Deneb Zavala

Triton Blood Detection Mobile Application

A: This tool is used to help the OR nurses and techs (directly) and physicians (indirectly) keep track of the number of gauze pads and how much blood has been absorbed by the gauze pads as a measure of patient blood lost. Using AI, the app is able to scan the gauze and liquid in the blood suction canister and separate the RBCs from the plasma and saline which is placed in the canister beforehand. The app uses the Iphone’s forward facing camera to scan the image of the gauze. It uses the Hemoglobin which is manually input into the app, and results in a measure of blood volume per gauze or suction canister. The suction canister requires a white strip as contrast in order for the app to detect and scan it.

E: A phone is hooked onto a stand at chest level. The stand is mobile and remains inside the OR, tucked into a corner. The nurse is able to touch the screen and input hemoglobin, as well as start the camera.

I: Nurses manually count the gauze 3 times before the final count is performed using Triton. They input the patient’s hemoglobin into the start screen on the app prior to scanning the gauze and suction canister. This was the primary use compared to tracking the blood volume in the suction canister as the OR had run out of contrast strips.

O: The app can be downloaded by using a phone with a camera. The user will scan the QR code and begin using the app. Triton provides disposable gauze pads, called “lapses”, that contain a material that can be tracked with the app.

U: Nurses primarily handle the app. Physicians indirectly use the data.

Desirability

Primary Observation: A: OB-GYN counseling patient with gestational diabetes (GDM) on dietary changes to manage blood sugar levels. Patient may not have the nutritional and blood glucose monitoring literacy to self-manage, present to clinic with symptoms and frustration. E: High Risk clinic. I: Patient is experiencing gestational diabetes and is overwhelmed by prenatal care on top of not being confident in how to adjust their nutrition. Patients may feel lost on how to use the Dexcom continuous glucose monitor on their phone and how to install it. They also feel frustrated with the dietary recommendations that are vague, not specific to their current diet or budget, and confusing. OB-GYNs are providing nutritional guidance considering mom’s health and the fetus’ development. They may use paper guides that are wordy, lengthy, and out of date with the patient’s food access constraints. O: given the lack of clear instructions, mom may not monitor their glucose or adopt sugar control dietary changes. This may further damage their health and their baby’s development, worsening their risk factors and patient-physician relationship. U: OB-GYN, patients, family.

Secondary Observation: The risks for women with GDM rise with worsening glucose control, including pre-eclampsia, early delivery via c-section, preterm delivery, polyhydramnios, macrosomia, shoulder dystocia, admission to the neonatal ICU, neonatal respiratory distress syndrome, fetal hypoglycemia, and hyperbilirubinemia. The risk for stillbirth and postpartum type 2 diabetes are also high (UpToDate)

Needs Statement:

First Version: There is a need for High Risk Mothers with Gestational Diabetes to receive dietary education in order to manage blood glucose leading to frustration and poor adherence.

Revised Version: There is a need for High Risk Mothers with Gestational Diabetes to receive dietary education in order to promote blood glucose tracking, prevent frustration and poor adherence to blood glucose tracking, and negative impacts on maternal and fetal health.

Feasibility

Many current mobile tools cover a wide breadth of diabetes care variables, with few focusing on nutrition education alone. Nutrition is a key step in controlling gestational diabetes. The IP potential is in developing a tool that uses evidence-based data and uses generative AI to provide culturally-sensitive nutritional guidance pre and postpartum, incorporating budget and resource constraints.

Commercial Solutions

eMOM: Mobile application tracking: exercise, sleep, diet, and can bluetooth connect to wearable glucose sensors. It produces educational content for patients: charts showing glucose level trends, and educational articles. Undergoing clinical trial.

MALAMA: Mobile application tracking meals, exercise, medication, stress. Shareable reports to EHR, bluetooth integration with glucose monitors. Provider portal with real-time patient monitoring and graphics. Personalized patient feedback and education emphasizing color-coded graphics for lower glycemic foods. Diabetes prevention post-partum. Free for MediCal patients; annual fee for providers.

Viability

General Market Assessment: GDM is on the rise due to expanded screening (and overdiagnosis), increasing weight gain and body mass, age of conception, and issues accessing healthcare and quality food.
However, increased focus on personalized, real-time monitoring of maternal health, prevention education, and empowerment are controlling rates (4).

Total Addressable Market (TAM): 7.8% (GDM prevalence, UpToDate) x 3.7M (US births, CDC)

References:

1. Lende M, Rijhsinghani A. Gestational Diabetes: Overview with Emphasis on Medical Management. Int J Environ Res Public Health. 2020 Dec 21;17(24):9573. doi: 10.3390/ijerph17249573. PMID: 33371325; PMCID: PMC7767324.
2. https://www.cdc.gov/nchs/data/vsrr/vsrr035.pdf
3. https://www-uptodate-com.proxy.cc.uic.edu/contents/gestational-diabetes-mellitus-screening-diagnosis-and-prevention?search=gestational%20diabetes&source=search_result&selectedTitle=2%7E150&usage_type=default&display_rank=2#H1
4. https://www.reanin.com/report-store/healthcare/pharmaceuticals-and-therapeutics/gestational-diabetes/global-gestational-diabetes-market#:~:text=In%20the%20year%202023%2C%20the,valued%20at%20USD%209%2C712.43%20million.

Need #2: There is a need for tools that allow OBGYN physicians  to aid the patient during natural delivery, that are not negatively impacted by the fluid in the environment.

Observations

Audience: The Kiwi vacuum is used by OB-GYN physicians to help the mother deliver when additional support is needed.

Environment: Labor and delivery

Interactions: The Kiwi vacuum is used when the baby is near the opening such that the OB-GYN physician is able to palpate the top of the baby’s head. The vacuum is placed on a specific spot. Once mom is ready to deliver, the physician is able to aid delivery by pulling on baby’s head using the suction. The vacuum is only as good as it’s surface ‒ if there are too many fluids, the suction can be broken which causes the procedure to fail. If the the Kiwi vacuum has failed, mom will need to consider delivering via c-section as physicians are allowed 3 tries for placement before moving on.

Objects: Delivering via c-section may not be appropriate for every pregnancy based on personal preference or safety. If the Kiwi vacuum fails 3x, the OB-GYN team will need to consider additional delivery options, which may be a challenge in certain cases.

Users: OB-GYN, mothers, mothers needing additional external support during natural delivery