2018 Health Hack Competition Challenges
Scroll down to see all challenges that will be presented in this year’s competition. These have been sub-divided into 5 categories: Wearables, Devices, Veterinary Medicine, Mobile Apps, and Medical Simulators. However, there is plenty of overlap, so please read through all of them!
Gait, Balance and Motor Coordination Assessment in Adults with Neurological Disorders
There are numerous disorders of the nervous system which adversely affect walking ability (gait), alter balance and coordination and motor control. Hydrocephalus is a neurological disorder associated with an increased size of the fluid chambers (ventricles) of the brain (ventriculomegaly). Adults with hydrocephalus may present with gait disturbance and cognitive impairment (dementia). These symptoms are, however, common and not specific to hydrocephalus. A common clinical challenge involves determining if symptoms of gait disturbance and cognitive dysfunction are linked (causative or connected) in a patient with hydrocephalus (large ventricles). This clinical challenge is currently addressed using a brief (short duration) assessment of gait velocity and cognitive tests before and after removal of a predetermined volume of spinal fluid with a lumbar puncture or lumbar drain.
A solution suggestion (if feasible) could involve use of “smartphone technology” to monitor gait velocity, and other parameters of balance and stability. If this could be linked to a cloud repository, patients could monitor their gait and provide this data to the staff in the Adult Hydrocephalus Clinic to aid in their treatment.
Wearable Neuro-technology for Concussion Management
Many concussion injuries are mismanaged in emergency departments, sports medicine clinics, and athletic facilities because there is a lack of portable imaging methods to monitor the injury. Near-infrared spectroscopy (NIRS), a non-invasive optical imaging system that measures changes in blood oxygenation in the brain, has shown promise as a concussion monitoring tool. Can you build a sleek, wireless, wearable device that uses NIRS technology to monitor concussion patients?
Chronic condition and activity tracking
AT INLIV, inliv.com, we want to integrate wearable devices into our programs for tracking of chronic disease, specifically hypertension and atrial fibrillation. It would be great if we were also able to track patient activity levels along with heart rate, blood pressure responses and ECG. If there was a way that a device could combine activity, heart rate and blood pressure readings (ECG as a wish list) and provide this data to physicians through syncing in an app that would be great for us.
Reducing fentanyl-related deaths, one pump at a time
Fentanyl is a strong synthetic narcotic — about 50 to 100 times more potent than morphine — and is typically prescribed to control severe pain. Illicitly manufactured fentanyl has been mixed with other street drugs and illegally sold in various forms such as pills and powders mixed into other drugs (e.g. cocaine, crystal meth, etc.). People who use drugs (PWUD) are at a higher risk of overdosing when using any substance containing fentanyl. Canada has seen a spike in fentanyl-related deaths, triggering a Public Health Emergency in some provinces. Naloxone is an effective antidote to control fentanyl-related overdoses and kits are available as part of overdose prevention strategies in some provinces, including Alberta. This antidote can be applied intramuscular (IM) by using specific doses based on overdose signs and symptoms. Innovators will be challenged to design a device for detecting and monitoring specific symptoms related to overdose (low body temperature, movement, blood oxygen levels, etc.) and delivering naloxone treatments if needed while also notifying medical personnel.
Intensity of upper limb dexterity rehabilitation on the stroke unit
Patients with stroke sit (or more properly lie in bed) on the stroke unit. After the first day or two selected patients have capacity to do upper limb rehab tasks, particularly those that are dexterous and involve fine motor skills. For example, building lego model or knitting or macrame etc. Patients need a menu of things to do that are fun and involve fine motor skills varying from simple to complex as they improve. They need it at the bedside so they can do it hundreds and hundreds of times to get the intensity of rehab that is needed. We need a 'rehab kit' for the stroke unit that would promote upper limb rehab, that can be done sitting or lying, with one hand or two, with graded progression of difficulty.
A Low-Cost Digital Otoscope
Access to tertiary care Ear Nose Throat (ENT) specialists is extremely limited in many regions outside of major academic centres in North America, while lengthy waitlists in metropolitan areas impair timely access to quality care. This disparity is even worse in most developing countries, where ENT specialist access is almost entirely through medical missions.
The challenge is to make a low cost digital otoscope, capable of taking pictures of the ear drum which can be sent to an ENT or other experienced health care provider to allow for more accurate and timely diagnosis. This solution could be given to primary care providers and could be consumer facing, democratizing access to timely and accurate tertiary specialist care.
The current leads we use have a clip that is squeezed to clip into the ekg dots on the patient. When removing these they often get caught tearing patient's skin or hair. The snap version of these lead can cause bruising. The clip form of the lead is ideal as it allows you to open the snap and clip it onto the ekg lead placed on the patient skin. We would suggest that some form of soft cover be placed over the snap to prevent it from being able to catch clothing/skin/ hair etc. Could you come up with a version that has the clip enclosed so it can't catch?
ECGs are diagnostic tools used at the bedside in emergency situations. These machines help diagnose the causes of chest pain and are vital components of a patient's care. When someone presents to the ER or Urgent Care with chest pain, protocols require their use within 10 minutes. ECGs are cumbersome machines. It can easily take a minute to manually input patients' data, proper land-marking of ECG stickers is often done incorrectly, and the wires are almost always tangled around each other. It can take several minutes to shave or wipe the area and a lot of manual manipulation of the leads. Can you develop a machine or even an app that can take a "picture" of the hearts electrical conduction and automatically upload it to the MUSE Cardiology Information system, where cardiologists interpret the results? A bar code scanner should do be implemented for patient data, similar to blood glucose machines now. Streamlining this process will be beneficial to the care and potential outcomes of patients.
Given current audiovisual and information technology advances, design and build a cost effective intra-oral camera for equine dentistry to improve diagnostic capabilities and animal welfare in both equine and rural multi-species practices. Challenges: low cost, compact, light source, variable focal distance, easily manipulated in a standing sedated horse with head and tongue movement, wireless transmission to a device able to record video and still images of the arcades, individual teeth, and soft tissue. Will need a dedicated light source and water flush to remove food debris and tooth dust, and be disinfect-able.
The light and camera source at the tip will need to be manipulated to at least two different angles. Ideally both still and video images could be captured and wirelessly transmitted to an ipad or flat screen. Images or video should be available in real time for diagnostic procedures, treatment purposes, and teaching of equine dentistry; as well as captured for use in medical records, scientific publications, and teaching.
All-In-One Vitals Monitor
It is essential for animals seen in triage to have their vitals assessed. Unfortunately, there are few monitors in clinical practice capable of conveniently and non-invasively measuring a full panel of vitals in animals. Common practice in an emergency veterinary hospital uses tools such as: rectal thermometer (body temperature), Doppler ultrasound (systolic blood pressure), auscultation (heart rate), pulse oximeter (percentage of oxygen saturation), and more. Recent developments in infrared technology have spurred the development of less invasive methods for vitals monitoring such as a non-contact body temperature reader. Infrared has also proved useful in measuring blood pressure, heart rate and SPO2, however a commercially available veterinary product has not been made that encompasses simultaneous measurement of these vitals. Innovators will be challenged to design an all-in-one infrared vitals monitor to provide clinicians with the efficiency they need to stabilize and perform critical medical procedures for their patients.
Development of a Post-Operative Pain Control Smartphone Application
Millions of children undergo surgery each year. These procedures commonly result in pain and distress. Poorly managed pain can result in negatively biased pain memories, fears, and for some children, phobias that persist into adulthood. This is, in part, due to inconsistent post-operative advice and teaching, variations in administration of analgesics and parental anxiety surrounding medication use. In addition, it has been shown that information handouts and educational videos are of limited value in terms of parental education surrounding post-operative issues. Recently developed mobile applications (apps) for the perioperative setting have demonstrated a beneficial impact on both the end user and the healthcare system. To date, app technology has not been extended to pediatric tonsillectomy patients, or pediatric ambulatory surgery.
We challenge you to design a smart phone app that 1. provides parents information about their child's upcoming surgery; 2. reminds parents about how much acetaminophen, ibuprofen, and liquids should be taken and when; 3. provides information regarding the normal post-operative course, including an FAQ section, as well as information about who and when to call with questions, and 4. collects information regarding post-operative course for physician's use.
Diagnosing Emergency Department Access Block Using Real Time Monitoring Technology and Dashboard Science
Emergency Department (ED) access block, often referred to as emergency overcrowding has been recognized as an international threat to patient and public well-being for well over 25 years with little sign of sustained improvement in Alberta or beyond. The harms associated with ED access block are myriad and include EMS offload delays which places the population at risk. The problem that exists in current ED operations in Canada and beyond is that managers lack the ability to “diagnose” the extent to which these various factors contribute to access block in real time. We need a dashboard that can assist with ambulance dispatch based and destination based on a selected number of metrics (REPAC) but these are insufficient to guide operational adjustments inside the ED. Alberta Health Services has access to a rich suite of real-time clinical and operational metrics that could inform ED managers of what factors are predominant at a given point in time and where to focus resources. These data sources are disparate and lack the integration and interpretative elements that can make them most helpful to managers.
Medication follow-up platform
It is a well known fact that medication side-effects place a huge burden on our healthcare system. I believe that the majority of these problems can be averted by identifying concerns early. Pharmacists are a great resource to help identify and manage medication-related problems. I have established the practice of doing follow-up phone calls with patients at my pharmacy whenever they start a new medication. I have seen the benefit that this has had with my patients and have been able to identify therapy problems and help resolve them. Unfortunately, this is not standard practice because of the limited time pharmacists have to engage in such activities. Innovators who choose this challenge will develop an automated SMS “chat bot” follow up system that can be programmed to follow up with patients that start new medications. The monitoring parameters and questions would be relevant and specific to each medication based on a clinical algorithm.
Smart-watch app for Intensive Care Monitoring
Doctors and nurses from wards such as the intensive care unit (ICU) can use a smart-watch connected to a system that monitors patient vitals. If a patient's readings reach a dangerous level, an alert is sent directly to the doctor and/or nurse through the smart-watch. These readings are monitored in real time and stored on a hospital’s central server or other advanced IT infrastructure. The patient particulars (name, readings, etc.) appear on the watch, so the doctor can react quickly and precisely. The IT infrastructure allowing devices to access patient records already exists in some hospitals and wards around the world, and will be arriving in Alberta over the next few years. With this, doctors and nurses can see information and act proactively before adverse events occur. Innovators will be challenged to design an application for Apple Watch and/or Android Wear platforms that would connect to a hospital's central server and IT infrastructure for effective IC monitoring.
Family Health App: Supporting Wellness by Monitoring Mobile Device Health Data
Public health nurses regularly meet with parents and their children to promote health and prevent illness from the age of two-months to five years. After this, families typically see their physician as needed. However, fewer than half of Canadians receive same day or next-day appointments when they need medical attention. Public health nurses remain in the community, many working in schools, and could potentially support families better if linked to their health information using a data sharing app. This technological solution would allow families to share their health data with professionals with their mobile devices.
Family doctor records are not linked into the public health data systems, making it challenging for health professionals to intervene early to promote health and prevent disease. The Family Health App would allow parents to provide relevant health data to support the monitoring of their personal/families' health and the possibility of the early diagnosis/prevention of illness. Further, we envision that this tech solution could have built-in algorithms to alert public health nurses of families who need follow-up/referrals/educational resources.
Finally, the Family Health App would further benefit parents/families if there was a to discuss their health-related concerns with their healthcare professionals, perhaps through an instant messaging tool. This technological solution would help empower families to better monitor and manage their own health, prevent disease, and contributing to the sustainability of our healthcare system.
interactive pedcases for medical students
PedsCases is a free online resource for medical students and residents (www.pedscases.com), based out of the University of Alberta in Edmonton. Content includes podcasts, cases (case study-based quizzes), and videos. We envision that this program will allow users to ask questions to a virtual patient and receive appropriate answers while progressing through the patient’s story, including taking a medical history, doing a physical exam, selecting appropriate laboratory and imaging tests and seeing the results, and coming up with a diagnosis.
This challenge would involve creating this interactive program, including determining how to set this up online and link it to the PedsCases website. Ideally this program would have an enticing and user-friendly design and be able to integrate images (e.g. X-ray or CT scans), audiovisual (e.g. sound and video clips) and tables. Ideally, we would like the cases to be set up so that a learner interacts with it as they would with a patient, with the computer providing responses to questions asked. For example, in the case of a child presenting with a cough, if the learner were to write, “How long has the child been sick for?”, the computer could respond, “3 days.” The learner would go through a medical history in this manner, and then move on to an appropriate physical exam. The physical exam could be set up in the same way or be more visual - we leave this up to the creativity of a potential I4H team for now. After completing the physical exam, the learner would go on to order laboratory or imaging tests if needed, look at the results (usually in the form of a table or an image) and come up with a diagnostic or treatment plan. One possible solution would be building on the open access H5P modules but we would be open to any ideas!
Simulations for Evaluating Wearable Tech in the Brain for Long Term Monitoring of Epilepsy
Epilepsy affects ~76 million people a year around the world. A significant portion of these patients doesn't respond to pharmaceutical interventions. These patients need to undergo surgery for diagnosis, treatment and long-term monitoring. The current diagnostic and monitoring regimen for these patients often lead to significantly reduced quality of life as the procedures are extremely invasive, cumbersome, and with low signal to noise ratio. With the advent of new technology in the field of EEG-lead, we are on the verge of turning the long-term neurological monitoring/stimulation into a wireless wearable technology that will dramatically improve the quality of life for the patients and the quality of data collected for physicians. In order to evaluate a wearable and wireless technology of the human brain, we need a simulator with: 1) Consistency and structure that faithfully reflects the human brain with meninges, boney cranium and skin (CT scans of the structures will be provided). 2) The ability to simulate the force and vibration. 3) Tissue layer transitional sensors.
The current simulators are expensive ($600 infant-$1000 adult CND) and require powerful computers to run the simulation program. Also, the simulators designed to help learners practice decision-making and actions associated with the procedure are based on a virtual reality tours and lacks the 3D texture training for the learners. Moreover, the simulators lack sensors that will alert learners when the tissue planes are transitioning. The current simulators are designed for perfectly straight spines. There are no simulators that can mimic patients with scoliosis and /or excessive lordosis and kyphosis. We propose a simulator for lumbar and thoracic puncture to collect CSF designed for novice learners that whilst being relatively cheap, anatomically correct and easy to use simulators, will standardize training of novice practitioners and be easily integrated early into medical education.
Simulation for collecting cerebral spinal fluid (CSF) for diagnosis of neurological disorders
Teams who accept this challenge will develop a portable simulated model for teaching Third Trimester - Point of Care Ultrasound (POCUS) in resource-poor countries that meets the ISUOG criteria. Ultimately, this model would allow for POCUS training to determine fetal position, number of fetuses, fetal heart rate, placental location, amniotic fluid volume (AFV) and fetal biometry in the third trimester of pregnancy. Rudimentary models have been attempted, but with little success. POCUS is the use of ultrasound technology to assess patients in variety of settings. Ultrasound machines have the added advantage of being portable, affordable, durable and reliable. Ultrasound imaging is the primary imaging modality for women’s health and is safe for obstetrical imaging. Simplified and standardized training on a portable model is required to ensure the systematic approach to a third trimester ultrasound examination and recognition of treatable anomalies in developing countries. Maternal mortality remains elevated in these countries. About 830 women die from pregnancy — or childbirth — related complications around the world every day. Most causes are preventable. The ability to use ultrasound in the setting of third trimester point of care screening in developing countries would positively affect delivery planning.