Improving neonatal transport
Kochi, KL, India
NeoPORT (www.neoport.org) is a digital platform for neonatal transport tracking. It connects referring doctors (Senders) with ambulance paramedics (Transporters) and physicians at the referral site (Receivers).
Infants with severe heart defects are routinely transported from secondary and tertiary hospitals, to specialized quaternary hospitals for interventions & surgery. Emergency transport of such infants requires systematic monitoring of heart rate, respiratory rate, temperature, blood glucose and oxygen saturation. Taken together, they represent the infant’s health comprehensively.
However, these vitals, particularly temperature and blood glucose, are often not measured in a consistent and timely manner, even though the necessary measurement tools are present in most ambulances, and are readily available for purchase. In the absence of timely monitoring, infant may develop life-threatening complications such as hypoglycemia and hypothermia during transport.
NeoPORT was designed and developed to address the acute need for a system that enables consistent and timely measurement of vitals, track transport, and captures critical clinical information.
How it works
Senders are grouped in an organization, managed by a Sender admin. Any member of the organization, i.e. an individual Sender, can create infant records — including vitals — and initiate transports. They can also add details such as medication, detailed respiratory status, and provisional diagnosis. If the sending organization only consists of one user, then a Sender admin role suffices.
Once a Sender creates a transport request, they assign it to a Receiver, and then a Transporter — both of whom can accept or decline the request. Once all parties accept, the transport starts.
The Sender can track the inbound movement of the Transporter to their location. Once the Sender hands over the infant to the Transporter, they can see the outbound trip to the Receiver. This data is also visible to the Receiver. When outbound, the Transporter has to measure infant vitals — based on rules set up by the Sender. If the Transporter misses a measurement, they receive an alert.
The Transporter’s location is tracked and used to notify the Sender and the Receiver. All three participants also have access to a group chat.
Once the transporter arrives at the Receiver’s location, they handover the infant. Once the Receiver takes charge of the infant, they close the transport episode by entering infant vitals into the system. Based on these inputs, the system calculates a Ca-TRIPS score, a clinically-validated scoring system of infant transport quality. The difference in scores between the start and end of the transport provides a measure of transport quality. NeoPORT has been used to generate scientific literature about transport quality and its impact on clinical outcomes.
The entire system is managed by a System Administrator, who can add Sender Admins, Senders, Transporters and Receivers. They can also create transport requests on behalf of Senders — to assist Senders who are new to the NeoPORT system.
User roles and platforms
Thus, there are 5 types of users in total, who access the system through 2 interfaces:
System Admin: Web dashboard
Sender Admin: Web dashboard + Android app
Sender: Web dashboard + Android app
Transporter: Android app
Receiver: Android app
The first phase of NeoPORT was funded with a grant from Grand Challenges Canada's Saving Lives at Birth program. The system was deployed in 2019, and quickly ramped up to capture information about 50+ transports.
In 2020, the second phase was developed and launched — consisting of the Sender Admin role, and the Sender's web dashboard. This was in response to end-user feedback. During shift changeovers, the mobile phones used by Senders would not be traceable. Desktops were a more readily accessible system in the emergency ward. The second phase was supported by the Genesis Foundation and Oracle India.