2015 CAMTech INDIA Jugaad-a-thon

June 26-28, 2015 | Bangalore

During the 2nd CAMTech INDIA Jugaad-a-thon, over 300 participants, industry mentors, organizers and volunteers came together to co-create and develop affordable health technologies that address reproductive, maternal, newborn and child health (RMNCH) in India.

The Jugaad-a-thon (derived from the Hindi word “jugaad” meaning an innovative fix or work-around), invites some of the world’s brightest minds to collaborate over a 48-hour period and develop solutions to identified clinical challenges through an open innovation platform. Prior to the Jugaad-a-thon, CAMTech INDIA held a Clinical Summit with clinicians, healthcare workers, government public health experts and patients from around the world to identify and discuss pressing maternal and child health challenges, as well as best practices in delivering care. The Summit also included a Technology Showcase for early-stage and newly-marketed medical technologies that aim to improve quality and access for RMNCH in India.

Check out the winners!

This year’s event awarded monetary prizes to winning teams in several categories, including:

  • USAID Grand Challenge Award: Family Planning and Reproductive Health: Team Trust+ won this prize for their development of a mobile platform for adolescents and adults that encourages open and effective communication about safe sex and family planning.
  • CAMTech-USAID Awards: CAMTech and USAID awarded prizes to the top three teams across all categories:
    • Team Slow Forward: an effective video consultation for rural areas with low bandwidth took first place
    • Team Peekaboo: an interactive gaming application that aids in identifying vision impairment for children, won second place
    • Team Shakthi Ki Yukthi: a low-cost female contraceptive tool, took the third prize
  • GE Healthcare India Awards: GE sponsored three challenges and awarded prizes to the following teams:
    • Nitrobooster: which developed a cost-effective and steady supply of nitrous oxide for surgeries
    • O2-Matic: a low-cost method for oxygen production to address unpredictable availability of medical gases in limited resource settings
    • Aawaazz: an affordable device that screens for hearing impairment in infants in under-served communities
  • MSD for Mothers (known as Merck in the US and Canada) Awards: These awards were given to:
    • MOM (Maternity over Mortality):which aims to reduce the culture time involved in the diagnosis of maternal sepsis:
    • Team Slow Forward

In addition to this year’s winners, Jugaad-a-thon participants had the opportunity to win a special post-Jugaad-a-thon award from FICCI and Terumo India for the top two innovations that made the most progress 30 days after the event.

Clinical Challenges

Challenge
Description
USAID Grand Challenge: Family Planning Education
Every individual (irrespective of sex, age, marital status, socio-economic level, etc.) should be entitled to: access to family planning information, which is scientifically accurate, objective, free of prejudice and discrimination; and access to the full range of legally-permissible family planning goods and services. The best decisions about family planning are those that individuals make for themselves, based on accurate information and a range of contraceptive options. People who make informed choices are better able to use family planning safely and effectively. However the full range of contraceptive options and the benefits and health risks of particular methods for family planning in India is often not well understood, especially by younger women and men. The challenge in India is that currently there are limited tools or products that help to broadly educate young men and women to enable them to make an informed choice.
GE Challenge: Medical Gases – continuous availability and affordability
Watch the video.
 
In low resource hospital environments, the challenges are compounded by unpredictable availability of medical gases such as oxygen, air, nitrous oxide. What would be the best way to ensure continuous and/or predictable supply of these gases to hospitals in rural and low resource settings of Africa, ASEAN and South Asia to aid in safe surgeries for maternal and infant care?
GE Challenge: Analytics driven care continuum for mothers & infants
Watch the video.
Mother & Child: In his seminal work on operant conditioning, behaviorist BF Skinner introduced the “Law of Effect: Reinforcement”. He stated that behavior which is reinforced tends to be repeated (i.e. strengthened); behavior which is not reinforced tends to die out-or be extinguished (i.e. weakened). In the context of Rural Indian pregnancies, lack of standard care affects (1) the mother, (2) the delivery, & (3) the infant. Traditional attitude, economical reasons, & awareness are some reasons for dangerous outcomes.
Behavioral modifications for favorable outcomes include (1) improved dietary practices, (2) seeking institutional deliveries/ deliveries by trained personnel (3) Timely vaccine and immunizations post-delivery. Care giver: The public/ private care givers set up healthcare delivery models with the best intention in mind. The challenge however is to track the efficiency of these models in terms of clinical, operational & financial success metrics across the target population.
At the care giver’s end, develop a care delivery tracking dashboard (Proto) that can track healthcare delivery to patients and identify both good and problematic areas. Connect this dashboard to the patients using a low-cost tech-driven model that incorporates behavioral modifications to achieve the stated outcomes.
GE Challenge: Improved access: Teleconsultation & Automation
Watch the video.
At a national level, we face a big shortage of trained doctors and paramedics. We only have about 1 doctor for every 1700 patients (WHO stipulates 1:1100). Apart from doctors, we are also short by 64 Lakh Allied Health Professionals. This shortage gets further amplified in rural areas due to both a high population and an unwillingness of trained professionals to work there.
The challenge is to develop a solution for a digital knowledge-based system complementing a tele-consulting module to address the shortage of trained manpower. Build learning opportunities both at the human and machine level to augment scalability of care delivery - assuming maternal and infant care as the care delivery area.
Merck for Mothers Challenge: Video Consultations in Low-Bandwidth Settings
Consultation and follow-ups are especially important in antenatal care (ANC) for pregnant women and can dramatically influence health outcomes. Low bandwidth availability in rural areas does not allow for video consultations to take place between rural healthcare providers and urban doctors, a persistent need in ANC. This kind of video consultation is core to telemedicine solutions that can help address the lack of qualified doctors in rural settings. The current available options are unsatisfactory since connections are repeatedly interrupted and dropped. World Health Partners, which provides this kind of maternal health through support from Merck for Mothers in Uttar Pradesh, proposes this challenge of how we can innovate to provide telemedicine solutions in the context of low bandwidth.
Merck for Mothers Challenge: Maternal Sepsis
Sepsis is an illness that can develop in some pregnant women, as well as in women who have recently delivered a baby or babies. Sepsis that occurs during pregnancy is called maternal sepsis — occurring at any time between the rupture of membranes (onset of labor) and 42 days postpartum. Merck for Mother is seeking an affordable, point-of-care diagnostic to identify and/or characterize the susceptibility of the most common pathogens involved in Maternal Sepsis.
 
Home-care technologies
70% of India lives below $2 a day. Focus on treatment, even at low costs, is not sufficient to cater to their needs. There is an additional requirement for technologies that can be used at home, and provide preventive care and early diagnosis. Such technology interventions can focus on high-risk segments first - such as pregnant mothers and infants.
An instance of such a technology is bed-nets for Malaria prevention. Widespread use of bed nets within a community - even if not 100% - reduces the risk of malaria transmission since vectors (mosquitoes) are unable to access both infected and healthy patients in large enough numbers to spread the disease. Thus, a key element of a successful Malaria prevention program is the dissemination of bed nets in wide enough numbers to “inoculate” the entire population within a locality.
Child Growth Monitoring & Nutrition
Developmental disorders in children due to poor nutrition are common in rural India. A system that monitors child growth, especially till the child is 2 years old, and also tracks nutrition - including adherence to prescribed supplements - would be of value to parents, community workers and primary care providers.
Such a system may first find application in monitoring low birth weight infants.
Fetal Heart Rate Monitoring
An instrument to monitor fetal heart rate that is more sensitive and specific than a Cardiotocogram is needed. However, such a system should be comparable in affordability, portability and ease of use to the Cardiotocogram. Such a monitoring system can prevent intra-uterine death, and enable early recognition of fetal distress/ compromise.
Both institutional users and at-home care providers require such an instrument - though with different specifications ("use cases"). The at-home product should focus on screening, whereas the in-hospital product should focus on accurate diagnosis.
The key technical challenge in designing an effective fetal monitor is with regard to signal processing. Fetal heart beats are faint, and are confounded by the mother’s heart beat and her arterial blood flow. Current monitors require skilled operators, since correct placement of probes on the mother’s belly is a crucial to get readings.
Once the mother goes into labor, changes in fetal heart rate over time are strong predictor of the health of the fetus and the likelihood of a normal delivery (versus a Cesarean section). Low-cost systems today do not integrate these elements of time-based changes into the diagnostic process.
Assistive Technologies for ASHA Workers
ASHA workers straddle the large divide between traditional forms of healthcare delivery, and community-centric healthcare. They are the backbone of most government health interventions, since they are the “last mile” of most outreach efforts.
ASHA workers require assistive technologies for the following activities:
  • Monitoring patients, especially pregnant mothers who require routine follow-up.

  • Reporting the results of their daily work to functionaries of the Government of India.

  • Delivering knowledge of better preventive health to patients and their families.

  • Increasing compliance to prescribed medication.


Such assistive technologies have to be intuitive, robust and scalable – so that are adopted quickly and effectively by ASHA workers.
Reliable Power for Medical Devices
Power supply in remote parts of India is unreliable - both in terms of quantity and quality. 220 volt power supply can drop down to as low as 150 volts, causing equipment failure.
Low-cost power supply and voltage stabilization, designed with hospitals in mind, can reduce operating costs related to equipment maintenance. A specific area where consistent supply of good quality power creates value is cold storage for vaccines and pathology reagents.
Early Diagnosis of Ectopic Pregnancies
Ectopic Pregnancies continue to be leading cause of maternal deaths during childbirth. Solutions that detect Ectopic Pregnancies early can save lives.
Ectopic pregnancies are diagnosed today using ultrasound. If ultrasound reports are inconclusive, then a diagnostic laparoscopy is prescribed. Testing beta-hCG levels is also used in developed countries to refine diagnosis.
In India, the use of Ultrasound as a diagnostic test has been limited due to female infanticide. Further, diagnostic laparoscopy requires infrastructure and skills that are not readily available in rural areas. Hence, rural India requires novel, low-cost and widely scalable methods of detecting Ectopic pregnancies early.
Cervical Cancer Screening & Diagnosis
Cervical cancer has one of the highest rates cure among cancers, if detected on a timely basis. The Pap Smear is simple, cost-effective and well established method to take a sample for an at-risk patient and evaluate it under a microscope.
However, the adoption of this solution is hindered by the following:
  • Social resistance to screening

  • Lack of access to pathologists – which leads to the need for samples to be transported over long distances, with consequent errors and delays in detection.

  • Lack of systems for patient follow-up – so that at-risk women, such as sex-workers, are routinely screening.


Technology-assisted solutions that address any of these constraints are of value.
Diarrhoea Prevention
Diarrhoea remains a prevalent disease in infants. Though oral rehydration therapy - boiled water, salt and sugar - is a simple and effective at-home remedy, parents prefer to have injectables used on infants, and perceive it to be more "proper" care.
Infants suffering from Diarrhea can go into shock if not treated on a timely manner. Tools, methods and program to improve the acceptance of at-home ORS, or the use of ORS packets (provided at no charge by Government-sponsored programs), would reduce disease burden and infant mortality.
Primary Pediatric Healthcare - Antibiotic Therapy
Watch the video.
Infants who need to undergo antibiotic therapy typically have to conform to a 7-day regime. In a community setting, this is a challenging protocol to administer, since parents may not return to the Primary Healthcare Center (PHC) once the child has started responding to the therapy - leading to incomplete regimes and increased antibiotic resistance.
Drug delivery mechanisms or communication/ outreach systems that can overcome compliance challenges will increase the effectiveness of antibiotic therapy for infants.
Treating Neonatal Sepsis in the ICU
Watch the video.
Sepsis is a common condition that causes Neonates and Infants to be admitted to the NICU (neonatal intensive care unit). Sepsis is a system infection, often blood borne. Without timely treatment, babies are at risk of dying. Diagnostic tools and methods that can identify bacteria early (early detection) can significantly reduce infant mortality.
Further, neonates & Infants also present with localized infections, such as an ear infection, which causes them to be admitted to the ICU.
The clinical signs for both systemic and local infections are often common - such as apnea, feeding intolerance, and need for increased respiratory support. Since infants are unable to communicate, they present with general distress that may arise from local infections or systemic infections (sepsis).
Thus, early distinction between local and systemic infections also has the ability to save lives. The extent of the problem is described in this publication.
The gold standard for diagnosis of neonatal sepsis is by positive blood culture. This can take up to 2 days to complete, and doctors have to resort to empirical (probability & protocol-based) antibiotic therapy in the meantime. One example of protocols for Neonatal Sepsis is available here.
Delays in blood culture report can lead to infant deaths. Other strategies to improve efficiency of diagnosis have been tried out. One such approach, using universal primer polymerase chain reactions (PCRs) is available here. This technology, however, had not found widespread adoption due to cost - reported to be as high as $125 per test.
Long waiting times at primary healthcare centers
Primary health centers in India have low resources – both in terms of personnel (doctors and nurses) and facilities/ equipment. Patients have to wait for hours for a consultation, which results in loss of income and strain.
Methods of work, supported by technology-based systems, are required to reduce strain and healthcare providers and patients alike.

Clinical Summit Agenda

Alia Hotel | Bangalore, India
June 26, 2015 (8.00 – 18.00)

Time
Description
8.00
Breakfast Served / Registration
9.00
Welcoming Remarks
9.45
Introductory Session (CAMTech INDIA: Clinical Challenges Driving Technology Innovation)
11.00
Tea
11.15
Family Planning & Reproductive Health: Progress and Challenges in the Last Decade
12.15
Preventable Deaths of Newborns and Under-Five Children:
Where Are We Falling Behind?
13.00
Lunch
13.45
Voice of the Patient: Challenges in Accessing Quality RMNCH Care
14.45
Tea
15.00
Global Maternal Mortality Trajectory and innovation Opportunities
16.00
Problem Statement and Pitch Workshop (Interactive & Collaborative Session to Identify Clinical Challenges in RMNCH)
17.00
Closing Remarks
17.30
Technology Showcase

Day 1: Saturday, 27 June 2015

Time
Description
7:30 AM
Registration Begins/ Breakfast
9:00 AM
Welcome Address by CAMTech
9:15 AM
Welcome Address by GE Healthcare
9:25 AM
Challenges presented by Sponsors
9:55 AM
EHS and Safety Guidelines by GE JFWTC
10:00 AM
How the hack-a-thon will work
10:15 AM
Move to Oddessy Building
10:30 AM
Pitch Session Begins
12:00 PM
Hacking Begins
1:30 PM
Lunch Served
2:30 PM
Hacker Shop Opens
3:00 PM
Final Presentation Sign-up Opens
4:00 PM
Tea
8:00 PM
Dinner
9:00 PM
Hacker Shop Closes

Day 2: Sunday, 28 June 2015

Time
Description
9:00 AM
Mentors Return
9:15 AM
Tea/Breakfast
9:30 AM
Hacker Shop Opens
10:00 AM
Practice Pitch Room Opens
11:00 AM
Final Presentation Sign-up Closes
1:00 PM
Lunch, Hacker Shop Closes
2:30 PM
Move to MG Hall
2:45 PM
Jugdes Introduced
3:00 PM
Final Presentations Begin
6:00 PM
Participant Feedback Session
6:30 PM
Prize Distribution Ceremony
6:45 PM
Closing Remarks
7:00 PM
Dispersal

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