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Cell phones are increasingly being used as common clients for a wide suite of distributed, database-centric healthcare
applications in developing regions. This is particularly true for rural developing regions where the bulk of the healthcare is handled by health workers due to lack of doctors; the widespread availability of cellular services have made mobile devices as an important computing platform for enabling healthcare applications for these health workers. Unfortunately, the current SQL model for distributed client/server systems is far too heavy-weight for these applications, particularly in light of the high
communications cost and extremely limited data transmission
capacity available in these environments.
In this demonstration, we describe the Efficient Lightweight Mobile Records (ELMER) system that provides a
practical and lightweight database access protocol for accessing and updating records remotely from mobile devices under an extremely bandwidth and cost-constrained Short Messaging Service (SMS) channel comprising of 140 byte packets. The design of ELMER employs a number of techniques including semantic compression of messages, a reduced query set, a userbased intermittent database consistency model and the batching of queries to reduce bandwidth and per-packet costs. Additionally, ELMER includes an SMS reliability layer to cope with poor wireless service, and a lightweight privacy model to prevent identity spoofing and theft of sensitive data. We have implemented ELMER using the RMS functionality in J2ME, and integrated it into an HIV treatment application we are developing for use by African health workers.