One World Doctor: A Remote Patient Monitoring and Educational System

Globally, there are over 5 billion active mobile phone users. SMS (text-based mobile communication) technology has become common way to communicate. By 2015 global SMS traffic will reach 8.7 trillion, up from the 5 trillion messages that were sent in 2010. Considering the prolific growth rate of this form of communication and the uptick in mobile health, addressing acute illnesses in developing countries such as Nigeria using SMS technology was bound to occur.

Unfortunately, many current mobile health programs in Africa are only supported by NGO funding for a limited time and when that initial funding ends the programs generally cease to function. Beyond that, most programs are reactive health programs that rely on the patient to initiate action after a poor health state has been reached.

Enter OneWorldDr. (OWD) a mobile-based platform that is a proactive system that continually monitors patient conditions and provides the tools for a physician or medical worker to intervene before an acute or unfavorable condition is reached. OWD allows for patients to be empowered and take control of their healthcare. It encourages patients to make behavioral changes, which generate positive healthy outcomes. By providing a SMS toolset that can be easily used by a healthcare provider as well as the patient, health and wellness become attainable and behavioral changes lead to a healthier lifestyle where wellness is an essential aspect of day-to-day activities.

Unlike NGO-funded programs, OWD was designed to be sustainable in a commercial as well as a non-profit market.

Instrat Global Health Solutions and The Anadach Group are the leading forces behind OneWorldDr. The platform uses text messaging to monitor patients’ vital signs and health remotely, alerting doctors when interventions are needed. OneWorldDr. collects the data from the patient, performs an analysis, and sends alerts out to the patients in response of the analysis. The Anadach Group is responsible for developing wellness messages and content focused on specific chronic diseases.

In October Instrat Global Health Solutions presented OneWorldDr. at our unNiched(micro) Scratch, Sniff & Learn event in New York City.

The presentation can be viewed here:

View more presentations from Path of the Blue Eye Project

Key Activities:

Currently the platform is targeting the following chronic diseases: hypertension, heart failure, diabetes, and asthma. Data monitoring regarding patient blood pressure, blood sugar, weight, BMI, and temperature is supported on desktop and laptop computers as well as hand-held devices such as mobile phones with SMS technology.

OWD proactively notifies patients to take their readings and respond; and notifies physicians/caregivers if readings are abnormal. The monitoring system is broken down into several steps that maintain both a private relationship as well as accurate responses between the physician and the patient. Therefore if there is a sensitive issue that may compromise a public figure’s image or if the patient feels embarrassed about going to a clinic in a small town to seek care they can receive a determined course of action from the healthcare provider on their mobile phone.

At scheduled time Patient receives reminder SMS/email to take BP/BS/Wt reading and reply with the reading
Patient takes current reading and replies in required format (e.g. BP 180/110)
Patient receives confirmation that reading has been received and processed
If reading is above normal: Patient, Caregiver, Doctor receive an alert Example: Alert! Current BP: 180/110 is outside target level.
Doctor/Caregiver has two means to get additional patient data: Web Portal (Desktop, laptop, tablets, smart phones) or Cell Phone: Non -smart phones
Doctor/Caregiver determines next course of action

Recently OWD has expanded to include a mobile messaging service that is capable of monitoring additional chronic conditions. This service has enlisted over 2,000 subscribers globally and includes messages related to:

Health Education, Wellness Tips, Chronic Disease Management
Locally nuanced dietary and nutritional advise
Interactive Health Information on difficult subjects
STDs, HIV, ED, Drug Abuse, Mental Illness, Women’s Sexual Health

Results:

In a six-month trial involving 50 patients with no other interventions, 16 patients or 32% of the sample progressed to satisfactory control of their pathology and another 15 or 30% remained poorly controlled and their care was escalated. The trial was conducted between March and September 2011. Patients were full-time employees across seven manufacturing sites and were either moderate/severe diabetes or hypertensive patients. Below is specific data relating to the study, which generated aforementioned results:

Readings Monitored: Blood Pressure, Blood Sugar (Twice weekly)

Equipment Used: Blood pressure meters and glucometers, test strips provided by Sponsor

Thresholds: Company medical adviser set upper and lower thresholds for patient readings

Action: Alerts sent to patients’ doctor/nurse when reading exceeded thresholds

Follow up: Patient was invited for special consultation and plan of action to bring down numbers

16 (32%) progressed to satisfactory control of their pathology,
15(30%) remain poorly controlled and require further medical intervention.
19(38%) were non compliant for several reasons

To date approximately 200 patients have participated in the remote patient monitoring services to date. OWD is planning a larger, controlled outcomes study involving approximately 1,000+ patients.

In conclusion, between the remote patient monitoring service and the messaging services this platform has already positively impacted the health and wellness of thousands of Nigerians who would have allowed their illnesses to become acute as opposed to addressing them preemptively using SMS technologies.

Industry:

Healthcare

Primary Communications Discipline:

Mobile Marketing

Organizations Involved:

Instrat Global Health Solutions, The Anadach Group

Campaign Dates:

March - September 2011

For More Information:

Remote Patient Monitoring with $9.3 Billion in 2014, Mobile Health News, May 2011, http://mobihealthnews.com/10969/report-patient-monitoring-worth-9-3-bill...
Remote Patient Monitoring: Global Pipeline Analysis, Opportunity Assessment and Market Forecasts to 2016, Business Wire, February 2011, http://www.businesswire.com/news/home/20110209005852/en/Research-Markets...
Where There is No Doctor, Try The Internet, Ayaka Online, June 2011, http://www.ayakaonline.com/life/where-there-is-no-doctor-try-the-interne...
Telehealth, Wikipedia, http://en.wikipedia.org/wiki/Telehealth
Remote Patient Monitoring, Wikipedia http://en.wikipedia.org/wiki/Remote_patient_monitoring

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