a service with "less clicks away"....We do not use menus or templates for our intelligent SMS interactive service. The user inserts a very short command which could be a combination of alpha / numeric and our back-end system applies rules and does all the work! We found this method to be very successful especially around clinicians who had limited time and needed quick access to key patient data; our response time is sub 5-10 seconds.

Kind regards
Jessie.