Design requirements for CHT-mHealth

[cliff]

Hello community

Building on the discussion here

We recently got a set of requirements as part of the MVP that we would like to get some more insights on, we ealier on this week had a call session with @michael and @Nicole_Orlowski which was very helpful though we also thought of bring this to the wider community and if there is any implementation out there which has implemented some of the requirements below, before making final conclusions…

• Are there CHT distributions that make phone calls directly from the CHT? How was this done ? There is the ability to make calls from app forms but we are looking at making calls directly from CHT ie a call option under messages or people tab

• We have a vision to embed a Library for Health Care Workers into the CHT. It would contain things like: PDFs of care guidelines, a set of FAQs, and potentially need more media like videos/diagrams to guide Case managers. Has this been done before within the CHT (COVID-19 training modules?)? How was this accomplished?
  

• How has CHT been optimized so that specific forms can be printed? For our intervention, only some patients will be enrolled and we’re digitizing a few core ministry of health forms for case management. How can we print these from CHT?

• What authentication mechanism is being used in CHT ? . We are looking a implementing single sign on authentication mechanism between CHT and superset …

• Is it possible to extract user data for healthcare workers using CHT? For our evaluation we’d like to measure eg frequency of logins and duration of each login (time out - time in to calculate minutes used)

Your thoughts and ideas are highly appreciated
cc @gareth @diana @michael @marc @mrjones @kitsao @Beth

[Beth]

Adding more questions to @cliff’s post!

We’re exploring using the offline mode for a set of facilty-based healthcare workers and curious about other’s experiences. CHT users have access to reliable internet. They will use both Forms & Tasks, so we’ve learned we will use Offline prividledges (based on a helpful conversation with @michael). Curious for input from others who have similar use case.

• Is it possible to configure CHT so that all forms remain online and not stored on the device when using offline mode? Our stakeholders are concerned about security of sensitive HIV care related information being stored on a device per MOH guidelines.

• How does synch work when Offline users are always on the internet? For example, if a patient visits a Social Worker and then meets with an adherence counselor at the same facility, can CHT be configured so that each healthcare worker sees most up-to-date information? Have other partners used CHT at the facility in similar ways?

• We learned about using Purge in Offline mode when there are more than 10k forms stored on a device to support speed. Given our use case, we would not want to rely on purge and would instead like all forms to be accessible to support longitunal HIV care. Have others taken a different approach?

[michael]

@cliff

Are there CHT distributions that make phone calls directly from the CHT? How was this done ? There is the ability to make calls from app forms but we are looking at making calls directly from CHT ie a call option under messages or people tab

@cliff , check out the permission called can_view_call_action. If a user has a role with that permission and the contact has a phone number, you can initiate a call (using the device’s calling capabilities) directly from that contact’s profile.

[gareth]

Hi @cliff and @Beth

Great questions! I think those would all be great individual forum discussion points, but I’ll answer them inline here as best I can.

We have a vision to embed a Library for Health Care Workers into the CHT. It would contain things like: PDFs of care guidelines, a set of FAQs, and potentially need more media like videos/diagrams to guide Case managers. Has this been done before within the CHT (COVID-19 training modules?)? How was this accomplished?

That sounds a little like this use case to integrate the CHT with OppiaMobile for training. It’s a little different in this case because it sounds like you want a library of resources rather than training modules, but have a look and see if that fits your requirements.

How has CHT been optimized so that specific forms can be printed? For our intervention, only some patients will be enrolled and we’re digitizing a few core ministry of health forms for case management. How can we print these from CHT?

As far as I’m aware no work has been done towards printing, and right now if you tried to print from the browser it will also print the navigation and left pane which is probably not what you want. A basic version of this could be implemented with a print CSS stylesheet to print what you see in the right pane on the reports tab. Is this what you were thinking?

What authentication mechanism is being used in CHT ? . We are looking a implementing single sign on authentication mechanism between CHT and superset …

The CHT uses CouchDB authentication. I haven’t explored SSO in the CHT but it could be useful, particularly as Superset becomes supported out of the box. Let me know what you discover!

Is it possible to extract user data for healthcare workers using CHT? For our evaluation we’d like to measure eg frequency of logins and duration of each login (time out - time in to calculate minutes used)

Quite a lot of information is collected and synced as user telemetry.

Is it possible to configure CHT so that all forms remain online and not stored on the device when using offline mode? Our stakeholders are concerned about security of sensitive HIV care related information being stored on a device per MOH guidelines.

While not specifically designed for this purpose I think purging may work for you. The report will remain on the device until it is synced to the server. When the purging runs on the server the doc will be marked to be purged, synced back to the client, and deleted. There will definitely be a delay but this will continually clean up synced reports. You’ll also want to ensure there’s sufficient security on the devices including passwords, PINs, disk encryption, etc.

How does synch work when Offline users are always on the internet? For example, if a patient visits a Social Worker and then meets with an adherence counselor at the same facility, can CHT be configured so that each healthcare worker sees most up-to-date information? Have other partners used CHT at the facility in similar ways?

Syncing occurs on offline devices when: a doc is created, the user clicks “sync”, a user comes back online, and every 5 minutes. In your example, the Social Worker would create/update a doc which would trigger the sync to the server. Then the adherence counselor will sync the doc to their device within 5 minutes. Users could be trained to manually click the sync button if they’re not seeing the reports they expect. There is an issue to make the 5 minute time configurable so please comment on that if that’d be useful to you.

We learned about using Purge in Offline mode when there are more than 10k forms stored on a device to support speed. Given our use case, we would not want to rely on purge and would instead like all forms to be accessible to support longitunal HIV care. Have others taken a different approach?

To support longitudinal care in offline mode the report will need to be on the device to generate tasks and contact summary details, which is in conflict with your other requirement to not store the HIV information on the device for security reasons. Purging can be configured with different rules per user group, so it is possible to have different rules for different roles if that would help. Alternatively you could use device security (as mentioned above), and consider using an MDM so the device can be wiped if it’s lost or stolen.

[cliff]

@gareth

That sounds a little like this use case to integrate the CHT with OppiaMobile for training. It’s a little different in this case because it sounds like you want a library of resources rather than training modules, but have a look and see if that fits your requirements.

thanks @gareth we looking into this

@gareth

As far as I’m aware no work has been done towards printing, and right now if you tried to print from the browser it will also print the navigation and left pane which is probably not what you want. A basic version of this could be implemented with a print CSS stylesheet to print what you see in the right pane on the reports tab. Is this what you were thinking?

we were looking at something like printing out the data in a pdf format ,

@gareth

Syncing occurs on offline devices when: a doc is created, the user clicks “sync”, a user comes back online, and every 5 minutes. In your example, the Social Worker would create/update a doc which would trigger the sync to the server. Then the adherence counselor will sync the doc to their device within 5 minutes. Users could be trained to manually click the sync button if they’re not seeing the reports they expect. There is an issue to make the 5 minute time configurable so please comment on that if that’d be useful to you.

we are keeping tabs on this to see how it can best help

[cliff]

@michael

@cliff , check out the permission called can_view_call_action. If a user has a role with that permission and the contact has a phone number, you can initiate a call (using the device’s calling capabilities) directly from that contact’s profile.

thanks @michael ,already implemented

[Beth]

@gareth - thanks for tackling this long list of questions. Happy to move conversations to other threads so feel free to split these up into individual forum discussions!

We’re really exploring using CHT as a point-of-care system at the facility for longitundinal HIV care. Thus, purging forms does not work well for our use case (think mini-electronic health record designed to support Social Workers so they would need to access old assessment forms to see progress).

• Are there other implementers who are using CHT at the facility as a point-of-care system? Note that we would have multiple people logging into CHT from the facility during a single care visit, meaning a patient may travel from one health care worker to another and each health care worker would need to access up-to-date information.

@cliff & @mozzy, tagging you here as an FYI and to clarify where I’ve gone astray