In this project, contracted clinics treat patients in exchange for vouchers, which are returned to the disbursement agency, along with a paper claim, for reimbursement. This “output-based” form of aid is intended to address skewed incentives by reimbursing clinics for services provided rather than services expected (see ICAS background paper). However, this approach is information intensive, and while the incentive structure is improved, the administrative overhead is increased. Furthermore, limitations in physical and communication infrastructure result in healthcare providers and management staff feeling discouraged by lack of feedback from the head office. Poorly filed paper claims result in disbursement delays and lost income. In addition, rural clinics face unreliable power and minimal security. In this context mobile phones offer a viable computing and communications platform for data management.

Clinics reside in a vast information ecosystem, interacting with Ministry of Health (reporting outpatient statistics via regular HMIS reports), Joint Medical Stores (resupplying pharmaceuticals), a variety of aid agencies, health insurance companies, patients, and others. By introducing a smartphone and web-application system for submitting and reviewing claims, we hope to reduce the delays and errors, increase clinics’ profitability and improve communication. ClaimsMobile has two main components, a mobile phone for use in the clinics to manage and submit electronic claims, and a web application, which receives the claims from the clinics and serves as the main user interface for the management staff. In addition to improving health information management in clinics and communication between the clinics and the management agency, the use of ClaimsMobile will also enable the project to scale over larger geographical areas by providing a reliable data distribution and collection mechanism for both financial and health information.

In addition: Since 2006, Ben Bellows (MPH, currently pursuing a PhD at UC Berkeley School of Public Health) has worked with partners at Mbarara University of Science and Technology to evaluate the population impact of contracted healthcare in the region with funding from the Global Partnership on Output-based Aid (World Bank) and the German Development Bank (KfW).

Melissa R. Ho (B.A., M.Sc. Computer Science, currently pursuing a PhD at the UC Berkeley School of Information) is currently running a feasibility study for mobile phones claims reporting. A pilot project will begin in early 2009 with the involvement of 10 clinics and the voucher management team at Marie Stopes International. She has previously implemented the Ghana Consultation Network, a distributed delay tolerant web application for medical tele-consultation, and participated in the deployment of long distance wireless networks for the Aravind Eye Hospital telemedicine network in India. Prior fieldwork includes the study of information practices and information technology use in health clinics and hospitals in Ghana, D. R. Congo, and Uganda.

Terry Lo (MPH, currently pursuing a DrPH at UC Berkeley School of Public Health) has worked with partners in Bangladesh, India, Kenya and Nigeria on disease surveillance and health professional training (and be sure to check out the excellent photos in his country links).

Locations