Delivering fast test results where needed most

Delivering critically important test results to patients in Sub-Saharan Africa and other countries with limited healthcare infrastructure can be a daunting task. To receive test results, some patients must travel for hours to a crowded clinic, leaving family behind and losing a day’s wages. Overwhelmed clinics and medical staff, meanwhile, scramble to provide services.

Test results can be delayed by weeks or months for the millions of adults and children living with HIV, women who are awaiting cervical cancer screening results or people who may have been exposed to COVID-19. The need for timely test results is great, with about 20 percent of the South African population living with HIV.

A mobile health solution means that patients in Sub-Saharan Africa with even the most basic smartphones can now receive fast test results, health education, reminders, wellness tips and a virtual high-five on a cell phone app. The goal? Improving compliance and eliminating disease.

The health management solution was launched in 2020 for HIV viral load and COVID-19. It was recently expanded to include cervical cancer screening including human papillomavirus (HPV) testing. Hepatitis and tuberculosis disease management workflows are expected to become available through the app by the end of 2021. Watch this video to learn more about how the mobile app works.

“This is truly one of those ‘doing now what patients need next’ projects,” said Dana Duncan, Director of Clinical Science for Virology at Roche Diagnostics, which developed the app.

Dana has a keen perspective on the patient experience, having worked in pediatric HIV/AIDS care and treatment programmes in Sub-Saharan Africa before joining Roche. “The real value comes in empowering patients to have access to their results so they can improve their health.”

The mobile app is the result of a collaboration between Roche teams in Belmont, Santa Clara and Pleasanton locations in California, US, along with teams in Rotkreuz, Switzerland, and South Africa. To create the app, the teams partnered closely with more than 500 pilot study patients, along with healthcare providers, the Ministries of Health, research universities and laboratories in Africa.

The collaboration allowed the team to better understand the challenges faced by patients and clinicians in ensuring that HIV-positive children and adults remain adherent to their lifesaving antiretroviral therapy, and that results in other critically important tests are delivered quickly.

For women balancing family care with work and community responsibilities, the app can make it easier to prioritize their own health, providing reminders to get screened for cervical cancer and other wellness tips that don’t require travel to a clinic.

“This collaboration has allowed us to gather key insights that resulted in the development of a solution that addresses really significant needs, while establishing close engagement with our external partners who support this innovation in reaching the patients that are in need of this powerful tool,” said Chad Morris, Senior International Product Manager.

Roche user experience designer Maya Venkatraman said for the app to be effective, it must work with the most basic smartphone. “We were diligent about making sure that the words that we use, the colours, the messaging really work for our audience.”

Once test results are available, patients can be immediately notified by a secure, colour-based message that lights up the phone screen.

In HIV viral-load monitoring, a bright green screen, complete with a congratulatory burst of fireworks, means the patient’s viral load is at a safe level. Yellow serves as a reminder to take medication daily, and a red message prompts the patient to return to the clinic. Additionally, HIV early infant diagnostic results can be sent to the caregiver alerting them that the child’s results are available at the clinic.

Patients have responded positively, with an enthusiastic nod to the celebratory fireworks. “Patients don’t always disclose to family or friends that they are HIV-positive,” Maya said. “It's a lonely journey for many people. You don’t have the place to celebrate the fact that you are doing well and taking your meds, so we put a little personal touch into the app. This sometimes is their moment of happiness.”

The mobile app can also help decrease the incidence of cervical cancer through information and education.

“It provides critical information in making sure that women receive their results quickly and that they are fully engaged in monitoring their health,” said Alejandra Guillen, International Business Leader for the mobile health solution.

“The elimination of cervical cancer is within reach, with proper vaccination, screening and treatment,” she added. “This mobile app can help us reach our goal of eliminating cervical cancer by reminding women when it’s time to get tested and letting them know quickly what next-step care is needed to prevent cancer from developing.”

When COVID-19 gripped the world in early 2020, developers redesigned the app to also deliver test results for the virus.

Up to five patients can access results privately on one phone, which comes in handy when families or communities share one device.

Said one patient who was part of the pilot programme, “It was nice getting results quickly - waiting causes anxiety.”

“When you see the results popping in and you’re doing great, it brings joy to your life,” reported another patient.

As Product Manager for the mobile health solution, Matt Pan said there was “never any doubt about why you would wake up every morning and go to work. It’s a very important product and a very important mission.”

A native of Malaysia, Matt said several project team members have experience living, working or growing up in developing countries. “Issues related to global health are close to our hearts, and this work has been very personally fulfilling.”