The Herald Proximity Project

Owner

Herald is an open source community project managed by volunteers with help and advice provided by Linux Foundation Public Health (LFPH). Herald was donated to LFPH by VMware Inc. and is now managed by the project’s contributors. It is supported by the infrastructure of LFPH as a steward, supporting Herald’s ongoing maintenance through community development. Using LFPH as a foundational home for the code, with deep expertise in open source software, gives the project a greater opportunity to build a community of collaborators and contributors.

It is licensed under Apache Licence 2.0, which allows for free use of the software for modification, distribution, patent use, private use and commercial use.

Background

Hospitals must be able to locate high-value equipment and samples, securely pass messages (ideally replacing outdated pagers), and facilitate visitor navigation. The Herald Proximity Project has been trialled, tested and deployed to provide contact tracing for people through the COVID 19 Pandemic, but the same idea can also be applied to tracking objects and devices within hospitals. The Herald team have established a sustainable governance model for the project and are now looking for partners in UK Hospitals to help develop and deploy their technology for the NHS.

Situation

Large hospital buildings can be complex and bewildering. In this environment, equipment often needs locating, samples require testing within a tight timeframe and patients and visitors need to navigate an unfamiliar environment to find specific services. All these issues take time and can cause unnecessary stress.

The Herald Project looks to take the lessons learned and technology developed from the COVID-19 Pandemic in Australia and Canada and apply them to this problem for the UK and elsewhere. When repurposing technical approaches from one context to another, nimble development, low cost infrastructure, reliable governance structures, and substantial community support are all immensely helpful. An open source approach makes this change in scope easier to achieve, helps improve the quality of code (and in this instance, the accuracy and efficacy of tracking objects), and lets partners inspect the project’s work before trial.

The sustainability of technical projects is a big problem in digital transformation, but Herald’s use of stewardship and neutral governance structures helps tackle some of the biggest hurdles for a sustainable approach.

Aspiration

• Improving visitors' and patients' experience, allowing easy navigation and interaction with hospital facilities and outpatient appointment systems.
• Making Health professionals’ day-to-day activities more efficient, helping them spend more time working with patients, instead of chasing equipment or information.
• Provide open source tools to the NHS with sustainable, independent and neutral ownership and governance.

Solution and impact

Contact tracing apps take constant readings of the proximity of nearby devices, allowing for up-to-date information. Herald is repurposing this approach to allow a device to record and broadcast its own route through an area over a low cost network.

Network solutions like Wi-Fi and 4G/5G are expensive to roll out across a hospital. The Herald protocol lets digital devices talk to each other through bluetooth and an Application Programming Interface (API), providing a secure and self-healing (MESH) network to pass messages via phones and low-cost USB dongles. These can be powered from any TV, power socket, or computer and integrated with existing consumer devices (including phones, tablets, and computers).

Potential applications then include a hospital map and location gazetteer for visitors, or the ability to locate equipment for staff, both shown on their own work or personal devices, without drawing on existing hospital networks or services. More than 97% of phones worldwide can use the Herald Protocol. There are many applications of such an infrastructure for small, timely messages. When coupled to different kinds of input, messaging could include temperature and light levels throughout a hospital, the density of people congregating in particular areas of waiting rooms, or even a reliable replacement for older on-call pager systems. This could then enable better environmental estate management, better coordination of emergency evacuations with visitor density and location information, and improved patient services with information about their appointment, delays etc.

Herald has taken advantage of governance know-how provided by the VMWare Open Source Program Office (OSPO). Detailed procedures can be a challenge for those moving to open source but OSPOs provide both internal support and more effective coordination with external providers. This includes: managing licensing and intellectual property issues, code contribution, maintenance and security, and how to manage and modify code or information notices. With a comprehensive base built up through a local OSPO, Herald’s governance process has been able to transition to management by the Linux Foundation for Public Health.

LFPH helps to build open source communities for projects being deployed with public health authorities, but also hosts openly licensed code for those projects, ensuring that no single body has executive control over a project in the public domain. They provide assistance for neutral and open governance, encourage adoption, contribution and collaboration, and help with events, documentation and security audits, among other forms of support.

Herald takes advantage of these structures, and also uses LFPH for international oversight.

Functionality

The Herald Project is currently in use as part of the Covid response in Australia and Canada (Alberta), and in teaching and outreach projects in the US. Its functionality includes:

• Accurate range finding and exposure notification
• Secure data and messaging through individual staff and patient phones, avoiding pagers, 3G/4G/5G networks, or in-hospital Wi-Fi
• Re-usable backbone Bluetooth MESH infrastructure for other future applications
• Local IT staff can easily maintain and monitor the network
• No requirement for licence fees

Capabilities

• Site navigation for staff and visitors, with proximity and availability of services
• Locating high-value equipment and samples for staff
• Outpatient appointment management

Scope

• A free open source mobile app would allow both staff and the public to interact with location services of any site, and to do so in an anonymous privacy-preserving manner
• Visitors could then use a mobile phone to pinpoint their position on a map of an unfamiliar area, which is especially useful for complex university campuses or hospitals. Both visitors and staff could be guided around a hospital using their own phones.
• A staff mobile app would allow for the location of equipment and samples, all accessed from work phones, nursing workstations and desktops
• Cloud-native applications could be installed on-site in hospitals’ own computer rooms to manage thousands of small messages flowing through their systems, rather than relying on third parties.
• Low-cost Bluetooth MESH could be used in a clinical setting, at home, and elsewhere
• open source eHealth wearables could be used to monitor patients in hospital, or in their home with data transfer either on-demand via a companion mobile phone app, or when revisiting a specialist.

Digital equalities

• Existing systems do not provide services to visitors or staff with their own devices, requiring expensive purchase and rollout of custom equipment for the staff or manual processes for visitors (E.g. outpatient arrival sign in, asking directions, asking staff for how long they have to wait)
• It would be better if patients could use their own accessibility tools on their own devices to interact with hospitals more easily. A person could then use their device’s existing digital assistive technology to navigate a hospital and its resources.

In 2021, Herald won an OpenUK award in the software category. Adam Fowler, platform architect and lead on the Herald Proximity project, comments:

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Page last updated: September 2022