On July 18, the SHOPS Plus team in Nigeria launched a new Android application for tuberculosis screening and tracking for accelerated referral and reporting: TB STARR. Since the launch, which took place at the National Tuberculosis Conference in Abuja, the application has gained 240 users and been downloaded more than 330 times.
The purpose of the app is to help increase tuberculosis case detection and enrollment in treatment through improved screening, documentation, and referral practices in the private sector. It has the potential for rapid scale and high impact in the fight against tuberculosis.
In Nigeria, the standard paper processes for screening, sputum sample collection and testing, and referral between clinical facilities is cumbersome and can result in delays in decision making, follow-up, and care. To address these challenges, SHOPS Plus developed the application to replace paper forms with a more efficient digital platform and support the reporting needs of clinical providers such as doctors and nurses, laboratory scientists, pharmacists, and patent and proprietary drug vendors.
The project partnered with Every1Mobile, a digital solutions design firm with experience designing tools for drug shops in Nigeria. Together, they worked with the National Tuberculosis and Leprosy Control Program, private providers, and other stakeholders in a user-centered design approach to identify bottlenecks and ensure that the application was responsive to the specific workflows and processes of each type of provider. As a result of this collaboration, the TB STARR app has a specially designed interface for each provider user type based on their needs.
A few key functions are the same no matter which type of provider is using the app. The first is a simple screening checklist of symptoms. If a client indicates that they have any of these symptoms, the provider will be alerted that the client has presumptive tuberculosis and will be prompted to collect further information. At that point they will either take a sputum sample for testing and diagnosis or refer the client to a higher level facility for care and treatment. Clinical providers who are in a shared network, such as the community-based private provider networks SHOPS Plus set up, can share client data across facilities, alerting facilities of referrals and reducing duplication.
Another feature that is shared across all user types is a “My Clients” database. Through this database, providers can review records for clients that they screened, referred, or otherwise interacted with. In addition, all user types have a simple dashboard that they can use to track their facility’s cascade of care, such as the number of clients that they have screened, the clients that are presumptive, the clients that are confirmed, and the clients that have been referred on for treatment. The system comprises a more comprehensive database and dashboard, called the TB STARR Data Portal, designed to consolidate data collection and analysis across all TB STARR users for the national and state tuberculosis programs.
The application, which currently consists of an independent provider user type, is currently available in the Google Play store. Other features and functionalities that are in process or planned for the application include text notifications to clients about referral, test results, and other key information; payment of airtime and mobile banking incentives to high-performing clinical providers; and integration with other tuberculosis information systems in Nigeria.
The team will launch the networked clinic, laboratory, and pharmacist or patent and proprietary drug vendor user types in September. Once all user types have been launched, rapid cycle user testing and revision will begin.
Listen to a podcast with SHOPS Plus Regional Manager for Nigeria Elaine Baruwa talking about defeating tuberculosis in Nigeria.