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Tuberculosis Surveillance: Using Digital Tools Optimally

Mobile Health (mHealth) solutions have been shown to have promising results in different disease domains. Use of mobile applications and digital tools can offer substantial benefits to tuberculosis (TB) management as the disease can go undiagnosed for long periods and requires treatment for up to 6-9 months. Keeping in mind the complexity of TB management, EPCON developed two mobile applications, EPICare for treatment adherence monitoring and Geocare 360 for digitising client records. Both applications support our AI driven Epidemic Control Platform.



EPICare allows healthcare providers to monitor client’s drug adherence, experience of drug related adverse effects and overall motivation to compliance throughout the treatment period. Care providers can conduct short surveys with clients via mobile application and text messages. The app can also be used for health promotion and follow ups with clients based on their responses to short surveys.


Geocare 360 allows digital capturing of data from field activities like household screening and community outreach. Healthcare workers can maintain their TB client’s complete profile from demographic information to diagnosis and treatment.


But successful implementation and optimum usage of such tools in real life settings comes with its set of challenges which need close monitoring.

Factors to consider here include:


Trust

Implementers of technology need to begin with building trust of the target users. Patients must know that their information is kept confidential and there are no costs involved - nothing is being sold to them. They must also be informed why and when they will receive surveys or messages via their mobile phones. Similarly, healthcare workers need to be explained how technology can make their work more efficient while reducing their day-to-day paperwork.


Training

Target users, whether patients or healthcare providers need to be trained and supported in the usage of technology. Certain users, like elderly people and those who are less well versed with technology might need more attention. Implementers must ensure that patients understand the messages sent and know how to respond correctly.


Support

Ongoing support is required. Patients need to have easy-to-use channels for sending feedback about any difficulties they are experiencing. One to one communication in the beginning can ensure more participation and higher response rate. Healthcare providers might also need regular feedback and follow up to ensure data captured is of good quality.


Human resistance for change

Switching over to new and advanced methods often encounters human resistance initially. Engaging target users from the beginning and providing them constant support and encouragement can overcome such challenges. Digitising of paper based records can offer long term advantages for both healthcare providers and patients.

The onus of successful implementation of digital tools also lies on its implementers. Resource constrained settings can benefit heavily from such tools, provided the interventions are well planned and monitored closely.