1. Reynaldo Manguni ● Mel Navarro ● Kathleen Rosario Adviser: Sir Cedric Festin Network and Distributed Systems Group UP Diliman Department of Computer Science

2. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction Typical Scene in a Rural Health Center

3. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| CHITS: Community Health Information Tracking System Community Health Information Tracking System (CHITS) is a system that stores records in a database from various vertical programs in the local health center. CHITS

4. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| CHITS Setup SERVER ROUTER WORKSTATIONS CHITS: Community Health Information Tracking System

5. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| Sample Scenario CHITS: Community Health Information Tracking System STEP 1: ARRIVAL

6. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| Sample Scenario CHITS: Community Health Information Tracking System STEP2: CONSULTATION

7. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| Sample Scenario CHITS: Community Health Information Tracking System STEP3: DEPARTURE

8. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| Problems CHITS: Community Health Information Tracking System  Target based approach Midwives pad and modify their data to meet their quota which is encouraged by the “pen and paper” approach  All-or-nothing phenomenon Reports from the lower layers are not passed to the higher levels until the records are completed

9. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| miCHITS: Mobile Interface for CHITS miCHITS (Mobile Interface for CHITS)  Recently developed to provide some answers to these problems by incorporating a mobile component to the system.  The database from the server is downloaded to the phone and the health worker can now encode the data into the phone and update the database later when he visits the center

10. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| miCHITS Setup miCHITS: Mobile Interface for CHITS

11. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| Sample Scenario miCHITS: Mobile Interface for CHITS STEP1: FIELD CONSULTATION

12. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| Sample Scenario miCHITS: Mobile Interface for CHITS STEP2: RETURN

13. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| Sample Scenario miCHITS: Mobile Interface for CHITS STEP3: SYNC/RESOLVE DATABASE

14. Solution Results Problem Impact Intro IntroIntro Conclusion Introduction| Problems Target based approach Target based approach The “pen and paper” approach would be replaced by the mobile component and there will be no more manual encoding since the database file is transferred directly to the server thus preventing the modification of data.  All-or-nothing phenomenon Records could still not be sent in real-time due to certain circumstances Examples: Health worker could not return to the health center Health worker lost the phone miCHITS: Mobile Interface for CHITS

15. Solution Results Problem Impact Intro IntroIntro Conclusion Problem  All-or-nothing phenomenon Problem      

16. Solution Results Problem Impact Intro ProblemProblem Conclusion Goal SERVER ROUTER WORKSTATIONS CHITS SETUP

17. Solution Results Problem Impact Intro ProblemProblem Conclusion Goal MOBILE APPLICATION miCHITS Setup WEB APPLICATION CHITS Setup

18. Solution Results Problem Impact Intro ProblemProblem Conclusion Goal miCHITS Setup Health worker after field work DB transfer via data cable/bluetooth CHITS Setup

19. Solution Results Problem Impact Intro ProblemProblem Conclusion Goal DB transfer via data cable/bluetooth No remote connection Health worker on field work miCHITS Setup CHITS Setup Inside health center Remote patients’ houses Health worker after field work

20. Solution Results Problem Impact Intro ResultsResults Conclusion Goal … to improve the current setup of miCHITS by integrating a cost-efficient and effective remote data connection between CHITS and miCHITS through the SMS functionality of mobile phones Our Goal is…

21. Solution Results Problem Impact Intro ResultsResults Conclusion Impact | Mobile Phones on Telehealth Africa – Uganda Health Information Network* Africa – Uganda Health Information Network* – 24% savings per unit – Improvement in weekly surveillance reporting 100% compliance rate (before: 63%) 100% compliance rate (before: 63%) – SMS reminding TB patients to take their pills (although there are stills problems on this)

22. Solution Results Problem Impact Intro ResultsResults Conclusion Impact | Mobile Phones on Telehealth “CHITS web-based application comprises only 5% of the first-hand data collection, the remaining 95% will be compensated by the mobile component.” Dr. Alvin Marcelo Director, National Telehealth Center

23. Solution Results Problem Impact Intro ResultsResults Conclusion System Architecture Health worker on field work miCHITS Setup CHITS Setup Health worker after field work SERVER PHONE Inside health center Remote patients’ houses Data transfer via SMS

24. Solution Results Problem Impact Intro ResultsResults Conclusion System Architecture Java ME  MIDP 2.0  CLDC 1.1  Compatible with most mid-class phones Modules  Personal information  Vital signs  Vaccination  Maternal care Mobile Interface

25. Solution Results Problem Impact Intro ResultsResults Conclusion System Architecture J2EE  Spring Framework 2.5  Apache Tomcat 6.0.18  MySQL Server Web Interface  Data compatibility and synchronization of the phone's local database and temporary database

26. Solution Results Problem Impact Intro ResultsResults Conclusion System Architecture  Java SE Desktop Interface  Used to process incoming messages and respond to the request  Connected to a phone which receives the messages

27. Solution Results Problem Impact Intro ResultsResults Conclusion System Architecture SMS Reliability Protocol Only ninety-five percent of the SMS sent reach the target phone. The other five percent are either delayed or lost. A modified selective repeat protocol was designed to factor in the constraints of implementing it over SMS and on a mobile platform. Best effort Best effort Stop-and-wait per session Stop-and-wait per session Session – s bit ID, at most m messages Session – s bit ID, at most m messages

28. Solution Results Problem Impact Intro ResultsResults Conclusion SMS Reliability Protocol Selective Repeat Protocol Sender Receiver Acknowledgements (ACKS) Data being transmitted Methodology | SMS Reliability Protocol

29. Solution Results Problem Impact Intro ResultsResults Conclusion Selective Repeat Protocol Sender Receiver Acknowledgements (ACKS) Sender Data being transmitted Designed Protocol Receiver ACK Vector Methodology | SMS Reliability Protocol 1101

30. Solution Results Problem Impact Intro ResultsResults Conclusion System Architecture Compression Deflate Algorithm  To lessen the amount of messages sent, the deflate compression algorithm will be used Operations  Operations usually take the length of ½ to 1 message (Ex. Adding a patient)  5 operations = about 373 characters  Compressed = about 234 characters ~ 38% reduced Compression of data SMS Messages are received by server phone Decompression of data

31. Solution Results Problem Impact Intro ResultsResults Conclusion System Architecture Temporary Database For conflicts in remote updates to be resolved, a temporary database was used to save the old states of the records being changed. The web interface handles the resolving of conflicts. CHITS DB TEMP DB

32. Solution Results Problem Impact Intro ResultsResults Conclusion Sample Scenario STEP1: FIELD CONSULTATION MOBILE APPLICATION REMOTE ACCESS TO SERVER RETRIEVE RECORDS System Architecture

33. Solution Results Problem Impact Intro ResultsResults Conclusion Sample Scenario STEP2: SYNC REAL TIME SYNC REMOTELY SAVE RECORDS System Architecture

34. Solution Results Problem Impact Intro ResultsResults Conclusion Sample Scenario STEP3: RESOLVE REMOTE CONFLICTS WEB APPLICATION CHECK FOR CONFLICTS AND RESOLVE CHITS DB TEMP DB System Architecture

35. Solution Results Problem Impact Intro ResultsResults Conclusion Results

36. Solution Results Problem Impact Intro ResultsResults Conclusion Comparison

37. Solution Results Problem Impact Intro ResultsResults Conclusion Results Comparison

38. Solution Results Problem Impact Intro ImpactImpact Conclusion Results Protocol: Bandwidth: 1400 bytes/111 secs ~1 message/12 secs Compression:  Unco mpressed  20 records = 1506 characters = 1318 bytes ~ 10 messages  Compressed  682 characters = 597 bytes (55% reduced) ~ 5 messages (50% reduced)

39. Solution Results Problem Impact Intro ImpactImpact Conclusion Impact | chitSMS The presence of a remote connection for updating the CHITS system promises to be a useful tool. Instead of travelling back to the health center to update the database, the health worker could easily update and view the patient records. In effect, he saves time and money, which he can use to do other useful work.

40. Solution Results Problem Impact Intro ImpactImpact Conclusion SMS Reliability Protocol Impact | SMS Reliability Protocol Any system that needs a reliability protocol where SMS can be used can use with our SMS reliability protocol. Example: Election Automation System

41. Conclusion Solution Results Problem Impact Intro ConclusionConclusion Conclusion The presence of a remote connection for updating the CHITS database promises to be a useful tool in providing telehealth services or other systems over SMS. The project utilizes the key feature of mobile phones which is SMS, in transmitting data from the mobile phone to the server to update patients records in a close to real-time manner.