FOSS based Mobile Solutions : Deliver Medical Facilities to Remote Areas

Following is the article that I wrote for Linux For You (July, 2012 Edition) . This article is released under CC by SA by Linux for You.

Foss based Mobile Solutions : Deliver Medical Facilities to Remote Areas

Sometime back mobile were considered only a device used for making/receiving call’s or sms. In the last several year the number of people using mobile phone have exploded. Now, mobile is a very well connected network which now connect people all across the globe. In the last few years healthcare industry has realized untapped potential that lies in beneath these mobiles. Things like crowdsorcing and crowdmapping using mobile for working out plan for healthcare support after disaster is used frequently.

Its is something that is becoming more and more important in public health. Earlier Google and Frontline SMS had collaborated during the Haiti post earthquake disaster relief efforts and used mobile technology to make health care workers aware of public health issues on the ground – Ushahidi was there, helping translate text messages and tweets to data on a map.

This article is intended for Doctors / Service providers in healthcare systems / people interested in leveraging benefit of open source application for public healthcare infrastructure.

In this article we will explore around SMS for Life, Ushahidi and SwiftRiver .

Before going into these lets first see what crowdmapping actually is. After an event – whether it be post disaster relief, or for any public health crisis – anyone can send a message related to public health to a SMS short code, or send a tweet. The message needs to contain the relevant public health info, along with a location. It can then be translated to data on a map, allowing public health workers to efficiently allocate resources in real time. These real time online interactive maps are called Crowdmapping. Once this information is collected, volunteers collaborate over the internet to put each post onto a map, which is updated second by second. This lets on-the-ground officials locate people with the most critical needs and deliver medical and humanitarian relief more quickly and efficiently.

SMS for Life

First-line malaria medication is needed within the first 24 to 48 hours after symptoms to save the lives of children under 5, and stock-outs are such a common problem, up-to-date information on supply levels is critical. SMS for Life is a project to track the supply levels of malaria medication in hospitals and clinics in Africa. Health workers send weekly text messages to report on their supply levels, and the data is collected and displayed on a map. District medical officers can then view up-to-date status of facilities in their district, and use the information to make forecasts and plan shipments.
The SMS for Life Map Viewer is open source, under the Apache 2.0 license.
It is a solution to the longstanding problem of stock-outs at the remote health facility level.
Maintaining adequate supplies of anti-malarial medicines at the health facility level in rural sub-Saharan Africa is a major barrier to effective management of the disease. Lack of visibility of anti-malarial stock levels at the health facility level is an important contributor to this problem.
The SMS for Life pilot provided visibility of anti-malarial stock levels to support more efficient stock management using simple and widely available SMS technology, via a public-private partnership model that worked highly effectively. The SMS for Life system has the potential to alleviate restricted availability of anti-malarial drugs or other medicines in rural or under-resourced areas.
Overall, the SMS for Life system was built to be a generic and highly scalable solution that can be leveraged to support any medicine or product, and can be implemented in any country with minimal tailoring. Additionally the system could also be utilized for disease surveillance.
The data captured through the SMS stock count messages was available through a secure reporting website. The website was then accessed via the internet on a computer or a Blackberry or other smart mobile phone. Access to the website was granted through a unique User ID and password allocated at the group level .

How does SMS for life work

“SMS for Life” will automatically send text messages to all health facilities on a weekly basis asking for their current stock of medicines. The responses will be collected and stored centrally on a website and will generate the following types of reporting:
Display of the stock situation by health facility at country and district levels
Alerts sent to the district or central stores will provide immediately information on stock-outs
Query and reporting of stocks by health facility, district, region, zone and calculate average weekly usage by health facility etc.
Early warning of malaria outbreaks, e.g. highlight when there is a sharp rise in weekly usage in a number of closely located health facilities.
The ‘SMS for Life’ Pilot was launched on 21 September 2009, in Tanzania. The project is piloted in the 3 districts of Lindi Rural, Ulanga and Kigoma, at a total of 155 public health facilities. The pilot was ran for five months and terminated in February 2010.
What is Ushahidi

Ushahidi is an open-source crowd-sourcing platform that can be used to collate and map information gathered from the public via email, SMS, twitter, etc. It has been used around the world to map or monitor incidents such as election violence, earthquakes in several crisis situations around the world from.

The Ushahidi platform is built on the Kohana web framework. It includes built-in support for Nexmo wholesale SMS API and Clickatell SMS gateways. Ushahidi provides the option of using OpenStreetMap maps in its user interface, but requires the Google Maps API for geocoding.

Ushahidi currently has an Android and Windows Mobile App, and plans on releasing an iPhone app later this year. Although apps aren’t required for Crowdmapping (SMS makes most sense in places such as Haiti) – smartphones make the use of Ushahidi significantly more powerful. Allowing automatic GPS and pictures to be loaded. The use of smartphone technology for Ushahidi in a public health setting would be something health care workers might be suited for – by being given Android phones to provide rich data.

How does Ushahidi work
Once and Ushahidi instance is setup, messages can be sent in via email, SMS, twitter or directly on the instances website. The messages are verified by an administrator and once a message is approved it is published and the location of the incident is displayed on a map. Incidents can be categorized. In this way, a visual display of incidents and categories can be built.

Ushahidi enables information to be gathered from the public through a variety of channels. It can be setup relatively quickly and supports several languages.

SwiftRiver (platform consisting of APIs) for data gathering of extracting useful information.

SwiftRiver is a platform that helps people make sense of a lot of information in a short amount of time. In practice, SwiftRiver enables the filtering and verification of real-time data from channels like Twitter, SMS, Email and RSS feeds. Its is an API ecosystem.

1. It helps to curate real-time data and analysis on any topic or interest relevant to you or your organization.

2. It helps users discover nascent relationships and trends in data sets that may appear to be unrelated.

3. It can be used to setup streams that search for mentions of your brand or product online and manage social media campaigns after disasters (e.g. Twitter, SMS, email) from one dashboard.

4. SwiftRiver adds context to content using semantic analysis. Auto-categorize and classify email, twitter, text messages or news articles based on keywords.

References

1. SMS for Life : http://www.rollbackmalaria.org/psm/smsWhatIsIt.html
2. Ushahidi : http://ushahidi.com/products/ushahidi-platform
3. SwiftRiver : http://ushahidi.com/products/swiftriver-platform