Project Planning

Initial meeting to discuss and formulate a project between eLifeLink and Champions for Nepal Health (CNH) took place during July-September of 2021. Abin and Arya Pradhan from eLifeLink and Dr. Sampurna M Tuladhar and Yuna Mathema of CNH participated in the discussions. The project team decided to organize a mini health camp for screening rheumatic heart disease in the outskirt town of Kathmandu valley instead of setting up telemedicine service in remote health post. eLifeLink purchased a number of digital medical equipment and Arya Pradhan tested their bluetooth feature and corresponding apps to capture diagnostics results and use AI to detect heart related issues. Rajesh Kayastha of Rotary Club of Kathmandu West talked to the Principal of Shiksha Sadan Secondary School to make available 75 students from classes 5-7 for Phase-1 of the health camp to be held on November 30, 2021. Additional meetings were held between eLifeLink, CNH and Rotary Club in Kathmandu, Nepal to finalize the details of the camp in the early parts of November 2021.

Project Resources

A team of two senior cardiologists – Dr. Sampurna M Tuladhar and Dr. Sanjay K Shrestha and a Cardiac Sonographer Ms. Katelyn Stickney were in-charge of the heart screening. They used Eko Duo EKG and Stethescope for initial screening of murmur and AFib, and an Echo (ultrasound) machine if further analysis was required. They were assisted by two nurses for taking blood pressure and blood oxygen saturation readings. A small number of students from the school volunteered for registering the students for screening as well as for taking their hight and weight. Two sets of blood pressure equipment and oximeters were made available for the screening. Abin Pradhan, Project Manager of eLifeLink travelled to Nepal for the project and helped to setup the process to capture EKG and heart sound from Eko Duo and use AI service to detect heart issues in real time. A simple MediRecord App was also used to capture all the medical records collected in the health camp. The school provided two rooms with desks, chairs and a bed for organizing the health camp. eLifeLink donated a set of Eko Duo EKG + Digital Stethoscope, digital Blood Pressure Machine, Spirometer, Oximeter and a digital thermometer to CNH for use in this health camp and for future telemedicine project to be implemented.

Heart Screening Process & Recommendation

Each student was given a medical data input slip at the registration station along with their unique ID number. Their height and weight were taken in the first station. In the next station their blood pressure, pulse and blood oxygen levels were taking. After that they are taken to a separate room to perform their heart screening using the Eko Duo digital stethoscope. This equipment is used for initial screening and the results are captured in an iPad and uploaded into the cloud (Eko’s data center). The system then uses Artificial Intelligence (AI) to detect if the patient has any heart related issues such and murmur or irregular heartbeat (Arrhythmia) within 15 seconds. If a murmur or any other issue is detected the student will undergo a thorough check using the ultrasound machine. Students having notable heart issues such as murmur are provided comprehensive consultation to their parents, recommending future course of actions. A process flow diagram illustrating the equipment used and the data collected is provided in the gallery below.

Results Summary

Of the 65 students who were screened for heart disease, two had irregular heartbeat (Arrhythmia), two had minor murmur and one had a distinct murmur. A nonconfidential version is available for download below. All three students underwent detailed screening using the echo (ultrasound) machine to confirm their cases. Their parents were called and consultation were provided by the senior cardiologist immediately. The goal of the health camp was early detection and prevention of cardiovascular disease in children, potentially due to rheumatic fever during their childhood.

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