Follow up tool for pregnancy in pandemic

Due to its recent onset, SARS-CoV-2 disease has little data about its health consequences at medium and long term, anthis gap is also evident during pregnancy. Consequently we thought that this  technological solution, a digital platform and an application to register using  mobile devices,will allow  the follow in our country specifically of women with COVID-19 and help to expand  our scientific knowledge  about it. Also is a key tool to trace and analize the hospital managements and evaluate their effectiveness and use the information to feed back our knowledge of the management of this disease. Our geography is diverse across the country and  it generates a huge  diversity in social and cultural environments, this tool will contribute to focus the best approaches to manage  effectively the pandemia in the  different zones through the territories. Evidence supports pregnancy registration systems, it can enhance health systems, increase accountability and reduce mortality.

In December 2019, the infectious disease caused by the SARS-CoV-2 virus was for the first time identified in Wuhan City, Hubei Province, China. It causes fever, cough, fatigue, dyspnea, and eventually acute respiratory distress. In March 2020, the World Health Organization (WHO) recognized it as a pandemic.  This situation has led to a global public health crisis, and for the 8th of June 2020, 7,038,942 cases  were confirmed  and 403,267 deaths as the  result of this virus have been reported. Currently no specific treatment or vaccine is available.

As background, the advent Influenza A (H1N1) pandemic,  pregnant women accounted  for 1% of influenza A-infected patients, however they provided the 5% of all virus-related mortality. Similarly, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) has been so far  responsible for severe complications in pregnant women, such as ICU admission, endotracheal intubation, renal failure and death. To date, there is no scientific evidence on the increased susceptibility of pregnant women to complications related to COVID-19 infection, however   it is lack of appropriate  evidence in the medium and long term on the reproductive and transmissional impacts between the mother and the foetus that SARS-Cov-2 may cause.

The proposed solution is to design a digital platform and a mobile application that allows the capture, processing and analysis of information in order to generate and accurate georeferenced of  cases -pregnant women  of any gestational or in postnatal period- infected with COVID-19, across  the Colombian territory. The application allows us to follow   their evolution and the final outcome of the disease. The collected information will be used to improve health care supply chains, improve the  management protocols  to optimize the diagnosis, monitoring and treatment of the pregnant population and  also their postnatal care. Also this instrument will  provide guidance, and proper information on frequently asked questions from SARS-CoV-2 infection, according to the life cycle in which the female population is located.

This solution objective is the population of pregnant women and also those in postnatal period, who are infected  and test positive for  COVID-19. Through their registration on the digital platform, they will receive support to receive timely attention, adecuate information about the illness and  they will be traced  during all the pregnancy or post natal care or as long as it requires attention. In addition, the analysis of the data obtained will not only strengthen the decision-making of health teams and access to primary care systems but will provide inside about the relationship between SARS-CoV-2 infection and maternal and perinatal outcomes.

COVID-19 has shown that health systems still need to be strengthened and that the scientific evidence about the relationship between infectious diseases and their repercussions on women and between mother and fetus is insufficient. Consequently, the proposed solution will generate information to expand scientific knowledge and to respond to future diseases in a faster and more effective way, improving and strengthening the medical care provided to the female population, especially pregnant and postpartum.

In our country, the development of a tool that allows the registration of pregnant women by themselves and who decide to allow follow-up during their process is an innovation, because it promotes their empowerment on this disease and takes advantage of the rapid improvement in mobility and coverage telephone and Internet connectivity in most of the Colombian territory and the increasing familiarity of health professionals and the general population with digital platforms, as part of their education and daily work.

Also the tool will be designed to connect the need for pregnant and postnatal women for quality primary obstetric care during COVID-19 infection and the need for health teams to obtain evidence-based information to describe clinical and sociodemographic characteristics, trace the evolution of symptoms and outcomes found during pregnancy and up to 42 days postpartum and establish the relationship between COVID-19 infection and the results found in this population. 

It will be a technological solution integrated by a digital platform supported on a website and a mobile application developed on IOS and Android operating systems. The development of the Web application would have a series of clinical and sociodemographic variables to achieve the capture, processing and analysis of information of women in pregnancy state.  The solution will also seek to integrate with the Open Data Strategy of the Ministry of Information and Communications Technologies of Colombia and the registration systems of the country's health institutions, as well as accompany them for the creation and implementation of the digital solution for pregnant and post-pregnant women. This solution will also ensure the protection of personal data in accordance with the provisions of Colombian Law 1712 of 2014 of Habeas Data.

The evidence that this technology works is given to the extent that the level of technological appropriation in Colombia has increased and the majority of the population is increasingly familiar with these digital applications; In addition, health institutions have been strengthening their information systems to keep citizens' data in the cloud and facilitate decision-making in the face of the situations that warrant it.

The change have two main components: one is the possibility to reach women in distant regions from the capital city and give them a proper follow up and also traicing the cases , and in the other hand the analysis of the data will provide further  information about the performance of the disease and this will help the medical  teams to use it in the process to build the best way to approach this pandemic , and also because it will also provide information about the effect in the fetus or newborn it will bring appropiate knowledge for counseling the women that are pregnant or even before the pregnancy during the preconceptional evaluation.

Based on the statistics of the female population generated by the National Administrative Department of Statistics of Colombia, and bearing in mind that this solution is aimed at women who may be affected by COVID-19 or some obstetric emergency or other infectious disease emerging, by the time the solution starts working, approximately 11,459,884 women would be benefiting. In the following year would be benefiting 11,562.9 women and in 5 years 11,712,731 women.

Within this year:

1 - 6 months:

• Design of the technological platform and the application for mobile devices to collect information from pregnant and postpartum women with COVID-19 and other obstetric emergencies.

• Prototyping of the application and based on the results, the corresponding adjustments would be made for its implementation.

Within the next year (6 first months):

• Pilot test in three Colombian territories to start capturing information on obstetric patients captured by the healthcare teams of each institution in the emergency services, hospitalization, outpatient consultation, prenatal control, delivery care and obstetric emergencies.

From the second semester of the next year and within the next 5 years:

During this period, it is expected to expand coverage to 90% of the territory, so that public and private health institutions have access to the technological platform and capture the information of pregnant and postpartum patients positive for COVID-19, to go generating scientific evidence that helps in clinical decision making and optimizes the diagnosis, monitoring and treatment of the Colombian pregnant population.

Failure to achieve strategic alliances with the government and the public and private health institutions present in the national territory, which causes that the application is not of massive use and therefore could not have consolidated data at the national level.

FECOLSOG is in the search and definition of strategic alliances with other national and international institutions, in addition to continuously verifying and applying to different grants. In addition, its revenue stream has planned to allocate a percentage of these from 2021 to cover part of the expected expenses and support this solution for its sustainability.

During the second semester of 2020, for the design and prototyping of the technological platform and the application for mobile devices, the work team will be:

Full time staff: Project Area Coordinator (1), Accounting Wizard (1) and Administrative Assistant (1).

Part time staff: Clinical Research Coordinator (1), Software Coordinator (1), Developer (1) and Graphic Designer (1).

From the next year the team would be:

Full time staff: Project Area Coordinator (1), Accounting Wizard (1) and Administrative Assistant (1).

Part time staff: Clinical Research Coordinator (1), Data capture coordinator (1) and Institutional Liaison Officer (1).

The Colombian Federation of Obstetrics and Gynecology (FECOLSOG by the name in Spanish), is a scientific society that gather almost 4000 OBGYN specialists trough the country. Also is supported by the Latin American Federation of Obstetrics and Gynecology (FLASOG) and the World Federation of Gynecology and Obstetrics (FIGO).

FECOLSOG as organization works toward to update and share scientific knowledge and technological advances and encourages local research about obstetrics and gynecology issues to improve the health and rights of Colombian women. Our work has been promoting partnership activities at national and international level, to strength the capacities of local health teams that works in with vulnerable populations Colombia. In addition, the Federation has a scientific committee that supervise all the activities to achieve quality work.

We believe that because our organization is well known and respected as technical consultant in topics related to sexual and reproductive health at country level, so it is possible for us to obtain the support of local organization and work  articulately with the Ministry of Health and the  public and private sector that provides  health services accross the colombian territory.

FECOLSOG is currently working with Okku Technology and Innovation, in the development of digital solutions for the health sector. This company adds value to people and organizations through the use, appropriation and exploitation of Information and Communication Technologies (ICT), through the design, development, implementation and evaluation of strategies tailored to people and organizations. to find opportunities on the Internet and that through ICT add value to the services or products they offer. The market opportunity for Okku Tecnología e Innovación are the great digital gaps that exist in Colombia, particularly related to how ICT can enhance products or services. Among the highlights of the organization are the development of national conferences on the use of ICT in educational contexts and the development of digital solutions such as websites, educational platforms, applications, digital content for different people and organizations.

The business model of the Colombian Federation of Obstetrics and Gynecology – FECOLSOG, has as key allies and stakeholders the governing bodies and national and international associations related to the social purpose of FECOLSOG. Customers and beneficiaries are from gynaecologists and obstetricians and health personnel, public and private health entities, the pharmaceutical industry, legal process actors and public and private decision makers. Among the main activities are the planning and development of academic events of continuing medical education, the edition and publication of the Colombian journal of obstetrics and gynecology and the planning and execution of projects in sexual and reproductive health, throughout the country, aimed at meeting the needs of women's integral health, continuing medical education and research. The services it offers include: to doctors and health professionals, the acquisition or updating of knowledge and competences, recognition and prestige, defense of the interests of the guild of obstetrics and gynecology and institutional support. To public and private (non-commercial) entities brand support and compliance support; to the industry support, call and logistical capacity; clinics and hospitals have access to next-generation devices and public and private decision-makers in the concept, support and representativeness. The distribution channels of these activities are mainly face-to-face and electronic.

To finance the design, development and implementation of this integrated technological solution, FECOLSOG is in the search and definition of strategic alliances with other national and international institutions, as well as continuously verifying and applying to different grants. In addition, its revenue stream has envisaged allocating from 2021 on a percentage of these to cover part of the expected expenditure and to support this solution.

We are applying Solve to have the seed capital that allows us to design the digital platform and the mobile application, in this way we can strengthen the health system in the face of the current situation and from its implementation and the alliances we generate with the entities of health of the departments, we begin to have more accurate and updated information on the relationship between the COVID-19 virus and the pregnant female population.

We have the skills and with our partner we have experience in the development of digital solutions for the health sector. Now we would like to have advice and assistance in the distribution of our solution and ensure that the health institutions and the Colombian population benefit from it.

For that to happen, we need to raise capital to design and implement our solution proposal and strengthen the response capacity of our health teams.

At this time we do not have specific names of organizations but we are open to collaborate with anyone who shares similar goals.