Preprint / Version 1

Using mobile technology to optimize disease surveillance and healthcare delivery at mass gatherings: a case study from India's Kumbh Mela

Authors

  • Dhruv Kazi Department of Medicine, Department of Epidemiology and Biostatistics, and Center for Vulnerable Populations, University of California, San Francisco, CA 94158, USA
  • P Greenough Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, 02115, USA
  • Rishi Madhok Capture Proof, San Francisco, CA, 94110, USA
  • Aaron Heerboth Department of Emergency Medicine, University of California, San Diego, CA, 92103, USA
  • Ahmed Shaikh Maharashtra Government Ministry of Health, Mumbai, Maharashtra, 400102, India
  • Jennifer Leaning Harvard TH Chan School of Public Health, Boston, MA 02115, USA
  • Satchit Balsari Harvard TH Chan School of Public Health, Boston, MA 02115, USA

Keywords:

Kumbh Mela, mass gatherings, mHealth, mobile phones, primary care, tablet, user-centered design

Abstract

Planning for mass gatherings often includes temporary healthcare systems to address the needs of attendees. However, paper-based record keeping has traditionally precluded the timely application of collected clinical data for epidemic surveillance or optimization of healthcare delivery. We evaluated the feasibility of harnessing ubiquitous mobile technologies for conducting disease surveillance and monitoring resource utilization at the Allahabad Kumbh Mela in India, a 55-day festival attended by over 70 million people. Methods We developed an inexpensive, tablet-based customized disease surveillance system with real-time analytic capabilities, and piloted it at five field hospitals. Results The system captured 49 131 outpatient encounters over the 3-week study period. The most common presenting complaints were musculoskeletal pain (19%), fever (17%), cough (17%), coryza (16%) and diarrhoea (5%). The majority of patients received at least one prescription. The most common prescriptions were for antimicrobials, acetaminophen and non-steroidal anti-inflammatory drugs. There was great inter-site variability in caseload with the busiest hospital seeing 650% more patients than the least busy hospital, despite identical staffing. Conclusions Mobile-based health information solutions developed with a focus on user-centred design can be successfully deployed at mass gatherings in resource-scarce settings to optimize care delivery by providing real-time access to field data. Keywords: Kumbh Mela, mass gatherings, mHealth, mobile phones, primary care, tablet, user-centered design

Author Biographies

Dhruv Kazi, Department of Medicine, Department of Epidemiology and Biostatistics, and Center for Vulnerable Populations, University of California, San Francisco, CA 94158, USA

Assistant Professor

P Greenough, Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, 02115, USA

Assistant Professor

Rishi Madhok, Capture Proof, San Francisco, CA, 94110, USA

Chief Medical Officer

Aaron Heerboth, Department of Emergency Medicine, University of California, San Diego, CA, 92103, USA

Resident Physician

Ahmed Shaikh, Maharashtra Government Ministry of Health, Mumbai, Maharashtra, 400102, India

Emergency Medical Officer

Jennifer Leaning, Harvard TH Chan School of Public Health, Boston, MA 02115, USA

FXB Professor of the Practice of Health and Human Rights, Director

Satchit Balsari, Harvard TH Chan School of Public Health, Boston, MA 02115, USA

Assistant Professor, Faculty

Downloads