THE WODIA PROJECT: A ZITEC PARTNERSHIP TO SUPPORT PATIENTS AND HEALTH PROFESSIONALS FROM THE ENTIRE SPECTRUM OF PERSONALIsED MEDICINE
Discover the insights of the ERA PerMed Personalised Medicine Screening and Monitoring Programme powered by Zitec.
Half a million women die in childbirth every year. Preeclampsia and gestational hypertension alone are the cause of 76,000 mothers and 9½ million children who die every year. Infants who survive often suffer from long-term health issues, including cerebral palsy, chronic lung disease, blindness and hearing loss, and the resulting health care costs are high.
Aimed at making it safer for women to give birth by identifying and tracking the early signs of preeclampsia while it is still preventable, by means of personalised medicine, screening service, therapy and monitoring at home, the WODIA project is yet another successful partnership between ERAPerMed and Zitec, the secrets of which we will unveil in this article.
ERA PerMed, Aarhus University
THE PARTNERSHIP: ENABLING PERSONALIsED MEDICINE SCREENING AND MONITORING WITH ZITEC & WODIA
Preeclampsia complicates up to 8% of all pregnancies worldwide and can lead to several life-threatening conditions, often requiring medical treatment and hospitalisation. Risks to the foetus include poor growth and premature birth. The cost of preeclampsia is estimated to be up to 13.5 billion euros per year in the European Union alone.
Once preeclampsia is diagnosed, it cannot be cured. Recent studies have shown promising new diagnostic approaches using an extensive battery of biomarker screening and monitoring combined with maternal phenotype and history categorisation, which are then classified. Based on this model, it was found that medical treatment with antiplatelet agents is effective in a cohort of over 61,000 pregnancies.
WODIA will combine the maternal characteristics with a range of biomarkers. Together, these will allow for more effective targeted personalised medicine with individual medication dosing and fewer and more effective clinical visits. It made sense to access Zitec professionals’ expertise in creating the right software which would support data management in a user-friendly way both for patients and for clinical staff.
The focus of the Zitec project team was on continuing the necessary elements of the WODIA technical platform, in order to integrate the sources, including devices from the home (telehealth) as well as from self-measurement in the ambulatory (care unit).
During stage 2 – 2023, the activity was carried out according to the project planning. Thus, meetings and activities specific to the preliminary analysis were carried out for the generation of work specifications and the development of the elements necessary for the WODIA technical platform: infrastructure, user and admin interface for data management, user management, deployment, data security, and app performance optimisation.
THE CHALLENGE POSED BY THE PROJECT
The WODIA project will support patients and healthcare professionals across the spectrum of personalised medicine: providing more accurate and predictive decision support, preventive, personalised and participatory medicine and easier collaboration with healthcare professionals:
- Accurate and predictive decision support tools using biomarkers, phenotype characteristics for screening and monitoring
- Preventive by early identification of women at increased risk of preeclampsia and gestational hypertension during which prophylactic treatment is still an option.
- Personalised through personalised feedback and adjustment of medication and treatment plans based on real-time sensor information obtained in the clinic and from the home and participatory environment, as it enables patients to care for and participate more in their own treatment.
In outlining the design and desired outcomes of the programme, finding a software solution to streamline the data collection, management and security was an imperative part of the success of this project.
ZITEC’S PROPOSITION OF AN API SOLUTION
Zitec’s choice of infrastructure and technologies reflected our aspiration to ensure a secure and user-friendly screening and monitoring process both for patients and for medical staff.
We chose MySQL for its robustness, reliability and ease of use, essential in handling and storing complex data. Nginx for its efficiency in handling a large number of simultaneous connections and load balancing capability, which contributes to the overall performance and stability of the application. jQuery helps us quickly develop dynamic and responsive user interfaces, while ApexCharts allow us to present data in a visually attractive and understandable way for users.
We used the Sonata Admin Bundle to create admin interfaces, and the FOS User Bundle for user management. These allowed us to build a robust and customised system for content and user management.
The API (application programming interface) is built with Symfony, FOS Rest Bundle, Swagger Annotations, accompanied by a detailed documentation made with Nelmio API Doc. The API follows REST standards, and requests and responses are structured according to an existing documentation on the site.
The administration interface (Admin) is built with Sonata Admin and provides CRUD functionality to the application users, with limitations or permissions depending on their role. This interface simplifies system management and data monitoring, while also providing admin users or medical staff with a set of custom tables that centralise metrics collected from patients.
As for the user interface (UI), it is built with JQuery, ApexCharts and Axios, providing an interactive experience for patients, administrators and medical staff, allowing them to view relevant information and graphs. For patients, the graphical interface also gives them the opportunity to enter their own measurements into the app or monitor their acquisition and recording in real time.
The interface has a responsive design and contains mobile-friendly elements, being mainly intended for easy use by patients.
HOW THE MAGIC WORKS
The API works in the CRUD system (create, review, update, delete), and the endpoints used allow the management of the following entities: municipalities, care organisations and their departments, devices and events received from the sensors, gateways and questionnaires. Data can be recorded by receiving it on the API endpoints, by manual input on the Admin interface, or by manual input by the patient in the user interface.
After the measurements are collected in the app, they are run through and processed to generate the graphs, tables and reports needed to record patients’ health.
All measurements are passed through a complex system of services built in Symfony with PHP, grouped according to sensor types, and then metrics and average values are calculated according to the required intervals.
The data is then sent to Sonata Admin or the user interface based on pre-set criteria for display.
Once the data has been stored in the application, it can be accessed through all existing components: API, administration interface, user interface. Access to this data depends on the type of user logged into the application.
THE NEED FOR DATA SECURITY AND THE SOLUTION PUT FORWARD BY ZITEC
The nature of preeclampsia and the need for strict and accurate monitoring of the patients go hand in hand with the fact that such sensitive patient data must be safely collected, stored and accessed. During the development and testing stages, mock patient data is used, while the actual patient data will only be used in separate instances of the application, which will be installed by medical centers on their own devices. This ensures that sensitive data is stored and managed in a controlled and secure environment.
Through these measures, we ensure that our application is not only functional, but also secure, protecting patient information and ensuring that access to critical functionality is properly controlled and monitored. These security practices are essential to maintaining user trust and compliance with data protection standards.
The development and implementation of our software application successfully addresses the critical aspects of flexibility, security, and user-friendliness. Through a straightforward design and meticulous development process, we have achieved a system that caters to the diverse needs of both patients and medical staff users.
The flexibility of our data management solution and our focus on making it easy for the end-users to navigate the application, not only enhance user satisfaction but also position our application as a versatile solution capable of accommodating evolving demands in a dynamic technological landscape.
As we move forward, it is our priority to continue our partner EraPerMed’s mission of supporting personalised medicine and accurate screening and monitoring, with an aim to make childbirth safer for women.