George Clinical, a leading contract research organization in the Asia Pacific region submitted the following article.
SMARTHealth – Provides Rural Areas with Better Access to Healthcare through a Mobile-Based Tool
Seventy percent of India’s population live in rural areas, where the doctor to patient ratio stands at 1 doctor to 1700 patients. Access to primary healthcare in these rural communities is poor. To improve upon this, a mobile-based system called SMARTHealth, was developed as a point-of-care, Clinical Decision Support (CDS) tool.
The mobile system assists local healthcare workers assess and manage Cardiovascular Disease (CVD) risk, and helps to expand the capabilities of current healthcare workers by providing them with proper equipment to monitor and measure CVD risk within these rural communities.
The CDS tool operating with a mobile health system is able to generate a risk-based prediction and management system along with a server side electronic medical record system.
This mobile tool helps non-physician health workers, such as Accredited Social Healthcare Activists (ASHA), and doctors make evidence-based management decisions to lower their patients’ CVD risk. This helps to prevent severe diseases that may occur later.
The mobile system is able to provide information on the risk of CVD to the patient through a visual projection meter built within the app. Through this projection meter, the cause and effect risk factor for each patient can be visually expressed in an easy to understand format.
Gender, age, systolic BP, cholesterol level, and behavioral risks are entered into the mobile system to estimate the patient’s risk of developing CVD. Knowing this information can encourage patients to adhere to their medication and change behavioral risk factors that may result in CVD, such as drinking or smoking.
SMARTHealth’s success hinges upon its ease of use, particularly by ASHAs that are local Indian women trained to work as an interface between the community and public health care system, thus increasing the capacity of local healthcare delivery.
The online system has been designed in a way for ASHAs to navigate through most of the app using a single button. The mobile system was field tested by eleven ASHAs and three primary health care doctors who screened 20 participants from three villages in rural India.
By the end of the study, the ASHAs recognized the ease of use and were highly capable of using the mobile system. Furthermore, physicians, villagers, and ASHAs had high levels of satisfaction with the system and viewed the tablet as a time saver.
However, the hardware is limited due to restricted battery life, screen damage may occur, plus the fact that there is limited connectivity in some villages and this can lead to prolonging the transmission of data to the central server.
Further, modifications such as simplifying the user interface, emphasizing the use of color to communicate the risk of CVD to patients also adds to the technical issues that need to be addressed.
Conclusion
It is important to consider with the success of any technology-based intervention, the user must be able to adapt the technology to the needs of their surrounding environment.
Field evaluation of the mobile tool has demonstrated how acceptable and feasible it can be. The ASHAs were able to effectively utilize the CVD projection meter within the mobile system to communicate the absolute CVD risk reduction to the patient.
By implementing this tablet based CDS tool in primary health care systems- particularly in Indian rural areas, the risk of suffering from CVD can potentially decrease.
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George Clinical www.georgeclinical.com operates in the Asia Pacific region with a staff of almost 200 in eleven countries. George Clinical has a proven track record in delivering large pivotal trials and has established world-class investigator networks. George Clinical works with top-tier and mid-sized pharmaceutical and medical technology companies to conduct mid and late phase trials of innovative drugs and devices.