High Stakes Twitter

UCI School of Nursing alumnus Omeid Heidari just finished his NP/MPH at John Hopkins and is beginning his PhD. But that’s not all he’s working on. Recently, Heidari was doing field work in Klerksdop, South Africa, putting USSD (Unstructured Supplementary Service Data) technology to new use. USSD codes are used extensively by cell phone providers and other information-based systems, as an easy way to communicate with users.

“In our case, we are using USSD codes to communicate with patients who are participating in a study we are conducting. Patients will dial the USSD code associated with this study into their phone and then be directed to a screen where they can enter an ID associated with their study profile and test results. In addition to results, messages about the need for more testing, medicine, or adherence counseling, can be communicated. Patients whose test results are normal receive a message reminding them about their next scheduled visit,” said Heidari.

Sick patients, who typically wait as long as two weeks for a return visit to the clinic, now receive their results faster along with a message that explains the results and conveys a sense of urgency for them to return for follow up care. Heidari is putting the USSD system to work with the treatment of South African HIV patients. However, new HIV treatment guidelines have made Heidari’s work more complicated.

“USSD screens are character limited; the more information we put in these messages, the more times the patient has to press “1” on their phone to continue to the next screen with more message. This is an opportunity for intervention failure. In an attempt to make the messages as short as possible, while still reflecting the latest guidelines for the treatment of HIV, I have rearranged the messages to be as short, but as medically accurate as possible. I call it High Stakes Twitter.”

Heidari constructs messages that both reflect the treatment guidelines and interrogate any scenario where the message would not fall under the ‘standard of care’ and regular clinic practices. He also has to consider situations where the message would be inappropriate for particular patient scenarios.

So far, Heidari has completed the English messages and received approval from the project leaders in Baltimore and Johannesburg.

“Once I received approval, I translated the messages into Setswana, Sesotho, and Xhosa, then trained the local study staff and started enrolling our first patients,” said Heidari.

The use of USSD codes for communicating with HIV patients in South Africa could streamline the treatment process and positively impact outcomes. Heidari is hoping to expand the use of this system to other patients soon.

“Omeid’s innovative use of technology to improve the delivery of healthcare is a shining example of the type of healthcare professionals we are developing here at the Sue & Bill Gross School of Nursing,” said Founding Dean Adey Nyamathi. “His work demonstrates the tremendous value nursing brings to bare on patient care.”