Several of the pilot projects presented at the 2nd Pan Asian evidence-based e-Health adoptation and application (in short form – Panacea), were m-Health projects. One of the Panacea projects THIRRA and LIRNEasia lead RTBP share some aspects one being working on disease information communication in Sri Lanka; however, differs in the goals where THIRRA aims to digitize the H-544 health form at the Public Health Inspector’s point of service – at the patient’s home. On the other hand, RTBP will digitize minimal set of parameters: location (postal code), disease (ICD Code), symptom, sign, age, and gender collected from health provider facilities. Some of the other m-Health projects; especially in Philippines, involved Filipino rural community health care workers strictly using SMS with prearranged formatted strings for communicating field data to a central database.
Prof. Juhnjuhnwala and Prof. Gonsalves lead team at IITM have already released the beta version of the “m-Health Survey”, a J2ME applet built on Java’s MIDP 2.0 and CLDC 1.1 standard application programing interfaces; thus any phone with MIDP and CLDC built can work the applet. The working model was demonstrated to the Panacea members. The J2ME applet stores the disease, symptom, and sign relationships in the mobile phone’s Record Management Storage (RMS) memory. This minimizes the number of messages passed over GPRS between the mobile phone and the web server. The challenge ahead is in adopting a dictionary that can ensure correct spelling of the health domain specific words. So far the applet has been tested on a Nokia 3110c, Sony Ericson s302c, Amoi A363, and Motorola.
RTBP will test EDXL/CAP as a standard for direct and cascading dissemination of health disease information back to the last-mile health workers. University of Alberta’s Gordon Gow is taking the lead in adopting the PHIN Guideline for Communication and Alerting health risk information. This element of the pilot will study interoperability between jurisdictions. It is quite likely that Agha Kan University in Karchi, Pakistan will join India and Sri Lanka in the RTBP. The three countries will provide a good platform for testing interoperability.
There is no clear cut classification as to where electronic delivery of health services is actually needed in the health sector. An aim of Panacea is to define a framework for clearly compartmentalizing the marriage between health services and ICT solutions. Researchers from Philippines, India, Pakistan, Nepal, Mongolia, Malaysia, and Sri Lanka are conducting 8 distinct projects where each project is piloted in 2 or 3 countries. LIRNEasia lead multipartner RTBP pilot shares commonalities and as a result will be closely associated with Panacea in terms of exchanging research knowledge.
It was confirmed that the study of information communication technology intervention cannot be measured only on morbidity and mortality with short term results. The proposition can be argued to even long term results because external forces that directly impact or create noise will distort the morbidity or motality results and not the tested e-Health solution; more so we would never know what the external forces are. Challenge lies in identifying the sufficient set of indicators to evaluate e-Health interventions. The initiative may even change present child mortality as an indicator to measure a country’s health sector performance to a set of realistic indicators.
RTBP work was presented at the meeting which took place at the Earl’s Regencey hotel, Kandy, Sri Lanka from 28 Jan – 03 Feb, 2009. The events were hosted by Aga Khan University and the local Panacea researcher Dr. Plitha Gunawardane.
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