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By Dr. Rose Hedges, DNP, R.N.
Dec. 14, 2018
For many years, nurses have been tinkerers, creators who manipulate the materials they have in order to care for patients’ needs. This has simply been a part of the nursing role, perhaps not discussed in the limelight but always in the background. Today this role is evolving — creations that nurses make are moving to a scalable size. Nurses are stepping out of the shadows to not only create solutions for one patient but to create sharable solutions that all patients can benefit from. For example, Ernesto Holguin, BSN, R.N., CNN, has created the DiFoBod (Diabetic Foot Body Center), a homecare device that assists patients in drying and inspecting their feet for ulcers, all while transmitting this information directly to the patient’s provider. The interoperability of this device assists patients in avoiding ulcerations, infections and hospital readmissions.
In a recent interview, Holguin shared his story on how he arrived at the decision to create the DiFoBod.
Continue reading at MedTechBoston.com
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.
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.
By David Crowder / El Paso Inc. staff writer
Nov 25, 2018
Eight companies, including four from Mexico, along with 40 budding innovators are part of two revamped business programs going on at the Medical Center of the Americas Innovation Center.
The products the group is working on include a solution to the inconvenient blood donation process in Mexico, an app to help improve people’s cognitive abilities, software for the diagnosis of asthma in children and the 3D printing of medical devices.
It’s the second year for the program at the MCA’s headquarters in the eye-catching Cardwell Collaborative building, which rises next to Interstate 10 just past the Reynolds exit on the edge of the MCA campus.
This year, eight new startup companies won places in a program where they’ll learn about running a business, originating and naming products and getting them on the market, Fuchsberg said.
“We also have a second program called the Innovator Program, and we have 28 people in there – not companies,” he said. “To say there was an appetite for this is an understatement.”
They meet for an hour on Thursday nights at the Collaborative.
“The turnout every week is awesome,” Fuchsberg said. “We’ve got a lot of people working on cool, impactful things. It’s also great to have everybody in the same place at the same time.”
But the demands of the class and the assignments are pretty rigorous, requiring commitment from people who may already have a full-time job.
“We already had one team drop out from the startup program,” he said.
At least six of the 28 innovator participants are women, and 16 of the products the group is working on are medically related, involving telemedicine or apps for smartphones and other devices.
A UTEP associate professor of psychology, Craig Field, is in the innovator class and working on an app to help Hispanic binge drinkers cut back.
“Every faculty member at UTEP is encouraged to pursue entrepreneurial efforts that are related to their work and research,” he said. “So, I’m in the innovation program to learn more about business and setting up a business.”
Field didn’t want to discuss details about how his app would work because he doesn’t want to give away his idea.
“I intend to pursue federal funding to develop it and help the business get to the point where it can be productive,” he said.
The year-long program and classes are free to participants, but getting in is competitive.
It’s all headed to a Demo Day next summer when participants will present their plans and products to potential investors and funders of the program for money and support to start companies or develop their products.
While classes for both groups are restricted to the participants who won admission, the Innovation Center offers a free night class that’s open to the public on one Thursday a month with a panel of local business people.
They come with ideas, answer questions and offer real-world advice.
The thrust of the comments from the panel at the last public session was to look for professional advice before naming a company or a new product – because you only get one chance to get it right the first time.
“Any name you come up with is going to be a bad name,” said Manny Rodriguez with Culture Span Marketing. “You’ve got to shop it around, and you don’t want to have to reel it back.”
Ray Sanchez with Ghostlight Creative recalled one company started by two men, Samuel and Max, who named their company S&M and regretted it.
“We changed their name,” he said.
One of the stars to come out of the Innovation Center’s first class is Ernesto Holguin, the coordinating dialysis nurse at Las Palmas Medical Center, who won second place at a pitch competition two months ago and picked up a $15,000 cash award.
By Aaron Montes / El Paso Inc. reporter Oct 30, 2017
El Paso-based technology startup companies will call the Cardwell Collaborative in Central El Paso home for the next six months as they sharpen their business plans and prepare their products to sell on the market.
The Medical Center of the Americas Foundation selected 11 teams out of 25 applicants to participate in a new technology “proof-of-concept” competition. It is part of a broader effort by city leaders to create more high-skill, high-wage jobs in the region by cultivating innovative growth companies.
The competition’s objectives are “to create new high-tech businesses focused on developing technologies born in our region and to help the technologies born in the labs in our region get out of the labs and into the marketplace,” said Jeff Fuchsberg, director of intellectual property and innovation projects at the MCA Foundation.
Continue reading at El Paso Inc.
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1-Rice, J. B., U. Desai, and A. K. Cumming et al. 2014. Burden of diabetic foot ulcers for Medicare and private insurers. Diabetes Care 37 (3):651-8.
2- David G. Armstrong, D.P.M., M.D., Ph.D., Andrew J.M. Boulton, M.D., and Sicco A. Bus, Ph.D. 2017. Diabetic Foot Ulcers and Their Recurrence. New England Journal of Medicine 376:24