...we are just creating a basic J2ME implementation; we know it's not going to run on every cell-phone platform, but we are aiming to make sure it runs on some devices that are sub-$100 devices. We will probably come up with a list of 10 devices it's designed to work on, which will include some low-end devices and some high-end.
Have you come up against any handset manufacturers or operators that are not willing to open up their systems or share information for this kind of project?
At the moment we haven't, but it will be interesting to find out in the next year or two if that happens. At the moment, we are aiming to have a field-testable instance of the first J2ME-based version of EpiSurveyor ready for spring. I am not sure what the position of mobile operators and handset manufacturers will be but, if we work with the J2ME standard, there are many phones that are closer to standards than others and will run the J2ME implementation.
So what phase is EpiSurveyor in at the moment — trial phase?
No, it's not in trial phase. It's in its implementation phase and I think the distinction is important. We went through a beta testing phase where the application simply didn't work, but thank heavens for our extremely long-suffering team of beta testers in the Ministry of Health in Kenya, who were able to pore through that software and spot the problems.
Once we had got the major bugs sorted out, we spent a year in Kenya and in Zambia, actually collecting data for public health. During that time we were able to re-work out training materials and hone the software to add the many features that people suggested from actual field use.
We have now moved in our current phase where we are working with WHO, to roll EpiSurveyor out along with mobile devices to regional health officers in sub-Saharan Africa. We have already rolled out to a lot of countries and will do another 10 this year. There are about 40 countries in sub-Saharan Africa and we are not quite to the halfway point.
Is EpiSurveyor the only application of its type out there? There must be proprietary alternatives.
There are other platforms such as Pendragon Forms, and I have used it before, but it is not inexpensive. However, I was using that back in 1997, but almost 10 years later I would still estimate that 95 percent or more of public health data in developing countries is collected on paper. So with EpiSurveyor we were trying to answer the question of why, if these mobile platforms are better than paper and have been around for such a long time, more people aren't using them.
One of the answers is complexity: if you had to program every time you sent an email, how many emails would you send? With public health data collection on these mobile devices, the problem is that commercial platforms are of such a complexity that is above the capability of many public health workers. Pendragon Forms, for example, is not at the level of using Microsoft Word or Excel.
How is EpiSurveyor making a difference right now?
One of the examples I use all the time is Zambia, which is one of our pilot countries for this particular roll-out. In Zambia they have been trying to implement a programme to find out the quality of care being delivered at clinics. They have been trying to do that for years, but again it's very difficult if you collect the data and then it takes six months to enter the data into a computer from your paper forms.
Using a PDA decreases the lag down to a day, from data collection to putting it in the hands of people who can understand it. They have now discovered things such as 40 percent of clinics in Zambia were missing essential malaria treatment medicine.
I think people who have not been involved in field studies don't understand how hard it is to know anything in the developing world: how many kids are attending schools, the HIV prevalence rate; all these different things. Now we have taken a very difficult thing, the actual mechanics of manipulating paper and doing data entry, and made it in an effortless process.
If the team that wants to do data collection doesn't have fuel for the vehicles, then EpiSurveyor is not going to help with that, but it does decrease what I see as the activation energy necessary to go out and collect data. So it's not just improving an old methodology, but they are going out and doing surveys that they simply wouldn't have done before.
