Biometric Monitoring as a Persuasive Technology: Ensuring Patients Visit Health Centers in India’s Slums

Managing chronic disease is particularly challenging in the developing world, because every trip to a health center can translate to lost time and wages on the part of the patient. This problem is especially acute for tuberculosis patients, who in India are required to visit a center over 40 times in the course of a six-month treatment period. In this paper, we explore the role of a biometric attendance terminal in persuading patients to complete follow-up health visits in slum communities of New Delhi, India. The terminal, which enrolled over 2,300 patients across 25 centers during our 2 years of observation, uses biometric fingerprint scanning to ensure that tuberculosis patients receive and take medications on the right schedule. We evaluate the perceived impact of the terminal via interviews with 8 health workers, 4 center owners, and 23 patients. Our findings suggest that the biometric terminal helps to draw patients to the center, both by incentivizing health workers to convince patients to come, and by persuading patients that in-person visits are important.