Made in Pittsburgh: 5 Great Ideas
Modern-day creation in Pittsburgh doesn’t just involve physical products; we also have a knack for hatching new ideas that can solve problems in innovative, unexpected ways. These locally based thinkers are applying big thoughts to bigger problems.
(page 1 of 5)
The Idea: To solve a longstanding health-care dilemma with cutting-edge technology.
photos by Douglas Duerring
Pressure injuries — previously known as pressure ulcers and commonly referred to as bedsores — are a surprisingly common affliction. The painful and often serious condition develops through a lack of movement; when continuous pressure is put on an area of the skin over time (as can occur when someone is immobile in a hospital bed), bedsores develop at the point of pressure.
Pressure injuries affect more than 2.5 million adults each year in the United States; one study of their prevalence determined nearly 2 percent of all adults admitted to hospitals will develop a bedsore.
Yet the most common method for detecting pressure injuries — the industry standard, to date — can be ineffective, especially on those with darker skin.
The “blanching test” is a rudimentary check to see if an area is the potential site of a bedsore: A caregiver presses gently on the skin. If it’s healthy, it should briefly turn white and then quickly return to its normal shade. If it’s unhealthy, it will stay white. Unfortunately, the darker the skin — regardless of race — the more difficult it is to detect a change in hue.
Sanna Gaspard, Ph.D., became aware of the difficulties of pressure-injury detection (and the scope of the condition) while pursuing her doctorate in biomedical engineering at Carnegie Mellon University. “When I learned about the condition,” she says, “how prevalent it was — and also that it was preventable ... those factors really caught my attention.”
Furthermore, the lack of a reliable detection method came as a surprise. “I thought, ‘How useful could an approach be if it doesn’t work on a large segment of the population?’”
Gaspard began exploring the problem while earning degrees from CMU (a master’s in 2005 and a doctorate in 2011); simultaneously, bedsores were thrust back into focus for hospital systems. After 2008, Medicare and Medicaid stopped reimbursing hospitals for a number of conditions developed after a patient was admitted, including falls and trauma, certain surgical-site infections — and pressure injuries. Suddenly, administrators were more eager than ever to dramatically reduce the number of bedsores developed at their facilities.
“[The public] hadn’t truly ... considered that it was preventable,” Gaspard says. “It was assumed that when you went to the hospital, if you were there for too long, you would develop a bedsore.” While it’s nearly impossible to catch every pressure injury before it develops, she explains, “There are places that have zero occurrence of bedsores.”
As with many conditions, early detection is the key to prevention; the blanching test, though, remained woefully ineffective. While pursuing her doctorate, Gaspard formed Rubitection, a startup aiming to develop a better way to detect the formation of pressure injuries, saving hospitals time and money — and, more importantly, saving patients the pain and potential complications that can arise.
The result is the Rubitect Assessment System, a handheld device in the late stages of development. A caregiver holds the probe against the surface of the skin in a potential problem area, and the device takes measurements related to skin health. Additional results, displayed on a companion app, can indicate whether a pressure injury is beginning to form (or is already present).
In essence, the Rubitect Assessment System performs the same function as the blanching test — with pinpoint accuracy and little risk of human error, regardless of the patient’s skin tone.
“Our advantage ... is having a system that is an extension of the clinical standard — so we’re not going to be asking them to do anything new,” Gaspard says. “We’re just asking them to use a better measurement tool to do the same thing they’ve been doing.”
A long-term goal, Gaspard says, is gradually establishing the Rubitect Assessment System as the clinical standard; in the meantime, Rubitection’s task is to further refine the device and demonstrate to hospitals, nursing homes and other facilities that it is the most cost-effective, accurate way to treat the problem. (A handful of competing devices are also under development, though none operate in the exact way that the Rubitect Assessment System does.)
And keeping the device cost-effective is not simply a matter of appealing to hospitals, Gaspard says; by developing a device that won’t be prohibitively expensive, the potential for the Rubitect Assessment System to prevent bedsores grows exponentially.
“Not just in hospitals, but also in the nursing home,” Gaspard says. “Not just in the U.S., but also through clinics [around the world] by supporting low-cost tools for providing better care.
“I selected this project as my Ph.D. work because I thought it was an area where technology could save a lot of lives.”