The Problem

In 2000, the United Nations developed an ambitious global agenda to reduce extreme poverty entitled the Millennium Development Goals.  Among these goals was a specific objective to reduce mortality rates of children under five years of age by two-thirds by the year 2015.

In the years since those goals were established, the neonatal mortality has remained stubbornly high.  According to the World Health Organization, 66% of the children who die in the vulnerable first month of life, die in the first day. Clearly, proper care immediately following birth through the first month of life is crucial to improving this epidemic.

Neonatal care is particularly challenging in rural and underserved areas. Proper neonatal care requires good infrastructure, health systems, and most importantly, well trained staff. Though there are accepted guidelines for caring for sick babies, the challenge has been getting those guidelines into practice 24 hours a day, 7 days a week. This training gap leads nurses to rely too heavily on doctors for decision making, and with few doctors available on-site in rural areas, the tragic end result is that the youngest and most vulnerable patients continue to suffer severely, often mortally, from delays in diagnosis and treatment.

The Challenge

President of Global Strategies Dr. Joshua Bress posed the following challenge to Metrodigi: create a state-of-the-art, diagnosis and decision-making application that is easy to use by technological novices who are working [often hands free] in high-stress situations. Dr. Bress selected Metrodigi due to a previous successful collaboration with Metrodigi’s professional services team that demonstrated the company’s expertise in developing powerful, user-friendly software solutions.

The Solution

Dr. Bress and the Metrodigi team worked side-by-side to develop and repeatedly test NoviGuide, a tablet-based, culturally sensitive application that literally puts the tools for medical decision making at the fingertips of nursery staff.  Using sophisticated algorithms, NoviGuide provides interactive assessments to help nurses assess a newborn’s health and quickly prescribe life-saving medical interventions, if needed. NoviGuide quickly and efficiently leads nurses through standard care protocols for infants through a series of yes/no questions designed to identify potential red flags.  When problems are identified, NoviGuide indicates the correct treatment, such as computing the amount of IV fluids needed. By automating common processes such as dosage calculations, NoviGuide increases efficiency and reduces human error, both of which are essential to maximizing an infant’s odds of survival.  

Dr. Bress and Metrodigi engineers and designers worked together seamlessly to identify vital components for the NoviGuide application.  One of the most critical components of NoviGuide was getting nurses to use it voluntarily. This meant a product that not only got the medicine right, but was also visually attractive, easy to use, and saved time. Metrodigi engineers customized the application so that it gives comprehensive information for a sick baby, but also allows a nurse to move quickly when caring for a healthy baby.

One of NoviGuide’s most powerful features is the ability to track and aggregate data. For example health administrators can monitor clinics remotely and identify clinics that are seeing an increase in a certain disease or are in need of additional training on a specific topic. NoviGuide does not track patients. Instead it aggregates how nurses care for anonymized patients, providing valuable information about care quality.

The Outcome

NoviGuide is rapidly becoming recognized as a bold new approach to saving newborn lives.  The application has been been studied by Boston Children’s University and used in the field in KwaZulu-Natal South Africa. As a next step, the application will be studied by the University of California San Francisco (UCSF) in Tororo, Uganda.

Furthermore, user feedback for the application has been overwhelmingly positive.  When used in the field, NoviGuide was able to identify and prevent medical errors, including dose calculations and the interpretation of lab values.  Nurses and medical professionals have consistently praised the utility of features such as NoviGuide’s dosage calculator, as well as the ease-of-use and depth of the overall application.  NoviGuide is a tool that nurses like using for on-the-spot evaluation and treatment, and they also utilized the videos during down time to reinforce and refresh their training.

Feedback from Global Strategies was equally positive.  “Working with Metrodigi was collaborative and constructive,” said Dr. Bress.  “By combining our medical expertise with their technological and development knowledge, we produced a product that will enhance the lives of infants and their caregivers around the world.”  

 

 

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