Technological advances include medical innovations. A case study of how the process of adapting a medical solution to the long term and post-acute care (LT/PAC) sector works is Medtronic’s foray into skilled nursing care with NURO therapy for incontinence.
Britton Garrett, executive director of Medtronic, tells Provider he hopes his company’s NURO solution offers a new way of looking at a longstanding clinical challenge.

While Medtronic has been in the business of treating the issue of overactive bladders for more than 20 years, the method involved implanting a device. “So, that is more of a surgical procedure. And, as we looked at the overall population of who needs help with incontinence, it was jumping off the page at us that we had a big gap in being able to help people with only that surgical-like technology,” Garrett says.

Long a leader in medical devices, having invented the pacemaker, Medtronic brought in its minimally invasive version for treating incontinence, which works through an acupuncture needle connected to a neurostimulator to change the brain’s inappropriate impulses that cause overactive bladders.
“A person who has issues with an overactive bladder will feel the sensation to go, and very oftentimes it is followed by an accident,” Garrett says. “We are impacting the negative communication channel and filtering it out.”

Partnering with Doctors

To find the best application to benefit residents, Medtronic worked in partnership with physicians who had experience in the LT/PAC setting.

“We really set off over the past three years to truly understand the pain points of incontinence in this care setting,” he says. So, Garrett, along with a facility in Cleveland that is part of the Cleveland Clinic Connected Care program, worked together to understand how they would apply the therapy and what real benefits would result for residents in the LT/PAC setting.

Right now, Medtronic is focusing its NURO therapy on skilled nursing centers since its staff understand who in the building may need an assessment for incontinence, Garrett says.

In addition to helping treat the resident, the product may also help improve the provider’s survey marks.
“An absolute key is to look at quality measures,” since many of them are related to incontinence, he says. And with Centers for Medicare & Medicaid Services data showing around 70 percent of individuals in a skilled building suffer with incontinence, the impact on quality scores can be immense if the root cause of
the problem is addressed, he says.

The importance of being on top of incontinence cases for a provider is made even more vital because the incontinence associated with overactive bladder may cause changes in skin integrity, skin irritation or breakdown, urinary tract infections, falls, fractures, and sleep disturbances. The condition can also result in social withdrawal, embarrassment, loss of dignity, and feelings of isolation.

In bringing the incontinence effort to the skilled nursing market, barriers do exist for many technologies due to cost. But, Medtronic says that in this case, the clinician using the treatment is reimbursed through Medicare Part B claims.