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Brad CunninghamSystemOne, LLC
Connectivity Needs for Improved Patient Care
Translating Laboratory Informatics into Patient Care: mHealth & Implementation Science Research
ASLM Conference, Cape Town3 December, 2016
© SystemOne LLC, 2016 All rights reserved.
Adoption in TB Through 2015
MARKET IS GROWING @ 14% PER MONTH
MORE THAN 2,000 GENEXPERTS ARE ALREADY PROGRAMMED FOR CONNECTIVITY, ACROSS 32 DEVELOPING NATIONS
© S y s t e m O n e , 2016 All rights reserved.
• Translating real-time data into real-time actionTreatment
• Diagnostics moving further away from centralized, well-controlled environmentsQuality
• Optimize utilization of instruments, consumption of consumables, improve ROICost
Faster, better quality health data leads to better patient outcomes
Misnomer
Data >> Connectivity
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• Expect POC instruments to traverse multiple network types / speeds (3+) each day
• Wide variety in signal strength / quality
Patient Care
Patient Management
Logistics
Diagnosis
Linkage to Care
© SystemOne LLC, 2016 All rights reserved.
Emerging mHealth trends inthe HIV/TB sector
Patient Care
Patient Management
Logistics
Diagnosis
Linkage to Care
Patient Management:• Geo-locating• Health-care contact info• Home-care help• Incentive-based care• Appointment booking• Patient registration • Patient identification• (direct) Contact information • Visit management & workflow• Screening • Sample Collection• Education, awareness & outreach• Result delivery • Re-engagement • Linkage to care
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Patient Care
Patient Management
Logistics
Diagnosis
Linkage to Care
Logistics:• Test order requests• ‘Smart’ courier • Sample transport tracking• Transport recording • Demand-based logistic routes• Reduce time-to-diagnosis• Improved consumable
management• Reduce stock shortages• Reduce gross over-purchasing
of consumables
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Patient Care
Patient Management
Logistics
Diagnosis
Linkage to Care
Diagnosis:• Recording & interpretation (RDT’s) • (ongoing) Quality Assurance • Measurement of ‘lab’ environment• Linking diagnosis to individuals• Reporting • Follow-up & reflexing• Real-time result delivery • Notifications (SMS, e-mail, in-app)
• Patient• Doctor• Nurses• Care centres (MDR, as
example)
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Patient Care
Patient Management
Logistics
Diagnosis
Linkage to Care
Linkage to Care:• Clinical translation of diagnostic &
connectivity efforts• Making sure the right data:
• Gets to the right person • At the right time• With the right information• In an appropriate manner
• Reduced time to result reporting• Get patient onto treatment
faster• Improve initiation on care
• Social engagement & personal care approach to increase retention in care & loss to follow up
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Patient Care
Patient Management
Logistics
Diagnosis
Linkage to Care
Where do things go wrong?• Do everything• Healthcare is too broad, too
diverse. • Start small
• Micro-populations. • Address specific need of the
population• Show value• Evolve• Scale out
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Where are we now?“Connectivity” is no longer a single result or even
a single system – connectivity is an ecosystem of platforms exchanging data.
• Emerging interoperability & standards• Developing best-practises in the field• Limited-scope patient engagement in cycle• Avoid persistent fragmentation • Web-based / cloud adoption increasing• Smarter devices (phones & diagnostics)• Clinical translation lacking
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GxAlert (example) allows data to flow across the health system
GeneXpert
SMS
ComputerApp
Other Systems:e-TB Manager
DHIS2
• Connects diagnostic devices
• Collects custom data
• Sends alerts, notifications,and reports
• Monitors and manages cartridge inventory
• Records service, warranty,and maintenance events
• Integrates with other health systems
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“Connectivity” is no longer a single system – connectivity is an ecosystem of platforms exchanging data.
What’s missing?
What’s missing? • Interfaces governed by open standards• Regulatory & governance framework for appropriate
sharing of data & information between systems• Unique patient identification
• National ID• Biometrics
• Innovative mechanisms to involve patient incontinuum of care
• Enhanced lab-clinic interface for translationalimpact
© SystemOne LLC, 2016 All rights reserved.
QUESTIONS?
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For any more information, please contact: Brad CunninghamVP, Implementation SystemOne LLC(m): +27 61 487 [email protected]
