January 8, 2015

The Johns Hopkins Department of Physical Medicine and Rehabilitation is tapping assistive technologies to provide a means of communication for hospitalized patients who are unable to talk or move.

The effort began as part of a research study spearheaded by Johns Hopkins trauma surgeon Albert Chi, who also directs the Targeted Muscle Reinnervation Program. Assistive communication devices, says Chi, are not provided in most acute care or inpatient rehab centers because insurance doesn’t fund them unless the patient is living at home.

The research team evaluated about 12 intensive care unit patients’ use of eye-gaze devices for functional communication, visual and cognitive retraining, and interaction with their environment (Internet, TV access). Using the eye-gaze system, patients can create a message or choose from a menu of phrases through brief eye contact with icons on an overhead screen. The message is then vocalized by the machine or sent as an email. Four specially trained occupational therapists and speech-language pathologists provided the training.

“Being able to communicate gives patients an improved sense of control and decreases their frustration,” says Kelly Casey, an occupational therapist who directs the assistive technology clinic at The Johns Hopkins Hospital. “The system also helps us better understand patient needs and preferences.”

To date, the assistive devices have been used to help at least 60 patients in Johns Hopkins Hospital intensive care units, including a middle-aged woman experiencing a difficult recovery following surgery to remove a brain tumor.

“She was in a lot of pain and in a really bad place,” Casey says. “The second we put the eye-gaze system in front of her, she lit up. She was able to talk to her husband again and email her friends.”