Pamela Cacchione, PhD, CRNP - Wearables, Robotics and Aging

Pamela Z. Cacchione, PhD, CRNP, BC, FGSA, FAAN
Dr. Cacchione is the Ralston House Term Chair in Gerontological Nursing, Professor of Geropsychiatric Nursing at the University of Pennsylvania School of Nursing and Nurse Scientist at Penn Presbyterian Medical Center. 

She is a Gerontological Nurse Practitioner who has practiced for over 30 years across the care continuum. She is a nurse innovator. She is the CEO and Founder of AgingSense a startup technology company to improve the lives of older adults with wearable technologies. Dr. Cacchione’s research focuses on low-cost robots to improve function as well as social robotics for older adults. Dr Cacchione received her BSN from Villanova University, MSN as a GNP from Marymount University, and PhD from Saint Louis University. She completed postdoctoral training at the University of Iowa. 

Dr. Cacchione has over 100 publications and is the Past Editor in Chief of Clinical Nursing Research and International Journal. Dr. Cacchione is a Fellow in the Gerontological Society of America and the American Academy of Nursing

Register for the wearables tech ecosystem at www.WearableTechVentures.org

Transcript

00:04.83
wearabletakeover
Hello folks welcome back to season 4 of wearable takeover we are the podcast that covers wearable technology and all those other good things. But the people that are behind it and inspiring the future now folks. If you have not listened to any of our prior episodes shame on you ah, but there's a reprieve you have access on any major platform wherever you listen to podcasts you can listen to those but I'm telling you you want to tune into today's episode because we have a phenomenal innovator. That is here on the East Coast that has been making strides and is developing some really really cool things in wearable technology. So folks. Let me get right into it because I believe our conversation is going to be incredibly rich and I'm excited to have Dr Pam Cashion who is a nurse scientist. Nurse innovator and Ceo and folks let me just tell you something she got to the bag. Yes, yes, yes, she has been making it rain for those of you that don't know what that means she is not only ah, an an educated woman who is influencing the world of. Um, innovation, wearable technology robotics and whatnot but she has recently acquired some funding because she is that amazing and so I gotta tell you how all this came about and we'll definitely get into the story. But if you ever been following us on Linkedin.

01:41.21
wearabletakeover
Um, especially you know wearable take ventures. You should have seen the announcement or if you're on Instagram you would have seen how excited we were that she was one of the finalists for our program that we supported at the national institutes of health national institutes of aging with their alzheimer's boot camp. But. Let me tell you she is just I hate using the word amazing but she truly is all that and then some now folks she has done research in robotics and older adults. Okay. And so what I love about her is that she is redefining this whole space of caring for adults in age tech and then redefining the future and working in robotics. But then also in her career. So let me just tell you a little bit about how she got to that. Because she has a lot of letters behind her name if you check the show notes you will be able to see all of those letters but Dr Cashion is the rolston house term chair in gerontologyologyal oh gosh. Gerontologyological nursing I got it right? that time. She's also a professor of gerald psychiatric nursing at the University Of Pennsylvania School of nursing and nurse scientists at penn presbyterian medical center.

03:09.17
wearabletakeover
Yes, okay, so you you know that was hard for me to say all that imagine but building all these roles. She's just on fabulous. She is also a gerontolicology nurse practitioner who has practiced for over 30 years across the care continuum she is a nurse innovator. She is the Ceo and founder of. Aging sts make sure you look up that company and you follow it. An aging sense is a startup technology company to improve the lives of older adults with wearable technologies. So Dr. Castion's research focuses on low-cost robots to improve function as well as so. So robotics for older adults and she received her Bsn from villanova university her emmason as a Gmp from Mary Mount University and ph d from St Louis University she completed postdoctoral training at the University Of Iowa and Dr Caciion has over one hundred publications and is the past editor inchief of clinical nursing research and international journal so she is a fellow in the gerontology jar I'm I'm gonna get this right. She is a fellow in the gerontology society of America and the american academy of nursing all right? So you know if I'm tripping over these words I want to see how fast she could say these things when we finally hear it right? You know I mean you know Dr Cast on how do you do it? First of all, how.

04:28.87
Pamela Cacchione
Um.

04:38.88
wearabletakeover
Say all these things. So oh yeah, and then number 2 you know how are you? How are you doing it. you are super woman. really you are super woman

04:50.61
Pamela Cacchione
Yeah I just take a lot longer to do things than most people I do a lot of things but it just yes, have to be patient with me because I'll get a you know I'll get to it eventually but um, gerontological Nurse practitioner. Um, and I just a funny story I was listed on a conference.

04:58.50
wearabletakeover
Who.

05:08.68
Pamela Cacchione
Brochure Once as a keynote speaker as a gerro pychic nurse it' instead of Gerro Psychiatric I'm like I can predict you all are going to be very disappointed.

05:21.74
wearabletakeover
Oh my? Yeah, it's hilarious. You're like you know what this too much here we go. We're gonna make it all up. Um.

05:29.58
Pamela Cacchione
but but ah it's really fun to wear all those hats and I get to do a lot of different things and I have to tell you a turning point in my career as a nurse was doing an innovation fellowship at the University Of Pennsylvania and connecting with 2 roboticists.

05:46.42
Pamela Cacchione
Here They just opened a world to me that really um, created opportunities that really I probably would not have pursued if I had not been exposed to these 2 roboticists I mean even about the socks I wouldn't have had the confidence To. Pursue this if I had not interacted with people outside my Discipline. So I think it often takes a village to create really innovative things and so it's been a lot of fun. My career tends to be very joyful. Robots are really fun to play with but the socks are. Ah, a mission of a passion really because it was a family issue. Not just a issue related to Health Care. So it was you know trying to manage my brother's heart failure after he had open heart surgery um and his forty s.

06:34.25
wearabletakeover
Oh.

06:44.16
Pamela Cacchione
So he had a mitro valve collapse and needed to have that repaired and he really went into heart failure following that surgery and I'm in Philly and he was in Maryland and I was trying to figure out how fluid overloaded he was and he wouldn't weigh himself like most patients with heart failure. And so I finally went to looking at his soccerings to see how the in how deep were the indentations over face time but in his legs to try and say okay, you really do look overloaded here but and so then I just.

07:10.33
wearabletakeover
Oh wow.

07:20.11
Pamela Cacchione
Blurted out, you just need heart failure monitoring socks and that's where the idea came from and I had a lot of encouragement here at the school of nursing to to pursue that and to really try to try to make that happen and so I want an accelerator here I've received money from the American nurses association.

07:37.30
wearabletakeover
Out spending.

07:39.37
Pamela Cacchione
And now also the national institute of aging which was a complete surprise to me I was very delighted to receive that funding. So That's really going to set me up for really human testing using the socks with with people and gathering the data to make to build the Algorithms. To use the Ai in machine learning.

07:56.81
wearabletakeover
I Love it. Okay, so let's backtrack a little bit because for some of our folks they may be saying okay wait. We heard a lot here. We heard all these titles What she's doing from the nursing world and then she's doing this research and then she's working with roboticists and then she's talking about socks too which is that actual wearable product that's coming to the marketplace.

08:05.14
Pamela Cacchione
Um.

08:14.82
Pamela Cacchione
Um, do.

08:16.14
wearabletakeover
So let's start with the latter then we'll work back to the history because you already dropped some gems and I hope that our listeners are taking some notes you actually amplified a theme that we like here at where we'll take ventures which is surrounding ourselves with people that may not necessarily be like us making.

08:34.00
Pamela Cacchione
Um, one right.

08:34.43
wearabletakeover
That we're constantly learning and you've just proven that you've been successful by doing that So starting with starting with the socks. So you know let's talk about your company and then let's let's talk about what that ultimately is and what you hope it will be.

08:43.63
Pamela Cacchione
Yes.

08:50.99
wearabletakeover
For those that may be able to use your product and then your future.

08:52.60
Pamela Cacchione
Right? right? So aging sense is a company that I did develop through the University and so it is a university based company. They really encourage faculty to develop companies when they have an idea and an innovation.

09:12.10
Pamela Cacchione
And so this is the first time I've started company I've probably been a serial innovator along the way. But this the socks are the first big thing that I've been doing and it's um so we have.

09:16.56
wearabletakeover
Me.

09:25.52
Pamela Cacchione
Developed and preliminarily tested these socks to to identify if they will pick up on different behavior patterns different sizes of legs different interactions of activity for people so that's. And really fun. These socks measure whether the stretch of your leg due to swelling from edema that happens with heart failure and then they also were creating a measure of fatigue and so we're using 2 other measures as kind of my secret sauce to. Combine those 2 measures to have a measure of fatigue because not everyone with heart failure gets swelling in their legs but everyone with heart failure gets fatigue. So having that combination will be really helpful so that we can identify people that.

10:12.69
wearabletakeover
Um.

10:18.88
Pamela Cacchione
Need intervention to prevent a hospitalization or to identify people who are having a response to treatment because as a gerontological Nurse practitioner I often would prescribe Medications for patients with heart failure and then send them home hoping that they took them. Hoping that they could afford to fill the prescription for one thing and then hoping that they would take them these socks would help me get an indication of whether they're getting better or worse so that I could follow up and say in between appointments and say did you fill that prescription. Do you have the medicine. Are you tolerating it? okay.

10:38.10
wearabletakeover
Um, yes.

10:55.74
Pamela Cacchione
Yeah, were there barriers to you taking it or you seem to be doing better is the medicine helping or are you doing something else which might be other indication that that we can be used that would be useful but ultimately.

11:07.32
wearabletakeover
So so let me let me pause you right? there. So so are you foreseeing that these socks would be prescription-based or would they be over the counter or that's the first. Question and the second thing is as far as the remote monitoring monitoring is that something that you're going to use your prize money to further develop.

11:26.76
Pamela Cacchione
Yeah, so the prize money is going to be used to collect the data to develop the algorithms and so I'm actually going to be going to a congregate living site nursing home where there are lots of patients with heart failure and they're all in the same place so it makes it a little bit easier to um.

11:30.42
wearabletakeover
Okay.

11:41.17
wearabletakeover
He.

11:44.56
Pamela Cacchione
To access them and have them wear the socks for three months and we'll collect the data as well as monitor them clinically to see if they're having any changes to their treatment or if they're hospitalized for heart failure or something else and to see what changes in the parameters that we're measuring occur. That might be predictive of those indications so we're really looking forward to this. It's we're building our team for this summer project and we're really looking forward to engaging.

12:15.45
wearabletakeover
So so help help us understand this style of sock I'm considering you're looking at this this older population. Um and understanding that swelling is a factor so is there your prototype and um. For those that you know of course this is their first introduction is your prototype one that encompasses different styles of socks or is it just one style.

12:42.60
Pamela Cacchione
So right now. It's just one style It's a cotton diabetic sock. Um, it's black. Ah and that was our third prototype and we're actually going to do a fourth prototype and test that this summer. Which is actually because we're going into a nursing home. We're going to actually use hospital socks with the with the non-skid treads because I don't think they'll let us in if we don't have those non-skid treads on them. So you know we're we're.

13:06.15
wearabletakeover
Um, real.

13:09.20
Pamela Cacchione
Buying socks at this point before we get to the point of manufacturing and adding our technology to existing Socks. So that's that's the tip I also at the health conference this year I had a behavioral economic person come up to me behavioral economist I guess would be the right term. Came up to me and said I'm going to give you one tip my free tip he said put pictures of their grandchildren on the socks and they'll wear them. But that's a little more complicated than I'm ready to get right now. But I think it's really a great idea. You know whatever's going to motivate them to wear the socks will be important to really.

13:37.86
wearabletakeover
Ah.

13:47.78
Pamela Cacchione
Have these be beneficial and improve you know quality of life for people they want to stay home. They want to enjoy their friends and family. They don't want to spend their time in the Hospital. So these socks ideally or that's the goal is to keep people out of the hospital. Keep them as healthy and as functional as possible. And and intervening only as necessary and so we have to really make sure that our algorithms are valid and reliable so providers will have trust in the decision support.

14:10.73
wearabletakeover
Um.

14:18.73
wearabletakeover
So This is great So thinking about you know, family members that may have a loved one. That's in the nursing home and I'm sure many of our listeners. You know, have this experience or they know someone I can recall when my grandmother was in a facility. Um, one of the things we worried about was. You know her belongings if we weren't able to come and do her laundry. You know, ah you know what would happen with that and then you know if some of her items were missing. So I know there are many people that and that were early on in wearable technology that were producing trackers for items such as that you know for their loved ones in a nursing home. Do you think that will be a component of what it is that you're developing and then also from the remote monitoring piece will family members be engaged in that process with with the health provider.

15:10.30
Pamela Cacchione
Yes, So ideally, um, particularly around family members. They're going to be notified as well as the providers of results so that they can follow up if they feel they need to basically we were going to allow the individual a trusted other and the provider be notified. Um, with the results or or primarily a useful dashboard or a trigger that might indicate that there's an emergency or urgency that needs to be addressed so in that Regard. Ah, we'll have a team around the individual to support them in this process.

15:38.17
wearabletakeover
Is.

15:47.30
Pamela Cacchione
And you know again, losing things and I think that's one of the big issues with the socks in the nursing home during this trial. We will be washing them. We'll be you know, putting them on in the morning and taking them off in the evening and then washing them ourselves so we don't lose them initially. But it's going to be important to figure those processes out so part of this study will be how do we develop a process for this. The electronics are removable so they do not go through the wash and so also. How do we make sure that that happens and that they're they're designated. The electronics are designated per individual so we'll have two electronic devices associated with 1 individual and a few pairs of socks wash one wear one when in the hamper kind of thing so that we'll make sure that we have.

16:31.26
wearabletakeover
Okay, so.

16:40.15
wearabletakeover
Okay.

16:44.20
Pamela Cacchione
Ah, usable pair of a clean, usable pair of socks each day that we will be using them in the nursing home. So that'll be exciting to see how that process works. It will also help us understand how many pairs of socks. They'll need for long term use and how will that work.

17:00.33
wearabletakeover
Okay, that's great So question about the study design because you said that you know you would place the socks on the individual in the morning take them off in the evening is the thought that because perhaps at night they're laying down their feet are elevated. Maybe they won't Face. You know as many challenges or measurements related to you know the edema or was there a reason behind.

17:19.72
Pamela Cacchione
Right? right? and they won't be moving around as much so the other measures will be less useful at that point in time and also the fall risk of having socks on at bedtime would be another issue in the nursing home.

17:32.17
wearabletakeover
Okay.

17:37.17
Pamela Cacchione
So just trying to work out those details of of what what and we anticipate that the edema will be less in the morning and greater by the end of the day just by virtue of dependent legs so are standing and so.

17:50.27
wearabletakeover
That.

17:56.80
Pamela Cacchione
That will be critical piece to work out in the algorithm and trying to tease that out for individuals and and knowing who's on what medicine and things like that will be really helpful to get us to understand the clinical side of the sock. So we're really excited about.

17:57.62
wearabletakeover
Here.

18:15.70
Pamela Cacchione
Getting in there and and and using the socks right now we've only used them on my mom who does have heart failure. My husband who does not have heart failure. My daughter who does not have heart failure myself and at the time I had a broken foot so I was walking around in a boot and so I was.

18:29.44
wearabletakeover
A wow.

18:34.26
Pamela Cacchione
Very minimally active. My mom was minimally active but my husband went to the Y and worked out every day and my daughter did orange theory so it was really interesting to see the variety of output from those socks and a couple things that we learned from those socks that we needed to redo the prototype is.

18:40.60
wearabletakeover
Oh yes.

18:53.95
Pamela Cacchione
They the electronics fell off frequently and so we have to have a stronger magnet to keep them in place and we have to have a different location so they're not knocked off as easily so those are kind of the prototype issues that you go through when you're developing these things I try to spiral.

18:55.80
wearabletakeover
And.

19:02.18
wearabletakeover
Who.

19:13.20
Pamela Cacchione
Um, sensor that didn't work and then I connected with a group called tevri a company called tevri out of California and they have a liquid stretch metal sensor. That's the size of a thread and the prior sensors were really really thick like the size of a shoelace so this has been. Ah, really significant game changer for us to be able to have much more streamlined design as well as aesthetically pleasing pear socks.

19:43.40
wearabletakeover
I'm excited about this and when you talk about a family affair with testing things. 1 of the other cases I thought of and I'm like you know when we think about maternal health and especially when you know black maternal health is is a big issue here in the country and when you think about edema I'm wondering if. Once you get through this cycle if that's a consideration to consider you know, using your wearable in that population.

20:04.47
Pamela Cacchione
Yeah, so I I've been in communication with my and my colleagues here who's a maternal child health expert at the school of nursing and she's really interested in pursuing that particularly postpartum. More. So for the cardiomyopathy piece that occurs. Um, but then I also had a pediatric nurse um nurse practitioner come I just was speaking about the socks last week and she was interested in oncology ah pediatric patients that develop heart failure from their treatment. And theyre often have difficulty monitoring their so symptoms inside of you know the side effects. So she's like I want to connect you with these 2 physicians that work in this pediatric space and I'm like wow pediatrics is not something I was thinking about when I created these socks. But.

20:54.59
wearabletakeover
Ah.

20:56.80
Pamela Cacchione
If they will help I will be happy to talk to people and try and test them in different populations to see how we can design and develop things that will help I mean the bottom line is we're we're here to make the world better right? We want to make the world better for as many people as possible and if.

21:08.18
wearabletakeover
Yes, absolutely.

21:14.83
Pamela Cacchione
These socks will help other people I remember 1 time someone said to me? Well what about in Florida people don't wear socks in Florida and I said I was just in Florida people wear socks in Florida and they're usually like black socks like I designed with sandals. Ah.

21:29.96
wearabletakeover
Like I was observing I saw it I saw it I know it? well well you know I Love your story and how you were here supporting your brother and then you blurt it out. Hey here's a possible option to look at and to know that you had support as faculty.

21:35.44
Pamela Cacchione
Ah.

21:48.43
wearabletakeover
Um, I think that that's encouraging because in the corporate workspace. There was a term that was introduced and it was intra entrepreneurreneurship and ah that was a a campaign maybe used maybe ten years ago or so.

21:56.96
Pamela Cacchione
Are.

22:04.50
wearabletakeover
Um, before innovation centers became commonplace in corporate centers where employees were encouraged to think out of the box and come up with new solutions and so um, you know the specific terminology is to to innovate in your particular role. Do you find. That's becoming more common where universities are encouraging faculty to innovate and what are some pros and cons to that.

22:32.49
Pamela Cacchione
Yeah, So um, absolutely universities want us to Innovate. We have a Penn center for innovation which is around tech and drug Discovery type Opportunities. We also have a Penn center for Health system innovation. And we have a master's in Health system Innovation. We have Wharton school here business school that also is all about innovation and has their own Programs. We have a pen I core they are all over it. Um, the benefits is you have incredible infrastructure to support. You. The challenges are.

22:58.90
wearabletakeover
Yes.

23:07.59
Pamela Cacchione
In some universities you lose a large portion of your ownership of the company and so you know sttrs and sbir type of funding mechanisms to the government help you get back some of that over time and so that's really important and that's an area that I'll be pursuing.

23:11.40
wearabletakeover
Is.

23:20.59
wearabletakeover
Yes.

23:26.28
Pamela Cacchione
Moving forward after I get this preliminary data the suburb's so excited. Ah, and um and so it's really important to understand when you're within a university some will take 5% some will take 49% so really have an understanding of.

23:28.38
wearabletakeover
Yeah.

23:45.14
Pamela Cacchione
What you're committing to when you do start that and we were really encouraged as nursing faculty if we had an idea to pursue a company here at Penn and so that that is what I did um and so it's. Had colleagues who before they came on faculty ad companies and so they made sure they wrote that out of their contract with the university that that was separate because they owned that outright so that that's really important to be able to do that and you can do that within the university and you know it's.

24:09.90
wearabletakeover
And.

24:20.40
wearabletakeover
Um.

24:21.63
Pamela Cacchione
<unk>re you know as nurses we're problem solvers. So we're innovating all the time Anyway, I mean with my robotics study I was having to I have a plush robotic seal that had to be wanded Uv Light wanded every day and it took forever to get this done So I just built a Uv light box that.

24:24.76
wearabletakeover
Zoom.

24:41.77
Pamela Cacchione
2 robots would fit in. It's like okay this is taking way too long I got to fix this problem. You just do it. You know it's like okay this is I could do I'll just build a box that that was really easy. Ah.

24:46.69
wearabletakeover
Um, yeah, you just do it.

24:54.82
wearabletakeover
Well, we're gonna get to that robotics side but I want to make sure we don't dismiss this notion because we actually hosted a webinar earlier this year with some of our innovators that were developing ah companies based off of their research and their doctoral programs and so there's.

25:09.64
Pamela Cacchione
Um, so great.

25:11.36
wearabletakeover
There was concern and from our standpoint we heard a number of researchers reach out to us and say hey we'rele tech ventures can you talk about this because there's concern and especially there was a lot of concern amongst female researchers as to how do they approach that ownership conversation with the university.

25:23.49
Pamela Cacchione
Are.

25:31.27
wearabletakeover
What rights did they have XYZ so we do have that on our website wearabletechventures.org you know that's available anybody can look at that one demand but with you coming from the faculty side. Can you give.

25:31.47
Pamela Cacchione
Are my.

25:46.20
wearabletakeover
Maybe 2 or 3 recommendations for any other faculty that may be listening now or folks that may become faculty in the future that may say hey is it different as a faculty to approach this conversation of ownership with university related innovations.

26:01.31
Pamela Cacchione
Um, right? Yeah it it really is as a faculty member. You know you you're doing work through that's funded oftentimes through the government either. Mine is and Nsf funding mostly. But and Nih funding as well and dod funding so like trying to figure out that's government dollars that have helped you create this research so you kind of have this global perspective that you owe it back to the community anyway. But then the university if you're gonna. Commercialize it is going to want a part of it because they've been supporting you as a faculty member for all this year and all this time and you're you're successful partially because you're at the university you know so they they feel that there is some.

26:46.12
wearabletakeover
Here.

26:51.86
Pamela Cacchione
Ownership There are different ways to do that like this is my first startup that I've tried and so with gaining the University's help they provided a lot of resources in the beginning and then took a larger cut so there are two ways to do it So you really need to meet with your tech transfer. Um.

27:04.56
wearabletakeover
Who.

27:11.80
Pamela Cacchione
Side of your university to understand what the options are because there may be very different options and then also getting legal support as well. Either you know through the University which may be biased or outside legal support as well would be very. Um, helpful I'm less attractive to venture capital funds because of the amount that the University maintains so that that was during the and I accelerator program that was a big disappointment for me, but it's. Reality and so you move forward you pivot and you keep moving forward and and deciding what direction to go to so now I have this startup funds and I'm going to be doing an sttr most likely next. So It's exciting. It's um, but it is. Important for you to understand what you're committing to and what the University's committing to because they they will offer you support in in based on the amount of commitment that we requesting.

28:08.27
wearabletakeover
Yes.

28:17.68
wearabletakeover
So this is a wonderful conversation and in our other webinar we were of course referring folks to the tech transfer office and giving providing some insights and potential questions that folks should be asking and I love that you highlighted that there could be 2 avenues right? where there's.

28:36.38
Pamela Cacchione
Um, full of.

28:37.13
wearabletakeover
Increase ownership or loan or a lower sense of ownership as relates with the university and you're absolutely right? as far as being attractive to Vc and this is something that all founders need to evaluate from the very beginning. Um I'm a proponent for telling founders.

28:49.90
Pamela Cacchione
On.

28:54.96
wearabletakeover
Do not take money unless you absolutely need it. You know we're proponents of saying go after the free money and we know there are different avenues and and so immediately I was like oh your your product will be perfect for Shark tank but Shark tank may say Hmm based off of that owner.

28:58.85
Pamela Cacchione
And then.

29:09.12
Pamela Cacchione
Um, yep.

29:10.66
wearabletakeover
With the university it may not be you know a great fit but I know for Tv it would make wonderful Tv like 1 of our other founders that was recently on shark tank. So with that being said, um I I urge everyone to listen and take heed to the advice that Dr Castcione just shared. Because that ownership conversation is going to be key and at the end of the day. A responsible founder takes care of their investors right? And so. Thank thank you for sharing out so that was shift a little bit because you were talking about robotics and I know many people think oh that's something that my kid that's something that might.

29:34.35
Pamela Cacchione
Um, are with the.

29:46.61
wearabletakeover
Nephew Do I can tell you my godsend goes to a summer camp at Mit and he is big into robotics and we have college students that we work with you know here at world worth tech ventures that are into that So ah, help folks understand what does that look like for you because people have different ideas.

29:53.00
Pamela Cacchione
That's awesome.

30:05.41
wearabletakeover
Of what robotics looks like number one so help us understand was this was this a forced introduction based off of it. It being absolutely needed at work was this an interest. Um how how did you.

30:06.20
Pamela Cacchione
And then me.

30:22.54
wearabletakeover
How did you get into that space.

30:22.83
Pamela Cacchione
Yeah, so I met a gal by the name of Michelle Johnson who's a roboticist who's actually was hired by the school of medicine here at Penn and her interest is in stroke. Her grandmother had a stroke and her grandmother helped raise her and she was very interested. In trying to improve outcomes for patients with stroke and so the first robot was called flow after her grandmother and it sometimes when you have a stroke you lose the ability to pay attention to the affected side and so you don't cross the midline so her robot helped. Train the older adult or the person who had had a stroke with crossing that midline by having them do exercises in that direction and so it was really wonderful. We brought it to I was in a clinical practice at the time at University Of Pennsylvania's school nursing's life program living independently for elders program which is a pace program of all inclusive care for elders program where you know about 250 older adults would come into the center each day and. Because they were part of the university they were used to being part of research because we would have nursing students come in and do their dissertations there and so it was really a great nursing students would be trained there as well. It was a very interprofessional practice. Really joyful place to work and so we brought flow there to the stroke group.

31:55.22
Pamela Cacchione
And then also we brought it to the blind group which was really interesting so that they could interact with the robot and I can remember initially they'd say oh my grandchildren would love this robot. You know it was about three feet tall it has orange and white and very bubbly conversationalist. But they really engaged with the robot.

31:57.60
wearabletakeover
And my house.

32:05.60
wearabletakeover
Ah.

32:15.18
Pamela Cacchione
Very very quickly and then we had another commercially available robot called relay which you may see in hotels. It's ah the page the older adults called it in ah the second study that we did they actually third study they called it. A glorified trash can.

32:32.25
wearabletakeover
Oh my.

32:34.39
Pamela Cacchione
Because it's round Cylindrical. It has a bin open at the top and we did focus groups to decide what this low-cost mobile Robot should do so we talked to patients participants at the life Program. We talked to their paid caregivers and we talked to Interdisciplinary clinicians. And it's a low-cost robot so it can't pick somebody up off the floor. It's not going to have you know a lot of bells and Whistles. So What we decided it would do was encourage walking and hydration or drinking water so it would take older adults for a walk and interact with them and then it would offer them water.

33:02.87
wearabletakeover
Nice.

33:12.39
Pamela Cacchione
And the older adults had these really nice exchanges with the robot which was really joyful. So I was really disappointed to hear that they described it as a glorified trash can but I get it. Ah and so then we did focus groups with them to see what they would like a robot to look.

33:20.65
wearabletakeover
Mobile.

33:30.20
Pamela Cacchione
Like and a lot of them described Rosie from the Jetsons the little you know that little robot so we developed a robot here at Penn called quarry and quarry was ah looked a lot like Rosie from the Jetson little head little um.

33:32.41
wearabletakeover
Okay, okay.

33:48.90
Pamela Cacchione
Body and then skirt kind of and was on wheels and then we were about to use it in a research study and covid hit and it was on display in the in the Philadelphia Art Museum and it got locked up in the museum for six months

34:00.36
wearabletakeover
Wow.

34:05.94
wearabletakeover
Oh Wow Oh wow.

34:08.67
Pamela Cacchione
And we couldn't get it out. But so that kind of really just you know Pamdemonium I Told you my nickname is pamdemonium. So um, that was one of the episodes of Pamdemonium so we had to pivot and figure out what we could have this robot do so we turned it into a Covid screener.

34:13.80
wearabletakeover
Yes.

34:27.91
Pamela Cacchione
So that when people came into the life program. It would ask the covid questions check the temperature and say whether you could go into the center and if you had symptoms you would be directed to your provider to be assessed and then sent home so we had to you know pivot and then and our latest one that we're doing with. Um, that I'm doing with Dr Johnson is the she has developed or a company called Recupero that has a robot that is much more looks more mechanical than like a machine than actual humanoid type robot and it.

35:01.15
wearabletakeover
And.

35:04.30
Pamela Cacchione
1 of the things we learned with older adults is they've told us if you want us to participate in research has to be fun, but it has to be competitive. We had not thought about competition with older adults I mean would you I mean I that was off a pool. so yeah so um

35:10.18
wearabletakeover
Um, yeah, oh Wow Wow No more. That's amazing insight.

35:23.42
Pamela Cacchione
With the relay robot we had them playing a cornhole game because the third activity that it did was a reach task where it would pick something out of a shelf or pick up the beam bags from the floor and hand them to the older adults to play cornhole so that was really fun but with this mechanical stroke robot.

35:29.32
wearabletakeover
Nice, nice.

35:42.69
Pamela Cacchione
Um, it has a handle and you play video games and you can play against yourself or you can play against another participant and that you might influence their game and they might influence your game. So it's really going to be exciting. We're just getting.

35:48.23
wearabletakeover
Um.

36:02.12
Pamela Cacchione
Started with that and so we've recruited about 5 participants so far so I'll have more to report in the future and then the paro yield is the other study that I did at the at Penn Presbyterian and we we use that in participants in the hospital who were agitated.

36:09.92
wearabletakeover
That's outstanding.

36:21.86
Pamela Cacchione
Either due to dementia and or delirium or acute confusion and what we identified with this robot is that it decreased agitation within the first twenty minutes and they had an hour long interaction and then it decreased their pain response because it was a really nice distraction. And also increased both vocalizations or verbalizations and it just was such a joyful study I mean even the the nurses and the physicians and other providers in the hospital were like what is that they videotaped themselves with the robot. It was hilarious, but.

36:58.80
wearabletakeover
Well this is this is interesting. So so do you think that robots will continue to be used or will they grow in usage as relates to aging research.

36:59.64
Pamela Cacchione
But it was really fun.

37:09.19
Pamela Cacchione
Yes, we've are. We're already seeing them in assisted living settings in nursing homes that they have a recreational purpose or there's a telehealth purpose they have used them extensively during Covid for Telehealth and so that was really helpful.

37:19.21
wearabletakeover
Do here, do.

37:27.63
Pamela Cacchione
Um, but there are a lot of robots being created that will interact and engage older adults to try and decrease social isolation you know and then there's the huge field of medical robotics and surgery and everything like that. So we're seeing all sorts of different applications I've been working with a group.

37:33.39
wearabletakeover
Who.

37:45.47
Pamela Cacchione
Try and develop a soft robot that would assist older adults in turning and lifting up in bed so that it would save the nurses back so trying to really figure out how a soft robot could do that and so it's it's just fascinating the field I think there's lots of room for growth.

37:52.74
wearabletakeover
Yes, yes.

38:05.50
Pamela Cacchione
And improvement in in the care of older adults in particular because there are going to be so many of us that there aren't going be enough people to take care of us. So.

38:09.99
wearabletakeover
Yes, well, you know there's a lot of conversation amongst medical professionals when we look at the pipeline of talent. You know who can actually help fulfill the demand and what I've been hearing from medical professionals and this this is most recent from. Ah, recent visit where um, a doctor was saying that most folks are are stressed even after the pandemic they're finding that stress is only increasing and that folks may be leaving due to not having you know that reprieve. So. When we look overall at the future of nursing. Um, what does that look like 1 number 2 what's the temperature of nurses are they optimistic about the uses of robots and even Ai and the reason I asked that is because. When we talk about ai and kind of and we're you know about to drive this conversation in that direction. Um, many folks? um are saying oh it won't affect me. It won't impact me or if it impacts me it will be totally positive and it won't be negative and so.

39:18.14
Pamela Cacchione
Um, like.

39:22.67
wearabletakeover
Just gave you a big box of questions there but but um, but you know we'll break that down. We got a little time to break that down. But I am curious because there are some things being developed and so the question is you know to start and we'll backtrack. Some is what our nurses outlook.

39:29.21
Pamela Cacchione
Ah, no.

39:41.30
wearabletakeover
Ah, what our what our nurses overall outlook you know we can't you know? ah you know, answer for everyone when we look at the introduction and utilization of robots and Ai.

39:51.40
Pamela Cacchione
So I would say based on my experience at Penn Presbyterian They love the opportunity to work with robots and we right now can only use them under research purposes because of their plush and they need. Um, cleaning so we're working on developing processes so that they could use the robots whenever they need them and so that would be really nice for the acute care for elders floor and the trauma floor but they're.

40:14.15
wearabletakeover
Who.

40:25.33
Pamela Cacchione
They're open to Ai I can remember when I was doing my pen Ai core questions and interviews and when I talked to nurses and home care. In particular one of the first nurses I spoke to said I want a wearable with decision support and I said okay my work here is done I don't need to do any more interviews and but actually it.

40:39.61
wearabletakeover
Mm.

40:44.67
wearabletakeover
Right.

40:44.91
Pamela Cacchione
That was just the beginning I mean there were much more to learn but decision support is is critical to two nurses but it has to be valid and reliable. They want to be able to trust it and it also has to address diverse populations.

40:50.58
wearabletakeover
Do. See who.

41:00.74
Pamela Cacchione
Because one of the biggest things we've learned about Ai is if you train it on homogeneous samples. You get a very biased biased response and so we really need diverse samples and fully engaging the population that we serve and so that's.

41:07.83
wearabletakeover
E.

41:17.15
Pamela Cacchione
Really exciting to me to be able to do that I mean that was one of the things we learned with the Quarry Robot we wanted to use facial recognition but our population at life is primarily African American and that was not going to work so we had to have a backup of Rfid tags.

41:25.28
wearabletakeover
Who.

41:35.58
Pamela Cacchione
To recognize because we were initially going to have Cory go up and find individuals and bring them to different activities based on their preferences or bring them to the clinic if they needed to see the podiatrist or the dentist or what have you and so if it could not recognize the individuals. It was not going to be helpful. And so really, we need to learn how ethically to create these algorithms. It's really really critical and so.

41:58.80
wearabletakeover
Yes, yes, that's one of our focuses for our curriculum this summer so we actually host a global wearable tech hackathon and there's a focus this year on the ethical ai usage and you mentioned something very important with the patient population which.

42:11.37
Pamela Cacchione
How nice.

42:17.90
wearabletakeover
Is actually not as represented in other samples. But you said there was a high percentage of african-american patients and what we found is that in many of the other arenas where Ai is being developed. There's a lack of representation right? So from your standpoint. Um.

42:35.90
Pamela Cacchione
2

42:37.76
wearabletakeover
You know from that particular sample are you saying it would have been skewed because you know that that one setting or also were there challenges with when you talk about detection melanin because we know that there has been in the past you know with that.

42:52.70
Pamela Cacchione
Um, yeah, and backlighting all these different things that were going to affect the facial recognition that we couldn't really guarantee that population in particular and is fabulous I've I worked there for 7 years as a clinician and now I do research there. Um, and they're you know West Philadelphia you know primarily born and bred Philadelphian some have emmirateted from the south but they um, they it's a dual eligible population. So they're both medicaid and medicare and what is so cool about that population is most of the caregivers are from that population also and so they have grown up with these older adults and so they know them incredibly well and it's such a joyful joyful place to work and.

43:27.70
wearabletakeover
Um.

43:34.90
wearabletakeover
Yes, yes.

43:44.77
Pamela Cacchione
The school of nursing has since sold it to Trinity Health and so they they own and operate now I think 4 pace model programs in the philadelphia region. So it's I guess 3 now 3 and then one in New Jersey and 1 to Delaware. So. It's really a ah neat model. And it's a really exciting place to to interact with participants they and luckily they're used to us so they've they participated in a lot of different research robotic studies and I remember 1 gal waved me down the other day and she said oh are you doing another study.

44:10.96
wearabletakeover
Yeah, yeah.

44:24.18
Pamela Cacchione
Can I can I mean this study I said have you had a stroke she said no and I've said I'm so sorry this one do you have to have a stroke have to have had a stroke she goes Well I Guess that's good news that I haven't had a stroke but.

44:27.38
wearabletakeover
I.

44:33.25
wearabletakeover
Absolutely absolutely absolutely. But when we think about you know because we're we're on the forefront of helping to when we say develop and promote wearable technology. We're at the forefront of saying hey here are some considerations as far as responsible and ethical development. We've worked.

44:50.27
Pamela Cacchione
And.

44:53.40
wearabletakeover
Over the past few years with Deloitte who is also a big proponent of the ethical. You know, usage of technology. Do you have any recommendations for um, our listeners who may be in that same space. They might be doing some testing and they could be um. You know a catalyst for ensuring that their work serves as a model that we want to see as it relates to incorporating ah incorporating Ai do you have any suggestions for that person that may be listening.

45:18.52
Pamela Cacchione
Um, yeah I think you know we when we talk about the ethical use of Ai. We often do go directly to the diversity question and the. Because that's been the biggest problem from the beginning was it was you know a homogeneous sample that these algorithms were based on and I think we are really beginning to recognize that. That's really a problem.

45:48.65
wearabletakeover
Yes, yes.

45:50.93
Pamela Cacchione
You know, unfortunately people have died because it's a problem. So I mean it's It's really important that we we engage the wealth of individuals in our communities but and so I would suggest you find a gatekeeper for population that you are trying to. Um, engage in research or gather data from and build relationships actually spend time in the community volunteer so that you are a trusted individual in that particular community or can be introduced.

46:27.10
Pamela Cacchione
It's amazing if there are new members at the life program that did not know me from when I was a clinician there if 1 of the caregivers goes up and says you you work with pam she's really great. You'll have a great time. She's she used to work here. She really loves this population and it just makes a huge difference.

46:42.93
wearabletakeover
Yes, it is.

46:45.60
Pamela Cacchione
To they're willing to talk to me. Yeah, the other thing is I'm very close with the chaplain there and so the first day I was there I saw him and had been a while and I gave it walked up to and gave him a big hug and it's like everybody's looking at me like who's this lady fucking the chaplain. But I mean it's just it's important. You know that.

46:55.75
wearabletakeover
I Love that. More yes.

47:04.33
Pamela Cacchione
You are part of that community and so that piece of it is really really critical and then stay after share what you find after you, you can't just walk away and not provide the information back. It's just and.

47:20.62
wearabletakeover
Um, yes, yes.

47:23.41
Pamela Cacchione
Unfortunate how that can happen and then also you know pay your participants. Ah, you know if they're going to the study we're doing for stroke. They earn three hundred and fifty dollars over twelve weeks and and it's really exciting to them to be able.

47:29.17
wearabletakeover
That part.

47:42.80
Pamela Cacchione
Actually approach them as saying this is almost like a part time job and we are making a commitment to you but you're also making a commitment to us but we are you know? So it's really, you have to have a sense of what what their time is worth.

47:45.58
wearabletakeover
But yeah, right.

47:57.51
wearabletakeover
Absolutely I Love I Love that and I appreciate you highlighting the notion that we are people building technology and so we have addressed humans as human beings. One of the things I'm famous for telling folks is we're not computers yet right? so.

48:00.63
Pamela Cacchione
You know and.

48:09.21
Pamela Cacchione
Um, bye.

48:16.26
wearabletakeover
Still treat us as human beings like we go through things we feel things we experience things I Love it.

48:17.60
Pamela Cacchione
Um.

48:21.23
Pamela Cacchione
Yeah, it's so true and that's that's been a benefit of working with engineers because they're really good at the mechanical computer stuff. Not always so good at the human stuff Some of them are really good but not always and so it's really being able to model for them. How to interact with older adults in particular.

48:30.95
wearabletakeover
Um, yes.

48:40.99
Pamela Cacchione
Has been really a joyful experience and and usually they can come away having learned something.

48:45.90
wearabletakeover
I love it so considering the future would you say that nurses might be 1 of the biggest drivers of innovation considering you know what you've experienced.

49:01.40
Pamela Cacchione
Yes I think particularly in the field of Ai because of where we see it can make a difference and how it can help us with decision support and how it can help us identify and we're educating more and more nurses in informatics.

49:08.20
wearabletakeover
And.

49:17.95
wearabletakeover
And.

49:20.12
Pamela Cacchione
And computer science so that they understand how to use the information and the medical records and the data that's coming from them even natural language processing. You know things like that because the medical record is so rich in you know.

49:39.25
wearabletakeover
Yes, yes.

49:39.99
Pamela Cacchione
Text and we need to figure out how to use that text to really improve the care that we give and I think one of the things that I would love to see more Ai focused on and it's not so it could be a wearable actually is they scribes.

49:57.79
wearabletakeover
And.

49:59.72
Pamela Cacchione
Because you know documentation in the clinical setting is one of the biggest sources of Burnout you know they'd much rather spend more time with patients I have have a colleague who did a study with the joy robots their little cats and dogs and.

50:04.24
wearabletakeover
Yes, yes.

50:16.55
Pamela Cacchione
1 of the things that she found in her study which was not something she really was looking for was that the patient said the nurses and the doctors stayed in the room longer when they had the robot in the room and so like trying to figure out how to harness technologies that will.

50:25.83
wearabletakeover
Wow.

50:35.17
Pamela Cacchione
Actually enhance engagement with patients is an interesting I mean there are just so many opportunities and nurses are natural problem Solvers I Mean if we have a problem we're going to develop. We call them workarounds but we have to really kind of develop those more. It's like building that Ub Light box.

50:47.46
wearabletakeover
Me.

50:54.96
Pamela Cacchione
I was tired of of wanting something so it's like problem solved I could put it in for 10 minutes flip it over 10 minutes and it's done. Ah, ah you know it was there were commercially available light boxes but they weren't big enough.

50:58.65
wearabletakeover
I Love it. What did it take for you to build that by the way.

51:12.25
wearabletakeover
And.

51:14.58
Pamela Cacchione
For my and so I this is It's a low tech one. It's built out of a sweater box like for winter sweaters and then I just lined it with reflective like material that you can buy online and I had a Uv light and then I had had a timer and it just zip it up. Put them in.

51:19.52
wearabletakeover
Yes, yes.

51:34.70
wearabletakeover
I love it I love it and I like sharing with our audience prototypes because we have folks that listen to this and often one of the barriers for folks to even you know, move forward with their innovation is that prototype they think it has to be fairly expensive but Dr Cash on with you just sharing that.

51:34.34
Pamela Cacchione
And it's it was so easy.

51:53.58
wearabletakeover
And then also when they listen back to the prototypes from our founder in Delaware then also with dawn when she did her stuff you use and home home depot materials. Um, you know we're saying innovation is accessible for us all we're all able to inspire influence.

52:01.32
Pamela Cacchione
Mother.

52:11.54
wearabletakeover
And drive innovation and I love your story I Love how you're a proponent of nurses helping to drive innovation. Um, so so as as we prepare to close I Want to kind of get a message from you.

52:20.20
Pamela Cacchione
Um.

52:28.16
wearabletakeover
It could be discussion points or whatnot. But I want to get a message from you on what does that look like how can people come to the table. How can they take themselves out of the box so that they can be like you or similar to you and help.

52:28.68
Pamela Cacchione
Um.

52:45.96
wearabletakeover
Create solutions to problems that their family members might face or their neighbors might face.

52:54.35
Pamela Cacchione
Um, so some of the things are some hackathons are huge I think just participating yes participating and engaging with other people.

52:57.50
wearabletakeover
Yes, that's applause so this is.

53:06.62
Pamela Cacchione
That are creative and giving yourself permission to be creative because we get so caught up in oh I've got to do these tasks and I've got to get this work done I've got to get this done but like when you give your once you start being creative. It's it's joyful and you just want to keep doing it. It's.

53:09.19
wearabletakeover
Yes, yes.

53:26.75
Pamela Cacchione
It's really quite fun and you'd be surprised how creative you are whether you think you're creative or not. It doesn't have to be pretty. It just has to be creative and different and thinking outside the the box necessarily and then there are organizations like in nursing we have sancel.

53:31.81
wearabletakeover
Yes, yes.

53:43.93
Pamela Cacchione
Which is an organization of nurse innovators and so joining those types of organizations or state chapters or things like that and um, you know reading you know it's always good to to think ah think about innovative books that might be helpful I um I asked 1 colleague of mine.

53:54.12
wearabletakeover
Yes, yes.

54:03.11
Pamela Cacchione
Um, can you recommend a book about innovation and she recommended Hamilton now that's a tone. Yeah, but when you think about it. He really was an innovator and he really had to think outside the box and and so it it was really kind of interesting idea. But there there are many others that we could.

54:08.84
wearabletakeover
Um, Wow. Wow.

54:22.86
Pamela Cacchione
Um, come come to think about, but just ah, engage there's ide. There are all sorts of different opportunities to think about design thinking and so engaging in that type of training and thinking you know, just.

54:33.86
wearabletakeover
Yeah.

54:41.63
Pamela Cacchione
Kind of trying to come up with some of the ah outrageous things and instead of saying oh no, that would never so work say yes and always say yes and yes and and it would also be good if didhdada you know, like thinking out you know and you know avoiding that term no.

54:48.19
wearabletakeover
Yes, yes. Yeah to use.

55:00.39
Pamela Cacchione
You don't want to say I can remember even when my kids were little I didn't want to say no all the time. So I only said no in an emergency otherwise I would say I don't think so ah.

55:03.30
wearabletakeover
Button.

55:12.84
Pamela Cacchione
But ah, then a no when it was serious but I don't think so.

55:14.46
wearabletakeover
I love it. I love it and for folks for those of you that are listening only Dr. Cashion is true to what she's saying because she's sitting in front of this tremendous Bookcase. It has all these amazing books. It looks like some are you know. Ah, textbooks ah research books. But then also like regular books so she she stays behind us. Ah.

55:31.11
Pamela Cacchione
Um, yeah, yeah, the achievement habit is right there. That's one but I was a journal editor So those are all my past edit um editions of the journal that I.

55:46.46
wearabletakeover
Editorial. Ah.

55:49.28
Pamela Cacchione
Issues there we go issues of the journal that I that I was a.

55:50.30
wearabletakeover
I love it. Well our community supports that so we do have if you listen to the show or watch the show notes and then also listen to some of the other advertisements to come out. We do have a monthly book of podcast club folks can join Dr. Castion gave us a great plug for the annual. Weable tech ventures hackathon which is hybrid meaning there's an in-person as well as a virtual component you can still compete get get yourself out of the box just get familiar practice ultimately is what it is. It's a safe environment to practice. Not a lot of pressure. You could do that with us at the end of july.

56:18.72
Pamela Cacchione
Are.

56:26.10
wearabletakeover
But you know what we want to know how can our listeners stay tuned to your progress with your research and with your product because I'm sure there are people that are interested.

56:33.65
Pamela Cacchione
Yeah, yeah, so um, you could follow me on Twitter at aging sense. All 1 word one and then I'm also on Linkedin but Pamela Cashio and I haven't set up a Linkedin for aging sense yet need to do that. But so I use that just. Professionally so Pamela Cashion you can find me on Linkedin. So it's probably the best way at this point in time.

56:57.19
wearabletakeover
Absolutely And folks you know what? check the news and check our page because you know we are going to promote anything that she does as she is developing the future. We are so excited to have you here on the wearable Takeover podcast and in the warable tech ventures ecosystem folks.

57:14.84
Pamela Cacchione
Thank you Thank you? This was a lot of fun.

57:16.86
wearabletakeover
Stay tuned and stay creative.