In healthcare, innovative and lifesaving technology is unavoidable—it’s seemingly everywhere. Patient-provider technology is rapidly evolving into a seamless communication stream that connects patient with caregiver, establishing unrelenting ‘big data’ for clinical decision support.  EHR systems such as Cerner and Epic, robots that perform surgery, smart and wireless IV pumps and even robots roaming the hallways of our hospitals delivering food and supplies! How could there possibly be a patient, or even worse still, a group of the most vulnerable patients in our hospitals that are not well-served by technology? How is it possible that a group of patients is completely let down and shunned by lack of innovation? Why were these patients and the caregivers that provide for them left behind in the technological revolution designed to improve entire healthcare populations?

Let’s take a minute to examine the details and the scope of this seemingly unbelievable situation. In our nation’s hospitals, roughly 3.9 million patients per year end up in our ICU’s in a non-verbal, non-mobile state¹. These patients cannot summon a caregiver, and even if they could – they couldn’t communicate with their caregiver to explain why they’re reaching out to them. These non-verbal patients are at a three times greater risk of a preventable adverse event than patients that can communicate with their caregivers². This issue costs our hospitals nearly $29 billion per year. Several studies examining patient-provider communication have indicated that the quality of the communication played a significant role in medical outcomes and in both patient and caregiver satisfaction^3-6.

Current hospital-based solutions used to communicate with non-verbal, non-mobile patients is straight out of the 18^th century. However, there is no one to blame here–this is not hospital leadership’s fault. Why? Because hospital providers are using what is most readily available to them: lip-reading, patient scribbling, laminated paper-based communications boards, etc. Technology born of last century.

If patient empowerment is truly the future of healthcare—how do we include the non-verbal, non-communicative patient in this promising future if current standard communication protocols in our nation’s hospitals leave them feeling frustrated, forgotten and without a voice? Voxello has a solution that brings these patients into the 21^st century of patient empowerment and communication directly impacting patient outcomes and provider stress with the noddle® technology that literally gives these patients a voice and empowers them to be active participants in their own care. We invite you learn more on our website. 

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On average every year hospitalized patients in the US experience almost 3 million preventable adverse events such as adverse drug reactions, falls, pressure ulcers and ventilator-associated pneumonia. The total cost to the US health system of treating these adverse events is in excess of $29 billion. Due to the regulatory shift towards quality and accountability, these are costs that hospitals must absorb. Hospital barriers to communication and poor patient-provider communication put individuals at increased risk of experiencing preventable adverse medical outcomes and unnecessary additional staff and patient stress.

To address the communication needs of the widest range of patients, Voxello continues to develop technology to support patients who face both physical and cognitive barriers to effective communication. Individuals who have limited physical abilities are often unable to effectively summon help and communicate with caregivers. How do you communicate a potential adverse reaction to a medication if you cannot speak or move? Voxello addresses these communication barriers and by doing so hospitals can potentially save capital dollars by reducing their adverse event rates. Effective patient-provider communication reduces both patient and staff stress and can significantly move the needle on patient satisfaction. Improving patient-provider communication is at the core of the Voxello mission.

See our recently published analysis of the cost of communication barriers (Perspectives of the ASHA Special Interest Groups,  SIG 12, Vol. 3(Part 3), 2018).

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It’s no secret that patients who are cognitively impaired or who have Alzheimer’s or Alzheimer’s related dementias have a great deal of difficulty communicating with caregivers. They have difficulty in understanding what they are being told and may also be unable to effectively let caregivers know how they are feeling and what their needs are.

Hospitalizations can be very challenging for patients with dementia because of the change in environment as well as the change in daily activity schedule due to the medical interventions. These patients’ chronic difficulties with word finding, short-term memory and attention, that impact their ability to speak and to comprehend can become significantly greater as a function of increased stress and disorientation associated with their hospitalization. This makes it more difficult for them to effectively communicate with their nurses and other healthcare providers, rendering them more susceptible to preventable adverse events and delirium. Their inability to effectively communicate about their needs also contributes to their increased agitation and non-compliant behaviors, which in turn requires increased use of sedation and increased risk of delirium.

Voxello has received an additional grant from the National Institute of Nursing Research (NIH) to expand their noddle-chat platform (communication software that enables patients with significant communication barriers the ability to actively engage with a  provider) so that it can also be used to support the communication needs of patients with Alzheimer’s Dementia and other patients who are cognitively impaired.

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Voxello and its clinical partners will be at ATIA in 2019 and will have two presentations on the docket.

The first will highlight Voxello’s newest sensor, the min-mo (patent pending). Voxello, with support from the NIH-NINR, has developed the min-mo sensor that uses motion-sensing technology to detect a wide range of small intentional gestures (e.g. head nod, shoulder shrug, wrist roll). It can be used in a plug-and-play mode or can learn to recognize a patient’s particular gesture. The sensor is designed to be directly mounted to the patient so that patients can, regardless of their position in bed, be able to use the noddle to activate the nurse call system and control the noddle-chat communication tablet with speech generation. With the addition of this sensor, Voxello has expanded the range of patients that can more effectively summon their nurses providing greatly enhanced communication and participation in their care.

The second presentation showcases a series of case studies at the University of Wisconsin Hospitals and Clinics following implementation of the noddle® and the noddle-chat communication device for patients with complex communication needs.  While the use of augmentative and alternative communication (AAC) strategies with outpatient populations is well established, it is not yet the standard of care for patients facing acute barriers to communication during a hospitalization. The presentation will describe the system barriers that must be overcome to incorporate AAC technology into clinical practice.  The presented cases will highlight the need for interprofessional practice and describe the implementation strategies and ongoing problem-solving needed to meet the communication needs of hospitalized patients.

You can also see the latest Voxello technology at the ATIA conference. 

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