HELP System

Referral doctors are often faced with problems of diagnosis and treatment for people living with HIV (PLHIV) in areas of high prevalence. They send emails to specialist doctors to ask for help. These exchanges of medical information were not secure and so the HELP System was designed to help doctors to improve the quality of care for PLHIV in Madagascar.

The HELP System or HIV Electronic Platform is a joint initiative by the Association Aide et Soins aux Malades (ASM) and the Association du Personnel de LARTIC (APL) to set up a network of care and telemedicine to improve HIV-AIDS management in Madagascar. It is a web/mobile portal that hosts telemedicine applications in its back office. The site is used by 45 family doctors who treat people living with HIV (PLWHA) practicing throughout Madagascar and who are directly and remotely linked with the central body, specialist doctors and their patients by means of this platform. The service offered includes an electronic medical application installed on a 3G tablet so that the doctor is comfortable entering the patient’s clinical data during medical consultations, because it connects to the Internet only once a month, when it synchronises its data. Another application is available for doctors to participate in continuing and online medical training sessions and online sessions to benefit from the help of specialists when working on difficult and complicated cases. PLWHA also have special access to the portal so that they can talk privately with their family doctor or with each other. This project is intended to collect national clinical data for use in research and for continuing medical education. The project started on 10 April, 2017 and was planned to continue for a period of 6 months, at the end of which a model will be presented and recommended to the partners and potential collaborators to support the national programme to fight against HIV/AIDS in Madagascar and possibly in other developing countries that wish to establish a network of care and telemedicine but are faced with equipment concerns and internet connection issues.

The factor blocking the proper functioning of a healthcare network in Madagascar often involves access issues, and Internet speed in remote areas far away from big cities. Hosted on a central server, the Help System application with its data synchronisation module serves as an alternative to constant Internet use so that physicians can input clinical observation information offline and only connect once a month, or when patients move, or when they need the help of a remote specialist.