Small device promises big fix In the future, abnormal heart rhythms could be controlled by a tiny device inserted directly into the heart, eliminating the wires that are attached to standard pacemakers and defibrillators. The device could also put an end to the invasive sur- gery needed to implant a traditional pacemaker or defibrillator. Aydin Babakhani, Ph.D., formerly of Rice Uni-

versity and now associate professor of electrical and computer engineering at the University of California at Los Angeles (UCLA), has been work- ing on this device for a year with Mehdi Razavi, M.D., director of clinical arrhythmia research and innovation at Texas Heart Institute (THI). “The ideal technology we will have will precisely

control the electrical pulse,” said Babakhani, who directs UCLA’s integrated sensors laboratory. “It is surprising that this has not been done in the last 50 years.” Traditional pacemakers and defibrillators are implanted near the heart. Pacemakers help control heart rhythms through electrical pulses from a wire lead that connects to the heart. Defibrillators also monitor heart rhythms, deliver- ing shocks when they sense an abnormality. The shocks are not only painful, but can be stressful to the patient. In contrast, the new battery-less pacemaker designed by Babakhani and Razavi—about the size of a dime—harvests energy wirelessly from microwaves transmitted by a battery pack that can be worn outside the body. The chip in the pacemaker is less than 4 millime-

ters wide, and pacing—the rhythm of contraction and relaxation in the heart—can be adjusted by increasing or decreasing the power transmitted to the receiving antenna in the chip. The new pacemaker provides solutions to many

of the complications associated with pacemakers and defibrillators, said Razavi, an associate profes- sor at Baylor College of Medicine. Some side effects of the wire leads include bleeding and infection. In addition, the continu- ous beating of the heart can cause the wire’s insulation to fail over time. Twenty percent of leads have issues after 20 years, Razavi said. Other recently introduced lead-less pacemakers

also reduce these complications, but they are unable to provide dual-chamber or biventricular pacing, which Babakhani and Razavi aim to do with their device. In addition, if a patient with the device ends

up in the intensive care unit, the external battery back could be placed up to 20 feet away and transmitted using telemetry. The new pacemaker also offers a different sort

of shock to the heart. When an ordinary cardiac defibrillator detects an abnormal heart rhythm, it shocks the heart in a painful way that Razavi describes as being hit with a two-by-four. The new technology will stimulate the heart with a lower voltage so the patient doesn’t even know it is happening.


How should providers pinpoint ROI, value? by Rick Dana Barlow


ot too long ago healthcare organi- zations considered extending be- yond bar coding to electronically track assets — people, including patients and staff, products and equipment — a luxury, a goal or even a dream. How quaint. Some might even classify it as short-sighted.

In today’s budget-conscious and eco- nomically stressed environment, howev- er, tracking assets represents a necessity that must happen. Bar coding remains a fundamental tool to match products and services to patients as well as reorder and restock supplies. But if you’re not using some type of real-time location system (RTLS) to move beyond line-of-sight recording, you’re behind the times, if not behind the 8-ball of clinical, financial and operational safety, security and serenity. Historically, healthcare organizations cast a wary eye toward adoption and implementation of any RTLS platform, regardless of modality, due in large part to the perceived higher net costs of mak- ing it happen, which includes the actual higher costs of the technology itself, as well as the training curve and behavioral modification necessary to upset the status quo that may have just became comfort- able with bar coding.

To promote the value of RTLS, manu-

facturers and first-moving providers embraced the return-on-investment the technology brought to their operations in terms of cost savings, efficiencies, process improvements and supply and service throughput and workflow visibility. “The ROI argument for RTLS is very strong,” assured Sagi Geva, Direc- tor, Acute Care Solutions, STANLEY Healthcare, Waltham, MA. “Hospitals often document savings that pay for the system in less than a year. Geva’s company, which is applying its AeroScout

Sagi Geva

RTLS to BD Alaris’ infusion pumps in a recent partnership, indicated that ROI for asset management use cases can focus on three different areas:


• Preventing the loss of assets, such as in- fusion pumps in the trash and telemetry packs in the laundry.

• Generating capital/rental cost savings by reducing purchases/rentals through higher and more efficient asset utiliza- tion rates.

• Making labor more efficient, which translates to higher productivity for biomed techs that handle equipment cleaning, preventive maintenance, re- pairs, recall management and updates; and for clinical users of that equipment. Geva cited a study that reported 85 per- cent of nurses spend 60 minutes or more per shift searching for equipment. That can equate to 72,000 hours per year in lost productivity at a 300-bed hospital, he added.

“Hospitals should expect a prospective RTLS vendor to provide them with a de- tailed ROI analysis for all three factors, and specify the investment and likely return for their implementation,” he said. RTLS can deliver accurate real-time visibility to resource locations and status, which improves communications and workflow according to Kevin Jackson, Chief Technologist, Versus Technol- ogy, a subsidiary of Midmark Corp., Traverse City, MI. Jackson further noted that facility staff can use measures, such as Search Time and Staff Productivity to determine a baseline ROI. “However, while these soft gains may improve staff satisfaction and pa- tient-caregiver interactions, solving equipment under-utilization issues is required to drive hard-dollar ROI,” Jackson continued. “For those charged with achieving measurable cost reduc- tions based on acceptable accounting practices, an Asset Management solution with PAR-Level visibility, management and informatics-driven operational intel- ligence will improve utilization rates and deliver ROI on measures such as Asset Utilization, Inventory Turns, Capital Expense, Service Expense, Device Recall

Kevin Jackson

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