Governance
Nothing reaches a phone without a source, a signature and a second signature.
Your medical director writes the reasoning. TPAS enforces how it is approved, changed and recorded, so you can show anyone exactly what was in use on any day, and who put it there.
The lifecycle
Six states, and the server decides when a protocol may move.
- DraftWritten in clinical terms
- Clinical reviewAttested by the medical director
- Business approvalA different person signs
- TestingWalked on a handset
- ActiveOn every phone
- RetiredKept, never deleted
- Sources
- WHO IMCI chart booklet 2014 · WHO/UNICEF iCCM 2012 · Liberia MoH CHA algorithm 2017
- Contents
- 11 questions, each citing its guideline section · 3 diagnoses · referral rules for young infants and danger signs · amoxicillin dose bands by weight and age
- Attestation
- “I have checked each question, threshold and dose band against the cited sources, and the protocol reflects them faithfully.”
- CitedNo protocol can be submitted without its source document, version and date.
- AttestedThe medical director approves in their own words, against the source.
- Two peopleThe second approval must come from someone else. The system will not accept it otherwise.
- Safe to activateActivation is refused while any question, rule or term it uses is still a draft.
- LockedActive protocols cannot be edited. A change is a new version through the same cycle.
- KeptRetired versions stay on record, so the protocol in use on any date can be shown.
Who can do what
Each person sees and signs only what their role allows.
Permissions are checked by the system on every action, not just hidden on the screen. Each program shapes its own roles. A funder can read the dashboards without being able to change a dose.
- Health worker
- Runs visits on the phone, records what they observe, gives the treatment the protocol allows and refers when it says so.
- Supervisor
- Follows escalations to their outcome, reviews visits answer by answer, and gives feedback on field observations.
- Clinician
- Reviews cases and, where they hold the right, records a diagnosis by hand. The record says it was made by a person.
- Medical director
- Writes and attests protocols against their sources. Nothing clinical goes live without this signature.
- Approver
- Gives the second signature. The server refuses it from the person who gave the first.
- Observer
- Reads dashboards and reports for a ministry, a funder or an evaluator. Changes nothing.
The audit trail
The record answers for itself.
Every action is recorded: who acted, in which role, what the record looked like before and after, and when. Corrections link to what they replaced. Skipped questions and referrals not made carry their reasons.
We attack our own approval rules on purpose, trying to get around signatures, roles and the order of steps, so that nobody else finds a way first.
- Medical directorActivated version 2 · handset test notes attached
- Program leadBusiness approval · version 2
- Medical directorBusiness approval refused · same person as clinical approval
- Medical directorClinical approval with attestation · version 2
- Medical directorFast-breathing threshold for 2 to 11 months · 50 a minute
Questions clinical leads ask
Straight answers.
Who is clinically responsible for what TPAS recommends?
The medical director who signs a protocol. TPAS applies their protocol exactly as approved and records who approved it, when, and against which source. It supports the health worker's judgment. It does not replace it.
Is TPAS artificial intelligence?
No. There is no model in the decision path. TPAS scores findings against rules a clinician wrote, with weights a clinician set, and the same answers always give the same result. Every recommendation can be traced back to the rule that produced it.
Can we use our own protocols?
Yes. Your medical director can adapt the demonstration protocols, complete one of the WHO reference drafts, or write new ones in clinical terms, without code. Every protocol goes through the same review, two signatures and handset walk before it is used.
What happens when national guidelines change?
The medical director drafts a new version against the new source. It passes the same review and signatures, is walked on a handset, and replaces the old version on every phone at once. The old version is retired and kept, so earlier visits still show the rules they were made under.
Can a health worker ignore a referral?
Not silently. A danger sign recommends referral, whatever the score, and home treatment is not offered. If the health worker leaves without referring, TPAS asks why, records the answer, and the supervisor sees it.
Request a demonstration
See a protocol go from draft to every phone.
In one hour, with demonstration data:
- A protocol, its sources and its signatures
- A second signature refused, and why
- A visit on a phone, both paths: treat at home and refer
- The audit trail behind all of it
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