Sana.
PCHR
Why Sana.PCHR?
Imagine a conflict that has crippled a nation’s health system capacity: hundreds of health facilities were attacked, the death tolls includes thousands of health workers; the capacity to provide health services is greatly diminished. At the same time, the need for chronic disease care is looming but is not a priority. Prior to the Syrian conflict, NCDs were estimated to account for 135,000 deaths annually or 46% of total mortality among 30-70 year old adults. Two of the most prevalent NCDs in Syria are hypertension (29.5%) and diabetes (7.4%).
Sana.PCHR application is an innovative and scalable approach which has shown promise during its development in Lebanon. It will be useful in health facilities and mobile clinics supported by the local government to evaluate the usability in an array of humanitarian settings. This technology solution was developed in close collaboration with health care workers, patients, and humanitarian organizations to allow a better understanding of service quality.
The Sana.PCHR application improves:
01
QUALITY
of NCD care by promoting adherence guidelines
02
COVERAGE
of care by supporting lesser-trained providers to deliver care
03
CONTINUITY
of care by having patient-managed information that can be used when changing providers
04
DATA ANALYTICS
so organizations can apply machine learning to improve operations and outcomes
Ensuring access to health services and consistent quality of care is crucial not only in developing countries, but particularly in conflict settings. Innovative technologies for supporting local healthcare facilities and community health workers are urgently needed. The Sana.PCHR tool is a tablet-based application for managing the treatment of patients with diabetes and hypertension. The application, designed based on field experience with Syrian refugees in Lebanon, is the only known mHealth tool for noncommunicable disease (NCD) management targeted towards gatekeepers in health care.
Sana.PCHR provides disease management guidelines as well as intuitive protocols for patient data storage. This application serves as a decision-making support tool for healthcare providers, thus promoting guideline adherence and quality of care. Patient-oriented outputs, such as text messages and printed visit data, are also delivered via this application.
PROJECT GOALS
ACTIVITIES
Sana.PCHR application aims to improve both quality and coverage of primary level NCD care. If successful, the application can be readily replicated in other settings.
METHODS
1) The Sana.PCHR application will be adapted using available guidelines and inputs from country-based health care facilities/providers; at the same time, data on existing NCD care will be collected at health care facilities for comparison purposes (months 0-6).
2) Health care workers will be trained accordingly and the application deployed in selected health care facilities (months 7-8).
3) Use of the application will be monitored and supported by MIT Sana and JHU, and modifications as needed. Related data will be collected for research purposes (months 9-21).
RESULTS
Country-based results will be measured according to:
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Number and type of providers using the application
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Provider satifaction and uptake
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Number of consultations
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Completeness of records and management in accordance to guidelines
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Health outcomes (disease control, risk categories) if feasible
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Patient perceptions of application and benefits (if any)
Long-term results will be assessed based on:
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Number of organizations using the application
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Number of countries where the application is in use
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Number of NCD patients benefitting from the application
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Awareness of and feedback from the stakeholders
Sana.PCHR User Manual
Users will find two options of logging in:
1) Scan with a QR code
2) Username/Password
Once logged in, the Sana.PCHR welcome screen will appear
Add a new patient and enter your patient's profile
Enter the details of a patient's medical history
Enter the physical measurements and clinical observations
Enter the results of all lab tests performed on the patients
Make changes to existing recommendations or medications, or add to the treatment plan
Add, overwrite, or modify existing medications and recommendations
Add a new prescription to the patient's record
Recommend lab tests following consultation
Add referrals for a patient
Recommend a return visit for the patient
Add other free text suggestions or recommendations for the patient
Patient profile example
Finish and Print
ABOUT THE SANA ORGANIZATION
Sana is a cross-disciplinary organization, including clinicians, engineers, policy, public health, and business experts along the entire healthcare value chain. Hosted at the Laboratory for Computational Physiology at MIT's Institute for Medical Engineering & Science.
Technology alone is not enough to transform global health and too often resources are indiscriminately thrown at problems without understanding what actually works. Furthermore, technology can't simply be transferred from developed countries to resource-limited settings, as solutions that work in one context, usually needs to be adapted to be sustainable in another locale.
We leverage a multidisciplinary team of Harvard and MIT trained clinicians and engineers, working together with public health professionals and researchers on the ground, to adapt the latest technologies to build sustainable practical solutions to global health problems.
Meet The Team
Kenneth Paik
MD, MBA, MMsc
Dr. Kenneth Paik (MD MBA MMSc) is the team lead. Dr. Paik is a Research Scientist at the MIT Institute for Medical Engineering, where he teaches courses in global health informatics to improve quality of care and secondary analysis of electronic health records. Dr. Kenneth Paik co-directs Sana at the MIT Institute for Medical Engineering and Science.
Erik Winkler
Eric Winkler is a lead developer at Sana. With his background in physics and computer science, he continuously develop Sana.PCHR platform, including mobile and backend components, targeted for use servicing traditionally underserved populations and as a research tool.
Collin Fair
Collin Fair is a firmware engineer at Fitbit. He’s part of Sana.PCHR development team.
Hok Hei Tam
PhD
Gilbert Burnham
MD, MS, PhD
Dr. Gilbert Burnham (MD MS PhD) is the founder of the Center for Refugee and Disaster Response at Johns Hopkins. He has extensive experience in emergency preparedness/response, particularly in humanitarian needs assessment, program planning, and evaluation that address the needs of vulnerable populations, and the development of training programs.
Hok Hei Tam (PhD) is a PhD in Chemical Engineering with a Minor in Machine Learning at MIT and works in Prof. Dan Anderson’s lab at the Koch Institute.He’s part of Sana.PCHR developer team.
Shannon Doocy
PhD
Dr. Shannon Doocy (PhD) works on populations affected by disasters and conflict. Current and recent research and projects have been implemented in collaboration with NGOs, UN agencies, and other academic institutions in a variety of countries including Lebanon, Syria, Jordan, Pakistan, the Philippines, the Democratic Republic of the Congo, South Sudan and Haiti.
Emily Lyles
MSPH
Emily Lyles (MSPH) is currently a PhD student in International Health at the Johns Hopkins Bloomberg School of Public Health. Her work focuses on providing evidence for humanitarian assistance program design and implementation in conflict-affected states. It includes the impact of conflict on health systems and population health, and continuity-of-care for chronic health conditions.
Kaisa Kontunen
MD, MPH
Dr. Kaisa Kontunen (MD MPH) is currently a health program coordinator for International Organization for Migration (IOM) stationed in Beirut, Lebanon.
She led the field implementation of a joint IOM - Johns Hopkins University - Massachusetts Institute of Technology (MIT) Sana two-year research project on non-communicable diseases (NCDs) in emergencies.
Poonam Dhavan
MBBS, DHA, MPH
Dr. Poonam Dhavan (MBBS DHA MPH) is a health program coordinator for the International Organization for Migration (IOM). She advises the Director of Migration Health Division (MHD) in developing and/or strengthening IOM strategy on Health Promotion and Assistance for Migrants programmes, and oversees standardization of migration health programmes
Abdullah Mkanna
Abdullah Mkanna works for the International Organization for Migration (IOM). He is part of Sana.PCHR development team.
Zeina Fahed
Zeina Fahed works for the International Organization for Migration (IOM). She is part of Sana.PCHR development team.
Andre Prawira Putra
MD, PGDFM
Andre Prawira Putra (MD, PGDFM) is a trained family physician from Indonesia with interests in clinical research, HIV policy, tuberculosis, and malaria. He is currently completing an MPH degree in Global Health at Harvard T.H. Chan School of Public Health with concentrations in epidemiology of infectious diseases and HuSEHR (Humanitarian Studies, Ethics and Human Rights).
Rachel Shin
Rachel Shin is a Global Health Master of Public Health student at Harvard T.H. Chan School of Public Health with a HuSEHR (Humanitarian Studies, Ethics and Human Rights) concentration. She is currently on leave from medical school at Virginia Commonwealth School of Medicine to pursue her MPH studies.
Patrick McSharry
MBBChBAO, MRCP
Patrick McSharry (MBBChBAO, MRCP London, Dip Trop Med) is a family physician from Ireland with 10 years experience working in a low resource environment in Primary care in Zambia. He is currently completing a Master of Public Health degree in Global Health at Harvard T.H. Chan School of Public Health while studying Global Health Informatics at MIT.