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#WhyIMake: Helping Diabetics Stay Safe & Healthy

By Ernesto Holguin | 03/13/2018

Ernesto Holguin is a 2017 Infy Maker award winner based in El Paso, TX and a member of Makernurse from MIT. His twenty-two years as a nurse working with thousands of diabetic patients led to him prototyping a telehealth device for diabetic patients.

According to the CDC, more than 100 million US adults are now living with diabetes or prediabetes and each year an estimated 1.5 million new cases of adult diabetes are diagnosed. A diabetic patient can develop painless foot sores (diabetic ulcers) which occur 25% of the time. Foot ulcers are a common reason for hospital stays and take weeks (or months) to heal. Per a Medscape February 2018 article, the cost of post-ulcer care and medical intervention is adding a staggering $9-13 billion to the annual cost of diabetes treatment.

As a nurse, it is my job to show each patient how to examine and monitor healing ulcers and prevent future ones. This self-monitoring procedure is best described as attempting to balance on one foot, while simultaneously raising and examining the other foot reflected in a mirror placed on the floor. And then repeat this inspection for the opposite foot. And do this inspection at least once a day. It is unrealistic for an older patient to successfully perform this antiquated procedure. In most cases, my patient has poor vision, limited mobility, little or no family support, and unreliable transportation.

What prompted me to create the Drying and Inspection prototype was to innovate this self-monitoring process and make it easier and safer for the patient to successfully do this as part of their regular bathing routine. The prototype includes a base platform, a monitor, a long support handle, a camera, and an air dryer. The patient can either stand on the base or wheel up to it in a wheelchair.

A camera located at the base of platform captures foot images which are displayed on the monitor. A blower assembly forces air through the base platform drying the patient’s feet speciﬁcally in-between the toes with complete drying taking 1-2 minutes. All information is transmitted to the Primary Clinician’s office for daily review. Early intervention will take place if warranted oppose to waiting 30 or more days for the next follow up appointment. Thus, saving worsening infections, amputation and deaths.

The Infy Maker Award prize money received in 2017 helped me pay off most of a patent loan and I also invested in creating an actual working prototype. I started OTEN Medical LLC company in December 2017 and am developing a medical grade product for extensive remote patient monitoring through the wireless transmission of high-quality feet images, vitals, and glucose levels—all captured by the OTEN Medical Device.

In addition to the Infy Maker award, I also received recognition in Texas in 2017: Medical Center of the Americas Foundation proof of concept winner in July; a Houston Makerfaire merit award winner in October; I was featured in an October 30th article in El Paso, Inc. magazine.

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The MagPi Magazine: DIABETIC FOOT HEALTH WITH RASPBERRY PI

AUGUST, 2018, ISSUE#78, PAGE 88

While we’ve seen the Raspberry Pi used in medical applications before, it’s still quite rare. We met Ernesto Holguin from El Paso, Texas at the Houston Maker Faire, showing off his fantastic new project, and decided we had to talk to him about how he too is improving medical technology with the humble Pi.

What is it you’ve made with a Raspberry Pi? I invented a device that is dedicated to the telemonitoring and drying of diabetic foot ulcers.The patented apparatus – US Patent #9 775 474: magpi.cc/vhseyj – utilises the Raspberry Pi 3 to inspect, dry, take images, and communicate other vital sign information with clinicians and family members. It uses a Python-programmed application, forming a team approach to that person’s care. One in five diabetic patients visit a clinic/hospital for treatment of an ulcerative wound. From the time of discharge till the next clinician’s visit, 30+ days on average, a patient’s affected skin is not monitored, resulting in worsening ulcers/wounds, leading to amputations and deaths. Worsening of wounds primarily occurs due to the improper monitoring and drying in-between the toes. The diabetic population suffers from high risk for infection, poor eyesight, and limited mobility. Limited family support and transportation adds to improper healing. My device would allow for patients to daily inspect their own feet … with the clinician overseeing the progress, from the comfort of the patient’s home. Earlier medical intervention will be established, leading to better patient outcomes.

Why the Raspberry Pi? The Raspberry Pi computer is small, fast, efficient, and is priced at an optimal value. It is pliable, allowing other applications to be easily added. I am a proud member of MakerNurse Community from MIT and they were instrumental in applying the Raspberry Pi with Python coding to my diabetic device.

How well does it perform? The Raspberry Pi has worked consistently well while I have presented my device in Maker Faire New York 2017, Maker Faire Houston 2017, University of Texas in El Paso (UTEP) SIAM Symposium 2017, SXSW 2018, UTEP’s System

Engineering Symposium 2018, and Mini-Maker Faire Galveston 2018. It has gone through multiple airports, mail deliveries, and vigorous car trips. The Raspberry Pi continues to perform true to its original intentions.

How else do you think the Raspberry Pi can be used in medical tech? The Raspberry Pi can be utilized in any upcoming medical device inventions in which the reliability of the system will be instrumental. The low-priced Pi will reduce the cost of production and make it more affordable to consumers.

Any future project plans using a Pi? Yes! I have five more projects lined up where I will be utilizing the Raspberry Pi. They’re projects that will be used to improve the monitoring of patients and water conservation. Technology is always advancing and making it more affordable to start projects people only dreamed of in the past. The Raspberry Pi is leading this new wave and has catapulted the idea I had in 2003 to a reality.

https://www.raspberrypi.org/magpi-issues/MagPi72.pdf

About Us

Mission Statement

To improve every diabetic's lives by allowing them to live longer and healthier. Utilizing our affordable medical device will allow for an improved medical outcome.

Diabetes In The U.S.

More than 100 million U.S. adults are now living with diabetes or pre-diabetes.
Diabetic foot ulcers are estimated to occur in up to 25% of patients with diabetes.
Ulcer care adds around US $9 to $13 billion to the direct yearly costs associated with diabetes itself.

Drying And Inspection Apparatus For Diabetics

The Drying and Inspcetion Apparatus improves the antiquated way of inspecting feet and better monitoring of ulcer healing.
Doctors ask patients to hover their feet over a mirror placed on the floor for inspection. This is dangerous when combining vision and balance problems diabetics have.
The apparatus is a device that enables the patient to properly dry foot ulcers/wounds and sends daily images with vital signs information to doctor offices without the patient leaving home.
Patients usually wait 30 or more days to visit a doctor after initial foot ulcer/wound treatment. Monitoring during that time is crucial in the healing process.
If left untreated, foot ulcers can progressively lead to bone/tissue infection, amputation and death.

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