Diagnosing Pneumonia with the Phone Oximeter

Diagnosing Pneumonia with the Phone Oximeter

UgandaVancouver, Canada
Organization type: 
nonprofit/ngo/citizen sector
Project Stage:
Start-Up
Budget: 
$250,000 - $500,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

UBC’s Phone Oximeter will provide an ultra low cost mobile device for the diagnosis and treatment advice for children with pneumonia in low-resource settings.

About Project

Problem: What problem is this project trying to address?

Pneumonia is known to be a global health priority (WHO), killing over two million children under five each year. Almost all deaths occur in low/middle income countries. Diagnosis is a major hurdle to effective treatment. Lack of access to clinical experts and costly tests for diagnosis delay treatment and reduce survival. Many deaths can be prevented by early detection and simple, timely treatments. Low blood oxygen saturation is a strong predictor of critical illness in pneumonia and can differentiate the common cold from a serious lung infection. Detection of key signs (abnormally high heart and respiratory rates) can improve accuracy in diagnosis.

Solution: What is the proposed solution? Please be specific!

The Phone Oximeter is a robust, portable, low-cost ($0.10 per test) system for rapid diagnosis and treatment of children with pneumonia. The device integrates a pulse oximeter with a cell phone, widely available in low income countries. The computing power of the cell phone, its peripheral resources (display; audio and serial connectivity), battery power and wide availability offer the chance to build a low-cost device that can be used by lay health workers. This novel device extracts additional key clinical information such as respiratory rate. The phone then rapidly displays diagnostic and treatment advice for pneumonia. Treatment response can be followed by repeated measurements with the Phone Oximeter. Early intervention will improve care and lowers cost by conserving rare, costly resources (i.e. oxygen, transportation). This addresses the components (Availability, Accessibility, Appropriateness, Affordability) required for global access of a medical device identified by the WHO.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

A mother sends a message to the local lay healthcare worker that her child has a cough and fever. These are the same symptoms observed in her neighbor’s child who died recently. The lay health worker visits the child, uses her Phone Oximeter to detect a low blood oxygen level, high heart rate and high respiratory rate. The Phone Oximeter advises her to administer an oral antibiotic and transfer the child immediately for treatment in a local clinic which has already been alerted of the severity of the child’s condition through the Phone Oximeter. The clinic immediately arranges for transportation of the child. The child is diagnosed within minutes and treated within hours rather than days or weeks. At the clinic, health care workers monitor the child with pneumonia using the Phone Oximeter (looking for changes in blood oxygen levels).. The health care workers administer oxygen on a priority, as-need basis based on the measured blood saturation level from the Phone Oximeter. This allows the clinic’s valuable oxygen supply to be used in the most efficient manner possible. Additionally, patient response to treatment is assessed by the Phone Oximeter.
Sustainability

Marketplace: Who else is addressing the problem outlined here? How does the proposed project differ from these approaches?

Clinical pulse oximeters have been marketed by industry competitors such as Nonin and Masimo. These devices are are bulky, high-cost and with poor user interfaces, preventing widespread use in developing countries.They are designed for monitoring during anesthesia and not for disease diagnosis. The Phone Oximeter is the first pulse oximetery based on a cell phone. These competitor devices do not extract breathing rate, or provide the expert clinical diagnosis and treatment advice that the Phone Oximeter can provide.
Team

Founding Story

I have trained and worked as a pediatric anesthesiologist for the past 25 years. I had witnessed the introduction of pulse oximetery into anesthesia (since 1985) and appreciated the significant enhancement in safety that this simple technology has had on anesthesia practice. I also understood the potential for pulse oximetry to be used in a wide number of additional clinical settings. However, the adoption of this new technology was slow – mainly due to the lack of accessibility and affordability. Being born and trained in Africa made me especially aware of the specific challenges to providing quality health care in these settings. One day, while travelling in a remote area of Africa I was amazed at the number of cell phones I had seen – even being used by the some of the most impoverished members of society, regardless of literacy. The idea of leveraging these readily available computers to provide simple diagnostic advice to anyone with a cell phone made my “Aha!” moment.
About You
Organization:
Pediatric Anesthesia Research Team and Electrical and Computer Engineering in Medicine, University of British Columbia
About You
First Name

Mark

Last Name

Ansermino

About Your Organization
Organization Name

Pediatric Anesthesia Research Team and Electrical and Computer Engineering in Medicine, University of British Columbia

Organization Country

, BC, Vancouver

Country where this project is creating social impact

, KMP

How long has your organization been operating?

More than 5 years

Innovation
How long have you been in operation?

Operating for more than 5 years

Which of the following best describes the barrier(s) your innovation addresses? Choose up to two

Access, Cost, Quality.

Social Impact
Please describe the goal of your initiative; outline what you are trying to achieve

Pneumonia kills over 2 million young children each year, although very simple treatments such as oxygen and antibiotics could save many lives. Because pneumonia occurs primarily in areas with restricted resources and access to clinical expertise, the cost of diagnosis is currently too high. We aim to produce a tailored mobile phone oximeter, capable of diagnosing pneumonia and providing reliable treatment recommendations for under $0.10 per test. This device will harness the processing, display and connectivity functions of the mobile phone, so that diagnosing and organizing treatment for pediatric patients with pneumonia will be at the fingertips of health care workers.

What has been the impact of your solution to date?

The Phone Oximeter is currently undergoing field trials in Uganda for the detection of critical events during anesthesia. Early identification of airway and respiratory problems that lead to low oxygen levels in the blood (hypoxemia), is the key to patient safety. Our Phone Oximeter is providing affordable and robust pulse oximeters that can be used by both specialist and non-specialist healthcare workers. This same technology can be used to diagnose pneumonia, also a cause of hypoxemia. A customized Phone Oximeter for the diagnosis of pneumonia is currently being developed by our team.

What is your projected impact over the next five years?

Our research team has focused our engineering efforts on pulse oximetry because of the potential global impact of this simple, non- invasive technology. There are a number of high impact applications of this technology. For example, childhood pneumonia is responsible for more than 2 million deaths in children less than 5 years of age. If we could reduce the rate pneumonia related mortality by only one percent with the use of this inexpensive device, we could conservatively save 20,000 lives a year!

What barriers might hinder the success of your project? How do you plan to overcome them?

The barriers to success are 1) Technical: to produce a robust pulse oximeter that would operate on a range of cell phones types at low cost. A number of our engineering and clinical projects address the challenges in developing such a device. Based on our progress to date the question no longer is not if we can achieve this, but rather whether we can support all cell phones and how low costs (hardware; training) can be. 2) Clinical validation: We validating our devices in a number of clinical studies. Steps towards regulatory approval (design specification; hazard analysis) are being undertaken. 3) Scale up: mass production and getting devices to those who need it is the biggest challenge. Partner organizations are assisting with this process and a draft plan has been produced.

Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact

Produce a prototype Phone Oximeter for pneumonia diagnosis for testing in a low-resource setting.

Identify three major tasks you will have to complete to reach your six-month milestone
Task 1

Produce a prototype for pneumonia diagnosis and management through hardware, algorithm and cell phone application development.

Task 2

Collect preliminary data from children with pneumonia in low or middle income country.

Task 3

Develop a diagnostic pathway for pneumonia diagnosis and treat based on preliminary data.

Now think bigger! Identify your 12-month impact milestone

Evaluate and implement usage of the Phone Oximeter for diagnosis and treatment of Pneumonia in a low resource setting.

Identify three major tasks you will have to complete to reach your 12-month milestone
Task 1

Usability evaluation of prototype Phone Oximeter by clinicians in developed and developing settings.

Task 2

Usability evaluation of Phone Oximeter by lay health workers in a low resource setting.

Task 3

Pilot study of Phone Oximeter for diagnosis of pneumonia in low resource setting.

Sustainability
Tell us about your partnerships

Partners include the British Columbia’s Children’s Hospital, Grand Challenges Canada, Canadian International Development Agency (CIDA), The University of British Columbia (UBC), British Columbia Children’s Hospital Foundation (BCCHF). We are currently collaborating with researchers in Uganda, Bangladesh and South Africa.

Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?

The Phone Oximeter can be used to monitor patients receiving general anesthesia for surgery and those with chronic lung diseases (asthma, obstructive airway disease). The Phone Oximeter has also been customized to predict adverse outcomes linked to pre-eclampsia (major cause of maternal and perinatal mortality) by integrating a predictive score with the Phone Oximeter. Community health workers will receive rapid and accurate risk assessment, referral, and treatment advice for pre-eclampsia, and can transmit information to referral centers for coordination of triage, transport and treatment.

What type of operating environment and internal organizational factors make your innovation successful?

The UBC groups ECEM and PART are a collaborative team, with the technical capability to solve real clinical problems in an economically feasible manner. This multidisciplinary collaboration (and established research projects in Africa) affords us valuable continuity from concept develop¬ment to clinical testing. Over the past nine years, this team has delivered bio¬medical advances from initial concepts to testable products. This proposal naturally extends our progress in intelligent signal processing by translating operating room expertise to the wider realm of community health care. We have already developed a mobile phone-pulse oximeter prototype for anesthesia monitoring in the developing world. The skills developed during this research work will directly inform our proposed research.

Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list

The need to efficiently assess and treat pneumonia is compelling as pneumonia is the number one killer of children worldwide. The device will be specifically designed to address the unique issues plaguing the low-resource health setting, and create maximum patient benefit per dollar.