Sana

Open Source Telemedicine

Joe Gene Quesada & Geoffrey Graham

What is Sana?
Technology: Open-source
Android Customizable Data capture & storage

Expertise: Implementation
Evaluation

Mission
Improve health care in resource poor settings through technology

Values
Innovation Partnership Sustainability

Why Sana?
Lack of access

Delayed dx and rx

Disability and death

Added cost

Health-care infrastructure in remote areas

Shortage of medical experts (but

abundance of semi-trained workforce)

Lack of hospitals and clinics Non-existent or poor information

systems

Intermittent electricity

mHealth is a viable solution

6000
5300

5000 4000 3000

2293

# (in million)

2000 1000
305

11

Hospital Beds

Computers

Mobile Phones

Population

Source: mHealth for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World. Washington, D.C. and Berkshire, UK: UN Foundation-Vodafone Foundation Partnership, 2009.

Cell Phone as a Medical Device

Suite of sensors Peripheral diagnostic devices Ubiquitous connections to database and network of experts Sufficient computational power for automated or semiautomated diagnosis and treatment recommendations

Key Features

User customizable medical decision trees and

forms

Image, audio, text and video support Integration with online medical record system Workflow management for efficient utilization of
remote medical experts

Data transfer optimized for poor coverage areas

Sana Workflow for Specialist Care

Patient

CHW

MDS

MRS

Dr.

SMS

Data Center
Clinic

Field

TCP/IP
SMS GPRS

patient visit

run Sana procedure

transmit to OpenMRS

physician review

A health worker examines a patient with postoperative wound drainage in a rural clinic.

The Sana Surgery FollowUp procedure prompts her to take a picture of the wound and ask some key questions.

Sana transmits the information back to the OpenMRS server and the surgeon is notified.

The surgeon reviews the data and prescribes a treatment recommendation, which is texted back to the health worker in real-time.

demo

Strategic Partners in the Philippines

Implementation & Operations
IT capacity & support Project management Training, monitoring and evaluation

Social Partner
Existing relationships with clinical community & target patients Dedicated to improving health of rural poor

Medical Partner
Medical specialists for backend support Community hospitals or clinics to handle patient referrals

Partners in the Philippines

Implementation & Operations

Asia Pacific College (APC), Integrated Open Source Solutions (IOSS), CS Foundation

Social Partner
Center for Community Transformation (CCT), Negros Women For Tomorrow Foundation (NWTF)

Medical Partners
St. Lukes Medical Center

Applications:
Maternal health

Tele-radiology
Tele-cardiology

Disease screening
Disaster response Data collection Education

Millennium Development Goal (MDG) 5 Maternal Health

Philippines Leading Countries

Maternal mortality (per 100k births)* Births attended by skilled health personnel*

230

<10

60% (2003)

100%

Source: World Health Organization website (www.who.int)

Millennium Development Goal (MDG) 5 Maternal Health

Translate WHO clinical guidelines for prenatal care into practice Create electronic records for pregnant women

Remind women of their visit using SMS

Identify high risk pregnancies for referral to an obstetrician

process

Where are we going?

Technology Development Data mining Deployments Validation

Questions?

www.sanamobile.org