Applications for Sana
Physical Diagnosis
Built on the Android platform, Sana allows nurses to transfer not just text, but also media such as images remotely. For example, the diagnosis of dermatologic conditions relies heavily on the physical appearance of the skin lesion. Real-time transmission of a good image of the lesion (rather than verbal description provided by a less trained healthcare worker) can bring dermatology expertise to a rural area.
Cervical Cancer Screening
Cervical cancer is a leading cause of death from cancer among women in resource-poor countries. Around the world, a woman dies of cervical cancer every 2 minutes. It is one of the few cancers with a long preclinical phase. Therefore, screening programs aimed at detecting and treating precancerous lesions reduce the number of cases that require treatment. Single visit screen-and-treat approach using visual inspection with 4% acetic acid (VIA) and early treatment with cryotherapy have been shown to be feasible, low-cost, and effective in reducing cervical cancer incidence and mortality in resource poor regions. However, lack of expert overview over screening in such regions leads to long lead times, and a loss of the opportunity to treat many patients. With Sana, health workers can acquire patient data and send back images of the cervix to a physician that can then remotely dispense a diagnosis. Even if the physician is hundreds of miles away, this response may arrive back to the health worker just minutes after sending the patient data to the Sana server. The health worker can then proceed with cryotherapy, if necessary, to treat the precancerous lesions.
Childhood Sickness Diagnostics
Each year, almost 7 million children under the age of five die due to conditions that could have been prevented by low-cost treatments. The World Health Organization and UNICEF have developed a set of standardized procedures for diagnosis and treatment called IMCI. Sana supports running protocols such as IMCI directly on the phone. This allows health workers to run through a set of step-by-step procedures to effectively treat the child.
Skin Condition Diagnosis
The diagnosis of dermatologic conditions relies heavily on the physical appearance of the skin lesion. Real-time transmission of a good image of the lesion (rather than verbal description provided by a less trained healthcare worker) can facilitate leveraging of dermatology expertise to areas where they are not available.
Follow-up after Surgery
Patients are required to see their surgeon for the weeks following surgery to make sure the surgical wound is healing without infection. Patients who live in remote areas usually forego these follow-ups because of the hassle involved in traveling to the hospital. As a result, those who develop wound infections later become far more problematic to treat. With our clinical system, these patients can just follow-up in their local rural health clinic and have photos taken of their incision wound. The photos are sent to the surgeon accompanied by some clinical information. If an infection is diagnosed, the patient can either be started on antibiotics or referred back to the hospital.
Emergency Response
Evaluation of Motor Vehicular Crash Scenes
First responders arrive at the scene of motor vehicular crashes and call for an air evacuation unit if the patients require urgent surgery or specialized care. Novice first responders are sometimes unable to accurately describe the status of the patients. A video or images of the patients and the scene of the crash will assist the air evacuation unit with such decisions as whether to bring type O negative blood, seniority of the personnel to send, etc. Sana is specifically designed to allow such an interaction. This set-up will be very helpful in countries with limited resources in situations where triaging is required when two or more crashes occur simultaneously within an area.
Sana Benefits
Sana is uniquely capable in several applications. Some of the key benefits that Sana provides are:
On-the-spot Screening
On-the-spot interpretation of test results is key in order to avoid patients being lost to lack of follow-up. Sana makes this possible by transmitting the results to a physician who can interpret the results while the patient is still with the nurse. This approach can be useful in screening for breast cancer, high-risk obstetric deliveries, cervical cancer, and cataract surgery just to name a few.
Specialty Clinic Follow-up
The above approach can address the very limited reach of specialists who are often confined within a few large cities in developing countries. Follow-up of chronic conditions that may require technology not available in remote areas will be made easier with Sana and remote real-time access to specialists. For example, follow-up of patients with multi-drug resistant tuberculosis can be assisted by periodic chest x-rays. Sana can assist the automatic upload of the x-ray into the electronic medical record and simplify data capture.