Informatics Research Seminar: Planning for mHealth in a Low Income Country – Challenges in Guatemala

March 27 @ 4:00 – 5:00 pm


Speaker: Patricia Abbott, PhD
Presented from Duke University

Broadcast Link: Seminar



Poverty, genetics, and cardiovascular disease (CVD) combine to form a lethal mix in Guatemala, requiring creative and comprehensive approaches to ameliorate.  In 2011, the UN Human Development Index (an indicator of education, health, poverty, etc.) ranked Guatemala at number 131 out of 187 countries globally.  Numerous social and environmental dimensions of health contribute to marked level of childhood malnutrition, stunting, and anemia, while a high percentage of child-bearing women are obese and hypertensive. This has been referred to as “starving with a full stomach”.  The number of deaths attributable to CVD in Guatemala increased by a staggering 61% between the years of 1990-2005 — and the trajectory continues.

In 2012, we partnered with a NHLBI Center of Excellence in Guatemala City to create a roadmap for an eHealth intervention that could be used to reverse some of the disturbing health trends emerging in country.  To address the multipronged issues of Guatemala’s increasing non-communicable disease (NCD) rate also required assessment of, and interventions at, the primary care level.  Health posts, located in remote areas, are typically staffed by low-skilled auxiliary “nurses” and community health workers who are untrained in NCD, with very high case loads.  Indigenous peoples (Mayans), already at genetic risk of CVD and distinctly marginalized, are particularly disadvantaged.  The bright spot is that over 80% of Guatemalans have cell phones and the tele-connectivity is very dense across this Central American country.   Part of the roadmap has been to simultaneously address the use of eHealth approaches for educating the ANs and the CHWs in the health posts, creating connectivity between health posts and the health centers where more expert practitioners are located, and working to influence patient behaviors via the use of text messaging.  This presentation will illustrate the planned “digital eco-system” roadmap of MoTeCH, CommCare HQ, and Open MRS in Guatemala and the challenges encountered along the way.


Dr. Patricia Abbott is an Associate Professor at the University of Michigan School of Nursing. Prior to arriving at the University she was an Associate Professor at the Johns Hopkins Schools of Nursing and Medicine. She completed a 2-year post-doctoral NIH funded research fellowship in the Department of Computer Science in the Human Computer Interaction Laboratory (HCIL) at the University of Maryland College Park where she focused upon the design of usable and error-mitigating HIT. Dr. Abbott extended her research background in knowledge discovery in large datasets (data analytics) at the HCIL by also focusing upon visualization (making sense of huge collections of healthcare data in a way that provides value), human computer interaction, and user-centered design.

Dr. Abbott is the P.I. on an ONC HITECH grant for health IT curricular development and a Co-Investigator on another ONC HITECH grant for University Based Training (both at Johns Hopkins). She is also the P.I. on a recently completed pilot grant from NINR/NIH where she is studying the impact of telehealth technologies on disease self-management in home-dwelling African American congestive heart failure patients. Patti has served as a member of the Board of Directors of the American Medical Informatics Association (AMIA) and the Journal of the American Medical Informatics Association Editorial Board. She is a member of HITAC (Health IT Advisory Commission) for the National Quality Forum and is a current member of the Biomedical Computing and Health Informatics Study Section at the US National Institutes of Health. Patti is a co-editor of NISTIR 7804 & NISTIR 7865, two new NIST Certification Standards for US Electronic Health Record Systems (National Institutes of Science & Technology/NIST; US Department of Commerce).

Dr. Abbott is passionate about developing IT for low-resource settings to increase health knowledge distribution to nurses and other care-givers in remote communities. She recently co-authored an AHRQ commissioned white paper regarding the use of information and communication technology (ICT) in medically underserved areas to improve health of people and communities. Her pioneering work in using knowledge networks optimized for low bandwidth areas has led to involvement with the Rockefeller Foundation, the Pan American Health Organization (PAHO), and the World Health Organization (WHO). She is currently collaborating with a NHLBI Center of Excellence in low-resource areas of Guatemala on a mHealth project focused on cardiovascular disease.