Feasibility of Real-Time Monitoring for Anemia Using Mobile Application Linked With Point-of-Care Testing Device

Background Anemia testing using digital hemoglobinometers (DH) enabled with real-time data visibility improves delivery outcomes, reduces the manual process of keeping records, and strengthens follow-up. In this study, testing of anemia was done by HealthTrender, an innovative mobile-based cloud-connected application, with HemoCue 301 device (HemoCue AB, Ängelholm, Sweden). Aim The objective of the study was to assess the feasibility, acceptability and coverage of anemia testing by the HealthTrender mobile application by the end users - Auxiliary Nursing Midwives (ANMs). Material and methods An exploratory mixed-method study was conducted for three months, i.e., from 1st January 2020 to 31st March 2020. The study was done at the antenatal clinics (ANCs) of two Primary Health Centres (PHCs) and their subcentres in the Ballabgarh block of Haryana, India. Qualitative data on the feasibility of the HealthTrender application was collected from 13 ANMs involved in the testing of anemia using in-depth interviews. Quantitative data of 1057 pregnant women attending the ANC clinics was also analysed. For data capturing, a Bluetooth dongle connected with HemoCue 301 transferred the hemoglobin (Hb) values to the HealthTrender mobile application and was uploaded to the cloud, displaying it on a webpage in real time. Result Among 1057 pregnant women enrolled, the mean (SD) hemoglobin was 10.9 gm/dl (1.5) and the prevalence of anemia was 47%. ANMs reported that the mobile application was easy to use, and half of them were very satisfied with its speed, easy uploading and quickness in reflecting Hb values on the mobile screen. Challenges related to internet connectivity, loss of Bluetooth dongle connection and less manpower with extra work required were expressed by the ANMs. Completion of records was significantly higher for the mobile application (100%) as compared to manual register-based records (81%). Conclusion Web-based application HealthTrender used by ANMs for screening pregnant women for anemia was feasible and had high acceptance. Using digital technology increases the reporting and coverage of hemoglobin testing. Information technology use may be highly beneficial for the serial recording of hemoglobin and subsequent management and follow-ups.