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More Than a Fashion Statement, Today’s Wearable Technology Can Save Patient Lives

Though wearable technology has been around for years, it’s finally getting the attention it deserves, thanks to the introduction of the new Apple Watch and its health monitoring applications.

For several years, wearables have enabled consumers to track virtually every aspect of their lives, including activity levels, sleep patterns, stress levels, and even vital signs. However, these devices have generally been consumer novelties – until Apple unveiled its new HealthKit platform, which facilitates users sharing medical information with their doctors.

I believe the real breakthrough application for wearables is in the patient-care environment, where this technology can help improve diagnostic capabilities and therapeutic outcomes.

About six years ago, I embarked on a journey to help prevent hospital-acquired pressure ulcers using wearable technology. I first learned about this problem as a medical student, when I witnessed a patient almost die from an infected pressure ulcer. I couldn’t believe that a pressure ulcer, a bedsore, was capable of threatening someone’s life, so I teamed up with a fellow medical student, Daniel Shen, to try to revolutionize pressure ulcer prevention.

The result was the Leaf Patient Monitoring System, which was recently cleared by the U.S. Food and Drug Administration. Our wireless, disposable, wearable sensor provides nurses with information that can be used to prevent complications associated with patient immobility.

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Enormous Threat to Patient Safety
One out of 30 hospitalized patients will develop a pressure ulcer – well over 1 million patients each year. Pressure ulcers cost our healthcare system more than $9 billion annually.

To put this cost into perspective, each year we spend more healthcare dollars treating pressure ulcers than we spend treating patients with influenza, (cdc/workplacehealthpromotion/immunization).  And since pressure ulcers are largely considered preventable, these costs are not reimbursable.

Furthermore, pressure ulcers negatively impact hospital quality metrics, which are becoming increasingly important in this era of pay-for-performance. To further exacerbate the problem, as the population ages, the percent of patients at risk for pressure ulcers is increasing.

The cost of pressure ulcers is compounded by the potential risk of legal liability. Several law firms have begun to specialize in filing lawsuits on behalf of pressure ulcer victims. Typical settlements have ranged from several hundred thousand dollars to several million for each case.

Given the magnitude of the pressure ulcer epidemic, the Joint Commission, the nation’s leading hospital standards organization, recently made pressure ulcer prevention a patient safety priority.

Treatment Unchanged in 160 Years
About 160 years ago, during the Crimean War, Florence Nightingale first popularized the importance of patient turning. She is credited with developing the concept of turning protocols, where wounded soldiers were turned and repositioned every two hours, around the clock.

Patient turning has become fundamental to nursing care. To this day, frequent and regular turning is recognized as critically important to pressure ulcer prevention.

That said studies show that compliance with turning protocols is poor, which explains why pressure ulcer rates remain high. A 2001 study found that national compliance with our standard two-hour turning protocol is only 66 percent. (Arch Intern Med. 2001 Jun 25;161(12):1549-54).

It’s almost universally recognized that compliance with turning protocols can and should be improved. In a world struggling to contain healthcare costs, it’s time to deploy smart technology that enables the delivery of more efficient and effective patient care.

Patient Safety Innovation

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The Leaf Patient Monitoring System has helped transform an age-old nursing practice by ensuring that patients at risk for pressure ulcers receive appropriate preventative care. The system allows nurses to focus their attention on those who need it most while at the same time ensuring that no patient is neglected.

The patient monitoring system is composed of a small, lightweight, waterproof sensor that adheres to patients, much like a standard EKG electrode sticker. This wearable sensor continuously monitors each patient’s position and movements, and wirelessly transmits the data to monitoring stations.

From monitoring stations, staff can view data from all patients. The system provides alerts when patient orientation or activity deviates from parameters set by healthcare providers. In addition, the system documents adequate patient self-turns which reduces the need to unnecessarily interrupt patients or distract staff. The Leaf system allows nurses to deliver a higher quality of care in an easier and more efficient manner.

Hospitals across the country are now using the system to help coordinate and optimize pressure ulcer prevention efforts. Results have been promising. Clinical trials have shown that the system dramatically improves compliance with prescribed turning protocols. In a yet-unpublished clinical study, compliance with turning protocols increased from 64 percent to 98 percent after the Leaf system was implemented.

Wearable Technology With Real Purpose
Traditionally, turning protocols have taken a one-size-fits-all approach. However, patient turning is a therapeutic intervention and therefore it should ideally be customized to the individual patient. Just as you wouldn’t give every patient the same medication, at the same dose, at the same time of day, turning should also be customized based on patient-specific factors. The Leaf system opens the door for the development of dynamic turning protocols that are based on individualized patient-care needs.

Given the tremendous burden that pressure ulcers place on our healthcare system, there is a substantial need for improved prevention methods. I’m hopeful that one day, every hospitalized patient will benefit from position and movement monitoring technology, and that we will no longer see the horrible complications associated with patient immobility.


Contributed by Dr. Barrett Larson, September 2014.

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Dr. Barrett Larson is a resident physician at Stanford University Medical Center and co-founder of Leaf Healthcare. At the Stanford Medicine X Conference on September 6th, Larson gave a presentation on the benefits of using wearable technology in the hospital environment.

For more information on Leaf Healthcare, visit: leafhealthcare.com


 

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