Dr. David Green's Compliance Service uses the Short Message Service (SMS) to alert tuberculosis (TB) patients to take their medication. The initiative has led to a significant increase in the recovery rate of patients and could lead to savings for healthcare authorities.
Funding or financial model: Commercially driven. A pilot project has been sponsored by the City Council of Cape Town.
Background: The population of Cape Town is divided along race and class lines. White people generally have access to middle and high-income jobs, good municipal services, and private healthcare, and they can afford comfortable housing. Coloured , and especially black citizens of Cape Town generally have low paid jobs or are unemployed, live in informal settlements where housing is often substandard, cannot rely on good municipal services, and have to use the overburdened public healthcare system. Cape Town's Mediterranean winters are cold and wet, and this poses an additional health hazard for people living in informal settlements. Large areas of these settlements are built below the waterline and are flooded during the winter months. Due to this combination of factors, poor black people are more prone to contracting TB. Unemployment countrywide is estimated at 41.5% and the GDP per capita is estimated at USD $8,500. (Global Insight, an international research company)
How ICT is used to overcome the problem: Evidence suggests that TB patients often do not take their medication simply because they forget. So, Dr. Green uses SMS (Short Messaging Service) -- text message service that enables short messages of up to 160 characters to be transmitted between cell phones -- to alert patients to take their medication.
Healthcare professional were skeptical whether the uptake of cell phone technology was high enough to justify the project. However, Dr. Green found that over 50% of people in the Cape Peninsula had access to cell phones. At the clinic where the pilot study was conducted, 71% of TB patients had access to a cell phone.
Dr. Green enters the names of TB patients onto a database. Every half an hour his computer server reads the database and sends personalised messages to the patients, reminding them to take their medication. The technology that he uses to send out the messages is extremely low-cost and robust: an open source software operating system, web server, mail transport agent, applications, and a database. Currently Dr. Green charges the City of Cape Town R11.80 per patient per month to send out SMS messages.Initially the SMS message sent to patients read: "Take your Rifafour now." When patients complained about the boring message, Dr. Green sent them a variety of alerts, including jokes and lifestyle tips with the result that he now has as database of over 800 messages that he changes on a daily basis. Of the 138 patients involved in the pilot, there was only one treatment failure.