Stepping Up Treatment with Mobility Outreach International

In the United States, when someone loses a limb, a whole network of doctors, prosthetics specialists, and physical therapists rush to help.

Head just a few hundred miles south to Haiti, and it becomes an entirely different story.

“[For] somebody [with] a disability in Haiti, life is not easy. Most of them don’t have help,” says Haitian orthotics and prosthetics consultant Mahmadou Soulé.

As he tells it, there is no way for those in need to get an artificial limb, which makes it even harder to earn a living in the poverty-stricken country.

But Soulé is not ready to abandon those in need. For him and his partners at Mobility Outreach International (MOi), helping someone walk means giving them a chance to live independently.

Founded 27 years ago in the wake of the Vietnam War, MOi and local clinicians have helped more than 20,000 people in Vietnam, Haiti, Sierra Leone, and Bangladesh regain their ability to walk, work, and live a full life without limitation.

Joining Map Data to Patient Data to Find Opportunities

When Carla Villoria joined MOi in 2014, her mandate was straightforward: analyze the organization’s data and help the in-country program teams increase their success rate.

Prosthetics, orthotics, and clubfoot treatment can require up to five years of consistent therapy and modification. But with so much of the record-keeping done on paper, very few clinicians had access to patient history and treatment schedules.

“Most of what we had was Excel sheets full of information that was pulled from paper forms once a month. It was riddled with errors and a painful process,” says Carla.

The treatment process is demanding and many patients often dropped out of the program, settling for a partial treatment or abandoning their prosthetics or clubfoot brace altogether.

“The doctors were operating day to day, but the only patient history was their memory. They did not even have a clinic level overview of what was going on, much less the whole country,” Carla says.
 There was a simple and immediate fix to the data problem: the smartphones in doctors’ pockets.

But getting the doctors to use the device to record the data posed a challenge. Here MOi saw an opportunity: If the organization could share the data with the doctors in a timely manner, doctors could stay more organized and provide a higher level of care.

The organization started using Dimagi’s CommCare app in 2015 to collect patient data by phone and track their progress. At the same time, the MOi team started prototyping and testing several Tableau dashboards that would inform both the individual clinics and the nationwide program.

At first, many of the experienced physicians were dubious about the value. But as the MOi team demonstrated the prototypes and quickly incorporated their feedback, they bought in.

Carla also got help automating reports and building visualizations from Tableau Service Corps volunteer Matt Coles and by October, 47 of MOi’s partner clinics in Vietnam, Haiti, and Sierra Leone were on board.

Tracking regional patient progress through map data in Tableau

Doctors are now recording their patient information through CommCare. They’re also using Tableau Cloud dashboards to manage their daily case load and track patient progress. They can get a holistic view of their clinic’s performance, and compare their progress against clinics across the country. This data, when combined with geographic data, allows MOi to chart the improvement of success rates by region.

For its part, the MOi program team can use the data to assess its work, improve effectiveness, and expanding outreach programs in lesser-served parts of the country.

The Long Run

MOi’s expects 100% of their partner clinics and prosthetics workshops in Vietnam, Haiti, and Sierra Leone, MOi to be on the system by mid-2016.

“The response in Haiti has been particularly overwhelming. Clinicians are so excited about cutting down the paperwork burden,” says Carla.

She is also excited about MOi’s track record of transferring these programs to the national Ministries of Health and seeing them thrive.

“We want to be part of the current healthcare system, help these governments build/ rebuild that capacity, and bring mobility—and a dignified life—back to as many people as we can,” says Carla.