group of children photography

The medAL-suite

“A digital solution for creating and deploying complex clinical decision support algorithms”

What is the medAL-suite?

  • Code-free design of complex algorithms
  • Intuitive user interface that follows normal consultation workflows
  • Multi-algorithm, multi-version, multi-health facility configuration
  • Optimized for low-power and low-connectivity settings
  • 100% open-source

Implementation & impact

  • Digital tool used in two large research studies
  • Deployed in nearly 300 health facilities
    • Tanzania
    • Rwanda
    • Kenya
    • Senegal
    • India
  • In the Dynamic study
    • Algorithm includes 150+ diagnoses for children aged 1 day to 14 years
    • 130,000+ consultations to date
    • 75% of cases completed in the application, resulting in reduced antibiotic prescription from 70% to 23%

130,000+

consultations to date

150+ diagnoses

for children aged 1 day to 14 years

50%+

antibiotic prescription reduction

person sitting while using laptop computer and green stethoscope near

The technologies

Create and publish clinical
decisions support algorithms

  • Create variables and pre-defined syndromes (e.g., basic measurement, physical exam, background calculation or score, etc.)
  • Construct decision trees using web-based drag-and-drop interface
  • Assign treatments and managements to each diagnosis
  • Incorporate learning content
  • Allow health workers to accept or reject proposed diagnoses and drugs

Manage patients from medical
history to drug dosing

  • Implement algorithm logic based on patient-specific inputs to determine the most appropriate diagnosis and treatment
  • Follow the algorithm in a typical
    consultation workflow; pause and resume consultations at any time
  • Compute drug dosage
  • View information from past medical cases for a given patient, add new consultations
  • View learning content (text, images, videos, sound clips)

» medAL-reader‘s open source code on GitHub.

Share cases among health
workers in a facility

  • Use a local network to enable case sharing among all tablet users in the health facility
  • Maintain a local database of patients without overloading tablet storage
  • Send data to medAL-data when connected to the intern
  • » medAL-hub‘s open source code on Bitbucket.

Deploy algorithms and
collect and manage data

  • Create and manage health facilities, users, and electronic devices
  • Manage algorithm versions assigned to each health facility
  • Monitor system and data sync status
  • Manage the patient database and export data
  • Generate unique patient QR codes
  • Manage duplicates and de-identification
  • » medAL-data‘s open source code on Bitbucket.

User-friendly monitoring and mentorship dashboard

  • Displays several quality-of-care and antimicrobial stewardship indicators (antibiotic prescription rate, completion of basic measurements, appropriate management of common illnesses)
  • Automatically powered by data entered in medal-reader
  • Provides feedback to support monitoring and mentorship activities
  • User-friendly interface, co-developed with district health management teams
  • » medAL-mentor leaflet

Disease surveillance and automated outbreak detection

  • Monitors the prevalence of common paediatric syndromes (severe cases, malaria, fever without source, pneumonia, acute diarrhoea, malnutrition, anemia,…)
  • Provided automated, near real-time outbreak detection
  • Automatically powered by data entered into medal-reader, no manual reporting required
  • User-centered design, co-developed with district health management teams
  • » medAL-outbreak leaflet

A web adaptation of medAL-reader showcasing EMR system integration

  • Connects with medAL-creator to display medical algorithms
  • Applies algorithm logic based on patient-specific data to suggest appropriate diagnoses and treatments
  • Follows the typical consultation workflow step by step
  • Calculates drug dosage
  • » medAL-reader Web’s open source code on Github