A startup called IntelligentM wants to make hospitals healthier by encouraging workers to clean their hands properly. Its solution is a bracelet that vibrates when the wearer has scrubbed sufficiently, giving employees a way to check their habits and letting employers know who is and isn’t doing things right.
Some 100,000 people a year in the United States alone die because of infections that arise from hospital visits, according to the Centers for Disease Control and Prevention, and a lot of these infections occur because doctors, nurses, and technicians don’t wash well enough. The problem has garnered more attention lately, in part because Medicare and other payers have stopped reimbursing hospitals for expenses related to treating hospital-acquired infections.
Currently, compliance with hand-washing standards is monitored mostly by supposedly secret observers who watch hospital employees as they work. “People are aware that they are being monitored and change their behavior based on that fact,” says Polly Trexler, associate director of hospital epidemiology and infection control at the Johns Hopkins Hospital. But this type of monitoring is labor intensive and typically happens only during the day, says Trexler.
Worse, studies find that hospital works meet proper standards around half the time or less. IntelligentM is just one of many companies trying to address this problem with technology; other solutions include dispensers that measure the amount of liquid used, chemical sensors that sniff out the presence of soap or sanitizer, and RFID-based systems that know the location of each cleaning station and whether a hospital worker has been there.
“Everybody is trying to solve the same problem,” says Brent Nibarger, chief client officer of BioVigil, a company developing a chemical-sensing monitor that can detect soap and alcohol-based sanitizers on workers’ hands. The challenge is to develop a cost-effective system that’s suited to the pace of clinical work and is not too complex to set up or use, he says.
IntelligentM’s wristband reads RFID tags on hand-washing and sanitizing stations. An accelerometer can detect how long an employee spends washing; the wristband buzzes once if it’s done correctly and three times if it’s not.
“Over the last two years, we have developed a technology that allows us to alert health-care workers on the spot if they aren’t washing or sanitizing according to the [Centers for Disease Control] specifications,” says IntelligentM president Seth Freedman.
Because RFID tags are also placed outside patients’ rooms and on some equipment, Freedman says, the system alerts health-care workers to clean their hands before doing a procedure that carries a high infection risk, such as inserting a catheter.
It also collects data from the bracelets through a microUSB connection at the end of each shift, which gives hospital epidemiologists a chance to see how each employee is doing.
The RFID reader for such a system needs to be very fast, says Trexler, whose hospital has tested another RFID system and found it too slow to notice when some employees grabbed a quick squirt of sanitizer as they zoomed on to the next patient. She likes the idea that the wristband provides feedback to employees, but she wonders if the bracelet itself could interfere with good hygiene. “A lot of people wash halfway up their arm,” she says. Still, a successful system could provide a lot of valuable information, especially around the clock, she believes: “The 24/7 aspect is fantastic, and I think it is going to be very important to help drive change.”
A hospital in Sarasota, Florida, began using the IntelligentM system in December 2012, and recently the company gained two more customers in the state. Although the company’s initial focus is on health care, it is also considering using its technology in food service and in soaps that can teach kids proper hand-washing techniques.
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