Forget Ringing the Button for the Nurse. Patients Now Stay Connected by Wearing One.
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HOUSTON — Patients admitted to Houston Methodist Hospital get a monitoring device about the size of a half-dollar affixed to their chest — and an unwitting role in the expanding use of artificial intelligence in health care.
The slender, battery-powered gadget, called a BioButton, records vital signs including heart and breathing rates, then wirelessly sends the readings to nurses sitting in a 24-hour control room elsewhere in the hospital or in their homes. The device’s software uses AI to analyze the voluminous data and detect signs a patient’s condition is deteriorating.
Hospital officials say the BioButton has improved care and reduced the workload of bedside nurses since its rollout last year.
“Because we catch things earlier, patients are doing better, as we don’t have to wait for the bedside team to notice if something is going wrong,” said Sarah Pletcher, system vice president at Houston Methodist.
But some nurses fear the technology could wind up replacing them rather than supporting them — and harming patients. Houston Methodist, one of dozens of U.S. hospitals to employ the device, is the first to use the BioButton to monitor all patients except those in intensive care, Pletcher said.
“The hype around a lot of these devices is they provide care at scale for less labor costs,” said Michelle Mahon, a registered nurse and an assistant director of National Nurses United, the profession’s largest U.S. union. “This is a trend that we find disturbing,” she said.
The rollout of BioButton is among the latest examples of hospitals deploying technology to improve efficiency and address a decades-old nursing shortage. But that transition has raised its own concerns, including about the device’s use of AI; polls show the public is wary of health providers relying on it for patient care.
In December 2022 the FDA cleared the BioButton for use in adult patients who are not in critical care. It is one of many AI tools now used by hospitals for tasks like reading diagnostic imaging results.
In 2023, President Joe Biden directed the Department of Health and Human Services to develop a plan to regulate AI in hospitals, including by collecting reports of patients harmed by its use.
The leader of BioIntelliSense, which developed the BioButton, said its device is a huge advance compared with nurses walking into a room every few hours to measure vital signs. “With AI, you now move from ‘I wonder why this patient crashed’ to ‘I can see this crash coming before it happens and intervene appropriately,’” said James Mault, CEO of the Golden, Colorado-based company.
The BioButton stays on the skin with an adhesive, is waterproof, and has up to a 30-day battery life. The company says the device — which allows providers to quickly notice deteriorating health by recording more than 1,000 measurements a day per patient — has been used on more than 80,000 hospital patients nationwide in the past year.
Hospitals pay BioIntelliSense an annual subscription fee for the devices and software.
Houston Methodist officials would not reveal how much the hospital pays for the technology, though Pletcher said it equates to less than a cup of coffee a day per patient.
For a hospital system that treats thousands of patients at a time — Houston Methodist has 2,653 non-ICU beds at its eight Houston-area hospitals — such an investment could still translate to millions of dollars a year.
Hospital officials say they have not made any changes in nurse staffing and have no plans to because of implementing the BioButton.
Inside the hospital’s control center for virtual monitoring on a recent morning, about 15 nurses and technicians dressed in scrubs sat in front of large monitors showing the health status of hundreds of patients they were assigned to monitor.
A red checkmark next to a patient’s name signaled the AI software had found readings trending outside normal. Staff members could click into a patient’s medical record, showing patients’ vital signs over time and other medical history. These virtual nurses, if you will, could contact nurses on the floor by phone or email, or even dial directly into the patient’s room via video call.
Nutanben Gandhi, a technician who was watching 446 patients on her monitor that morning, said that when she gets an alert, she looks at the patient’s health record to see if the anomaly can be easily explained by something in the patient’s condition or if she needs to contact nurses on the patient’s floor.
Oftentimes an alert can be easily dismissed. But identifying signs of deteriorating health can be tough, said Steve Klahn, Houston Methodist’s clinical director of virtual medicine.
“We are looking for a needle in a haystack,” he said.
Donald Eustes, 65, was admitted to Houston Methodist in March for prostate cancer treatment and has since been treated for a stroke. He is happy to wear the BioButton.
“You never know what can 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 uses AI, the Montgomery, Texas, man said he has no problem with its helping his clinical team. “This sounds like a good use of artificial intelligence.”
Patients and nurses alike benefit from remote monitoring like the BioButton, said Pletcher of Houston Methodist.
The hospital has placed small cameras and microphones inside all patient rooms enabling nurses outside to communicate with patients and perform tasks such as helping with patient admissions and discharge instructions. Patients can include family members on the remote calls with nurses or a doctor, she said.
Virtual technology frees up on-duty nurses to provide more hands-on help, such as starting an intravenous line, Pletcher said. With the BioButton, nurses can wait to take routine vital signs every eight hours instead of every four, she said.
Pletcher said the device reduces nurses’ stress in monitoring patients and allows some to work more flexible hours because virtual care can be done from home rather than coming to the hospital. Ultimately it helps retain nurses, not drive them away, she said.
Sheeba Roy, a nurse manager at Houston Methodist, said some members of the nursing staff were nervous about relying on the device and not checking patients’ vital signs as often themselves. But testing has shown the device provides accurate information.
“After we implemented it, the staff loves it,” Roy said.
Serena Bumpus, chief executive officer of the Texas Nurses Association, said her concern with any technology is that it can be more burdensome on nurses and take away time with patients.
“We have to be hypervigilant in ensuring that we are not leaning on this to replace the ability of nurses to critically think and assess patients and validate what this device is telling us is true,” Bumpus said.
Houston Methodist this year plans to send the BioButton home with patients so the hospital can better track their progress in the weeks after discharge, measuring the quality of their sleep and checking their gait.
“We are not going to need less nurses in health care, but we have limited resources and we have to use those as thoughtfully as we can,” Pletcher said. “Looking at projected demand and seeing the supply we have coming, we will not have enough to meet demand, so anything we can do to give time back to nurses is a good thing.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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The Lies That Depression Tells Us
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In this short (6:42) video, psychiatrist Dr. Tracey Marks talks about 8 commonly-believed lies that depression often tells us. They are:
- “I don’t measure up”
- “No one cares about me”
- “I’m better off alone”
- “No one understands”
- “It’s all my fault”
- “I have no reason to be depressed”
- “Nothing matters”
- “I’ll never get better”
Some of these can be reinforced by people around us; it’s easy to believe that “no one understands” if for example the few people we interact with the most don’t understand, or that “I have no reason to be depressed” if people try to cheer you up by pointing out your many good fortunes.
The reality, of course, is that depression is a large, complex, and many-headed beast, with firm roots in neurobiology.
There are things we can do that may ameliorate it… But they also may not, and sometimes life is just going to suck for a while. That doesn’t mean we should give up (that, too, is depression lying to us, per “I’ll never get better”), but it does mean that we should not be so hard on ourselves for not having “walked it off” the way one might “just walk off” a broken leg.
Oh, you can’t “just walk off” a broken leg? Well then, perhaps it’s not surprising if we don’t “just think off” a broken brain, either. The brain can rebuild itself, but that’s a slow process, so buckle in:
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Want to know more?
You might like these previous articles of ours about depression (managing it, and overcoming it):
- The Mental Health First-Aid That You’ll Hopefully Never Need
- Behavioral Activation Against Depression & Anxiety
- The Easiest Way To Take Up Journaling
- Antidepressants: Personalization Is Key!
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This Is When Your Muscles Are Strongest
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Dr. Karyn Esser is a professor in the Department of Physiology and Aging at the University of Florida, where she’s also the co-director of the University of Florida Older Americans Independence Center, and she has insights to share on when it’s best to exercise:
It’s 4–5pm
Surprise, no clickbait or burying the lede!
This goes regardless of age or sex, but as we get older, it’s common for our circadian rhythm to weaken, which may result in a tendency to fluctuate a bit more.
However, since it’s healthy to keep one’s circadian rhythm as stable as reasonably possible, this is a good reason to try to keep our main exercise focused around that time of day, as it provides a sort of “anchor point” for the rest of our day to attach to, so that our body can know what time it is relative to that.
It’s also the most useful time of day to exercise, because most exercises give benefits proportional to progressive overloading, so training at our peak efficiency time will give the most efficient results. So much for those 5am runs!
On which note: while the title says “strongest” and the thumbnail has dumbbells, this does go for all different types of exercises that have been tested.
For more details on all of the above, enjoy:
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You might also like to read:
The Circadian Rhythm: Far More Than Most People Know
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Meals That Heal – by Dr. Carolyn Williams
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Inflammation is implicated as a contributory or casual factor in almost all chronic diseases (and still exacerbates the ones in which it’s not directly implicated causally), so if there’s one area of health to focus on with one’s diet, then reducing inflammation is a top candidate.
This book sets about doing exactly that.
You may be wondering whether, per the book’s subtitle, they can really all be done in 30 minutes or under. The answer is: no, not unless you have a team of sous-chefs to do all the prep work for you, and line up everything mise-en-place style for when you start the clock. If you do have that team of sous-chefs working for you, then you can probably do most of them in under 30 minutes. If you don’t have that team, then budget about an hour in total, sometimes less, sometimes more, depending on the recipe.
The recipes themselves are mostly Mediterranean-inspired, though you might want to do a few swaps where the author has oddly recommended using seed oils instead of olive oil, or plant milk in place of where she has used dairy milk in a couple of “recipes” for smoothies. You might also want to be a little more generous with the seasonings, if you’re anything like this reviewer.
Bottom line: if you’re looking for an anti-inflammatory starter cookbook, you could do worse than this. You could probably do better, too, such as starting with The Inflammation Spectrum – by Dr. Will Cole.
Alternatively, click here if you want to check out Meals That Heal, and dive straight in!
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The Metabolism Reset Diet – by Alan Christianson
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The liver is an incredible organ that does a very important job, but what’s not generally talked about is how we can help it… Beyond the obvious “try to not poison it too much with alcohol, tobacco, etc”. But what can we do that’s actually positive for it?
That’s what Alan Christianson offers in this book.
Now, usually when someone speaks of a “four week cleanse” as this book advertises on its front cover, it’s a lot of bunk. The liver cleanses itself, and the liver and kidneys between them (along with some other organs and processes) detoxify your body for you. No amount of celery juice will do that. However, this book does better than that:
What it’s about, is not really about trying to do a “detox” at all, so much as supporting your liver function by:
- Giving your liver what it needs to regenerate (mostly: protein)
- Not over-taxing your liver while it does so
The liver is a self-regenerating organ (the mythological story of Prometheus aside, here in real life it can regenerate up to 80% of itself, given the opportunity), so whatever the current state of your liver, it’s probably not too late to fix it.
Maybe you’ve been drinking a little too much, or maybe you’ve been taking some meds that have hobbled it a bit (some medications strain the liver rather), or maybe your diet hasn’t been great. Christianson invites you to draw a line under that, and move forwards:
The book gives an overview of the science involved, and explains about the liver’s role in metabolism (hence the promised weight loss benefits) and our dietary habits’ impact on liver function. This is about what we eat, and also about when we eat it, and how and when our body metabolizes that.
Christianson also provides meal ideas and recipes. If we’re honest (and we always are), the science/principles part of the book are worth a lot more than the meal-plan part of the book, though.
In short: a great book for understanding how the liver works and how we can help it do its job effectively.
Click here to check out “The Metabolism Reset Diet” on Amazon today!
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The voice in your head may help you recall and process words. But what if you don’t have one?
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Can you imagine hearing yourself speak? A voice inside your head – perhaps reciting a shopping list or a phone number? What would life be like if you couldn’t?
Some people, including me, cannot have imagined visual experiences. We cannot close our eyes and conjure an experience of seeing a loved one’s face, or imagine our lounge room layout – to consider if a new piece of furniture might fit in it. This is called “aphantasia”, from a Greek phrase where the “a” means without, and “phantasia” refers to an image. Colloquially, people like myself are often referred to as having a “blind mind”.
While most attention has been given to the inability to have imagined visual sensations, aphantasics can lack other imagined experiences. We might be unable to experience imagined tastes or smells. Some people cannot imagine hearing themselves speak.
A recent study has advanced our understanding of people who cannot imagine hearing their own internal monologue. Importantly, the authors have identified some tasks that such people are more likely to find challenging.
fizkes/Shutterstock What the study found
Researchers at the University of Copenhagen in Denmark and at the University of Wisconsin-Madison in the United States recruited 93 volunteers. They included 46 adults who reported low levels of inner speech and 47 who reported high levels.
Both groups were given challenging tasks: judging if the names of objects they had seen would rhyme and recalling words. The group without an inner monologue performed worse. But differences disappeared when everyone could say words aloud.
Importantly, people who reported less inner speech were not worse at all tasks. They could recall similar numbers of words when the words had a different appearance to one another. This negates any suggestion that aphants (people with aphantasia) simply weren’t trying or were less capable.
Hearing our own imagined voice may play an important role in word processing. sutadimages/Shutterstock A welcome validation
The study provides some welcome evidence for the lived experiences of some aphants, who are still often told their experiences are not different, but rather that they cannot describe their imagined experiences. Some people feel anxiety when they realise other people can have imagined experiences that they cannot. These feelings may be deepened when others assert they are merely confused or inarticulate.
In my own aphantasia research I have often quizzed crowds of people on their capacity to have imagined experiences.
Questions about the capacity to have imagined visual or audio sensations tend to be excitedly endorsed by a vast majority, but questions about imagined experiences of taste or smell seem to cause more confusion. Some people are adamant they can do this, including a colleague who says he can imagine what combinations of ingredients will taste like when cooked together. But other responses suggest subtypes of aphantasia may prove to be more common than we realise.
The authors of the recent study suggest the inability to imagine hearing yourself speak should be referred to as “anendophasia”, meaning without inner speech. Other authors had suggested anauralia (meaning without auditory imagery). Still other researchers have referred to all types of imagined sensation as being different types of “imagery”.
Having consistent names is important. It can help scientists “talk” to one another to compare findings. If different authors use different names, important evidence can be missed.
We’re starting to broaden our understanding of the senses and how we imagine them. Napat Chaichanasiri/Shutterstock We have more than 5 senses
Debate continues about how many senses humans have, but some scientists reasonably argue for a number greater than 20.
In addition to the five senses of sight, smell, taste, touch and hearing, lesser known senses include thermoception (our sense of heat) and proprioception (awareness of the positions of our body parts). Thanks to proprioception, most of us can close our eyes and touch the tip of our index finger to our nose. Thanks to our vestibular sense, we typically have a good idea of which way is up and can maintain balance.
It may be tempting to give a new name to each inability to have a given type of imagined sensation. But this could lead to confusion. Another approach would be to adapt phrases that are already widely used. People who are unable to have imagined sensations commonly refer to ourselves as “aphants”. This could be adapted with a prefix, such as “audio aphant”. Time will tell which approach is adopted by most researchers.
Why we should keep investigating
Regardless of the names we use, the study of multiple types of inability to have an imagined sensation is important. These investigations could reveal the essential processes in human brains that bring about a conscious experience of an imagined sensation.
In time, this will not only lead to a better understanding of the diversity of humans, but may help uncover how human brains can create any conscious sensation. This question – how and where our conscious feelings are generated – remains one of the great mysteries of science.
Derek Arnold, Professor, School of Psychology, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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5 Ways To Make Your Smoothie Blood Sugar Friendly (Avoid the Spike!)
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At 10almonds, we are often saying “eat whole fruit; don’t drink your calories”. Whole fruit is great for blood sugars; fruit juices and many smoothies on the other hand, not so much. Especially juices, being near-completely or perhaps even completely stripped of fiber, but even smoothies have had a lot of the fiber broken down and are still a liquid, meaning they are very quickly and easily digestible, and thus their sugars (whatever carbs are in there) can just zip straight into your veins.
However, there are ways to mitigate this…
Slow it down
The theme here is “give the digestive process something else to do”; some things are more quickly and easily digestible than others, and if it’s working on breaking down some of the slower things, it’s not waving sugars straight on through; they have to wait their turn.
To that end, recommendations include:
- Full-fat Greek yogurt which provides both protein and fat, helping to slow down the absorption of sugar. Always choose unsweetened versions to avoid added sugars, though!
- Coconut milk (canned) which is low in sugar and carbs, high in fat. This helps reduce blood sugar spikes, as she found through personal experimentation too.
- Avocado which is rich in healthy fats that help stabilize blood sugar. As a bonus, it blends well into smoothies without affecting the taste much.
- Coconut oil which contains medium-chain triglycerides (MCTs) that are quickly absorbed for energy without involving glucose, promoting fat-burning and reducing blood sugar spikes.
- Collagen powder which is a protein that helps lower blood sugar spikes while also supporting muscle growth, skin, and joints.
For more on all of these, enjoy:
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