Poster Y7 - Clinical Feedback on a Novel Low-Resource Oxygen Delivery Device

Introduction: In sub-Saharan Africa (SSA), respiratory diseases are prevalent and on the rise due to environmental and globalization factors [1]. Even so, patients who seek treatment in this region's clinics are often left untreated due to inadequate or limited access to oxygen delivery devices [2]. In 2022, a team of University of Delaware students aimed to address these disparities through the development of SPLiTO2, a mechanical device that can be attached to an oxygen source. The device delivers oxygen to four patients simultaneously at their own flow rates. With initial development completed, the team sought clinician feedback on the device. Previous studies have compiled healthcare provider feedback about novel medical technologies, but have not thoroughly compared high-resource (HR) and low-resource (LR) clinician feedback on medical devices designed for LR healthcare clinics [3]. This data will inform further developers of LR medical technologies on how each group values the usability and functionality of novel medical devices differently. This study focuses on the opinions of high resource U.S. clinicians (HR US) on the SPLiTO2 and will be compared with feedback collected from high-resource South African clinicians (HR SA) and low-resource South African clinicians (LR SA) in Cape Town, South Africa in August 2024. While all clinical settings will value the reliability and accuracy of the design, it was hypothesized that HR US will especially value the ease-of-use of the technology while HR SA and LR SA end-users will value the low-cost and durability of the design.

Materials and

Methods: Twelve healthcare providers in northern Delaware were interviewed using a questionnaire approved by the University of Delaware Institutional Review Board. Clinicians were recruited from various healthcare systems in the region and included physicians, nurses, respiratory therapists, and emergency medicine technicians (EMTs). The interview questions were structured such that the same questions could be posed to LR SA and HR SA end users. Clinicians were introduced to the prototype visualized in Figure 1. Topics included the usability, applicability, and feasibility of use of the device in the clinician’s respective healthcare system. Clinicians reflected on the portability and ease of use of oxygen delivery devices they are familiar with, the SPLiTO2 device’s usability, and which healthcare settings they believe would benefit from the implementation of this device. The healthcare provider feedback was organized into three categories including insight into the healthcare providers’ experiences with oxygen providing treatments, feedback about the SPLiTO2 device, and potential for integration of the SPLiTO2 device into familiar healthcare settings. Following interviews with LR SA and HR SA in SSA in August 2024, the similarities in each group’s most common responses, themes, and average rating of the device will be analyzed. This analysis will explore the hypothesis that HR US prioritize design while LR and HR SA prioritize functionality. The percentage of clinicians who mentioned each theme will also be compared between groups.

Results, Conclusions, and Discussions: Clinicians emphasized ease-of-use and the device's potential for disaster response preparedness in HR environments. 42% noted they most commonly use central oxygen services in individual patient rooms and canisters only during transport, triage, or other short-term scenarios. They did not report many concerns with their current use of oxygen delivery systems, besides frequent port-tubing disconnections and the impedance of lengthy tubing on staff ergonomics. 66% of clinicians expressed doubt in the accuracy of the flow readings provided by their current systems due to lengthy tubing or improper connections, but 75% admitted they generally trust the flow reading of the equipment with no further interventions, although the original design team previously prioritized the implementation of a continuous flow meter in future iterations. Common themes included increasing the size of flow readings on the device for easier monitoring and adjustment of flow rates and increasing the transportability of the device. 83% of clinicians were concerned about faster deprivation of the oxygen canister when multiple patients connect to the same source as this strains the providers who switch these tanks as they deplete the oxygen reserve. They suggested the device would be most useful in holding areas with closely-grouped patients, outpatient settings like assisted living facilities or infusion centers, or during mass disasters where many patients need treatment. The EMT specifically noted its utility in response to carbon monoxide leaks, apartment fires, or large toxic waste exposures. This feedback is insightful, since many HR hospitals purchase disaster preparedness resources for scenarios when their central oxygen supplies or electricity may be depleted or unavailable. This increases the marketability of the device, provides areas of improvement, and increases in its indications for use. These results will make the SPLiTO2 oxygen delivery system more user friendly and suitable for both HR and LR environments, despite the study’s limited sample size, minimal regional diversity, and early prototype usage. The data will help refine the questionnaire for the team’s August 2024 trip to interview LR SA and HR SA. The current results suggest ease of use and disaster-preparedness are motivating factors when marketing LR solutions to HR clinicians.

Acknowledgements (Optional):

References:
Erharbor, J Pan African Thoracic Society 2021.
Navuluri et al, J Global Health 2021.
Dzik, British J Haematology 2007.