Contact-free patient sensor reduces alarm fatigue

Avner Halperin and three colleagues were frustrated that their asthmatic children had to repeatedly go to the hospital. They were told early detection through algorithms interpreting data on respiratory rate and patterns would lead to earlier intervention and better outcomes.

So they invented a sensor that monitors heart rate, respiratory rate and patient movement and does not require direct contact with the patient. It could sense wheezing or coughing. It can be placed beneath a mattress or chair pad. Signals from the sensor are interpreted by algorithms whose predictions are informed by aggregated outcomes data.

In 2004, the American and Israeli scientists founded Waltham, Mass.-based EarlySense. But consumers weren't buying the product. So they refocused on hospitals, basing their pitch on patient safety, staff efficiency, quality management and reduced alarm fatigue.

Halperin, the privately held firm's CEO, said the big opportunity is in medical-surgical units, where patients are not continuously monitored.

Designing the sensor so it does not have to be in contact with the patient's body eliminates a lot of staff work in setting up the monitors and gives patients greater comfort and freedom of movement, he said. And unlike with sensors that attach to the patient, hospital staffers don't have to worry about the monitor falling off. That means fewer false alarms and hence less alarm fatigue, a major concern for safety experts. The Joint Commission named alarm fatigue as one of its top issues for 2014.

The EarlySense system allows for personalization of detection and prediction of patient-safety and medical problems. It can be tailored for each patient based on movement history, allowing staff to get to patients' bedside before they try to get up from their bed.

It alerts nurses via large screens at the unit's central display station as well as on handheld devices. And it documents individual and team response times, serving as a management and quality assurance tool.

EarlySense's monitors are used by some hospitals in several big systems including Partners HealthCare, Dignity Healthcare and the Veterans Affairs Department.

The firm reported a 100% leap in revenue from 2013 to 2014. It also recently received a $20 million round of funding, led by Samsung's venture capital arm.

The system has shown some impressive early results. A March 2014 article in the American Journal of Medicine comparing results for 7,643 patients using the monitors in the California Hospital Medical Center's medical-surgical unit in Los Angeles with a control group of 5,329 patients found significant reductions in days spent in the ICU following a transfer, as well as in overall length of stay and code blue rates.

Gladys Castro, a nurse manager at California Hospital Medical Center, credits the EarlySense system for significant reductions in the hospital's rates of patient falls and pressure ulcers. When she started working at the hospital, there was an average of eight to 11 patient falls a month, she said. In the last monthly staff meeting, only four falls were reported.

The biggest challenge in implementing the system, she said, was training nurses to activate the system in the correct way. Different alarms are armed for different patients. So, for instance, nurses must remember to activate the fall alarm for patients at risk of falls. And they must integrate the sensors into their routine, making sure to press a button showing they responded to the alarm. The system enables her to better track nurse responses.

At Newton (Mass.)-Wellesley Hospital, Dr. Perry An, chief operating officer of the hospitalist division, said he encountered initial staff skepticism about the system. Previous monitors had produced too many false alarms. But acceptance of EarlySense has been better because when the system gives an alert, it's generally a reliable one.

His hospital is gathering data to evaluate the effectiveness of the system. Meanwhile, though, An said he often sees cases demonstrating its effectiveness. He cited a patient in his 60s whose breathing rate had decreased steadily following surgery. The system alerted doctors to the problem; they found the patient's slowed breathing was due to the opioid drug regimen he was placed on after surgery.

“Sensors need to be very reliable and valid,” he said.

Follow Darius Tahir on Twitter: @dariustahir