TLI mHealth Platform
TLI mHealth Platform (commcare)
To facilitate the management of patients at the lowest-tier health facilities, we designed and implemented an mHealth system for lab specimen registration, diagnostic test requisition and results reporting between the central, rural lab and the surrounding clinics. This smartphone-based system, currently operational in Ghana, is coupled to a dedicated lab specimen transport system which enables access to diagnostic services in all 6 health centers within the cluster.
The Lab Reporting module was built using CommCare, an open-source software (Dimagi, Cambridge, MASS) that runs on any Android-platform phone, and consists of 4 general forms (See Figure 1 for screenshots of the system). When a lab specimen is collected at any one of the 6 health centers within the cluster, the health care worker fills out a Lab Requisition Form in CommCare on the dedicated smartphone, which is automatically submitted to the lab. TLI motorbike drivers then transport the sample(s) from the clinic to the Tontokrom lab. The information is submitted in real-time, enabling the lab technician to plan his work-flow for the day. Additionally, once a patient’s information is entered into the CommCare system it will stay there, such that whenever a new sample is collected for that patient (irrespective of which of the 6 clinics the patient is attending), his registration information remains stored on the phone.
Once the specimen is received at the lab, the technician assesses the quality of the sample. If there are any issues that would prohibit him from performing the requested test, he can fill in a Sample Error Form, which is sent back to the requesting clinic so they are alerted to re-collect the specimen. If the sample is acceptable, then the lab technician performs all requested assays and then submits the results using the Results Form, which, once completed can be automatically viewed by the health care worker. The last form, to be completed by the health care worker upon receipt if the results, is the Reporting Form, which clears the sample from the phone’s list only once the health care worker indicates that the results have been recorded in the patient’s records and have been discussed with the patient. Each of these steps is recorded in a backend database, which can be exported to excel for subsequent analysis.
Below: System Specifics
Screenshots of the login screen, form menu, example of a question in a form and a list of samples in the system