Field based development and validation of an integrated ......• UI/UX • Treatments CLINICAL...
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Field based development and validation of an integrated clinical severity assessment platform for children 2-59 months of age by community health workers using the MEDSINC ® platform B. Finette, M. McLaughlin, S. Zimmerman, R. Shah, Ikma, A. Rahman, H. Khondker, M. Young, S. Nibitanga, D. Muhoza, A. Seck, V. Zombre, S. Sana, A. Ilboudo, I Garango, M Grunauer, E. Teran, M. Bahamonde, E. Quzhpe, and B. Health Summary Problem: The WHO and UNICEF estimates that ~3 million children less than 5 years living in low and middle income (LMIC) die from preventable diseases, mainly due to the global shortage healthcare professionals and limited healthcare infrastructure. Innovation: MEDSINC ® is a mHealth clinical assessment, triage and treatment software platform, which enables users to determine how sick a child is for: respiratory distress, dehydration, sepsis-SIRS, acute malnutrition, malaria, meningitis, anemia, urinary tract infection, skin infection, measles, ear infection and dysentery. Method: We have performed MEDSINC ® validation and usability testing with community health workers (CHWs) in Burkina Faso, Ecuador and Bangladesh following 2 hours of training. Over 900 independent CHWs generated assessments of children 2-59 months were acquired with the MEDSINC TM platform and correlated with that of local physician’s. Results: Clinical correlations by CHWs using MEDSINC ® and local physician examining the same child revealed 55%- over 90% clinical assessment correlations. Analysis of usability and feasibility of all relevant stakeholders revealed very positive responses to ease of use and potential public health impact. Conclusion: The MEDSINC ® platform could significantly improve LMIC CHW programs to identify the health status of children and facilitate early triage and therapeutic intervention(s) for children 2- 59 months of age. Innovation The MEDSINC ® platform could significantly improve LMIC CHW programs to identify the health status of children and facilitate early triage and therapeutic intervention(s) for children 2-59 months of age. R100 MEDSINC transforms how PHYSICIANS clinically assess sick children onto a SIMPLE digital mobile platform Medical History Symptoms Vital Signs Physical Examination Clinical Assessment,Triage, Treatment, Instructions Bayesian/Pattern based Logic Algorithms Is this child sick and how severe? Decision Tree Conventional Approaches Does this child have pneumonia? Methods • Respiratory Distress • Dehydration • Sepsis-SIRS • Malnutrition • Malaria • Anemia • Meningitis • UTI • Cellulitis • Ear Infection • Measles • Dysentery • Content • Language • UI/UX • Treatments CLINICAL SEVERITY ASSESSMENT DISEASE ASSESSMENT CUSTOMIZATION LOCALIZATION (None-Moderate-Severe) CHWs were trained over a 2 hour period by local healthcare professionals using a train the trainer approach. Following completion of this training CHWs independently assessed children between 2-59 months of age using the MEDSINC ® platform. Following their assessment, the same children were independently assessed by local healthcare professionals. Winner of Innovation into Action Challenge >1000 Patients >50,000 data points Clinical Severity Assessment Corrlation (n=995) 0 20 40 60 80 100 Respiratory Distress Dehydration Sepsis-SIRS Acute Malnutrition Bangladesh-1 Peru Ecuador-1 Burkina Faso Ecuador-2 Bangladesh-2 N=59 N=36 N=47 N=163 N=429 N=269 Results 0 20 40 60 80 100 Malaria Dysentery Meningitis Ear Infection Anemia Skin Infection Measles UTI ECUADOR (n=429) BANGLADESH (n=269) Clinical Disease Assessment Correlation 385 20 3 400 8 0 Standard Immediate Urgent CHW MD Respirator Distress 228 29 2 252 6 1 Standard Immediate Urgent CHW MD Respirator Distress 403 4 1 398 10 0 Standard Immediate Urgent CHW MD Dehydration 395 13 0 401 7 0 Standard Immediate Urgent CHW MD Sepsis-SIRS 374 32 2 388 18 2 Standard Immediate Urgent CHW MD Acute Malnutrition 249 10 0 256 3 0 Standard Immediate Urgent CHW MD Dehydration 250 9 0 256 3 0 Standard Immediate Urgent CHW MD Sepsis-SIRS 141 101 11 96 131 32 Standard Immediate Urgent CHW MD Acute Malnutrition Triage Recommendation Correlation Ecuador (n =429) Bangladesh (n =269) Conclusion 0 10 20 30 0 1 2 3 4 5 6 7 8 9 10 DIFFICULT VERY EASY How Easy to Learn Usability and Acceptability: CHWs 0 10 20 30 40 0 1 2 3 4 5 6 7 8 9 10 How Easy to Use DIFFICULT VERY EASY 0 10 20 30 40 50 60 0 1 2 3 4 5 6 7 8 9 10 Allows you to do your job better Not At All Very Much Burkina Faso (n = 163)
Transcript of Field based development and validation of an integrated ......• UI/UX • Treatments CLINICAL...
Field based development and validation of an integrated clinicalseverity assessment platform for children 2-59 months of ageby community health workers using the MEDSINC® platform
B. Finette, M. McLaughlin, S. Zimmerman, R. Shah, Ikma, A. Rahman, H. Khondker, M. Young, S. Nibitanga, D. Muhoza, A. Seck, V. Zombre, S. Sana, A. Ilboudo, I Garango, M Grunauer, E. Teran, M. Bahamonde, E. Quzhpe, and B. Health
SummaryProblem: The WHO and UNICEF estimates that ~3 million children less than 5 years living in low and middle income (LMIC) die from preventable diseases, mainly due to the global shortage healthcare professionals and limited healthcare infrastructure.
Innovation: MEDSINC® is a mHealth clinical assessment, triage and treatment software platform, which enables users to determine how sick a child is for: respiratory distress, dehydration, sepsis-SIRS, acute malnutrition, malaria, meningitis, anemia, urinary tract infection, skin infection, measles, ear infection and dysentery.
Method: We have performed MEDSINC® validation and usability testing with community health workers (CHWs) in Burkina Faso, Ecuador and Bangladesh following 2 hours of training. Over 900 independent CHWs generated assessments of children 2-59 months were acquired with the MEDSINCTM platform and correlated with that of local physician’s.
Results: Clinical correlations by CHWs using MEDSINC® and local physician examining the same child revealed 55%- over 90% clinical assessment correlations. Analysis of usability and feasibility of all relevant stakeholders revealed very positive responses to ease of use and potential public health impact.
Conclusion: The MEDSINC® platform could significantly improve LMIC CHW programs to identify the health status of children and facilitate early triage and therapeutic intervention(s) for children 2-59 months of age.
Innovation
The MEDSINC® platform could significantly improve LMIC CHW programs to identify the health status of children and facilitate early triage and therapeutic intervention(s) for children 2-59 months of age.
R100
MEDSINC transforms how PHYSICIANS clinically assess sick children onto a SIMPLE digital mobile platform
Medical History Symptoms Vital Signs Physical Examination Clinical Assessment,Triage, Treatment, Instructions
Bayesian/Pattern based Logic Algorithms
Is this child sick and how severe?
Decision TreeConventional Approaches
Does this child have pneumonia?
Methods
• Respiratory Distress• Dehydration• Sepsis-SIRS• Malnutrition
• Malaria• Anemia• Meningitis• UTI• Cellulitis• Ear Infection• Measles• Dysentery
• Content• Language• UI/UX• Treatments
CLINICAL SEVERITYASSESSMENT
DISEASEASSESSMENT
CUSTOMIZATIONLOCALIZATION
(None-Moderate-Severe)
CHWs were trained over a 2 hour period by local healthcare professionals using a train the trainer approach. Following completion of this training CHWs independently assessed children between 2-59 months of age using the MEDSINC® platform. Following their assessment, the same children were independently assessed by local healthcare professionals.
Winner of Innovation into Action Challenge
>1000 Patients>50,000 data points
Clinical Severity Assessment Corrlation (n=995)
0
20
40
60
80
100
Respiratory Distress Dehydration Sepsis-SIRS Acute Malnutrition
Bangladesh-1 Peru Ecuador-1 Burkina Faso Ecuador-2 Bangladesh-2N=59 N=36 N=47 N=163 N=429 N=269
Results
0
20
40
60
80
100
Malaria Dysentery Meningitis Ear Infection Anemia Skin Infection
Measles UTI
ECUADOR (n=429) BANGLADESH (n=269)
Clinical Disease Assessment Correlation
385
20 3
400
8 0
Standard Immediate Urgent
CHW MD Respirator Distress
228
29 2
252
6 1
Standard Immediate Urgent
CHW MD Respirator Distress
403
4 1
398
10 0
Standard Immediate Urgent
CHW MD Dehydration
395
13 0
401
7 0
Standard Immediate Urgent
CHW MD Sepsis-SIRS
374
32 2
388
18 2
Standard Immediate Urgent
CHW MD Acute Malnutrition
249
10 0
256
3 0
Standard Immediate Urgent
CHW MD Dehydration
250
9 0
256
3 0
Standard Immediate Urgent
CHW MD Sepsis-SIRS
141101
11
96131
32
Standard Immediate Urgent
CHW MD Acute Malnutrition
Triage Recommendation CorrelationEcuador (n =429) Bangladesh (n =269)
Conclusion
0
10
20
30
0 1 2 3 4 5 6 7 8 9 10DIFFICULT VERY EASY
How Easy to Learn
Usability and Acceptability: CHWs
010203040
0 1 2 3 4 5 6 7 8 9 10
How Easy to Use
DIFFICULT VERY EASY
0102030405060
0 1 2 3 4 5 6 7 8 9 10
Allows you to do your job better
Not At All Very MuchBurkina Faso (n = 163)
