Director of the mHealth Expert learning Program (mHELP), Dr Peter Benjamin, recently talked to eHealthNews about his involvement in MomConnect and how he believes it could lead to be the Electronic Health Record (EHR) breakthrough South Africa has been looking for.
Dr Benjamin has over 20 years of experience in the social use of technology, which over the last decade has come to include mHealth. Prior to joining mHELP in June he was the Managing Director at Cell-Life for seven years.
While there have been a number of mHealth services in the country over the last four years, MomConnect is expected to be the strongest and most successful to date due to endorsement from the National Department of Health (NDoH) along with the involvement of some of the top organisations involved in promoting eHealth in South Africa, such as Jembi, Anova and AAT. “To my knowledge there are only two other systems in the world like MomConnect – one in Ghana and the other in India,” said Dr Benjamin.
Benjamin explained how the MomConnect project was initiated two years ago when Minister of Health, Dr Aaron Motsoaledi, wanted to create a more sophisticated version of the Mobile Alliance for Maternal Action (MAMA) project that included a National Pregnancy Register (NPR).
MomConnect was envisioned as an mHealth messaging system to support mothers from pregnancy to their baby’s first birthday. “The system focuses on three different aspects: it messages women throughout their different stages of pregnancy; acts as a point-of-care tool because it links women to nurses at their health facility; and acts as an NPR by storing all the accumulated data in a central location.” said Dr Benjamin.
In February 2014 a number of workshops and discussions were organised with midwives to determine how MomConnect could fit in with established prenatal and post birth healthcare practices. The NDoH then introduced guidelines and training on how to use the system at 2,000 clinics. “The system is useful, but the reality is that it adds to the workload of healthcare workers. Therefore it was, and still is, essential to provide assistance to healthcare workers to realise the system’s value in obtaining better patient information using their mobile phone to access past health records. We’ve tested and monitored the system at dozens of facilities and it seems to be working reasonably well,” said Dr Benjamin.
MomConnect was specifically designed to be accessible on any mobile phone from older, basic phones to smart phones. During the registration process, users are asked basic questions such as their ID number, due date and preferred language. “One of the first questions asked is ‘Is this the mobile phone number of the patient?’, because sometimes the patient either doesn’t have a mobile phone or doesn’t have it with them so registration can still be done using the healthcare worker’s phone,” said Dr Benjamin.
According to initial reports, MomConnect is off to a good start with 10,000 registrations in the first few weeks of its launch. “We’ve received feedback from nurses who have said they like it because it improves interaction with their patients; pregnant women have also provided positive feedback, with a satisfaction rate of over 90%,” said Dr Benjamin.
According to Dr Benjamin, the aggregate data that is being generated from the project will be used to provide more specialised care. “MomConnect is allowing us to have better insight about pregnant women who have particular health needs. All this data is being collected and stored on a patient record system, which is a major step towards continuous, cradle-to-the-grave EHRs,” said Dr Benjamin.
Security measures have been taken by ensuring the gathered information and data does not reside on the mobile phone, but is rather sent through a USSD session to the database. “The data is owned by the NDoH; no one else can access the data,” said Dr Benjamin.
Dr Benjamin revealed that the next phase of MomConnect is to be more interactive by allowing pregnant women to submit questions and report on any problems encountered at facilities to generate quality of care indicators. “Ideally there will be specialised call centres that women can phone or send an SMS to. This is however still in the early planning stages because we don’t know how big the demand is yet; we don’t want to make promises and set up such a service that can’t be delivered efficiently,” said Dr Benjamin.
MomConnect has been given a budget for two years (until the end of August 2016) and has a clearly defined monitoring and evaluation (M&E) plan involving a number of top local universities to measure its success. “Reviews will be held informally every two weeks and formally every six months, the first to be held in February 2015, to check how it’s being used, if the patients like it and to monitor health outcomes. We’ll also be measuring the quality of data generated, associated costs, benefits and ultimately how sustainable it is. After the two year period it will be decided whether to keep the system in place and to make it an official NDoH service,” said Dr Benjamin.
Dr Benjamin concluded by saying how mHealth is quickly becoming the new normal in global health systems and that “it’s important to design the system for scale and with the end goal in mind. For this to happen, it’s essential to build partnerships, reuse and adapt existing systems, and develop open standards to link all the players.”