In Mali, Using Cell Phones to Create Patient Records

Imagine that you're a mother in Mali, named Mme Magassa. When you go to visit a health clinic, you need to arrive with a big, pulpy pile of paperwork. These are your child’s clinical records, which you've shepherded through five different homes over the course of as many years. In Mali, patients are responsible for their own medical records, a fact that sometimes has dire consequences: clinicians have no idea what medicines a child has been given, what his or her allergies are and whether or not she has pre-existing conditions. Most homes are made out of mudbrick — and accordingly, with one roof leak, a whole medical history can be lost. Furthermore, many women like Mme Magassa are illiterate: mixed in with the childs records are old electric bills and other irrelevant bureaucracy.

How do we fix this mess of paperwork?

Frontline SMS: Medic offers a solution. Thanks to Frontline SMS: Medic, community health workers can carry simple phones devised to assist at all times. Programmed into these phones are a series of forms with checkboxes and fill-in-the-blank questions. When such a health worker does an exam, or responds to an emergency call, he or she fills in these forms, which are in turn sent automatically to a central database.

Until recently, this database looked like a stream of coded data, not a useable interface. But this week, Frontline SMS: Medic — in partnership with an organization I co-founded, the Mali Health Organizing Project (MHOP) — launched the first pilot of “PatientView,” an interface clinicians can use to call up this data and track patients. Clinicians can now be warned when a child needs emergency care in the field. They can track children’s weight over time, and they can enter in their own exam results into the database by filling out Frontline forms on an office computer.

And, in fact, this system is actually quite financially efficient. The cost of an SMS in Mali is roughly 10 cents, the same cost as a photocopy. Because checkboxes are a binary code, you can fit many questions into the 160 characters of a single SMS. While the technology involves significant upfront cost, the saved labor cost in data entry is enormous.

The public beta of PatientView was released this week, and you can visit this site to test it out. Just a few days ago, the founders of Frontline SMS: Medic were awarded an Echoing Green fellowship for this innovative program.

In the quest to collect data for statistical analysis, we can't allow ourselves to forget the true purpose of data — that is, to help clinicians make better decisions and allow children of women like Mme Magassa to live healthier lives.

Photo Credit: Mali Health Organizing Project