IT not a silver bullet for health

By Paul Vecchiatto, ITWeb Cape Town correspondent

Cape Town, 11 May 2005

An evaluation of a pilot study examining the use of SMS reminders to help TB patients take their medication says technology is not a silver bullet to solve the adherence problem.

The evaluation was recently completed by ICT non-government organisation Bridges.org, of the SMS notification services developed by Cape Town-based SIMpill.

The company conducted a pilot programme over an 18-month period with about 1 100 TB sufferers who were outpatients at the Chapel Street clinic in the city centre.

Bridges.org says the study unearthed important issues around technology use in primary healthcare - shedding light on the practical realities of the developing world context.

It says that over the long-term, innovative technology uses like this are likely to play a critical role in the roll-out of treatment for HIV/AIDS and other diseases in the developing world.

However, Bridges.org notes they will only make a difference when patients and healthcare workers embrace new systems and implement them effectively at ground level.

SIMpill MD David Green says patients' non-adherence to their prescriptions is a major problem, adding significant costs to the health sector.

"An epileptic seizure could easily cost R7 000 a time in the private sector with ambulance fees, hospitalisation and a battery of tests included," he explains.

Green, who is a medical doctor, says his company charges the City of Cape Town R13.80 per patient per month for its reminder service, and while costs could come down slightly in terms of volume, there will still be the costs of protecting a patient's data and the scheduling of the individual reminders.

His company has also completed a similar pilot with the Durban City Council, where 3 000 patients were put on the SMS alert system.

SIMpill's system operates off the FreeBSD operating system, which Green describes as "Unix-like" and uses the MySQL database and runs on an Apache server.

The company's other product is a GPRS-linked medicine-dispensing bottle that Tellumat manufactures on a consignment basis. The bottle alerts a server when it is opened. Reminders are sent to patients if the bottle is not opened at certain times. Green says orders have been received for the bottle from the UK, Belgium, Italy, Australia and the US.