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This is an SMS based system that could be useful in many settings. It would be great to see where organizations or people thought this technology could be useful.

RapidResponse is a customized mHealth platform developed for the Millennium Villages Project with support from the UNICEF Innovation Group. RapidResponse uses SMS text messages to facilitate and coordinate the activities of field based health care providers, usually community health care workers (CHWs). Using simple text messages, CHWs are able to register patients and send in health reports to a central web dashboard that allows a health team to closely monitor the health of their community. Powerful messaging features help facilitate communication between the members of the health system and an automated alert system helps reduce gaps in treatment.

A video tour of rapidResponse, a system built on rapidSMS
http://www.rapidsms.org/about/take-the-tour/

 
Aaron Beals
Replied at 10:50 AM, 24 Aug 2009

Thanks for posting this, Joaquin. I heard about rapidSMS at the GHC conference and started thinking about uses for SMS within the global health world.

What do other folks in the Health IT community think about the use of SMS vs longer-form input (via smart phones, etc) for health care purposes? Are the applications severely limited due to the length of text messages?

Many of of the applications I've seen so far have focused on doctors, nurses, or CHWs -- given that many patients also have SMS-capable cell phones, are there patient-focused applications that could improve health care delivery?

O G
Replied at 12:00 PM, 24 Aug 2009

I'd say smartphones for in-clinic use and upstream reporting, but surveys, diagnostic questions and other patient interaction has to be sms for widest access.

Seems like parsing a larger form into individual sms messages could act as an in-between solution.

Hamish Fraser, MBChB, MRCP, MSc
Replied at 2:26 PM, 24 Aug 2009

I have been looking at systems like RapidSMS and it is exciting to see tools that provide access to decision support in remote areas where staff often have limited support systems and training. However I have a couple of major concerns here for me. Firstly as you note there are real limitations on what data can be entered in an SMS message. More seriously, the issue of data quality is a constant challenge in all of our projects even when staff have excellent user interfaces with good sized screens. Anything which is cryptic to view and requires coded entry of data worries me a lot. If the result of that data entry is advice that determines a patients treatment even more so... So I strongly advocate the use of somewhat more advanced phones that can support a simple Q&A interface using java for example.

The second issue is more general. People have been building cool decision support tools for decades, many prior to the availability of decent tools for clinical data collection like EMRs. We have learnt a lot about good decision support and the types of algorithms that work well, and it would be great to see them used or built on for these new situations. We also need some very thorough evaluation of the systems in the field before we start driving clinical care this way. Rapid SMS has been used in Kenya with nurses and there may be evaluation data from that.

Isaac Kastenbaum
Replied at 2:38 PM, 24 Aug 2009

Just to piggyback on Hamish's comment, you may want to take a look at FrontlineSMS (http://www.frontlinesms.com/). I had the chance to meet with an employee of the organization and he introduced me to their Java-based forms which can collect a large amount of data (in a standardized Q&A format), separate it out over several messages, and be send it to a central location where it will be interpreted as one encounter.

Holly Ladd
Replied at 2:47 PM, 24 Aug 2009

You may also want to consider GATHER. We are partnering with several projects using this platform to create forms for java enable phones (openrosa) at the moment but soon to other phone os's. GATHER gives you the capacity to collect large amounts of data on a single or multiple forms resident on the phone and have that data sent to mysql database. see: http://www.healthnet.org/gather

Isaac Holeman
Replied at 8:45 AM, 25 Aug 2009

Hi All,
I'm the Field Director for FrontlineSMS:Medic, and just met with Meredith who is working with RapidSMS in Malawi (and she blogged about it: http://montagenik.blogspot.com/2009/08/software-and-developing-world.html). Turns out there is a lot going on in Malawi right now, and both projects are worth following.

A note about interfaces: Yesterday I demoed Baobab's version of the OpenMRS medical records system for the main health information manager at a large hospital here. It took him just a few minutes to get the hang of patient registration, recording vitals, diagnosis, treatment, and next appointment. His comment was "it is so simple, they made it just like a cellphone."

Like Hamish I'm skeptical about potential for error in "structured" text messages that are really just CSV. But it seems like the limited screen space on the lowest end java enabled phones (as opposed to android/iphone) is more a feature than a bug among people who are more accustomed to cell phone interfaces than to computer/web interfaces.

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