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Forget about calling the nurse. Patients now stay connected by wearing one – the Daily Bulletin

The BioButton monitoring device is used in dozens of hospitals that use artificial intelligence to analyze patients’ vital signs. (Phil Galewitz/KFF Health News/TNS)

Author: Phil Galewitz, KFF Health News

Patients admitted to Houston Methodist Hospital are given a monitoring device about the size of a half-dollar attached to their chests — an unwitting role in the growing use of artificial intelligence in health care.

The slim, battery-powered gadget, called the BioButton, records vital signs, including heart and respiratory rates, and then wirelessly transmits the readings to nurses in a 24-hour control room elsewhere in the hospital or in their homes. The device’s software uses artificial intelligence to analyze extensive data and detect signs of deterioration of the patient’s condition.

Hospital officials say that since its introduction last year, BioButton has improved care and reduced the burden on bedside nurses.

A nurse is virtually speaking with Donald Eustes, a patient at Houston Methodist Hospital, from the facility's virtual care center.  (Parts of this photo have been blurred to protect privacy.) (Phil Galewitz/KFF Health News/TNS)
A nurse is virtually speaking with Donald Eustes, a patient at Houston Methodist Hospital, from the facility’s virtual care center. (Parts of this photo have been blurred to protect privacy.) (Phil Galewitz/KFF Health News/TNS)

“Because we detect certain symptoms earlier, patients feel better because we don’t have to wait for the bedside team to notice something is wrong,” said Sarah Pletcher, system vice president at Houston Methodist.

But some nurses fear technology could replace them rather than support them – and harm patients. Houston Methodist, one of dozens of U.S. hospitals to use the device, is the first to use BioButton to monitor all patients except those in intensive care, Pletcher said.

“The hype around a lot of these devices is that they provide care at scale with lower labor costs,” said Michelle Mahon, a registered nurse and deputy director of National Nurses United, the largest labor union in the US. “This is a trend that we find disturbing,” she said.

Houston Methodist Hospital, located just a few miles south of downtown Houston, is located within a gigantic medical complex that includes several hospitals.  (Phil Galewitz/KFF Health News/TNS)
Houston Methodist Hospital, located just a few miles south of downtown Houston, is located within a gigantic medical complex that includes several hospitals. (Phil Galewitz/KFF Health News/TNS)

The introduction of BioButton is one of the latest examples of hospitals using technology to improve efficiency and address a nursing shortage that has existed for decades. However, this transition has raised its own concerns, including the use of artificial intelligence in the device; polls show the public is distrustful of health care providers who rely on them to care for patients.

In December 2022, the FDA cleared BioButton for use in adult patients who are not in intensive care. It is one of many artificial intelligence tools currently used by hospitals for tasks such as reading the results of imaging tests.

In 2023, President Joe Biden directed the Department of Health and Human Services to develop a plan to regulate artificial intelligence in hospitals, including: by collecting reports of patients harmed by its use.

The leader of the BioIntelliSense project, makers of the BioButton, said her device was a huge improvement over nurses entering the room every few hours to take vital signs. “With AI, you can now go from, ‘I wonder why this patient crashed,’ to, ‘I see an accident before it happens and intervene accordingly,’” said James Mault, CEO of Colorado-based Golden.

BioButton stays on the skin with adhesive, is waterproof and has a battery life of up to 30 days. The company says the device, which allows providers to quickly spot deteriorating health conditions by recording more than 1,000 measurements per patient per day, was used on more than 80,000 hospital patients nationwide last year.

Hospitals pay BioIntelliSense an annual subscription fee for devices and software.

A nurse in Houston Methodist Hospital's virtual intensive care unit monitors patients from afar.  Nurses can track dozens of patients using technology that helps them supplement bedside care.  (Phil Galewitz/KFF Health News/TNS)
A nurse in Houston Methodist Hospital’s virtual intensive care unit monitors patients from afar. Nurses can track dozens of patients using technology that helps them supplement bedside care. (Phil Galewitz/KFF Health News/TNS)

Houston Methodist officials did not disclose how much the hospital is paying for the technology, although Pletcher said it equates to less than a cup of coffee per patient per day.

For a hospital system that treats thousands of patients at a time – Houston Methodist has 2,653 non-ICU beds at eight Houston-area hospitals – such an investment could still translate into millions of dollars a year.

The hospital authorities claim that they have not made any changes in the nursing staff and have no such plans in connection with the implementation of BioButton.

On a recent morning, in a hospital control center that allows for virtual monitoring, about 15 nurses and technicians wearing scrubs sat in front of large monitors showing the health status of hundreds of patients they were assigned to monitor.

Sarah Pletcher, system vice president at Houston Methodist, stands in the 24-hour virtual intensive care unit where patients are monitored by nurses and technicians.  (Phil Galewitz/KFF Health News/TNS)
Sarah Pletcher, system vice president at Houston Methodist, stands in the 24-hour virtual intensive care unit where patients are monitored by nurses and technicians. (Phil Galewitz/KFF Health News/TNS)

A red checkmark next to the patient’s name signaled that the AI ​​software found readings that trended out of the norm. Employees could click on a patient’s medical record, showing the patient’s vital signs over time and other medical history. These virtual nurses, if you wish, can contact nurses on the floor by phone or email, and even connect directly to the patient’s room via video call.

Nutanben Gandhi, a technician who was monitoring 446 patients that morning, said that when she receives an alert, she checks the patient’s health chart to see if the anomaly can be easily explained by the patient’s condition or whether he needs help. to contact the nurses on the patient’s floor.

Often, the alert can be easily dismissed. But identifying signs of deteriorating health can be difficult, said Steve Klahn, clinical director of virtual medicine at Houston Methodist.

“We are looking for a needle in a haystack,” he said.

Donald Eustes, 65, was admitted to Houston Methodist in March for treatment of prostate cancer and has since been treated for a stroke. He likes to wear BioButton.

“You never know what might happen here, and having an extra set of eyes looking at you is a good thing,” he said from his hospital bed. After being told the device used artificial intelligence in Montgomery, Texas, a man said he had no problem with it helping his clinical team. “It sounds like a good use of artificial intelligence.”

Both patients and nurses benefit from remote monitoring such as BioButton, said Houston Methodist’s Pletcher.