Open-Source Integration for Advanced AMR Data Management (OSI-ADAM)

OSI-ADAM would be an open-source digital tool that utilizes Artificial Intelligence to provide bespoke information to users, while generating evidence-based data to guide AMR policy decision-making. OSI-ADAM would leverage multi-sectoral data collected using tools that are integrated into everyday mobile use to analyze AMR trends, economic impacts, and treatment optimization.

Dr. John Amuasi heads the Global Health Department at the KNUST in Ghana, Group Leader of the Global One Health Research Group at BNITM, Germany and KCCR in Ghana.

Existing AMR data in Ghana and other LMICs in sub-Saharan Africa is crucial for policy formulation and development of intervention strategies. However this data falls short in several key aspects: it is not representative of the broader population, lacks standardization, does not include citizen-generated data and lacks a centralized coordination system for real-time data aggregation and analysis. Moreover, the methodologies employed in data collection often lack transparency and reliability, undermining the credibility and usefulness of the information gathered. This situation creates a significant barrier to generating actionable insights, essential for effective AMR management. Without a solid foundation of reliable, standardized, and centralized data, efforts to combat AMR lag significantly, preventing the development of targeted, impactful policies and interventions. Addressing this core issue requires a strategic overhaul in how AMR data is collected, analyzed and presented in actionable formats needed to guide evidence-based health decision-making.

OSI-ADAM will serve a broad range of stakeholders in Ghana which can be extended to other LMICs. First, it offers policymakers and health officials an easy and cost-effective way to gather and analyze standardized and reliable patient data on the use of antimicrobials, using tools that are already integrated into everyday use. Furthermore, they can easily extract insights on antibiotic use, allergies, adverse reactions, patient compliance, demographics, accessibility and cost of treatment, prescription patterns, and usage without the need for technical skills, and where already existing data is available through electronic health records. Second, the platform provides consumers/patients with a convenient way to chronicle and report their antibiotic use and receive valuable feedback including medication reminders and drug side effects. Third, the open nature of OSI-ADAM means that the aggregated and anonymized data collected can serve as a valuable resource for clinicians by integrating existing hospital data (obtained via existing HIMS used in facilities) and other microbiology data such as antimicrobial susceptibility data to support clinical decision making. It will also be a valuable platform for academic and clinical researchers studying AMR patterns, treatment outcomes, and resistance mechanisms.

OSI-ADAM will serve as a platform that can generate comprehensive and real-time evidence needed to support informed policy decisions and guide the development of targeted interventions to combat AMR. The platform increases awareness and engagement among the public and healthcare providers by facilitating easy data contribution and access to AMR information. This broad participation helps build a more informed society, aware of the proper use of antibiotics and the challenges of AMR.

Additionally, OSI-ADAM integrates patient-reported data with healthcare records, enriching the data pool for more accurate and actionable insights. This integration benefits public health officials and researchers by offering a comprehensive view of AMR trends and antibiotic usage, aiding in the design of precise, effective interventions.

OSI-ADAM will create a significant impact in the following ways:

1. For Policymakers and Health Officials: It provides accurate data on AMR and antimicrobial use, enabling the formulation of effective policies and interventions to promote rational antibiotic use to reduce the emergence and spread of resistant bacteria.
2. For Patients and the Public: The platform increases awareness about antibiotic use and resistance. Patients get information on their medications, promoting responsible use and adherence to treatments while also receiving other relevant information on antibiotics dos and don’ts.
3. For Researchers: As a continuous learning platform, OSI-ADAM will offer a valuable dataset for studying AMR patterns, supporting research that can lead to new strategies and treatments for fighting AMR.

By addressing these areas, OSI-ADAM contributes to better health outcomes, enhanced public health policies, and a more informed public, helping to curb AMR in Ghana. This approach not only aligns with national health priorities but also adds to the global effort to mitigate AMR challenges.

In the coming year, we will concentrate on pilot studies in the Amansie West and the Asante Akim North Municipal Districts in the Ashanti region and the Assin Central Municipal District of the Central region of Ghana where we have set up AMR surveillance systems and established long-standing collaboration with the district hospitals and the communities within the districts. The pilot will enable us to refine and adapt the platform for wider AMR surveillance and management using the insights gained to enhance OSI-ADAM's effectiveness and user engagement.

Leveraging the success and learnings from the selected sites, we aim to expand OSI-ADAM to other parts of Ghana and Africa. This expansion strategy is supported by our key role in the African Coalition for Epidemic Research, Response, and Training (ALERRT), facilitating collaborations with public health regulatory authorities, including the Ministry of Health in Ghana and similar bodies across Africa.

1.       OSI-ADAM Engagement: By targeting about 10,000 active users at the end of pilot phase in the pilot sites which possess both rural and semi-urban characteristics, we anticipate patients to actively engage the system with about 60% following through and adhering to their treatment regimens. This will be evaluated through interaction monitoring and patients confirming the successful completion of the dose regimen.

2.       OSI-ADAM Adaptive Learning: We anticipate the system to keep adapting and advancing in providing usable output information and response to users. This will be measured based on how users rate the usefulness of the information they received during their interaction with the system.

3.       Increase in AMR Awareness:  OSI-ADAM is expected to promote positive health seeking behaviour in both the short and long-run. We anticipate the effect of this to be a 30% rise in AMR awareness and appropriate use of antibiotics by the end of the first year of implementation. This will be evaluated through pre- and post-intervention surveys.

4.       Economic Impact: Through such evidence-based decisions, we project a 25% reduction in AMR-related healthcare costs within three years among the health facilities that adopt and integrate OSI-ADAM into their existing database.

1. Financial Constraints: Sustaining such a not-for-profit intervention, requires significant investment and support. With this proof of concept, we aim to secure funding through global health innovation grants and partners with local and international health organizations as well as local stakeholders such as the Ministry of Health, the Ghana Health Service, and local telecommunications providers to support its sustainable implementation.
2. Legal and Policy Hurdles: Leveraging support from our institution’s legal framework and our working relationship with the Ministry of Health in Ghana, results from the pilot could prove critical in galvanizing the needed support from key stakeholders including the Ministry of Health and the Ghana Health Service to ensure smooth processing to meet all required data protection laws and supportive digital health policies and regulations.
3. Cultural and Education Gaps: Rural Ghanaian populations are mostly skeptical about adopting new technology, particularly when the area of the innovation is not well known and understood. Using targeted education campaigns and leveraging our rich experience and engagement with the target communities’ leaders and local authorities from previous studies including clinical trials and interventions, we will bridge the digital literacy gap using available local and traditional platforms and channels to build trust in OSI-ADAM.

1. Technical Challenges: Our current capacity supports a low scale deployment of the tool in the short run. However, we intend to build capacity and collaborate with tech firms in Kenya and Ghana and experts in academia with the required capacity and technical know-how to enhance our platform's scalability and robustness.
2. Infrastructure Limitations: Through this pilot face we aim to establish the base infrastructure but anticipate expanding during scale up to accommodate the traffic. Acknowledging the limited access to internet networks in remote and rural communities, we plan to establish offline functionalities and partner with telecom companies to promote access to such populations.

TBD