As a midwife, Tiffany Lundeen's heard her share of emergency scenarios gone wrong. But there's one that keeps getting replayed over and over:
A health care provider who's still learning the ropes comes up against a hemorrhaging mother, and there's no one with more experience on call. As the panic sets in, the procedures that were once easy to remember in training fly out the window.
Paralyzed by fear, the provider doesn't take any actions to save the mother's life and ends up referring her to a nearby hospital. Because the referral process takes some time, the mother bleeds out on the way there.
Since postpartum hemorrhaging (PPH) is the leading cause of maternal mortality worldwide, this scenario can happen just about anywhere. However, it's most common in developing countries where clinics are often manned by providers who aren't experienced in emergency protocol.
That's why Lundeen, together with her friend, Dr. Dilys Walker, decided to develop a smart tool to help guide providers through lifesaving PPH procedures.
Photo via UCSF VirtualMentor/YouTube.
Walker and Lundeen work together at the University of California at San Francisco (UCSF) Global Health Sciences. During a discussion they had back in 2017, the two women realized that a major impediment to maternal and newborn emergency care was the Safe Childbirth Checklist.
Basically it's a list that helps birth attendants remember all the essential preventative practices that can effectively diminish the rate of maternal and newborn mortalities.
The problem, however, is that the list is written down.
"In terms of my workflow in taking care of women and babies during childbirth, using a paper checklist wouldn't be very practical for me," Lundeen explains. "I'd rather have something that could prompt me audibly."
This makes even more sense in an emergency situation — how can providers keep checking a list when they're in the middle of trying to save a life and grappling with all the stress and panic that comes with that?
While a mentor who provides audible, step-by-step instructions seemed like the perfect solution, they wanted to be sure it would work in places that needed the most help.
So they took the idea to Kenya.
A nurse during a PPH simulation in Kenya. Photo by Melanie Wise, used with permission.
They partnered with Dr. Anthony Wanyoro, an OB-GYN who's on staff at Kenyatta University and at two maternity hospitals in Kenya. Wanyoro has long been dedicated to reducing maternal mortality rates in Kenya, so from the moment Lundeen and Walker proposed what they were calling the Virtual Mentor to him, he was on board.
"The idea of bringing an expert in the room to help focus, guide, and center everyone sounded like the right thing," Walker says.
Walker had actually been working for years with a nonprofit called Pronto International, which helps train birth attendants through simulation all over the world. That, along with their partnership with Wanyoro, provided the perfect platform to test out the Virtual Mentor in real-life settings.
For the past year, Lundeen, Walker and Wanyoro have been working with health care providers in Kenya to make sure the steps and language their prototype will use are the most helpful. It's been a lot of trial and error, but the nurses and midwives have been incredibly receptive and optimistic about their work.
Wanyoro in a brainstorming session in Kenya. Photo by Melanie Wise.
According to Lundeen, during testing, many of the midwives said, "As soon as I heard the voice, I didn't feel scared anymore because I knew I wouldn't forget to do the right thing."
The project's still in the very early stages, but thanks to the funds they've received from being a GenH finalist, they've been able to get going on their prototype's software.
GenH acknowledges and rewards innovators who are taking world health care to the next level. Needless to say, Lundeen, Walker and Wanyoro fit the criteria.
Aside from the monetary help, GenH has provided the medical practitioners with invaluable resources to help them turn their clinical idea into a model that can be reproduced anywhere.
Once they have a fully functional prototype, they plan to do rigorous testing to see just how much of a difference being aided by a virtual mentor makes to health care providers during a birth emergency.
If the testing ultimately shows its usefulness, they hope to one day develop software for a whole host of emergency birth scenarios, including pre-eclampsia and newborn resuscitation. They also want the mentor to be able to log what procedures providers complete, which in turn will cut down how much providers have to document after the fact — a major frustration in the medical profession.
Lundeen can already see the positive impact her innovation is having. And one day, in the not too distant future, she can see the difference it could make in any medical emergency where experts are lacking.
Lundeen and Walker perform a PPH simulation. Photo via UCSF VirtualMentor/YouTube.
"We know exactly how useful it could be," says Lundeen. "And we are totally committed to working and thinking through all the technical and clinical challenges."
If the guesswork in medical emergencies was taken out of the equation, doing nothing out of fear or to avoid liability would become a thing of the past. In fact, what were once dubbed life-threatening scenarios might be permanently downgraded to run-of-the-mill.
And it's all thanks to three medical professionals who recognized the importance of having your hands free.