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The PEARL Study (run by the University of Sydney and the Ministry of Health Kiribati) is part of the World Health Organization’s ‘End TB Strategy’. Focusing on the Republic of Kiribati, PEARL aims to systemically test the population of South Tawara for active and latent TB, and leprosy. Following initial diagnostic tests, participants will be offered preventive or active treatment, as appropriate.  Through a concerted island wide test and treat programme, this intervention aims to eradicate TB and leprosy from the island population.

Participant identification is a recurring problem in the Pacific Islands; the PEARL Study is therefore employing Simprints facial recognition software as a primary means of patient identification. Handheld tablets are used to run the identification process (Health Selfie) and collect participant data via the REDCap app. A REDCap (data management platform) backend system is used to gather and store participant’s health and treatment information. Simprints and REDCap do not naturally integrate, so PEARL Pal was developed by the Software for Health foundation, to act as a companion app, to transfer the Simprints generated participant identifier into the REDCap database. PEARL Pal pull supporting participant information (such as name, age, and sex) from the REDCap database into PEARL Pal to assist the app user with identification of returning participants.

The Software for Health Foundation, (part of the AoS Health initiative), has worked in collaboration with the University of Sydney and Simprints to develop ‘PEARL Pal’ which runs on Android tablets, to enable ‘on device’ transfer of information between Simprints, REDCap and the REDCap API. Connectivity and mobile data access is an additional challenge in the Pacific regions, and South Tarawa is no exception. To address this PEARL Pal works in an offline mode and will synchronise data with REDCap during daily synchronisation events. This will transfer new information gathered that day to the REDCap database and pull-down participant records to PEARL Pal to enable future participant identification. 

PEARL Pal is used early in the participant enrolment stage of the intervention, to trigger Simprints to open. Simprints is then used to take a facial scan of the participant, capturing facial coordinates, and generating a global unique identifier (GUID). This GUID is returned to the PEARL Pal application and then transferred to the relevant participant file in REDCap, during the following synchronisation event. Participants (especially if receiving treatment) will return over a period of 3-4 months, during which, PEARL Pal will be used to identify the returning individual, by matching the facial scan to the GUID stored in the patient records.

The innovative approach has never been used with a Pacific Island community before so as well as the PEARL Study working to eliminate TB and leprosy, it is also acting as a pilot study for a new way to identify patients and linking health records to individuals. The Software for Health Foundation’s on device interoperability application PEARL Pal sits at the heart of this innovative data journey, linking existing and pre-selected digital tools together, to create a robust and workable on-island data management service.

The next steps for PEARL Pal are to establish a more generalisable and distributable version which can be configured for a wide variety of scenarios including the configuration of data collection fields, and to make the app widely available, in order to establish it as a global public good. There is a huge amount of potential for this application, as it allows for information to be transferred between previously incompatible applications. Although initially a developed as a prototype application for this specific project, the PEARL project will provide a way to further gather requirements to make the application more distributable when development continues.