d-tree international who we are, what we do. d-tree background vision - a world in which every...
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D REE
INTERNATIONAL
D-Tree International
Who we are, what we do
D REE
INTERNATIONAL
D-Tree background
• Vision - A world in which every person has access to high quality healthcare
• Mission – To develop and support electronic clinical protocols that that enable health workers worldwide to deliver high quality care
• Founded in 2004: Currently have 5 staff in US, 14 in Tanzania, 1 in Malawi and 1 in India
D REE
INTERNATIONAL
D-tree background…
• Health workers in clinics and community health workers are the front line of the health system, yet face high turnover and often have little training
• Challenges also exist in collecting and reporting data
• We build mobile applications to reinforce the training provided and to assist our partners in monitoring and managing the work that is done in remote locations
D REE
INTERNATIONAL
Our process
Design
• Review of guidelines
• Observe patient flow
• Develop protocol
• Develop prototype
Field Refinement
• Train small group of workers
• Weekly meetings to collect feedback
• Incremental application refinement based on HCW feedback
Training and Pilot prep
• Train larger group of workers
• Complete central server set-up
Pilot
• Monitor use of field applications
• Regular meetings with HCWs
• Validate reports
Assessment
• Data analysis• Measure
effectiveness of application and interventions
• Lessons learned for larger scale-up
D REE
INTERNATIONAL
Adolescent Life Skills +
Health Antenatal Labor +
Delivery
Neonatal Infant Care
Child Dev. + Nutrition
PostNatal
ParentingSkills
Family Planning
Continuum of Care
D-treeActivites
• develop / refine defined quality standards• develop phone based delivery of standards to improve use• monitoring tools of standards use for supervision• patient data for quality improvement and links among providers• data links to HMIS/DHIS for supervisors + managers
D REE
INTERNATIONAL
Applications
• Community– Maternal and Child Health (Ante-natal, Post-natal, Neo-natal)– TB screening– Home based care– Orphans and Vulnerable Children– Family Planning
• Facility– IMCI– Maternal and Child Health (Ante-natal, Post-natal, Neo-natal)– Active Management of Third stage of labor– Immediate Newborn Assessment
D REE
INTERNATIONAL
Representative Clients
D REE
INTERNATIONAL
Software in the field
D REE
INTERNATIONAL
Pathfinder
• Developed mobile application to assist CHWs in the home visits for PLHA and Chronically ill patients
• Guide management of patient schedule visits• Provide referral reminders for follow-ups all
referred patients• Deployed and in use by over 107 CHWs in the
field. Plan to have over 200 CHWs users end of Nov 2010
D REE
INTERNATIONAL Pathfinder…Focus group discussion
D REE
INTERNATIONAL
JHPIEGO
• Developed facility and community protocols for antenatal, neonatal and postnatal care in accordance with Tanzania MOH guidelines
• Developed prototype applications ready for field refinement
D REE
INTERNATIONAL
JHPIEGO…
Check for danger signsTreatment based on
lab results
Counseling messages
D REE
INTERNATIONAL
UNICEF
• Developed protocols to support outpatient treatment of severe acute malnutrition in Zanzibar
• Developed application to support screening, registration, treatment and prescribing to be done at the health facility
• Field refinement and pilot to be completed by June 2011
D REE
INTERNATIONAL
UNICEF…
D REE
INTERNATIONAL
PATH
• Designed and Refinement of mobile app for District TB/HIV Coordinators (DTHCs) in Tanzania
• Designed and Refinement of mobile application for Community Volunteers to do TB screening in the community
D REE
INTERNATIONAL
PATH - Summary of data submissions
• Number of users (CHWs & DTHCs): 14 • Total forms processed by 25 Oct: 1284
Form Number Received Most Recent Submission
CHW- Diagnosis form 129 30/07/2010
CHW- Registration form 202 01/10/2010
CHW-Survey form 525 25/10/2010
CHW-TB screening form 201 06/09/2010
DTHC-closing facility form 18 17/10/2010
DTHC-facility registration form 155 22/10/2010
DTHC-TBHIV Data collection form 32 07/10/2010
DTHC-TBHIV Supervision form 22 07/10/2010
D REE
INTERNATIONAL
CARE-India
• Developed protocols for Individual Birth Planning and ANC, Active Management of 3rd Stage of Labor, Immediate Newborn Assessment and Postpartum follow-up for mother and child
• Establishing server for integration of all patient data in OpenMRS
• Application development and field refinement ongoing and due for completion by January 2011
D REE
INTERNATIONAL
What’s coming next
• Linkage of community and facility based information and tools
• Incorporation of media (pictures, videos, voice) into protocols
• More in depth clinical protocols• Improved supervisory reporting• Reporting from OpenMRS