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A Cause for Celebration! by Mobile Health Team on April 2, 2011 | 19 comments

It was orientation day! I was prepared to introduce the health workers in the KEEA district of Ghana to the new Mobile Phone Assisted Cardiovascular Teaching (mPACT) BP tool. The mHealth team of ICHA had spent several months designing, creating and testing the program that would eventually allow the Ghanain health workers to enter patient blood pressure data in a mobile phone and receive smart prompts about treatment guidelines. We hoped that these guidelines would make treating hypertension a breeze! However, not everything had been a smooth sail so far. Since arriving in Ghana, we discovered that the phones we had tailored our program to were out of stock in all the stores we checked in. Luckily, we found a similar phone that was within our budget. Once the phone was loaded with a SIM card and activated, I anxiously downloaded the BP tool. The download and one test data entry was successful but the program stopped communicating with our server soon after. The phones still refused to connect to the internet reliably on the morning of the outreach. By this time, the technology team in the US had been up most of the night, reading forums and trying to figure out what was wrong. Finally, Jason called the network provider only to learn that the company was experiencing outages in the Elmina area that would be fixed in 24 hours! We didn't know whether to be happy or sad! Patchy internet meant that the phones would not be able to receive the smart prompt for treatment guidelines. Instead, each time the health workers submitted the data, they would see an error message! However, it also meant that once the internet was up and running, our program would work again!

The technology team had been resourceful and prepared for a scenario like this. They had a version of the program that did not rely on the internet for providing the smart prompt. Although we would still not receive any data from the phones using this version of the program, at least the health workers would see treatment guidelines instead of an error message when they submitted data using the phone. At this point, we still had a couple of hours till the outreach was set to begin so we tried to download this "dumb" version of the program in the 30 sec intervals that the internet worked.

The health workers started trickling in at 1 pm. Polite welcomes and smiles were exchanged. Then it was time. I worked my way through the materials we had planned to cover, telling the health workers the objective of our program, why they should use it and how they should use it. Thankfully, the health workers had no problem learning the program. Individual questions about data entry were easily managed by Jason and Abby while the rest of the class followed along with me. The health workers were really excited about the prompts for treatment guidelines. As we ran though several example scenarios of the data, there was almost a competition as each health worker tried to be the first to report what guidelines were displayed! As we prompted for questions, we were surprised by the large number of relevant questions and great suggestions we received. Finally, we wound up the orientation and sent the health workers home with their new BP tool. Once the network was up again, we would download the smart program and start receiving data from the phones, but that would be tomorrow. Today, we had launched ICHA's first mHealth program in Ghana. It was time to celebrate.

The Mobile Health Team