It happens all too frequently: A patient goes to the hospital for treatment and ends up contracting a potentially deadly infection such as MRSA or C. difficile.
“When you start talking to people about these infections, almost everyone will say, ‘Oh yeah, I know someone who got that,’” said Dr. Mark Stibich, an infectious disease epidemiologist and visiting scientist at the MD Anderson Cancer Center in Houston. “But it may not always connect for them to link it back to the hospital — to know that this was a healthcare-associated infection.”
According to the Centers for Disease Control and Prevention, one in 25 patients in the U.S. contracts an infection from the hospital treating him or her. Nearly 100,000 people die from these healthcare-associated infections (HAIs) every year, about the same as the number of lives claimed annually by HIV, breast cancer and auto accidents combined.
It’s a problem that San Antonio–based Xenex is trying to change, with some help from the internet of things — defined as the interconnection of everyday objects using sensors, electronics and software that allow the objects to send and receive data.
The company, founded in Houston in 2009 by Stibich and his wife, fellow epidemiologist Dr. Julie Stachowiak, makes a robot that uses pulsed xenon ultraviolet light to disinfect rooms at healthcare facilities. These “lightstrike germ-zapping robots,” as the company calls them, are used to pick up the slack left over by traditional manual cleaning methods, which research has shown to be about 50 percent effective for high-touch surfaces.
“There are some really, really scary antibiotic-resistant organisms out there, and we’re seeing them pop up more and more [often],” Stibich said. “So preventing infections from happening in the first place is the best thing you can do.”
Hospital units using Xenex’s robots have reported between 50 and 100 percent decreases in their infection rates.
In 2011, MD Anderson released a study showing that, in a hospital room already cleaned by housekeepers, the robot was able to further reduce the amount of vancomycin-resistant enterococci to the point where it was eliminated. VRE are a type of bacteria that are resistant to many antibiotics,
Compared with the first half of 2017, when it had no robot, Hunterdon Healthcare in New Jersey said it saw a 76 percent decrease in C. diff infections after implementing the robot in the second half of 2017.
“It was a huge percent decrease in our number of cases,” said Lisa Rasimowicz, director of infection prevention at Hunterdon. “The unit has had zero infections so far this year.”
An important part of Xenex’s strategy to reduce HAIs has involved IoT. About three years ago, all of the company’s robots were equipped with technology that enabled them automatically to send hospitals data about when, where, and how long the robot was used. The robot previously required more manual data logging, which isn’t always reliable.
Though the company doesn’t have data on exactly how much more effective the robots are with IoT technology, Stibich said that, anecdotally, “It’s a night-and-day [before-and-after] difference.”
“The real-time data is great because we can drill down to the user level,” Stibich said. “So if we see that, on Wednesday afternoons, the robot seems to be taking longer to get to rooms than it should, we can look up who the operator is on Wednesday afternoons and figure out why that’s happening.”
Rasimowicz said this is one of the things she really likes about the robots.
“I can see whether or not employees covered all of our rooms,” Rasimowicz said. “And that’s been really great.”
The company’s robots are used in about 400 hospitals. Xenex CEO Morris Miller says it hopes to grow that number.
“In the U.S., somewhere between 300,000 and 500,000 rooms are discharged every day; we want to be disinfecting all of these rooms,” Miller said.
Though the robot carries a $100,000 price tag, Miller said that Xenex won’t send hospitals a bill unless they see at least a 10 percent reduction in their infection rate. And that point, Miller said, the robot has paid for itself.
“You only have to prevent 7 percent of your infections for the robot to pay for itself,” Miller said.
HAIs have been estimated to cost the healthcare industry roughly $30 billion a year. The Association for Professionals in Infection Control and Epidemiology estimates that HAIs increase patient care costs by $4.5 billion to $5.7 billion per year.
Stibich believes the cost to society is even greater.
“A lot of these infections will happen to people who would otherwise recover, leave the hospital and go on to be productive, earn wages, pay taxes and the like,” Stibich said.