We just heard a fantastic talk by Jacqui Maher about her work on the Boabab project, fighting AIDS in Malawi, Africa.
First, she gave us an overview of the AIDS epidemic, especially in Africa:
- Africa has 12% of the world’s population, but 60% of the people with AIDs
- In Malawi
- 14% of adults have AIDS
- 8 people die every hour from aids
- there are 280 doctors
- 3500 HIV/AIDS patients per doctor
When she arrived, patients would wait in long lines to see a doctor and patient intake would typically take 15 minutes. It was all paper-based an error-prone. In Malawi, they have a national id program where every ID card has a bar code. This could be used for easy patient intake. After they developed the hardware/software solution, it would take less than 1 minute to register new patients and less than 10 seconds for returning patients to get through the intake process.
The solution was designed to help in a number of areas:
- Patient Registration: entering new patient data, generate national id bar code, or scan an existing one
- Encounters: any patient interaction
- Observations: diagnosis, progression, vitals, patients complaints, drug regimen
- Prescriptions: drugs, ingredients, inventory, etc.
They overcame challenges with spotty internet connections and low bandwidth. They use a wireless mesh network, which is self-healing. The portable computer they used was based on the I-Opener (initially bought from the US on eBay, then 2000 were donated) which was hacked to include a touchscreen, ethernet, PoE (power over ethernet) and a bar code scanner. The software is Ubunto, Ruby on Rails, and MySQL.
More details on the software:
- BART – Baobab Anti-Retroviral Treatment
- OpenMRS Data model
- templating using ERB
- App calls via AJAX
- Rspec tests
Jacqui told a great story about Gem the Janitor (yes, that is his real name) who just picked up the device during a busy time when all of the nurses were busy, figured out the interface quickly and started helping register people. Now he runs the whole intake process.
- great community
- common consensus on best practices
- active contributions to OSS
- very accessible information on every part of the stack
- supurb interactive tutorials like peepcode
- Ruby is easier to learn offline that other languages, comes with documentation
- ActiveRecord: makes complex data models easier
Now 265 of the 280 doctors are using this app. The data collection enables extensive reporting, enables agencies to use the data to focus research & funding, and influence policy decisions.
You can help!