COVID-19 Ready NICUs

by | Aug 22, 2020 | Articles | 0 comments

A remotely enabled setup of NICU making it accessible to doctors and parents.

Introduction

With the current COVID-19 situation, an immense increase in the use of digital services across every domain is witnessed. Even the healthcare sector, primarily the Intensive Care Units (ICU) are witnessing a radical transformation in their care delivery. In March 2020, the number of COVID-19 infected patients began to escalate, making it crucial to find methods to provide high-quality medical care to infants in NICUs without exposing the clinic staff or infants to the virus. With most of the countries implementing ‘lockdown’ rules, Neonatal Intensive Care Units (NICUs) have had to quickly adapt to these new public health concerns about nosocomial COVID-19 infections (global context). To contain the spread of the virus in these circumstances, NICU environments have to redefine what a physician-patient interaction looks like, given a health emergency and limited resource supply condition. Additionally, streamlining of workflows for shortening the length of stays, clinical management, and infection prevention will matter not only to the patients in a NICU but also to health-care workers and visitors who are at risk from this transmission. Social distancing is the new norm and the hospitals are rethinking their visitor and healthcare movement policies to reduce the infection rates.

NICU guidelines to manage COVID outbreak

Recently, multiple strategies have been suggested for preparing COVID response in a NICU [1]. This includes taking the following measures to reduce the risk of infection to the neonates, staff and visitors:

  • Planning the NICU bed allocation and cohorts of infants born to mothers with suspected or proven COVID-19
  • Equipping NICU staff with PPE
  • Planning healthcare staff visits
  • Allowing only one parent to visit the NICU
  • Utilizing phone and video modalities to maintain contact. 

CHIL Technology

In these unprecedented times, Child Health Imprints Limited(CHIL) brings additional technology that have been added to support COVID specific use cases:

Remote consultation plugin/e-rounds

This plugin allows the onsite neonatologist to get a specialised consultation of the neonates during rounds in a NICU by a specialist anywhere anytime. This extension available over iNICU platform allows the direct interaction between onsite consultant/resident and a remote specialised consultant. The remote consultant/specialist can view neonates’ clinical records and perform visual assessment through a live video feed. These clinical records contain physiological parameters, nutrition, medication, intake-output etc which give a structured and holistic view for evaluation. This method of e-rounds not only reduces the need for specialist’s visit but also can provide opportunities to gain access to relevant expertise, without the barriers of geographic distance.

Remote specialised consultation of neonates

Remote view plugin

The live view of the neonate is streamed over the iNICU platform and is accessible through the iCHR app which is available over phone remotely to the parents. In this method, the time slots for a live view of every infant are scheduled. The parents are provided with iCHR (Integrated Child Health Record) app from where they can view their baby. Notification of upcoming live video is sent to the parents 15 minutes ahead of their time slot. This reduces the need for parents’ visit to the NICU and the associated infection transmission risks.

Remote view of neonates for the parents

Video counselling/consultation

Conventionally in a NICU, a counselling session happens between the neonatologist and the parents daily. This session is meant for updating the parents on the current health condition of their baby. The neonatologist keeps handy a summary of baby’s nutrition, medications, ongoing respiratory support mode, any clinical event etc. The “Video counselling” plugin allows the parents/attendants to have a live video call with the doctors to understand the health status of the baby. In this method, the iNICU platform acts as a doctor’s interface and iCHR app acts as a parents’ interface. The doctor is facilitated with the entire live information of the baby which he/she can use at the time of video call.

Video counselling between parents & the doctors

Post-discharge management of neonate at home

iCHR platform acts as an engagement platform connecting parents of neonates with neonatologists/paediatricians. Post-discharge of the neonates, the iCHR users will be provided remote kits. These kits will record and store vital clinical information like heart rate, respiratory rate, oxygen saturation, body temperature, oral view on the iCHR server.

Neonatologists/paediatricians can view these records and this will allow all examination results to be available prior to consultation and the doctor can request for any specific inputs during the parent’s interaction.

The same app is also used for reminding parents on the upcoming vaccinations for the baby as per the recommended schedule. These vaccinations can be ordered in advance and sent to the parents for home vaccination.

Home management of the babies by the doctors

We at CHI, have collected and amalgamated the best learnings from our medical advisors across the globe and have designed these solutions in a way that makes it easy for you to monitor and manage your neonate’s health remotely in the best way possible during this pandemic.

So, if you are looking to manage your NICU remotely look no further and reach out to us today!

References

  • Neonatal recommendations for COVID-19. 2020; : 1–4. https://www.starship.org.nz/guidelines/neonatal-recommendations-for-covid-19/
  • Singh H, Kaur R, Gangadharan A, IEEE AP, 2018. Neo-Bedside Monitoring Device for Integrated Neonatal Intensive Care Unit (iNICU). ieeexploreieeeorg. 7:7803-7813. doi:10.1109/ACCESS.2018.2886879
  • Singh H, Yadav G, Mallaiah R, et al. iNICU – Integrated Neonatal Care Unit: Capturing Neonatal Journey in an Intelligent Data Way. Journal of Medical Systems. 2017;41(8):132.
  • iCHRCloud: Web & Mobile based Child Health Imprints for Smart Healthcare .J Med Syst. 42: 14. https://doi.org/10.1007/s10916-017-0866-5


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