Health IT

Appreciate the simplicity of it -- and great to see the "pay-as-you-go" SaaS
business model. Too often global health IT tools require professional
services for installation/setup.

Thanks,
Anup


--
Anup Akkihal
http://samaanguru.org
+1 917 981 9106 (USA)
+91 9731505098 (India)
+1 617 812 8121 (e-fax)

Participate eHEALTCARE project in Brazil, for transmission of biomedical data, blood pressure and glucose, are beginning in the own mobile software for managing medications.
Contact:
msn:

The average cost of a text message in Kenya now is kshs1/$0.012. The pricing
model you have is averaging at kshs11/text message how feasible is that?

--
John Wesonga

Michael:

This is certainly a very good intervention geared at improving overall health of our patients and it's also timely coming against the backdrop of Richard Lester, et al paper "Effects of a mobile phone short message service on
antiretroviral treatment adherence in Kenya (WelTel
Kenya1): a randomised trial" that basically concluded that "...Patients who received SMS support had significantly improved ART adherence and rates of viral
suppression compared with the control individuals. Mobile phones might be effective tools to improve patient
outcome in resource-limited settings".
My colleague John Wesonga and I were just that the cost will be prohibitive (11KES/SMS) and will therefore limit mass uptake of this service. Have you thought of partnering with some of the mobile services providers in Kenya? Safaricom, Telkom, Airtel to subsidize this cost? Sending an SMS on average now costs 1KES even across networks and therefore potential clients of this SMS service would rather use other means of doing the same thing. E.g. enhance their EMRs to proactively provide them with reminders of which patients to call/sms to remind them to take their medications or come to clinic. In RIchard's study, "The
health workers used multiple recipient ...

Michael:

This is certainly a very good intervention geared at improving overall health of our patients and it's also timely coming against the backdrop of Richard Lester, et al paper "Effects of a mobile phone short message service on
antiretroviral treatment adherence in Kenya (WelTel
Kenya1): a randomised trial" that basically concluded that "...Patients who received SMS support had significantly improved ART adherence and rates of viral
suppression compared with the control individuals. Mobile phones might be effective tools to improve patient
outcome in resource-limited settings".
My colleague John Wesonga and I were just that the cost will be prohibitive (11KES/SMS) and will therefore limit mass uptake of this service. Have you thought of partnering with some of the mobile services providers in Kenya? Safaricom, Telkom, Airtel to subsidize this cost? Sending an SMS on average now costs 1KES even across networks and therefore potential clients of this SMS service would rather use other means of doing the same thing. E.g. enhance their EMRs to proactively provide them with reminders of which patients to call/sms to remind them to take their medications or come to clinic. In RIchard's study, "The
health workers used multiple recipient (bulk) messaging functions to improve efficiency." Lastly, in terms of actual expenses, Richard's study reported that "The SMS intervention is inexpensive (each SMS costs about US$0·05, equivalent to $20 per 100 patients per month, and follow-up voice calls averaged $3·75 per nurse per month)".

So all I'm trying to say in a long winded way is that this intervention would receive more uptake if the costs were lowered.

Has anyone tried to use this technique in areas outside of Kenya where
the AppointmentSMS
service isn't available? Perhaps Skype could be configured to work in this
manner.


Dennis Palmer, DO., FACP, FWACP (Int Med)
Program Director, Christian Internal Medicine Specialization Residency
Mbingo Baptist Hospital
PMB 42, Bamenda, Cameroon
Phone: (Country code 237) 7750-1198
Website: dennisandnancy.us

Hi Michael
I don't see a description of the medical professionals actually using the system for reminders for patients in Africa. Is there something written about that and if so can you please make the link more obvious?
Thanks

Hamish

What about the "No Answer" SMS features? Small bits of data can be transferred without the full SMS transaction.

om

This is a great idea with even higher impact implications that just sms reminders. We developed a use case that a group in Nigeria is now adapting to their practice.
I would have to agree w/Steven Wanyee Macharia however that the difference between the cost of market SMS tariffs and this reminder service will limit its adoption by patients and providers alike. Partnering w/mobile providers is one way, if they are interested, but may not address your need to have a revenue stream, if small, to sustain the endeavor. You may need to do an analysis of incentives for health care providers and mobile phone service providers and decide where to lean for your margin. Leaning on patients is likely to affect adoption. kco
http://obalafoundation.org

Hi All,

Thanks so much for your valuable feedback - all very good points.
I agree that the pricing is very uncompetitive and needs to be changed. Currently the price is dictated by the SMS gateway provider the software uses.
I will attempt to establish contact with the mobile phone networks in Kenya and/or switch SMS providers, so that the pricing can be reduced to current market rates in Kenya.

I have seen the study recently released on how SMS reminders are beneficial to AIDS patients. In truth, the idea for releasing the service in Kenya came from a post from a health informatics professional in Kenya who suggested that the software could benefit the third world in this way.

Cheers,
Michael