Transcript TxtAlert presentation April 2011

TxtAlert: An Introduction
mHealth Working Group
20 April 2011
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Gustav Praekelt
Founder
Marcha
Neethling
Operations
Simon
de Haan
Chief Engineer
David
Maclay
Engineer
© 2010
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An Introduction
What is txtAlert?
txtAlert is an SMS communication tool which:
Was developed by the Praekelt Foundation and launched in
conjunction with Right to Care’s Themba Lethu Clinic at the
Helen Joseph Hospital in 2007.
Aims to increase appointment attendance of ARV-patients
Notifies patients of their upcoming appointments (via SMS) and
requests that they reschedule if they are unable to attend (via
Please Call Me’s).
Helps us understand the reasons for missed appointments in
an attempt to reduce the number of patients who discontinue
treatment.
txtAlert Goals
Short-Term Goals:
Increase appointment attendance
Decrease “Lost-to-follow-up” (LTFU)
Long-Term Goal:
Improve adherence to ARVs
How does it all work?
Virtual Purple / Therapy Edge
TxtAlert: Process Flow
Patient Opts in
Day after message
2 Weeks before message
Day before message
Patient attends clinic
appointment and opts-in to
the TxtAlert service
Thanks for attending your appointment.
We will remind you of your next appointment
closer to the time
Your next appointment is on..
Opportunity to change appointment for
free, by sending a Please Call Me to a
TxtAlert administrator
See you at the clinic tomorrow
Day after Appointment
Day after
message:
Attendance
Thanks for
attending your
appointment
OR
Day after
message:
NonAttendance
You missed your
appointment. Send a
Please Call Me to
reschedule.
The power of “Please Call
Me’s”
Please Call
0834132002
Please Call Me’s are a free form of SMS which are
extremely popular in South Africa.
In both TxtAlert reminder SMSs, (2 weeks before / 1 day
before), a number is given to which a patient can send a
Please Call Me if they want to:
Confirm an appointment
Reschedule a missed appointment
A TxtAlert administrator then receives the patient’s Please
Call Me-message, (on a phone or web interface) and then
phones the patient back to assist him/her to confirm or reschedule an appointment.
TxtAlert’s Please Call Me
Management System
Praekelt Foundation has developed an on-line dashboard system for managing
the incoming Please Call Me-messages sent by patients. This system enables the
TxtAlert administrator to:
Track incoming Please Call Me’s of patients linked to their specific site.
Choose the reason for the Please Call Me from a pre-configures drop-down menu
Add unique patient / conversation notes to a notes field
Categorize patients in high, medium, and low risk groups in terms of their
propensity to miss their appointments
Link the Please Call Me to the patient’s unique Therapy Edge/Virtual Purple
number.
txtAlert’s Please Call Me
Management System
Addressing “Lost to follow up”
at the Helen Joseph Hospital's
and Temba Lethu Clinic
Oct 04
Launched
Apr - Jun 07
Mar 08
TxtAlert Results
“The success of TxtAlert is
telling: missed appointments
have fallen from 30% to 4%.
LTFU has declined from 27%
to 4%”
Dr Ian Sanne / CEO of Right to Care / 28 Nov 2009
TxtAlert Next steps:
1) TxtAlert-TB
2) TxtAlert-PMTCT
1) TxtAlert-TB
Key Facts of the SA TB Crisis:
SA has the highest burden of HIV-TB co-infection globally: 70% of TB patients are
co-infected with HIV.
SA has one of the lowest TB treatment completion and cure rates. TB is treatable
and curable with a simple 6-month course of treatment that is free, but treatment is
only successful if completed.
Patients are diagnosed late with TB (i.e. they are in advanced stages of the
disease).
Once on treatment, patients start to feel better, they stop taking drugs, and this
causes almost untreatable drug resistant (MDR / XDR) TB that is 60-85% fatal.
TB remains the #1 killer here and in all of Africa
1) TxtAlert-TB
Targets the following aspects of the TB pandemic:
Low TB treatment completion
High TB mortality rates
High rates of TB drug resistance (which is preventable if treatment is completed
successfully)
Applies a novel approach of engaging local and international
celebrities to be virtual 'celebrity treatment buddies' for patients
on TB Treatment.
TxtAlert-TB
At enrollment, patients can choose their
celebrity treatment buddy and language
and receive an ID card with the image/name of their
buddy from whom they will receive personalized,
automated monthly treatment reminders.
Thanks for making me your
TxtAlert Treatment Buddy!
I will help you to stick to your
treatment via SMS reminders!
Remember to continue to take
your medication even if you are
feeling better!
LOVE:
Thanks for making me your
TxtAlert Treatment Buddy!
I will help you to stick to your
treatment via SMS reminders!
Remember to continue to take
your medication even if you are
feeling better!
LOVE:
John Legend
Annie
Hi Thando,
Annie Lennox
here.
Remember to go
to the clinic
tomorrow. You
have 2 months
left. keep it up!
Annie xxx
TxtAlert-TB
At completion of the 6-8 month treatment
course, patients will get an airtime voucher
donated directly to their mobile phone.
Why incentives?
TB treatment is a short course, that unlike ARVs, you can
stop to take after course completion
Drug resistant TB (MDR and XDR) is completely
preventable, if treatment is successfully completed.
An airtime prize will be a cost-effective incentive to
all patients that complete successfully a small price to pay to prevent the expensive
treatment of MDR and XDR TB.
Hi Thando,
Annie Lennox
here. congrats
on completing
your treatment!
click here to
download your
airtime
1334455633123
TxtAlert-PMTCT
Program Goal
Set up the first PMTCT appointment /treatment reminder system in South Africa.
Remind mothers of their follow up visits to the doctor, so that treatment of mother and
child can successfully be completed, and mother-to-child-transmission can be
prevented.
Program Partners
Desired Outcomes
Bring down the MTCT-rates of HIV in South Africa.
Conclusions
TxtAlert has had a positive effect on health care in South Africa.
During a three year implementation phase, we have seen:
increased patient appointment attendance rates
an upward trend in the utilization of Please Call Me’s for rescheduling of appointments
improved communication between patients and clinics
improved logistics flow at large treatment sites
Contact Us
[email protected]
Phone: +27 83 413 2002
http://praekeltfoundation.org
twitter.com/praekeltfound