By Andy Williams, Associate Editor, Avisian Publications
Near field communication may be hyped because of its payment abilities, but a health care project in Pakistan is helping save children’s lives and showing the flexibility the technology can enable.
Called an Interactive Alerts system, it was designed by NextLab at MIT, Cambridge, Mass. and Interactive Research & Development of Pakistan (IRD), a Karachi-based non-profit company that offers low-cost health care technologies for developing countries. Indus Hospital, a 150-bed care center in Pakistan, is also involved in the project and Nokia has provided NFC handsets to support the initiative.
“The purpose of the project is to conduct surveillance for early childhood pneumonia in preparation for a vaccine trial,” says Dr. Aamir Khan of IRD. Using the NFC phone as a reader makes it easier for IRD staff to compile information on the children, he says.
While the project started in 2007, it didn’t begin enrolling children until November 2008. Khan says there are about 3,000 children enrolled in the program, but the aim is to get another 1,500 involved.
Using NFC phones to access immunization records and essential health alerts
At the time of their six-week vaccination visit, children are given an RFID tag embedded in a bracelet. This tag provides a unique ID to the child, and parents are advised and encouraged to take sick children to participating general practitioner clinics or general hospitals in the program.
The Nokia 6131 NFC phone scans the child’s tag. Pertinent immunization, clinical and laboratory data is collected and posted to the server in real-time and can be viewed over a secure Web site.
The objective for collecting this data is to provide policy makers in Pakistan and in the region the information required for introducing new vaccines against pneumonia, a leading cause of childhood death in countries with high under age five mortality rates, according to IRD. The same system can also be used to track other diseases, such as meningitis, sepsis, severe dehydration, tuberculosis and malaria, says Khan.
This approach helps overcome the challenges of disease tracking and patient referral in settings where medical records and referral systems do not exist, says Dr. Khan. The RFID bracelet provides the information that health workers need to verify identity, view basic medical records and respond to emergencies quickly.
One of the challenges was “figuring out the social acceptability of bracelets and cards,” says Dr. Khan. “We went for the bracelet form factor in very young infants, although all patients have the option of taking a card only.”
When the patient is examined at a participating clinic the practitioner can generate an “interactive alert,” a text message, to the doctor or health worker, who can respond as needed, including visiting the patient at the clinic, adds Khan.
The genesis of this project came from an initial 2008 MIT class on information and communication technologies, recalls Luis F. G. Sarmenta, research scientist at MIT Media Lab. That class has since evolved to become part of MIT’s Next Billion Network initiative, called “NextLab,” which focuses on new cell phone technology. The initiative is aptly names as one billion new people are expected to become regular cell phone users over the next couple years.
“During this class, our students communicated with IRD, and produced a basic working prototype of the idea,” says Sarmenta. “We then handed the source code to IRD, and they continued to develop it themselves, adding many more features and integrating it into their other mobile systems.”
What IRD coders did was design a data capture and reporting system called “Interactive Alerts,” says Khan. The system enables a health worker or doctor easy access to a patient’s records. After scanning the bracelet, the doctor can log in to a Web site to review the patient’s data and see if they are scheduled for any treatment. For example, has the patient missed a vaccination.
Why NFC instead of other types of identification, such as bar codes?
NFC technology was new to the IRD team. Khan had never heard of it before it was suggested by Sarmenta’s team. “We had considered other RFID readers, but none on cell phones,” says Khan.
“NFC requires a simple tap. Phones that take pictures of bar codes need to be handled in just the right way to get a readable picture,” says Khan. “There is often no time in the general practitioner clinics for this, and they would almost never make a second attempt if the first one did not work. Some see more than 100 patients in three hours.”
Khan says the program has been very successful, but IRD is trying to figure out a way to further entice physicians to use it.
“We are trying to figure out what incentives to provide the general practitioners to get them to use the system,” says Khan. “What does this bring him? More patients, more referrals? The system definitely works, but to scale up to the next level, we need to package the incentive of participation for the physician without transferring the costs on to the patient,” he adds.