The value of a fully digital approach in Human Milk Banks
Digital transformation, especially in this period of global pandemics, has become a fundamental factor to improve processes, efficiency and productivity in all kinds of industrial sectors. Healthcare makes no exception, and can now leverage innovative technologies able to drastically impact the quality of services provided to patients, such as Artificial Intelligence (AI)-enabled medical devices, or the application of blockchain technology to electronic health records, just to mention a few.
The use of digital tools can also significantly improve the way healthcare providers work, streamline and simplify their workflow, and finally enable them to focus more on what is most important in their mission, their patients’ care.
Narrowing down to human milk and feeding management for hospitalized term and preterm infants, few challenges apply. We know the extraordinary work that both Neonatal Intensive Care Units (NICUs) and Human Milk Banks (HMBs) perform every day to save infants’ lives and ensure they get all the nutrition they need to thrive. Innovative tools can support them in their daily work, not only providing new ways to personalize patients’ care, but also to automate, and therefore simplify operations, save time and costs, and avoid potential errors.
Unfortunately, NICUs and HMBs in Europe have different levels of digitalization, ranging from highly automated software systems to a poorly integrated mix of different tools, including dedicated software programmes, generic spreadsheet software such as Microsoft Excel, and paper-based records. One of the main issues is that each NICU and HMB has a specific procedure for managing human milk, collecting and storing the milk in the freezers, testing the milk for bacterial load, calculating the fortification needed for the infants, and so on. Digitalizing such variability of processes and improving their effectiveness through dedicated software requires a certain level of customization. This explains why NICUs and HMBs often use software solutions designed or even developed internally, or still exploit paper-based approaches or Excel files to record operations and calculate milk fortification.
We firmly believe that process automation through a dedicated end-to-end software solution like Preemie’s can bring several advantages, by reducing at the bare minimum human operations that waste time and generate errors (e.g. feeding an infant with the wrong milk, errors in calculating the milk fortification for the infant), and at the same time speeding up processes, especially when handling and processing human milk.
After having interacted with a large number of both NICUs and HMBs in Europe, it is worth to outline just a few examples of how digitalization could generate value. They don’t mean to be exhaustive, of course, but just to provide a sense of how a dedicated software solution can impact at different levels. These examples are related to the way HMBs manage the milk from reception to delivery, manage the processes at the HMB and the related data generated.
Control over the expiration date of the milk
This seems a simple operation, but still HMB operators in some cases do it visually by checking the bottles in the freezers. An automated way to infer such information in the software could prevent HMBs from losing expired milk, but also help them in selecting which milk should be delivered first to avoid aging.
Store and know the position of the milk, easily retrieve the milk, select the milk to be delivered based on specific factors (age, donor, type of milk): all such operations can be streamlined through the applications of filters in the software to select the most suitable milk to be prepared and also to identify where the milk has been stored in the freezer and in the related compartments, thus saving time for the operator.
Keeping track of the milk history seems to be one of the most time-consuming operations at the HMB. Registering the milk and its source, managing and storing the different batches received over time and how they are processed (pooling, thawing, pasteurizing, etc.), recording and managing requests for milk coming from hospitals, keeping track of milk prepared and delivered: they are just a few operations that require time and efforts for being recorded and tracked over time. All of them can be managed digitally, through software solutions that enable fast data entry, and above all keep all data recorded and readily available in case the operator needs to access whatever information – for instance, the milk batches that need to be pooled, the list and features of milk requested by hospitals, and so on. This also enables operators to be more focused on the actual operations to be performed on the milk, with less distractions for administrative work that could lead to milk contamination or mistakes.
Matching milk type and recipient
Milk’s content varies depending on various factors that can be tracked, including the fact of being term or preterm milk, single donor’s milk or pooled milk. Each HMB and NICU manages differently the milk based on such features. For instance, some HMBs do not pool milk while others do, others try to administer only colostrum-like milk to very fragile infants, while others provide milk to hospitals mainly based on logistics issues. In some cases, operators write down manually information about the milk on the bottle or in paper registries, which makes very time-consuming for them to retrieve the milk which matches specific recipients. An automated solution could easily support them in milk selection or even suggest this match based on pre-set instructions.
This is a more sophisticated example of how digitalization and innovative technologies can drive a step change in how neonatologists work and personalize care. After having analysed the milk received from donors by using the Preemie sensor, our system can suggest which milk batches should be pooled in order to reach certain levels of macronutrients (for instance, high or low protein levels), so as to match the specific needs of an infant. Needless to say, every operator and neonatologist we spoke was enthusiastic about this.
Clearly, similar examples can be mentioned in relation to the activity in the NICU, and also in the way NICUs and HMBs interact. In a following blog article, we will analyse in more detail how a digitalized approach can help neonatologists and nurse in calculating milk fortification, as well as parenteral and enteral nutrition, and how a fully integrated system can facilitate interactions between NICUs and HBMs, streamlining operations, enhancing transparency and traceability, and finally improving patients care.