1. Where does the name D-tree come from?

D-tree stands for “Decision tree” and is based on our core work of building decision support tools that run on mobile devices. These decision trees are medical protocols that guide health workers through a series of questions that ultimately lead to a diagnosis and treatment.

2. What is mHealth?

mHealth, which stands for “mobile health,” refers to the practice of medicine and public health supported by mobile electronic devices. Mobile phones are now available and commonplace in every corner of the world. The idea of mHealth is to leverage this availability in efficient and creative ways to improve health care delivery and health systems. mHealth is a promising and cost-effective method for making high-impact improvements to all levels of the health system, particularly in developing countries, hard-to-reach areas and resource-poor settings.

3. What do you mean by “evidence-based”?

Evidence-based medicine aims to apply the best available evidence gained from scientific research to clinical decision making. Simply put: it is using research to improve medical care. Evidence-based medicine is important because it is provides internal checks and balances, feedback loops, opportunities for evaluation and improvement, accountability and ultimately, better health outcomes. In other words, instead of having an idea to a solution and immediately implementing it, it forces a slower and more rigorous process to evaluate ideas. This is necessary because the problems heath systems are facing are complex and while a solution may seem feasible, it is important to ask questions each step of the way and investigate if the interventions being made are having the intended impact on care.

4. What makes D-tree unique?

There are a few things that together make us unique in the field of global health:

  • We are not a technology company – we are a health organization. While we use technology to improve the delivery of health care, our goals lie in improving healthcare not in the medium we use to do this.
  • Our goal is to improve health care, not to own it. We work in a partnership model where we support rather than replace existing health systems. This means that we work with existing programs, most often those of the government health services and improve care within the existing structure and with the existing personnel. This gives us the ability to work widely with a broad range of partners, as well as credibility in the communities we serve.
  • Our work is based on an in-depth understanding of health systems around the world and of the real problems have on the ground when seeking care.
  • All our work is supported by rigorous scientific studies and solid evaluation to ensure that we always follow the Hippocratic code to “First, do no harm.”

5. Who are the beneficiaries of D-tree’s work?

The direct beneficiaries of our work are the front-line health workers and the clients and patients who receive care from them. We work with health workers to provide them with our easy-to-use electronic medical protocols and equip them with the tools they need to diagnose and treat their patients. This in turn helps build trust in local health systems as patients benefit from higher quality health care. The health systems and communities that they serve are thus also beneficiaries of our work. We maintain strong relationships with frontline health workers who provide us with direct feedback on our tools to make sure they serve the needs in each location where we work. In this way, the beneficiaries are also key contributors to our work.

6. How long does it take to train a health worker to use D-tree’s protocols?

Our experience is that it generally takes a health worker ½ day to learn to use the protocols. This includes how to use the phone, how to log in, and how to synchronize the data with a server.

7. Where do the protocols come from? Do you create them yourself?

We develop the tools in concert with government guidelines, medical practice in clinics (i.e. what kind of facilities and medications are available), and the health workers themselves. We have a five step process to develop each electronic protocol:

  1. Map existing guidelines into a paper-based decision tree
  2. Observe health workers in the care-giving setting
  3. Make an electronic prototype of the application and test with a small group of health workers.
  4. Incorporate health worker feedback, any adjustments for local settings, and finalize application
  5. Train larger groups of health workers in the final tool

This iterative development methodology ensures that each tool is tailored to the location where it will be used and that the health workers have a tool that they are comfortable with.