The Phone Oximeter: An innovation for maternal health in design and process




3One of the most pressing needs that many communities in the developing world have is maternal care. If children born in these communities face challenges while still in the womb, their capacities to go forth and be a force for change is made all the more difficult. Adding to that, expectant mothers should be worrying about making things as comfortable as possible for the new baby, and not about how their pregnancy might be a death sentence.

Pre-eclampsia is one such problem that threatens mothers in the developing world. Around 10 million pregnant women suffer with the condition every year, and around 76,000 of them die. Additionally, it is estimated that 500,000 fetus and infant deaths can be attributed to pre-eclampsia. In fact, the condition and related complications are the second-leading cause of maternal death. According to Dr. von Dadelszen of the University of British Columbia, “That equates to over 1,600 deaths of pregnant young women and babies every day – an unacceptable burden – and more than 99% of these deaths occur in developing countries, an issue of social justice.”

A solution is needed to right this injustice, and the Phone Oximeter™ from LionsGate Technologies (LGTmedical) is an innovative project that aims to do just that.

This project is innovative for two reasons: what it does, and how it came to be.

6The Phone Oximeter™

For medical practitioners to begin to treat patients with pre-eclampsia, there must first be a diagnosis, but this is not a simple task. First, many of the symptoms of a pre-eclampsia sufferer are common in normal pregnancies – the tell-tale pain in the esophagus, for example, can easily be confused with normal heartburn associated with pregnancy. Often the best way of getting a diagnosis is with a pulse oximetry system, which measures the oxygen levels in a person’s blood. These types of sensors are fairly common in many hospitals around the world, but in many resource-deprived communities, access to conventional versions of these technologies is simply not possible.

Faced with this problem, Vancouver-based LGTmedical set out to deliver a means for medical practitioners to diagnose pre-eclampsia (and other killer conditions, like pneumonia, responsible for an additional two million deaths among children-under-five per year) in contexts where traditional medical technologies are unavailable.

The method chosen was pulse oximetry, which is a standard means of measuring blood oxygen levels, and therefore whether or not a patient has the condition. A sensor is attached to the patient’s finger, or in the case of infants, their feet, and their blood oxygen levels are measured in a non-invasive, pain-free process. The problem was getting pulse oximetry into every home, which is the team’s goal.

Mark Ansermino (left) and Guy Dumont, two of the lead researchers behind the Phone Oximeter

To this end, LGTmedical needed only to look into their pockets, where they carried their smartphones. If one technology has become essentially universally available in recent years, it has been mobile phones. Mobile-cellular penetration is estimated at 89% in the developing world – that is to say, 89% of people have access to these technologies. The obvious choice, then, is to adapt the means of detecting pre-eclampsia to what the communities have available.

The result is the Phone Oximeter. The product includes two components: the hardware, a small sensor that fits onto the patient’s finger and connects to common mobile systems, and the software, which works with the sensor to interpret and display the information. The system is designed to be intuitive and simple, allowing, for example, a patient to use the technologies while in communication with medical professionals remotely.

1Early tests have shown an 80% success rate, with refinements being made continually as the system is put through field trials among 80,000 women in India, Pakistan, Mozambique, and Nigeria. The target price is $40, which is 80% less expensive than any other similar devices on the market.

The Phone Oximeter is an important part of LGTmedical’s goal of delivering “care anywhere.” Another innovative technology they have developed along these lines is the Vital Signs DSP (Digital Signal Processor), which is another device-and-software combination that allows medical professionals to use standard medical sensor equipment in conjunction with mobile technology, by connecting the medical sensors to the mobile devices via the standard audio jack. A lot of the work that went into the Vital Signs DSP has helped with the Phone Oximeter, which is a product that essentially takes the standard sensory equipment out of the equation in favour of a low-cost, highly accessible device.

These initiatives are a part of the mobile health, or mHealth, trend in global healthcare, a rapidly-growing phenomenon that is allowing a better level of healthcare to be delivered in remote and resource-deprived communities. The global mHealth market was $500 million in 2010. Estimates say mHealth will grow to $23 billion by 2017. Thus, the Phone Oximeter is part of a new wave of innovation in healthcare. The possibilities are indeed exciting. Perhaps an expectant mother in Mali generates data from her Phone Oximeter, which is then diagnosed immediately by a doctor in Nairobi. Who then can inform the nearest clinic to send required medicines via an automated drone? We can only imagine!

The Phone Oximeter is an innovative product in and of itself, but another aspect of why this project is innovative is in the way it came into being.

Public-Private Partnerships for Health

As governments increasingly espouse a mandate of austerity, development budgets are very vulnerable targets. With unemployment and underemployment so high in much of the developed world, the notion of spending the public’s purse on the developing world becomes a very hard sell. Because of this, actors in the development sector have begun searching more broadly for sources of funding other than the traditional government donors. The process of allying public money with the resources of the private sector, often dubbed public-private partnerships, promises to open up many new streams of revenue to actors in the development sector, while at the same time providing opportunities for the private enterprises involved.

The genealogy of the Phone Oximeter, in terms of how it was funded, is an example of these possibilities. The project received its initial funding from the Bill and Melinda Gates Foundation, which was followed by 4further funding in 2011 from “Saving Lives at Birth”, a joint initiative for maternal health in the developing world that includes the Gates Foundation, USAID, the United Kingdom’s DFID, Norway’s Norad, and Grand Challenges Canada (GCC).

Grand Challenges Canada came into being to bolster innovations in the health sector in the developing world and in Canada, which makes the Phone Oximeter a perfect fit. On March 9th, 2014, GCC announced that it would be continuing its support of LGTmedical and the Phone Oximeter project with a $2 million dollar investment, half of which would be coming from Coleco Investments, a Vancouver-based private firm. Aware of how the project is tapping into the rapidly expanding fields of mHealth and PPPs, head of GCC Dr. Peter Singer said, “We hope this innovation will move swiftly from its invention in a Vancouver lab to villages around the world, creating jobs in Canada while saving lives.”

This project is the first beneficiary of a partnership between GCC and Canada’s Department of Foreign Affairs, Trade and Development with a budget of $10 million that will seek to spur on more such innovations in global health while seeking to utilize the resources and expertise of the private sector.

The Phone Oximeter is expected to be available later this year. But one should also expect to see similar innovations in both the kinds of products that we will begin to see, and the way those products are going to be developed. The Phone Oximeter is an exciting project, and not just because of how many mothers and babies it will help to save.

You can read more about the Phone Oximeter here, and LGTmedical’s website is here.

Ross Harding

Ross Harding

Ross is a non-profit project management professional based in Brampton, Canada.

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