Handhelds gather health data

Handhelds gather health data

CDC's Joel Selanikio surveys refugees on the Thai-Burma border. Palm III handhelds help him order medicine, supplies and food quickly.

The challenges of poverty, disease and political conflict in the Third World prompted the Center of Excellence in Disaster Management and Humanitarian Assistance to conduct its health research in a small way.

Rather than using notebook PCs to perform tasks such as population estimates, the center chose handheld devices. The handhelds, running specialty applications, minimized the problems researchers had taking large computers into the developing world: unavailability of power, short battery life and carry weight.

The result: The time it took for relief workers to conduct a population estimate dropped from one week to three or four days, and the accuracy of the reporting improved. Handhelds also help relief workers deliver services faster.

'Handhelds allow us to more quickly assess situations, order medicine for disease outbreaks, and order food and supplies,' said Dr. Joel Selanikio, an epidemiologist with the Centers for Disease Control and Prevention, and director of Center of Excellence medical programs.

Based in Honolulu, the center functions as a partnership of the Pacific Command, the Pacific Regional Medical Command, CDC and the University of Hawaii. Its mission is to help prevent and mitigate humanitarian emergencies by conducting research, collecting information and providing consultation to civilian and military agencies.

Recently, the center's workers began using Palm IIIc and IIIxe handheld units from Palm Inc. of Santa Clara, Calif. for nutritional surveys at refugee camps along the border of Thailand and Burma.

Workers conducted the surveys with electronic forms developed using software from Pendragon Software Corp. of Libertyville, Ill., and a custom application.

Vital statistics

Relief workers used to spend an entire day surveying for data such as the number of refugees present, cases of malaria occurring daily and dysentery-related fatalities. Then they would return to base to transcribe field notes into notebook PCs. This could add another six or seven hours to the workday, delaying relief efforts.

Using handheld units, workers question refugees then tap the answers into the handheld forms. Automatic prompts move to the next question.

When workers return to base, they place the Palm in a sync cradle to download the day's data into a PC. It takes five minutes.

Selanikio called the pilot a success. The nutritional survey module is available for download at the center's Web site, at coe-dmha.org, and two newly hired programmers will develop other modules for refugee registration and disease surveillance.

'The plan now is to obtain enough funding to replace paper-based surveying with handhelds in the Thai-Burma area,' he said.

The center also is using handhelds in its work with the Naval Medical Research Unit in Jakarta, Indonesia, and the Indonesian Ministry of Health on the Early Warning Outbreak Recognition System project. EWORS integrates public health and hospital networks to collect information and detect unusual patterns of symptoms and potential disease outbreaks.

In less than two years of pilot operation, the system boasts seven instances of early outbreak recognition. EWORS lets medical planners and public health officials to focus scarce resources, to intervene early and prevent epidemics.

'As EWORS was designed for laptop PCs, it couldn't be implemented in areas lacking electricity and tech-savvy personnel,' Selanikio said. 'Handhelds are being field tested in East Timor, Indonesia, in order to extend the EWORS network.'


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