Hill-Rom's Envella Air
Fluidized Therapy bed

Can smart hospital beds replace patient monitors?

April 04, 2017
by Lauren Dubinsky, Senior Reporter
Bedsores are the No. 3 disorder after cancer and cardiovascular diseases in terms of cost, according to a 2015 study published in the International Journal of Research in Medical Sciences. Grade 1 and 2 bedsores can cost between $125 and $451, and grades 3 and 4 between $1,400 and $2,300.

The Centers for Medicare & Medicaid Services penalizes hospitals for these hospital-acquired infections. The cost issue, combined with the fact that bedsores affect over 1.3 million adults globally per year, has encouraged hospitals to look for a solution.

“Hospitals are extremely aware of what they will and won’t be reimbursed for, so if they can invest a few more dollars in a [hospital] bed that will save them an average of $40,000 per hospital-acquired pressure ulcer, that’s a good return on investment,” says Julie Andrews, clinical analyst at MD Buyline.

Smart hospital beds are capable of automatically turning patients every few hours. North York General Hospital in Toronto has been using these beds since the early 2000s in its intensive care unit to prevent bedsores. “[The beds] rotate patients so [nurses] don’t have to roll and turn them as frequently,” says Dr. Donna McRitchie, vice president of medical and academic affairs at the hospital. “It also does it in a somewhat gentler way with a continuous slow rotation. That helps take pressure off skin and other bodily areas that can be impacted by pressure.”

The patients that present to the ICU are very different than those of 20 years ago. Many of them are elderly or obese with multiple chronic diseases such as diabetes and infections, and the smart beds are especially useful for them. The beds can move in all directions, be tilted at different angles and extended for very tall patients. They can also weigh patients and perform vibration and percussion massages. Historically, a team of nurses would have to manually turn patients every two hours. With these new beds, the staff isn’t at risk for wrist or back injuries. “Once it became very apparent that this was a quality of care issue and not just a nice thing to have, we really needed to step up and redefine our priorities and the smart beds became a must have,” says McRitchie.

The smarter, the better
Smart beds are also capable of sensing the patient’s position, alerting the clinicians regarding any issues and transmitting the data to the hospital’s electronic medical record (EMR). Stryker Corporation offers a technology called iBed Awareness on its InTouch Critical Care and S3 Med-Surg beds. It monitors local bed status and alerts clinicians if preset parameters are compromised. The company’s iBed Connectivity technology connects the beds to third-party systems like EMRs. A major hurdle for hospitals is cost. A standard hospital bed costs about $6,000, but the smart beds can range from $10,000 to $40,000, according to MD Buyline.

Although hospitals are cost-conscious, they see the added value in the smart bed data, says Ken Clark, senior technology solutions manager of Stryker’s medical division. “When you look at the impact the beds can have on programs such as a fall prevention program at a hospital, the return on investment can be significant,” he adds. “In the ICU, the protocol reminders allow caregivers to better track events such as turns and skin checks, again helping caregivers to better improve outcomes and reduce the cost of care.”

In December, Stryker delivered new S3 Med-Surg beds to Three Rivers Hospital in Brewster, Washington, and provided free upgrades to the iBed technology. The hospital can now benefit from anti-fall warning lights and sounds to help protect high-risk patients. If a patient typically moves two to three times per minute and starts to move 10 times per minute, the smart bed technology can
spot that change and alert clinicians.

Hill-Rom, another major player in the hospital bed market, also offers smart beds that can send alerts. Alerts can either be transmitted through the EMR or sent directly to nurses’ mobile devices. “Some customers want us to integrate with the EMR so we can send relevant patient information like bed weight and head of bed angle,” says Paul Johnson, president of patient support systems at Hill-Rom.

“If the patient is going through some therapy in the bed, they want that information transferred to the EMR so they can keep track of it.” The big question on customers’ minds is if these smart beds can replace patient monitors. Hill-Rom gets many requests for beds that are capable of monitoring respiratory and heart rate. “If we can do that in a reliable and sustainable way, that might be an interesting way to provide some of the real-time monitoring,” says Johnson. “Whether it replaces it or not, it’s a little early [to tell], but I think there is some natural synergy that will probably occur and we are looking at it.”

Hill-Rom is testing different technologies and looking into creating a bed that can run the patient data through sophisticated algorithms to predict if the patient is going to move or get out of bed.

Floating bed
Hill-Rom recently introduced its Envella Air Fluidized Therapy (AFT) bed for specialized wound care. It’s geared toward patients with burns or skin grafts from a surgical procedure. “It’s like floating on air,” says Johnson. “There are silica beads [inside] that heat up and get excited and create a frictionless surface.” AFT helps to accelerate wound healing and reduce complications, which helps to improve outcomes for patients with flaps/grafts, stage 3 to 4 pressure injuries and deep tissue injuries. Joerns Healthcare’s Dolphin Fluid Immersion Simulation (FIS) system is a competitor of Envella. This system redistributes pressure by simulating the effects of a body immersed in a fluid. It automatically measures the characteristics of patients when they are on the support surface and then creates a personalized immersion profile.

The U.S. market
The U.S. hospital bed market was worth $1.2 billion in 2016 and is expected to grow at an annualized rate of 2.8 percent and reach $1.4 billion by 2021, according to an IBISWorld report published in February. Stryker makes up 15.5 percent of the market and Hill-Rom accounts for 52.2 percent. The market is increasingly demanding bariatric beds. More than one in three adults in the U.S. are considered to be obese, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Hill-Rom’s most popular bed for obese patients is the Compella Bariatric Bed, which can support up to 1,000 pounds. Johnson has noticed that hospitals are ramping up bariatric services and a popular option is to rent the beds.

“You might not have the need for a lot of these bariatric beds, but when you need them, it’s an urgent [situation], or you may [only] need it for a week or two,” he adds. Other factors driving the market are the rising elderly population and incentives from health insurance providers to use at-home hospital beds to lower the rate of hospitalization. Most hospital beds in the U.S. have some form of smart bed technology, according to MD Buyline.

It can range from basic alarm capabilities to advanced integration with the EMR and mobile devices. Since hospitals have made a significant investment in EMRs, many are now looking to incorporate medical device data to enhance their EMRs. “If the trend over the last three years is an indicator of the future, we will continue to see this technology become adopted by more hospitals, similar to the way bed exit and local bed status monitoring options became standards in the past,” says Stryker’s Clark.