India is the second-most-populated country in the world. Its rural and urban distribution of population is 68.84 per cent and 31.16 per cent, respectively, as per the Census Report 2011. Well, nothing much can be done about the growing population apart from educating people. But education, poverty and health in the rural areas need more focus. Swasthya Sanjivani—an innovative kit developed at Manav Rachna College of Engineering (MRCE)—aims to eliminate lack of healthcare facilities from this list. Swasthya Sanjivani is an affordable, approachable and automated on-the-spot blood and urine testing system with immediate confirmatory results for detection of diseases such as diabetes, anaemia, renal damage and jaundice.

Trigger for innovation
There is a team of five behind Swasthya Sanjivani—Manasvi Sihag, Hardik Garg, Nikhil Dalmia, Prashant Gupta and Pritam Singh.

Before delving into what Swasthya Sanjivani is all about, let us look at what inspired them to come up with this solution and what exactly they are trying to solve.

Fig. 1: Swasthya Sanjivani basic architecture
Fig. 1: Swasthya Sanjivani basic architecture
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Moved by the fact that “One billion people lack access to basic healthcare,” the team decided to come up with a solution. They conducted a survey in 23 different villages, which revealed that these areas lacked adequate healthcare facilities, and people could not afford the current facilities because of lack of money.

The team says, “Even if these people get tested at small camps, they have to travel to distant locations to get further tests carried out, which puts a heavy burden on their restricted earnings. We read a quote: “Everyone wants to change the world. You can,” which inspired us to develop a solution to this problem and thus Swasthya Sanjivani was born.”

Fig. 2: Inside the kit (prototype)
Fig. 2: Inside the kit (prototype)

What is Swasthya Sanjivani?
Swasthya Sanjivani enables basic digital literates at isolated centres to perform tests prescribed by medical practitioners of repute at distant locations. These expert doctors, through video conferencing, would be present all the time, right from the time the patient enters the centre till he leaves it with all the answers concerning his health.

The system is basically a portable digital testing laboratory. It also consists of an electronic pill box, which is provided to the patients to remind them about their medicine and appointment schedule.

This project aims at addressing the lack of diagnostic facilities at a primary level, especially in rural areas. It could be termed as a cheaper, effective substitute for telemedicine. In telemedicine, the diagnosis can be performed from a remote location but it is an expensive process and demands an accurate setup. Swasthya Sanjivani is a simplified substitute as it requires just the kit, Internet connection, trained technicians, and a laptop or PC.

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The direct beneficiaries of this system are patients of anaemia, diabetes, renal damage and jaundice, people living in unapproachable areas, people below poverty line, diagnostic centres and hospitals in heavily populated areas, and clinics into blood and urine testing.

System architecture
Swasthya Sanjivani has a three-tier architecture comprising:

Tier 1: Laptop. A laptop acts as the interface between the doctor and the Swasthya Sanjivani kit. Video conferencing connecting the doctor to the patient is achieved through Skype connection on the laptop.

Tier 2: Swasthya Sanjivani kit. This kit is supplied to operators in rural areas. The kit ensures that patients get an economical and on-the-spot blood and urine testing system at their doorstep.

Tier 3: Web portal (SkyDrive). The Web portal bridges the gap between rural and urban areas. The patient can be treated by a specialist doctor from a distant location.

How does it work?
The Swasthya Sanjivani kit works on the principle of colour-matching technique that has been widely used for urine and blood samples for years. The staff at rural centres can be technically trained to use the kit, take photographs and send these over to the expert centres where these samples could be diagnosed.

The kit consists of a test-tube stand, test tubes, camera, battery, motors and chain drive. A burette is positioned right above the test tube, with the help of an external stand.

After the blood or urine sample has been collected by the operator, he places the test tube with the sample in the test-tube stand. The sample moves towards the burette with the help of the motor and chain drive, and positions itself right under the tip of the burette with the help of sensors. With the help of the burette supported externally with a stand, the operator mixes the desired amount of a particular reagent in the sample. This initiates a chemical reaction in the test tube, which changes the colour of the sample.

Diseases like jaundice, diabetes and renal damage can be diagnosed by such colour-changing tests. The camera (attached on the left-hand side of the system) captures a picture of the chemically altered sample in the test tube and feeds it directly to the laptop.

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The colour generator, when provided with RGB values, generates the colour of the sample. (Red, green and blue (RGB) are primary colours and any colour can be formed from the combination of these three colours.) This colour is communicated to the doctor by the operator and the doctor gives the feedback almost immediately to the patient.

Electronic pill box
The electronic pill box has small slots for distinct medicines. It is of great help to poor, illiterate people for three reasons: They can’t read the name of the medicine, they often overlook or neglect the medicines that they are supposed to take, and most of the medicines look the same to them.

 

Doctors’ take on Swasthya Sanjivani

“Swasthya Sanjivani is an innovative diagnostic test and alert system for diseases that can be really beneficial for peripheral areas.”

—Dr Nisha Marwa, professor, Department of Pathology, PGIMS, Rohtak

“Test results performed by the kit completely match lab results.”

—Khem Chand, senior lab technician, Department of Pathology, PGIMS, Rohtak

“Swasthya Sanjivani is a ground-breaking innovation that will open new research paradigms in the field of healthcare and prove to be a great help for people who are devoid of even the basic healthcare services.”

—Dr Suresh Arora, chairman, Surya Orthopedic Centre, Faridabad

This pill box helps patients to take the right drug, right dose at the right time. It connects to a PC/tablet via USB. The installed software permits the operator to easily customise the device to the patient’s medication regimen and dosage timing. The medication information stored in the memory of the pill box initiates an audio-visual signal to remind the patient about different medicine dosages and his next appointment scheduled with the doctor.

Components. The electronic pill box device is a portable embedded hardware device that incorporates a number of peripherals:

ATmega 328. Present on the Arduino Uno board, ATmega 328 microcontroller IC is used to program the electronic pill box. The Arduino board is connected to the computer via a USB port and can be programmed with the desired medication and appointment schedules through an app.

Real-time clock. DS1307 real-time clock is serially customised using I2C protocol. It is used for medicine scheduling and appointment by communicating with a Windows 8 application.

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Fig. 3: Electronic pill box
Fig. 3: Electronic pill box

Reminder buzzer. It is used to alert the user about an appointment or time to take the medicine prescribed.

LEDs. SMD LEDs are used to guide the user on medicines and schedules as follows:

Medicines. LEDs placed below the compartment of the medicine blink at the scheduled time.

Scheduling. LEDs use innovative displays to indicate the various schedules that need to be followed.

Challenges faced
“We have done image processing using Matlab tool. We made an executable file using Matlab, which runs on a Windows standalone application. Selecting pixels increases the accuracy of testing, which is presently not achieved by wavelength comparison,” informs the team.

On the kind of difficulties faced, they say, “Being engineers, it was very difficult for us to develop a system that is healthcare based. One needs to do a research on even the most basic facets of medicine and consult a doctor for each and every change that one plans to make in the current system.”

Similar products in the market
The kit developers say, “There are definitely many fully automatic and semi-automatic analysers available in the market that can diagnose these diseases, but they are expensive, immobile, and require low temperature for operation, specialised reagents to perform tests and an expert technician to operate them. With Swasthya Sanjivani we plan to solve these issues.” The cost of Swasthya Sanjivani kit is Rs 180,000.

In the pipeline
The kit has passed testing successfully and received very positive feedback from some of the doctors and the pathology labs that the team has consulted. This has encouraged the team to improve the system even further.

“We are planning a newer version of the kit that is completely electronic and a pill box with Internet connectivity so as to monitor the patient’s performance on cloud. We are in negotiation with various NPOs and NGOs to reach out to the people who need our kit the most. We have developed various business models of the kit and pill box and plan to market them separately for different target audiences,” the developers say.

“We have already filed a patent to the present version of the solution. The patent covers the idea, design of the kit and the pill box, and the software of the solution.”


The author is a tech correspondent at EFY Bengaluru

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