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Mobile Telemedicine: Fighting Pneumonia with Smart Bracelets in Pakistan

The IRD-PATH group aims to find a technological solution to help decrease morbidity and mortality due to pneumonia in newborns and children up to 24 months old in Karachi, Pakistan. With a worldwide incidence of more than 150 million cases per year, pneumonia kills more children under five years of age than any other disease. Although more recent figures have shown improvements in estimates of deaths, the global burden of deaths due to pneumonia remains unchanged. The United Nations (UN) has established a goal to reduce the mortality rate of children under five by two-thirds as one of their eight Millennium Development Goals (MDGs), to be completed by the year 2015.
RD-PATH is interested in studying the effects of vaccination by identifying and tracking patients suffering from pneumonia. To accomplish this goal, IRD-PATH plans to enroll 7,500 newborns in a pneumonia surveillance study. Karachi's health care system does not support patient identification and tracking, however, making patient tracking a difficult technical challenge for the study. Newborns are seen by different physicians in tens of clinics, and there is no location for medical records. In addition, since health centers (clinics and hospitals) are understaffed, physicians have to see a large number of patients in a short period of time (at the extreme, a physician may see one patient every two minutes) and may not have time to report every pneumonia case through some lengthy procedure. To facilitate pneumonia detection, IRD-PATH hopes to utilize radio frequency identification devices (RFID) and cellular phone technology to follow participants until they are 24 months old. The participants of the study will identify themselves by presenting an RFID tag when they visit a clinic. The physician will report a diagnosis of whether they have pneumonia by sending this data to a central server by cell phone. On receiving a positive diagnosis, a mobile care team will be dispatched to pick up the participant for further study.

Proposed Solution

IRD-PATH is already tracking patients, but as the work is heavily human-dependent, making the process inefficient and error-prone. The human-dependent solution requires one worker per clinic, making the study difficult to scale to the tens of clinics available to the study population. Furthermore, the manual tracking of such a large amount of patients introduces the risk of error. Thus our team proposes to create a fully electronic system to reduce the tracking system's current dependence on humans and expedite the overall surveillance process. We designed and built a cellular phone- and RFID-based patient presence alert system which identifies infants participating in the study. Patients enrolled in the study will wear an RFID bracelet, which the physician will scan with a cell phone during a medical encounter. Consequently, the study participant will be identified and the physician will be prompted to select the patient's pneumonia diagnosis on the cell phone. The selection of a positive diagnosis by the physician will then alert a specialized team to go to the patient's location for further study and treatment.

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