Digital Health

Enormous opportunities and challenges come with digital innovations that are transforming medical service provision and health services management. Swiss TPH's holds substantial expertise in identifying and implementing digital health solutions, including health information applications for improved health services, health financing, computerised epidemiological surveillance systems, health management information systems as well as digital solutions for training health professionals.

Clinical Decision Support Systems

New technologies are progressively impacting healthcare delivery. In health facilities, point-of-care devices can support clinical personnel in the diagnosis and care of patients. The aim is to provide up to date and adapted clinical know-how to frontline healthcare workers in the form of computerised applications (frequently on tablets or mobile phones). Swiss TPH is specialised in data management and the technical set up of computer readable codes for applications on mobile devices and has rolled out multiple Clinical Decision Support Systems (CDSS). A multitude of Swiss TPH managed projects are based on CDSS methods and technologies. Examples include the childcare enhancement projects in Nigeria and Somalia (ALMANACH), a project to improve healthcare for refugee camps in Chad (SysRef) and an innovative approach on infant care in Tanzania and Rwanda (DYNAMIC).

Insurance Informatics

Swiss TPH's expertise includes health insurance needs assessments, the design of scheme processes and accompanying software specifications, architecture design as well as capacity development and implementation support. An example is the Insurance Management Information System (IMIS), which Swiss TPH designed and implemented in multiple countries to improve the efficiency and transparency of insurance schemes. The system uses mobile phones to optimise insurance processes and forms the basis of the global openIMIS Initiative, where we contribute to the development of an open source solution for managing health financing.

Health Management Information Systems (HMIS)

At a system level, health information tools help aggregate and visualise data, which facilitate decision-making for managers and policy makers. To assist healthcare professionals and managers to register and analyse clinical and health data, and to define an adequate treatment pathway, Swiss TPH and partners have rolled out multiple HMIS for various use cases, such as the monitoring of disease outbreaks, the visualisation of care utilisation patterns or the tracking of utility cost.

Swiss TPH adapts and deploys the popular and versatile DHIS2 open source system. In general, our health information specialists together with clinicians and epidemiologists design health information systems that link to other relevant applications such as Electronic Medical Record systems (e.g. openEMR) and disease outbreak systems (e.g. SORMAS).

Clinical care is increasingly dependent of the availability of medical equipment and devices. These sophisticated and maintenance intensive technologies need to be actively managed in order to operate safely and efficiently. Computerised Maintenance Management Systems (CMMS) constitute the backbone of equipment management and enable inventories and preventive maintenance. Swiss TPH has developed CMMS software (openMEDIS) that enables biomedical engineers and healthcare managers to systematically oversee and manage healthcare assets.

Tools for Integrated Management of Childhood Illness — **SysRef Project in Chad**
Improving the quality of health for refugees and displaced people living in refugee camps through the development and deployment of digital tools in partnership with the Centre de Support en Santé internationale, UNHCR and other partners in Chad.

Dynamic electronic decision trees to manage childhood illness in Rwanda — **Dynamic Project, Rwanda**
Enhancing the quality of care for children in low resource settings by implementing a novel point-of-care electronic clinical decision support algorithm (ePOCT+), connected to biosensors and rapid tests to guide and train health workers in management of sick children.

Tools for Integrated Management of Childhood Illness (TIMCI) — **Tools for Integrated Management of Childhood Illness**
Working with an innovative clinical decision support system in conjunction with a pulsoximeter to improve the screening accuracy and diagnosis of illnesses in children under five in India, Kenya, Myanmar, Senegal, and Tanzania.

ALMAMACH - Improve the Diagnosis and Treatment of Children

The ALgorithm for the MANAgement of CHildhood illnesses (ALMANACH), developed by Swiss TPH, is an upgraded electronic version of the IMCI (Integrated Management of Childhood Illnesses), an initiative that focuses on both curative care and disease prevention. As an innovative application on tablets or smartphones, ALMANACH provides valuable services in regions where healthcare is insufficient or difficult to access. In partnership with the International Committee of the Red Cross (ICRC) and the Adamawa State Primary Health Care Agency, we have been working with ALMANACH in Nigeria since 2016. ALMANACH helps health workers by asking targeted questions during the diagnosis process and suggesting medication for treatment.

From 2016 to 2018, ALMANACH was implemented in 11 health facilities and one hospital in Nigeria. Since 2018, scale-up activities have been initiated. By 2021, ALMANACH was implemented in over 400 facilities. A further national scale up is currently considered by the Federal Ministry of Health.

In September 2020, ALMANACH was launched in Somalia in collaboration with the ICRC and the Somali Red Crescent Society (SRCS) and has so far been implemented in 20 facilities. A further roll-out in 7 clinics in Somaliland and Puntland is planned in the coming months with the Finnish Red Cross and SRCS.