Technology: The eCompliance Project
Tracking the Patient (eCompliance) The World Health Organization introduced the DOTS (Directly Observed Therapy) model in 1993. The main objective of the DOTS model is preventing multidrug-resistant tuberculosis (MDR-TB), which develops when patients stop treatment before they complete the full course. Although the DOTS model drastically improved modern TB treatment, TB and MDR-TB are still threats across the world, especially in high-burden TB countries such as India. OpASHA has developed technology to address the lingering problems concerning TB treatment.
To help us monitor and track our patients, we’ve partnered with Microsoft Research and Innovators in Health to develop eCompliance (formerly named eDOTS), a biometric identification system. The system consists of a netbook (a small laptop), a fingerprint reader and a low-cost SMS modem. A second version of eCompliance has been rolled out in Delhi. This is technologically superior and has lower costs. It uses an android phone and finger print reader. Progressively, this will be installed everywhere.
Each center has a portable eCompliance system installed, and every time a patient visits a center, he or she scans a finger using the reader. This provides proof that the patient visited the treatment center and took the scheduled dose in the presence of the community partner or provider. At the end of each day, the eCompliance terminal automatically sends the attendance logs through SMS to a central database where reports are generated for analysis.
Each time a patient fails to appear for a scheduled treatment, the eCompliance terminal sends a separate text message to the responsible provider and overseeing program manager to notify them of the patient’s absence. The provider then has 48 hours to follow up with the patient, administer the required medications, and provide individual counseling on the dangers of missing a dose. Every provider also carries an eCompliance system in his or her bag. The provider is required to bring the system to the patient’s home and scan the patient’s fingerprint to record the follow-up visit.
Because the system alerts OpASHA providers and program managers every time a patient misses a dose, we can provide targeted counseling and care to the patients who need it most.
We installed the first system in March 2010, and now have 159 eCompliance terminals operating in 136 centers in South Delhi, West Delhi, East Delhi, Jaipur, Bhiwandi, Bhopal, Indore, Sagar, Raipur, Durg-Bhilai, Korba, Gwalior ,Gwalior Rural, Dharavi, Bhubaneswar, Koderma and Daunkeo. Till date 2087 currently undergoing treatment and over 200000 visits logged. The eCompliance initiative has reduced the number of missed doses to 1.5 percent.
The system’s success has prompted us to develop an advocacy team to help other NGOs, public health departments and government bodies replicate eCompliance. If you are interested in learning more about the software and how to use it, please write to Sandeep Ahuja, CEO, at firstname.lastname@example.org.