SELV-CT Integration User Requirements Notes

Owned by Ron Pankiewicz (Deactivated)
Oct 20, 2014

Use Cases Write-Up for SELV-ColdTrace (CT) Integration
Meeting Notes: Wendy, Ron, Vidya
17 October 2014
Tafara, Aida, Ruth, and Wendy discussed questions sent from Seattle, and came up with these preliminary specifications:
User Type 1: Field Coordinators (FC)
Problem that integration will address:
FCs need to know if a health center has a working fridge or not, such that they can plan their monthly distribution based on this knowledge. It is better to have this information before leaving the province, instead of finding out only when they reach the district level.
Ideally, they should be able to see the following for each delivery zone, before the go on the distribution:

  • List of health centers where fridge is currently not working, the reason for why it's out (from data entered by FCs into SELV) and the length of time it's been out (from data collected by CT). The latter needs to be near real-time information from ColdTrace (having SELV pull data from the CT server every 24 hours should be sufficient).
  • How does this help? – The FCs will find out the problems, and then decide to go or not go; for example to deliver vaccines to Coleman icebox if it is known that a health center is continuing to administer vaccines using that.


During the discussion with Wendy, the Moz. group did not specifically talk about the "irregular" fridges (working, but with temperature excursions now and then). What seemed to matter most to the group was working fridges versus non-working fridges ("picking their battles").
Wendy, Ron, and Vidya discussed adding this capability to SELV by creating a Cold Chain Problems Summary screen that presents the following information:

  • Category 1: list of health centers, by province, by delivery zone, by district, which have fridges that are known to be broken down / not working, plus the time that each fridge has been out of operation. A fridge would be declared "broken" down after a certain number of hours or days of operating out of the normal 2-8ºC temperature range. (Still to be determined are the he criteria for declaring a fridge "broken down," and the extent to which this will be hard-coded in the system vs configurable by a system administrator. The latter is more expensive to develop.)
  • Category 2: list of health centers, by province, by delivery zone, by district with "irregular" fridges. A fridge would be declared "irregular" after a certain number of hours of operation out of the normal 2-8ºC temperature range, or a certain number of temperature excursions over a given number of days. (Still to be determined are the criteria for declaring a fridge "irregular," and the extent to which this will be hard-coded in the system vs configurable by a system administrator. The latter is more expensive to develop.) Fridges listed in this section would also have a clickable button next to it, which takes the user to the CT page showing equipment status, power status, including details of how many times the fridge has gone above or below the normal range, and time-out range.
  • Category 3: list of health centers, by province, by delivery zone, by district with fridges of unknown status. This condition will arise in situations where the CT server has not received any data from the monitoring equipment in the field over some predetermined interval of time. It is expected this would typically be addressed by having the FC call the health center to determine the current status of their fridge. (Still to be determined are the criteria for declaring a fridge's status "unknown," and the extent to which this will be hard-coded in the system vs configurable by a system administrator. The latter is more expensive to develop.)


This Cold Chain Status Summary screen would also have a drop-down pick-list control that allows the user to see status for problematic fridges at all provinces, or to view the problematic fridges for a single province, selected from drop-down pick list.
How can the above request be accommodated in SELV? Some ideas discussed by Wendy, Ron, Vidya:
Idea 1: On the Manage Distribution page in SELV, next to the [View Load Amounts] button, and the [Initiate a Distribution] button, add a new button [View Cold Chain Status] which brings up the Cold Chain Status Summary screen. If the user had already selected a delivery zone, the summary screen ideally would include only health centers in the selected zone. Otherwise it would initially display a sorted list of all health centers with problematic fridges. A mock-up is shown below.
Idea 2: Have each health center's fridge status be inserted as traffic lights (green, yellow, red, black) on the Plan Your Trip page (accessed by clicking on "View Load Amounts" on the Manage Distribution page) (see picture below). Wendy thinks that the FCs may not be using the Plan Your Trip page, so presenting this status information on this page would neither help nor hinder; this needs further investigation.
Related Idea: While not essential to the goal of integrating the two systems, Ron suggested the Plan Your Trip screen could be modified to re-calculate the total amounts to take for each zone, based on which health centers the FCs choose to visit for that month (e.g., there would be a check box beside each health center in the delivery zone list, allowing the FC to deselect it from this month's distribution, based on the CCE status or other criteria). This is likely out of scope. Further, the utility of this is dependent on how much the FCs use this screen. A mock-up is shown below.
Mock-up of Cold Chain Status Summary Screen
FAILED REFRIGERATORS
Province Delivery Zone District Facility Down Days Problem
Gaza Norte Gaza Chicualacuala C.S Pafúri4 Burner problem
Gaza Norte Gaza Mabalane Pfukwe 9 N/A
Gaza Sul Gaza Chókwè Massavass17 Battery

IRREGULAR REFRIGERATORS
Province Delivery Zone District Facility High Alarms Low Alarms
Gaza Norte Gaza Chigubo C.S Saúte 13 1 [View]

NON-REPORTING REFRIGERATORS
Province Delivery Zone District Facility Days With No Update
Gaza Sul Gaza Manjacaze Chibondzane 13

Mock-up of Revised "Plan Your Trip" Screen

Expected Outcome changes:
For fridges that have broken down: there is little the FC can do to make the fridges perform in this scenario, apart from maybe checking in with the DPS technician to see if he is aware of these health centers. But as mentioned earlier, it helps the FC determine which health centers to visit, which ones to leave their supplies at the district office, which ones to deliver a smaller amount of vaccines, etc.
For fridges that are operating irregularly: there is quite a bit the FC can do at the health centers with these fridges; seeing this list should trigger a preventative maintenance checklist in the FC's mind, prompting the FC to do the following:

  • See if it is possible to take the technician along to the health centers with wonky fridges that might be visited;
  • Check viability of vaccines for those fridges showing temperature excursions (such as VVM test for high temperature excursions, shake test for low temperature excursions) Ideally, the system should break the list down to show which test to perform at which HC, but this sounds like a "nice to have" feature;
  • If vaccines are bad, follow procedures to send back to the district, or destroy them there (actual reality);
  • Wastage rate can be confirmed by FC, to help monitor level of loss because of poorly working fridge (question: how does the FC currently do this – this needs to be flushed out more).
  • Fridges showing power problems—check where power problems are;
  • Remind nurses of procedures—put vaccines into Coleman icebox if down for a long time.
  • Communicate with district to inform about situation.


User Type 2: Chefe de PAV at DPS
This user, situated at the province DPS, would need:
On the same Cold Chain Status Summary screen, a list of health centers with fridges for category 1 and category 2 described above, plus a column with the cause of problem (if available in SELV); Note that the Moz. team advises that the number of hi/low excursions or alerts is not important to this role. (The usefulness of this information is still to be verified with the Chefe de PAV; a set of questions for Tafara to review with the Chefe de PAV is listed below.)

User Type 3: MISAU personnel
This user, situated at the central level of the MoH, would be someone like Balbina Mario, the PAV logistician at the ministry, and would need:

  • Summary of health centers with problem fridges and how long have had these problems. From initial conversations, it appears that Users of type 2 and type 3 would use the same information.
  • Equipment inventory and reliability – shows break-down rates by brand and model, to identify which are more reliable over time. This sounds like a "nice to have" feature, which does not necessarily need to get built into SELV, but could be provided to the user when needed? [This last item should be covered with a report that the logistician can run periodically, rather than covered with a dedicated user screen in SELV. –RP]



Additional background info on the current CT dashboards
As per Tafara, the most useful tab on CT dashboard is the equipment status tab, because it provided information on power and the function of the fridge. Our understanding of the current functionality is that if a fridge problem at a health center is not resolved within in 10 hours, then an alert is sent to designated staff at the district office, which then opens a ticket. Our understanding is that CT keeps sending these alerts twice a day, until the problem is resolved.
For the integration, these health centers would ideally go into the category of getting alerts and not resolved for XX time and in the list of not visit or get more info before visiting.

Questions and Issues that need Clarification from Moz:
Questions for Tafara:

  1. Repair tracking of CCE: there is a form at the HC that is supposed to have picked up by the FC each time they visit, but not sure if there is information here or if the FCs are picking up the form. Please investigate and let us know what the current practice is.
  2. Below is a list of questions for Field Coordinators in Gaza (staff other than Amelia), and the Chefe de PAV (Amelia Dipuve). Please interview them using these questions and let us know of their responses.


Interview questions for Chefe de PAV:

  1. What information is currently available to the Chefe de PAV about each health center's fridge?
  2. How does the Chefe de PAV use the current information available for decision making, etc?
  3. What information is needed regarding the cold chain at each facility?
  4. Is information needed to ensure that the fridges are regularly maintained
  5. Is information needed to ensure that broken fridges have been repaired?
  6. How does the Chefe de PAV use the current Tableau workbook? Particularly, the Cold Chain Status page (please have the Chefe de PAV open the Summary PDF file or the Tableau workbook, whichever is used by her). Please have the Chefe de PAV walk you through this report, explaining what she thinks is useful, what is not useful, and how any of the Tableau information gets used.  What could be added or changed to make it better.
  7. How does the Chefe de PAV use the current ColdTrace dashboards? Please have her walk you through the dashboard tabs, explaining what is useful, what is not useful, what is hard to understand, how she uses the information, and what else she needs.
  8. Would the Chefe de PAV find it useful to get an email each week/two weeks/month, listing all the problem fridges, and how long they've been out? If yes, what details would she want to receive in this email?   What information would be most useful, and what might she do with this information?
  9. Would the Chefe de PAV be supportive of having Field Coordinators add the cause of a fridge problem in SELV, if she has access to this information?


Interview questions for Field Coordinators:

  1. How do they plan how much vaccines to take when preparing for a distribution?
  2. How do they decide how much to leave at each health center?
  3. Does the "Plan Your Trip" page on SELV get used at all?
  4. If yes, how do they use it? What information is useful on this page?
  5. If no, what is not useful? How can it be made better so that it is useful to you?
  6. What do the FCs do when they arrive at a health center, and the nurse informs them that the fridge is showing some problems, but is generally working? Do they leave a full delivery, or a few vaccines to use in an icebox, or not leave any vaccines?
  7. Do they do any preventative maintenance at these health centers? Do they let anyone back at the district or province know about the fridge showing problems?
  8. Please show the FCs in Gaza the current set of CT dashboards, and see if they understand it/can describe it easily.
  9. Are the FCs in Gaza currently using the ColdTrace dashboard? If yes, how do they use it? If no, why not?
  10. Please make a note of what they find most useful on the CT dashboard, what they do not understand, and what they think is not useful to their work.


Questions for Nexleaf:

  1. When a fridge's status is shown with a grey tile on the CT dashboards, what does that mean? …No updates in the last 12 hours? 24 hours? Or ???
  2. Once a fridge has been in alarm state for more than 10 hours, is there a cap on how many text alerts the system sends to the district office, or does it keep sending alerts until the fridge is fixed?