Auxiliary nurse midwives Vidya, Shoba, Meena and Molly training with their Ca:sh handhelds.
Ca:sh (Community Access to Sustainable Health) is a Media Lab Asia project for investigating how information technology can be used to improve rural healthcare in an economically sustainable manner. This web site has been set up to support continued development of a medical informatics software package that is currently being used in a pilot study outside New Delhi, India.
The Ca:sh project targets primary healthcare workers in Indian rural areas. Each of these workers monitor and manage the health of several thousand people every month. Their responsibilities include infectious disease management, prenatal care, family planning education and immunizations. Unfortunately, these tasks are made very difficult by the complete lack of accurate and accessible medical records for the majority of the rural population.
High-quality healthcare is dependent on high-quality information about the patients and their communities. Using handheld computers, the Ca:sh project provides health workers with an efficient data collection tool and instant access to patient records during home visits. Updated patient information is exported to removable storage cards, and sent to the nearest healthcare clinic for analysis and archiving.
Using off-the-shelf hardware and freely available software, the Ca:sh project provides a mobile medical record system to rural healthcare workers at a cost of less than 25¢ per patient per year.
The initial Ca:sh software was developed by three former MIT students (now Dimagi) in collaboration with AIIMS staff. Four female healthcare workers in the Ballabhgarh area outside Delhi have been using the system to manage over 30,000 patient records since February 2002. Since then, Media Lab Asia staff has developed interface improvements and additional features in response to feedback from the healthcare workers. In addition, six more healthcare workers are being trained in using the handheld computers. Eventually, more than 80,000 patient records will be handled by the system.
The Ca:sh software is a Linux-based Qt/Embedded application for the entry and retrieval of demographic and medical data. An embedded MySQL database is used for data manipulation and storage. The software is currently deployed on Compaq iPAQ handheld devices. However, alternative low-cost platforms, such as the Simputer and the Palm, are being evaluated for use in large-scale implementations.
The initial success of the Ca:sh pilot study has inspired several related projects: The Delhi-based Centre for Spatial Database Management & Solutions is integrating their mobile GIS-solution GramChitra with the Ca:sh software to provide spatial data collection capabilities. In the US, the Harvard Decision Systems Group is integrating a rule-based expert system with Ca:sh to provide instant feedback and medical advice in the field. The same group, funded by the Fogarty Foundation, is also in the process of adapting the Ca:sh system for use in Brazil.
For more information about the Ca:sh project, please write to kaash-request@media.mit.edu
The Ca:sh system was demonstrated at the American Medical Informatics Association 2002 Annual Symposium.
This manuscript gives a high-level overview of the Ca:sh project.
Project Page News and general information CVS Tree Get the source code here Documentation Current manuals and white papers
Dr. Vishwanath Anantraman MIT, Dimagi Reshma Khilnani MIT Ramasubramanian Krishnamurthi Media Lab Asia Vikram Kumar Harvard Medical School, Dimagi Tarjei Mikkelsen Dimagi
Prof. K. Anand AIIMS Prof. S. Kapoor AIIMS Prof. Lucila Ohno-Machado Harvard Medical School Prof. Alex (Sandy) Pentland MIT Media Lab, Media Lab Asia
| Last updated December 4, 2002 |
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