Patient Outcomes and Environmental Monitoring System (POEMS)
Utilizing mobile and information technology tools to to assess health and environmental impact.
Video overview of the POEMS mobile application.
GHRF, in partnership with the World Wildlife Fund (WWF), local government and community leaders are partnering to utilize mobile and information technology tools to warehouse health and environmental data together to allow multi-level assessments and cross-correlation of outcomes to assess health and environmental impact.
Utilizing key mobile and IT tools to ensure collected data is accessed and utilized rapidly will allow providers to target resources and to identify working solutions. This may improve local communities' life and health, facilitate eco-health balance and identify and reduce the burden of disease. This technology will help rangers, health workers and local communities track and preserve environment and local species in biodiversity "hotspots". Simple but carefully designed mobile and data utilization tools are being tested to ensure they are sustainably deployed, generating rapid access to health and environmental data, thus allowing proactive (rather than reactive) eco-health interventions.
Tools serving this project include the an SQL-based data repository (co-housing health and environmental key indicator data currently collected by health workers and rangers), mobile cellular phones and tablets with simple user interfaces (downloadable application) allowing more efficient data collection (including wireless data transfer, geo-tagging and biometric species and patient identifier systems built-in), and Geo-Alert tool providing instant and covert communication of dangerous situations (presence of poacher, wild animal, kidnapper).
This system is designed to model effective problem identification, disease reduction, resource targeting and efficiency, as well as a platform for true "tests of change" (reduction in morbidity/mortality, etc). Tools integrated into POEMS are designed to be interoperable, flexible and transferrable, utilizing open platform models, and interoperating with pre-existing "not so open platforms" to ensure best use of limited resources. Well modeled, these simple but powerful tools will facilitate the identification of "best practices", ensuring that service providers can intelligently tackle major health and environmental challenges, even at the most resource-poor local level, despite (in fact, aided by) the constant evolution of technology.
Although Bhutan and Nepal are not considered countries in crisis, human populations in many regions do face a crushing burden of disease, and extremely limited resources. Manas and Chitwan, for example, are among the few remaining areas of critical biodiversity - for example, a last refuge for wild tigers, of which some estimates suggest only roughly 3200 remain (there are over 5000 in captivity, but est. only 3200 in the wild). Ministries of Health work to control TB, Malaria and maternal mortality (at 560 per 100,0000 in remote regions, compared with 11 per 100,000 in US.] Still, the infrastructure exists within WWF and its affiliates to model a system able to increase the speed of data collection and use of information to proactively manage health and environment (the data warehouse, rapid-cycle "tests of change", data utilization processes in collaborative development in this project). Rooted in a committed system, health and environmental data warehoused together may allow multi-level assessment and cross-correlation of outcomes to rapidly detect health and environmental impact. This is an invaluable opportunity to model and assess interventions aimed to protect the environment, improve human life and health and reduce the burden of disease. Well modeled, this system will be extremely transferable and scalable.
In February 2012, GHRF brought the completed beta version of the mobile user-interface and data warehouse system to Nepal and Bhutan rangers and healthworkers. Units were introduced and tested to ensure functionality for the providers. Ancillary software meeting the specific needs of users were also identified and will be integrated (patient and species identifier systems, smartcard, barcode, fingerprint, "touchscreen" species ID forms and other systems and "point of care" diagnostics). Among the "point of care diagnostics" (POCs) were a mobile, wireless pulse oximeter for respiratory disease, and "RDTs" (rapid diagnostic tests), identifying key diseases by "fingerstick" (one drop of blood) or cheek swab. These included test kits donated by Global Solutions for Infectious Disease (GSID - RDTs) and Nonin (wireless pulse oximeter). Disease testing may also be useful for animal diagnostics and detection of zoonotic transmission for vets/rangers.
Ranger and healthworker partners are now in possession of beta-version units, and co-development is underway. Software iterations are loaded on GHRF site and downloaded to the mobile units as updated. Delivery of final set of units and data repository scheduled for July, 2012. At that time, GHRF tech team will return to oversee installation and training, and two GHRF program managers will remain on site for 8 weeks to ensure all is running smoothly.