DailyDash, a simplified dashboard for daily view of data.

Health workers collect and report data routinely on all their activities. The very people who oversee, deliver services, and collect data are the last ones who get a view of the data they collect in formats that are useful to them. These include frontline health care providers who deliver services and supervisors.  Studies show that very little of this vast amount of information is used by those collecting the data and by local health management at health facility or county levels (WHO, 2007). Ideally, local data should be collected, analyzed, and used to support local health management, health promotion and prevention, and to improve local health service delivery.

Data use for decision making at the facility level remains a challenge due to the lack of simplified tools to attract and motivate health providers to synthesize their data—many providers have turned into data processors hence the lack of ownership. Through the Tools for Integrated Management of Childhood Illness (TIMCI) project, PATH developed a dashboard using tableau software that visualizes sick child case management through digital tool data collected. We seek through this opportunity to visualize the data in a way that is useful for the providers who capture it with the intent of using data for better case management and support to sick children. The TIMCI project is a global effort led by PATH to accelerate the availability, adoption, and scale-up of tools to identify severe illness and decrease mortality in children. With a goal to improve primary health care (PHC) workers’ ability to diagnose moderate to severe disease by equipping them with pulse oximeters (PO) and electronic clinical decision support algorithms (CDSAs) in collaboration with country stakeholders. 

DailyDash, built on the tableau data visualization tool, helps health care providers access, and interpret clinical data generated from health facilities with greater ease, by leveraging a facility based CDSA that the health care providers use to offer treatment and management of children under five years. The providers regularly submit data to the data server managed by the project. This data is downloaded in excel formats and processed through a power query into the tableau dashboard that visualizes several outcomes important to the providers and the project, such as the number of treatment cases per facility, treatment options, diagnosis, and medications provided as well as CDSA use at the health facility.

The published material from the visualization is then shared with the health facility providers and supervisors via presentations and through a portable document format for ease of use. With the online version of the dashboards, supervisors and other project stakeholders can also consult the dashboard and manipulate the visualizations at their convenience through the filter possibilities. The tool can be used on smartphones, tablets, and computers.

Supervisors and stakeholders are most interested in Medal Reader usage indicators, daily device functionality, hypoxemia diagnostic case trends, morbidity distribution, provider acceptance of diagnoses and proposed treatments, and referral rates for severe cases. Health care providers are more interested in consultation data. They have access to the consultation list, which allows them to review case management, and diagnosis trends and to have an idea of drug availability and prescription.

The DailyDash solution was designed to serve PHC providers by monitoring the progress of CDSA use, helping health care providers better understand the epidemiological profile of children under five years of age, and seeing a synthesized picture of the management of sick children. DailyDash also provides providers with information on their use of the algorithm compared to their colleagues in other health facilities. This exercise motivates providers by allowing them to evaluate their performance. The tool enables supervisors to prioritize the providers or facilities that need more formative supervision, which helps maximize resources. Additionally, refining the solution with further user input will improve the provider’s confidence to regularly use, own, interact and make critical decisions. 

In a participative approach, our multidisciplinary team composed of clinicians, public health, and evaluation professionals, human-centered designers, and data specialists, have years of experience working with health data and synthesizing key insights in digestible dashboards. Our team also works closely with other stakeholders such as the ministry of health and local leadership who in turn review and share insights on our data tools. Our co-creation approach ensures engagement and buy-in from key decision makers leading to better sustainability long term.

• County presence with the ongoing TIMCI project, good working relationships with the National Health Ministry, county leadership and health management and facility staff.
• Regular engagements through in-person and virtual meetings.  
• Co-creation approach on concepts and proposals.

We have challenges in the following areas: 

1. Routinization of data analysis in primary health care level.

2. Data ownership.

3.  Decision making for improving management of childhood illness.

We want to refine the solution to address the identified challenges in limited resource settings where the health providers will not depend on research projects or other partner-led interventions but can make their own decisions at any given time.

• Co-created using the actual users i.e., users at the center. 
• Aimed at using minimal resources and run-on existing platforms – HIMS and Microsoft office solutions.
• Implementable and sustainable at lower levels – ownership.
• Makes decision making easy for even lower cadre of staff at the health facility.
• A focus on providers: data led by providers to support providers in their job.

• Improve treatment and management of childhood illness through data use for decision making using simple dashboards.
• Improve decision making at various levels of health services delivery.
• Provides motivation to the health care providers at the primary health care level.

The following indicators will be used to measure progress and impact:

• Proportion of health providers and supervisors with improved capacity to use simple dashboards for data management.
• Percent(%) or the number of health care providers with an easier ability to report accurate quality data. 
• Percent(%) or the number of health facilities with regular data review and sharing for decision making.
•  Percent(%) or the number of health facilities targeted to have supportive supervision through dashboard analysis.
• Percent(%)  or the number of healthcare facilities that have developed action plans from DailyDash.

The solution is currently driven by Microsoft excel and tableau. The simplified solution will be customized to use simple excel format that allows simple data entry and produce simple dashboard that is simple and usable in low resource setting . The visualization will make it to have different color codes that can easily be noticed by health care providers and inform them on necessary actions to be taken and decisions. 

Primary health care providers who are based at health facilities and use clinical decision support algorithms to delivers health care to children.

At PATH, We practice diversity, equity and inclusivity(DEI) within and outside the organization. We a functional department that guides and ensures all the projects at that incorporate DEI in programming. 

Our business model is on donor funding and partnership with governments to improve health equity. We apply for funding opportunities from funders and work with governments to develop and co-create lasting and sustainable solutions.  

Work with governments and build cost share approaches for sustainability.

• Co-funding county governments and co-implement projects as we win off the funding and leave them to continue once they have matured.
• Working on cost shares at projects design that includes sharing of equipment and spaces to implement activities. 
• work with the government staff through training and capacity building to drive activities and interventions.