Infectious Diseases Tracker For Uganda

Empowering Uganda's clinicians to improve management of patients with infectious diseases and proper use of antimicrobials through Artificial Intelligence and data science.

The primary Investigator is Associate Professor Annabella Habinka Basaza. She is the head of Faculty of Information Systems and Technology at King Ceasor University and Mbarara University of Science and Technology

Infectious diseases and antimicrobial resistance poses a massive global economic burden. While significant data on infectious diseases have been collected from patients in developed countries, there is considerably fewer data from developing countries.

Contemporary description of demographics, socioeconomic factors, comorbidities, current management protocols and contemporary understanding of infectious diseases is required. 

An assessment of barriers to care at patient and systems' levels, their impact and outcomes, has not been well documented and such information is vital to overcoming gaps to evidence-based care in all settings.

In Uganda, the above challenges are complicated by dire shortage of healthcare workers, such that even if medicine is available, it is often a hurdle for patients most especially from rural communities to reach certified physicians who can arrive on a right diagnosis and prescribe a right medication. 

The above situation has forced massive population to go and buy medicine from nearby community dispensaries without knowing the right diagnosis of their condition hence increasing the chance of being given a wrong medication.

Wrong prescription results into poor prognosis of the underlying condition, increased morbidity and mortality rates, waste of resources (medicine) and has led to an increased burden of antimicrobial resistance.

Large employers who offer preventive and healthcare monitoring plans to employees, as part of the employment benefit package [e.g., MTN, Shell, Total energies, Airtel]. For patients with infectious diseases, a software as a service model (SaaS) will provide treating physician access to the patient monitoring portal that will use the Tracker intelligence to personalize management. 

Another strategy intended to ensure sustainability, will showcase the comprehensive infectious diseases management model to Uganda’s insurance plans [e.g., Jubilee Insurance, UAP Old Mutrual, Liberty Insurance, etc] demonstrating personalized patient risk management reduction, re-admissions and hospital stays, resulting in reduction of the healthcare 

TRACKER Established. This will:

§  Secure access to vast amounts of heterogeneous data and cloud computing resources.

§  Enable semantic enrichment & interoperability between live population cohorts and electronic health record (EHR)

§  Facilitate interactive, real-time, and explorative data-science and data-analytics tasked to answer Reporter topics of interest, categorized into:

a.     Operational clinical care [management, care coordination, access]

b.     Capacity building needs [intellectual and infrastructure]

c.      Discovery and innovation [address identified clinical and infrastructure gaps (see a, b above)]

d.     Education & Training [identify and address education and training needs].

2.     Tracker Developed and deployed. This will:

Facilitate delivery of a unified hybrid solution which integrates:

 (a) Explainable AI. The Clinical Reasoning Framework (an adaptation of the ontology theory and multi-dimensional data analysis) is a methodology that allows the conversion of evidence-based guidelines and practice of care principles into a machine-usable, no-gap & no-overlap rules engine. It provides a suggestion for each drug class, with direct traceability to its original evidence-based guideline. 

(b) Future-adaptable methodology. Updates to the clinical guidelines can be easily integrated.

 (c) Object-oriented/Linear Programming. This approach allows for prioritizing and sequentially computing each drug class’ impact, while keeping track of the predicted effect of the overall treatment.  

Clinical benefits: Improved disease management of patients with infectious diseases

The clinical impact of Tracker will extend to improvements in Uganda healthcare systems for the management of other chronic non-communicable diseases such as COPD, diabetes, and cancer which together with cardiovascular diseases such as HF, account for 70% of morbidity and mortality worldwide [Oktay, 2013]. This will be accomplished through translation and extrapolation of the Tracker in other healthcare domains beyond infectious diseases . 

  Patient benefits: Improved QoL

Tracker will dramatically enhance the poor quality of Life (QoL) of infectious diseases patients, which according to Oktay et al. is similar to patients with end-stage renal disease [Oktay, 2013].  This significant improvement in QoL will be achieved through increased patient comfort resulting from less medication side effects and improved treatment efficacy due to personalized medical therapy. 

  Societal benefits: 

The productivity of clinicians managing the care of patients with infectious diseases will be increased due to more precise and personalized patient stratification and diagnosis, as well as more optimal therapy selection. 

At economic level:

 Improved treatment efficacy will result in fewer unplanned hospitalizations, which account for 70% of the cost burden of patients with infectious diseases [Dunlay, 2011; Savarese, 2017]. 

Tracker business model Established.

The benefits of a personalized medicine approach have been recognized. Variation in how patients are diagnosed, treated and monitored; variation in the costs of diagnostic tests and treatments; and variation in the real-world accuracy of diagnostic tests and the real-world effectiveness of treatments must be considered. 

These factors have to be included in order to estimate the potential cost-effectiveness of a new approach like Tracker. Therefore, we will conduct Uganda's-specific cost-effectiveness analyses of the Tracker using country-specific information.

Tracker will approach sustainability differently. The Hub will integrate commercialization models that target country-specific large employers who offer preventive and healthcare monitoring plans to employees, as part of the employment benefit package [e.g., MTN, Shell, Total energies, Airtel]. For these patients with infectious diseases, a software as a service model (SaaS) will provide treating physician access to the patient monitoring portal that will use the Tracker intelligence to personalize management. 

Another strategy intended to ensure sustainability, will showcase the comprehensive infectious diseases management model to Uganda’s insurance plans [e.g., Jubilee Insurance, UAP Old Mutrual, Liberty Insurance, etc] demonstrating personalized patient risk management reduction, re-admissions and hospital stays, resulting in reduction of the healthcare 

Success shall be measured by the number of partnerships with our clients (patients with infectious diseases), collaborating physicians, large employers' organizations and insurance companies 

Financial barriers; Insufficient capital to establish cloud infrastructure.

Technical barriers:– inadequate internet connectivity is one challenge that increases the systems operational cost.

We hope Trinity Challenge Fund will enable us to tackle the above challenges.

The funding from Trinity Challenge will provide an unprecedented opportunity to mature and structure healthcare data science efforts in Uganda.

 Tracker Hub will sustain and scale-up the founding goal through technology adoption and commercialization, training activities, expansion of the collaborative network, and scalability into additional geographical regions as well as high-impact conditions beyond infectious diseases.

Mbarara University of Science and Technology. A team from the department of Computing and informatics will offer technical support while establishing the cloud infrastructure.