ICT 4D CONFERENCE Title: Mobile Digital Diagnosis and Data Management By: Dr. Elias K. Sory, Director, Fio Health Gh

1. ICT 4D CONFERENCETitle: Mobile Digital Diagnosis and Data ManagementBy:Dr. Elias K. Sory,Director, Fio Health Ghana Ltd.

2. FIO HEALTH GHANA • Fio Health Ghana Ltd. has partnered with Fio Corporation of Canada to use Fionet in Ghana’s health care delivery system to enable high impact, high quality diagnosis of infectious diseases and real-time readily accessible data for health managers. • Directors: Dr. Elias K. Sory, MD – Former Dir. Gen. Of GHS Dr. Edem Adzogenu, MD – Sr. Adv. to Ministry of Health

3. Fionet Validation • Fionet Accra Phase – GHS • Luminary deployment with GHS • over 150 health workers trained • over 50 sites deployed and functioning • over 20,000 patient encounters • Fionet Clinical Field Validation • US NIH Center of Excellence in Malaria, Colombia • The Global Fund, Colombian NIH, MOH • US Department of Defense, KEMRI • Ifakara Health Institute, Tanzania • Experience • 7,500 patient sessions, 50 health workers, 30 sites • 4 countries • Consistently successful

4. Two of the Biggest Infectious Disease Mgmt Problems Clinical Workflow Data Aggregation Health Workers Managers, Administrators, Funders, Public Health, Industry Inadequate Care Inadequate Data Monitoring and Data Mining Diagnostic Testing Data Capture & Transmission Health Worker Guidance • Incomplete, inaccurate, untimely data • Ineffective tracking and direction of resources, results, performance, epidemiology, demography, surveillance, accountability, … • Blind spending and investment • Error-prone diagnostic testing • Ineffective clinical work-up and therapy • Negligible data capture and transmission, despite enormous information access

5. Cloud Aggregates data, continually and automatically uploaded from Fio smart-devices at point of care Delivers information services via web portal to managers, administrators, workers, funders, health agencies, patients via local cell networks via standard browsers Readers, Tablets, Phones for health workers at point of care Web Portal for managers & data stakeholders, anywhere Automated diagnostic interpretation, workflow guidance, data capture Gateway: for data mining, analyzing, reporting; and, for remotely managing health workers

6. Digital Diagnosis: • Consistent, Accurate RDT Results Incubation Timing Interpreting RDT Results RDT Identification RDT Processing QC Digitally analyzing RDT results Auto-detecting RDT make/model Enabling accurate multiple patient throughput Accepting or rejecting RDT processing

7. Capturing Records, Connecting Anywhere Clinical Patient Demographics Easy-to-use Data Entry …via any Android device Custom Health Forms/Surveys Deki Reader Workflow Guidance Deki Tablet Alerts / Messaging Training Deki Phone

8. Health worker connectivity: Remote Configuration/Communication with Deki Deki Management Via Spiri, managers track/administer their fleets of Deki devices: • Locations, activities, configurations, problems, user permissions, alerts, … • Shut down, reset, or group Deki devices • Multidirectional communication for managers and health workers via Deki devices & Spiri

9. Process Improvement: Automated Reporting of Point-of-Care Data Data Reports Reports can be flexibly configured to present data about devices, users, diagnostic results, demographics, surveys, time, geo-location, ...

10. Process Standardization Example: Monitoring service delivery RDT image captured in the record • Managers identify deviations from protocol, correlate diagnostic activity to drug dispensing • Managers track worker activity and performance patterns over time • RDT images are captured and routinely included as part of the record • Managers assess RDT processing skills of healthcare workers and over-read RDTs if necessary

11. Pricing Model • Deki : no capital equipment barrier; rental pegged to usage • Spiri: fee per dataset upload for information services; uploads pegged to usage • “dataset” is the data associated with one patient session, which is uploaded at once • fees organized to fit into existing data budgets… not from diagnostic budget • pricing model designed for sustainability • Purchase order a three-year contract