At Recovery Force Health, innovation is fueled not only by technology but by the talented team members behind it. This summer, we had the pleasure of working with Nealon Shah, an ambitious young computer science major at Indiana University. As his internship draws to a close, we sat down with Nealon to learn more about his activities with us this summer, his interests, and how his time at RF Health is helping to shape his future plans. 

Q: Tell us about yourself and how you landed at RF Health this summer. 

I’m originally from Fishers, Indiana, which is also where RF Health is headquartered, so it feels like home. I’m currently studying Computer Science and minoring in Economics at Indiana University. Eventually, I hope to work in finance, using AI and data analytics to solve complex problems. 

I connected with RF Health through Matt Wyatt, a longtime family friend. I reached out to him to explore opportunities, and he introduced me to Jason and Karlee. After learning more about the company and the exciting challenges they were working on, I knew I wanted to be part of it. 

Q: What kind of work did you take on during your internship? 

In the beginning, I spent time understanding our existing data pipeline and how we collect and analyze data from our devices, especially the MAC System. This foundation helped me identify ways we could evolve our approach. 

From there, I started building dashboards to help clinicians and internal teams better visualize data. These tools are already helping us uncover insights from trial data and could eventually support broader efforts like gamification, which is an idea that’s still in development but very promising. 

Most recently, I’ve been working with machine learning models to help us forecast trends and make more proactive decisions. It’s all about enabling the team to act on insights quickly—ultimately improving outcomes for patients. 

Q: What has been the most rewarding part of your internship? 

The people. The RF Health team has been incredibly supportive and collaborative. I’ve worked closely with Karlee, and what’s been amazing is how our skill sets complement each other. She brings the customer and clinical perspective, and I bring the technical. It’s a true symbiotic relationship, and we’ve been able to accomplish a lot together. 

Also, I’ve been given quite a bit of agency here, which has been incredible. I didn’t expect to have such a major role in building out the data strategy, but I’ve been trusted to lead and execute. That’s rare for an intern and something I really value. 

Q: What surprised you most about your experience at RF Health? 

Honestly, I was surprised by how much I’d be able to support and shape the data infrastructure. I thought I’d be refining existing systems, but instead, I’m helping to build a new data foundation from the ground up. That level of ownership was unexpected, and it’s been incredibly fulfilling. 

Q: What are some key lessons you’re taking with you? 

The biggest one is learning to think strategically, not just analytically. Early on, I was focused on pulling insights from the data, but over time, I learned to anticipate what insights would be useful, where we should be heading, and how to align data work with broader company goals. That shift from analysis to strategy is something I’ll carry with me going forward. 

Q: Where do you see yourself in five or ten years? 

Five years is a long time from now, so I’m not exactly sure, but I do know I want to be in a role where I’m leading a team, driving innovation, and working proactively, not reactively. I want to make meaningful changes and build solutions that have real value for others. 

Q: Any final reflections on your summer at RF Health? 

Being part of a fast-growing company has been an incredible experience. There’s so much energy here and so much momentum—it’s exciting to contribute to something that’s evolving in real time. I’ve loved being part of this journey and learning how much a small, focused team can accomplish when everyone is aligned on a mission. 

Nealon’s work this summer has laid the foundation for a more powerful, proactive use of data at RF Health. We’ve enjoyed his expertise, input and willingness to jump in. We can’t wait to see what he accomplishes next. 

Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a significant health concern in US hospitals, affecting 350,000 to 600,000 patients annually. A leading cause of avoidable hospital deaths and post-surgical readmissions, VTE prevention is crucial for patient safety and cost-effective care.

To address this, healthcare organizations are prioritizing critical interventions such as mechanical prophylaxis, with electronic Clinical Quality Measures (eCQMs) playing a key role in tracking and reporting VTE prophylaxis and hospital-associated VTE (HA-VTE) rates. 

Tracking VTE with CMS Electronic Clinical Quality Measures (eCQMs)  

The Centers for Medicare & Medicaid Services (CMS) guides hospitals in tracking and reporting on VTE through specific eCQMs, focusing on harm reduction and improved patient safety. These measures are part of CMS’s broader initiative to enhance patient safety and care quality by monitoring and reducing the incidence of hospital-acquired conditions, such as VTE.

Two key measures are:

• Hospital Harm – Postoperative Venous Thromboembolism eCQM: This measure assesses the proportion of patients (aged 18 and above) who develop at least one post-operative VTE event, such as a PE or DVT, during a hospital encounter, serving as an indicator of care quality and incentivizing hospitals to improve care processes.
• CMS108v11: Venous Thromboembolism Prophylaxis: This eCQM assesses whether patients receive VTE prophylaxis or have documented reasons for not receiving it, aiming to prevent VTE and its complications.

The Importance of VTE Prophylaxis

Up to 70% of VTE cases among hospitalized patients are preventable, yet fewer than half receive adequate preventive treatment. Effective VTE prophylaxis protocols can significantly reduce hospital mortality and morbidity.

There are two primary categories of VTE prophylaxis:

• Pharmacological prophylaxis: Anticoagulant medications to inhibit blood clotting, such as Low Molecular Weight Heparins (LMWHs)

• Mechanical prophylaxis: Techniques to promote venous blood flow and reduce blood clot risk , such as intermittent pneumatic compression (IPC) devices

Mechanical Prophylaxis: A Key Component of VTE Prevention

Mechanical prophylaxis is an integral part of VTE prevention, particularly when pharmacological options are contraindicated or in patients at mid-to-low risk who may not require medication. A combination of both mechanical and pharmacological interventions can also effectively reduce the risk of VTE in some cases. (See our recent blog to learn more on this.)

IPC devices are widely accepted as a standard of care for mechanical VTE prophylaxis, but nonadherence remains a challenge. While studies show IPC devices can effectively reduce the risk of VTE, reported compliance rates are often as low as 40%. Discomfort is also a primary factor, making it difficult for patients to achieve the recommended wear time of 18-22 hours per day.

Enhancing VTE Prevention and Tracking with Data-Driven Insights

Hospitals can also enhance VTE prevention strategies and patient outcomes by analyzing data to develop more effective strategies to reduce the incidence of VTE. However, despite the critical importance of VTE prevention, the integration of eCQMs presents challenges, including reliance on documentation that may not accurately reflect prophylactic measures. Addressing these issues requires a more concerted effort in data collection to ensure accuracy and provide meaningful insights.

Key Metrics for VTE Prevention

Obtaining critical metrics, such as prophylaxis prevalence and hospital-associated VTE incidence, is essential for effective VTE prevention. A data-driven approach can significantly enhance this process by:

• Providing accurate documentation of patient mobility levels and wear time compliance
• Empowering healthcare providers to make informed decisions that improve patient outcomes and care quality
• Enabling bedside caregivers to support adherence to the recommended 18-22 hours of VTE prophylaxis
• Helping hospitals to facilitate early mobilization, refine prevention protocols, reduce complications and length of stay, and lower healthcare costs

By leveraging data-driven insights, hospitals can optimize their VTE prevention strategies, drive quality improvement, and ultimately deliver better patient outcomes.

Innovations in Mechanical Prophylaxis

Despite its effectiveness, VTE prophylaxis remains underused or is used sub optimally in both medical and surgical patients. This is largely due to the current standard of care, where IPC devices often fail to meet patients’ needs due to significant limitations that impact their effectiveness and safety. (Learn more here) New technologies, such as wearable mobile compression devices, offer promising solutions to overcome the limitations of traditional IPC devices.

Wearable Compression Technology

 One novel approach to VTE prevention that’s gaining traction, backed by evidence-based research, is the Movement And Compressions (MAC) System. The MAC System is a battery-operated, cordless, and tubeless wearable therapeutic compression device that provides compressions to the calf muscles using force instead of air to increase venous blood flow and reduce the risk of clot formation.

 An integrated display highlights individual patient mobility data, including compliance (wear time), time in bed, time upright (such as time spent sitting a chair or dangling at the side of the bed), and number of steps taken, with seamless integration capabilities into electronic medical record (EMR) to streamline data tracking and inform care decisions. Up to 48 hours of patient data are available to empower bedside caregivers with critical metrics to support the execution of in-hospital mobility and adherence to the recommended 18-22 hours of VTE prophylaxis.

Its innovative design addresses many limitations of traditional IPC devices, enhancing early mobilization efforts and improving patient outcomes. It is the only known portable, non-pneumatic compression device that also measures and displays patient mobility data, along with its EMR integration capabilities, currently available in the clinical setting.

Benefits of the MAC System include:

• Measures and tracks patient mobility data and adherence to VTE prophylaxis, providing accurate documentation with actionable insights for bedside caregivers Achieves target peak blood flow velocity 3x over baseline across all BMIs using force instead of air to provide consistent compressions that mimic ambulation
• Enhances patient mobility and comfort, with significantly longer wear times and improved patient satisfaction

Evidence-Based Research Supporting the MAC System

 Studies have shown that wearable therapeutic compression devices like the MAC System can lead to:

• Significantly longer wear times, with more patients wearing the device for at least 18 hours per day
• Improved patient comfort and satisfaction with meeting mobility goals
• Enhanced clinical usability with accurate documentation of patient mobility levels
• Reduced incidence of VTEs and improved patient safety

A recent Quality Improvement (QI) project reported a 92% increase in compliance and a reduction in VTE incidence over a 7-month period using the MAC System.

The accurate and actionable data provided by wearable compression devices, such as the MAC system, can help hospitals overcome the limitations of traditional data collection methods and improve their eCQM reporting. As hospitals adopt these new technologies, they can enhance their VTE prevention strategies while meeting CMS reporting requirements and driving quality improvement initiatives, ultimately leading to better patient outcomes.

Preparing for CMS eCQM Compliance and Harm Reduction

 As CMS continues to prioritize harm reduction measures, hospitals must stay ahead of the curve by implementing effective strategies for VTE prevention. To meet CMS reporting requirements and improve patient outcomes, hospitals should focus on the following:

• Developing and implementing evidence-based VTE prophylaxis protocols
• Tracking and reporting VTE rates using eCQMs
• Analyzing data to identify areas for improvement and drive quality initiatives

By prioritizing VTE prevention, harm reduction, and leveraging solutions such as wearable compression devices with data-driven insights, hospitals can enhance patient safety, reduce VTE incidence, and improve care quality.

Venous thromboembolism (VTE) is a significant concern in healthcare, being a leading cause of preventable hospital deaths and readmissions following surgery. Even though as many as 70% of healthcare-associated VTE cases are preventable, fewer than half of hospitalized patients receive preventative measures.

Our recent blog explored the dual approach to VTE prevention, detailing the role of pharmacological and mechanical prophylaxis and when to use each based on established clinical guidelines, studies, and risk stratifications. Mechanical prophylaxis is regularly recommended for use in combination with pharmacologic prophylaxis to reduce the incidence of VTE, particularly in surgical patients. It also plays a crucial role in preventing VTE in patients at high risk of bleeding or those who cannot receive pharmacological prophylaxis.

However, despite the benefits of mechanical prophylaxis, the current standard of care Intermittent Pneumatic Compression (IPC) devices are failing patients due to significant limitations that impact their effectiveness and patient safety. Nonadherence to recommended use of IPCs is an ongoing problem and frequently leads healthcare staff to opt for pharmacological approaches, even in mid-to-low-risk patients who may not require medication.

Patient Compliance: A Major Challenge

One of the primary limitations of traditional IPC devices is patient compliance, which is critical for achieving optimal therapeutic outcomes. Studies have shown that adherence to IPC devices can be as low as 40%. 

Non-compliance with prescribed mechanical prophylaxis protocols can result in insufficient treatment, increased risk of blood clots, and costly medical interventions. Multiple studies have identified reasons for non-compliance, including discomfort associated with wrapping a non-breathable air bladder around the leg. These sleeves cause sweating, increasing discomfort and leading patients to use their call light and have the nurse remove the device. Patients have reported trouble sleeping due to the noise generated by IPC devices, and multiple, cumbersome tubes and cords hinder patient mobility—a key preventive measure to reduce the risks of VTE.

These factors make it difficult for patients and caregivers to achieve compliance with the recommended therapeutic wear time of 18 to 22 hours daily.

Exploring the Impact Traditional IPC Devices Have on Mobility

IPC devices are not intended as standalone treatments; they are often integrated into a comprehensive approach that includes additional preventive measures such as early and progressive mobility. However, IPC devices, like other medical equipment such as IV poles, can hinder patient mobility in the hospital setting. The presence of multiple cords and tubes can significantly impact mobility by essentially tethering patients to their beds, increasing the risk of falls and creating a reluctance to mobilize for both patients and healthcare workers. Furthermore, if the IPC Sleeves are removed for patient mobilization, they are not always reapplied in a timely manner.

Strategies to Enhance Compliance and Mobility

One approach to enhance compliance and mobility is focusing on practical ways to remove some of the barriers presented by traditional IPC devices in the healthcare setting. Several strategies can be employed to overcome these limitations: 

1. Cordless and Tubeless Devices: Multiple cords and tubes connected to IPC devices tether patients to the bed and hinder their mobility. When patients are ready to mobilize, healthcare workers are typically called into the room to disconnect/reconnect the tubes and reposition the sleeves, taking them away from other critical duties. Not only that, they present a trip and fall hazard for both patients and staff. Using cordless and tubeless wearable therapeutic compression devices can promote safe mobility and increase compliance.
2. Improved Patient Comfort: Focusing on patient comfort by providing a compression device that is lightweight, quiet, and breathable can increase compliance and improve patient outcomes. Additionally, features such as moisture-wicking straps and a pressure prevention pad allow for breathability and maximum patient comfort. 
3. Incorporating a Data-Driven Approach with Compliance and Mobility Data: A data-driven approach can enhance clinical usability and provide accurate documentation of patient mobility levels and wear time compliance. This data helps empower healthcare providers with actionable insights to improve patient outcomes and make informed decisions on their care.

New technologies, such as wearable mobile compression devices, offer promising solutions to the existing limitations of traditional IPC devices. These devices are more comfortable and allow patients to mobilize with ease while also measuring mobility to provide critical data to monitor adherence. This ultimately increases compliance and the effectiveness of recommended mechanical prophylaxis protocols.

Evidence-Based Results: The Impact of Wearable Mobile Compression Devices 

Studies have shown that wearable therapeutic compression devices, such as the Movement And Compressions™ (MAC) System, can lead to significantly longer wear times, improved patient satisfaction, and enhanced mobility. For example, a study published in an international, peer-reviewed trauma nursing journal aimed to determine whether using the MAC System compared with an IPC device impacts compliance with mechanical VTE prophylaxis in trauma patients. The results concluded that the absence of cords and tubes promotes safe mobility. This significantly influenced compliance and enabled patients to be mobilized safely without the need to unplug/re-plug the device.

Patients who used the cordless and tubeless mechanical prophylaxis device exhibited considerably more time upright than patients using the current standard of care IPC. The difference was attributed to its ability to provide real-time mobility data on the patient’s upright time, walking time, and the number of steps taken. 

A recent Quality Improvement (QI) project noted that improving patient comfort, independence, and satisfaction by utilizing the cordless, tubeless, non-pneumatic MAC device led to a 92% increase in compliance, reduced the incidence of VTEs over a 7-month period, and improved overall patient safety. It allowed patients to receive VTE prophylaxis and mobilize simultaneously (i.e., dangle their legs at the side of the bed, get to the chair, and ambulate).

A comparative study published in the American Journal of Nursing highlighted the potential of the MAC System to improve patient outcomes and reduce the risk of VTE. Key findings include:

• Significantly longer wear time, with more patients wearing the novel mechanical compression device for at least 18 hours per day.
• Tripping hazards created by tubes and cords on current IPC devices and the negative impact on mobility were substantially improved using the novel mechanical compression device. 
• The device resulted in improved patient comfort and significantly greater patient satisfaction with achieving mobility goals.
• The system’s data-driven approach enhanced clinical usability for nurses, with accurate documentation of patient mobility levels.

Conclusion

Since the National Institutes of Health (NIH) 1986 Consensus Development Statement on the effectiveness of external pneumatic compression, IPC devices have been the standard of care in the hospital. In the 30-plus years following this adoption, the mechanism for moving blood and providing needed prophylaxis remains consistent and unchanged.

The limitations of traditional IPC devices are a significant concern in preventing VTE, often leading to an overreliance on pharmacological prophylaxis methods for patients that do not require them, as well as increased risk in patients where pharmacological methods are contraindicated. Nonadherence to recommended prophylaxis with IPC devices can lead to costly medical interventions that could often be prevented. However, by acknowledging these limitations and adopting innovative alternatives that address the shortcomings of the standard of care IPC devices, healthcare providers can improve patient outcomes and reduce the risk of VTE.

The shift towards cordless, tubeless devices is shaping the future of compression therapy. Evidence suggests that wearable mobile compression devices like the MAC System can significantly enhance compliance, mobility, and patient satisfaction.

RF Health has taken a significant step forward in addressing the leading causes of hospital-acquired pressure injuries (HAPIs) by acquiring HeelP.O.D., a unique pressure offloading device that ensures full heel access and visualization while effectively offloading or “floating” the foot. This strategic move solidifies our commitment to providing comprehensive pressure injury prevention solutions, enhancing patient outcomes, and reducing healthcare costs. 

The Devastating Reality of Pressure Injuries  

Pressure injuries are one of the most prevalent and costly hospital-acquired conditions in the U.S., with the sacrum and heels being the two most common sites to develop pressure injuries. Over 2.5 million patients in the U.S. suffer from pressure injuries annually, resulting in significant pain, increased infection risks, and a higher workload for hospital staff. Despite efforts to prevent them, hospital-acquired pressure injuries continue to result in morbidity, mortality, and associated increased healthcare costs.  

Aside from the high cost of treatment, pressure injuries also significantly impact patients’ lives and a provider’s ability to administer appropriate care. The Centers for Medicare & Medicaid Services (CMS) has recognized this growing problem and introduced the “Hospital Harm – Pressure Injury” electronic Clinical Quality Measure (eCQM) measure for the 2025 Inpatient Quality Reporting program. This measure will require hospitals to report new Stage 2 pressure injuries starting in 2028, making it voluntary in 2025, directly impacting reimbursement rates. With pressure injuries costing the U.S. healthcare system nearly an estimated $12 billion annually, hospitals need to invest in offloading solutions to improve patient outcomes and reduce costs.  

The Importance of Prevention 

Patients are at higher risk for developing a pressure injury when they have a medical condition that prevents them from changing positions or moving. The primary contributing factors for these injuries are pressure, friction, and shear.  

Most pressure injuries are preventable through interventions by healthcare workers, caregivers, and patients. The National Pressure Injury Advisory Panel (NPIAP) created guidelines, including a Standardized Pressure Injury Prevention Protocol (S-PIPP) checklist for daily assessment, including the following methods to redistribute pressure: 

• Use positioning aids that minimize friction/shear  

• Use high-specification reactive foam for immobile persons 

Support Surface Immersion and Envelopment: The Key to Effective Pressure Redistribution 

Extensive literature supports the significance of load distribution on pressure injury risk. According to the NPIAP, immersion and envelopment are both needed for effective pressure redistribution.  

A simple analogy for immersion and envelopment would be similar to a memory foam surface type. Immersion refers to the ability of a surface to distribute body weight by allowing a patient to “sink in” to the support surface. Envelopment is the ability of the support surface to conform to the shape of the body part as it sinks in.   

Unfortunately, commonly used support surfaces are not designed to manage pressure injury risk through immersion and envelopment. Both the HeelP.O.D. and ELEVATE Patient Positioners are made of a proprietary memory foam that provides optimal pressure redistribution and offloading with immersion and envelopment technology to aid in improving patient comfort and compliance. 

Redefining Pressure Injury Prevention   

As the healthcare community continues to struggle with the complexities of pressure injuries, it’s clear that new, innovative approaches are needed.  

At RF Health, our mission is to help solve fundamental patient and healthcare team member challenges with evidence-based solutions. We’re committed to leveraging medical device technology to promote healthier lifestyles and reduce hospital-acquired conditions, including hospital-acquired immobility and hospital-acquired pressure injuries. 

The acquisition of HeelP.O.D. marks a significant milestone in our journey to revolutionize pressure injury prevention. With the addition of HeelP.O.D. to our innovative Pressure Injury Prevention (PIP) portfolio, we now offer a comprehensive portfolio of innovative solutions to address the top two leading causes of hospital-acquired pressure injuries.  

We’re excited about what’s ahead in our quest to help make a meaningful impact on patient outcomes.