Steve Wilhelm: Using SMS in the Fight Against Tuberculosis and HIV/AIDS
After 15 years programming applications for Palo Alto-based Reuters Innovation Studios, Steve Wilhelm happened to visit a Stanford graduate course that broadened his horizons all the way to Cape Town, South Africa. The course, taught by Stanford Communications Professor Clifford Naas, charged students with creating culturally appropriate products for developing countries. Inspired, Steve applied to the Digital Vision Program and was soon dreaming up a project of his own.
His project, Umunhum, would try to improve treatment for chronically ill Tuberculosis and HIV/AIDS patients in Africa. By naming his project for a mountain in the Sierra Azul Open Space Preserve that overlooks the South Bay, Steve was paying subtle tribute to Tracy Kidder’s Pulitzer Prize-winning book Mountains Beyond Mountains. The book, which chronicles one doctor’s struggle to expand Tuberculosis and HIV/AIDS treatment in the developing world, likened the mission to the frustration of climbing a mountain, only to find many more waiting on the horizon. When Steve arrived at Stanford in 2003, he encountered his first mountain almost immediately.
Even if patients connected with healthcare providers, he discovered, they often forgot to take their medicines regularly and return for check-ups.
“You have to be very rigorous in taking your drugs, and you can imagine in some rural areas, reminding people to take their drugs is a problem,” he said.
An essential step in helping patients, Steve decided, was reminding them to stick to the demanding, often lengthy treatment regimens essential for controlling the spread of Tuberculosis and AIDS. Treatments for these diseases involve multi-drug regimens, and Tuberculosis can require up to two years of continued medication, even if symptoms completely disappear. Steve also saw another mountain: what if the reminder service he envisioned required more development time than his year at Stanford allowed?
Steve struck research gold when he stumbled on Dr. David Green’s website. Green, of the Chapel Street Clinic in Cape Town, South Africa, was already using cellular short message services (SMS) technology to send his patients brief medical reminders, but he wanted to extend the service to more clinics. With Steve’s technological expertise, the two turned Dr. Green’s existing web-based reminder system, On-Cue, into a remote desktop application. That meant clinics could connect to the Internet to distribute reminders once or twice a day instead of needing costly, continuous online access.
As Dr. Green’s efforts to reach patients with chronic illnesses continue, contracted developers and a 2004-2005 Digital Vision Fellow will carry Project Umunhum into the future.
—Lorraine Sanders