Growing up in South Africa at the turn of the century, Emma Gibson saw the rise of the HIV/AIDS epidemic and its devastating impact on her home country, where many people lacked vital health care. At the time, Gibson was too young to understand what a sexually transmitted infection was, but she knew that HIV infected millions of South Africans and that AIDS claimed hundreds of thousands of lives. “As a child, I was terrified of this monster that was HIV and felt so helpless to do anything,” she says.
Today, as an adult, his childhood fear of the HIV epidemic has turned into a desire to fight it. Gibson seeks to improve health care for HIV and other diseases in resource-constrained areas, including South Africa. She wants to help health facilities in these regions use their resources more efficiently so that patients can more easily seek treatment.
To help him achieve his goal, Gibson trained in mathematics and logistics through higher education in South Africa. She first obtained her bachelor’s degree in mathematical sciences at the University of the Witwatersrand, then her master’s degree in operations research at the University of Stellenbosch. There she learned to solve complex decision-making problems using math, statistics, and computer simulations.
During her master’s degree, Gibson studied the operational challenges faced in rural South African healthcare facilities by working with staff at Zithulele Hospital in the Eastern Cape, one of the country’s poorest provinces. His research has focused on ways to reduce wait times by several hours for patients seeking same-day care. Ultimately, she developed a software tool to model patient congestion throughout the day and optimize staff schedules accordingly, allowing the hospital to care for its patients more efficiently.
After completing her master’s degree, Gibson wanted to continue her education outside of South Africa and left to pursue a doctorate in operations research at MIT. Upon arrival, she diversified her research and worked on a project to improve breast cancer treatment in health care in the United States, a very different environment than she was used to.
Two years later, Gibson had the opportunity to resume his research on health care in resource-constrained settings and began working with Jónas Jónasson, associate professor at MIT Sloan School of Management, on a new project aimed at improve diagnostic services in sub-Saharan Africa. . For the past four years, she has worked diligently on this project in collaboration with researchers from the Indian School of Business and Northwestern University. “My love language is time,” she says. “If I invest a lot of time in something, I really appreciate it.”
Sample transport planning
Diagnostic tests are an essential tool that allows medical professionals to identify new diagnoses in patients and to monitor the condition of patients during their treatment. For example, people living with HIV need regular blood tests to ensure that the treatments prescribed to them are working effectively and to provide early warning of potential treatment failures.
For Gibson’s current project, she is trying to improve diagnostic services in Malawi, a landlocked country in southeast Africa. “We have the tools” to diagnose and treat diseases like HIV, she says. “But in resource-limited settings, we often lack the money, staff and infrastructure to reach all the patients who need it.”
When diagnostic tests are needed, clinicians collect samples from patients and send the samples for testing to a laboratory, which then sends the results back to the facility where the patient is being treated. To move these items between facilities and laboratories, Malawi has developed a national sample transport network. The transportation system plays an important role in connecting remote rural facilities to laboratory services and ensuring that patients in these areas can access diagnostic tests through community clinics. Specimens collected at these clinics are first transported to nearby district centers and then transported to laboratories in urban areas. Since most facilities do not have computers or communications infrastructure, labs print out copies of test results and return them to facilities through the same shipping process.
The sample transport cycle is expensive, but it is a practical solution to a difficult problem. “During the Covid pandemic, we saw how difficult it was to develop the diagnostic infrastructure,” says Gibson. Diagnostic services in sub-Saharan Africa face “similar challenges, but in a much poorer setting”.
In Malawi, sample transport is managed by a non-governmental organization called Riders 4 Health. The organization has about 80 motorcycle couriers who transport samples and test results between facilities. “When we started working with [Riders], the couriers operated on fixed weekly schedules, visiting each site once or twice a week,” says Gibson. But it resulted in “a lot of unnecessary travel and delays”.
To make sample transport more efficient, Gibson has developed a dynamic scheduling system that adapts to today’s demand for diagnostic testing. The system consists of two main parts: an information sharing platform that aggregates sample transport data and an algorithm that uses the data to generate optimized routes and schedules for sample transport couriers. .
In 2019, Gibson conducted a four-month pilot test for this system in three of Malawi’s 27 districts. During the pilot study, six couriers transported more than 20,000 samples and results to 51 healthcare facilities, and 150 healthcare workers participated in data sharing.
The pilot was a success. Gibson’s dynamic planning system has eliminated about half of unnecessary trips and reduced transportation delays by 25% – a delay that was four days has been reduced to three. Now Riders 4 Health is developing its own version of Gibson’s system to operate nationwide in Malawi. Throughout this project, “we tried to make sure it was something that could grow with the organization,” she says. “It’s gratifying to see this actually happening.”
Leverage patient data
Gibson is finishing his degree from MIT in September but will continue to work to improve health care in Africa. Upon graduation, she will join the healthcare technology and analytics practice of a company based in South Africa. It will initially focus on public healthcare facilities, including Chris Hani Baragwanath University Hospital in Johannesburg, the third largest hospital in the world.
In this role, Gibson will work to fill gaps in African patient data for medical operations research and develop ways to use this data more effectively to improve healthcare in resource-constrained areas. For example, better data systems can help monitor the prevalence and impact of different diseases, showing where health workers and researchers are working to help the most people. “You can’t make good decisions if you don’t have all the information,” says Gibson.
To get the most out of patient data to improve healthcare, Gibson plans to reevaluate how data systems are structured and used in the hospital. For ideas on how to upgrade the current system, she will look to existing data systems in other countries to see what works and what doesn’t, while also drawing on her past research experience. in health care in the United States. Ultimately, she will tailor the new hospital data system to South African needs to accurately inform future healthcare directions.
Gibson’s new job — her “dream job” — will be based in the UK, but she plans to spend a lot of time in Johannesburg. “I have so many opportunities in the rest of the world, but the ones that attract me are always back where I came from,” she says.