MOTECH

The MOTECH Project is an open-source health interoperability layer that is used by health organizations to provide connected health services across a variety of platforms.

I worked on the project as a UI engineer, where I focused on consolidating the technical debt and making a more cohesive experience. Through this project I experienced partnering with health systems to support different communities.

At the Grameen Foundation I worked on the MOTECH Project, which is an open-source software platform to enable integrated health services delivery. MOTECH uses point-to-point integration to connect electronic medical systems, epidemiological data platforms, and telephony systems (like text messaging).

A powerful feature in MOTECH is the UI through which tasks can be defined to move and transform between systems on pre-defined events. These features help organizations implementing electronic health systems lessen the technical overhead needed to configure and sustain these health records, which is very important for organizations in low and middle income countries.

I joined the MOTECH project as a UI Engineer, where my goal was to create a more unified and usable interface. The problems with the MOTECH UI was that the implementation was different in sections of the the UI, and that integrating information systems has never been an easy task.

I had decided to take an approach to change the UI in place, rather than overhaul the entire UI, as it wasn’t part of the projects culture to make such large changes. I started by creating a more semantic markup pattern and documenting it in a styleguide generated from the project source code. Then worked on creating components that could be reused, allowing for a DRY codebase. These steps were the building blocks to start working on larger UX issues, so we could create changes to a maintainable UI.

Implementations

Another side of my work on the MOTECH project was to aid implementations of MOTECH. In general our work at the Grameen Foundation was to support the MOTECH platform, like all Global Health technologies, major features are driven by implementation projects. In these situations we work closely with the implementation team to find an adeuate solution and build a capacity for long term support.

The project that I worked most closely on was an implementation with PossibleHealth in Accham, Nepal. PossibleHealth was integrating a CommCare, a smartphone data collection system, with Bahmni, an electronic medical record system designed for rural clinics. The goal was to support their Community Health Workers when following up with pregnant mothers, surgical, and chronic disease patients.

Helping PossibleHealth understand how this type of data integration works, so they can help us answer complex questions in how their technology is meaningfully used in their health system. When first visiting them in country, it became immedatly obvious that the people who would be responsible for the long-term success of this project were just ‘head-nodding’ and not understanding the decisions we were asking them to make. Many of them were asking for ‘automatic’ and ‘magic’ solutions, but for most neuanced health system problems this wasn’t a viable solution. It seems obvious, but using skills in visual and plain language communication to translate our discussion items helped build a deeper understanding.

My hope for MOTECH is to have more implementation experiences, so we can build the inperson training we are doing directly into the UI, to allow for a more sustainable and workable solution.

The real challenge is getting clients away from wanting ‘automatic’ ‘magic’ solutions, as healthcare is a domain of technology where there are many exceptions that often need human intervention. Using MOTECH to orchestrate human intervention is great because it is designed around sending Email and text messages so contacting a person and requesting action is easy.