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

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro

ConclusionConclusion

Introduction

Typical Scene in a Rural Health CenterTypical Scene in a Rural Health Center

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction| CHITS: Community Health InformationTracking System

Community Health Information Tracking System (Community Health Information Tracking System (CHITSCHITS) is a system that stores ) is a system that stores records in a database from various vertical programs in the local health center. records in a database from various vertical programs in the local health center.

CHITS

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction|

CHITS Setup

SERVERSERVERROUTERROUTER

WORKSTATIONSWORKSTATIONS

CHITS: Community Health InformationTracking System

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction|

Sample Scenario


STEP 1: ARRIVALSTEP 1: ARRIVAL

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction|

Sample Scenario


STEP2: STEP2: CONSULTATIONCONSULTATION

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction|

Sample Scenario


STEP3: DEPARTURESTEP3: DEPARTURE

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction|

Problems


Target based approachTarget based approachMidwives pad and modify their data to meet their quota which is Midwives pad and modify their data to meet their quota which is encouraged by the “pen and paper” approachencouraged by the “pen and paper” approach

All-or-nothing phenomenonAll-or-nothing phenomenonReports from the lower layers are not passed to the higher levels Reports from the lower layers are not passed to the higher levels until the records are completeduntil the records are completed

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction| miCHITS: Mobile Interface for CHITS

miCHITS (Mobile Interface for CHITS) miCHITS (Mobile Interface for CHITS) Recently developed to provide some answers Recently developed to provide some answers to these problems by incorporating a mobile to these problems by incorporating a mobile component to the system. component to the system.

The database from the server is downloaded The database from the server is downloaded to the phone and the health worker can now to the phone and the health worker can now encode the data into the phone and update encode the data into the phone and update the database later when he visits the centerthe database later when he visits the center

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction|

miCHITS Setup

miCHITS: Mobile Interface for CHITS

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction|

Sample Scenario


STEP1: FIELD CONSULTATIONSTEP1: FIELD CONSULTATION

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction|

Sample Scenario


STEP2: RETURNSTEP2: RETURN

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction|

Sample Scenario


STEP3: SYNC/RESOLVE DATABASESTEP3: SYNC/RESOLVE DATABASE

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Introduction|

Problems

Target based approachTarget based approachThe “pen and paper” approach would be replaced by the mobile The “pen and paper” approach would be replaced by the mobile component and there will be no more manual encoding since the component and there will be no more manual encoding since the database file is transferred directly to the server thus preventing database file is transferred directly to the server thus preventing the modification of data.the modification of data.

All-or-nothing phenomenonAll-or-nothing phenomenonRecords could still not be sent in real-time due to certain Records could still not be sent in real-time due to certain circumstances circumstances Examples:Examples:

Health worker could not return to the health centerHealth worker could not return to the health centerHealth worker lost the phoneHealth worker lost the phone


SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Problem All-or-nothing phenomenonAll-or-nothing phenomenon

Problem

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Goal

SERVERSERVER ROUTERROUTER

WORKSTATIONSWORKSTATIONS

CHITS SETUPCHITS SETUP

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Goal

MOBILE APPLICATIONMOBILE APPLICATION

miCHITS SetupmiCHITS Setup

WEB APPLICATIONWEB APPLICATION

CHITS SetupCHITS Setup

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Goal


Health worker Health worker after field workafter field work

DB transfer via data DB transfer via data cable/bluetoothcable/bluetooth


SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Goal

DB transfer via data DB transfer via data cable/bluetoothcable/bluetooth

No remote No remote connectionconnection

Health worker Health worker on field workon field work



Inside health center


Remote patients’ houses



SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Goal

… … to improve the current setup of miCHITS by integrating a to improve the current setup of miCHITS by integrating a cost-efficient and effective remote data connection cost-efficient and effective remote data connection between CHITS and miCHITS through the SMS functionality between CHITS and miCHITS through the SMS functionality of mobile phonesof mobile phones

Our Goal is…

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Impact |Mobile Phones on Telehealth

Africa – Uganda Health Information Network*Africa – Uganda Health Information Network*– 24% savings per unit24% savings per unit– Improvement in weekly surveillance reportingImprovement in weekly surveillance reporting• 100% compliance rate (before: 63%)100% compliance rate (before: 63%)

– SMS reminding TB patients to take their pillsSMS reminding TB patients to take their pills(although there are stills problems on this)(although there are stills problems on this)

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Impact |Mobile Phones on Telehealth

““CHITS web-based application comprises only 5% CHITS web-based application comprises only 5% of the first-hand data collection, the remaining of the first-hand data collection, the remaining 95% will be compensated by the mobile 95% will be compensated by the mobile componentcomponent.”.”

Dr. Alvin MarceloDr. Alvin MarceloDirector, National Telehealth CenterDirector, National Telehealth Center

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


System Architecture

Health worker Health worker on field workon field work




SERVER PHONESERVER PHONE




Remote patients’ housesData transfer via SMSData transfer via SMS

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


System Architecture

Java MEJava MEMIDP 2.0MIDP 2.0CLDC 1.1CLDC 1.1

Compatible with most Compatible with most mid-class phonesmid-class phones

ModulesModules Personal informationPersonal information Vital signsVital signs VaccinationVaccination Maternal careMaternal care

Mobile Interface

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


System Architecture

J2EEJ2EE Spring Framework 2.5Spring Framework 2.5 Apache Tomcat 6.0.18Apache Tomcat 6.0.18 MySQL ServerMySQL Server

Web Interface Data compatibility and Data compatibility and synchronization of the phone's synchronization of the phone's local database and temporary local database and temporary databasedatabase

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


System Architecture

Java SEJava SE

Desktop Interface

Used to process incoming messages and respond to Used to process incoming messages and respond to the requestthe request Connected to a phone which receives the messagesConnected to a phone which receives the messages

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


System Architecture

SMS Reliability Protocol

Only ninety-five percent of the SMS sent reach the target phone. Only ninety-five percent of the SMS sent reach the target phone. The other five percent are either delayed or lost. The other five percent are either delayed or lost.

A modified selective repeat protocol was designed to factor in the A modified selective repeat protocol was designed to factor in the constraints of implementing it over SMS and on a mobile constraints of implementing it over SMS and on a mobile platform.platform.

• Best effortBest effort• Stop-and-wait per sessionStop-and-wait per session• Session – s bit ID, at most m messagesSession – s bit ID, at most m messages

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro



Selective Repeat ProtocolSelective Repeat Protocol

SenderSender

ReceiverReceiver

Acknowledgements (ACKS)Acknowledgements (ACKS)

Data being transmittedData being transmitted

Methodology |SMS Reliability Protocol

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro



Selective Repeat ProtocolSelective Repeat Protocol

SenderSender

ReceiverReceiver

Acknowledgements (ACKS)Acknowledgements (ACKS)

SenderSender

Data being transmittedData being transmitted Data being transmittedData being transmitted

Designed ProtocolDesigned Protocol

ReceiverReceiver

ACK VectorACK Vector

Methodology |SMS Reliability Protocol

11011101

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


System Architecture

CompressionDeflate AlgorithmDeflate AlgorithmTo lessen the amount of messages sent, the deflate compression To lessen the amount of messages sent, the deflate compression algorithm will be used algorithm will be used

OperationsOperations Operations usually take the length of ½ to 1 message (Ex. Operations usually take the length of ½ to 1 message (Ex. Adding a patient)Adding a patient)

5 operations = about 373 characters5 operations = about 373 characters Compressed = about 234 characters ~ 38% reducedCompressed = about 234 characters ~ 38% reduced

Compression of data

SMS Messages are received by server phone

Decompression of data

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


System Architecture

Temporary DatabaseFor conflicts in remote updates to be resolved, a For conflicts in remote updates to be resolved, a temporary database was used to save the old states of the temporary database was used to save the old states of the records being changed.records being changed.

The web interface handles the resolving of conflicts.The web interface handles the resolving of conflicts.

CHITS DB TEMP DB

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Sample Scenario

STEP1: FIELD CONSULTATIONSTEP1: FIELD CONSULTATION

MOBILE APPLICATION

REMOTE ACCESS TO

SERVER

RETRIEVERECORDS

System Architecture

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Sample Scenario

STEP2: SYNC REAL TIMESTEP2: SYNC REAL TIME

SYNCREMOTELY

SAVERECORDS

System Architecture

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Sample Scenario

STEP3: RESOLVE REMOTE CONFLICTSSTEP3: RESOLVE REMOTE CONFLICTS

WEB APPLICATION

CHECK FOR CONFLICTS AND

RESOLVE

CHITS DB

TEMP DB

System Architecture

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Results

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Duration in Server

0

50

100

150

200

250

300

350

1 2 3 4 5 6 7 8 9 10

Number of messages

Time (s)

Designed protocol

Selective Repeat

Go-Back-N

Stop-and-Wait

Results

Comparison

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Duration in Phone

0

50

100

150

200

250

300

350

1 2 3 4 5 6 7 8 9 10

Number of messages

Time (s)Designed protocol

Selective Repeat

Go-Back-N

Stop-and-Wait

Results

Comparison

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Results

Protocol: Protocol: Bandwidth: 1400 bytes/111 secsBandwidth: 1400 bytes/111 secs

~1 message/12 secs~1 message/12 secs

Compression:Compression: UncoUncompressedmpressed

20 records = 1506 characters = 1318 bytes 20 records = 1506 characters = 1318 bytes ~ 10 messages~ 10 messages

Compressed Compressed 682 characters = 597 bytes (55% reduced) 682 characters = 597 bytes (55% reduced) ~ 5 messages (50% reduced) ~ 5 messages (50% reduced)

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


Impact |

chitSMS

chitSMS

The presence of a remote connection for updating the CHITS The presence of a remote connection for updating the CHITS system promises to be a useful tool. system promises to be a useful tool.

Instead of travelling back to the health center to update the Instead of travelling back to the health center to update the database, the health worker could easily update and view the database, the health worker could easily update and view the patient records. In effect, he saves time and money, which he can patient records. In effect, he saves time and money, which he can use to do other useful work.use to do other useful work.

SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro


SMS Reliability ProtocolImpact |


Any system that needs a reliability protocol where SMS can be Any system that needs a reliability protocol where SMS can be used can use with our SMS reliability protocol.used can use with our SMS reliability protocol.

Example:Example:Election Automation SystemElection Automation System


SolutionSolution

ResultsResults

ProblemProblem

ImpactImpact

IntroIntro

Conclusion

Conclusion

The presence of a remote connection for updating the CHITS The presence of a remote connection for updating the CHITS database promises to be a useful tool in providing telehealth database promises to be a useful tool in providing telehealth services or other systems over SMS.services or other systems over SMS.

The project utilizes the key feature of mobile phones which is The project utilizes the key feature of mobile phones which is SMS, in transmitting data from the mobile phone to the server to SMS, in transmitting data from the mobile phone to the server to update patients records in a close to real-time manner.update patients records in a close to real-time manner.

Documents

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