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Excelscope

Remote microscopic diagnosis device for rural health centres.

 

This project began as an exploration and need assessment of problems existing in the health centers of rural Uganda, mainly focusing on diagnosis. The initial research into the topic was done with help of existing literature and support of experts from TU Delft, Center for Frugal Innovation in Africa and Leiden University. 

This was followed by a field trip to Uganda, which  comprised of in-depth interviews with both the practising health care workers and the experts and innovators in the sector. Our research took us to the deepest of villages of Uganda, where we could observe first hand how the state of current operation was. 

Upon our return, we had to carefully organise and analyse all the data that we had collected over all our expert meetings, interviews and observation. This began with discussing the findings within the team and the together categorising it.

The data, after careful scrutiny was arranged in order to infer more from it. An extensive problem map was created that highlighted where the problem areas where and what where the connections between them.

This lead to a decision on dealing with problems at Health Center 2 level, the lowest health center level authorised to do a diagnosis. Upon taking a closer look at the problems pertaining to that health center, it was soon discovered that there was serious inaccuracy and inefficiency in diagnosing the most common of diseased due to lack of equipments. 

It was discovered through research that Microscope was the 'gold standard' to diagnose many of the diseases that occurred there. However, just supplying them with the microscope isn't sufficient, as the nurses in charge of these health centers don't have the expertise to detect parasites under a microscope. This was the problem.

This lead to the idea generation phase, where based on the information generated earlier several options were looked at and several scenarios imagined. One of the ideas that emerged as the most promising one was where a microscopic device could capture images of the blood smears prepared and send these images to a pathologist or lab technician at a remote location for a diagnosis. 

The process was looked into with more detail to understand the cognitive work and the interaction such a work would require. 

At this point a thorough functional analysis of the microscope was done to understand its composition.

On doing further research and discussing with optics experts at this point, it was understood what would be required to construct a microscope for such frugal use. A decision was made to maximise the use of a smartphone as it provided a camera, a processor, a screen and a communication device at an affordable price factor in comparison to sourcing them individually. Also, the familiarity of Ugandan people with smartphones and application would contribute to easier adoption.

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The microscope was ripped to its bones (lenses) and then we began reconstructing from there with only what was essential for our cause, decreasing complexities. Meanwhile, we did in-depth research with optics experts at the TU Delft to understand alternate approaches. As lenses are the most expensive part of a microscope, a lot of research was focused towards that.

A solution was found in research, that reversing the smartphone lenses provides great magnification. Samples were immediately procured to build a test set up.

However, the magnification attained by the inverse camera lens wasn't at the level required for diagnosis of diseases like malaria, it was discovered that it can be enhanced digitally and optically. Hence, it was decided to go for two approaches: traditional and radical. The traditional approach would incorporate the same lens module that the current microscopes posses and the radical approach would explore the inverse camera lens module that can provide serious reduction in cost and form factor.

Some initial form exploration were done, to determine the most suitable form for the microscope.

Some of the forms were detailed in CAD.

Quick prototypes were made to test some of the forms and detail several aspects. A design of a slide adapter was created to accommodate the slide inside the device without error and uniformly.

Along with the device, a preparation module was also designed to help the nurse prepare the blood smears correctly by providing clear instructions, use cues and an integrated system. An accompanying app was also diligently designed keeping in mind the context and expertise level of the users. The process of preparing the blood smear for the test can be seen in the video below. 

The device and the preparation module is currently undergoing a user test in Uganda with on field nurses, practitioners and experts. The concept was validated for its context compatibility and system structure by taking it back to the field in Uganda and reflecting upon its use case and applications with several medical staff and experts.

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