D-tree International, Inc

Our Organizational Vision is a world in which every person has access to high quality health care. Our Mission is to develop and support electronic clinical protocols that enable health workers worldwide to deliver high quality care. Our work focuses on the delivery of decision support to health workers in both health facilities and in the community. This decision support, running on mobile phones, takes the health worker step-by-step from a presenting problem to a clinical assessment and recommended action or treatment. In the case of acute illness such as acute respiratory infection, it prompts for information leading to a diagnosis and then suggests a treatment based on available drug...

D-tree International, Inc
52 Whitney Tavern Road
Marc D Mitchell
Weston, MASSACHUSETTS 02493
United States
617-432-6322
http://www.d-tree.org/

President

Marc Mitchell

Mission

Our Organizational Vision is a world in which every person has access to high quality health care. Our Mission is to develop and support electronic clinical protocols that enable health workers worldwide to deliver high quality care. Our work focuses on the delivery of decision support to health workers in both health facilities and in the community. This decision support, running on mobile phones, takes the health worker step-by-step from a presenting problem to a clinical assessment and recommended action or treatment. In the case of acute illness such as acute respiratory infection, it prompts for information leading to a diagnosis and then suggests a treatment based on available drugs, age and weight of the patient (if a child) and local policies. For preventive care such as antenatal care, it presents a list of things to check for and based on these inputs suggests further action such as referral or when to come back for another appointment. In all cases the record of the visit can be stored and used for subsequent visits to track weight, blood pressure, etc.

Programs

For Community Health Workers 1. In Tanzania we are working with UNICEF and Jhpiego on the development of antenatal, neonatal, and post-natal protocols for use at both the clinic and community level. This project incorporates the ability to link patient data between clinic and community to provide a continuum of care for women and their newborns. 2. In Zanzibar (Tanzania) we are working with the MoHSW and UNICEF to support health workers at both the clinic and community level working with malnourished children. This project tracks the children as they progress from being acutely malnourished to improved nutrition. We have recently gotten funding to scale this application to be the standard approach to the treatment of malnutrition for all of Zanzibar. 3. In Zanzibar (Tanzania) we are working with the MoHSW and Zantel, a telecom company on a project to reduce maternal deaths for women who deliver at home. This project, funded by the Bill and Melinda Gates Foundation provides support to community based midwives when women delivery at home but need urgent referral to a hospital. The protocol includes (a) an algorithm to identify danger signs during labor and delivery; (b) cell phone numbers of local vehicle owners who can transport the patient in an emergency; (c) money to pay for transportation using phone based banking; (d) recorded permissions from husband, mother in law, and others needed to transport mother and infant in case of emergency; and (e) phone call to referral facility indicating emergency transfer and what will be required on arrival. 4. In Malawi we are working with Catholic Relief Services to improve the quality of care at the community level by providing support to community health workers (CHWs) assisting orphans and other vulnerable children. 5. In Malawi we are working with Catholic Relief Services and the Ministry of Health to develop electronic IMCI protocols for use by CHWs. This project is about to be expanded to more regions in Malawi. 6. In Tanzania we are working with Pathfinder International to support their CHWs to provide home-based care for People Living with HIV/AIDS. We have 300 CHWs who serve over 3,000 patients using the mobile phone-based applications which include TB screening, home-based HIV counseling and testing, family planning protocols for use at the community level. We have also introduced an application that sends an SMS alert to the CHW and supervisor if there are patients who have not been visited in a month. 7. In India we worked with CARE on the development of antenatal, neonatal, and post natal protocols for use at the community level. Patient data is linked to a server and used for quality improvement, support of community health workers (ANMs and ASHAs), and management planning. For Clinic Health Workers 1. In Tanzania we are working with the Ministry of Health and Ifakara Health Institute we have done a study showing that electronic protocols significantly improves the quality of care when treating acutely ill children in clinics. 2. In Tanzania we are working with the Ministry of Health and URC in Tanzania we are preparing to scale up eIMCI for use in one entire region of Tanzania using newly revised protocols developed with the Ministry. 3. Working with the Ministry of Health and Social Welfare, Columbia University and IntraHealth to develop and test a clinic-based screening protocol for patients on treatment for HIV/AIDS. This protocol screens those patients who are doing well and do not require a physician's care during the current visit. Part of this protocol is an enhanced screening for Tuberculosis (TB). 4. In Tanzania we are working with Muhimbili Medical Center and the Ministry of Health to develop and test improved checklists and treatment protocols for infants under 2 months of age.

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