uNotify offers 4 different devices which can all be used to help ensure adherence to drug regimens, specifically for TB cases. All devices send information to a centralized information management system. This server monitors program activity and alerts personnel when required (e.g., when doses are missed). The management system also maintains electronic records of all patients (EMR) and automates administrative tasks.
- Reduction in travel to provider sites that is currently required for checking records
- Automatic and timely alerts when doses are missed
- Reduction in the auditing time that required to ascertain the veracity of records
- Elimination of tedious analysis of paper records to spot irregularities
- Allows program-wide performance tracking and reporting
- Automation of administrative tasks
uNotify allows providers to pick a recording and authentication device that is best suited to the program's context and cost-performance constraints:
The uBox is a palm-sized, intelligent pill dispenser, which reminds a patient when it is time to take medication and records when a patient does so. It also tracks visits by program personnel via electronic keys with unique IDs which are inserted into the box. The box requires refilling once a month. The uBox is unique among uNotify devices because it enables patients to take medication themselves. It also addresses a major barrier to access: the need for patients to travel to providers. It is not meant to replace providers, who help and motivate patients. Rather, it enables patients who are able to adhere to their regimen to do so, allowing providers to aid patients facing the steepest challenges.
The uPrint ensures that patients receive their drugs from providers using fingerprint identification. The solution consists of a fingerprint reader attached to a processing device, like a netbook or a cell phone, running custom software. Prints are recorded by pressing the finger on a reader. The system then searches a database of previously registered patients and personnel prints to identify and authenticate the user. Each provider is equipped with a unit and both patients and providers register their prints to establish the meeting. While readers tend to be expensive, they are affordable in, for example, urban settings where a single provider may serve a hundred patients a year. Operation ASHA is currently using uPrint with documented success.
The uPhone is an ordinary cell phone equipped with software that allows program implementers to collect detailed health information. It has a custom menu in the local language (as well as English) that allows community workers with basic training to check off indicators related to TB. The uPhone may be used for both detecting new cases and periodically checking up on patients undergoing treatment. Programs can intervene, for instance, if side effects interfere with therapy, or if the patient continues to be symptomatic despite treatment.
uMessage, simplest way to use uNotify, records doses using a basic cell phone with no custom software. All treatment providers are given a cell phone that can send and receive text messages (SMS). Providers text the patient ID to the uNotify system when dispensing the dose. At the end of each day, the system generates a list of all patients who did not receive their dose and sends it to program personnel for follow up. Two mechanisms are used to provide a measure of authentication. First, the uNotify system responds to a provider text with a random 4-digit acknowledgment code. The provider copies the code on a coupon and hands it to the patient. Periodic checks discourage false reporting. Second, the system occasionally alerts managers when dose notifications are received. Managers can then call providers and ask to speak with the patient. While uMessage provides limited authentication, it is cost-effective in communities where providers serve only a few patients every year, (e.g., sparsely populated rural areas).