This abstract has been accepted at the 2024 DHIS2 Annual Conference
Integrating DHIS2 and Smart Pillboxes: Building linkages between digital adherence technology and case-based ETL to improve TB care in Tanzania
Over the past decade, the use of the smart pillbox digital adherence technology (DAT) to support patients undergoing treatment for various diseases has grown worldwide. This person centered tool not only facilitates remote support and enables real time follow up, but is recommended by the WHO and made available to countries in the GDF catalogue for health system improvement via Global Fund support. However, to reach full positive impact for both individuals and health systems, DATs need to be integrated with the national electronic systems supporting patient management. Currently available third party platforms have proven prohibitively expensive for governments to implement, and home built solutions are time and resource intensive. For Tanzania and countries like it, linking essential adherence data from the smart pillbox into DHIS2 is the way forward for scaling up impactful, person centered DAT tools and improving health outcomes through integrated care. In Tanzania, the smart pillbox is used for individuals undergoing treatment for tuberculosis. This is a disease where daily adherence to anti TB medication (antibiotics) is essential to beating the infection and becoming healthy. The anti TB pills are stored in the box, and when the individual opens the lid to complete daily intake, an embedded module senses the opening, logs it in the microchip, and sends the data via eSIM to the central database. An API developed by box manufacturer WisePill (in collaboration with KNCV) enables pulling of this adherence data into linked systems. In partnership with the Tanzania MOH, HISP Tanzania and KNCV TB PLUS have built an integration ensuring this real time medication dosing data is linked with the case based records of patients in the ETL (Electronic TB and Leprosy Register). Through this linkage we have enhanced the DHIS2 ETL instance through not only creation of patient adherence calendars and filterable lists for patient follow up, but have enabled registration of patients on devices, remote configuration of smart pillbox alarms and reminders, and streamlining of HCW actions around device management. The development of the DHIS2 adherence application linkage directly benefits the NTP of Tanzania and will be made publicly available for other countries to customize for their DHIS2 deployment, paving the way for scale up of DAT tools around the globe. With new countries adopting smart pillox solutions each year, this linkage is essential for reaching full positive impact for both patients and the health systems supporting them.
Primary Author: Rachel Powers
Keywords:
DAT, Digital Adherence Technology, adherence, medication support, patient support, treatment, integration, DHIS2, API, ETL, tuberculosis, TB, person-centered
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