Louisville Medicine Volume 66, Issue 2 | Page 36

DOCTORS' Lounge SPEAK YOUR MIND If you would like to respond to an article in this issue, please submit an article or letter to the editor. Contributions may be sent to [email protected] or may be submitted online at www.glms.org. The GLMS Editorial Board reserves the right to choose what will be published. Please note that the views expressed in Doctors’ Lounge or any other article in this publication are not those of the Greater Louisville Medical Society or Louisville Medicine. An Eye For A Hand Mary G. Barry, MD Louisville Medicine Editor [email protected] B ig Brother is watching - but sometimes, not the right things. I have long thought computers that monitor our every move: the Fitbit that sup- posedly counts every step (but not biking or swimming), the endless quest for the current password, the electronic signatures that document our digital presence in any record at all times, are more trouble than they’re worth. But a recent article by Lisa Ward in the Wall Street Journal of May 29 might be changing my mind. She cites the work of researcher Dr. Arnold Milstein, professor of medicine and director of the Clinical Excellence Research Center at Stanford Uni- versity. He and his colleagues have been studying whether computer technology can help detect if people like us actually wash our hands before and after we touch the pa- tient. Since the CDC has said that one in 25 patients can develop a health care associated infection, and the recent epidemic here of hepatitis A has raised everyone’s awareness to some degree, now is a good time to worry 34 LOUISVILLE MEDICINE more about this. The researchers in these studies have installed sensors that generate identi- ty-blurred video that confirms whether or not someone has stopped at the hand san- itizer station just inside the patient room. Per Ms. Ward, they collected thousands and thousands of images of people sensed by the device above the hand sanitizer, and taught the computer program to recognize when they had used the sanitizer and when they had not. The algorithm was then applied to an ICU in Salt Lake City at Intermountain Healthcare, and when images generated by its own computer system were used, the accuracy rose to 98 percent in identifying who sanitized and who did not. So far they have not worked out exactly how to tell if someone washes her hands at the sink, or not. One odd thing that Ms. Ward noted was, “The idea is to see if current practices, like washing hands after touching a patient, effectively fight harmful and drug resistant bacteria or if different steps are needed.” What different steps? Right now, Ebo- la has come back with a vengeance in the Congo. Dispatches from the doctors, scien- tists and nurses there so far are reporting cautious optimism. Instead of starting from ground zero with this dreaded disease that kills the caregivers first, the medical teams are starting from a strong knowledge base. They have learned the lessons of caring for patients with Ebola in the most costly and terrible way, so now they have protocols, logistics, equipment and manpower needs well calculated. They have been able to strike hard and fast this time. After a rural bishop traveled over 100 miles by foot, boat and motorcycle to report the current outbreak, teams in the Congo were activated within hours. When I review all of the guidelines for personal hygiene and personal protective equipment use for prevention of the spread of Ebola and the protection of all caregivers, every drop of information says that hand washing and/or hand sanitizing are essen- tial. Because of the particular struggles of obtaining proper equipment in poor places in rural Africa, the World Health Orga-