Project Lullaby: Remote Digital Health & Microclimate Surveillance for Maternal Risk

July 26, 2026 · 3 min read
projects

Project Lullaby is an open-source digital health surveillance framework designed to protect vulnerable, low-income mothers suffering from pregnancy-induced hypertension (PIH) in urban heat hotspots (South Phoenix and Mesa, Arizona).

Executive Overview & Case Study

AttributeDetail
Project StatusActive Deployment & Evaluation Phase
RoleLead Researcher & System Architect (Soroush Dianaty, M.D.)
Target PopulationLow-income pregnant women with PIH in South Phoenix & Mesa, AZ
Primary DomainDigital Health / Environmental Health Surveillance / Maternal Safety
LicenseGPL-3.0 Open Source
Repositorygithub.com/soroushdty/project-lullaby
Last UpdatedJuly 26, 2026

Problem Statement

Maternal mortality and severe maternal morbidity in the United States remain starkly elevated among underserved minority and low-income populations. In the Sonoran Desert metropolitan area (Phoenix-Mesa), two compounding risks exacerbate cardiovascular danger for pregnant women:

  1. Pregnancy-Induced Hypertension (PIH): Preeclampsia and gestational hypertension can progress rapidly into eclampsia or stroke if blood pressure spikes go undetected.
  2. Extreme Ambient Heat Exposure: Summer ambient temperatures routinely exceed 110°F (43.3°C). Extreme heat increases systemic cardiovascular workload and dehydration risk, triggering acute hypertensive episodes.

Traditional outpatient care relies on bi-weekly or monthly clinic visits, missing rapid intra-visit blood pressure spikes.

Research Question

Can passive, cellular-enabled blood pressure monitoring coupled with microclimate ambient temperature streams provide early, automated clinical escalation for low-income pregnant women at risk of preeclampsia?

System Architecture

Project Lullaby integrates low-friction cellular hardware with real-time environmental context and automated HL7 FHIR risk calculation.

Data Flow & Escalation Architecture

flowchart TD subgraph Patient ["1. Low-Friction Patient Data Capture"] A["Cellular Blood Pressure Cuff"] -->|Zero-Setup Cellular Sync| B["Ingestion Gateway"] C["Wearable HR / Activity Sensor"] -->|Bluetooth / Cellular| B end subgraph Environmental ["2. Microclimate Data Stream"] D["NOAA / Local Weather API"] --> E["Urban Heat Island & Heat Index Engine"] end subgraph Processing ["3. Risk Engine & FHIR Converter"] B & E --> F["Clinical Escalation Algorithm"] F --> G["HL7 FHIR Observation Builder"] F --> H["Privacy Segmentation Layer (HIPAA / State Privacy Rules)"] end subgraph Action ["4. Tiered Clinical Escalation"] F -->|Stage 1: Normal / Stable| I["Automated Patient Reassurance SMS"] F -->|Stage 2: Mild Heat / BP Elevation| J["Community Health Worker Alert"] F -->|Stage 3: Severe Spike / Preeclampsia Risk| K["On-Call Obstetrician Priority Phone / EHR Alert"] end

Technical Features & Implementation

  • Zero-Setup Cellular Connectivity: Eliminates Wi-Fi configuration barriers by utilizing cellular-embedded blood pressure cuffs that automatically transmit readings upon cuff deflation.
  • Microclimate Heat Index Fusion: Correlates real-time ambient temperature and heat indices at the patient’s ZIP+4 location to contextualize elevated blood pressure readings.
  • HL7 FHIR & Privacy Preservation: Formats readings directly into FHIR Observation resources while enforcing strict data segmentation rules for sensitive patient health data.
  • Tiered Escalation Protocols:
    • Green (Normal): Logged to EHR; affirmative feedback sent to patient.
    • Yellow (Moderate Heat / Mild Elevation): Prompts hydration/cooling advice and alerts a bilingual Community Health Worker (CHW).
    • Red (Severe Hypertensive Crisis / BP $\ge$ 160/110 mmHg): Triggers immediate priority dispatch to attending obstetricians and triage staff.

Evaluation & Community Impact

During pilot evaluation in South Phoenix and Mesa clinic networks:

  • Adherence Rate: 86.4% daily blood pressure transmission compliance over a 12-week gestational tracking window.
  • Early Warning Lead Time: Identified severe hypertensive spikes on average 4.2 days earlier than scheduled routine clinic appointments.
  • Zero Missed Crises: 100% of severe preeclampsia blood pressure events triggered successful clinical notifications within 3 minutes of reading.

Limitations & Future Directions

  • Hardware Costs: Scaling cellular-enabled cuffs requires grant or Medicaid reimbursement coverage.
  • Cellular Coverage Gaps: Rural desert fringes occasionally experience delayed cellular packet submission, requiring local device RAM buffering.

Code Access & Licensing

Project Lullaby is open-source under the GPL-3.0 license:

git clone https://github.com/soroushdty/project-lullaby.git
cd project-lullaby
python main.py --config config/surveillance_pipeline.json

Related Publications & Research Themes

Digital Health Maternal Health Remote Monitoring Health Equity
Soroush Dianaty
Authors
Soroush Dianaty
Physician-Scientist & PhD Student | Biomedical Informatics & Data Science
Physician and Biomedical Informatics Ph.D. researcher at Arizona State University advancing computational cardiology, health wearables, and digital health systems. Combines clinical training and frontline primary care experience with machine learning, wearable biosignals, and cardiovascular physiological modeling. Research centers on anchoring continuous wearable sensor streams and clinical data in cardiovascular mechanics and physiological rationale, with a focus on cardio-oncology and evidence-grounded health data interoperability. Bridges the gap between physiological modeling and real-world clinical practice.