The present day disease surveillance and notification system in Sri Lanka, confined to a handful of diseases, known as Notifiable disease, and reporting large numbers of common cases, is what the British introduced in 1897 as part of the quarantine and prevention of diseases ordinance. This paper based surveillance and reporting system has its shortcomings that the health professionals themselves have voiced. The Real-Time Biosurveillance Program (RTBP) pilot, during the first week of April, interviewed health workers and health officials in Kurunegala District to study the notification and response policy and procedures. These interviews revealed that in some occasions by the time health officials receive the notification to inspect the patient, with the infectious disease, at the patient’s residence, the patient had already died; health workers literally pull their hair trying to decipher the illegible handwriting on the paper forms; they also mentioned that they have to travel long distance from their villages to the Medical Officer of Health (MOH) office to pickup the paper forms with the patient’s information. These inefficiencies and excessive costs can be drastically reduced with ICT; with a technique as simple as a communicating the information via SMS text messages that costs Rupees 0.
A m-HealthSurvey Certification Exercise was carried out as part of the m-Health Real-Time Biosurveillance Program (RTBP) to measure the usability and adoptability of the m-HealthSurvey mobile application. The exercise was conducted with health workers in Sivagangai District, Tamil Nadu, India and in Kurunegala District, Sri Lanka. The final results of the exercise will be published in the near future. m-HealthSurvey is a mobile application developed by indian Institute of technology Madras’s Rural Technology and Business Incubator (RTBI) for collecting near real-time patient disease, syndrome, and demographic data for rapid detection of disease outbreaks. It is a J2ME midlet that allows users to select categorical data as well as type information to generate patient clinical records to be submitted via GPRS to a central database.
m-Health Real-Time Biosurveillance Program (RTBP) interviewed Medical Officers in Kurunegal District in Sri Lanka and Sivagangai District in Tamil Nadu, India, during the months of September and October, 2009. These interactions revealed that outpatient health record entry in real-time by Medical Officers, using the mobile phone key pad is inefficient and the idea was rejected by them. The aim of the RTBP is to collect digitized patient disease, syndrome, and demographic information from the point of care to rapidly detect disease outbreaks. Village Health Nurses in Tamil Nadu examine at most 70 patients a week. Ninety percent of the Village Health Nurses opt to jot down the records on paper and later enter them leisurely after the day’s work is complete.
The Real-Time Biosurveillance Program (RTBP) information communication system comprises an upstream health data submission by last-mile health workers, data processing by epidemiologist, and downstream alerting by health officials.There are four components to the RTBP software: mobile phone application, desktop web application, database, T-Cube analytic tools, and Common Alerting Protocol messaging. The individual components are to be developed by Rural Technology and Business Incubator, Respere (Private) Limited, and Auton Lab. Following are the four software requirement specification documents – 1) Sahana biosurveillance module (database and desktop web application) 2) Mobile J2ME application (data collection) 3) T-Cube web interface (analysis and event detection) 4) Sahana Common Alerting Protocol Messaging Module (publishing SMS/Email/Web alerts)
“Leptospirosis is out and Dengue is in” – these are the words of the Sarvodaya Research Assistant – Pubudini weerakoon – working in Kurunegala District of Sri Lanka on the real-time biosurveillance program (RTBP). This report on Leptospirosis in Sri Lanka gives a full account of the past events. The aim of the RTBP is to gather patient case information through the m-Healthsurvey mobile application and subject that data to real time analysis for rapid detection of emerging health events. The automated analytic and detection is driven by the T-Cube software, developed by Carnegie Mellon Universities Auton Lab, based on data mining principles. We took the weekly epidemiological reports (WER) from the past two years and put T-Cube to the test.