SmartTrack is a low-cost and sustainable mHealth platform that aims to enable a wide range of cost-effective mobile healthcare solutions for rural developing regions on low-end mobile devices. While there has been a lot of work of mHealth solutions across the world, achieving sustainability in rural contexts has remained fundamentally hard due to high costs for data connectivity and the use of high-end mobile devices such as smartphones by several projects. Data connectivity solutions such as 3G/GPRS/EDGE are not ubiquitously available in rural areas; even where available, the cost of data transmission is incredibly high. A significant fraction of the low-end device market and rural population base is restricted to voice and SMS as the primary communication channels; both these communication channels are both extremely expensive (on a cost per bit basis) and also strictly constrained in the number of bits they can support. SMS messages are restricted to 140 bytes which may cost anywhere between 3 cents to 20 cents per message.
SmartTrack is a sustainable mHealth platform that aims to address all these challenges. SmartTrack is designed for low-end mobile devices ($20-$30 phones) with SMS as the only data transport layer. The design of SmartTrack has evolved over the years and currently supports a full-fledged application stack that can enable several mobile healthcare applications on a single platform. We are thankful to our partners who have helped us test and deploy different versions of SmartTrack.
At the base level, SmartTrack uses SMS as the base transport layer on top of which it supports a semantic compression layer that achieves very high compression levels for SMS-based applications. For example, the compression layer can compress nearly 5-30 simple patient record updates in a single SMS message. On top of the compression layer, SmartTrack supports Efficient Lightweight Mobile Records (ELMR), a generic record-level abstraction for database-centric applications. On top of ELMR sits SMSAppStore, a platform that enables users to encode a variety of mHealth applications where the application specification is made extremely simple. We have ported 3 specific style of mHealth applications on SMSAppStore: (a) Mobile health records; (b) A drug tracking system for low-cost detection of counterfeit pharmaceuticals; (c) An efficient and generic SMS-based search service for different mHealth services.
SmartTrack for HAART programs
According to the World Health Organization, effective HIV/AIDS care requires antiretroviral therapy (ART) as a treatment option. In order to be successful in combating this deadly disease, strict adherence to a highly active antiretroviral therapy (HAART) combining two to five medications is of paramount importance. Lack of medical oversight, or inappropriate use of ARVs not only harms the health of patients but may also encourage drug-resistant strains of HIV, posing a substantial public health risk. We have identified two important barriers that have impeded the introduction and implementation of HAART in various parts of Africa despite the enormous subsidies from African governments to promote the effort: 1) lack of accountability and 2) lack of proper adherence to the regimen. Our solution to the aforementioned problems builds upon the position of the WHO which has argued the need for a drug tracking system that can monitor the flow of drugs from the supplier to the patient. We have tailored SmartTrack to create a distributed drug information system that can be used for tracking the flow and consumption of ARV drugs in HAART programs, ultimately leading to improved patient outcomes. In a joint collaborative effort between researchers in NYU Computer Science, NYU School of Medicine, Leap of Faith Technologies, Korlebu Hospital and West Africa AIDS Foundation in Ghana, we performed a field user study of SmartTrack on 516 AIDS patients across Ghana. This has subsequently led to the development of a pharmaco-vigilance system currently being deployed at Korlebu Hospital in Ghana.
Building New mHealth Apps using SMSAppStore
The SMSAppStore platform in SmartTrack allows mHealth developers to develop new SMS-based mHealth applications within a very short time period (< 1 hour). Writing a new application is simplified to specifying a simple XML configuration file. SMSAppStore allows a standard set of operations and specialized operations are exported as XML files. SMSAppStore separates the application from the platform. We have developed several mobile apps on top of SMSAppStore including translating different health epidemiology forms into new data collection applications.
SmartTrack for better Drug Tracking
Counterfeit and expired pharmaceuticals are a significant problem in the developing world, constituting up to 80% of stock on pharmacy shelves. This is due both to poor existing controls and to lack of supporting infrastructure on which to build such controls. We have extended SmartTrack to support a drug tracking system which uses bar-codes coupled with built-in functionality in midlevel mobile telephones including cameras, SMS to construct a robust system for tracking and verifying the pedigrees of pharmaceutical products at every point in the distribution chain, particularly in the developing world. We have demonstrated a version of the SmartTrack drug tracking system to Clinton Foundation and we are jointly exploring large-scale deployment pilot projects. An off-the-shelf analysis estimated the SmartTrack based drug tracking system to cost less than $20,000 for a district level deployment.
SMSFind: Extending SmartTrack for Enhanced Search Services
SMSFind is an efficient SMS-based search service that can be supported on SmartTrack. Efficient search is an essential building block across many mHealth and other SMS-based mobile information services. SMSFind is an SMS-based search service that enables users to obtain extremely concise (1-2 SMS messages of 140 bytes) and appropriate search responses for queries across arbitrary topics in one round of interaction. Existing SMS-based search services are either extremely limited in the topics they can recognize (Google, Yahoo, MSN) or involve a human in the loop (Chacha, Just-Dial). SMSFind is designed as a search service for unstructured queries (like search engine queries) for arbitrary topics. Given a query, SMSFind, uses a traditional search engine as a backend to elicit several search responses and uses a combination of information retrieval techniques to extract themost appropriate 140-byte snippet as the final SMS search response. We show that SMSFind returns appropriate responses for 66%of Google Trends queries and 47.8% of ChaCha search queries across arbitrary topics (none of which can be answered by Google SMS or Yahoo).
Cell Phone–Based System Could Improve HIV/AIDS Drug Tracking. Microsoft Research Case Study
Catching Fake Meds in a Snapshot: Two-dimensional bar codes could reduce drug counterfeiting in the developing world. In MIT Tech Review