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D REE I N TER N A TIO N A L D-Tree International Who we are, what we do

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Page 1: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

D-Tree International

Who we are, what we do

Page 2: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

D-Tree background

• Vision - A world in which every person has access to high quality healthcare

• Mission – To develop and support electronic clinical protocols that that enable health workers worldwide to deliver high quality care

• Founded in 2004: Currently have 5 staff in US, 14 in Tanzania, 1 in Malawi and 1 in India

Page 3: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

D-tree background…

• Health workers in clinics and community health workers are the front line of the health system, yet face high turnover and often have little training

• Challenges also exist in collecting and reporting data

• We build mobile applications to reinforce the training provided and to assist our partners in monitoring and managing the work that is done in remote locations

Page 4: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

Our process

Design

• Review of guidelines

• Observe patient flow

• Develop protocol

• Develop prototype

Field Refinement

• Train small group of workers

• Weekly meetings to collect feedback

• Incremental application refinement based on HCW feedback

Training and Pilot prep

• Train larger group of workers

• Complete central server set-up

Pilot

• Monitor use of field applications

• Regular meetings with HCWs

• Validate reports

Assessment

• Data analysis• Measure

effectiveness of application and interventions

• Lessons learned for larger scale-up

Page 5: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

Adolescent Life Skills +

Health Antenatal Labor +

Delivery

Neonatal Infant Care

Child Dev. + Nutrition

PostNatal

ParentingSkills

Family Planning

Continuum of Care

D-treeActivites

• develop / refine defined quality standards• develop phone based delivery of standards to improve use• monitoring tools of standards use for supervision• patient data for quality improvement and links among providers• data links to HMIS/DHIS for supervisors + managers

Page 6: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

Applications

• Community– Maternal and Child Health (Ante-natal, Post-natal, Neo-natal)– TB screening– Home based care– Orphans and Vulnerable Children– Family Planning

• Facility– IMCI– Maternal and Child Health (Ante-natal, Post-natal, Neo-natal)– Active Management of Third stage of labor– Immediate Newborn Assessment

Page 7: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

Representative Clients

Page 8: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

Software in the field

Page 9: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

Pathfinder

• Developed mobile application to assist CHWs in the home visits for PLHA and Chronically ill patients

• Guide management of patient schedule visits• Provide referral reminders for follow-ups all

referred patients• Deployed and in use by over 107 CHWs in the

field. Plan to have over 200 CHWs users end of Nov 2010

Page 10: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL Pathfinder…Focus group discussion

Page 11: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

JHPIEGO

• Developed facility and community protocols for antenatal, neonatal and postnatal care in accordance with Tanzania MOH guidelines

• Developed prototype applications ready for field refinement

Page 12: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

JHPIEGO…

Check for danger signsTreatment based on

lab results

Counseling messages

Page 13: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

UNICEF

• Developed protocols to support outpatient treatment of severe acute malnutrition in Zanzibar

• Developed application to support screening, registration, treatment and prescribing to be done at the health facility

• Field refinement and pilot to be completed by June 2011

Page 14: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

UNICEF…

Page 15: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

PATH

• Designed and Refinement of mobile app for District TB/HIV Coordinators (DTHCs) in Tanzania

• Designed and Refinement of mobile application for Community Volunteers to do TB screening in the community

Page 16: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

PATH - Summary of data submissions

• Number of users (CHWs & DTHCs): 14 • Total forms processed by 25 Oct: 1284

Form Number Received Most Recent Submission

CHW- Diagnosis form 129 30/07/2010

CHW- Registration form 202 01/10/2010

CHW-Survey form 525 25/10/2010

CHW-TB screening form 201 06/09/2010

DTHC-closing facility form 18 17/10/2010

DTHC-facility registration form 155 22/10/2010

DTHC-TBHIV Data collection form 32 07/10/2010

DTHC-TBHIV Supervision form 22 07/10/2010

Page 17: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

CARE-India

• Developed protocols for Individual Birth Planning and ANC, Active Management of 3rd Stage of Labor, Immediate Newborn Assessment and Postpartum follow-up for mother and child

• Establishing server for integration of all patient data in OpenMRS

• Application development and field refinement ongoing and due for completion by January 2011

Page 18: D-Tree International Who we are, what we do. D-Tree background Vision - A world in which every person has access to high quality healthcare Mission –

D REE

INTERNATIONAL

What’s coming next

• Linkage of community and facility based information and tools

• Incorporation of media (pictures, videos, voice) into protocols

• More in depth clinical protocols• Improved supervisory reporting• Reporting from OpenMRS


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