Treatments for diseases like tuberculosis (TB) and HIV are lengthy and complex. Medications need to be taken regularly and for extended periods. Interruptions come at a high cost for patients, their families, and the health systems that treat them.
Over the past several years, professionals across a range of disciplines have focused on creating solutions at all levels of the health system. From a tool that helps governments calculate the economic cost of medicine stock-outs to a piece of software that allows doctors across Ukraine to follow a patient’s complex TB treatment, technology can play a critical role in bringing solutions to scale and making significant progress in the age-old fight against deadly diseases.
Here are two examples of how MSH is helping health workers use computers to fight back.
A DIGITAL HEALTH INNOVATION TO IMPROVE TB CARE AND PREVENTION: E-TB MANAGER
To appreciate the importance of having these tools, you might need to be reminded of two things. First, that curing a patient of TB requires a months-long course of antibiotics whose dose and type often need adjusting over the life of the treatment. Even then, success is not guaranteed. Second, if a patient does not finish the complete course of antibiotics, he or she may develop resistance to the medicine. That “stronger” form of the illness—called multidrug-resistant, or MDR-TB—is harder to treat, and is also more contagious. This is, in part, how MDR-TB came to be, and why we’re running out of medicines to treat certain types of TB.
To deal with TB effectively, we need systems to identify it early and treat it appropriately with an uninterrupted course of medicine.
Enter the innovators from Systems for Improved Access to Pharmaceuticals and Services (SIAPS)—a USAID-funded program implemented by Management Sciences for Health that bolsters pharmaceutical management for better health outcomes. They built a web-based digital health technology called e-TB Manager that allows a country’s health system to manage all the information needed for tuberculosis control. The tool enables health workers to monitor in real time the status of TB treatment and flow of medicines by integrating data across key aspects of TB control (presumptive cases, patients, medicines, laboratory testing, diagnoses, treatments, and outcomes). e-TB Manager has been adopted by national TB control programs in 10 countries.
But they didn’t just build the technology. They worked with health ministries across those countries to train users and test, implement, and institutionalize the tool. At the end of it all, they studied user adoption and satisfaction.
Take Ukraine, where TB is among the leading cause of death among infectious diseases. According to a study by SIAPS’s Niranjan Konduri, whose research findings appear in the European Respiratory Journal Open Research, since its implementation in 2008, e-TB Manager has shown strong results: 90% of users, including doctors, nurses, and laboratory professionals, agree that it has improved patient care, and 82% say it enhances productivity.
“I once encountered a situation in the office of a Ukrainian doctor who had to approve for a hospital maternity ward to release a newborn to his TB-positive mother,” says Konduri. “Instead of making time-consuming phone calls to the patient’s district health facility, the doctor was able to swiftly review the mother’s treatment history in e-TB Manager and discover that she had developed multidrug-resistant TB. That information had not been communicated to the maternity hospital. Eventually, the doctor decided to withhold releasing the newborn to the mother until she finished her treatment to protect the baby.”
Seeing such tangible benefits, Konduri explains, goes a long way toward reducing any reluctance doctors and health workers may feel toward adopting a digital health technology.