BACKGROUND AND IMPORTANCE
INDONESIA and Covid-19 tracing system
In the early days of the virus, when there were only a few cases, contact tracing could be done manually. With hundreds to thousands of cases, early detection and contact tracing has become much more difficult. With increasing smart phone use and widening of Internet access in rural Indonesia, an innovative mobile technology could be one among a variety of means to enable effective early detection and contact tracing for COVID-19.
In the current absence of medical treatment and vaccination, disease prevention and mitigation analysis have become essential aspects in tackling the COVID-19 pandemic. Early detection, contact tracing and case isolation are crucial parts for controlling infectious disease outbreaks.
With the development of the infection into hundreds to thousands of cases, early detection and contact tracing has become much more difficult to be done manually. Therefore it is needed to develop an efficient and effective early detection and contract tracing system for COVID-19, particularly in rural Indonesia.
This current project is designed to develop and establish an innovative, multifaceted mobile technology-enabled primary care for the prevention and mitigation of the spread of COVID-19 pandemic in rural population in Indonesia through the SMARTHealth COVID-19 system.
What is SMARTHealth Covid-19 System?
Since 2016 we have developed an innovative multifaceted mobile technology to control the cardiovascular disease (CVD) risk in rural Indonesia, namely the SMARTHealth Cardiovascular. SMART (Systematic Medical Appraisal, Referral and Treatment) health is a smartphone-enabled ecosystem that aims to improve the delivery of high-quality essential primary healthcare to the communities. Built on our collaborative work involving researchers from Universitas Brawijaya, University of Manchester and The George Institute Australia the SMARThealth technology was designed to enable effective screening and collection of essential health-related information, to inform the subject of their risk status, to provide lifestyle advice for the prevention of CVD, and to refer high-risk patients for nurse or physician consultation. SMARThealth supports the provision of preventive care in the community by strengthening existing health systems. It draws on the principles of “task-sharing” whereby many routine clinical procedures are transferred from doctors to non-physician healthcare workers in an effort to increase access to healthcare and to reduce health costs. This is facilitated by a suite of innovative and affordable digital technologies, which were developed to provide evidence-based decision support for both the providers and consumers.
One of the key success factors of SMARThealth innovation is the multifaceted mobile technology platform, which is able to facilitate community health workers (kader kesehatan desa/Posyandu) to reach 90.6% of the target population. Most of the high-risk individuals identified by SMARThealth programme had at least one clinical follow-up visit. The intervention can reach the most needed individuals (i.e., poor, older individuals and women in the villages) who have the least access to primary health services. The SMARThealth mobile technology allows community health workers to collect essential health-related information, inform the subject of their risk status, provide lifestyle advice for prevention, and refer high-risk patients to the community nurse or medical doctor to get medical advice. With our experience in developing SMARThealth cardiovascular system to design a mobile device–based Clinical Decision Support Software (CDSS) for COVID-19 risk management by incorporating SMARThealth Covid-19.
National Priorities and Technology Readiness Level (TRL)
COVID-19 has been declared as global pandemic by WHO on March 11th 2020. It affects most countries worldwide including Indonesia and UK. There are >7 million Covid-19 confirmed cases reported globally with >400K deaths. Indonesia is one of the worst affected countries in Asia with 34,316 confirmed cases including 1959 deaths (as of 10 June 2020) and the number of new infection and covid-19 deaths are still rising. It is clear that this pandemic causes a huge burden to health service systems, the global economy and civil societies. Therefore, we believe that this project strongly matches the national priorities (both Indonesia and UK) in tackling this disease.
The SMARTHealth technology has been developed and implemented in several countries including Australia, India, China and Indonesia [5, 8-11]. The successful implementation of this technology (i.e. the SMARTHealth Cardiovascular] in Indonesia has been documented (see references [5] and the description of the award from The Ministry of Health in the annex). Based on the description above, we believe that the SMARThealth technology is at the TRL 9 following the EU TRL scale (TRL9: the actual system is proven in operational environment).
