Presentation by SystemOne's Brad Cunningham, VP of Implementation, during an AIDSFree webinar. July 2017.

1. Disease Intelligence and Response
Information Technology Tools to Support the Scale Up of Viral
Load Testing and Early Infant Diagnosis
Brad Cunningham
VP, Implementation
SystemOne LLC
www.systemone.id
bcunningham@systemone.id

2. WHAT DO WE DO?
Connected Diagnostics and Disease Intelligence for
Global Health
• Provide a real-time data reporting system
• Active data network to ensure collection of quality data
directly from diagnostic instrument
– Diagnostic data
– Operational data
• Data can be transmitted to multiple levels of
stakeholders for real-time decision-making and policy
response.
• Enables: rapid detection + response to healthcare
challenges worldwide

3. As of July 2017
MORE THAN HALF OF ALL GENEXPERTS IN AFRICA
ARE CONNECTED TO
Countries
Devices
Results
IMPACT
• Governance models changed
• More instruments purchased
• Faster result reporting
• Time to treatment slashed
60 days  2 days
• Stock-outs and expirations down
• Trust factor: rapid, quality data decision-makers
trust and take action on

4. Diagnostic instrument placed at testing facility.
Integrated via 3G with Aspect™ Connector
MoH Dashboard
Inventory Management
QA/QC
Utilization
Supply Chain
Real Time Notifications
MoH Operational Management
MoH Data Stream
Cloud or In-country Server
External API’s and data integration
… + many others
Migration to Aspect in 2017
Multi-disease/multi-device platform
TB, CD4, Zika, Ebola, HCV, HIV Viral Load,
HIV EID….
WHAT DOES THIS LOOK LIKE?

5. Operational management of devices
nationally and regionally. Measure quality,
utilization, unsuccessful testing
rates and customized programmatic reporting.
DISEASE INTELLIGENCE
Identify and Respond

6. Plan future procurement
Does instrument capacity meet
burden?
Targeted retraining
Customized Data Collection:
Collect additional information for
reporting, monitoring and
surveillance purposes:
- Patient Age
- Gender
- Contact Information
- Sample Type
- Referring Clinician / Facility
Provides a much richer data set
for analysis.
DISEASE INTELLIGENCE
Identify and Respond

7. Significant investment in VL testing
Endemic problem of slow, poor quality reporting
Need for accurate and timely disease intelligence for decision-making
- 6 countries (2% of the
global HIV burden),
have high quality data
reporting on the HIV
care continuum and
progress towards the
UNAIDS 90-90-90
target
- 9 countries in sub-
Saharan Africa have
surveillance data for
viral suppression.
Ref: Granich R et al. PLOS
Medicine 14(4): e1002253. (2017).

8. CONNECTED DIAGNOSTICS TO MEET THE FIRST AND LAST 90
• 1st 90: HIV Screening, reporting, QC and the role of connected
diagnostics
• 2nd 90: VL - Monitoring viral suppression; EID - Monitoring of
positives, negatives, indeterminates, rejected
• Collection of custom data fields
–Disaggregation of data by age and sex to monitor breadth and depth of response
• Monitor data on a national, district, site level to better understand
geographical distribution and response

9. Aspect ReporterTM
Delivers test results immediately from lab to clinic, extending the reach of
centralised diagnostic testing to the POC
Aspect Reporter has two components located at the clinic:
• A small server receives test results from the lab over cellular networks.
• A solar powered tablet displays the results. Clinic staff use its simple interface
to review and acknowledge test results as they arrive from the lab.
FACILITATING RAPID HIV VL RESULT DELIVERY
Cloud or In-country Server
Returning results from the diagnostic instrument back to
the facility treating the patient

10. Aspect Core
Aspect
Reporter™
Clinical Receipt of Results
• Digital lab results to clinic
• Clinician transcribes into existing
paper ledgers and enrolls patients
• Reduces TAT of result reporting
• Hardware appliance w/2g/3g & solar
installed at each clinic
Aspect
Supply Chain™
Clinical Lab Requests
• Software add-on to Aspect Reporter
• Initiates specimen transport pickup
• Logs lab orders
• Forecasts testing demand
• Calculates full-spectrum TAT
In development
Labs
Clinics
HOW ARE WE ADDRESSING 90-90-90?
Connecting Lab and Clinical Activities

11. Boston
- Product Development
- Market Development
- Operations
- Financial
- Executive
Johannesburg
- Implementation
- Support
- Service
- Training
Contact us:
+ additional Support & Operational staff in Malawi & Nigeria
info@systemone.id
@SystemOneCo
www.systemone.id