Dr. Marilyn Rantz

Expert Exchange

In coming years more than 76 million baby boomers will be reaching their 75th birthdays and at least 40 percent will need extensive health care services.

Through extensive research, development and implementation of advanced technology the University of Missouri’s Dr. Marilyn Rantz has dedicated her career to improving senior healthcare services, while at the same time lowering costs.

An exciting part of Dr. Rantz’s work is ongoing at Tiger Place, an independent living community close to the MU Columbia campus. Here residents are monitored around the clock by non-invasive sensors that detect emerging health issues before they become urgent clinical problems. Rantz refers to the process as early illness detection.

Marilyn Rantz“With these technologies we can flag problems and intervene early for the health problem that is brewing,” said Rantz. “We can look at the resident’s normal activity and measure variations of normal activity to detect problems early.”

The best part? All this data can be collected with no work on the resident’s behalf.

“In everyday life people don’t want to hook up to stuff. That’s the beauty of what we’ve designed,” Rantz said. “You don’t have to think about it.”

Motion sensors, web cams, radar sensors and the Microsoft Kinect® (originally designed for video games) are used to automatically detect falls and fall risks. A bed sensor is used to establish routine patterns in respiration and pulse. The bed sensor is a tube placed under the resident’s mattress able to capture data through residents’ movement on the mattress. The data collected by the sensor goes into an automated system and patterns are detected. Changes in the data represent changes in the residents’ health and when changes occur, nurses are alerted and take action before things like hospitalizations and emergency room visits are necessary.

Rantz thinks of the new evaluation of patterns as the new vital signs.

“Having continuous measures, we can see patterns that we were never able to see when we just occasionally checked blood pressure or pulse,” she said. “Now we can see changes in patterns that are far more sensitive than what people feel when stuff goes wrong in the body.”

Tiger Place is the only healthcare facility of its kind using formulated algorithms for early illness detection. Rantz said they are currently working on getting a commercial partner for these technologies and that she can see an application for them in elder housing, private homes, nursing homes and even the hospital setting. Once these technologies have been perfected she hopes that seniors will be able to stay healthy longer and age hassle free in their own homes.

The belief follows an Aging in Place (AIP) study Rantz completed that looked into deterioration of health in seniors as they moved from one level of care to the next and how that deterioration could be eliminated. The study found that seniors able to age in the home environment of their choice, with supportive health care services as needed, saved thousands of dollars compared to those of traditional care options. The study showed improved clinical outcomes in depression, skin quality and mental health problems.

Early illness detection and AIP practices are only a small piece of the puzzle that comprises Dr. Rantz’s successful career as a researcher, clinician and former nursing home administrator. Her hard work has landed her one of the highest honors in health and medicine – admittance to the Institute of Medicine of the National Academies – an achievement that only goes to health professionals who have demonstrated outstanding achievement and commitment to service.

Currently Rantz is focusing on senior nursing home care as she is facilitating the use of the largest research grant the University of Missouri has ever received. The $15 million grant comes from the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services, which reported that in 2011 potentially avoidable hospitalizations amounted to more than $7 billion. The goal of the grant is to decrease that number dramatically by fully funding the placement of advanced practice nurses who are better trained to use technology and able to quickly assess data and make decisions, into 16 St. Louis area nursing homes.

As Dr. Rantz’s research and findings accumulate she is hopeful for the future.

“There’s going to be a paradigm shift in how we evaluate people for disease management and health management,” Rantz said. “I think the most exciting aspect of the research is being able to understand these new patterns in people’s lives using the environmentally imbedded sensors. Being able to see signs that something is about to happen, then being able to help people before the health event develops and they require extensive treatment.”