August 16, 2013

The Wheel of Destiny Is Made Of Paper

Every week until 2010, Dr. Sophornnarith, director of the Kien Svay Operational District (OD), noticed irregularity of the weekly reports of some health centers in the district. The Health Center staff were not careless about completing and sending the reports, but they were expected to follow a process that created logistical problems.

For two years, the combination of Geochat and Reporting Wheel, two technologies developed by InSTEDD, has become the must-have solution for Health Centers to cope with reporting difficulties. And this approach has become a great deal, more reliable and understandable way to complete this critical reporting task. 
A Health Care Worker uses the Reporting Wheel for reporting communicable diseases in Kien Svay, Cambodia
Previously, in order to pass the report on to Kien Svay Operational District, the Health Center staff had many options, but none of them were 100% reliable. They could use either  walkie-talkies, a simple telephone handset or physical paper documents to display the data regarding the number of detected cases of twelve infectious diseases, such as very serious ones like Dengue Fever, Rabies, Meningitis Encephalitis… The paper-based report option hand carried by motorbike to the OD could have been an alternative solution, but some routes are closed or difficult during rainy season, making driving unsafe. In this scenario, the transfer of the report would be delayed and therefore any response was also delayed.

How is the report involved in the medical response? In fact, if the 12 infectious diseases report isn’t timely collected by the Health Center, the trend of the diseases can not be accurately detected and real time support and response to outbreaks could be delayed.   Under these conditions, the spread of these illnesses could occur rapidly and easily and can trigger disease outbreaks, such as H5N1 or H1N1.

In order to improve the report collection mechanism and the communication with Health Centers, the director of the Kean Svay Operational District  expressed his needs to InSTEDD.
The weekly report received by the OD staff…
or how to know anywhere in real-time the situation of communicable diseases.
ARI, AWD, DHF are acronyms for diseases
Due to the large surface of the geographic area of the Kean Svay OD, the access to real time communication between the HCs and the OD is critical for an efficient follow-up to the spread of communicable diseases throughout the district.

If the OD staff receive the reports from the health centers in real time, they will be able to provide technical support to the Health Center without delay if needed. And this is the promise of the use of this combination of Geochat and the Reporting Wheel, the two main elements of the system. For Dr. Sophornnarith, these tools are seen as the gateway to a more efficient reporting system, and ultimately, the road to the containment of communicable diseases that strike Kien Svay Operational District.

As far as implementation of these technology tools is concerned, there’s no need for the HC and OD staff to be tech-savvies.The Reporting Wheel acts to facilitate the effectiveness of the GeoChat system for health workers.

(CAPTION : the Reporting Wheel : A costless, self-documented and intuitive tool)
The Reporting Wheel overcomes this literacy barrier : it associates a numerical code with the combination of one disease among the twelve diseases and the number of patients infected by this disease. On the reporting wheel, the Health Center staff just need to move the wheel to select  the name of the disease and the number of the cases to report, and automatically a code number appears on the other side of the wheel. This code is the only detail needed on the SMS that has to be sent by the health workers themselves. Because it is by far easier to teach the health staff to write SMS with numbers instead of letters, the Reporting Wheel helps solving the challenge on SMS reporting with the use of Geochat alone.

It offers therefore a long-lasting solution for the Kien Svay OD Director.

Watch here how to send the report by using Reporting Wheel:

Besides, Reporting wheel tool is provided with a user’s guide.  It is easy to follow and to train health staff how to use it, usually health staff does not take more than 5 minutes to learn.

Can it detect any typing error ? the code used in Reporting Wheel consists of prime numbers, which helps to detect any wrong input by the user. In such cases, an SMS message about the error is sent to the user.
InSTEDD iLab Southeast Asia field support staff, Yon explaining to HC staff how to send SMS
Dr.Yi Sophonnarith is a champion leader who adopted - not without some difficulties - the new technology to enhance the traditional routine health reporting work.

He purchased and gave phones to the 18 Health Centers under his OD to use for this reporting. But the use of the system triggered many problems. In August 2010, Geochat was implemented in Health Centers to send the weekly report. Dr. Sophonnarith still had to face some difficulties with the weekly reports. Therefore, InSTEDD improved it in December 2011 by combining the use of Geochat with another tool, Reporting Wheel. It is by far easier for the HC staff to understand. In an interview with staff of Kampong Phnom Health Center, they claimed that “Using this system (Geochat + Reporting Wheel) is easier than the previous paper-based system. The report can be sent anytime, regardless of bad weather conditions. It arrives quicker and on time at the OD”. According to their words, it’s a great success, no irregularities of the weekly reports are pointed out.

At the end of the day, Dr. Sophonnarith demonstrated how easy health information system could be at the grassroot level with the real-time update of the data. In addition to the reports, Geochat + Reporting Wheel are indeed used by the OD director to send SMS, most of the time in Khmer language, to Health Centers to keep them updated with news about infectious diseases in the region, meeting reminders…

Nobody can now complain about the difficulty of the system’s use. Therefore, whenever there is a regional health workshop, he advertises the numerous advantages of this system to the other OD directors. And what about you ?


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