Shifo Selects Resilio Platform for Reliable Data Ingest and Automated Processing From the Extreme Edge

Introduction

Millions of children in hard-to-reach communities suffer or die from preventable diseases each year. Vaccinations and medications for diseases like polio, malaria, measles, tuberculosis, pneumonia—and now Covid—can’t reach the mothers and children that need them most. Shifo’s mission is to change that—where nobody dies from preventable diseases. 

Through the development of reliable, sustainable, and cost-saving health data solutions, Shifo is helping partner countries and health organizations save millions of lives and reduce the cost of delivering healthcare to remote communities. Shifo’s system is adopted by over 3,000 communities across eight countries, and reaches over one million patients worldwide.  

To do so, Shifo relies on timely, dependable, and predictable file delivery over extremely poor quality networks. And that’s where Resilio comes in. Shifo trusts Resilio Platform to move its transformational healthcare data to remote communities, in the fastest time possible. 

Shifo’s file delivery times went from months to days using Resilio Platform. 

Challenges

According to Rustam Nabiev, Shifo’s CEO and IT leader, the most vulnerable populations are those farthest  from centralized health facilities with running water, electricity, and computer devices connected to networks. 

What healthcare records exist are fragmented. “In Uganda, for example, there are massive information gaps. In some communities, there is no census information on kids. Are they getting the nutrition that they need? Or vaccines? How could we simply get this data?”

In the past, collecting data on smartphones and other handheld devices hasn’t worked well; devices are costly, stolen, broken, or in need of technical support. While that may change in the future, Shifo needed a solution today—and developed its Smart Paper Technology (SPT) to simplify data collection and improve data accuracy. Frontline workers use SPT to collect health information on each patient. SPT forms are gathered and taken to remote facilities where they are scanned and digitized. 

Once digitized, the challenge then became moving the data from each facility. Each facility has a scanner connected to a PC and slow, unreliable, or intermittent Internet connectivity.  

Solution

Shifo’s innovative hybrid physical & digital solution blends Smart Paper Technology (SPT) with Resilio Platform. Healthcare workers use SPT on the frontend replacing conventional paper. Resilio Platform is used on the backend at each scanning facility—as a ubiquitous system to centrally control and manage file delivery across all remote locations. 

Resilio Platform is a software-only, agent-based solution that runs on Windows and other popular operating systems. Resilio agents run on each Windows system in the remote facility.  As SPT forms are scanned at each facility, files are digitized and automatically synchronized. 

The Shifo team uses the Resilio Platform management console to centrally manage all operations from its operations center in Sweden. The team tracks, monitors, and automates all file delivery operations for each participating country.  Once the smart paper forms are collected and scanned, they are digitized to PDF, and stored on a remote PC. Once scanned, Resilio Platform automatically detects the new file and reliably uploads the PDF to a remote server. Once uploaded, the files are stored and processed by Shifo’s health information management systems (HIMS). 

Having this smart form data continuously available to the HIMS system is hugely valuable. Shifo’s customers and stakeholders rely on timely access to this health data for each country. This health data pipeline automates data conversion, ingestion, and processing for the healthcare system. 

This is no easy task at the extreme edge—especially in the Congo—where failures and problems are commonplace. Resilio’s unique peer-to-peer software architecture dynamically routes around network interruptions and failures. Unlike traditional file transfer software, Resilio overcomes failures in the network, network latency, and other routing issues. The architecture is well suited to far edge deployments and handling unpredictable connectivity—no matter how poor. Connections can be dial-up, radio, cell, VSAT, WiFI, as well as fast broadband and multi-gigabit networks. 

Shifo piloted Resilio Platform in all eight countries and standardized on Resilio. Shifo standardized on Resilio to deliver accurate, actionable, and timely data.

Impact

Today, Shifo’s entire file flow is built around Resilio Platform. The solution is extremely rugged, resilient, and reliable—and what Nabiev refers to as “Congo approved”.

Highly reliable and predictable file delivery

Shifo is able to predictably transport and synchronize files of any size and type across any type of network; no matter how poor or unreliable the connection.  

“Resilio Platform reliably runs in the background—and just works. Like a humble, dependable friend,” added Nabiev. “

The more reliable the solution, the faster we can start moving files and making changes. Resilio gets the job done, even in areas with intermittent or extremely poor connectivity.  Larger file uploads still take some time—where bandwidth may only be a few kilobits—but we feel confident knowing that all of the vital health data will be delivered in predictable timeframes. We know how long it takes to move the data.”   

“We went from weeks waiting on file uploads and sync with Google Drive to a few hours with Resilio,” stated Nabiev.

Faster healthcare information delivery

Nabiev believes timely reporting—getting the right information into the hands of healthcare teams ASAP—is of the utmost importance. Shifo tracks the time it takes to collect, process, and deliver information—back into the hands of healthcare workers and decision-makers. 

“We deliver health information monthly instead of in 3 to 5 years. And we are gradually moving from monthly data to real-time data,” he says.   A big part of this relies on Resilio.  

“Now our frontline people have the most up-to-date and accurate information. We believe this new system enables a key missing piece to achieving our vision that no mother or child dies from preventable diseases. Which kids have problems and where are they located?  Which facilities are performing well? We report on this on a monthly basis.”  

But Shifo isn't stopping there. Nabiev says that healthcare performance can be continuously improved and dramatically faster. As healthcare workers are able to scan directly from their devices, doing more data entry on smart devices, then we can transition from Smart Paper to faster data collection tools. “Resilio will continue to enable this no matter the type of data entry and collection.” 

Improved visibility to save time and gain peace of mind

The Shifo team uses the Resilio management console to centrally control, monitor, and visualize file delivery. Shifo saves time managing and tracking file synchronization jobs and other tasks. 

“With Resilio, we save a lot of time. There’s no more troubleshooting or worrying which files were sent and which were not,” says Nabiev. 

The team gains visibility into file delivery operations like:

• Job tracking status or individual countries—at each remote facility.
  

• Progress on transfers and synchronization jobs to determine how much data has been delivered—and projected delivery times.
  

• Bandwidth policies and allocations for each remote facility. 
  

• Infrastructure-independent. Resilio supports any type of on-premise data center (network, servers, storage) and cloud provider, out-of-the-box.
  

Scaling the system and improving health outcomes

Another goal was scale: delivering a reliable, cost-saving, and scalable model for each partner country.  According to Nabiev, “We’re helping healthcare workers through simplicity and ease of use; so they would not need to fill in 15 different paper-based forms.  Each deployment needs to scale within and across the host country to initiate systemic change.

”While the Shifo system itself works well, this is not an overnight process. Nabiev says it takes time for governments and stakeholders to make policies and change their systems. “That said, once we pilot this solution successfully, then we scale nationally.”  

“The real success is when things are working, operations-wise,” says Nabiev. “Operations are working flawlessly with Resilio, where things just work. And when the data is in place, that’s just the beginning.”

Congo approved—resilience for extreme endurance at scale

Naviev says the ultimate litmus test for Resilio was validated in the field:  “Any solution we deliver has to be Congo approved. That’s the solution we are building. Resilio is really hard to kill when it’s up and running. It’s important because governments don’t have much money to maintain these systems. And if it’s not easily maintainable and reliable it’s going to die.”  

“We sleep better because Resilio is there. That’s a critical piece. You can’t imagine how difficult it was for us (prior to Resilio): Delays, nothing being synchronized; now I don’t hear any of those problems. Now we can focus on solving healthcare problems (instead of moving files).”  

“It’s amazing what you guys are doing. Without Resilio, many things wouldn’t work or be possible. Resilio is an important piece in the bigger puzzle.” 

Part of that puzzle improves data accuracy, says Nabiev. “When you have accurate data, that’s when you start doing all the exciting things. Helping children and saving lives. Now managers can proactively reach out to villages and people to spend more time to give them services and educate them on healthcare services. That type of information is critical.”

“It’s amazing what you guys are doing. Without Resilio, many things wouldn’t work or be possible. Resilio is an important piece in the bigger puzzle.” – Rustam Nabiev, CEO and IT leader @Shifo Foundation.