Intelligent Hospital Food Tray
Entry By: Martin Perez, M.D. and Carlos Perez
Affiliation: MobileBiomedical, LLC
MobileBiomedical has created the IntelliTray, a smart hospital food tray that employs weights and digital images to optimize and quantify our assessment of malnutrition. It is an intelligent food tray with the ability to securely transmit and download weights and images to a tablet or smartphone using wireless WiFi and Bluetooth technologies. IntelliTray features patient ID tracking and integration with hospital telemetry and Electronic Medical Records. Anywhere that caloric intake needs to be monitored by a physician or dietitian, IntelliTray is the solution.
How does Intelligent Hospital Food Tray use Internet Technology?
The IntelliTray system contains a Yocto Linux-based embedded microprocessor unit (MCU) with both 802.11 WiFi and Bluetooth wireless capability. Each wireless interface permits different Internet technologies to complement each other. There are three main areas where we are using IP
- Wireless communications: 802.11 WiFi allows the embedded application to send camera and telemetry data using the MQTT (formerly Message Queue Telemetry Transport) protocol. An embedded Node.js web service allows camera images to be retrieved using Hypertext Transfer Protocol (HTTP). MQTT and HTTP are robust and mature Internet protocols and are the foundation of modern web services and telemetry services for IoT devices.
- Near-field communications: Bluetooth supports Bluetooth Network Encapsulation Protocol (BNEP) using the Personal Area Networking (PAN) profile. BNEP allows the IoT device to enable Dynamic Host Configuration Protocol (DHCP) which is an infrastructure service for the Internet. BNEP and DHCP permit a nearby mobile device, such as an iPad, to connect to the IoT device over Bluetooth. Using the WebSocket protocol (IP standard RFC 6455), a remote Socket.IO mobile “app” can communicate with the MCU Node.js service.
- Hardwired communications: The tray MCUs require firmware updates and system administration. Toward that end, a USB cable can be attached to the IoT device to enable TCP/IP using the well-supported Linux USB Gadget API. USB TCP/IP networking allows remote access using Secure Shell (SSH) and enables Internet services such as Domain Name Services (DNS) and Network Time Protocol (NTP). The USB interface also has the advantage of powering the device and charging the batteries on the tray in addition to TCP/IP networking, thus, while we are “charging,” we are also sending packets using IP.
Why did you choose to invent an Intelligent Hospital Food Tray? What problem do you see that it can solve?
As a practicing hospitalist, Dr. Martin Perez, MobileBiomedical CEO and co-founder, has consistently noticed insufficient, objective data in our nutrition assessment tools for patients with malnutrition. Even with all the screening and nutrition therapy tools we have today, we are still unable to accurately quantify the oral caloric intake in hospitalized patients with malnutrition. Ultimately, the problem is that we never truly know how much our patients are eating on a daily basis. We chose to create IntelliTray to optimize and quantify our assessment of malnutrition by using weights and digital photography. In this context, we decided to undertake a project that could be built from concept to prototype using the resources of a lean startup– 3 engineers, part-time over 3 months.
What is the practical application of the Intelligent Hospital Food Tray for the everyday user?
The data obtained by IntelliTray will automatically be sent to the Electronic Medical Records (EMR) system which is linked to a nutrition database, making dietary assessment by the clinical staff more practical, efficient and accurate. This data will provide the much needed evidence-based individualization of dietary recommendations that are linked to the patient’s disease risk. With IntelliTray, the everyday user can finally monitor quantifiable caloric intake of the malnourished patient.
Are there plans to produce Intelligent Hospital Food Tray for the marketplace, or is it already a product that can be purchased/obtained?
The IntelliTray will be produced for the healthcare marketplace. Since IntelliTray utilizes active patient monitoring requiring more stringent manufacturing controls, initial investments will be used for premarket submissions as an FDA Class II device. An initial investment of $500,000 will be focused on Class II FDA approval and manufacturing. After FDA classification and approval, the IntelliTray will cost $200 to $300 to manufacture per tray. The selling price will be $300 – $500 per tray. No assembly will be required for the hospitals. There will be an easy transition from standard hospital trays to IntelliTrays since the same standard dimensions are used. Initial equipment, installation of software and training services for the hospital will cost $4,500. Software upgrades, maintenance, support services and user license agreement will be $50 per license per month. A one-year manufacturing warranty will be provided. Equipment rentals and financing will also be available. Assuming we can lower the Hospital Length of Stay by 2.3 days in patients with malnutrition, the overall goal of savings per device will be $4,567 per admission. For a hospital with an average daily census of 100 patients and assuming 1/3 of the patients are malnourished on admission, then the end-of-year savings would be $5,074,230.
Why would you consider Intelligent Hospital Food Tray to be “innovative”?
The solution is innovative in three respects:
- Accuracy: the current health care system does not have the tools to accurately quantify food and calorie intake in the clinical setting. There is a “data gap” that can be solved using IoT technology.
- Scope: the solution can be used in all health care settings where doctors need to treat nutrition-related ailments. This includes hospital intensive care units, short and long-term acute care hospitals, rehabilitation facilities, skilled nursing facilities, and home health care settings. In other words, anywhere caloric intake needs to be monitored by a physician or dietitian, our solution can be used.
- Cost: The IntelliTray will cost $200 to manufacture. An initial investment of $500,000 will be focused on Class II FDA approval and manufacturing. Low-cost IoT devices will allow us to expand the reach of this solution to undeserved areas; for example, rural hospitals, nursing homes, and individual physician practices.
What would winning IPSO CHALLENGE 2015 mean for you or your company?
As a start-up in the IoT health and medical device field, exposure to quality venture capital partners would get us to the next level of product engineering, testing, clinical trials and FDA certifications. Winning the IPSO CHALLENGE will elevate our profile and visibility with venture capital firms.
If selected as the Grand Prize winner, how do you think you will spend the $10,000 prize?
Since our product will be used in a regulated hospital environment, our plan is to use the prize money to hire a consultant to marshal our product through the FDA certification process. We also intend to share some of the prize money with the people who are currently assisting us with product development.
What would you like to see in the future for the Internet of Things?
It is a well-worn truism that “security” needs to be built into the fabric of IoT. With respect to health care, medical devices require an additional dimension known as “accountability”. Medical doctors and clinicians are ultimately accountable to the patient, and thus, IoT accountability will be integral to the doctor-patient trust relationship. This model runs counter to autonomous and ubiquitous IoT devices, so balancing accountability with autonomy will be the challenge facing IoT designers through the next several years.
Why should more companies utilize IP?
IP works well not only with low-power, low-cost mobile IoT devices, but also has the added benefit of stability, security and performance. Unlike other IoT protocols which are in their relative infancy, decades of industry experience with mature IP technology stacks provides us the necessary tools to lock-down, optimize, and monitor IP-based systems.
Why did you decide to enter IPSO CHALLENGE 2015?
The mission at MobileBiomedical is to make biomedical science smarter through mobile technology. The IPSO CHALLENGE is the perfect venue for a start-up company to showcase its capabilities and to demonstrate how “smart objects” can improve patient care.