SmartTrack

From CATER

SmartTrack

According to the World Health Organization, “effective HIV/AIDS care requires antiretroviral therapy (ART) as a treatment option. Without access to antiretroviral therapy, people living with HIV/AIDS cannot attain the fullest possible physical and mental health and cannot play their fullest role as actors in the fight against the epidemic, because their life expectancy will be too short.” While ART is commonplace in developed countries, these life saving medications have reached only a small percentage of the more than 40 million Africans infected with HIV or suffering from AIDS. In order to be successful in combating this deadly disease, strict adherence to a highly active antiretroviral therapy (HAART) combining two to five medications is of paramount importance. Lack of medical oversight, or inappropriate use of ARVs not only harms the health of patients but may also encourage drug-resistant strains of HIV, posing a substantial public health risk.

In our preliminary investigation, we have identified two important barriers that have impeded the introduction and implementation of HAART in various parts of Africa despite the enormous subsidies from African governments to promote the effort: 1) lack of accountability and 2) lack of proper adherence to the regimen. Our solution to the aforementioned problems builds upon the position of the WHO which has argued the need for a drug tracking system that can monitor the flow of drugs from the supplier to the patient.

The SmartTrack project aims to create a highly reliable, widely available, secure and ultra low-cost smartphone based distributed drug information system that can be used for tracking the flow and consumption of ARV drugs in HAART programs, ultimately leading to improved patient outcomes. SmartTrack is a joint collaborative effort between researchers in NYU Computer Science, NYU School of Medicine, Leap of Faith Technologies and West Africa AIDS Foundation in Ghana. SmartTrack builds upon the eMedonline project, an extremely successful effort by Leap of Faith Technologies that leverages smartphones and RFID technology to optimize medication compliance, track medication usage and extend patient care to remote settings. eMedonline has been successfully used in the US for tracking adverse events and improving compliance with oral antineoplastic (anti-cancer) therapy; efficacy is currently being demonstrated among cardiovascular disease populations. By leveraging the strengths of eMedonline and extending it to the healthcare environment in Africa, with Ghana as our model, we believe that we can successfully facilitate the flow and consumption of ARV drugs, while improving patient compliance and healthcare outcomes.

People

Brian Levine
Mary Ann Hopkins
Barbara Rapchak (Founder, Leap of Faith Technologies,Inc.)
Mekbib Gemeda
Eddie Donton (Chief Executive Officer, West Africa AIDS Foundation)
Lakshminaryanan Subramanian

Publications

The Case for SmartTrack. Michael Paik, Ashlesh Sharma, Arthur Meacham, Giulio Quarta, Phil Smith, John Trahanas, Brian Levine, Mary Ann Hopkins, Barbara Rapchak and Lakshminarayanan Subramanian.IEEE/ACM Conference on Information and Communication Technologies and Development (ICTD), 2009.

Related Efforts

OpenMRS

Partners in Health

Dimagi

D-Tree

Satellife: The Global Health Information Network

ELMER

Cell phones are increasingly being used as common clients for a wide suite of distributed, database-centric healthcare applications in developing regions. This is particularly true for rural developing regions where the bulk of the healthcare is handled by health workers due to lack of doctors; the widespread availability of cellular services have made mobile devices as an important computing platform for enabling healthcare applications for these health workers. Unfortunately, the current SQL model for distributed client/server systems is far too heavy-weight for these applications, particularly in light of the high communications cost and extremely limited data transmission capacity available in these environments.

Efficient Lightweight Mobile Records (ELMER) is a system that provides a practical and lightweight database access protocol for accessing and updating records remotely from mobile devices under an extremely bandwidth and cost-constrained Short Messaging Service (SMS) channel comprising of 140 byte packets. The design of ELMER employs a number of techniques including semantic compression of messages, a reduced query set, a user- based intermittent database consistency model and the batching of queries to reduce bandwidth and per-packet costs. Additionally, ELMER includes an SMS reliability layer to cope with poor wireless service, and a lightweight privacy model to prevent identity spoofing and theft of sensitive data. We have implemented ELMER using the RMS functionality in J2ME, and integrated it into an HIV treatment application we are developing for use by African health workers.

People

Arvind Kumar
Amey Purandare
Lakshminaryanan Subramanian

Publications

ELMER: Efficient Lightweight Mobile Health Records. Arvind Kumar, Amey Purandare, Arthur Meacham and Lakshminarayanan Subramanian. NYU Technical Report

Related Efforts

Brian DeRenzi, et al., e-IMCI: Improving Pediatric Health Care in Low-Income Countries, ACM Conference on Computer-Human Interaction (CHI), April 7-10, 2008, Florence, Italy