Successful Innovation is 1% Inspiration and 99% Perspiration

When Exergen Corporation was invited to be a mission sponsor for Northeastern University’s first ever Nurse Innovation & Entrepreneurship Summit and Hackathon, we knew that it would be a great opportunity to collaborate with a world-class university and nurses from all practice settings to develop innovative solutions to improve patient care.  As a nurse, scientist and an entrepreneurial businessperson, I have always been driven to find solutions to large-scale problems, so it is exciting to be part of a weekend with this same focus.

Nurses are on the front lines of patient care and it has always been our mission at Exergen to support their work and help make their jobs easier and more effective.

Until recently, all of the thermometers required an uncomfortable and sometimes risky probe insertion into a body cavity to obtain requisite accuracy for medical decisions.  Armed with new non-invasive technology developed for industry, Exergen decided to change the way the world takes temperature in healthcare.

When I joined Exergen, it was an industrial company beginning its first efforts in developing medical devices with groundbreaking noninvasive infrared (IR) technology. At that point, we had new infrared skin scanners being used by chiropractors, and were just beginning development of the ear thermometer technology that would eventually be used in most of the ear thermometers in the world. While observing and listening to the responses from nurses and patients, there weren’t many that were in love with ear thermometers.  And so we began a search for a better way – an accurate thermometer that would be truly noninvasive.

Back to the lab, and back to basics, deciding nurses (and moms) might be right that touching the forehead was an indicator of fever, we decided to put the forehead to the test.  We had an interesting and eclectic search that included hospitalized patients with AIDS and Dengue Fever, MICU’s, NICU’s, SICU’s, PICU’s, pediatric offices, schools, anywhere we could get permission and where nurses were interested in helping us gather data for a new thermometry method.

We were invited to join the Boston Marathon Medical Team in 1989 because of their concern for heat stress, and the fact we had this brand new ear thermometer technology (they had been using rectal, which NOBODY liked).  This data played an important role in the scientific work of understanding thermoregulation and temperature distribution due to the extremes of thermal stresses to the runners, both internally and externally generated.  We worked with nurses in the Medical Tent over the 18 years we were part of the medical team, providing fast, accurate, thermal assessment of the runners and expanding everyone’s knowledge of how to treat the runners.

After that, it was back to the lab to incorporate all of our new understanding from the hospitals and medical tent.  We figured out why the forehead measure worked sometimes and not other times, and the central role the temporal artery at the forehead played.  Back to the hospitals for more data to test our new hypothesis with nurses and patients, and back to the lab for prototype designs, internal testing, patent application, then field test prototypes with nurses and patients.  Paraphrasing Thomas Edison, innovation is one percent inspiration and 99 percent perspiration.

There was a great deal of skepticism that our new thermometry method would actually work.  We were fortunate to be near premier hospitals that were interested in studying a new thermometry method that was potentially revolutionary – accurate temperature with only a gentle scan of the forehead.  Our first studies were conducted by research nurses at MGH and then again later by pediatricians and nurses at Boston Children’s Hospital.  After these studies demonstrated accuracy, there was a little less skepticism, but still a big challenge to overcome.  Fortunately these studies, and several others we commissioned, were adequate for FDA approval, but did not overcome widespread skepticism from both physicians and nurses, although nurses seemed to be warming to the idea more so than physicians.

From day one, Exergen decided to manufacture the new Temporal Artery Thermometers (TAT), including the consumer retail version, in the USA at our plant in Watertown.  This was very challenging given the cost disadvantage we had compared to overseas thermometer manufacturers, but with our new technology we did not want to leave anything to chance in producing a high quality product. There were successes, but challenges galore from the skepticism.

Fortunately for us, many physician and nurse researchers were interested in the potential patient and clinician benefits of eliminating probe insertions into body cavities, so they initiated their own independent studies and published their results.  As of 2016, there are more than 60 peer-reviewed published studies attesting to the accuracy of the Exergen TAT.  These studies cover all patient ages from preemies to geriatrics, and all settings in healthcare (see www.exergen.com/nu1).  We are grateful for the time and effort so many physicians and nurses gave to prove our new product’s accuracy in so many settings.  These studies were clearly instrumental in reducing skepticism, emphasizing the importance of independent reviews.

Innovation is a long and challenging path, but well worth taking if the idea is sound, since it can change the world.

We are delighted to partner with Northeastern University for the first ever Nurse Innovation & Entrepreneurship Summit and Hackathon to help the future of healthcare bring their ideas to life. We hope that one day this next generation can experience the same successes that we have experienced from lots of hard work and perspiration.