Wearable technology speeds up eye surgeries in Ghana

Half of the seven million cases of blindness in Africa are due to cataracts, which can be cured with a 10-minute surgery. But in places without an internet connection and in rural areas, healthcare workers spend an average of an hour collecting information on paper forms for a single patient – enough time for six life-changing surgeries.

This is about to change. Stanford University students worked with an eye-care nonprofit to transform this process of collecting patient data using near-field communication bracelets – or NFCs – and a associated application. The project, called Eye-dentify, originally from Design program for an extremely affordable price, a two-quarter graduate course and a follow-up incubator program hosted by the Hasso Plattner Institute of Design (the d.school) and listed by the Business School and the Department of Mechanical Engineering.

Through Design for Extreme Affordability, students were matched with the Himalayan Cataract Project, a global nonprofit health organization that funds and manages large volume cataract surgical awareness campaigns in Ghana and other African countries. to cure preventable blindness. “They go to remote areas where there is not as much health infrastructure to perform hundreds of cataract surgeries a day to cure blindness in villages,” said Manali Kulkarni, master’s student. in community health and prevention research in Stanford School of Medicine and member of the Eye-dentify team.

After identifying the needs in the classroom and discussing with their nonprofit collaborators, the students decided to focus on the problem of manual data collection, which is a bottleneck in the surgical procedure process. Small-scale prototyping and user testing led them to the final design of their bracelet and application. Then, as comrades of the Social entrepreneurship laboratory – an opportunity that expands Design for Extreme Affordability projects – they facilitated a pilot test of their system in Ghana with the staff of the Himalayan Cataract project in the country for 385 participants in June 2021.

The Eye-dentify team found that the complete digitization of off-grid patient records reduced patient processing time and improved medical data tracking. Compared to using paper forms, the team believes that using the wristbands will increase the number of patients attending their postoperative check-up care.

Off-grid information

Kulkarni, with Radwa Hamed, a Knight-Hennessy scholar and graduate student in design impact starting at the Business School this fall, and Aishwarya Venkatramani, a graduate of the Master’s program in Biological Engineering, worked with her associates to increase the efficiency of their operations.

“We have created an offline application where you can enter patient information to mimic the paper form used by healthcare workers. The surgery consists of four or five stations, so we needed a way to transmit data between stations without WiFi, ”Hamed said. “We used very affordable NFC bracelets – less than a dollar – much like a hospital bracelet, which the patient can wear.”

These bracelets use the same material that allows contactless payments with a credit card. By using this pre-existing technology, the team significantly reduced costs. Many modern smartphones are already equipped with NFC readers, making NFC bracelets an obvious choice for the Eye-dentify team.

“NFC technology adapts to a high volume setting. There is a lot of work to be done to encode and decode this data when entering patient information into the NFC bracelet, and it is quite unique in that it can work off-grid, ”said Venkatramani. .

The wristband data includes patient demographics, relevant history, preoperative eye assessment, surgery results and complications (if any), as well as postoperative check-up details. The data is encrypted for security reasons, but can be saved to a cloud database when there is a hotspot or WiFi connection. Having an aggregated collection of patient data helps the team perform analysis of patient health and patient care models, while also tracking the performance of different surgeons in terms of surgical outcomes and patient care. number of surgeries performed.

This analysis not only helped improve the efforts of their collaborators in Ghana, but also demonstrated that this technology can advance medical care in a variety of settings, Hamed said.

A digital revolution

In addition to increasing attendance at follow-up appointments, the team received positive feedback from attendees, physicians and their nonprofit collaborators. Bracelet wearers appreciated how easy the bracelets were to wear and use, allowing better access to local references. Meanwhile, doctors were excited about the time they saved using Eye-dentify, as were members of the Himalayan Cataract Project, who found it to be a much more effective way to collect and analyze data. Encouraged by the results, the Eye-dentify team applied for and received a provisional US patent for their work.

“It was very gratifying to see testimonials from doctors who said it changes the way they do things,” Hamed said. “Patients get an 88% return on getting follow-up data the next day, which is much higher than with the original paper forms. Doctors we spoke to even suggested that we should be using this technology at all levels in all public hospitals, and not just in their remote surgeries. “

As part of the Design for Extreme Affordability development process, the Eye-dentify team worked closely with their collaborators to develop their tool, paying particular attention to feedback from physicians and patients in the field to create a product. that people will use and trust.

“Co-designing with the community was one of our main goals. We wanted to approach this work by frequently connecting with the community, gaining their trust, and making sure their voice guides the design process. It has been very empowering to hear their positive feedback and to know that they are participating in the design they want, ”Kulkarni said.

The Eye-dentify team says their next step is to further refine their app based on the information they received from their pilot test and the doctors and patients who used the tool. They also hope to look to the US market, taking advantage of the already wide availability of NFC to expand the potential applications of their patient tracking and data collection tools. For the US market, they have chosen to focus their product on patients, providers, and researchers who have, treat, or study autoimmune disorders, as monitoring medical care related to these disorders may involve aggregation and organizing data from many different healthcare providers.

“The pandemic sparked a digital revolution in healthcare because everything had to be remote so it was great to work on Eye-dentify in this context,” Kulkarni said. “This is the direction that many global health systems want to go, so it’s very motivating and it feels like we were doing important work at the right time. “