1. MHIS – Port Elizabeth a collaborative project to extend health information to the point of care

2. Mobile Health Information System 1.identify need 2.identify content to meet need 3.identify delivery device 4.identify delivery service 5.train users 6.train support system 7.evaluate impact

3. does access to quality health and medical information at the point of care improve practice? can we make the provision of quality information at the point of care affordable, accessible and relevant? do cell phones provide a viable option for the delivery of content for use at the point of care ? will nurses use information on a cell phone to improve their work? Study questions:

4. Put a mobile library of local and international content on a cell phone and update that content regularly; allow nurses to access other content via the web and email; cap monthly usage (costs).

5. Needs assessment conducted – over 700 responses – top issues: extreme multiple drug resistant tuberculosis (TB) (76.4%) HIV/AIDS (72.8%) multiple drug resistant TB (72.1%) ARV (71.2%) PMTCT (53%) non-communicable diseases/ chronic diseases of lifestyle (52.2%) STIs (43.4%), Malaria (42.6%), public health legislation (40.4%)

6. guide server updates and new content nurses access: content web email sms voice

7. Clinical content identified, packaged (GUIDE) 50 PEHC nurses trained IT dept staff trained Refresher training Tech/User Support - 3-tier model (peer-to-peer, - weekly meetings, IT support, MTN and ADE-SATELLIFE)

8. Content converted to mobile format and organized for ease of use

9. Evaluation (Conducted by NMMU, Nursing Sciences Department – Dr. Ricks et al) 73% of nurses aged 45-60 years 68% with little or no computer training

10. 89% reported improved nursing practice through information access

11. 81% found it extremely easy to easy to find and read content on the mobile device

15. cost elements: smart phone air time training content conversion local server and internet access evaluation program management 100% will continue to use cell phone post project 92% said it was helpful to carry the phone to access content while at work 92% would be willing to buy their own phone 82% felt their practice improved

16. Partners: AED-SATELLIFE Port Elizabeth Hospital Complex South Africa Partners Qualcomm Department of Health for the Eastern Cape Nelson Mandela Metropolitan University MTN-South Africa

17. Health care workers want and use content to improve decision making Cell phones are viable delivery tools and the cell network can deliver customized content Next Steps: 1.Expand to the full province 2.Use cell phones to collect data and provide continuing education, job aids and reference tools hladd@aed.org