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

Sun, 26 Jul 2026 00:00:00 +0000

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

Attribute	Detail
Project Status	Active Deployment & Evaluation Phase
Role	Lead Researcher & System Architect (Soroush Dianaty, M.D.)
Target Population	Low-income pregnant women with PIH in South Phoenix & Mesa, AZ
Primary Domain	Digital Health / Environmental Health Surveillance / Maternal Safety
License	GPL-3.0 Open Source
Repository
Last Updated	July 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:

Pregnancy-Induced Hypertension (PIH): Preeclampsia and gestational hypertension can progress rapidly into eclampsia or stroke if blood pressure spikes go undetected.
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

Research Focus:
Publication:
Contact: Interested in collaborating on maternal digital health interventions? .

Maternal Health | Soroush Dianaty, M.D.