SINC "System Improvement for Neonatal Care" is a regional project made in collaboration with four companies, two departments of research of the “Università Politecnica delle Marche” and the "Women’s and Children’s Hospital G. Salesi" of Ancona as the coordinator of all the regional Neonatal Intensive Care Units. The project started in January 2017 and will last three years.

The objective of the project is to study, develop and test on real cases an innovative system for neonatal care that consists of new products in support of a new organizational model.
The project has three specific objectives:

  • The development and testing of 4 new devices for the detection of physiological parameters, 3 of which will operate without physical contact with the subject
  • The creation and management of a cloud computing service that makes available to the project territory services and utilities that can collect and integrate monitoring data collected by these devices in order to facilitate the diagnosis
  • The testing of a new hospital/territorial model for the integrated management of neonatal care and treatment among the various grades of hospital specializations in the Marche Region, supported by devices and distributed data management systems

Today biomedical innovation in the field of monitoring devices focuses on exceeding the limit of the current gold standard that involves skin contact to develop contactless measurement systems for physiological monitoring, which is the principle area of research and experimentation of this project.

The requirement is to develop three innovative monitoring contactless devices capable of monitoring local and remote cardiac and respiratory frequency, fundamental physiological parameters for determining the state of health of preterm
infants whose size and epidermal maturity make contactless measures a highly desirable feature.

The 3 devices to be realized, connected to a data analysis Cloud IOT (Internet of Things) are: a bilirubinometer, an electromagnetic device dedicated to respiratory rate measurements, two different devices (1 hospital based and 1 domestic unit) based on system of computer vision (RGB-D) for heart and respiratory rate. This device allows the detection also of the spontaneous motility of preterm infants that has an important clinical significance since it is a predictor of cerebral palsy and minor neurological. In addition to the vision system the instrument will also be equipped with a microphone array that will acquire the sound signals emitted by the baby and, using appropriate methods of Digital Signal Processing and Computational Intelligence, will be able to extract useful information about the activity of the newborn.

The main goal of this project is the definition of regional level data standards to collect data coming from Neonatologists’ Electronic Health Records (EHRs) on a cloud based architecture and to allow secure data sharing between them in order to create an integrated cloud-based network that automates the process that begins with data collection from multiple medical devices and ends with information made available from medical staff.

It is important to create a process of data collection from the various instruments, with reference to IOT, by normalising the data according to a standardized data format (HL7 for neonatology) and forward them to the Cloud facility. A system built with these characteristics ensures data compatibility between all the data collected, thus permitting online sharing of healthcare data in encrypted form. The ability to share data and especially the care protocols is of fundamental importance in the regional distribution of Neonatology services which would then transmit seamlessly the standardized diagnosis and treatment formats.

A further area of research is in the data analysis framework and decision support system (DSS) supported in the Cloud facility. Into the analysis system of the new medical neonatology record will be built DSS algorithms that are designed and studied within the project, permitting the analysis of the 80% of the problems that may be encountered in a newborn infant: for example the onset of jaundice, respiratory capacity through automated Walsh tests and thermoregulation.

In a domestic environment, it is also highly desirable to develop a further test for the monitoring of cardiac and respiratory rate without contact through a RGBD system that can be placed over the crib of the baby continuing the same high quality monitoring of the infant after initial discharge from the hospital facility.