eHealth Lessons from the Millennium Villages Project

In Uganda, as in many resource-constrained settings, a clinic was worried about the amount of malaria medication they were using – and they were in constant fear of running out. Luckily, they were part of an innovative use of information and communication technology that was collecting health information on all patients seen in the clinic. This system showed that half of the patients who came in and were tested for malaria were still being treated with drugs, even if they tested negative for the disease.

Millennium Villages project

A store in one of the Millennium Villages Project (MVP) clinics in rural Ghana.

The clinic implemented a training program for the medical staff focused on standardized treatment guidelines, and the overmedication declined while the number of tests administered increased – a win-win. They saved a significant amount of money—enough to offset much of the cost of the information system! This was all possible due to an incredible collaboration overseen by Dr. Andrew Kanter, a Columbia University assistant professor in the Department of Biomedical Informatics (DBMI).

Dr. Kanter helped develop the Millennium Village Global Network (MVG-Net), an Open Source platform that is part of the Columbia International eHealth Laboratory (CIEL). The network connects resources and people in 10 different sub-Saharan Africa countries. It works in across diverse languages and situations, from community health workers using mobile phones to storing medical records and creating local knowledge centers. “Most of these countries are using basic paper information systems that just can’t do the job,” explains Kanter. The MVG-Net system offers a much more comprehensive way to store and transmit health information in a timely and resource-efficient manner.

The system links community health workers through a mobile health (mHealth) initiative. It also improves record-keeping at bigger health centers, and can help address emerging infectious diseases by recording and assessing health records in a systematic way. It also is able to parse the language of medical terms in different countries ensuring interoperability and seamless integration of different information systems– so far, the medical concept dictionary contains more than 49,000 diseases, procedures and medications in multiple languages, all mapped to international standards. “The dictionary allows health workers to pull from a corpus of concepts that are being used around the globe,” says Kanter. That makes it easier to share and understand and evaluate data from anywhere – via the web, mobile phones and various types of software.

“We definitely think that this project is helping to pave the semantic highway — providing a common infrastructure for resource-poor settings to innovate and build success stories for their own countries in a way that’s sustainable and also in line with international norms,” he says. Having an open-source project is especially useful, because anyone around the globe can create a module and share it.

For example, the project was also able to take an open source immunization management system (EzVac) from New York Presbyterian Hospital and plug it into the MVG-Net platform in Tanzania with minimal effort.

The technology is not only connecting people across the world. It also brings allows Columbia to play a seminal role in the movement to support innovation, and provides a home for academic training for students and faculty interested in global health informatics. “It’s not enough to simply create systems – someone needs to look at data and learn from them,” says Kanter. The clinic in Uganda and the Immunization program in Tanzania were able to save money and improve care thanks to locally-grown platform supported by a large international community and an academic department thousands of miles away.