Frugal development and deployment of an innovative mobile health platform for COVID-19 in Sri Lanka: the case of SelfShield app

© Author(s) (or their employer(s)) 2021. No commercial reuse. See rights and permissions. Published by BMJ. INTRODUCTION During the early phases of the COVID19 pandemic, emerging technologies focused largely on strengthening the health system, supporting law enforcement authorities, and enabling researchers to model COVID19 outbreaks and resource requirements. When the health systems are burdened by the influx of patients with COVID19, it is neither practical nor rational to treat all patients with COVID19 in the hospital as many will either be asymptomatic or mildly symptomatic. Thus, home monitoring of patients has been practised in many countries. 3 Respiratory involvement was the first documented site of complications and still continues to be responsible for majority of the deaths. Therefore, in order to provide effective home care for patients with COVID19, we recognised the need for a frugal technology tool to monitor patients remotely including monitoring the breathing performance. Guided by the Commonwealth Centre for Digital Health (CWCDH), a voluntary group of medical doctors, health informaticians and software developers from Sri Lanka embarked on a mission to fulfil this need by developing a smart phonebased selfhealth checking tool. Named the SelfShield project, the system comprised a smart phone app, a dashboard for medical teams and machine learning algorithms capable of analysing breathing and voice signals. This report reflects on our early experience with the SelfShield system and we were guided by the following key objectives: 1. Identifying already validated bedside clinical tests that may be cost effectively transformed into a mobile platform. 2. Designing and developing a mobile app to capture subjective and objective COVID19related data in a userfriendly manner and a dashboard that can help medical professionals assist consenting users. 3. Developing machine learning algorithms capable of analysing sound signals to facilitate decision making related to COVID19. 4. Deploying the system as a COVID19 response tool with a focus on citizen empowerment.