Remote HIV/AIDS patient monitoring tool using 3G/GPRS packet-switched mobile technology

Abstract

Since 2003, South Africa has been putting strategies in place to manage one of the largest HIV/AIDS Antiretroviral Treatment (ART) roll-outs in the world. Focus lies not only on intensified training of medical staff, but also on using resources in a more effective way to cope with the additional demands on the public healthcare system. Innovative solutions, such as the use of mobile phones to monitor patients at various geographical locations, have allowed for the creation of virtual infrastructures and support for the limited medical staff and resources. South Africa has a mobile penetration rate of 41% and quality GSM networks that give 90% of the population access to mobile communication. In 2002, Cell-life developed a Wireless Internet Gateway (WIG) / Short Message Service (SMS) based patient Aftercare tool which has success1fully been implemented and used by medical staff. Staff use the system to collect information regarding drug adherence, symptoms and tuberculosis (TB) information from the patient's home. Newer mobile technologies have since been made available in South Africa which offers greater scope for increased usability, performance, security, cost-effectiveness and multilingual support. This paper is an investigation of a Java Micro Edition (JavaME) adaptation of the current aftercare tool to assess the possibilities of a scalable national implementation. The system was developed based on human-computer interaction (HCI) theory and catering for different cultural backgrounds formed a fundamental objective of this research. The developed prototype uses packet-switched mobile technologies such as general packet radio service (GPRS), enhanced data-rate for GSM evolution (EDGE) and 3G to implement end-to-end secure encrypted communication. A basic research into cost-effectiveness showed that although 3G-enabled mobile handsets are still too costly, when compared to the average income of the target communities, GPRS and Java enabled handset prices form a viable option. Immediate cost per transaction savings of 31% were observed and due to economies of scale, future savings are in the region of 93% per transaction.