Potential game-changer for expectant mothers

The Science Foundation Ireland-funded Infant centre (Irish Centre for Foetal and Neonatal Translational Research) at University College Cork has teamed up with IBM on a pilot research project aimed providing remote healthcare monitoring to expectant mothers to improve the detection and treatment of hypertension and pre-eclampsia during pregnancy.

The Leanbh (Learning to Evaluate Blood Pressure at Home) project has the potential to improve care and the quality of life for pregnant women at the same time as delivering reduced costs to the health service.

Pre-eclampsia is a pregnancy complication that affects about 5 per cent of pregnancies. Hypertension, one indicator of pre-eclampsia, is more common in all expectant mothers. The overall objective of Leanbh is to manage hypertension and pre-eclampsia care in a patient’s home using remote monitoring of the medical data of the at-risk expectant mothers. It aims to reduce the number of unnecessary follow- on hospital visits, lowering the additional stress and cost of visits to the patients and on the healthcare system.

The Infant centre is combining its clinical expertise with IBM technological know-how to create a patient-centred perinatal system that combines real-time remote monitoring technology via mobile with web-based advanced analytics and care management.

This remote monitoring will be combined with predictive analytics that can enable faster responses and a higher quality of care through automated alerts to doctors. It also aims to help improve data sharing among the healthcare team members and offer the ability to integrate with electronic healthcare records.

"We are really excited about this project," says obstetrician and Infant director Prof Louise Kenny. "It's one of those projects that sounds so simple that it makes you wonder why it hasn't been done before. It really is a game-changer, it's very disruptive and it could have enormous societal and economic benefits."

Ante

natal care appointments She points out that

76,000 babies are born in Ireland every year and that the mother of each of them has to go for multiple antenatal care appointments.

“Most of these appointments are very routine. They mainly consist of blood pressure and urine tests and later on the baby is examined. The tests are both looking for indications of pre-eclampsia. But you can get a blood pressure testing device in Boots – a woman shouldn’t have to go to hospital or a GP for a simple test like that.”

The Leanbh project will develop a system whereby mothers can take their own blood pressure readings at home or at work and have them relayed to a clinical centre via the internet.

“If the readings are high the mother can be called in for further tests in hospital, if not they do not have to visit”, says Kenny.

The project also has potential for other healthcare areas. “The ability to measure basic clinical parameters at home is fundamental to the whole area of connected health. The technology is quite generic and it can be transferred to other clinical problems. Take diabetes for instance, it could help patients out of hospital and in their own home.

“The same applies to the elderly who could have a whole range of clinical data transmitted back to a hospital to enable them to stay in their own homes. This might all sound very sci-fi but blood pressure measuring devices are readily available, it’s just a question of gathering the data and getting it transmitted back to a decision support system in a clinical setting.”

IBM is responsible for developing and providing the IT infrastructure that will transmit and analyse the data. “We had been working on it for three years and we were delighted when IBM came on board,” Kenny adds.

"One of our people attended a conference last year and heard Louise speak about the Infant centre", says IBM Ireland operations manager Robert McCarthy. "That led to our interest in the work there. We went in and had a look at what they were doing there in Cork University Hospital. It is one of the largest in Europe with 9,000 births a year. We decided that it would be good to help the expectant mothers on their journey. With up to 5 per cent of pregnant women experiencing pre- eclampsia that could be up to 450 women each year that we would be helping."

According to McCarthy, Infant was already working with a locally-based SME on the monitoring technology when IBM got involved.

“We looked at what we could do to tie it all together. The technology we are providing will deliver mobile alerts to mothers, alerts to clinicians, data analysis, data integration and increased data richness and integrity. The overall aim is to deliver better outcomes for mothers. We are working with Infant to build a system of systems.”

He foresees multiple benefits arising from the project: “It gives us at IBM the opportunity to add value to something with real social benefits. From the healthcare side of things it will reduce the strain on hospitals and GPs and it will relieve the strain on mothers by reducing the number of visits they have to make.

The economic impact is also potentially very high – the cost of a hospital visit for an expectant mother with pre-eclampsia has been estimated at €200 and the Leanbh project could result in savings of anything up to €20 million annually if successful.”

These savings will be some time in coming of course. “In healthcare everyone likes to think that their innovation will bring about savings,” Kenny notes. “The research usually does bring about patient- care improvements but in most cases doesn’t deliver savings. I have very high hopes that Leanbh will, though.

“I was that pregnant mum who had to go to hospital for basic blood pressure tests and I thought to myself: ‘This is bonkers, I should be able to get this information to the clinician myself.’ We are working with an 18th- and 19th-century way of delivering clinical care. But all the elements are there now in terms of the technology in order to bring it into the 21st century. All the ducks are now in a row for it to happen and IBM are plugging the technology gap for us. IBM is a great company to work with. They are very committed to the whole area of connected health. The technology has the potential to revolutionise antenatal care for expectant mothers on a global scale.”