Lessons from the Evaluation of a Clinical Decision Support Tool for Cardiovascular Disease Risk Management in Rural India
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The rise of chronic disease and failure in the implementation of adequate prevention strategies places a heavy burden on the health systems of low- and middle-income countries. Despite vast interest in mobile health (mHealth) technologies, there is a lack of evidence for the clinical impact and scalability of mHealth tools for managing chronic diseases in a resource-constrained setting. This paper outlines the development and field evaluation of an mHealth solution in the form of a clinical decision support (CDS) tool. The CDS tool was tailored for use by healthcare providers within a primary care setup in rural India to perform screening and management of cardiovascular disease (CVD) risk. The CDS tool was designed prior to, and during an agile development phase that comprehensively engaged end-users namely primary health centre (PHC) physicians and rural non-physician healthcare workers (NPHWs). Lessons learnt from a pilot implementation are presented to help inform strategies for large-scale evaluation of mHealth technology in resource-constrained settings.
KeywordsClinical Decision Support User Centered Design Android Application Clinical Decision Support Tool Blood Pressure Device
This project was funded by the National Health and Medical Research Council (NHMRC), Australia, under the Global Alliances for Chronic Disease Grant (ID1040147). Arvind Raghu is funded by the Wellcome Trust/EPSRC Oxford Centre for Excellence in Medical Engineering (grant number WT 088877/Z/09/Z), University of Oxford. Devarsetty Praveen is supported by the Australian Agency for International Development (AusAID). David Peiris is supported by a NHMRC post-doctoral fellowship (ID 1054754). The authors wish to thank the support of the Sanamobile development team, especially its lead software developer Eric Winkler.
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