In intensive care units across the country, the daily treatment of patients with severe cases of COVID-19 requires healthcare workers to go from bed to bed to closely monitor and adjust the settings of their ventilators—with each instance potentially exposing them to the novel coronavirus while also consuming valuable protective equipment.
To make that a somewhat safer task, Medtronic is currently rolling out free upgrades that will allow each of its ventilators to be controlled from a dedicated device outside of the isolation room.
These adjustments—such as changes in the rate and amount of air pushed by the machine—are designed to slowly wean the patient off the ventilator as they regain the ability to breathe on their own and to avoid overextending the capacity of their lungs.
“The best type of ventilator is one that can adjust to the individual differences of the patient—no two patients will be identical,” Medtronic’s president of respiratory, gastrointestinal and informatics, Vafa Jamali, said to Fierce MedTech in an interview. “So a doctor is looking at the different readings from the ventilator, and is now making these tweaks and adjustments through this remote capability. And that’s a real game changer for clinicians.”
So far, the company’s teams have upgraded Puritan Bennett 980 ventilators at 14 hospitals in a pilot project involving a portion of the 8,500 critical-care devices installed at 940 hospitals across the country.
In the near future, Medtronic plans to deploy a software update that will allow hospitals to set this system up themselves—enabling the use of their own laptops or other devices as a second ventilator monitor, either directly or wirelessly through the hospital’s IT network, Jamali said.
This also represents a step forward for a field of durable hospital devices that had not seen much advancement or innovations in the years prior to the COVID-19 pandemic.
“The ventilator market hasn't been a dynamic one for the last 10 years or so. It's been relatively stable, with low growth and slow replacement cycles,” Jamali said. “But what we've been able to do with this surge is reinvest—what really wasn't there, in terms of research and development dollars—into new technologies that are very relevant today.”
In addition, the project mirrors similar efforts for the company’s pulse oximetry devices, used to measure a person’s blood oxygen levels.
After the Javits Center in New York was converted into a large field hospital, Medtronic installed 400 of these vital sign monitors and within three days had them connected to a centralized data platform.
“The stat that really blows my mind is that the Javits Center is able to manage 400 patients with 10 clinicians, in order to reduce COVID-19 exposure,” he said. “That ratio is incredible. If you can do that in a surge state, you're making a meaningful difference to the lives of the caregivers and you're not sacrificing patient care.”
Over the past few months, the FDA has been working to streamline the use of these remote medtech technologies in response to the coronavirus. In mid-March, the agency issued policies giving manufacturers additional leeway in marketing patient-monitoring products.
“So far, we have been able to turn around new ideas into tangible, effective technology—in hospitals, and on patients—at a speed that we've never seen in the device industry,” Jamali said, adding that the company feels comfortable submitting its developments for full regulatory clearances in the future.
Additionally, the more opportunities you have to make a ventilator smarter and more flexible, the better, he said.
“Ultimately, if you think about what we have applied in consumer tech to ventilators—I'd say it’s probably very little so far, but that's really where the doors start opening up,” said Jamali. “So you start thinking about where informatics and AI could play into ventilators, and how they could help manage the patient.”
“Do I know where all the ventilators in the U.S. are right now? Are they all on? Or are they all sitting in a broom closet? These are relatively standard technologies that we just never implemented into the ventilator,” he said, adding this could help states redirect excess ventilator capacity to hospitals with higher demand.
And on the patient care side, predictive algorithms could also help alleviate the burden on healthcare providers.
“By understanding where a patient's going and making that adjustment ahead of time, versus waiting for a doctor to come and make the adjustment when the patient is due for that visit, I think those advancements are really critical, and probably closer to execution now than they are a dream.”