Using technology to make a difference in newborn care

Peter Anto Johnson understands that a few seconds can mean the difference between life and death. When he was an infant, he was diagnosed with intussusception-a condition that twists and clogs the intestines. His family was living in rural India where access to healthcare was limited.

"It was a miracle that I was able to survive because, as soon as my family got to the hospital, I had emergency surgery and wouldn't have survived if we were delayed by even a few seconds. This really influenced me to pursue pediatrics and newborn medicine," says Johnson, now a graduate student in the Department of Pediatrics.

Johnson joins fellow learners Emily Zehnder and Simran Ghoman in the Centre for Studies of Asphyxia and Resuscitation (CSAR) where the three have separate research projects using technology to make a difference in newborn care. All three are supervised by Georg Schmӧlzer, associate professor in the Division of Neonatal-Perinatal Care.

A phone app and digital stethoscope could improve survival

Seconds matter in neonatal resuscitation. That's why Johnson is drawn to examining the use of a phone app called NeoTapLifeSupport (NeoTapLS). The app can be paired with a stethoscope for heart rate assessment. Healthcare providers tap the app as they hear the heartbeat, which provides the timing interval for the app's algorithm to calculate heart rate. "During lab testing, we determined using the app provides a faster heart rate assessment time compared to currently recommended methods using only the stethoscope," he says.

Johnson is also examining the use of a digital stethoscope, which can detect the heart rate or heartbeat much more accurately than the standard counterparts. "This is the first time that we are looking at this technology for heart rate assessments in newborn infants. We're comparing the accuracy of a digital stethoscope versus a normal stethoscope, which we'll soon validate by starting a clinical trial at the Royal Alexandra Hospital," he explains.

"With new innovations coming out, the heart of research has really shifted more towards gaining a fuller view of these game-changing technologies," adds Johnson.

Eye tracking glasses used for two studies

Zehnder and Ghoman are using eye tracking glasses in separate research projects. This special technology is worn by clinicians to record eye movements during procedures or other activities.

Zehnder examines eye movement during neonatal resuscitations to learn more about a clinician's decision-making processes. "I'm using the video that's created from the eye tracking glasses as a tool to prompt questions during an interview with healthcare providers after the fact. I'm interested in what the prioritizations and predictions are and how those guide the decisions they have to make," she says. "When a healthcare provider is asked to describe a procedure without the video, they oftentimes omit the majority of their decisions because they are so familiar with it."

She adds clinicians also may not be thinking that they need to share this inner monologue with others. However, this information can be valuable to learners or to people who are developing other technologies for the delivery room.

Showing clinicians their eye movements has also brought new information forward. During her interviews, Zehnder asked healthcare providers to describe their thought process while watching the video and often the interviewees remarked that they didn't realize they were spending so much time looking at a particular spot. "It has really helped them reflect on their thought process during either the resuscitation or intubations on the unit."

Ghoman is using the eye tracking glasses to improve a simulation-based digital game called RETAIN (see previous story). RETAIN provides neonatal resuscitation training scenarios for its users. The glasses track how healthcare providers use the game. She will use the results from her study to inform the game developer if changes are needed to improve the presentation of RETAIN. "It's interesting to see what people pay attention to visually while training. My next step will be to compare this data to the eye-tracking recordings from real resuscitations at the hospital. I want to compare where people look during a clinical resuscitation, to where people look while playing a simulated resuscitation. My aim is to see if people behave similarly in between both environments," she says.

Technology is becoming more prevalent in research and neonatology. While initially developed for use in psychology, design, and marketing, Ghoman sees the possibility of how the eye tracking glasses could be used in different health applications. "It's going to be exciting to see how this technology continues to be adapted in the future. We can always look at existing tools in new and creative ways to help solve important problems across disciplines," she says.