Skip to end of metadata
Go to start of metadata

Patient Side

Technology

Pros

Cons

RapidSMS

  • Have a system to process observations coming from the CHW and sending back care suggestions
  • Decision tree potentially can be expanded to include AMPATH care suggestions decision tree
  • Support bulk SMS
  • Development process is active. Last commit in github is November 2011
  • Need to learn SMS syntax

Medic Mobile (formerly FrontlineSMS)

  • Lower cost because SIM apps can run on a $15 phone
  • Support bulk SMS
  • Actively developed. Last commit November 2011
  • TextForms, SIM apps doesn't have demo site or demo video.

Messaging Module

  • Support multiple ways of sending data (e.g.Twitter, SMS)
  • Seamless integration with OpenMRS
  • Need internet connection or access to the OpenMRS server

Provider Side

Technology

Pros

Cons

ODK Collect + ODK Clinic

  • Have been using this technology in AMPATH
  • Have a better exposure on what the software can and can't do
  • Actively developed
  • Potentially better support
  • Tied to Android technology
  • Higher starting up cost because of the need to get a higher end android based phone or android based tablet.

Long Term & Short Term Projection

Immediate Needs

AMPATH and OpenMRS already have experience with Open Data Kit (ODK) mobile platform, particularly with access to primary developers in the technology. Community health workers have proven the success of ODK through the HCT program at AMPATH. This experience will inform the process of exposing data and forms to providers through ODK.

ODK runs only on Android phones or tablets. Providers will most likely need to use tablets, so the start-up costs may be higher than if we used simple SMS. Costs will be offset by savings on developer time and becoming familiar with the platform. A working prototype of the system should be easy to demonstrate early on, due to the existing technology, allowing us to gather user feedback early in the development process.

Future Plans

Frontline SMS, or Medic Mobile, has better potential for long-term use. It requires slightly more complicated hardware in the central site, but much less complicated hardware (simple cellular phones) at remote sites. These translate into lower overall costs as well.

Smart phones and tablets make sense to use in a small, controlled pilot, but security concerns and high costs of hardware and data connectivity prohibit large-scale rollout. Medic Mobile only requires users to use a SIM app on a simple phone.

The biggest challenge with Medic Mobile will be learning (and possibly adapting) the TextForms product. Along with this comes a much smaller screen, much more limited kinds of data a remote provider can send, and a potentially unreliable means of communication; SMS is powerful but certainly is not guaranteed or as good a connection as 3G. Nonetheless, the benefits certainly outweigh the costs and Medic Mobile should be pursued as our long-term alternative for remote provider access to our EMR.

Excluded Technology

OpenXData

It is only compatible with OpenMRS 1.5, and AMPATH is currently on OpenMRS 1.8. It would require considerable effort to make changes in the OpenXData, test them with Ampath settings and then start the deployment process.

mOpenMRS

mOpenMRS is built on top on the OpenXData technology. This means it's not going to be trivial to use them in Ampath for the same reason with OpenXData. Other potential drawback would be the lack of documentation which means we will end up relying on support from the main developer only.

MoTech

The last information obviously available is from February 2010, and appears to have been a pilot project in Ghana that ran once. Technology and experiences from this project might be valuable for our purposes, so it may be nice to speak with the authors or developers at some point.

PicoRosa

We do not have sufficient information available to review this technology, just a few demos.

Moca Mobile

This technology requires high-cost provider equipment and has relatively little information available for investigation.

OpenMRS JR

Rely on the XForms to generate the form in the phone. Given the situation where we don't know which form technology we will pursue, I think it's best to stay away from relying on certain technology too much.

References:
Rapid Response by RapidSMS
Mobile Technology at OpenMRS Wiki