eCompliance Suite
MLC Vanguard | Created by Operation Asha
eCompliance is a biometric terminal that contributes to preventing drug-resistant strains of tuberculosis from developing during patient treatment.
7,000,000 Lives Impacted
Tuberculosis (TB) is the biggest infectious disease killer in the world, and the world’s biggest health crisis. 10.4 million people contract TB annually; 1.8 million die. TB-related stigma leads to great suffering. TB is a socio-economic problem. In India, 100,000 women are abandoned and 300,000 children forced to leave school annually because of this fully curable disease (Annual TB Report, Government of India, 2008). TB patients are thrown out of jobs and entire families sink into poverty. The loss of wages is $300 million annually in India alone. It is estimated that the world will lose over US $3.4 trillion because of TB in the next decade. Incomplete treatment has led to the emerging man made epidemic of Drug Resistant TB, which has the potential to wipe out millions.
Operation ASHA has a local, deep, low-cost, high-impact scalable and replicable model for TB detection and treatment, utilizing local communities and empowering them with technology. Our doorstep delivery model has TB treatment centres within community premises, open at convenient hours. In rural areas we have workers on foot, on bikes or even boats ( as in the Mekong delta of Cambodia). We take services to the doorsteps of the disadvantaged, for free. We hire and train local people as Community Health Workers (CHWs). CHWs carry out awareness, counseling, and take care of stigma and myths. They use eCompliance Suite, a suite of apps loaded on low cost tablets. Workflow: CHWs screen people for symptoms of TB using eDetection. Where patients are scattered as in mountains, rural areas or islands, CHWs carry strips of medicines and the technology device in their back packs. They give supervised daily doses for 6 months and use eCompliance (biometric fingerprinting), on each visit, which gives real time information if a dose is missed. This requires prompt action by the CHW who must visit the patient in his home, find out what is the matter, provide a solution, give the medicine, and take fingerprint as poof of visit. This prevents Drug Resistant TB. Technology ensures accuracy; a fingerprint cannot be fudged and there is no manual entry. CHWs and their managers get incentives based salaries, with incentives built in for each detection and for ensuring full treatment. We leverage the trust of community leaders for best results.
The Innovation
Our innovation is not just technology. It is a model where local people are hired and trained to deliver health services, and given cash incentives for results and outcomes. Our technology innovation, the eCompliance Suite consists of the following applications loaded on a low cost tablet: a) eCompliance: a biometric tracking system created by Microsoft Research to improve adherence. The system uses fingerprint scan verification at the time of each dose, and gives real-time information of missed doses which result in prompt action by health workers, thus preventing default (drop out).
Methodology: The eCompliance terminals are kept securely in TB treatment centres in disadvantaged areas, and also carried by health workers in their backpacks. During each patient visit, the patient and healthcare worker scan their fingers, only then the medication is dispensed. If a patient misses a dose, real time information is there, and a text message alert is sent to the healthcare worker and the supervisor. The healthcare worker is then responsible to meet the patient within 24-48 hours to administer the medication and record the treatment again using the biometric terminal. Also by GPS tracking we get to know of the movements of our CHWs. This has great impact in treating TB that requires prolonged and strict treatment regimens. Each eCompliance terminal consists of low cost, off the shelf components. There is an Android Tablet with SIM card and USB Host Functionality, and a Fingerprint Reader. The terminals work offline, and internet is needed only to access the reports.
Benefits: The biggest benefit of eCompliance is that of increased patient adherence, preventing default, thus ‘turning the tap off’ on Drug Resistant TB. It provides a sure and certain method of tracking patient treatment. There is accurate, secure, and timely patient data tracking. Each time a patient is administered their medication, the patient visit is immediately recorded in eCompliance's Electronic Medical Record (EMR). The EMR collates the data in formats designed by various governments/organizations. All data is encrypted and the eCompliance application sends updates to the central database every 15 minutes via the SIM card. It improves impact measurement and decision-making guidance. Government/Organization supervisors can access reports for the specific intervention area and use them to analyse and improve processes and results, and make policy and budgeting decisions. There is great ease of use and portability. The software is user-friendly and can easily be installed. For health care workers requiring mobility, the Android tablet is a light and portable option. eCompliance has recorded over two million transactions. It is being used by Operation ASHA in India and Cambodia. 3rd party replication of eCompliance has also been done in Uganda, Kenya, Peru, Dominican Republic, Afghanistan, Tanzania and Zambia.
Implemented in
WRPO Countries, including: Cambodia, Uganda, Dominican Republic and Kenya, India
Get in touch
Operation ASHA HQ
About Operation ASHA
Operation ASHA serves the disadvantaged with a focus on the poorest of the poor, those who are marginalised and in need, irrespective of religion, colour, caste, creed, background, political or religious beliefs, or sexual orientation. We work in India, Afghanistan, Cambodia and Zambia. Past projects have been in Peru, Dominican Republic, Uganda and Kenya. We believe in justice and inclusion. These are our core principles. We try to serve as many women and children as possible in our programs, making them our key beneficiaries. Most of our Community Health Workers are illiterate and semiliterate, and more than 50% are women. We empower women with jobs, thus giving them respect in the family and neighbourhood. We invest time and resources in addressing issues of stigma and discrimination. We provide vocational training to TB patients and carry out counselling of families to prevent abandonment. We create jobs for local people. We have saved jobs of 93 TB patients by providing counselling and legal advice to their employers.
