Download m2Health Application, a Consumer Health Informatics Tool

m2Health Application, a Consumer Health Informatics Tool for Evidence-based
Self-Management Against Postpartum Infection
Mary O.
1,2
Ejiwale ,
Timothy
2
Patrick ,
Jake
2
Luo
1. Biomedical and Health Informatics, PhD Program; UWM-Milwaukee, 2. Department of Health Informatics and Administration, UWM-Milwaukee.
GOALS
ABSTRACT
Maternal morbidity and mortality is a public health
concern for both the developed and developing
nations. At the global level, infection (sepsis) is the
second leading cause of postpartum complications,
and death surrounding childbirth, abortion or
miscarriage. It persistently remains the third cause of
pregnancy-related death in the United States (Center
for Disease Control and Prevention [CDC]. 2012,
2017). It is also the first leading cause of women’s
death in the United Kingdom (Acosta et al., 2014).
The occurrence of maternal sepsis is independent of
the mode of delivery, natural or caesarean section,
although, the latter has a higher predisposition.
SIGNIFICANCE OF THE PROBLEM
Pregnancy-related death takes the lives of over 600
women per year, (Centers for Disease Control and
Prevention, [CDC]. 2012), 99 % of such death takes
place in the developing countries (World Health
Organization, [WHO]. 2016). At least, half of maternal
deaths are of preventable causes, which include
puerperal infection (Bingham, Strauss, & Coeytaux,
2011); (Shamshad, Shamsher, & Rauf, 2010). Every 90
seconds, a woman succumbs to needless death of this
nature (American Public Health Association, 2011)
[APHA], 2011). Additionally, Isabey, Poliquin,
Schneider, & Morris (2015) assert that postpartum
infection is cost-ineffective, as it accounts for one third
of maternal re-admission, and emergency room visit
after the initial discharge, with, Urinary Tract Infection
(UTI), and surgical site infection (SSI) being the most
reported childbirth-related sepsis (Bommarito, Fraser, &
Olsen, 2015). Early detection and reporting are
lifesaving strategies for this problem (WHO, 2016).
DATA SPEAKS!
The aim
aim od
od this
this study
study is
is to::
to::
The
 Introduce
Introduce aa novel
novel approach
approach to
to the
the prevention,
prevention, early
early

recognition
and
reporting
of
postpartum
sepsis.
recognition and reporting of postpartum sepsis.
 Develop
Develop aa consumer-centric
consumer-centric mobile
mobile health
health

application, called,
called, “m2Health”
“m2Health” (Maternal
(Maternal Mobile
Mobile
application,
Health),
thatofprovides
provides
evidence-based
self-care
Comparison:
Summary
Pregnancy-related
Mortality Data in USA,
Health),
that
evidence-based
self-care
2011–2012, and 2011-2013 (The latest data available, Jan, 2017).
information
to
women
ofdue
both
the developed
developed
and
information
women
of
both
the
and
Observation:
Percentageto
of Maternal
Death
to Infection
Remains Unchanged
developing
nations.
developing nations.
 Enhance
Enhance women’s
women’s health
health decision
decision making
making power
power

through the
the concept of self-monitoring, and selfthrough
management, so they become co-producers of
postpartum quality outcome with their providers.
 Ultimately support the World Health Organization
Source:Safe
CenterMotherhood
for Disease Control and
Prevention (CDC)
(WHO)’s global
Initiative
FUNCTIONALITIES
The aim of this study is, To:
 Introduce a novel approach to the prevention, early recognition and reporting of postpartum sepsis.
 Develop a consumer-centric mobile health application, called, “m2Health” (Maternal Mobile Health), that
provides evidence-based self-care information to women of both the developed and developing nations.
 Enhance women’s health decision making power through the concept of self-monitoring, and selfmanagement, so they become co-producers of postpartum quality outcome with their providers.
 Ultimately support the World Health Organization (WHO)’s global Safe Motherhood Initiative
m2Health “app” has dual phases of functionality:
Early Start Phase: This is the antenatal phase. The main
goal of this phase is to prepare for a healthy postpartum
outcome, through a “good” prenatal self-management.
Users also get acquainted with the application, build selfconfidence in navigating and interacting with the “app”
before their pregnancy is over.
Latter Phase: The pregnancy is over (childbirth,
abortion or miscarriage) at this stage. m2Health “app”
users interact with the “app” for the first six weeks after
pregnancy (puerperium). Active self-management and
monitoring activities kicks in against clinical signs and
symptoms of maternal sepsis etc. Both phases work
towards the realization of a healthy postpartum outcome.
METHODOLOGY
This is a cohort and prospective study. Fifty pregnant women would be recruited during their first antenatal care
visit. The participants would be divided into experimental and control group. The control group would continue
with the current antenatal and postpartum care protocol, practices and guidelines, while the experimental group
uses the m2Health “app”, both also at the antenatal and postpartum period (after childbirth, abortion or
miscarriage). Every participant in the latter group would be given one free digital body thermometer of the
same brand for temperature measurement. The attending nurse would demonstrate how to measure, and record
the values of three cardinal vital signs that are pertinent to maternal sepsis (temperature, respiration, and heart
rate). The “app” includes the normal range of these measurements, and flags any aberrant, so, the patient can
promptly seek medical intervention. This self-monitoring exercise continues till the end of the first six-weeks
after pregnancy (puerperal phase). Other Evidence-based information related to nutrition during and after
pregnancy, personal hygiene (hand, vulva and breast), and other self-care activities related go pregnancy and
puerperium are also available through the “app”.
WHY AN “APP” ?
Paper-based Postpartum Health Information
Internet-based Postpartum Health Information
“Hard to narrow down internet-based
postpartum health information. Wish there’s
an “app” focusing on maternal sepsis”
–Hypothetical postpartum woman.
Extensive research proves the acceptance (Willcox et al., 2015) and effectiveness of patient-facing application as a medium
for disseminating maternal health education (Zurovac, D., Talisuna, A. O., & Snow, R. W., 2012). Evidence also exists
supporting self-care as a efficient approach to promoting postpartum quality outcome (Jung ES, 2002); (Troy & DalgasPelish, 2003); (de Vaate, Coleman, Manneh, & Walraven, 2002), and safe motherhood (Vincent De Brouwere and Wim Van
Lerberghe., 2004).
mHealth application ameliorates the shortcomings of paper-based maternal health education(e.g. loss of material), breaks the
barrier of location/ distance to tested-and-proven postpartum care information, making it readily available and accessible to
women of both the developed and developing nations, enhances women’s health decision making power, and promotes safe
motherhood at the global level. Additionally, this application supports the concept of self-monitoring by enabling women to
measure and record their vital signs, know the normal range of values and promptly identify and report an aberrant.
Cardinal Signs and Symptoms of Puerperal Infection:
Fever: Temperature >100.4 F (38.0 C ), rigors / chills, tachycardia (Heart rate >= 90bpm), respiration rate >20
breaths/min, pain / tenderness (Lower abdominal, breast, episiotomy or surgical site)
(Royal College of Obstetricians and Gynecologists, 2012).
CONCLUSION
Postpartum infection turns tragic so quickly, early detection is the key. This formidable work-in progress is an
innovative strategy against this global health problem.m2Health application would save the cost associated with
readmission due to peurperal sepsis, and it would save women’s lives throughout the world.
m2Health “APP” IN A FLASH!
.
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