neoWEAR-Neonatal Wearable for Early Assessment and Referral, a wearable device to end preventable neonatal death.
What is it?
Over 2.9 million babies die each year in low and middle income countries, many due to preventable causes. The Mortality Busters team has developed neoWEAR-Neonatal Wearable for Early Assessment and Referral, a wearable device to address this disparity and end preventable neonatal death. neoWEAR is a mobile health solution that combines the simplicity of wearable sensors with the incredible power of machine learning to generate a risk score, which identifies neonates with the highest risk of death.
Imagine simple, inexpensive wearable sensors that Community Health Workers (CHWs) place on neonates that record heart rate, oxygen saturation, respiratory rate and temperature. This valuable information could be used to detect neonatal distress or illness and identify the need to refer the patient to a facility in a timely fashion. The problem is – who is equipped to make these inferences and appropriately assess the health of the baby? CHWs do not have the adequate training or expertise to make these judgements alone. Now imagine that CHWs were armed with a mobile phone application that receives vital signs data and uses a validated risk-prediction algorithm to categorize risk of mortality for neonates as “high” or “low” for early referral. This is the multi-faceted approach that the Mortality Busters will use to bridge the gap in neonatal care in remote, resource-poor communities all across the world.
How is it used?
The vital sign sensors will be worn on the body where they are able to acquire the necessary biological signals. See the neoWEAR storyboard “How neoWEAR is used”.
What technologies does it incorporate?
The design incorporates sensors, data capture, and machine learning to execute its assessment of neonatal status. The technology used to measure both oxygen saturation and heart rate will be pulse oximetry, since it a universal and validated approach to gathering these data. However, it is imperative that the Mortality Busters team is able to design robust, low-cost sensors that require low power. The respiratory rate sensor measures changes in the volume of the chest cavity while breathing with a chest band. A simple thermistor for temperature measurement completes the vital signs monitoring system.
NeoWEAR also uses a mobile phone app with a mortality risk prediction algorithm to calculate a risk score based on the vital signs data. The algorithm utilizes a modified version of PhysiScore, an existing risk-prediction score for neonates with a high sensitivity and specificity (see reference to PhysiScore in section “Why do we need it?”).
How does it work?
The early stage prototype, which is currently under development at the Johns Hopkins University Center for Bioengineering Innovation and Design, incorporates a respiration rate measurement sensor and temperature sensor into an easy-to-wear chest band. The combined oxygen saturation and heart rate sensor is incorporated into an adjustable sock that can be put onto the foot of the neonate. While data is recorded, the Community Health Worker (CHW) would input a few simple answers to questions on the mobile phone application (such as birth weight and approximate gestational age). The data acquired is fed into a mobile phone app that calculates a risk score using a unique risk prediction algorithm and outputs an assessment of the neonate, which could be “high” or “low” risk of death. High risk infants would be referred to a facility where they could receive appropriate treatment.
Who uses it?
neoWEAR is worn by infants and the app is used by Community Health Workers in order to make referral decisions for the neonate. The data will be transferred to a data server where over time, it can be used to further refine prediction algorithms and for neonatal health surveillance.
Why does it help?
neoWEAR solves the problem by improving the early recognition of neonatal distress. More than 75% of neonatal deaths occur on the very first day of life due to complications arising from preterm birth, birth asphyxia or sepsis. Community Health Workers (CHWs) do not have sufficient clinical education to consistently and accurately evaluate the clinical signs and symptoms arising from these conditions. Therefore, when subtle signs of an impending medical emergency begin, a CHW may not refer a neonate to receive care at a facility until the signs of distress become more apparent. However, this pause in seeking care allows the disease condition to progress further and will become more difficult to treat by the time care is ultimately sought.
neoWEAR will solve this problem by encouraging CHWs to refer patients when the disease condition is less severe, and sufficient time still exists to seek the necessary care. The device’s ability to decipher vital signs and produce a meaningful assessment reduces the human error that exists with the CHW’s judgement. Therefore, the inclusion of the device in the routine assessment of neonates immediately after birth will create a more timely and reliable referral process.
Neha Goel, Chanya Godzich, Joseph Pia, Samuel Zschack, Victor San Hou Yu
Diagnosis/Treatment/Referral, Data Collection/Data Insight
These pages have been pulled directly from applications submitted to the Wearables for Good Challenge in 2015. They represent the work of the individual teams and have subsequently not been edited.