Patient Outcomes and Environmental Monitoring System (POEMS)

POEMS establishes an open-platform system incorporating two key tools for service providers: a simple but powerful smartphone-based data collection system, allowing integration of multiple data sources, and a data repository and reporting system, allowing near real-time access to key indicators of disease and environment, for rapid action.  Multple provider-specific functionalities may be layered into this open-platform "floor", ensuring community- or provider-specific utility.

Mobile and Information Technology tools will be integrated to ensure collected data is accessed and utilized rapidly, allowing rangers and providers to target resources and to identify working solutions, with the goal to improve local communities' life and health, facilitate eco-health balance and identify and reduce the burden of disease.  POEMS technology is designed to ease data entry for health workers, rangers and local communities, allowing participants to track, report and act on health and environmental data, disease data, and to allow rapid evaluation of the efficacy of interventions.  Simple but carefully designed mobile and data utilization tools have been developed collaboratively with communities in POEMS, and are currently undergoing formal usability testing on site to ensure they are sustainably deployed, straightforward, and  generate rapid access to health and environmental data, thus allowing proactive (rather than reactive)  interventions.   

Tools serving this project include an open-platform android-based mobile data gathering user interface for healthworkers, a similar interface for rangers, an SQL-based data repository and reporting system (co-housing health and environmental key indicator data currently collected by health workers and rangers).   Mobile tools include android-based cellular phones and tablets, which are loaded with the interoperable user interface downloadable from GHRF-maintained website.  The user interface allows efficient data collection (including wireless data transfer, geo-tagging and biometric species and patient identifier systems built-in), species tracking and patient data colleection systems co-developed with users, and Geo-Alert functionalities  ensuring instant and covert communication of dangerous situations (presence of poacher, wild animal, kidnapper, emergent health situation), and allows layering in of currently used programs such as tree-diameter calcuation, forestation and species-specific pattern-recognition, geomapping tools and current data systems already in use.  

The POEMS system is designed to model effective problem identification, disease reduction, resource targeting and efficiency, as well as providing a platform for true "tests of change" (reduction in morbidity/mortality, etc).   Tools integrated into POEMS are designed to be interoperable, flexible and transferrable, utilizing open platform models, and interoperating with pre-existing "not so open platforms" to ensure best use of limited resources.  Well modeled, these simple but powerful tools will facilitate the identification of “best practices”, ensuring that service providers can intelligently tackle major health and environmental challenges, even at the most resource-poor local level, despite (in fact, aided by) the constant evolution of technology. 

Although Bhutan and Nepal are not considered countries in crisis, human populations in many regions do face a crushing burden of disease, and extremely limited resources.   Still, the infrastructure exists within the Ministries of Health and NGO affiliates to model a system able to increase the speed of data collection and use of information to proactively manage health information (the data warehouse, rapid-cycle "tests of change", data utilization processes in collaborative development in this project).   Rooted in a committed system, health and environmental data warehoused together may allow multi-level assessment and cross-correlation of outcomes to rapidly detect health and environmental impact.  This is an invaluable opportunity to model and assess interventions aimed to improve human life and health and reduce the burden of disease.  Well modeled, this system is expected to be extremely transferable and scalable.  

In February 2012, GHRF brought the  completed  beta version of the mobile user-interface and data warehouse system to Nepal and Bhutan rangers and healthworkers.  Units were introduced and tested to ensure functionality for the providers.  Ancillary software meeting the specific needs of users are being identified and will be integrated (patient and species identifier systems, smartcard, barcode, fingerprint, “touchscreen” species ID forms and other systems and "point of care" diagnostics).  Among the "point of care diagnostics" (POCs) are  “RDTs” (rapid diagnostic tests), identifying key diseases by “fingerstick” (one drop of blood) or cheek swab. These included test kits donated by Global Solutions for Infectious Disease (GSID).  Disease testing may also be useful for environmental and animal diagnostics and detection of zoonotic transmission for vets/rangers.