Duke researchers are partnering with providers in Moshi, Tanzania, to use artificial intelligence and virtual reality technology to revolutionize emergency care for patients with traumatic brain injuries (TBI). João Ricardo Nickenig Vissoci, MSc, PhD, chief of the division of translational health science in the department of emergency medicine, is collaborating with Kilimanjaro Christian Medical Centre (KCMC) to create two health intervention tools.
There are 70 million cases of TBIs worldwide each year. In rural and low- and middle-income countries, care can be delayed, and the quality varies, Vissoci said. Those delays are often due to a shortage of available surgeons and nearby hospitals, resulting in a high rate of preventable deaths.
People living in rural regions of the United States also face an increased risk of TBIs and have a 23% higher chance of death than those in urban areas. “Even in high income countries, we still see a heterogeneity of care, which means that there is still room to improve the consistency of care offered in different areas of the US,” Vissoci said.
To help patients receive faster and more comprehensive care, the researchers are building and deploying a mobile health tool called the Kuishi-TBI app, and an immersive extended reality system called SURVIVRS+, in KCMC’s referral network.
“I am thrilled to see these advanced and cutting-edge technologies being used to address critical gaps in care in areas of need,” said Vissoci, one of the researchers developing prototypes of the tools.
The Kuishi-TBI app will use both current evidence-based clinical practices and machine-learning-based predictive models to improve health outcomes and reduce costs. It will analyze health information and categorize patients based on the severity of the trauma to help providers identify the most urgent cases. “We want to get the right patients to the right place at the right time,” Vissoci said.
The app will also coordinate patient transportation and facilitate communication between district and referral hospitals. Additionally, patients will receive SMS text messages that explain how to care for themselves after experiencing a TBI.
SURVIVRS+, the extended reality tool, will provide enhanced surgical guidance and training for specialists in Tanzania.
The researchers will create a virtual operating room that an experienced surgeon can join remotely, in real-time, to guide specialists through procedures. Using a 360-degree camera and eye tracking features, the system provides a detailed view of the surgical field. Each session will be recorded and stored in a library that can be accessed by specialists looking to train in an immersive environment using real cases.
“It’s exciting to be able to leverage data, cutting-edge analytical methods and new technologies to expand access to quality treatments,” Vissoci said.
Once the prototypes of the app and extended reality system are built, the team will launch a clinical trial to evaluate how effective they are in a health system.
The tools will be considered successful if they are shown to reduce patient mortality and morbidity. “Our key measure here is time. If we can reduce the time it takes for a patient to receive care, we have the potential to make a meaningful difference [in people’s lives],” he said.
These projects are the result of a longstanding partnership with KCMC, an initiative led by Catherine Staton, MD, a member of the Duke Global Health Institute and professor of emergency medicine.