Low-Cost, Sustainable Solution for Rural Ultrasound Imaging, Transmission and Diagnosis
Imaging the World (ITW) will change global health by providing access to medical imaging and diagnosis to rural communities in poor regions. ITW’s, low-cost technology-based solution makes it possible for minimally trained health workers to create ultrasound images by sweeping a transducer across the body area of interest, creating images in a file similar to a video clip. A novel integrated compression and transmission system sends it over a low bandwidth connection via the internet to a server where it can be securely accessed by medical experts anywhere in the world. Experts view the images and transmit their findings from a menu of text messages to a cell phone back to the rural health clinic. This platform will enable expert medical diagnosis anywhere there is a cell phone signal.
Sobre Você
Sobre Você
Nome
Kristen
Sobrenome
DeStigter M.D.
http://twitter.com/#!/ImagingTheWorld
Perfil no Facebook
Sobre Sua Organização
Nome da Organização
Imaging the World
Página da organização na internet
Telefone da organização
206.200.7560
Endereço da organização
País da organização
Estados Unidos , WA, King County
Países onde este projeto vem gerando impacto social
Uganda, KML
Sua organização é
OSCIP/ONG
Há quanto tempo sua organização está em operação?
Entre 1 e 5 anos
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INOVAÇÃO
Nome Projeto/Inovação
Low-Cost, Sustainable Solution for Rural Ultrasound Imaging, Transmission and Diagnosis
Qual a mudança que você quer trazer para o mundo?
Imaging the World (ITW) will change global health by providing access to medical imaging and diagnosis to rural communities in poor regions. ITW’s, low-cost technology-based solution makes it possible for minimally trained health workers to create ultrasound images by sweeping a transducer across the body area of interest, creating images in a file similar to a video clip. A novel integrated compression and transmission system sends it over a low bandwidth connection via the internet to a server where it can be securely accessed by medical experts anywhere in the world. Experts view the images and transmit their findings from a menu of text messages to a cell phone back to the rural health clinic. This platform will enable expert medical diagnosis anywhere there is a cell phone signal.
Quais são as principais atividades do seu projeto?
In early 2012, ITW, with the Ernest Cook Ultrasound Research and Education Institute (ECUREI) and Kamuli Mission Hospital (KMH), will launch an outcomes study to measure the impact of obstetric ultrasound diagnoses on maternal and perinatal outcomes, specifically targeting the United Nations’ Millennium Development Goal (MDG) 5 – Improve Maternal Health. Six nurse midwives, with no prior exposure to ultrasound, will be trained to perform the ITW protocols. After completing the training, the ITW technology platform will be installed at their respective health clinics. Each eligible, consenting patient will receive an ultrasound examination using the obstetric protocol. Images will be sent to a remote server, where expert ultrasound professionals at KMH, ECUREI and ITW, will access them and provide medical interpretation. The interpretations will be sent back to the health clinic via text message and email, to guide the nurse midwives in patient management. Patients at both experimental and control sites will be followed throughout the remainder of their pregnancies, deliveries and through the post-partum period. Specific outcomes data will be gathered and used to evaluate improvements in maternal and perinatal morbidity and mortality. Data from the experimental sites will be compared with contemporary and historical data to evaluate the impact of ultrasound on maternal morbidity and mortality. Ashoka funding will provide salary for a Ugandan field technician to support the technical platform at each of the sites.
O que é inovador sobre a seu projeto? De que forma ele é uma nova contribuição para esse campo de atuação?
ITW’s cutting-edge tele-medicine model consists of several components:
1)A concise curriculum to train frontline healthcare workers how to generate ultrasound images based on surface anatomic landmarks using easy to learn ultrasound scanning protocols that can be mastered in two days - no previous knowledge of internal anatomy or pathology is required. Testing of this phase has already begun.
2) Development of a customized, low-cost (less than $2500) ultrasound scanner in collaboration with a technology partner, suitable for use in remote, low resource areas.
3) Development of an integrated compression and transmission system that highly compresses the image data (using state of the art MPEG 4 compression) while maintaining full diagnostic image quality. This transmission system operates without the need for operator intervention, further decreasing the need for operator training.
4) A novel structured reporting system that both reports and recommends appropriate diagnostic and treatment plans using SMS messaging for preliminary reporting, and email for full reporting.
5) A very low-cost, portable, solar setup customized to stabilize power.
6) A network and management system enabling ultrasound interpretation specialists to access images and make interpretations.
This low-cost technology/training package will total less than $10,000 for each rural clinic, This platform has the potential to change medicine worldwide and is extensible to rural areas in the USA, triage situations (ie Haiti) and in the military.
Em que estágio está seu projeto?
Em execução entre 1 e 5 anos
Conte-nos sobre a comunidade em que atua. Por exemplo, as condições econômicas, as estruturas políticas, normas e valores, as tendências demográficas, história e experiência com as tentativas de mobilização.
Uganda was selected as an ideal location to pilot and test ITW’s model as 88% of Uganda’s population lives in rural areas, and because Uganda was rated 182nd out of 191 countries worldwide for healthy life expectancy. Uganda’s rankings for maternal and neonatal health also lag behind the global average for disparity of rural to urban access to services.
In sub-Saharan Africa, a woman has a 1 in 30 chance of dying from complications of childbirth compared to 1 in 5,600 in developed regions; estimates for Uganda suggest that 10,000 women and girls die each year due to pregnancy related complications. Furthermore, in Uganda, for every woman or girl who dies as a result of pregnancy related causes, between 20 and 30 more will suffer short and long-term disabilities such as obstetric fistula, ruptured uterus, or pelvic inflammatory disease.
Other causes of morbidity and mortality in Uganda include trauma from motorcycle accidents, high incidence of thyroid cancer and an unusually high occurrence of breast cancer in women under 30. Since there are currently no methods for early cancer detection in rural areas, most cancer patients don’t get help until their conditions are too advanced for any intervention to be successful. ITW’s protocols will be instrumental in early cancer diagnosis and trauma triage.
The Uganda Ministry of Health is very supportive of ITW’s efforts to bring diagnostic services to rural health clinics, and there is enough existing radiological infrastructure to support rural initiatives.
Compartilhe a história do(a) fundador(a) e o que o(a) inspirou a iniciar este projeto
In the early 1990’s ITW co-founder, Dr. Kristen DeStigter was investigating parasitic disease in remote areas on the border of Kenya and Sudan, as part of a research team. After finishing daily research she and her colleagues conducted an impromptu health clinic. They would perform exams at the end of each day; by using ultrasound they discovered significant problems like placenta previa in near-term pregnancy. They were able to counsel patients to get to a health-care facility where they could get appropriate, lifesaving treatment.
Over the years, Dr. DeStigter considered the problem of bringing a permanent ultrasound solution to the most rural areas of the world. In 2007, Dr. DeStigter began working with Dr. Brian Garra, who had been promoting volume scans for ultrasound diagnosis since 2001. Volume scans replace each still ultrasound image with a series of images that are gathered by sweeping the transducer across the organ or body area of interest. Unlike static images, which provide only a few sample images of each organ, volume scanning provides one image every millimeter. This markedly reduces the need for physician scanning and makes it possible to train a machine operator to gather images without needing to look at the screen forfeedback. By compressing and sending the volume scans to experts at remote locations, a high performance low cost tele-ultrasound system was developed and Imaging the World was founded, offering highly accurate ultrasound diagnosis anywhere in the world where a cell phone signal is available.
IMPACTO SOCIAL
Temas relacionados à inscrição
Por favor, descreva como o projeto tem sido bem sucedido e como esse sucesso é medido.
In June 2010, ITW/ECUREI launched a pilot project in Kamuli District, Uganda, with the objective of comparing ITW’s obstetrical protocols to traditional ultrasound examination, following approval by national and local regulatory groups. A team of international volunteers and Ugandans spent two days training nurse-midwives to use anatomical landmarks to generate obstetrical ultrasound scans on pregnant women, following two days of basic training in ultrasound safety, physics, ethics and appropriateness.
Our success is measured by how well we achieve the metrics designed by the WHO: increasing the number and frequency of visits to clinics by pregnant women and increasing the number of attended deliveries (MDG 5: Improving Maternal Health). Initial data indicate that offering ultrasound as a component to antenatal care draws additional patients to a clinic, and that there is more continuity of care shown by an increase in the frequency of pregnant mothers’ visits to the clinic.
Since ITW’s intervention began, maternal patients had a 53% increase in antenatal visits and a 54% increase in clinic deliveries over the prior year. In addition, antenatal visit frequency increased for each specified antenatal care visit (four visits are recommended during pregnancy) By the fourth visit, mean post-intervention visits exceeded pre-intervention by 300%.
An unanticipated but welcome trend has been observed as a result of ITW’s introduction; many husbands are attending antenatal visits with their wives for the first time and becoming engaged in their wives’ pregnancy care.
Quantas pessoas foram impactadas por seu projeto?
1,001- 10,000
Quantas pessoas poderão ser impactadas por seu projeto nos próximos três anos?
> 10.000
Em desafios anteriores, participantes bem sucedidos apresentaram um plano sólido detalhando como farão para crescer. Informe os principais marcos de crescimento do seu impacto previstos para os próximos seis meses .
Over the next six months, ITW will deploy its innovative platform to 6 additional rural health clinics in Uganda.
Atividade 1
Complete integrated field testing of technology platform at one site in Uganda
Atividade 2
Implement three sites as part of outcomes study (Kamuli region)
Atividade 3
Implement additional three sites in Bwindi region of Uganda (considered one of the poorest communities in the world)
Informe os principais marcos de impacto previstos para os próximos 12 meses.
Collect data at each site to assess the impact of ITW’s model on healthcare using clinically approved subject review protocols and reporting.
Atividade 1
Establish baseline historical data for each clinic.
Atividade 2
Collect data at a clinic without ITW platform for additional baseline creation.
Atividade 3
Collect the same data from ITW sites and compare to baseline using approved clinical and statistical methods.
Como seu projeto se expandirá ao longo dos próximos três anos?
Over the next three years, ITW will introduce protocols for the liver/gallbladder, thyroid, kidneys, female (non-pregnant) pelvis, as well as breast cancer, lymphoma and trauma to the chest, abdomen and long-bones. Three additional protocols are in development: eFAST (images of the abdomen and chest for signs of significant trauma), pediatrics and cardiac.
We expect to partner with the Uganda Ministry of Health to expand ITW’s program throughout Uganda, reaching dozens of rural health clinics and improving the lives of hundreds of thousands of patients and their families.
ITW is assessing new countries for ITW implementation based on need. Potential regions include additional countries in sub-Saharan Africa and areas in China and India.
SUSTENTABILIDADE
Quais são as barreiras que podem dificultar o sucesso de seu projeto e como pretende superá-las?
Through careful planning and due diligence, ITW makes all attempts to mitigate problematic situations before they happen. Nevertheless, ITW is aware that external factors could present obstacles and problems. These might include: government instability, changing governmental regulations (creating opportunities or hurdles), theft of equipment, unpredictable infrastructure (power supply or wireless access; we are implementing solar power to minimize power grid instability), inappropriate use of ultrasound equipment (we provide an ultrasound ethics course to mitigate) and funding challenges. We are developing a fundraising platform to assist us in sustaining and expanding our training, patient outreach, research, and technology. Other external factors could have positive effects on the success of the project including: synergistic opportunities that create channel and funding opportunities; less expensive, more sophisticated machines could become more widely available; technology and bandwidth infrastructure could evolve and emergency transportation services could become available in areas where ITW operates.
Por favor, explique de que forma o estabelecimento de parcerias é importante para o sucesso de sua inovação
The ITW program has a comparative advantage through the support and collaboration of several entities, each with deep knowledge and experience in their respective specialties. Our leading financial supporters include The Bill & Melinda Gates Foundation, The Joseph Fineberg Foundation and Philips Healthcare. The Department of Radiology, University of Vermont College of Medicine and Fletcher Allen Health Care has donated significantly through supporting the co-founders’ time and efforts as well as sponsoring projects. Industry partners General Electric Health Care, Philips Health Care, and McKesson have donated technology as well as professional expertise. Pegasus Lectures has donated extensive training material direction. The World Federation of Ultrasound and Rad-Aid, non-profit organizations with overlapping missions, have agreed to further ITW’s mission through facilitating outreach and education as well as helping to coordinate training and a radiologist network. Each of these organizations brings uniquely different technology and/or significant ultrasound expertise to the ITW collaboration. PieData has generously donated project management software and training to aid in this process.
In Uganda, Kamuli Mission Hospital, the referral hospital, supports the additional patient load that will come from rural areas and ITW supports advanced training of workers from KMH. In Kampala, Dr. Michael Kawooya, Associate Professor of Radiology at Makrere University and Director of the Ernest Cook Ultrasound and Education Institute (ECUREI) will oversee the project in Uganda.
Orçamento anual atual do projeto em US$:
$500.001‐1 million
Detalhe as suas escolhas acima
The Joseph Fineberg Foundation has committed to support us annually and generously. Beginning in 2012, we will be eligible to apply for a Phase II grant from the Bill & Melinda Gates Foundation for up to $1 million, following our receipt of the $100,000 Grand Challenges grant. Philips Healthcare remains committed to ITW’s program, and we expect to receive annual research support through our initial projects from additional corporate sponsors.
We have created a comprehensive fundraising plan to expand our grant research and application process, and incorporate individual and corporate giving campaigns. By leveraging the talent and relationships of our Board Members and Volunteers, we will include donor outreach programs in the United States, Canada and Australia.
De que forma você planeja fortalecer financeiramente seu projeto ao longo dos próximos três anos?
Effective capacity building is the key to strengthening our project in Uganda, informing best practices for expansion to additional countries. In order to make ITW’s model for rural ultrasound truly sustainable, our practices will be seamlessly integrated with current infrastructure, improving local access using existing channels, with culturally appropriate initiations. To be most effective, local talent and resources must be leveraged and reinforced.
ITW’s model to bring ultrasound to rural Uganda was designed in collaboration with the Catholic Diocese of Jinja, Kamuli Mission Hospital and ECUREI with support from the Ministry of Health. The model is geared to be culturally sensitive, maximizing use of in-place healthcare systems and patterns. Through health needs assessment, we tailored outreach methods around management of crucial health issues in the Kamuli region, to include concerns outside of ultrasound and maternal health. For example, through effective in-country collaboration, the ITW’s Integrated Community Outreach pilot leveraged local community enthusiasm for ultrasound to deliver inoculations and HIV testing kits with public health messages about ultrasound.
Desafios
Quais desafios/obstáculos na área da saúde e bem estar seu projeto busca solucionar?
Por favor, selecione até três opções, em ordem de importância (a mais importante deve ser indicada como 1 e a menos como 3)
Primário
Limitação no diagnóstico/detecção de doenças
SEGUNDO
Ausência de acessibilidade às instalações de assistência ou falta de instalações
TERCEIRO
Mudança de comportamento em saúde
Por favor, descreva como a sua inovação aborda especificamente os obstáculos listados acima.
Limited diagnosis of disease
ITW’s platform addresses limited capacity for diagnoses of disease through bringing a low-cost ultrasound imaging solution to rural communities.
Lack of physical access
Access to diagnostic care within the communities where they live and work can provide patients the advance notice to treat potentially serious health problems while they are still manageable. Without advance diagnosis, many patients do not visit a hospital until their conditions are too advanced or emergent to treat.
Health behavior change
In conjunction with ultrasound diagnosis, ITW sponsors community outreach in each community it serves to educate the population about ultrasound and other primary health concerns (for example, HIV testing and infant inoculations).
O que você está fazendo para ampliar o impacto de sua organização ou iniciativa?
Por favor, selecione até três estratégias abaixo, em ordem de importância (a mais importante deve ser indicada como 1 e a menos como 3).
primário
Alcance geográfico: No país de atuação
SEGUNDO
Alcance geográfico: Em vários Países
TERCEIRO
Alcance geográfico: Global
Por favor, descreva qual ou quais das atividades de seu crescimento estão em curso ou planejadas para o futuro imediato.
ITW has developed a three-phased model to build permanent ultrasound infrastructure, creating a stream of revenue to strengthen service delivery in rural health centers. In Phase I, ITW provides a low-cost ultrasound set-up to a health center, training health workers in ITW protocols. In Phase II, select health workers attend specialized training to learn to make very basic interpretations. In Phase III, some health workers are eligible to be credentialed as ultrasonographers, making a broad range of diagnoses.
The program goal is to become “owned” within a country, with the majority of interpretations, training and proliferation of health centers taking place at the local level, freeing up ITW’s resources to expand to locations outside of Uganda.
Você colabora ou faz parcerias com algum dos abaixo? (marque todas que se aplicam)
Governo, Fornecedores de tecnologia, ONGs / entidades sem fins lucrativos, Empresas, Academia / Universidades.
Se sim, como essas colaborações e parcerias vêm ajudando sua inovação a obter sucesso?
Government: The government of Uganda supports innovative program such as ITW’s to advance safe, effective improvements in health.
Technology providers: The Ugandan telecom company MTN is working with ITW to specifically address email to SMS conversion for ITW projects.
NGOs: With St. Joseph’s Vocational Training Center for at-risk teenagers in Kamuli, ITW sponsored a Community Outreach pilot to educate men in the community, since they often make household healthcare decisions.
For profit companies: Sanofi-Aventis, the French Pharmaceutical company sponsored ITW’s community outreach at Nawanyago.
Universities: Through supporting the activities of co-founders, the University of Vermont has been pivotal in the development of ITW.
 | 83 semanas atrás Andrea Newton disse: These are great comments and concerns, and they are things we have spent lots of time considering. There are many components to the ... sobre esse Competition Entry. - leia mais > |
| 84 semanas atrás Jacqueline Cutts disse: I love this idea, as I think that it would bring valuable services to poor regions. But I have some questions about sustainability. You ... sobre esse Competition Entry. - leia mais > |
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