FrontlineSMS:Medic becomes Medic Mobile

FrontlineSMS:Medic is now Medic Mobile. From the start, FrontlineSMS:Medic implemented and extended FrontlineSMS to bridge gaps in healthcare delivery systems. After a successful pilot, the FrontlineSMS software and community acted as a launchpad for an organization that uses open source software to support health services across the globe. The launch of a new name, Medic Mobile, reflects the growth and trajectory of that organization. Medic Mobile will continue to be one of the most emphatic champions of FrontlineSMS – contributing code, user experiences, and peer-reviewed research back to the community. Here, Isaac Holeman and Josh Nesbit, co-Founders of FrontlineSMS:Medic, walk us through the history of the project, and where they see Medic Mobile heading in the future.

The FrontlineSMS:Medic Story

Inception

FrontlineSMS:Medic was preceded by two independent projects, Mobiles in Malawi and MobilizeMRS. Josh Nesbit initiated Mobiles in Malawi in the summer of 2007, working at a rural Malawian hospital that serves 250,000 patients spread 100 miles in every direction. To reach remote patients, the hospital trained volunteer community health workers (CHWs) like Dickson Mtanga, a subsistence farmer. Dickson had to walk 35 miles to submit hand-written reports on 25 HIV-positive patients in his community. The hospital needed a simple means of communication, and in the summer of 2008 Josh returned to the hospital with mobile phones and a laptop running FrontlineSMS to provide it.

MobilizeMRS was born with a focus on electronic medical records, and the notion that the technology could be extended to engage CHWs in structured data collection. Isaac Holeman discovered Mobiles in Malawi and contacted Josh online, and in late 2008 they decided to join forces. Isaac brought the key characteristics of MobilizeMRS with him – a commitment to extending OpenMRS, the initiative to formalize their projects as a venture, insistence that the venture should have a distinct brand and leadership authority, and commitment to developing innovative software.

In February of 2009, Josh, Isaac, and a group of students from Stanford and Lewis & Clark founded FrontlineSMS:Medic together. The mission was to help health workers communicate, coordinate patient care, and provide diagnostics using low-cost, appropriate technology.

Impact

In six months, the pilot in Malawi using FrontlineSMS saved hospital staff 1200 hours of follow-up time and over $3,000 in motorbike fuel. Over 100 patients started tuberculosis treatment after their symptoms were noticed by CHWs and reported by text message. The SMS network brought the Home-Based Care unit to the homes of 130 patients who would not have otherwise received care, and texting saved 21 antiretroviral therapy (ART) monitors 900 hours of travel time, eliminating the need to hand deliver paper reports. You can read more about this pilot in the Journal of Technology and Health Care publication.

After the 2010 earthquake in Haiti, Josh reached out to FrontlineSMS users on the ground and connected with mobile operators. Soon after, FrontlineSMS:Medic helped coordinate The 4636 Project, an effort to create an emergency communications channel. Working with the Office of Innovation at the US Department of State, technology providers, Digicel, and Voila, a system was created to process text messages expressing urgent needs from the ground. Using crowd-sourced translation, categorization, and geo-tagging, reports were created for first responders within 5 minutes of receiving an SMS. Over 80,000 messages were received in the first five weeks of operation, focusing relief efforts for thousands of Haitians.

In less than one year, FrontlineSMS:Medic expanded from 75 to 1,500 end users linked to clinics serving approximately 3.5 million patients. Growing from the first pilot at a single hospital in Malawi, they established programs in 40% of Malawi’s district hospitals and implemented projects in nine other countries, including Honduras, Haiti, Uganda, Mali, Kenya, South Africa, Cameroon, India and Bangladesh.

A growing toolkit

In 2010, the FrontlineSMS:Medic team expanded and began creating new mobile tools. Software developers built on the FrontlineSMS platform to create a lightweight patient records system, PatientView, and a text-based information collection module, TextForms.

Developed by volunteers in less than two days, the initial 4636 system combined a number of technology platforms. Most recently, FrontlineSMS:Medic developers worked on a messaging module for OpenMRS, a project that had been in the works since the MobilizeMRS days prior to FrontlineSMS:Medic. It became clear to the team that building upon and implementing various open source tools was the best way to serve users and achieve impact.

Next Steps

FrontlineSMS acts as a catalyst for new projects – incubating ideas, teams, and software for legal systems, education, financial services, radio, and other fields. The model replicates FrontlineSMS:Medic’s sector-specific approach and builds on a community of users innovating every day

Medic Mobile continues FrontlineSMS:Medic’s team, values, and mission – using mobile tools to create connected, coordinated health systems that save more lives.

Plan International case study: helping children report abuse in Benin

We're delighted to announce the publication of the first in our series of in-depth case studies of FrontlineSMS implementations, from Plan International, documenting their work in Benin to develop and pilot a Violence Against Children SMS helpline. Linda Raftree, who many of you will know as @meowtree on Twitter, has written extensively about the programme on her blog, but the case study tries to pull out a bit more of the institutional processes and the technical pitfalls they overcame in the process.

About the programme

In early 2009, Plan was working to strengthen both local and national reporting of trafficking and violence in Benin, West Africa. They were looking for a way to lower children’s and community members’ barriers to reporting, including the risk of reprisals and stigma, communications challenges, and access to places where violence could be reported. The Plan team theorised that collecting reports via SMS, which is anonymous and low-cost, would encourage reporting and allow for a better understanding of the nature and the quantity of violence that was happening.

This in turn could be used to raise awareness around the severity of the problem, advocate for the necessary resources to prevent it, and develop better and more targeted response and follow-up mechanisms. The ability to visualise the data on a map could also have an impact on decision makers and might be a tool that children and youth could use to generate dialogue and advocate an end to cultural practices that allow for violence against them.

The case study covers the training and piloting process, combining Ushahidi and FrontlineSMS, results and key learning to date, and some of the challenges they faced - such as finding appropriate modems, and getting people to SMS, rather than calling, the helpline number.

Seeking new case studies

We hope to produce many such case studies, which are aimed at staff looking to implement SMS or FrontlineSMS in their work, but also can be passed on to managers and donors to help them understand the concepts and challenges involved - if you would like to be one of them, get in touch!

To read more about the programme, download the case study here: Plan International VAC case study, [pdf 1MB].

Announcing the "Mobile Message"

Over the past year or so, it's become increasingly clear to us that we need to take the "mobile message" out of its technology silo and make it more available - and accessible - to a wider audience. This was the thinking behind our regular series on PC World, and is the thinking behind a new series we're launching today in collaboration with National Geographic.

The "Mobile Message" is aimed at a broad audience, but most importantly people who would never likely visit a mobile-specific site. Recent talks at Communicate - aimed at conservationists - and Nat Geo Live! - aimed at the general public - have convinced us even more that we need to stop just talking among ourselves and take the message out to more mainstream, broader audiences.

According to the first "Mobile Message" posted today:

"Over the next few months we will delve into the human stories behind the growth of mobile technology in the developing world. We'll take a closer look at the background and thinking behind FrontlineSMS, and hear from a number of users applying it to very real social and environmental problems in their communities. We will also hear thoughts and insights from other key mobile innovators in the field, from anthropologists to technologists to local innovators."

You can read the rest of the introductory post on the National Geographic website here.