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BU alums give voice to patients with new 'verbal' app

Posted by Christina Jedra  March 19, 2013 10:29 AM

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Nick Dougherty, Professor Theodore Morse, Greg Zoeller, Eric Hsiao

Photo courtesy of Red Electric Consulting

When Boston University Professor Emeritus Theodore Morse was in the hospital in 2008, his nurse would come and sit him up in his bed to take his pills at night. Morse had suffered a heart attack followed by a stroke and couldn’t speak or write. 

One night, his nurse was in such a hurry that she forgot to recline the bed before leaving the room. Morse couldn’t tell her to move the bed. He stayed in the upright position all night. 

When Morse speaks of the time in his life when he could not communicate his basic needs, tears come to his eyes.

“It was the most awful thing I have known,” he said. “I could not write, and I could not speak a word. [Yet] all of the perceptions of the outside world were clear to me.”

Since then, Morse has recovered 50 percent of his speaking ability and 90 percent of his writing ability.

But from his experience, Morse decided to propose a project tackling hospital patients’ problems communicating, to the College of Engineering at BU. Nick Dougherty, Greg Zoeller and Eric Hsiao, all seniors at the time majoring in computer engineering, teamed up on the project, periodically meeting with Morse to report their progress. Though Morse was not their professor, the students were inspired by his experience.

“I signed up knowing I could help this go in the right direction and help people,” said Zoeller. “That was really my driving force.”

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Out of that effort has come an iPad application dubbed “Verbal.” While still in development, the application has been so successful that the trio, all 2012 graduates, won not only the Entrepreneurial Award from the College of Engineering, but began piloting the app through an internal review board at Massachusetts General Hospital’s Respiratory Acute Care Unit (RACU) and Thoracic Unit.

The three have shadowed nurses as they provide day-to-day care of patients who suffer from an inability to communicate. They’ve seen the frustrations that patients experience up close.

“It’s like looking them in the eye and not knowing what they need,” said Hsiao. “That’s some sort of crazy hell.”

Zoeller described shadowing a nurse tending to a patient who was a lawyer and who wanted to write an email to his family, but couldn’t.Zoeller approached the man and told him about the application.

“You could see him tearing up,” said Zoeller. “A lot of [patients] are hugely successful intellectuals who are then cut off from the world.”

The purpose of following nurses is to understand not only how to improve the application to better fit patients’ needs, but also to listen to nurses’ needs.

“We have already found multiple uses for this device,” said Marian Jeffries, a clinical nurse specialist in the thoracic unit, adding that “right now, we are using primitive communication technology,” such as letter boards, white boards and lip-reading.

“I always feel for the patient,” said Jeffries. “It’s tough and it’s frightening to be that person that’s lying in a bed, that can’t get up, that can’t breath and can’t vocalize it.”

Ellayne Ganzfried, executive director of the National Aphasia Association, said that many medical personnel “are not sensitive, or at least have not been trained appropriately, as to how to communicate with someone with aphasia.” She said that while there is some technology to aid patients with communication, “most of the time, people access the technology or learn about it after they’ve gone through therapy and rehabilitation and after they’re home.” Paper and pencil, dry erase boards and using pictures are common communication tools, she said.

Ganzfried said she knew of few technologies designed specifically for hospital settings.

So far, the application has been tested on six patients, said Dr. Diane Carroll, one of the investigators on the testing of the app and a nurse researcher at the Yvonne L. Munn Center for Nursing Research.The investigators are gauging patients’ confidence in using the application and are targeting older patients because many do not own iPhones or iPads.

"Verbal” consists of icons or pictures, organized into categories, that relate to the possible needs of the patient. There is an emergency button, a scale to communicate how much pain the patient is experiencing, a button to indicate where the pain is, and buttons pertaining to bathroom needs, such as showering or using the toilet.

Morse said communication about toileting and pain were key frustrations when he lost his ability to speak and write.

The team has improved the application so that when a patient clicks on one of the buttons, there is an audible voice that speaks the patient’s needs.Working with nurses, the team is now trying to advance the system by enabling the patient to send messages directly to nurses’ iPhones. At present, all that is available is the call system, which allows patients to call the nurses and verbalize what they need. 

“We’re hoping this moves forward, because the patients who have tested it loved it,” Jeffries said.The alums plan to look for funding to integrate the application into the call system.
So far, feedback on the app has been promising. Sen. John Kerry wrote a letter of support for Verbal and the team’s work. The team also has made it to the finals of the 13th Annual New Venture Competition Finals at the BU School of Management, where participants pitch their projectsto a group of business experts and investors. 

Dougherty, Zoeller and Hsiao all have full-time jobs and work on the application in their free time.  But they are committed to seeing the project through, for people like Morse.

“When you’re unable to get your point across, I think that’s one of the worst ways to go through life. If I had to deal with that on a daily basis, I don’t know if I could,” said Zoeller. “It just wouldn’t . . . it wouldn’t feel like I’m living. So I want to give a voice to those people who don’t have the ability to do that.”

This article was reported and written under the supervision of Northeastern University journalism instructor Lisa Chedekel, as part of a collaboration between The Boston Globe and Northeastern.

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