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Mobile Phones Catch Epidemics Earlier in South Asia

The Real‐time Biosurveillance Program (RTBP) was launched in India
and Sri Lanka by by LRNEasia, the Indian Institute of Technology —Madras (IITM), Carnegie Mellon University's Auton Lab, the University of Alberta and the International Development Research Center (IDRC), "to test the potential of using mobile phones in health data collection.

They developed "a Java-based application for collecting patient data using low-cost mobile phones;... implemented Auton Lab's analytic software and T-Cube Web Interface for analyzing patient records and almost real-time prediction of disease outbreaks; and [adopted and implemented] the Common Altering Protocol for multi-channel health alerts."

"It was the first of its kind to field test an integrated end-to-end operational system using mobile phones and intelligent soft-ware in the area of real-time disease surveillance."

Currently, Sri Lanka and India's primary disease surveillance system takes hand-written patient data from regional and community health centers and then analyzed the data to id potential disease outbreaks. On finding a trend, "the regional office issue notifications to local authorities... using paper based methods. In the case of epidemics, this process takes two-to-three weeks."

The RTBP pilot augmented this existing paper based system, instead of replacing it.

"Health center staff collected patient data using mobile phones, in addition to their routine paper-­‐based work. A software application implemented on mobile phones helped collect patient records and transmit them to a central server using commercial cellular data services.
Statistical analysis was carried out using advanced software developed by Carnegie Mellon\ University’s Auton Lab. Regional and local health officials could then access the results as electronic notifications through a variety of devices, including mobile phones."

RTPB identified more than 12 instances of potential outbreaks and local authorities confirmed four of them. "The project dramatically reduced time taken for outbreak detection and alerting, from the current period of two-to-three weeks to a single day"

Implications:

"Cost savings of over 35% was observed in both India and Sri Lanka in comparison to existing systems and costs."

"Importantly, the project also demonstrated how low-cost mobile phones and existing commercial cellular infrastructure and services could be utilized to enable primary health centers to report patient information even as they record them."

"The project motivated front-line health staff to improve the quality of data collection"

"The Alerting Protocol was meant for health alert purposes, but it was also being used by health officials to meet other messaging requirements, such as improving efficiency in routine operations. This... suggested the need for a more general health notification system using mobile phones"

“The Tamil Nadu Government has been very enthusiastic and supportive of RTBP in the state. For scaling up, this project will need similarly committed partners.”

Noviscape also asserts that mobile phones worked better than computers because the phones are more ubiquitous and staff are more comfortable with them.

Barriers to scale include difficultly inputing large volumes of data on conventional phone keypads and a reluctance for health workers to take on an additional burden. The article also mentions "cultural aspects" that need to be "addressed" but does not elaborate.

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Sources:

Intellecap May 2011 page 1, 2, 3:
http://newsletters.clearsignals.org/Intellecap_May2011.pdf#page=1