Project: Develop an android/ios mobile application NeoRoo (An integrated mHealth platform to improve nursing care for premature babies)

NeoRoo, an integrated mHealth platform to improve nursing care for premature babies, developed by the American Academy of Pediatrics, is an integral part of mHBS/DHIS2 (mobile Helping Babies Survive powered by DHIS2)

Hospitals in low/middle-income settings have an acute shortage of incubators, because of a lack of medical equipment and medical professionals around 92% of newborn babies face hypothermia complexities. The Kangaroo Mother Care(KMC) innovation is a patented biomedical device for newborn care intervention to improve the health of newborn babies with premature complexities. NeoRoo connected to the KMC device provides a digital interface that automatically monitors an infant’s vitals and sends alerts to responsible medical professionals and parents if babies vitals are abnormal.

Our research team (@sunbiz ; @shbucher ) worked with students to design semi-functional prototypes of a mobile application, the NeoRoo Digital Action Plan, that is purposely built to supports the development of shared goals & coordinated tasks, among families and healthcare providers, for clinical care, education, and discharge.

We are eager to collaborate with motivated students, during Google Summer of Code 2022, who have skills in HTML, JavaScript, Flutter, and are interested in helping us to move the NeoRoo, an integrated mHealth platform to improve nursing care for premature babies from the design to development phase.

In particular, we are interested in developing full functionality in regards to several innovative features of the app, including:

  • User Interface of NeoRoo mobile application
  • Ability to track multiple babies at a time
  • A communication channel between parents and medical professionals
  • Continuous monitoring of neonatal vital sighs
  • Reminders/alerts to provide recommended essential newborn care interventions
  • Setting and Tracking Goals

The goal is to have a fully functional prototype, by the end of GSoC 2022, whereby our team can then conduct usability testing of the app in Kenya, among nurses and doctors.

Mentors: @shbucher @munjal-vandana

Secondary: @_nimishathakur

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Thanks, This prroject is of interest to me. I will love to work on it. I have experience on Javascript, HTML and flutter.

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2022-04-04T18:00:00Z is when you can submit your proposal

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I will get started with my proposal. I will ask questions that I need clarification here. Thanks a lot.

Hi, @r0bby @Salisu its a really interesting project to work on I have a few doubts related to The Kangaroo Mother Care biomedical device.

Actually, I don’t know much about this KMC device I went through a few resources to get the idea of how this device works and transmits data. is there is any specific resource or platform where I can get details about this device?

As there are two roles:-

  1. Parents
  2. Medical professionals

We are trying to share Premature Neonates’ vital data from Parents to Medical professionals right ?

As far as I understand the flow of data will go like this:- KMC Device → Parents NeoRoo App - > Medical professionals NeoRoo app.

Are we targeting to make two apps one for Parents and another for Medical professionals or the same app with a different user interface we will show the interface according to roles?

Thank you would love to hear your thoughts.

I believe a single app can be enough. Many apps have a role based authentication. Moreover, I think KMC device to professionals and parents, both is better. Everyone will be in a loop.

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We can decide the format in which the streaming data will come to the app over Bluetooth. We don’t have any documentation available for now, as that device is still under construction. We might be able to provide some hardware specs, but for all practical purposes, you can propose a data streaming format.

It will be one app with two different roles and depending on the logged in role in the DHIS2, we need to customize the UI and data fields.

The ECEB app codebase is a great example of how to build the DHIS2 connection from the NeoRoo app.

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Thank you @sunbiz for the details in case I have any doubts I’ll get back to you. Meanwhile, I’ll prepare a draft proposal for the idea :slight_smile:

@sunbiz this makes me ask one more question. Does this work similar to the fitness watch? The mobile is connected to the KMC device via BLE and the device independently transmits data to the cloud? The bluetooth connectivity point has made me ask this question. So how is the data flowing and from where is the data to be fetched from? The device or the server like in the ECEB project? The data can be sent in json format and fetched in json like in most apps.

Also can I get the PCB layout and schematics of the device? I have worked with embedded systems in the past. This will definitely help me get a clearer picture.

Also actually I have been working on a similar project with a similar device for a hospital as a part of my mandatory internship in college. In my draft proposal, can I attach the code for that as well? It is not open source now but I can speak to them and get it done.

@Hrishikesh-Bhagwat --Great question. Yes, many of the proposed processes for this app are adapted from a specially adapted “smartwatch,” developed by engineering colleagues at Purdue University, to detect and monitor vital signs, in real time, among adult opioid abusers. With NeoRoo, we are working with our colleagues at Purdue University, and contributors at GSoC, to adapt the processes for detection of key vital signs in newborns (rather than adults). We are particularly interested in the biomedical device detecting parameters related to breathing, heart rate, blood oxygen saturation, and temperature – and then relaying these vital signs readings to the NeoRoo app.

As Dr. Purkayastha explained, there is one NeoRoo app (integrated within the DHIS2 platform), but 2 user interfaces – one targeting parents/families and the other targeting healthcare providers. The type of vital signs information that is displayed for parents/families is not necessarily always the same as for healthcare providers. For example, a parent may not need to know the exact body temperature or breathing rate of their baby – they only need to understand if if it “too high,” “too low” or “normal.” But a healthcare worker may require more sophisticated display of information – exactly what degree (C) the baby’s body temperature is, or the exact rate/pattern of breathing over the past few hours.

For more information (preliminary data) regarding the biomedical device, and vital signs monitoring hardware/software (with which NeoRoo will integrate) please see these articles:

Bluhm NDP, Hoilett OS, Walters BD, Pickering AS, Bucher SL, Linnes JC. NeoWarm: Kangaroo Mother Care with Continuous Temperature Tracking and Heating. Annu Int Conf IEEE Eng Med Biol Soc. 2020 Jul;2020:4514-4517. doi: 10.1109/EMBC44109.2020.9176509. PMID: 33018997.

Hoilett, Orlando S et al. “Kick LL: A Smartwatch for Monitoring Respiration and Heart Rate using Photoplethysmography.” Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference vol. 2018 (2018): 3821-3824. doi:10.1109/EMBC.2018.8513356

J. D. Ummel et al., “Kick Ring LL: A Multi-Sensor Ring Capturing Respiration, Electrocardiogram, Oxygen Saturation, and Skin Temperature1,” 2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC), 2020, pp. 4394-4397, doi: 10.1109/EMBC44109.2020.9176654.

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The device is patented – please see here, for some schematics (although, we have iterated the prototype in the meantime): US10390630B2 - Infant thermoregulation and monitoring support system - Google Patents

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All good questions… thanks for asking.

Yes, similar to this, connected over BLE. The data will need to be pulled for the NeoWarm device over BLE. We could also do a BLE server on the app and get push data from the device, but I think that will reduce the battery life on the device and it might be better to pull from the app instead.

The app should connect to the DHIS2 server like the ECEB.

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Thanks a lot @sunbiz @shbucher for clearing my doubts. I have started going through the material and am studying how DHIS2 can be architectured for the given problem statement.

Thanks, @Hrishikesh-Bhagwat for your doubts :slight_smile: these questions helped me too, to understand the project.

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Hi, @sunbiz @shbucher just wanted to know about the multiple babies tracking feature.

For example:- Let’s say a family has two babies who are using a KMC device, are we wanted to make NeoRoo App compatible to connect with two or more KMC devices? so that we can fetch information from different KMC devices in a single App.

Why I am asking this question is that we can add functionality like **ADD BABY ** so that family members can create an info card insert basic baby information and select the KMC device in which specific baby is kept.

In this case, we need to connect NeoRoo app with multiple KMC devices.

The multiple babies tracking feature has several considerations.

Parent app: it is possible that parents might have twins or triplets. If so, each baby may be wearing a separate NeoWarm biomedical device, and require vitals signs tracking. The babies would not each be wearing the same device, at the same time, in current versions of the device prototype. However, the NeoRoo app would somehow have to capture and differentiate among the information being collected for a particular parents’ set of twins, from each of their devices.

Healthcare providers: This is where tracking of multiple babies is even more important. Nurses, especially, are very busy, and often have to care for MANY babies during a shift. They need to be able to track all of these babies in real time, but also, be alerted whenever any of the babies’ displays worrisome vital signs. For example. If a baby begins to have long pauses in breathing (apnea), or their body temperature drops, both the parents and the nurse need to know this, perhaps through an automated alert on the NeoRoo app.

Another consideration is that multiple babies must be tracked over time (across nursing shifts; over days and weeks), and will be cared for by multiple providers. Different babies, at any given time, will enter and exit the system, based on when they are assigned to the biomedical device, and their clinical progression. Theoretically, a nurse may need to be tracking babies that are a day old, and just assigned to the device, or weeks old, and have been wearing the device for a while. Thus, a feature where the NeoRoo app is able to capture, store, and retrieve this information, caputured over time, for each baby, is also desirable.

The balancing act, in designing this app, is that it be able to provide the desired features and functions whereby nurses and parents can receive (and retrieve) information about the babies who are wearing the biomedical device, BUT that the information is presented in such a way that it is very clear to the target audience (parents or HCPs), and also does not overwhelm them. There need to be actions that can be executed as a result of the information. Thus, if pauses in breathing are detected, both the parents and nurse should receive an alert on NeoRoo. Parents should be instructed to summon a nurse or doctor, and the nurse should receive specific information on the baby’s breating rate and pattern, and an alert to check the baby. If the baby in this hypothetical example has been wearing the device for a week, the nurse should also, optimally, be able to check back to see if this baby has a history of breathing difficulties, or, if this is a new problem.

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Good work @adarsh-technocrat and @Hrishikesh-Bhagwat. Good Luck!

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Can you tell me what types of goals can be set and tracked ? I guess reminder/alert feature and goals feature can work hand in hand like creating and adding tasks and assigning it to parents or nurses by any medical officials so that they can take all precautionary measures according to it and giving time to time reminders at every step.

Thanks alot @shbucher and @sunbiz . Your answers are very helpful.

Hi, @shbucher @sunbiz can you provide us KMC device BLE service and characteristics value related information?

and secondly, I am following this doc https://egyankosh.ac.in/bitstream/123456789/47432/1/Unit-3.pdf for declaring various conditions where we can notify parents and health workers about the condition of the baby.

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