eCompliance Suite

The eCompliance Suite of technologies was originally developed for the detection and treatment of Tuberculosis. It was developed in 2010 and has since then been used in the NGO Operation ASHA’s (OpASHA’s) main TB treatment program.

It provides end to end TB services like detection, counselling and adherence to the treatment protocol. However, it is not limited to TB. It has been used by pharmaceutical company Baxter to track adherence to the treatment protocol of haemophilia. It has been used by Columbia University in Telangana to identify chronic absentees and thus improve school attendance via follow-ups. It has also been used by the Karnataka government to provide nutritional packets to pregnant women. Its possibilities for customization are limitless. Since it is a biometric based technology based on taking finger/iris scans of the beneficiaries, it can be used in any use case where adherence and/or unique identification of beneficiaries is a priority.

A few of the Android applications it consists of are as follows:

  • eCompliance - A biometric based application based on taking finger/iris scans of the beneficiaries. It is used to ensure adherence to the difficult TB treatment protocol, and also ensuring minimum missed doses.
  • eDetection - A questionnaire based screening application that is used to screen for symptoms of TB. It works in two modes which are contact tracing and active case finding.
  • eAlert - This is an electronic version of a manual lab register kept in the labs with the lab technician. It alerts the CHW (Community health Workers) regarding the exact finding of the patient’s sputum test for TB.
  • eFAQ - Using this app a CHW can quickly find relevant documents that answer their queries.
  • eQuality - A survey based application used in internal audits.
  • eCounselling -  An application that downloads a series of videos from a central repository and plays them one by one without any pause or fast forward. It is used for showing counselling videos to the patient and his family.
  • Trip Tracker - It calculates the exact distance traveled by CHW and time taken using GPS
  • EMR - An electronic medical record system which is on the server. Data from all the above Android applications is synced into this once in 24 hours and hence automatic reporting and visualizations of data can be done.

These applications are loaded on the Android tablet that OpASHA provides its CHW’s.

Many social impact programs/businesses and even government programs struggle with accurate, secure and timely beneficiary tracking. This gap can be filled by eCompliance Suite since one can track every transaction through a fingerprint/iris scan. The tracking is highly ‘accurate’ since a fingerprint/iris scan cannot be manipulated. It is ‘secure’ since all data is encrypted, both on tablet and server as well as in transit during sync.

Another problem that many programs, especially in healthcare are that of adherence. With eCompliance Suite, maximum adherence takes place, since on any missed transaction a text alert is sent to the field workers which can be followed up. Another problem that occurs in many organizations is excess use of manpower due to administration and reporting purposes. In eCompliance Suite, there is automatic reporting at the backend. Also, all organizations need technology that is user friendly and portable. The eCompliance Suite apps are extremely user-friendly and can easily be installed on an Android tablet. For field workers requiring mobility, the Android tablet is a light and portable option. Another problems that businesses face is that of tracking the location of their workers. In eCompliance Suite, GPS tracking is built in. Thus at any point of time one can see the exact locations of all the field workers.

Many organizations want to give performance based remuneration to employees however, they struggle with obtaining an accurate representation of the work done. Using eCompliance Suite, it is easy since there is accurate tracking of employee time and commitment using fingerprinting of field workers and beneficiaries both. There is also an inbuilt video counselling feature in eCompliance Suite in which counselling/advertising videos can be shown to the beneficiaries and also most importantly, tracking can be done at the back end as to whether the videos were actually shown or not and for how long the session lasted.

Adherence or compliance to the treatment protocol is a very big problem especially for TB patients. The DOTS (Directly Observed Treatment, Short Course) treatment protocol mandates daily directly observable doses for 6-8 months for drug sensitive TB. For MDR-TB, this duration can last up to 2 years. Patients stop being compliant for a variety of reasons. They start feeling better after a few doses thus they think that they can go without the rest of the doses. Or they are so frustrated by the side effects of TB medication. Using eCompliance Suite, OpASHA has achieved a Treatment Success Rate of 85% in drug sensitive patients and a dropout rate of less than 4%, results that are unmatched. It works as follows. The patient’s fingerprint/iris is scanned during the registration process by a CHW and is saved in the system. Subsequently, whenever the patient visits the TB clinic to take a dose, his fingerprint/iris is scanned. The patient is given the dose only after simultaneous scanning of fingerprints by the CHW and patient. This is proof that the dose was given under direct supervision. If a patient misses a dose, a text alert is sent by eCompliance both to the patient as well as the CHW. The CHW then follows up with the patient by phone call/ text message or goes to the patient’s house to give him the medication. This way through eCompliance, the missed doses are minimum.

Detection of TB patients is another huge problem. There are 10.4 million new cases of TB every year. Out of these 4 million go missing i.e. they are undetected. They continue to suffer and infect others. Using the eDetection app, we can find out these missing cases and promptly put them on treatment. Initial default is also a huge problem in India. A recent research paper by the deputy director general of the WHO states that there is 18% initial default all over the country. This means that 18% patients are detected, however they are not put on treatment. eAlert app helps reduce time lag between detection and treatment and also ensures that all detected cases are indeed put on treatment by adding them to eCompliance automatically.

eCompliance suite consists of a number of Android applications to ensure highly efficient end-to-end TB treatment. The various applications speak to each other automatically, without human intervention. For example, as soon as a symptomatic is detected in the eDetection application, their record is automatically added in eAlert only if the eDetection algorithm recommends a sputum test. The moment a lab technician enters a positive result in eAlert, the corresponding entry is added in eCompliance application, which is used for treatment and adherence to the treatment. Also, follow-up lab tests from eCompliance are added back in eAlert. Thus, eCompliance Suite automates the entire management of the disease, including detection, diagnosis and treatment.

Use of this innovative technology ensures highly effective TB detection and treatment (Treatment Success rate for OpASHA is 85% in Drug Sensitive TB and default rate i.e. rate of dropouts from the program is less than 5%).

India, Cambodia, Afghanistan, Tanzania

Key Facts

Organization: Operation ASHA
Website: http://www.opasha.org
Contact person: Sandeep Ahuja
Email: sandeep.ahuja@opasha.org
Operating in: India, Cambodia, Afghanistan

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