Jay Alberts, PhD, Neuroscience and Biomedical Engineering and Technology Development and Robert Chatburn, MHHS, RRT-NPS, FAARC, Enterprise Program Manager of Respiratory Care Research at Cleveland Clinic and Professor at Lerner College, talk about a newly developed application that allows care providers to quickly adjust to the interfaces of unfamiliar ventilators.
Ventilator use varies widely for the staff. Can you tell me a little bit about that?
ALBERTS: Ventilators are almost like thinking about different makes of cars. You could have a Ford, Chevy, Honda, or Ferrari. Regardless of the make of the car, if you put it in D, everyone knows that’s drive and R is for reverse. That’s standardized across the vehicles regardless of the make. So, it’s a little different with ventilators. There are 38 different ventilator manufacturers and 400 plus models. They each have proprietary settings. So, imagine if you are used to working with the Honda and suddenly another ventilator comes in, and you’re not familiar with that. Trying to find those right settings can be time consuming and maybe problematic in terms of getting the right settings.
Was this slowing the staff down a little bit with so many different models? Was it a matter of there needing to be a consistent way to treat patients?
ALBERTS: Yes, exactly. As you mentioned, I think those are very important in terms of the consistency and ability to optimize staff time and effort. We were doing this really in anticipation of a situation where a group or a hospital system had to spend so much time setting these up. We’re trying to make it more efficient, and trying to optimize the people on the frontlines, the respiratory therapists, time so they can do the great work that they’re trained to do.
When it comes to COVID-19 and people in respiratory distress, time is important and life-saving, correct?
ALBERTS: Yes. I think time is important, and then also making sure that you have enough time to allocate to each patient. You only have a certain amount of time in the day, and if you spend that time in not the most optimal way because you’re having to learn these different settings, that reduces the time that you can treat patients. We’re trying to really provide the health care provider with some tool that will make their day a bit easier.
How long did it take to come up with the app? Was it already in development before COVID-19?
ALBERTS: Yes. A few years ago, we had talked to Rob Chatburn from Respiratory Institute and were looking for some really easy projects to do from an app perspective with some of the new people on my team. We connected with Rob and did this proof of concept. It was on the shelf for a couple of years because there wasn’t a need, per se. Then, as I was in some of these daily meetings regarding COVID-19 and talking about the influx of ventilators, it occurred to me that this could be an app that we should revive. So again, working with Rob Chatburn and other members of the clinical team, we revived it and turned it from a student project into a full-fledged development project. That took about a week for us to turn that around.
Describe for me, in layman’s terms, how the therapists are able to use it to be able to figure out the optimal way to use the ventilator in front of them.
ALBERTS: If, for example you’re used to a GE ventilator, a certain model, and then you now have a new model coming in from a different manufacturer, you can tap on a picture of that model that you’re familiar with and then map it to and tap on the picture of the new model. It will show you and provide you very simple terms of what the connection between the two would be in terms of how to program it and how to identify the proper settings. It’s a very easy application that tries to connect two dots. Normally, it would be a little bit more time consuming to connect those dots if you had to look at two different manuals provided by the manufacturers.
Has it rolled out to other hospital systems, other than Cleveland Clinic, because we are all in the same boat?
ALBERTS: It’s certainly live in the Cleveland Clinic, and we have pushed the app to Itunes App Store and Android. It’s freely available for anyone to download, and we’ve seen several downloads so far. I’m originally from a very small town in Iowa, and we talked about here that rural and underserved areas might be impacted because they’re getting new equipment in and things like that. If we can potentially help facilitate that and the operations of that equipment, I think that’s a fantastic win for us.
And, you put it on the shelf just because you were busy with other things?
ALBERTS: Yes. It was just a proof of concept. It’s not a big deal in the normal operations of the hospital because you typically have six ventilators and a couple respiratory therapists who know how to operate them. So, three years ago, this was an interesting thought project of, can we do it? It kept some students busy and gave them experience in the development side. But now, I think it’s turned into a technology-enabled solution that can help facilitate care and hopefully optimize care. And, at the end of the day will help save lives.
You mentioned some numbers in the beginning. How many makes and models of ventilators are there in it?
ALBERTS: The last count was 36 different manufacturers and about 480 different settings across those. So, you think you could do all this if you had all their manuals, but, think about your own different items that come into your own house. Do you still have the manual for your dishwasher? These things go missing. And then again, as they get shipped from or moved from hospital to hospital, that becomes an even bigger challenge.
Is there anything else you want people to know either about the pandemic that we’re in and the work that the frontline is doing, or about this app and the way it fits in context?
ALBERTS: Our overall goal here is really to help those people on the frontlines and to help them help patients. Our theme is how do we provide technology to enable providers, whether it’s in this pandemic or just regular clinical care? And, figuring out how we can provide technology to help facilitate care as opposed to having to babysit technology or adding another level of complexity to your daily activities.
Robert Chatburn, MHHS, RRT-NPS, FAARC, Enterprise Program Manager, Respiratory Care Research at Cleveland Clinic, and Professor at Lerner College
CHATBURN: This is basically a phone application that provides us the ability to look up, compare, contrast modes, and find which ones are the same and which ones are different independent of the names that the manufacturers have given. It’s very similar to a drug formulary in that respect.
CHATBURN: These people that are not familiar are going to be faced with using very complex machines with all this unfamiliar terminology, and that’s where the communication between the physician and the other healthcare provider becomes very critical. You want that simplified. You want that to be standardized as much as possible, and this application helps to do that.
CHATBURN: It’s critical now because of the COVID pandemic. The usage of mechanical ventilators has increased exponentially in a very short period of time. And therefore, the people that must use ventilators and understand how they operate have to come up to speed very quickly. So, it serves that need to help those caregivers meet that critical need.
CHATBURN: You type in the name of the mode, find what ventilators that has, find the generic name behind that, and then see it’s like this other mode that you are familiar with. Now, you’re in a comfort zone and feel confident that you’re able to carry forth the orders and provide for the patient’s needs in a way that everybody understands, and everybody agrees upon.
Interview conducted by Ivanhoe Broadcast News.
END OF INTERVIEW
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Cleveland Clinic
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Cleveland Clinic
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