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SMSaude: design, development and implementation of a remote/mobile patient management system to improve retention in care for HIV/AIDS and tuberculosis patients
Örebro University, Örebro University School of Business. Informatics, Department of Mathematics and Informatics, Eduardo Mondlane University, Maputo, Mozambique. (Infomatics)ORCID iD: 0000-0001-8933-2906
Örebro University, Örebro University School of Business. (Informatics)ORCID iD: 0000-0002-3713-346X
Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Maputo, Mozambique.ORCID iD: 0000-0002-7823-2894
2015 (English)In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 3, no 1, e26Article in journal (Refereed) Published
Abstract [en]

Background: The widespread and low cost of mobile phones and the convenience of short message service (SMS) text messaging suggest potential suitability for use with alternative strategies for supporting retention in care and adherence to the treatment of various chronic diseases, such as HIV and tuberculosis (TB). Despite the growing body of literature reporting positive outcomes of SMS text message-based communication with patients, there is yet very little research about the integration of communication technologies and electronic medical records or electronic patient tracking systems.

Objective: To design, develop, and implement an integrated mobile phone text messaging system used to follow up with patients with HIV and TB in treatment in Mozambique.

Methods: Following the design science research methodology, we developed a Web-based system that provides support to patients. A case study involving three health care sites in Mozambique was a basis for discussing design issues for this kind of system. We used brainstorming techniques to solicit usability requirements, focus group meetings to discuss and define system architecture, and prototyping to test in real environments and to improve the system.

Results: We found six sets of system requirements that need to be addressed for success: data collection, telecommunication costs, privacy and data security, text message content, connectivity, and system scalability. A text messaging system was designed and implemented in three health facilities. These sites feed data into a central data repository, which can be used for analysis of operations and decision support. Based on the treatment schedule, the system automatically sent SMS text message appointment reminders, medication reminders, as well as motivational and educational messages to patients enrolled in antiretroviral therapy and TB treatment programs.

Conclusions: We successfully defined the requirements for, designed, and implemented a mobile phone text messaging system to support HIV and TB treatments. Implementation of this system could improve patients' self-management skills and strengthen communication between patients and health care providers.

Place, publisher, year, edition, pages
Toronto, Canada: J M I R Publications, Inc. , 2015. Vol. 3, no 1, e26
Keyword [en]
Mobile health, text messaging, SMS system, patient management, design science research, Mozambique
National Category
Information Systems
Research subject
Informatics
Identifiers
URN: urn:nbn:se:oru:diva-42527DOI: 10.2196/mhealth.3854ISI: 000359791000019PubMedID: 25757551Scopus ID: 2-s2.0-84988336269OAI: oai:DiVA.org:oru-42527DiVA: diva2:786904
Available from: 2015-02-06 Created: 2015-02-06 Last updated: 2017-12-04Bibliographically approved
In thesis
1. Integration of Mobile Technologies with Routine Healthcare Services in Mozambique
Open this publication in new window or tab >>Integration of Mobile Technologies with Routine Healthcare Services in Mozambique
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Mobile technologies are emerging as one way to help address health challenges in many countries, including in Least Developed Countries. Mobile technology can reach a large share of the population but in order to provide effective support to healthcare services, technology, information collection and dissemination, and work processes need to be well aligned. The thesis uses a design science methodological approach and mixes qualitative and quantitative data analysis to address the question of, How can mobile technologies be effectively integrated with routine healthcare services?

The study concerns the design, implementation, and evaluation of a mobile technology-based system, called SMSaúde, with the aim of improving the care of patients with HIV/AIDS and tuberculosis in Mozambique. The work started with the elicitation of functional and user requirements, based on focus group discussions. An important challenge, as in many mHealth interventions, was the integration with routine healthcare services and the existing IT systems, as well as developing a scalable technical structure. The system has now been in routine use since 2013 in more than 16 healthcare clinics in Mozambique. Evaluation was done by a randomised controlled study. Analysis of patient records showed that retention in care in urban areas was significantly higher in the intervention group than in the control group. In a user study both patients and health professionals were very positive to the system. The thesis contributes to research by demonstrating how information system artefacts can be constructed and successfully implemented in resource-constrained settings. The practical contributions include the designed artefact itself as well as improved healthcare practices and mHealth policy recommendations.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2017. 136 p.
Series
Örebro Studies in Informatics, 13
Keyword
mobile technologies, mobile health, mHealth, Least Developed Countries, Mozambique, mobile phones, information systems artefact, design science research
National Category
Information Systems, Social aspects
Identifiers
urn:nbn:se:oru:diva-56948 (URN)978-91-7529-195-6 (ISBN)
Public defence
2017-06-12, Örebro universitet, Musikhögskolan, Hörsal M, Fakultetsgatan 1, Örebro, 13:00 (English)
Opponent
Supervisors
Available from: 2017-04-04 Created: 2017-04-04 Last updated: 2017-10-18Bibliographically approved

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