VSM Bridge

People who suffer from chronic diseases are required to have continuous monitoring and recording of their vital signs. The usual method of recording is periodic visits by nurses to every patient and manually recording the vital signs from the patient monitors, typically every hour. In such a method, it is quite possible to miss sudden changes in a patient's health; a patient's health may suddenly deteriorate in the absence of a nurse or doctor, and by the time the medical staff are notified and help arrives it might be too late. This is especially true in the recent pandemic situation, where thousands of critically ill patients are admitted in hospitals everyday, and very few ICUs and medical personnel are available.

The objective of the VSM bridge is to develop a system that will convert all ICU related works into a digital mode including patient management within the ICU from admission to bed allocation. One of its most unique features is remote continuous monitoring in ICUs. Vital signs (temperature, oxygen saturation, pulse, and electrocardiogram of a patient) along with other parameters will all be monitored remotely. These data will be wirelessly transferred to a remote observation station to be viewed by physicians and nurses. This will greatly help in minimizing exposure to patients in the ICU who may have communicable diseases, thus protecting healthcare workers so they may carry on their duties and cross transmission to patients. This feature is very valuable during the COVID-19 times, as chances of virus spreading from patient to doctor is reduced. 

The project also includes the prospect of automating vital signs monitoring by creating a better and more secure system for the collection and storage of patient data. A mobile integrated app will also be executed. 

Our solution will also implement a system using Early Warning Score (EWS) and Medical Calculators using the vital signs measurements and clinical input, that will be able to detect early signs of clinical deterioration in patients thus improving patient management and outcomes.

In 2016, 8.6 million premature deaths occurred in LMICs from causes that should not occur in the presence of timely & effective care. Standards of physiological monitoring are often not met due to high population & lack of manpower. In the high income settings ICU model, it is achieved with costly equipment, high-quality laboratory support and large numbers of trained staff. In LMICs with limited infrastructure in critical care settings, patients are identified too late or not identified at all. 

A machine integrated system with a cloud based server that will allow patients in ICUs to be monitored continuously and remotely through designated software modules, including mobile integration. This will enhance communication about patients and their medical needs between healthcare professionals in the ICU. Improved real-time remote monitoring reduces in-person contact, reducing the transmission of communicable diseases within the ICU. An EWS system and medical calculator will be incorporated into the project for alerting doctors regarding clinical deterioration and supporting clinical decision making, thus helping with patient treatment and improving hospital productivity while implementing international medical standards.

Our hardware and software integrated device system and standardized formats are ready. We are able to improve clinical communication by organizing content and decreasing errors. Our product can be easily added to any ICU or critical care setting for better monitoring and does require a specific setup. There is also no need for extensive cabling, since our module is completely wireless and can be viewed remotely from any place around the world.

Government primary health care institutes are the nation's main hope while fighting critical situations such as the COVID-19 pandemic. In recent times a lot of patients infected with chronic illness have been admitted to the ICUs who needed continuous vital signs monitoring. Monitoring these patients poses a huge risk to HCWs becoming ill themselves which would be detrimental to health services for the country. It also becomes a challenge to monitor all the patient's vitals at a time. Remote monitoring  enables us to monitor numerous patients at once. It reduces the need for the physical presence of the caregiver to the patient but ensures maximum safety of the patient. As such, all government healthcare institutes should have this facility to minimize the risk of infectious diseases for the caregivers while improving patient management.       

Enhanced Medical Communication is absolutely essential when treating patients to ensure that all medical staff giving care and treatment to the patient are aware of the patient’s condition and needs. Remote communication through the app allows ongoing observation of patients’ vital signs, streamlines treatment and ensures that it occurs efficiently and as rapidly as possible. This improves both the capacity for healthcare workers to provide care to multiple patients and allows fast intervention to improve the patients’ health. 

Since the VSM Bridge can send updates to senior consultants instantly and remotely, emergencies in the ICU can be prevented. If an emergencies or situation occur, the junior doctor or nurse can immediately contact the senior consultant who might be far away and the consultant will be able to monitor the patient, check the patient's vitals and give necessary feedback and suggestions to help the professionals on the clock to tackle the situation. This will also enable an expert consultant to look over multiple hospital's patients' condition. 

Integrated EWS and medical calculators within the ICU management system help doctors be notified of patient deterioration immediately and calculate necessary diagnostic information at computation speed without needing to remember formulas and functions. They aid in diagnosing, helping identify the proper course of treatment and improves patient care. Immediate alerts allow treatment to be given at faster speed and identify which patients require urgent care efficiently. By digitising calculations, physicians have more time on their hands to see more patients, determine patient conditions and make careful decisions about treatment. 

Cloud based technology is the key to bring multiple platforms in a single stage. It has numerous applications in the healthcare field. Different aspects of this technology are yet to be explored. Cloud based vital sign monitoring is such an aspect that can facilitate HCW as well as patient care. This project is focused to aggregate the research prospects of digital ICU Management System with cloud-based databases to inspire future innovations in this field.

A study reveals that in a tertiary level hospital like Dhaka Medical College and hospital with bed capacity of 2,400, about 4,000 patients are taken care of at any one time. High workload pressure prevails for physicians and nurses in ICUs, which not only increases their stress but also leaves room for errors. Our solution minimizes this work load by automating patient vitals, generating EWS score and informing other stakeholders. Side by side, every day around a dozen patients come to ICU but only two or three can get admitted at best. In each month almost 500-600 patients apply for intensive care support but only 80-90 could be admitted. Studies done in other countries show that modules such as ours decrease length of stay giving opportunities for more patients to be admitted to ICU and get proper life saving treatment. It can play an important role in minimizing cost, reducing hospital bed occupancy, preventing complications and reducing patients suffering during hospitalization. 

Seeing the recent advances in artificial intelligence (AI) technology for disease screening, we will also be using predictive modeling for the management of patients with the potential to help control the mortality rate for diseases.Stressful conditions and burnout in health care providers can reduce their clinical performance, and a lack of accurate judgment can lead to increased mortality rates. Artificial intelligence can help healthcare professionals determine who needs a critical level of care more precisely. Data collected can also be used for research and improved management of diseases.

The combination of doctors, engineers & business specialists in our team allows us to take on challenges at all angles. We are bringing a change in the system through initiating local manufacturing. Over the years we have also prioritized research. We currently have 3 journal publications and are working on 4 more with our various technologies. 

Being co-founded by a female chairperson, in Bioforge we firmly believe in equity, diversity and we work towards helping even the most underprivileged sector of people. Most importantly, the VSM Bridge is made by Healthcare professionals to serve healthcare and make medical care easier. The collective network of Bioforge comprises doctors & strategic advisors which helps us to get the technology easily into the right places. Therefore, we believe that our previous experiences, intensive passion and growing mindset will help us deliver the solution efficiently.

We have an opportunity to impact lives for the better. People are suffering and we have the right technology to ease their path. We ask you to partner with us to bring more scale to the VSM Bridge and reach more patients. Financial support from MIT Solve will help us get our module out faster and at a much larger extent. We also aim to get feedback on our design complying to international standards from experts in the network. The community can also support us by opportunities to reach out to potential partner organizations.

Measurement of vital signs is a necessary task done by healthcare workers everyday. Currently in Bangladesh, it is done manually which poses many challenges. Such a technology where patients will be monitored continuously and remotely using a machine integrated system is a very innovative solution. Our technology provides an automated solution to the problem, speeding up processes in critical care settings reducing workload on nurses and consultants by providing the opportunity of remote monitoring and remote consultation. Human resources are already stressed in such low resource settings. This technology would remove an exhausting task out of the way, allowing healthcare workers to focus more on the quality of care, having an impact on patient outcomes significantly.

Within the next year we want to refine our technology and aim to deploy VSM bridge in at least five to six hospitals in Bangladesh and start revenue generation. We will be publishing research articles regarding our solution and bringing awareness to our paper. We will improve our technology with the feedback we receive through the papers.

Within the next five years we want to upgrade the VSM bridge more. We want to familiarise Bangladeshi people with newschart digitisation. By the next five years, we aim to reach at least 50 hospitals within the country and 10 hospitals beyond Bangladesh with our solution. We target to reach at least three to five Low-to-Middle-Income Countries(LMICs) with the VSM bridge. We want to make sure that people are aware that there is a solution like this.

As to how we will proceed with our impact goal, we are already in contact with three hospitals. We are discussing our plans with them, taking their feedback and testing the VSM bridge in these hospitals. Then we are further expanding our network through known individuals who will find us the right types of hospitals that add to our target market and where we can market our devices. We already have a team who's actively reaching out to hospitals and health professionals with the solution.

We are measuring our progress toward our impact goals through the following procedure.

1. The development of the technology: We will measure how much we can improve our technology and refine our solution.

2. Number of test cases we would get: We are continuously testing our device. So the number of test cases we conduct and get test reports that prove our claims are also an important method of measuring our progress.

3. Number of clients acquired: We will be counting the number of hospitals who adapt to our technology, positive responses from the hospitals. We can also measure our progress by counting how many people are interested in our technology

4. Publishing research papers: We will be publishing research articles about our solution. We will be able to get people's valuable feedback on our technology through our papers. This will show our progress well

5. Revenue generation in Taka: With the deployment of the VSM bridge in hospitals in Bangladesh, we aim to generate revenue through the solution.

In 2016, 8.6 million premature deaths occurred in LMICs from causes that should not occur in the presence of timely & effective care. Standards of physiological monitoring are often not met due to high population & lack of manpower. We aim to solve this problem by introducing VSM bridge in critical care settings allowing patients to be monitored continuously and remotely through designated software modules, including mobile integration. This will enhance communication about patients and their medical needs between healthcare professionals in the ICU.

The key outcomes of VSM bridge will be:

• Improved critical care services throughout the country, especially in hospital with low resources,

• Improved patient outcomes,

• Decrease burden on healthcare workers,

• Decreased mortality rates, 

• Enhanced healthcare services in all regions of Bangladesh, 

• Efficient communication with healthcare system,

• Decreased financial pressure on hospitals and families.

The VSM Bridge sits at the intersection of hardware and software. Our developed system is a very simple, inexpensive and low powered system that can work on any patient monitor with a VGA port or HDMI port. The hardware consists of a single-board computer that collects the patient monitor feed via the VGA or HDMI port, and through the aid of WiFi sends the data to an app installed in the nurse’s station computer, from where it can be viewed much like a surveillance system. The app is capable of displaying multiple patient monitor data at the same time, and requires no internet connection since all data transmissions are done locally.

Resource constraints and robustness require that streams from different VSMs are never lost. Multiple feeds can be sent over a local network, and the app sits on the receiving end of the pipeline. The application can be configured to receive all VSMs within a care unit. A pre-trained OCR model within the application can run inference on the receiving video streams at regular intervals, and the data can be stored for longer term trend analysis. Based on each patient’s vital parameters, aggregate scoring metrics used in NHS hospitals, such as the National Early Warning Score, can be calculated, to allow for rapidly identifying acutely ill patients.

In addition, the system can store and generate graphs of a patient’s health parameters over a period of time, hence allowing doctors to study the trends in the patient’s changes in health conditions and accordingly provide the necessary treatment. With further progress, the system will be able to learn the trends itself with the aid of AI, and hence predict any health detroriations that may occur, much like an Early Warning System (EWS).

The solution is made by doctors with years of experience. So the health professionals are using their direct access to primary health care data to build this solution.

Bioforge believes in creating a diverse, equitable and inclusive workplace for all. We have diverse hiring practices, equity in pay and a friendly and supportive environment where each and every individual is welcome to share their values and opinion. As the leader of bioforge, I reach out to my employees for their feedback on how we as a team can be more diverse, equitable and inclusive. From small to big, we have many practices that help team members feel valued and included. As we have developed strong connections over the years, we all celebrate our differences  and are able to communicate our opinions with respect. These practices add more value to our organization as a whole.

We have been working on the solution for almost two years. Within this time, we have gathered the right resources to develop the solution, we have had conversations with a myriad of advisors, healthcare workers (HCWs) to create an effective user-friendly model. We successfully built and also tested our technology at Japan Bangladesh Friendship Hospital (JBFH). There is a demand for such technology worldwide, and the need is even more acute in developing countries like Bangladesh. Here patients are suffering to get timely, proper care and HCWs are struggling to provide the care needed due to immense pressure. At a national level, there is a shortage of skilled healthcare service providers, especially for critical patient management. We aim to solve these intricate challenges through creating a system that benefits patients, HCWs and also mitigates challenges at a national level. We aim to follow a combination of modern and traditional business models with direct sales and franchising. Bioforge follows a social business model- a successful business centered around a social need not on profit and ROI. The profit will be brought back into our organization to have a larger impact, to impact a broader area. We also aim to add more advanced functionalities in our system in the future. 

Bioforge as a company continues to create constant innovative solutions and also inexpensive solutions that will sell more and save more lives. For our VSM bridge, we are already in conversation with numerous hospitals who want our product. Japan Bangladesh Friendship Hospital (JBFH) has already set up our device in their ICU. In our subscription as a service (SAS) model, initial setup cost for the device is $100, with a monthly maintenance fee of $25. We are currently working on the project through self financing, and are also looking for funds to increase our initial capital. Our SAS model ensures profitability and financial sustainability in the long run. We are also open to take donations from general people, philanthropists and other organizations.

In 2020, Bioforge’s Technology was selected for MIT Solve Maternal and Newborn Health Challenge. We also secured the Community Prize in MIT Solve Challenge 2020.

We are in discussion with a couple of hospitals who are interested in testing our technology. From this, we believe that there is an opportunity for them buying the technology and getting our subscription plan. We have also shared the project with some prominent doctors and healthcare investors. They have expressed their interest in the technology and they are also interested in investing in the technology including large pharmaceutical companies in the country. We can have financial support as well as domain expenses from here. We are also actively applying for funding opportunities that might assist us in this bug journey.