Sabrcare App Proposal

Technical Support
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India-based nonprofit Sabrcare wants to create an implementation of the CHT to help connect cancer patients with better care. You can refer to this doc for a broad overview of Sabrcare’s goals, process, and intentions for the app, but here are what I think are the most essential details pertaining to our potential CHT implementation:

The initial version of the Sabrcare App will be used primarily by family members of the patient (who are usually children) to enter and update basic patient information as well as add reports to the timeline representing the physical documents given by care-providers at each stage of the patient’s treatment. Each report will include one or more image (or potentially other media) uploads of the related documents and materials. This will assist caregivers in monitoring and tracking the patient’s condition and allow them a quick snapshot of the patient’s course of treatment via the timeline. The app will also be used by Sabrcare’s volunteer social workers who will be able to view and edit information for multiple patients.

My chief concerns that I’m hoping to get answers on are:

  1. What is the state of media support in reports currently?
  2. Is what is described viable with the CHT data model? Rather than caregivers, our primary users are the parents or family members of patients (we can assume that only one will be using the app for a given patient), so they will only be able to access/update data for the single patient in the family. They should be at the bottom of the graph and neither be able to access other patients’ information nor create new patients. At the higher level, we have volunteers who are responsible for creating the patients’ records, and can view all patient data. Currently Sabrcare has less than 60 clients so I wouldn’t anticipate memory limitations becoming an issue. Sabrcare does plan on growing and operating in cities outside of Goa, but I think that’s fairly out of scope for the MVP.

Your feedback on this as well as anything else you might be able to provide as far as advice on building our implementation would be greatly appreciated.

Thanks

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Hi @jsampson, thank you for this post and your questions! Our full team is currently in Nepal for an organizational meet-up, so please forgive a little delay in our response. We’re excited to dig in and give it our full attention as soon as our schedule here allows. Thanks!

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Hi @jsampson, thanks for reaching out. Looks like an interesting use case for the CHT, though a bit outside of what we typically see for deployments (the app was designed with and for CHWs, but can be used by caregivers in a similar way). Regarding your questions:

Yes, multimedia can currently be uploaded and submitted with forms.

It sounds like you are describing a tree hierarchy where caregivers are associated to the lowest hierarchy level. In this case, it will work in the way that you are describing - the lowest hierarchy level is not able to access other patients’ information nor create new patients. If a user is at a higher level in the hierarchy, which, from your description is where a volunteer would sit, they are able to create patient records and be configured as a supervisor to view multiple patients data across the hierarchy.

We have also just recently started building a more comprehensive documentation site which may be a good reference for your initial app deployment: https://docs.communityhealthtoolkit.org/

Hope this helps and good luck with your MVP!

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Cool to hear about this project @jsampson, I’ll build on Max’s comments with a couple more points.

As Max said community health workers are often key users of CHT apps, and if patients are interacting with the service on their own devices, it’s often via SMS rather than an app. For example, here’s a paper about a trial we worked on in Zimbabwe, where we supported text message-based follow up after surgery through a mix of automated SMS and patients SMSing with nurses. Reducing Provider Workload While Preserving Patient Safety: A Randomized Control Trial Using 2-Way Texting for Postoperative Follow-up in Zimbabwe's Voluntary Medical Male Circumcision Program - PMC

One of the design questions we needed to address for this project was how best to support initial registration and enrollment in the program. In this case we decided to have nurses at the facilities use laptops to complete enrollment forms and perform initial education and counseling with patients. Our protocol had nurses ensure that before leaving the clinic, each patient was able to receive an SMS on their phone, to ensure that if someone had a phone malfunction or had said their number incorrectly, they’d be able to get support. You might want to do something similar here–help the patients/family members get the software downloaded and ensure they can login before leaving the facility.

Anyway, this seems like a really innovative project and I think others on the forum would be very keen to hear how it goes for you. Best of luck with initial prototyping!

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