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.
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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 devices software uses AI to analyze the voluminous data and detect signs a patients 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 dont 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 professions 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 devices use of AI; polls show the public is wary of health providers relying on it for patient care. The BioButton, a monitoring device, is being used in dozens of hospitals employing artificial intelligence to analyze patients vital signs. (Phil Galewitz/KFF Health News) Houston Methodist Hospital, just a few miles south of downtown Houston, is located amid a giant medical complex that includes several hospitals. (Phil Galewitz/KFF Health News)
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. Email Sign-Up
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Hospital officials say they have not made any changes in nurse staffing and have no plans to because of implementing the BioButton.
Inside the hospitals 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 patients name signaled the AI software had found readings trending outside normal. Staff members could click into a patients 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 patients 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 patients health record to see if the anomaly can be easily explained by something in the patients condition or if she needs to contact nurses on the patients floor.
Oftentimes an alert can be easily dismissed. But identifying signs of deteriorating health can be tough, said Steve Klahn, Houston Methodists 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. A nurse inside Houston Methodist Hospitals 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) Sarah Pletcher, system vice president at Houston Methodist, stands inside the hospitals 24-hour virtual intensive care unit where patients are monitored by nurses and technicians. (Phil Galewitz/KFF Health News)
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. 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.(Phil Galewitz/KFF Health News)
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 nt 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.
Phil Galewitz: pgalewitz@kff.org, @philgalewitz Related Topics States Colorado Health IT Hospitals Nurses Texas Contact Us Submit a Story Tip