Mobile Technology To Improve Health Service Delivery Within Government
Project Street Address
Project City
Project Province/State
Project Postal/Zip Code
Project Country
Focus of activity
Service/process
Year the initiative began (yyyy)
2004
Which of these barriers is the primary focus of your work?
Patients not empowered
Which of the principles is the primary focus of your work?
Simplify through technology
If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic:
This field has not been completed
Name Your Project
Mobile Technology To Improve Health Service Delivery Within Government
Describe Your Idea
Define the innovation
Improving the delivery of health services to the majority of South Africans is a key challenge faced by the SA government in the 2nd decade of democracy.Information& communication technologies(ICT)are an enabler that can enhance the ability of the public service to adequately address service delivery backlogs, while providing citizens with a range of more creative options for accessing services.Amongst the many ICT options available to govt to improve the efficiency& effectiveness of its delivery process,mobile & wireless technologies offer some exciting opportunities for a low cost,high reach service.There is strong evidence that mobile technologies could be instrumental in addressing slow response rates,of govt to citizen requests,poor access to services,particularly for low-income and marginalised populations in under-serviced rural areas.In addition,mobile technologies offer significant opportunities for improving the back-office operations of govt.In the SA context,medical institutions-hospitals & clinics-all operate on different systems for gathering & maintaining patient information.In addition,many primary healthcare clinics located in the rural areas do not have any electronic systems at all & continue to operate paper- based systems,resulting in patient records being kept by patients themselves. The impact of the use of multiple systems is that it is difficult& costly to develop a national overview of patient statistics.On a more basic level,it is extremely difficult for idividual institutions within the healthcare sector to share information between each other.One of the clearest examples of this is to be found in the sharing of patient laboratory results.Currently in most instances,this only takes place through manual exchange.Govt identified the Dokoza pilot as one that could enable electronic data-sharing in a manner that enhances the ability of the health worker.
Context for Disruption:
The Dokoza system is a new innovative cost-effective interactive real-time mobile system for fast-tracking & improving critical services to the broader majority.Components of the system have been patented(SA Patent#2002/1242),the system has been developed in SA for use initially in HIV/AIDS(specifically in respect of the roll-out of anti-retroviral therapy)and TB treatment,with the view to including other diseases.The system involves the use of SMS& cell phone technology for information management, transactional exchange & personal communication.The cell phone makes use of a regular issue SIM card across any existing cell phone network.The system standard is normal SMS text messaging and therefore does not require special additional SIM software or downloading of templates for interacting.Dokoza back-end system is extensively rules based for intelligent interaction to build capacity for health workers with little knowledge.For e.g.,the system is able to process an ARV/TB programme in the context of particular disease management protocols managed by a chosen group of Patient Management Clinicians(PMC).The PMC is not the treating health worker,but rather the person responsible for the design and monitoring of treatment protocols.Furthermore,Dokoza back-end system is easily integrated with all existing hospital systems(such as the National Lab)and Dokoza can also be accessed in real-time via PC web,laptop,PDA,Smartphone,Palmtop and is able to interact with fax and email.Overall there are various levels of security measures,firewalls and encryption.Dokoza does not display HIV sensitive information on the web and further security is required to view these in a back-office environment.Dokoza offers the Dept of Health a cost- effective accessible national platform,with the capacity to collect& disseminate real-time data& transaction exchange,without further systems development on the part of the Dept apart from establishing connectivity with Dokoza.
Delivery Model
The idea is that the system is concieved from the outset as a system that is fundamentally common to all participating facilities across the country, by using the Web and GSM platforms,and that is an integral part of the broader public health system of South Africa, or any other country. The system is designed to support key health requirements and functions, such as offering capacity for resource poor settings( resource poor in terms of no computer hardware and /or little knowledge), national patient tracking and surveillance, or easy access to patient history in order to make accurate clinical decisions and so on. The system caters for: 1)Single Patient View 2)Mobility 3)Open Source Solution. We believe that our model is designed to reach and improve health service delivery to low-income or marginalised populations, cost-effectively and easily achievable in the short term.
Key Operational Partnerships
During 2004/2005 the pilot project was implemented at 2- government sites (Helen Joseph Hospital HIV/AIDS Adult Clinic and Johannesburg General Hospital HIV/AIDS Childrens Clinic) with the cooperation of the Gauteng Provincial Health and the National Department of Health. Other participants were members from the 2- hospitals' Health Information Systems:Medicom & PAAB, and The National Health Laboratory Service.The Dokoza pilot project was commissioned and fully funded by the following government departments: State Information Technology Agency (SITA), Centre for Public Service Innovation(CPSI), Centre for Scientific and Industrial Research(CSIR), Meraka Institute with the cooperation of the National Department of Health. Also, the pilot was simultaneously implemented at a private site: Tugela STD (Sexually Transmitted Disease) Clinic in KwaZulu Natal South Africa. This STD clinic is run by the National Road Freight Industry and is supported by the Department of Health in terms of staffing and providing medicine supplies. The STD Clinic services national long distance drivers and sex workers from within the area. This private pilot was fully funded by Dokoza and its partners. Regarding our business, Dokoza's strategic partners are Neil Harvey & Associates (NHA)who is Dokoza IT partner and Deloitte is Dokoza partner for Data Analysis & Reporting, Risk Management and Strategic Advice.
Financial Model
1)Dokoza will charge no upfront development fees 2)On successful implementation of the system, the Department of Health will be charged a small capitation fee on a per registered patient per month basis 3)The Department of Health will also pay for Dokoza ingoing and outgoing SMS costs, via a toll-free/reverse charge SMS line, for all health worker interactions 4) Patients receiving SMSs for health alerts, medicine compliance reminders, appointment reminders, notification for receipt of blood test results and so on, will receive this as a 'free service' i.e., this will be treated as a Dokoza outgoing SMS as per point no. 3 above and invoiced to the Department of Health.
What is your annual operating budget?
0%
What are your current sources of revenue? (please list any sources that are foundation grants)
The project currently generates no income.
Effectiveness
1. User Acceptance. During the pilot, some health workers who were not computer literate and in some cases had never used a computer, were easily willing to learn and successfully used the cell phone for data & transaction exchange. 2) Increased Treatment Compliance. Feedback, from patients who participated in receiving SMS health alerts, was very encouraging and positive. Patients indicated that, by receiving an SMS reminder to take their meds twice a day at the appointed times, this made treatment compliance easier.
Which element of the program proved itself most effective?
Accessibility to clinical data easily and timeously. There is a general lack of computers and lack of readily available clinical and other information.
Number of clients in the last year?
0 last year
What is the potential demand?
We believe that all 'resource-poor' countries('resource- poor' in terms of health workers with no computers and /or little knowledge) would benefit from Dokoza.
Scaling up Strategy
We are involved in various health tender submissions to the SA government.
Stage of the initiative:
1
Expansion plan:
The South African National Department of Health has issued out a tender for the SA National Electronic Record, where Dokoza has responded as part of a large consortium. Should we be successful, then the project for the next 3-years is to roll-out mobile technology to all 9-provinces in South Africa. Simultaneously we will sell mobility to other SA goverment departments and we will also actively look to other health markets in other countries who may be interested in our proven solution.
Origin of the Initiative
Dokoza is a registered trademark and brand name for a health mobile system created by Kubatana Close Corporation. Jessie Dias-Alf is the sole owner of Kubatana CC / Dokoza project and has been working on this project since 2004 to date. Jessie Dias-Alf has been active in the SA medical aid industry since 1992.A main motivation for the invention was real-time empowerment for rural doctors who do not have access to computers to switch or submit patient medical aid accounts to private sector Medical Aid Schemes, for example.We believe that Dokoza is an exciting opportunity that will enhance government service delivery and improve internal efficiencies.
This Entry is about (Issues)
What are your two main challenges to finance the growth of your initiative
The greatest challenge with most pilot projects in the public sector is that they do not move beyond the piloting phase, with very little replication or mainstreaming taking place. The Dokoza project faces similar challenges. In order to ensure that the project becomes sustainable, a number of environmental challenges need to be overcome, both within the specific pilot sites,and within the public healthcare sector more broadly. Due to the fact that pilots such as Dokoza are selected through a public solicitation process, but one not fitting with requirements of formal public sector procurement, departments are reluctant to take over the outcomes of the project, particularly when they are linked to a specific service provider. A limited number of options are available to any Department, as they are to the Department of Health in this case.
How did you hear about this contest and what is your main incentive to participate?
Have heard about this contest through a colleague. Our main incentive for participation is around potential funding to assist with the scaling up of the project.
Do you have an annual financial statement?
The project currently generates no income.
Do you currently have an annual financial statement that tracks profit/loss?
The project currently generates no income.
Please describe the amount (and/or type) of funding you need to implement your initiative, at year 1 and at year 5.
Our financial model has been drawn up and this is available on request.
 | Grin barrig said: learned something new http://www.google.com Does this show about this idea. - 102 days ago read more > |
| Deniesh Smith said: I think SMS Messaging sent to every resource center, homeless shelters, medical centers, etc. and all homeless clients registered could ... about this idea. - 113 days ago read more > |
| Baja Caribe said: Supposedly, there was an outbreak of TB in homeless shelters in San Francisco California during months before September 2007 that ... about this idea. - 907 days ago read more > |
| Lawrence Wasserman said: Dear Deb Levine: As one who has worked in business and development management for the past 20+ years, mobile phone devices have ... about this idea. - 949 days ago read more > |
| Jessie Dias-Alf said: Thank you for your comments. To answer your questions: (A)What is it (the system) capable of doing right now? 1) Real time data & ... about this idea. - 975 days ago read more > |
| Jessie Dias-Alf said: Our back-end system is extensively rules based and capable of initiating an intelligent chain of activities to deal with situations such ... about this idea. - 975 days ago read more > |
| Jessie Dias-Alf said: Hi Deb, Thank you for your comments. It's interesting that you talk about providing a service with "less clicks away"....We do not ... about this idea. - 975 days ago read more > |
| Deb Levine said: I applaud Ms. Dias-Alf's work using cell phones for HIV prevention and TB management in South Africa. It is quite brilliant. As the use ... about this idea. - 981 days ago read more > |
| Tyler Ahn said: Dear Ms. Dias-Alf: Cell phones are becoming ubiquitous even in rural Africa. The health sector can learn from your example and use ... about this idea. - 987 days ago read more > |
| Tyler Ahn said: Dear Ms. Dias-Alf: Theuse of text messaging as a form of health notifications is indeed fascinating. Due to our lack of knowledge on ... about this idea. - 992 days ago read more > |
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