Africa On Rails

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pub_openminds.indd 1 11/15/06 10:53:57 AM











Africa on RailsFrank Louwers - http://frank.be






This presentation

• Not mine!

• Mike McKay

• RailsConfEurope, Berlin, September 2007

• Baobab Health

• Openminds sponsors a virtual server with ready-to-run Rails stack






Malawi: statistics

• Africa

• GNI of 160 $ per capita

• Life expectancy: about 40 years

GNI Belgium: over 30 000 $ per capitaMalawi is probably the poorest place on earth. Think about how your own life would change if you thought you would only live to be 40 years old.






Malawi: interesting statistics

•12 000 000

•1 000 000

•160

12 million is the population of Malawi1 million is the number of people infected with HIV160 is the total number of doctors in Malawi

Belgium equivalent: 48,000 doctors for 12 million people

HIV has caused a crisis in Malawi. For the past 20-25 years the problem has been lack of drugs. Now we have effective drugs but it's a complex treatment process that requires careful diagnosis and tailoring for each individual as well as ongoing monitoring and adjustments for the rest of the patients life. The world has spent billions of dollars to ensure that the required drugs are freely available for those that need it. Malawi has managed to get 60,000 people on treatment, but this is a small percentage of the total number that need it. Malawi can't scale the treatment to everyone that needs it due to the lack of skilled health care workers and a monitoring system. Both of these are critical due to the complex nature of HIV treatment.






Problem

• Patients not being seen

• Data not being collected

As there are almost no doctors, you can’t rely on them for solutions. However, drug administration is not that difficult. It comes to two problems: get patients to visit the healthcare center, and make sure the data is collected in a reliable way






Baobab Solution

Baobab places touchscreen workstations at every point of patient care. This guides healthcare workers through the care process, enforcing that all critical medical issues are investigated. Furthermore, it alerts them to any important issues in the patient's medical record. Not only does this ensure good quality of care for the patient, but it also means that complete and accurate information about the patient is instantly and reliably captured. This data allows for excellent patient level monitoring as well as aggregate reports that summarize key statistics about all of the patients at a clinic.






Baobab Solution

• Eliminate physician dependency

• Eliminate paper forms

• Data is collected more accurate

• Patient registration takes no more than 2 minutes

Eliminate physician dependency: Diagnosis and treatment typically requires 20-30 questions (for example “Are you able to walk”) that then need to be analyzed in order to determine the proper treatment. Baobab's touchscreens lead the healthcare workers through this process and analyses the results and recommends the proper treatments. This allows undertrained healthcare workers to easily perform complex diagnoses and treatment.

By allowing complex tasks to be performed by less skilled health care workers Baobab has reduced the critical bottleneck to scaling up HIV treatment. Previous tasks such as patient registration used to take about 10 minutes and caused long lines. Now the process takes less than 2 minutes. Without Baobab, the average urban HIV clinic in Malawi can treat no more than 1000 patients. With Baobab technology clinics have scaled to 5000 patients on treatment.

Eliminate paper forms: Every other HIV treatment system in Africa is paper based. Data is written onto paper forms and sometimes manually inputted into a computer. The consistency of data capture, archiving and retrieval is poor which has a significant impact on patient outcomes. Good data improves patient care by informing health care workers about a patient's treatment history. Furthermore, without it, it becomes impossible to predict how many drugs will be needed to continue treatment for all of a clinics patients. If a patient misses even a few days of treatment the patient will build up resistance to future treatment, which will result in failure of treatment. Baobab's system captures data in real-time. As soon as the health care worker asks a question, the answer is captured electronically. This data is then stored for use during subsequent visits and is compiled into a drug forecasting report which is sent to the ministry of health.






Technical Solution

• Rails application

• Touchscreen computers

• Central server at each clinic

• Batteries, Power over Ethernet, Windmills











Cheap hardware (“Internet PC” -company that went bust and sold all it’s hardware on ebay), modified so they can handle touch-screens.Central “server” at each clinic: Pentium class






Buzzword Compliance

• Ajax

• RoR

• Web 2.0

• IRC

• Open Source (improve and give back)

• Selenium

• PoE

• Renewable Energy

• Africa

• Capacity Building

• Git

Free and Open Software Solutions for Healthcare Industry






Buzzword non-Compliance

• TDD

• REST

• Capistrano (almost there)






Demo of touchscreen application

http://youtube.com/watch?v=jKxYLqL_fk0








Demo of patient registration

http://youtube.com/watch?v=cf49zRxhKhc








Results (September 2007)

• > 200 clinical workstations deployed

• > 500 000 patients treated

• 3 HIV clinics

• 12 000 HIV patients






Africans on Rails - meet the team











http://youtube.com/watch?v=gvjCueL-C0A













http://youtube.com/watch?v=NzH3Eh5ZolY








What can you do?

• Gather (baobabhealth.org, Facebook group, irc)

• Give

• Go

• Spread the word

So perhaps you're thinking – wow this is really amazing. I wish I could help out.

Gather – join the mailing list, hangout on IRC.

Give – give us some money. We can do a lot with very little.

Go – come to Malawi for 6 months or a couple of years and experience what its like to do something utterly meaningful.

Spread the word - give this presentation at events you attend :)

Africa On Rails

Health & Medicine

Transcript of Africa On Rails