Gathering data from remote locations can be very time consuming, using paper based collection methods may mean it takes a long time for the data to reach those who are going to use or analyse it. Collecting accurate medical and epidemiological data is essential to get a true picture of the health of the inhabitants for resource planning and research. With the growth in availability and decline in cost of smartphones, these seem an ideal technology to help to improve the accuracy of data collected and vastly reduce the time taken for the data to reach those who need it.
Interviewing rural health workers
- 64 rural health workers interviewed
- Symbian and Android smartphones tested
- better than expected GPRS coverage
Digital Campus is testing a variety of technologies for the collection of public health data to help determine which may be most suitable for application in the field. Working with PhD students in maternal health care an initial study to discover the possible challenges and options for using mobile technologies has already been completed. Over 39 health posts in 3 districts of Tigray (northern Ethiopian) were visited to interview the Health Extension Workers (HEWs) based there.
They were interviewed to try to determine their knowledge, training and experience in maternal health with a view to identifying any gaps in their knowledge and designing a programme to help fill these. Additionally, and crucially if a technology based solution is to be implemented, information regarding their technology experience and the infrastructure facilities (such as mobile reception and electricity access) was collected.
Fast and accurate data dissemination
All the data collected during the interviews was recorded on a smartphone using a questionnaire created using the episurveyor web application (a propietary but nice platform so far). Using the client software (installed on the actual phone), responses to the survey are recorded on the phone, as soon as an area with GPRS signal is reached, the data is automatically uploaded to the EpiSurveyor server, making it available to anyone (with the right permissions) around the world. Each record uploaded is automatically time and location (with GPS) stamped, making it possible it pinpoint exactly where and when the interview took place.
One of our initial concerns was that the GPRS coverage would be limited, perhaps only to large towns/cities, but in fact almost all the Health Posts had good GPRS coverage, even those where the villages didn’t have reliable electricity provision. Only a handful of very remote posts had no mobile coverage at all.
We used Symbian and Android based smartphones to collect the data, but in fact the EpiSurveyor client software will run on almost any java enabled phone. We are also currently setting up a more sophisticated platform based on the Sana community-based development MIT project, with the intention of developing it as a more powerful open-source mobile health platform , that will allow us not only to gather epidemiological data, but to use it for electronic clinical records, telediagnostic applications, decision support systems and posgraduate training
We are in the process of writing a detailed technical paper, describing in more detail the survey results and technology used, along with the main challenges and possible solutions to using smartphone technologies in this environment.
Over the coming months we will provide a small group of Health Extension Workers with smartphones to determine what (if any) issues and challenges they face in using these and also to gain a clearer picture of how this technology could be used to improve their skills, training, data collection and reporting methods. Once the results from this pre-implementation phase are known, we will be in a position to design a larger scale programme.