Vitex-Medical Pandemic Assistance Tool.

A mobile device that disinfects hospital wards by using cutting edge far UVC  that is safe to use in occupied rooms and improves patient care and practitioner assistance.

In Uganda higher Hospital Acquired Infection rates, emerging new infections, and antimicrobial resistant strains have been reported. There is also a burden of medical administration that puts pressure on the thinly stretched medical workers in developing countries. According to WHO (2015), there were an average of 33 nurses/midwives and 5 pharmaceutical personnel per 10,000 people. This underscores the need to have the technology to assist the few available health workers when delivering services.

In hospitals and quarantine centres, health workers are faced with the challenge of i) inadequate supply of full personal protective gear, exposing them to a high risk of infection due to frequent, unprotected patient contacts; ii) risk of physical and emotional stress resulting from being overwhelmed by the number of patients to attend to. Many health workers have lost their lives in Liberia, including one in Uganda (Agaba, 2014). There is an urgent need to develop systems that would protect the few health-care workers from the risk of infection, especially the recent Ebola outbreak (VOA, 2022).

The proposed improved Vitex device version 2.0 is aimed at reducing infections (especially the recurrent Ebola Outbreaks) and enhancing the effectiveness and efficiency of our hospitals in meeting the basic clinical needs of in-ward patients. It is equipped with an intelligent remote sensing and a low-cost safe sterilising system that uses far Ultraviolet (UV) light to disinfect both air and floor surfaces. It is equipped with intelligent remote communication capabilities between the patient and the medical professionals.  In the hospital, the patient can be given their supplies in the absence of the nurse or doctor after which it self-sterilises using the safe far UV light, Far-UVC radiation safety is due to the strong protein absorption and the larger size of human cells compared to most microorganisms, while bacteria or viruses (typical diameter 1 µm and 0.1 µm, respectively) are irradiated completely (Buonanno et al., 2020). In addition, if patients are in distress, they can press a button and speak to a health worker through the patient care response subsystem, which can also be triggered automatically when a fall is registered.

References.

1.   Agaba, J. (2014, Oct 10). Another Ugandan Doctor dies of Ebola.  Retrieved 24/09/2022, from https://www.newvision.co.ug/ne...

2.    Buonanno, M..., & Brenner, D. J. (2020). Far-UVC light (222 nm) efficiently and safely inactivates airborne human coronaviruses. 10(1), 1-8. 

3.   VOA (2022). Uganda Confirms Seven Ebola Cases So Far, One Death. Retrieved 9/23/2022, from https://www.voanews.com/amp/ug...

4.   WHO (2015). World Health Statistics 2015, World Health Organization, Geneva, Switzerland, 2015. Retrieved 9/23/2022, from https://www.who.int/docs/defau...

We are proposing an improved version of our innovation called “Vitex System 2.0.”  It is made up of two elements - a device (Vitex device) and a software (Patient Risk Stratification Software.) Vitex device sterilizes wards up to 99.99%, by employing far UVC light that can be used in occupied rooms. Far UVC light of 222nm kills pathogens efficiently regardless of their drug-resistant proficiency, but without skin and eye damaging effects associated with conventional germicidal UV exposure, thus exposing no risk of cancer and cataracts, therefore, it can work in typical Ugandan hospitals. Vitex further sterilizes medical supplies like masks, water, and oxygen sensors within the device.

Proposed updated Vitex Device version 2.0 will be equipped with the following features: i) intelligent robot driven, safe  far UVC disinfection unit; ii) smart camera-enhanced dual-channel video communication module; iv) remote sensing feature for fall detection, and v) a component to hold supplies for up to three patients. Our design will also be equipped with artificial intelligence capability that calls patients by name and communicates with them in english and their local language. These features reduce nurses’ workload, and freeing up their time for other critical duties in the hospitals.

Beneficiaries of our system include hospitals, hospices and other long-term care facilities and patients especially medical personnel at risk of infection posed by poor health care facilities, such as in congested wards and operating rooms, non-adherence to safety and sanitation protocols and low availability of healthcare professionals. The percentage of time to distribute supplies to patients should improve by 40% over the manual processes thereby enabling nurses to concentrate on other critical issues. Vitex will lead to; reduction in spending on protective personal gear due to reduced contact, reduction in practitioner infections especially in this Ebola outbreak, reduce mortality due to infections and antimicrobial resistant strains, and most importantly reduce costs for recurrent disinfection and hand sanitizers. Our anticipated community impact is a reduction in the morbidity and mortality rates due to hospital acquired infections and antimicrobial resistant strains. 

Vitex will lead to; Reduction in spending on protective personal gear due to reduced contact, reduced practitioner infections, reduced mortality due to infections and antimicrobial resistant strains,  Improved patient records and most importantly reduced costs for recurrent disinfection and hand sanitizers.

Our anticipated community impact is a reduction of the morbidity and mortality rates especially in maternal and neonates to better healthcare services and antimicrobial resistance mitigation. These resultantly can increase  lifespan and survival.

Our team is made up of highly qualified, committed and skilled professionals in computer systems, artificial intelligence programming, medicine, research professionals and undergraduate students who are innovative. One of our student team members won the 2020 best innovative student award in medical systems by the Ministry Of Health organised Heroes In Health Awards (HIHA).  This team has transformed our crude first prototype into a sleek modern design and has laid plans to improve it further and scale.

The initial Vitex device  was tested in 4 hospitals in Uganda and received positive reviews and feedback this was later published in the Future Technologies Conference in Canada(Gift et al, 2020). It was further developed into an advanced medical assistant, a modern, sleek 3D printed design that is made out of 80% waste plastic(Uzoka et al, 2022).   

We entered into a consortium style collaboration with an engineering firm, a marketing firm and a medical device production and facilitation organization called the Consortium for Affordable Medical Technologies (CAMTech) for device development.

References

1.   Mugisha, G.A. et al. (2021). Usability Evaluation of Low-Cost Smart Pill Dispenser by Health Care Practitioners. In: Arai, K., Kapoor, S., Bhatia, R. (eds) Proceedings of the Future Technologies Conference (FTC) 2020, Volume 3. FTC 2020. Advances in Intelligent Systems and Computing, vol 1290. Springer, Cham. https://doi-org.ezproxyberklee.flo.org/10.1007/978-3-...

2.   Uzoka, F. M.,.... & Kyeyune, G. (2022, May). Tackling Occupational and Nosocomial Infection using Vitex-Medical Assistant Tool. DOI: 10.23919/IST-Africa56635.2022.9845540

Vitex device version 2.0  is an eco-friendly system that utilizes antimicrobial materials, these nano copper filaments continuously eliminate dangerous pathogens up to 99.99% on the device surface. Additionally, affordable 3D materials made from 80% waste plastic are used unlike existing systems.This device sterilizes wards up to 99.99% , by employing  far UVC light that can be used in occupied rooms, far UVC light of 222nm kills pathogens efficiently regardless of their drug-resistant proficiency (Buonanno et al., 2020), but without  skin and eye damaging effects associated with conventional germicidal UV exposure thus it can work in typical Ugandan congested facilities unlike systems like  Xenex machine that work in only unoccupied rooms. Vitex can haul medical waste of up to 10 kilograms through mobile dustbins unlike other systems that don’t. Our project is a marked enhancement of the standard method of disinfection that utilizes chemicals which are relatively expensive, potentially toxic with a low efficacy, and lead to equipment damage (Ventilators) due to liquid sanitizers. Vitex is unique as it acts as a platform on which practitioners and patients can interface without physical contact. it speaks in the patient's language, and sends  notifications during emergency (Vital parameters change.)

We expect to reduce the risk of resistant strains and nosocomial infections for over 18,250 people in the course of one year, this is by rolling out the product to more health facilities.

The primary outcome is improved sanitation practices by using clinically proven effectiveness of far UV-C light. Vitex disinfects  rooms of 100sq ft from a fixed point but can be increased since the device is mobile, it will also sanitize hands and other small objects such as oxygen sensors and cell phones by inactivating microorganisms at the cellular level in seconds.

Beneficiaries of our system include hospitals, hospices and other long-term care facilities and Patients especially medical personnel at risk of infection posed by poor health care facilities, such as in congested wards and operating rooms, non-adherence to safety and sanitation protocols and low availability of healthcare professionals. The percentage of time to distribute supplies to patients should improve by 40% over the manual processes thereby enabling nurses to concentrate on other critical issues. Vitex will lead to; reduction in spending on protective personal gear due to reduced contact, reduction in practitioner infections, reduce mortality due to infections and antimicrobial resistant strains, and most importantly reduce costs for recurrent disinfection and hand sanitizers. Our anticipated community impact is a reduction in the morbidity and mortality rates due to hospital acquired infections and antimicrobial resistant strains. 

Vitex device is aimed at reducing infections (especially Ebola) and enhancing the effectiveness and efficiency of our hospitals in meeting the basic clinical needs of inward- patients. It is equipped with;

Notification Unit: This unit notifies patients of the need to come collect their drugs, supplements or other necessities like food. The notification system is programmed to speak in the language that the patient understands. This is vital for e-counselling and consultation.

Ultraviolet light C sterilizing module: The Vitex device sterilizing module is powered by cutting edge safe far UVC light. The device with its strobe light emits a surplus of high-power far UVC light. The intense UV light bounces off of surfaces all around the room and is absorbed by pathogens on surfaces, thus inactivating them. Hospital room floors, walls, air, tray tables, sinks, telephones and handrails can be sanctuaries for infection-causing bacteria and pathogens as they are easily left out.

Remote sensing subsystem: This is activated by the emergency system when a fall, change in breathing, noise and heart rate fluctuations are registered. The patient may manually activate this system or automatically when a triggering threshold is met.

Power supply: We use Li-Polymer battery cells as they have about four times the energy density of lead-acid batteries. The device will also be compatible with getting a power supply from the mains.

Mobility: The device uses wheels with auto balance and adequate control algorithms that are important in device motion and prevent falls.

Device structure: Vitex structure and vital components  prone to a lot of touching are  made out of 3D-printed copper and Nano Copper that inhibits the replication and propagation abilities of COVID-19, dangerous bacteria like Staphylococcus aureus among others, and other respiratory viruses, these materials have a high antimicrobial (antiviral and antibacterial) potential after a short period of exposure (Teamone, 2019). These continuously eliminate dangerous pathogens up to 99.9% on the device surface. Additionally, affordable 3D-printed materials made from 80% waste plastic are used.

Performance: One of the Vitex’s version 2.0 core strengths will be its operating system, which will allow our team, as well as external developers to integrate existing digital health solutions onto the platform, and to create new and exciting native and mobile applications. The updated device version spots a Snapdragon 8 Gen 1 octa-core chipset that will improve performance and ease upgradability via over the air software updates. 

We expect to serve over 18,250 people in the course of one year.

Approximately service provision per device - 50 patients and sanitise 10 rooms per day (18,250 patients and 3,650 rooms per annum). 

As with any innovation scale-up, we have some challenges, most of which  relate to anticipation of partnership involvement and funding. It is our expectation that ministry of health, government hospitals and private healthcare companies such as pharmaceuticals and private hospitals, in the respective countries will partner with us, providing about 10% of the financial support, plus the legal framework for system implementation. There is a possibility that we might encounter regulatory challenges. To mitigate the risk, we will enter into prior discussions with the health authorities and obtain all implementation approvals prior to scaling. The MIT SOLVE award  is highly competitive. We are confident that we will obtain the award to support the piloting of our innovation and enable us scale up the innovation. However, in the event that we are unsuccessful, we will approach organizations in Uganda,  that have community health as part of their social responsibility programs for funding. In that case, the level of scaling may vary from the initially planned level. We intend to strike collaborations with innovators, researchers and health professionals in Uganda, as a strategy for navigating the contextual peculiarities.

Our innovation is in partnership with Mount Royal University and Makerere University (MUK), MUK is a center of excellence in research and innovation in Uganda. MUK has a number of innovations aimed at addressing societal challenges. Notable to mention is the COVID-19 Rapid Antibody Test Kits (2021),  Mount Royal University (MRU), Canada has extensive experience in conducting research and managing large funds from the Government of Canada & other external agencies.

We will  sell the Vitex devices and also earn from non confidential statistical data that will be harnessed by research organisations and this will give us an investment to keep the project running.

The two major guiding principles in our innovation are cost-effectiveness (built into the design) and sustainability (derived for potential scale up partnerships). We will use monetary unit, going concern, dual aspect of the duality and cost accounting principles to report the financial statements of our innovation. The subsidy enjoyed on purchase of medical equipment will help to mass produce the vitex project at a minimum cost and profit generated in a long run will be rollover to expand the production on larger scale.

Additionaly, the following are potential sources of funds: i) Canadian Institute of Health Research, and ii) New Frontiers in Research Funds, Canada.