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Contact General Specializations in Countries Contribution to the Global Plan Declaration

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Organization Contact Information

Name: SystemOne
Street 1: 1350 Main St
Street 2: Suite 500
City: Springfield
Province: Massachusetts
Post Code: 01103
Country: United States of America
Phone: +1-202-744-6806
Organization Email: lekbladh@systemone.id
Web Site: http://www.systemone.id
Other Online Presence:

Focal Point Contact Information

Salutation: Ms
First Name: Leah
Last Name: Ekbladh
Title: Team Leader, Global Health
Email: lekbladh@systemone.id
Phone: +1 202 744 6806

Alternate Focal Point Contact Information

Salutation: Mr
First Name: Nicolas
Last Name: Boillot
Title: Chief Operating Officer
Email: nboillot@systemone.id
Phone: +1 888 845 2610

General Information

Board Constituency: Private sector
Is your organization legally registered in your country: Yes
If yes, please enter your registration number:
Organization Type - Primary: Private Sector
Organization Type - Secondary: Company
Organization Description:
1. Mission and main focus of our work:
To connect diagnostic and clinical support platforms (GxAlert/Aspect) that provide real-time results to clinicians and national disease programs (including TB) to promote better treatment outcomes for those infected.

2. Why SystemOne is interested in tuberculosis:
Because in low income countries TB is the most common cause of death from a single source of infection among adults, SystemOne initiated its connectivity solutions by connecting to GeneXperts for Tb diagnosis in Nigeria. Since then, we have expanded our solution to 36 additional low and middle income countries. Our solutions have shown that getting a diagnostic test result faster can initiate treatment initiation sooner and help clinicians monitor patients over time. Our solution also helps national Tb programs track and monitor the functionality and utilization their fleet of diagnostic instruments and make more rational commodity forecasts. This helps optimize scarce health resources to better respond to and prevent Tb worldwide.

3. What are we doing for TB control:
i. Providing point-of-care diagnostic data services and decision support dashboards that tie into existing systems and provide a single view into a country's health care system. User-friendly alert systems enable health workers and supervisors at working in TB to understand diagnoses in real-time, take action, move inventory and more. Our open-source solutions provide the freedom national TB programs need to make the right data and technology decisions to improve the turn around time for diagnostics and expedite time to treatment.

ii. Implementing connectivity solutions to ensure access to TB data (diagnostic results, treatment initiation and monitoring, and clinical outcomes) in areas that suffer from power challenges, bandwidth constraints and spotty connectivity. SystemOne's technology has been called the "gold standard" of connectivity in the field. We have connected to Tb diagnostic instruments at point of care (GeneXpert and
 
Do you know about the UNHLM declaration:

Specializations / Areas of Work

Provision of drugs, diagnostics and commodities
Research and Development
Technical Assistance

Other Organization Information

Total number of staff in your organization: 26 - 50
Number of full-time staff who are directly involved with TB: 11 - 25
Number of part-time staff who are directly involved with TB: 1 - 5
Number of volunteers who are directly involved with TB: 0
 
How did you hear about the Stop TB Partnership: Involvement in TB control provision
If you were informed or referred by another partner of the Stop TB Partnership please tell us who: Lions Head Global Partners
Why do you wish join the Stop TB Partnership: Involvement in Stop TB Working Groups
 
Are you a member of a Stop TB national partnership: No
Are you in contact with your national TB programme: No
Please tell us how your organization is contributing to your country's national TB control plan:
In the 37 countries where SytemOne works, we provide connected diagnostic and clinical support platforms (GxAlert/Aspect) to provide real-time results to clinicians, partners, National TB Programs, and other MoH program staff.  A single web-based system centralizes case detection and empowers state, local, and national staff to identify diagnosed patients and enroll them on treatment.  Different module dashboards allow logistics staff to manage consumables management and distribution to prevent stock outs and expirations as well as forecast consumption and future procurement needs.  A separate module allows Authorized Service Providers to manage maintenance service, calibration dates, warranty expirations, and repairs.  Key service information is available to central program staff to monitor downtime and forecast service/warranty costs.  A custom data capture component allows additional fields and values to be defined centrally and pushed out to diagnostic machines.  When each new test is started, a popup window appears requesting the additional custom data, which is then associated with the test result and uploaded to the secure server.
 

Geographical Reach

Which country is your headquarters located in: United States of America
Which countries do you do operate in:
(This includes countries you are conducting activities in)
Afghanistan
Azerbaijan
Bangladesh
Botswana
Brazil
Congo
Equatorial Guinea
Eswatini
Ethiopia
Ghana
Indonesia
Kenya
Kyrgyzstan
Malawi
Mozambique
Myanmar
Nepal
Nigeria
Papua New Guinea
Philippines
Republic of Moldova
Sierra Leone
South Africa
Thailand
Uganda
Ukraine
United Republic of Tanzania
Zambia
Zimbabwe

Contribution

Please tell us how your organization will contribute to the Global Plan to Stop TB by briefly describing its involvement in any of the areas of work listed below:

TB Care Delivery:
In all 37 countries in which we work, we have currently connected GxAlert to the countries' fleets of GeneXpert machines for their TB and HIV assays. By having connected diagnostic instruments, the countries' TB programs and referring clinicians are in a position to receive diagnostic results in real time and initiate patients on treatment faster. This specifically contributes to early case detection through quality-assured diagnosis. Connectivity also allows for National TB programs to monitor case detection over time by geographic region, age and sex to see where "hot spots" of disease may lie within certain populations. As of October 2017, across the 37 countries, 1603 GeneXperts have been connected, 2.9 million results reported and over 600,000 result notifications sent to referring clinicians.

Drug-Resistant TB:
In 5 countries (Nigeria, Kenya, Kyrgyzstan, Mozambique, and the Philippines) we plan to conduct national GxAlert roll out to GeneXperts, MGIT, and LPA machines to connect all DR TB diagnostics by patient. By having integrated and interconnected diagnostic instruments the country program would be in a unique position to quickly determine who should be tested, whether they were tested, and whether patients diagnosed with mTB, DR-TB, or MDR-TB are potentially eligible for which drug therapies and shorter regimens.

Likewise, in these countries we are planning to rollout SystemOne's Aspect Reporter to remote treatment sites that either do not have a GeneXpert on site and/or are relying on centralized lab tests (MGIT, LPA) for diagnostic results. Reporter will allow each site to time stamp when a sample is sent and then receive the result in real time back to the Reporter device in the clinic. The Reporter will also come equipped with a clinical decision support application (content and training provided by one of our partners) to help clinicians interpret various results and get patients on the appropriate treatment faster.

Reporter will also come equipped to track patients at the treatment site through a unique SystemOne-developed patient ID system. By having a unified ID across tests-- Xpert, MGIT, LPA and HIV Viral Load, treatment outcomes and ongoing testing can be monitored and analyzed in case change in medication or duration of treatment is needed.

TB-HIV:
SystemOne's GxAlert already captures HIV VL results being used in countries that are using Abbot, Roche and Cepheid HIV VL instruments and assays. HIV VL results are sent in real time back to point of care via Aspect Reporter, SMS and email. HIV VL and TV results can be seen currently in Malawi, Mozambique, Tanzania, Guinea and Cameroon.

Laboratory Strengthening:
GxAlert and Reporter have the capability to accurately and efficiently improve clinical laboratory testing. The laboratory testing process consists of many steps, beginning with test selection and ordering, followed by sample collection and transport, sample processing and analysis, and finally, result reporting and interpretation. Errors or inefficiencies at any step of this testing chain can undermine the entire process and lead to suboptimal patient management. SystemOne’s GxAlert and Aspect Reporter™ provides reliable infrastructure for delivering test results back to point of care and decreases turnaround time from when a patient’s sample is drawn at the clinic to when the results are returned. Aspect Reporter™ is a system that streamlines and automates the flow of test results to and from the clinics and labs through a solar powered, cloud connected workstation throughout the country. It also has capabilities to improve order entry and specimen transport.

Likewise, GxAlert allows labs to monitor device performance, utilization, cartridge and assay use, error rates, service warranties and repair and alerts the lab when calibrations are necessary. We are also in Mozambique working to integrate DISA, DISALab and Open LDR systems via GxAlert so all diagnostic and lab information is centralized and can be shared across laboratory and clinical networks.

We are currently implementing Reporter in Malawi with plans in 2018-2019 to place reporter in Mozambique, Kenya, Nigeria, Kyrgyzstan, Philippines, and Zambia. GxAlert is in 37 countries to date (Oct 2017).


New Diagnostics:
SystemOne currently has relationships with Cepheid, BlueSense, ThermoFisher, Becton Dickinson, Hain, Abbot and Roche in connecting their devices used for diagnosing, TB, HIV, Dengue, and Zika. We are well positioned to support new diagnostics from these manufacturers and others as they come to market.

New TB Drugs:
In 2018-2022 in Nigeria, Kenya, Kyrgyzstan, Mozambique, and the Philippines, by connecting TB diagnostics to GxAlert and Aspect Reporter, we can enable and measure timely diagnosis to clinical care. The data generated can provide insights on correlations between treatment regimen and treatment outcomes, commodity supply and demand and drug resistance patterns mapped per country. The project will support clinicians to better track and treat patients put on various drug regimens and monitor their time to culture conversion and overall treatment outcome. Tracking and documenting clinical outcomes alongside their timely, individual diagnosis in a central repository will help with: a) surveillance efforts for 1st line and 2nd line drug resistance; b) mapping what drugs are needed, where, and when; c) mapping hotspots for transmission and d) reshaping drug procurement and treatment policy recommendations. The research conducted will provide rich information on DR mutations and clinical outcomes.

Fundamental Research:
Currently, in the 37 countries where we work, we are able to work with host country governments to identify custom fields so the country can track trends in TB-HIV confection, ART initiation rates, and TB treatment (including pretreatment) rates by age, sex, and specimen type (ie, pulmonary or EPTB). In addition to research purposes, having these custom fields automatically reporting can better inform annual planning and help programs streamline clinical decision making.

In addition, in 2020-2022 in Nigeria, Kenya, Kyrgyzstan, Mozambique, and the Philippines, we have proposed the following studies be conducted with one of our global research partners: 1) Clinical impact of the implementation of a TB diagnostic and connectivity platform for DR TB diagnosis; 2) Resistance profiles of DR TB patients assessed through different methods (LPA, Xpert MTB/RIF, MGIT Culture, New Genome Sequencing) and treatment outcomes among those with discordant results; 3) Cost effectiveness of the proposed intervention package using DALYs and QALYs as measure of disease burden; and, 4) Acceptability and perceptions of the use of the connected diagnostics platform for communication of TB lab results among lab technicians, health workers and NTP managers.


Declaration

Declaration of interests:
No conflicts of interest were delacred.

Application date: October 3, 2017
Last updated: May 2, 2018