Made in San Antonio Robots Zap Deadly Hospital Infections

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R2-D2, Wonk and Xenex.

R2-D2, Wonk and Xenex.

John BurmanIn a building just 13 miles north of downtown San Antonio assembly workers are quietly busy in what appears to be a Star Wars droid manufacturing plant. Its real identity: Xenex Healthcare Services headquarters, a cutting-edge startup that’s leading the global charge against often deadly hospital-contracted infections.

Xenex (pronounced “zen-ex”) is led by Morris Miller, an entrepreneur and one of the co-founders of Rackspace. He and his partners have developed a robot that aims to increase hospital safety for patients by revolutionizing the way hospital rooms are disinfected.

While Xenex is starting to turn heads all across the world, patients won’t find any of the silver bots working to kill infectious bacteria in local hospitals. At least not yet. Given San Antonio’s drive to become a homestead for biotech industries, locals will soon enough know that hospital operators elsewhere have found trials very convincing and are moving to adopt the new technology.

I had the opportunity to visit Xenex headquarters to see what all the no-fuss was about. That tour of the Xenex facility located a few miles from the San Antonio International Airport included a lot of conversation about hospital infection rates and patient mortality, and the art and science of disinfecting hospital environments. But, honestly, as a 25-year-old man, the best part of the day was getting to meet and operate the quirky, three-foot tall, life-saving little bot referred to by its makers as R2-D2. (Once there, however, I realized it more closely resembled  the GNK (aka “Gonk”) power droid.)

R2-D2, Gonk and Xenex.

R2-D2, Gonk and Xenex.

Operating Xenex’s mobile disinfecting unit was even easier than pounding buttons on my iPhone. Seriously, all you do is input your name, set the timer and the little bot handles an empty hospital room in the space of about five minutes.

Unlike the standard chemicals hospital workers use to clean rooms, the Xenex bot uses pulse UV radiation.

According to the Xenex website, “this UV light works by penetrating cell walls and disrupting the nucleic acids (DNA and RNA) in microorganisms, preventing cell replication and repair …”

Translation by Miller: The light is specially calibrated to kill bacteria at a microscopic level and thus prevents drug-resistant mutations. It’s physics instead of chemistry. Because UV radiation cannot be seen by the human eye, Xenex emits purple flashes to let you know it isn’t sleeping on the job.

Xenex devices are made in San Antonio and friendlier to the environment than cleaning chemicals or UV devices using toxic mercury. A recent study performed at MD Anderson Cancer Center demonstrated that the Xenex system was more effective than bleach in reducing C. diff in patient rooms.

Xenex devices are made in San Antonio and friendlier to the environment than cleaning chemicals or UV devices using toxic mercury. A recent study performed at MD Anderson Cancer Center demonstrated that the Xenex system was more effective than bleach in reducing C. diff in patient rooms.

After the demonstration, we meandered past several rooms named after Anakin and C-3PO before arriving at the Chewbacca conference room to discuss some of the major problems in hospitals and what Xenex is doing to address them.

Though Xenex has proven to be extremely effective in a number of studies and in practice at major hospitals across the country including UCLA and The University of Texas MD Anderson Cancer Center, with infection rate reductions from 45 to 82% – it’s still a new, under review technology. Local hospitals, perhaps,  are waiting for more data to confirm Xenex’s reporter results.

Medical advances often come only after exhausting levels of testing and approval, but given the liability hospitals face when patients suffer from infections unrelated to their own treatments, it seems logical that hospitals would invest in the new devices while awaiting official confirmation of the technology’s efficacy. Miller and his colleagues at Xenex believe hospital infection related deaths will be cut in half once the company places enough units in the market.

Hospital contracted infections are a silent epidemic in this country taking the lives of roughly 100,000 Americans a year. This means that more people die a year from an infection than from diabetes, influenza, nephritis, and Alzheimer’s. According to the Center for Disease Control and Prevention, about 1.7 million individuals will contract a serious infection during their hospital stay this year. Put another way, one out of every 20 Americans admitted to a hospital will suffer an infection related set-back during their stay.

The Xenex “robot” uses pulse xenon to deliver UV light throughout patient rooms, operating rooms (ORs), equipment rooms, emergency rooms, intensive care units (ICUs) and public areas to destroy viruses, bacteria and bacterial spores in just 5-10 minutes per room.

The Xenex “robot” uses pulse xenon to deliver UV light throughout patient rooms, operating rooms (ORs), equipment rooms, emergency rooms, intensive care units (ICUs) and public areas to destroy viruses, bacteria and bacterial spores in just 5-10 minutes per room.

These numbers not only have a huge impact on people, but they also represent a major financial problem for the healthcare industry as prolonged hospital stays and additional medication costs between $28 billion to $35 billion in the U.S. every year.

While hospital related infections have always been a serious problem, the number of contracted cases have risen exponentially over the past 20 years due to the development of drug and disinfectant resistant strains of bacteria such as Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (“C.diff”). While continuous medical advancements in other areas of care have managed, to a degree, to stay on pace with the rise of these bacterial and viral strains, hospital disinfection has remained woefully archaic until now.

Most hospitals still rely on 19th century cleaning methods. The chemicals have changed, but the idea has roughly remained the same: wipe it down with bleach. Harsh chemicals slowly degrade surfaces, and the process leaves a lot of room for human error. Hand cleaning also is ineffective in eliminating bacteria like C.diff, which can remain on a surface for weeks and float through the air in spore form.

Recently, I spoke with Dr. Joanne Levin, a leading expert in patient safety research. According to Dr. Levin, her hospital, Cooley Dickinson in Massachusetts, rated one of the safest in the country, began using two Xenex bots in 2011 and were shocked with the results. Within the first six months of implementation, they saw a 82% reduction in C.diff rates, which resulted in five saved lives (click for a PDF summary of their results). They immediately purchased additional robots, becoming the first hospital in the world to use the Xenex device to disinfect their entire facility.

One reason more hospitals in San Antonio and beyond have not yet adopted Xenex units is that the technology does not come cheap. Each bot costs about $120,000. Dr. Levin measures that costs by noting that Xenex has saved lives and her hospital millions of dollars.  One case of hospital contracted C.diff is likely to cost a hospital upwards of $30,000, so by investing in a robot that prevents the initial infection, Xenex pays for itself in a month or two, according to Miller.

When I pressed Dr. Levin about whether the use of Xenex would become ubiquitous in the health care industry, without hesitating she told me that, “without a doubt, (Xenex) will become the standard of care in this country, especially given the fact that hospitals will begin being paid by success rates and not the quantity of procedures.”

Dr. Levin isn’t the only researcher singing the Xenex song, either.  Every hospital to introduce Xenex to their room disinfecting procedure has seen a reduction in both infection rates and cost.  In one study, Cone Healthcare System found that Xenex reduced their MRSA rate to zero and reduced infection-related bed days from more than 2,000 to about 600.

These results cannot be understated  and are leading more hospitals to rent or purchase Xenex bots.

It costs approximately $3 per room to disinfect a room using the Xenex system and the device is operated by a hospital’s EVS staff, so it’s efficient and easy to use.

It costs approximately $3 per room to disinfect a room using the Xenex system and the device is operated by a hospital’s EVS staff, so it’s efficient and easy to use.

The cool looking bots have humble roots. The original bot was the brain child of an under-financed Russian entrepreneur who constructed his prototype out of old car parts and UV lights. As opposed to the sleek models now on the market, the head of the original bot was lifted out of the body using the motor from a windshield wiper.

The prototype was purchased by Dr. Mark Stibich and Dr. Julie Stachowiak from Johns Hopkins University in Baltimore, who connected with Miller, and the manufacturing center was moved to Texas for a southern makeover. After spending three years in Austin, the Xenex bot packed its bags once again in 2012, this time down Interstate 35 to its new destination near the heart of San Antonio.

Now Xenex founders believes the company and its life-saving units are on the verge of breaking through.

John Burnam is a nonprofit consultant currently working with San Antonio Christian Dental and The Louise Batz Foundation for Bedside Advocacy. He works in patient safety, community health and well-being, and nonprofit development. He graduated from Trinity University with a Bachelors in Art History and Classics and from Vanderbilt University  with a master’s degree in theological studies.  Prospective employers can check him out on LinkedIn.

 

Related Stories on the Rivard Report:

San Antonio: ‘A Ton of Potential, a Lot of Inadequacies.’

The Essence of Patient Safety and Bedside Advocacy

Healthcare and Biosciences: Invest More to Grow Faster

The Palmaz Award: Celebrating Biomedical Innovation in the Alamo City

The Feed: Five Minutes With The Mayor’s Fitness Council

6 thoughts on “Made in San Antonio Robots Zap Deadly Hospital Infections

  1. Very interesting article. As you mentioned given the nature of litigation against hospitals especially in cases of non-procedural and post operative infections, this device would appear to be well worth the cost. I would think that mid to large hospitals would recoup the expense of the units in a relatively short amount time. I suspect this will become the future trend for hospital disinfection. It is a shame they could not make the unit look more like R2-D2. They would probably sell faster.

  2. Quite amazing how some technologies that are used frequently and successfully in one feild can be overlooked in another area. In my classroom I have A UV cleaning cabinet for my students safety-glasses. I always give students a brief lesson on it and how it works, to ensure that the procedure of putting the safety glasses away properly takes hold. Students always seem amazed that UV light has these “magical cleaning properties”.

    I may incorporate this article when I go through my lesson for the safety-glasses UV cabinet next time. I’m sure my students will be excited to know that it is the same innovative technology that is used by life-saving robots!

    Well I ramble. Great article, keep up the good work. 🙂

    • Thanks, Nic, for your nice note. We sure like publishing teachers. Perhaps a homage to chemistry
      or your subject of choice is in order? We could headline it, “Breaking Good.”–RR

  3. [Posted it on Facebook, I’m going to post it again here]

    It’s definitely a benefit and necessity for hospitals (I would volunteer for two years in ICU and worried about getting sick), however it appears to be more of a push cart rather than a robot.

    Now if it could drive itself around like a Roomba and thermal scanned the room to make sure there were no humans around prior to scanning, then I’d call it a bot. The cost would go up but it would be worth it.

    Also Xenex may benefit from pushing smaller consumer units for homes, as that’s where chemicals, fungus, and germs buildup the most (preventative care).

  4. Rick, thanks for the post.

    They’ve had a surprising number of people request a home version.

    I think they’ve started using it for cruise ships now, though.

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