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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