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TxtAlert

Challenges Entered: 

TxtAlert is an adherence messaging system.   It is an open source mobile technology tool that supports both ART patients and - service providers, to improve adherence to ARV-medication.

•      It supports patients through SMS alerts about their future clinic appointments and offers a free mechanism (called "Please-Call-Me") that allows patients to reschedule appointments,
•      It supports ART service providers through a tracking mechanism that allows them to track when patients have attended and missed appointments or medication pick-up, in an attempt to reduce "lost to follow up".

What challenge is TxtAlert trying to address?

Between 10-30% of ART patients in South Africa are "lost to follow up" each year, meaning that treatment discontinued.   The TxtAlert hypothesis is that patients who do not receive regular check-ups and medication are more likely to a) deviate from treatment programmes, and b) develop drug-resistant strains of the HI-Virus. Ultimately, TxtAlert aims to prove that increasing patient-provider communication and contact will improve treatment adherence over time.

How does it work?

Patients opt-in, allowing for the delivery of messages to remind them of future appointments.   Patients also receive follow-up messages to reschedule if an appointment is being missed.   Meanwhile, clinic staff members are able to monitor trends in attendance through a user-friendly web-based interface.  

What are the benefits?

TxtAlert allows clinic staff to extend patient-provider communication beyond face-to-face appointments.   It reduces the burden on clinic staff by lowering the number of unexpected or not-booked patients, and corresponding administration.  

What's next?

TxtAlert, although piloted with ART, is intended to support any disease management protocol.   Drug resistance due to non-adherence to TB or malaria medication, may similarly be prevented by TxtAlert reminders.   TxtAlert's ultimate goal is to offer adherence support and monitoring across a range of diseases thereby strengthening public health systems as a whole.

Project Details
Project url: 
http://praekeltfoundation.org/products-and-services/txtalert
Supporting organization: 
Right To Care
Project Assessment
Financial support: 
Project has financial support
Sustainability Model: 
This open-source tool is freely available and self-sustainable because it does not require huge maintenance costs.   It can be adapted to suit unique partner needs and the only real cost of using TxtAlert, is messaging.   Should the rescheduling-function be maintained partners might consider appointing a TxtAlert administrator who can phone patients back when they want to reschedule appointments.   Alternatively a   web-based interface can be built and calls can then be monitored and rescheduled accordingly.   Incentives are also popular ways of increasing clinic attendance and might require additional financial inputs from partners.
Expertise needed: 
Marketing/Media Expertise: Current estimations are that South Africa is home to 6 million HIV positive people of whom 470,000 are on treatment at the end of 2008.   This provides TxtAlert with the opportunity to expand its services of support to approximately 5 million HIV positive people, once they start treatment.   Proper marketing of the product and its functionalities is therefore needed to attract more ARV service providers in the public and private sphere, to ultimately increase clinic attendance and treatment adherence.
Technical Expertise: A team of mobile technology experts at Praekelt Foundation has developed TxtAlert.   The base product development is complete and functional.   We also have a roadmap for effectively proving our hypothesis that regular clinic attendance will increase treatment adherence.   The tool however needs further technical development and expertise to put this roadmap in place.
Project goals: 
The project has been successfully piloted at Right to Care's Themba Lethu Clinic, at Helen Joseph Hospital, Johannesburg, since August 2007.   Of the 9438 ARV patients registered at the clinic in November 2008, 9414 have voluntarily opted into TxtAlert.   More than 30,000 visit reminder messages have been sent to patients from April to October 2008.   During this period over 1000 patients made use of the free rescheduling function through sending a "Please call me" message, to change their appointments.  
Identified Obstacles: 
TxtAlert must ideally be to be linked to some form of electronic hospital / clinic appointment booking system.   Our aim is to extend TxtAlert into Africa, but In deep-rural settings where electricity, connectivity and mobile phone coverage are not freely available, the system will struggle to operate at its peak.  
Submitted by Praekelt_Foundation on March 17, 2010 - 5:19pm

Great work!!!!!!!!

Submitted by Leeneck on March 16, 2009 - 3:58am.

Hi I just read through your project and its good work you are doing. I'm also wanting to develop an sMS service in my country targeting students. please go through my project and offer me your help on how can I go about developing such a software to help implement my project. I have pasted link below.

http://www.netsquared.org/projects/eduican-sharing-knowledge

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