Presentation Curioso

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Design and implementation of aDesign and implementation of a

realreal--time surveillance system fortime surveillance system for

adverse events usingadverse events using

cell phones in Perucell phones in Peru(Cell(Cell--PREVEN)PREVEN)

Walter H. Curioso, MD, MPHcWalter H. Curioso, MD, MPHc

2005. All rights reserved. Walter H. [email protected]

School of Public Health and Community Medicine

University of Washington


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Walter H. Curioso, M.D. Dr. Walter H. Curioso is a physician

from the Universidad PeruanaCayetano Heredia, Peru and currentlya Master in Public Health's candidate

at the University of Washington,Seattle.

He has more than thirty publicationsin the following fields: healthinformatics and informationtechnology, evidence-basedmedicine, public health in developingcountries and clinical medicine.

Dr. Curioso is an e-health consultant

for international and privateorganizations, including the designand implementation of informationsystems and technology in publichealth and health care organizations.

http://www.waltercurioso.comhttp://students.washington.edu/wcurioso/


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Estimated new cases of curable

STI* among adults, 1999

Western Europe

17 million

Western Europe17 million

Eastern Europe and Central Asia

22 million

Eastern Europe and Central Asia

22 million

North Africa & Middle East

10 million

North Africa & Middle East

10 million South & South-East Asia

151 million

South & South-East Asia151 million

Australasia

1 million

Australasia1 million

Sub-Saharan Africa

69 million

Sub-Saharan Africa

69 million

* gonorrhoea, chlamydial infection, syphilis and trichomoniasis

Source: WHO. http://www.who.int/docstore/hiv/GRSTI/pdf/figure02.pdf

North America

14 million

North America

14 million

Latin America &

The Caribbean

38 million

Latin America &

The Caribbean38 million

East Asia & Pacific

18 million

East Asia & Pacific

18 million

Global total: 340 million


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Adapted from Eysenbach 2003

Population Health Technology


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Evaluation of information technologies in Peru. 2004

Cell Phone Technology

Growth

rate


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http://www.yachay.com/especiales/cabinas/2ba.htm

Internet in Peru

Evolution of public booths(Cabinas publicas)

417

1371

1973

2600

3600

0

500

1000

1500

2000

2500

3000

3500

4000

Total number

1999 2000 2001 2002 2003

Year


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Internet in Peru

Public booths / Internet cafes(Cabinas publicas)

http://www.yachay.com/especiales/cabinas/2ba.htm


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Background

System that combines the Internetand the telephone to collect and

transmit data. Health professionals can enterreports in real time using a fixedphone line or a cell phone -.

Authorized users log on and followsimple instructions on a card or asimple voice-prompted menu andenter information about adverse

events. They can attach additional

information in voice files.

http://www.voxiva.net/about.html


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Background We implemented the system to collect data from an existing national

urban-community randomized trial of routine presumptive periodictreatment of bacterial vaginosis called PREVEN.

One of the target components is the female sex workers (FSW) inwhich a mobile team treats preventively trichomonasand bacterialvaginosis with Metronidazole; and screens and treat Neisseriagonorrheaand Chlamydia trachomatis.

http://www.upch.edu.pe/faspa/preven/

Mobile teamFSW

Nurse or obstetrician Peer educator


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Cell-PREVEN Project

Enter data of FSW in real time

Surveillance system for adverse events PREVEN


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Multicentric

Piura

Huanuco

Chincha


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Consolidationin Level 2

CentralLevel:

Analysisand

decision-

making

Consolitationin Level 3

Datacollection

atcommunity

level

Analysis andProcess of theinformation

Analysis andProcess of the

Information

Paper based system

Days, weeks or months (collection andtransmission of data)


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Central Level:Analysis and

decision-making

Datacollection

atcommunity

level

Consolidacinen Nivel 2

Consolidacinen Nivel 3

Anlisis yProcesamiento de

la informacin

Anlisis y

Procesamiento dela informacin

Seconds

9 Implementation of asurveillance system

9 Enhanced ability to

manage clinical STDprograms

9 Real time access to data.

9 Transparency,

accountability and dataprivacy.

9 First-hand information

9 Opportune

decision-making based ontimely information

9 Improved onitoring atfacility level

Cell phone system


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Information isavailable inmediatelyand timely processed

for multiple needs

Queries on demand

Real time warnings via text messages

Real time warnings via E-mail

Information isreceived at Voxiva

hub (Lima) andstored in a secureweb-based database

Data of adverseevents is collecting

and sending inreal time on field


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Any symptom

Specific symptomsAdditional informationSatisfactionAnother report

Any symptom

Specific symptomsAdditional informationSatisfactionAnother report

How it works?


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Training

Training andmonitoring

Technical support:telephone, cellphone, e-mail or

even by chat (MSN)


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Users card


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Before . . .


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Now . . .


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Access: Demo call phone report

Cdigo de Usuario 123456

Clave de Usuario 12376


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Access: Demo call phone report

La participante tuvo nuseas elprimer dia.

Clave de participante 12376


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Technical support

Technical support:24 hours / 7 days aweek

through Voxiva

http://www.voxiva.net/about.html


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ALERT PREVENALERT PREVENScreen example Alert:

text message


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University of WashingtonSeattle.

The Wellcome Trust

Imperial College London Universidad Peruana Cayetano

Heredia (School of PublicHealth: FASPA)Lima, Peru.

VoxivaLima, Peru.

Institutions involved


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My advisors:

Ann Marie Kimball, MD, MPH Bryant Karras, MD

King Holmes, MD, PhD

Pablo Campos, MD, MPH

Pamela Johnson, MD Francisco Rubio, MD

Ernesto Gozzer, MD

Special thanks to


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Gracias !Gracias !

Cell phone project Web page: http://www.prevenperu.org

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