Asset case study
The ASSET app is a simple mobile app which is revolutionising the healthcare model for patients with common medical conditions in sub-Saharan Africa, guiding improved care.
Mindwave has partnered with the research team from ASSET, the National Institute for Health Research (NIHR) Global Health Research Unit on Health System Strengthening in Sub-Saharan Africa, to create a mobile application which can be used by health workers in their everyday practice.
The app enables workers to record their assessment of people with hypertension and/or depression, and to record changes in their symptoms over time, providing improved continuity of care.
Healthcare resources across sub-Saharan Africa are limited, with the majority of treatments provided by non-specialists, and there is little continuity of care.
Supported by government funding, ASSET’s aim is to find practical ways to improve the coverage and quality of care across the region, through health system strengthening interventions.
ASSET brings together surgeons, obstetricians, midwives, psychiatrists, public health dentists, palliative care and general healthcare specialists to work with social scientists, health economists, information technologists and implementation scientists.
The NIHR Unit is led by a team from King’s College London working with a number of partner institutions, including Addis Ababa University (Ethiopia); the University of Cape Town, University of Cape Town Lung Institute; University of KwaZulu Natal (South Africa); the University of Zimbabwe (Zimbabwe); the College of Medicine and Allied Health Sciences and King’s Sierra Leone Partnership (Sierra Leone).
ASSET is working on a five-year project in four countries – Ethiopia, South Africa, Sierra Leone and Zimbabwe – to improve healthcare provision across three platforms: integrated primary healthcare, maternal care and surgical care.
The research team’s ambition is to find new ways of treating non-communicable chronic conditions over time by supporting the introduction of a chronic care model of care in rural Ethiopia.
Focusing initially on mental health and hypertension in Ethiopia, the research team wanted to find a simple way for health workers in a primary health care setting to record and track conditions in their patients, over time. The researchers approached Mindwave to work with them as ASSET’s technology partner and create a simple mobile application that could be used by health workers in their everyday practice.
Mindwave was tasked with creating an app for use by health workers in Ethiopia, where the current infrastructure is best placed to support the introduction of new technology and ways of working.
We worked with all the organisations involved in the project to gather information on the specific issues the app needed to address.
Currently, patients visit clinics for an assessment when they need medical attention, but there are almost no record-keeping systems, which affects continuity of care. The app, accessed via an Android tablet, enables workers to record the outcome of the initial assessment and changes in symptoms over time.
On the first appointment, the health worker enters data about the individual including background information and risk factors. They record diagnosis and treatment decisions in the app and schedule further appointments.
When the patient returns for their next appointment the clinician has a record of the previous interaction and are able to enter new data, so building a longitudinal picture over time. This continuous record enables the app to raise crisis flags and alert clinicians to any serious problems.
The app also contains a built-in decision support tool with screening questionnaires to help clinicians diagnose conditions such as depression and diabetes.
As well as improving continuity of care and clinician support, the anonymised aggregated data gathered through the app will assist researchers and governments in understanding more about both conditions at a population level and allocate resources accordingly.in order to guide improved care at a national level. This will include the introduction of quality improvement cycles, driven by data harvested from the app, to shape improvements in care and patient outcomes at both district and regional level.
Prototype testing of the app was carried out in a number of clinics in Ethiopia. Mindwave’s CEO Kumar Jacob visited some of the clinics using it during the prototype testing phase, along with Dr Rosie Mason from Kings’ College London, and feedback from the clinicians was very positive. The app is now ready to be rolled out for a full pilot scheme.
The app has been designed and built in such a way that it will be able to be edited and adapted for use with a variety of conditions and in all countries involved in the project.