Real Time Bio-surveillance using mobiles.

The larger ambition is to evolve an Integrated Disease Surveillance system in rural areas.

M. Somasekhar

Can the mobile phone, which is rapidly reaching the remote villages in the country as an affordable communication gadget, play an important role in helping people improve their health status?

Is it possible to track common epidemics, such as malaria, diarrhoea, dengue fever, etc, and come up with models that can forecast their occurrence and thereby ensure preventive steps?

Computer-based bio-surveillance projects have gone to some length in generating data about diseases and efforts at creating databases on healthcare in rural areas are also on in India. The Indian Institute of Chemical Technology (IICT) in Hyderabad has developed a model to forecast possible epidemics of diseases such as malaria and encephalitis in rural Andhra Pradesh.

A recent initiative by a global consortia consisting of the Indian Institute of Technology, Madras, the National Centre for Biological Sciences, Carnegie Mellon University's Auton Lab, LIRNEasia, University of Alberta, Respere Lanka, Lanka Jathika Sarvodhaya Society and the International Development Research Centre (IDRC), called the Real Time Biosurveillance Program (RTBP), has attempted to use the power of the mobile phone in developing a healthcare model.

A pilot project done in Sri Lanka and Tamil Nadu by the consortia has demonstrated gains for the delivery of health services using the mobile phone platform as well as secure transfer and exchange of health information. The advantages of the mobile phone, such as easy availability, cost-effectiveness, ease of use and a good network both to communicate and act as a computing device have been harnessed in the project, says Nuwan Waidyanatha, Senior Researcher at LIRNEasia.

Around 30 nurses (who knew how to use the mobile to talk) were trained to collect data on notifiable diseases such as malaria, diarrhoea, etc, at the Rural Technology Incubator at IIT Madras and use SMS. By using a tool from Carnegie Mellon University, which has the capability of analysing large sets of data, it is possible to come up with interesting information. If you give a query, you can obtain the answer quickly. Thereafter, algorithms can be used to check current data against long term in any specific village, he explains.

The objective is to develop a standard module that will give alerts for, say, a possible outbreak of H1N1 or diarrhoea so that health officials can quickly come up with appropriate interventions. The larger ambition is to evolve an Integrated Disease Surveillance system in rural areas.

3 key stages

There are three key stages for implementing the RTBP. The first is the installation of the programme into the mobile phones used by the trained healthcare workers. The second is real-time digitisation of patient information by nurses as they treat patients. The information includes vital statistics and symptoms that are to be analysed for health events. At present, paper forms are used to fill the details. The third step involves epidemiologists, who will take the data, analyse it for signs of adverse health events, and recommend appropriate action to respond to the situation.

The detection of spread of respiratory tract infection in conjunction with a viral fever in Sri Lanka that caught the attention of the health departments and escalating diarrhoea cases in Tamil Nadu were detected in a matter of a day after the onset of the outbreaks. Through alert systems in the pilot project, such situations were communicated to the local community and health departments, who then publicised preventive measures and treatment. Potentially, the RTBP reduces the time to identify a potential disease outbreak to just a day.

At present, 95 per cent of resources for healthcare in rural areas are pumped into collection of data. There is hardly any detection or alert system to fight these diseases, which puts a heavy drain on both human life and healthcare operations. The developments in mobile phone features and ICT can help scale up the project to entire districts, Waidyanatha says.

The main costs would be in training people. Operational costs would be low as mobile phones are affordable. It would require co-ordination between health workers, hospitals and health departments to effectively implement such a system.

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(This article was published in the Business Line print edition dated September 13, 2010)
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