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Based on the CliftonStrengths assessment (Rath, 2017), my top 5 strengths are: Relator, Belief, Responsibility, Restorative, and Stategic.
The following team members were chosen based on their CliftonStrengths (Rath, 2017).
1.) Alice (Achiever)-The implementation of a new innovation such as the electronic tattoo will require a lot of hard work.  Alice's balcony descriptors of "tireless" and "go-getter" are a perfect match for the task.
2.) Angelica (Analytical)-The electronic tattoo is a new concept in patient monitoring and implementing a new intervention can result in increased stress in some and unbridled excitement in others. Angelica's balcony descriptors of "organizer," "smart," and "logical" will assist developing measures to rein in the excitement and decrease the stress on the unit.
3.) Abraham (Arranger)-Implementation of the electronic tattoo may be complicated with a lot of "moving parts" to organize.  Abraham's balcony descriptors of "organizer," "efficient," and "conductor" show that he is able to help lead the task.
4.) Carter (Communicating)-There will be several phases of the implementation process which will need to be communicated clearly to all those involved in patient care.  Carter's balcony descriptors of "easy to talk to," "energizer," and "charismatic" make him perfect for the task of helping to communicate with all those involved and encourage participation and acceptance of the new innovation.
5.) Emily (Empathy)-Change on a unit can be stressful for the patients and the staff.  Often, if a person can express their concerns and frustrations to someone they trust, it can reduce the stress and aid in the success of the change.  Emily will provide balance with her balcony descriptors of "creates trust," and "customizes approach to others" as she has the ability to help others express their concerns and frustration and trust the implementation of the new innovation.
(Illustration: topmba.com)

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I have two primary concerns related to the electronic tattoo and they both involve patient safety.  Each patient reacts differently to foreign objects that are placed on their bodies.  I am concerned that the application of an electronic tattoo could cause harm to the patient’s skin.  The patient could have a reaction to the substrate or the sensors of the electronic tattoo. Most hospitalized patients have compromised immune systems placing them at greater risk for infection, and a break in skin integrity would increase that risk.  This is a concern for the patient’s physical safety.  I also question the security of the patient’s confidential health information while they are monitored by an electronic tattoo.  Computer hackers are becoming increasingly proficient at stealing information stored on computers and smart devices; including those within medical facilities.  What would impede hackers from stealing confidential information while a patient is monitored on a wireless electronic tattoo device?  This is a concern for the safety of the patient’s private information.  Even with the aforementioned concerns, there is excitement surrounding the development of a new and less burdensome patient monitoring system.  The implementation of the electronic tattoo in patient care could provide a pathway for greater healthcare innovations leading to improved patient outcomes.

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Part I: The Story of an Electronic Tattoo

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Part I: The Story of an Electronic Tattoo

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A team of scientists and engineers have discovered an innovative method to monitor a patient’s condition, and the device is similar to a temporary tattoo (Ameri et al., 2017).  In 2005 Professor Yonggang Huang, a mechanical engineer, and Dr. John Rogers, a material scientist and electrical engineer, developed the wireless, epidermal electronic system (EES), or “electronic tattoo.”  Although the device is labeled a tattoo, it does not require the skin to be punctured or pierced and it sticks to the skin without glue (National Science Foundation, 2013). The electronic sensors within the electronic tattoo are thin and soft, and can assess the function of the body’s organs including the heart and brain, and monitor vital signs (Ameri et al., 2017).

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The secret behind the adherence of the electronic tattoo can be attributed to the feet structure of a lizard such as this giant leaf-tail gecko (Suresh, 2018).  Huang and Rogers studied the reptile’s feet and its ability to stick to walls. The engineers then microscopically mimicked the dry-adhesive structures in the material design of the electronic tattoo. (National Science Foundation, 2013).

(Photograph: Vickers, 2008)

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Part III: Detailed Structures of an Electronic Tattoo

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Part III: Detailed Structures of an Electronic Tattoo

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Everyone’s skin surface is different, and some are more sensitive to foreign materials than others. Engineers were tasked with developing a substrate for the electronic tattoo that would not cause more harm than good.  The electronic tattoo material must be hair-thin, skin-soft, pliable, breathable, and be worn for long periods of time without causing irritation.  The first electronic tattoos to be tested were made of silicon with hair-thin strands of gold as sensors.  Although the gold was nonirritating, the silicon did not allow the skin to breath and skin irritation resulted. Also, a challenge faced by engineers and scientists was the natural shedding of the human skin’s epidermis. The dead skin cells affect the longevity of the electronic tattoo and contribute to inflammation (Amari et al., 2017).  An article by Miyamoto et al. (2017) details the creation of an electronic tattoo in which only the sensors are applied to the skin and is described as “substrate-free electronics, that inflammation-free, highly gas-permeable, ultrathin, lightweight, and stretchable sensors directly attachable to human skin for long periods of time…” (p. 907).  The electronic tattoo described by Miyamoto et al. (2017) is illustrated below.

(Illustration: Miyamoto et al., 2017)

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(Photograph: Han, 2018)

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Ameri, S. K., R., Jang, H., Tao,
L., Wang, Y., Wang, L., . . . Lu,
N. (2017). Graphene

electronic tattoo sensors. ACS
Nano, 11(8), 7634-7641.
doi:10.1021/acsnano.7b02182
Berger, M. (2016, November 23).
Stick-on epidermal electronics
tattoo to measure UV exposure

[Web log post]. Retrieved from https://www.nanowerk.com/spotlight/spotid=45164.php

Han, G. (2018). The future of
wearables is elastic electronic
skin [Photograph].

Retrieved from https://design
milk.com/future-electronic-
skin-technology/
Kim, J., Salvatore, G., Araki, H.,
Chisrelli, A. M., Xie, Z., Banks,
A., . . . Rogers, J. A. (2016).

Battery-free, stretchable
optoelectronic systems for
wireless optical
characterization of

the skin. Science Advances, 2(8),  doi:10.1126/sciadv.1600418

Michard, F., Pinsky, M. R., &
Vincent, J. (2017). Intensive
care medicine in 2050: NEWS
for hemodynamic monitoring.
Intensive Care Medicine, 43(3),
440-442.
doi:http://dx.doi.org/10.1007/s00134-016-4674-z

Miyamoto, A., Lee, S., Cooray, N.
F., Lee, S., Mori, M., Matsuhisa,
N., . . . Someya, T. (2017).

Inflammation-free, gas-
permeable, lightweight,
stretchable on-skin

electronics with nanomeshes.
Nature Nanotechnology, 12(9),
907-913.

doi:10.1038/nnano.2017.125

National Science Foundation
(Producer). (2013). Science of
innovation (2013): Electronic
tattoos [video].  Retrieved
from
https://www.nsf.gov/news/special_reports/innovation/electronictattoo.jsp
Rath, T. (2017). Strengthfinder 2.0
discover your
CliftonStrengths. New York,
NY: Gallup Press.
Suresh, P. K. (2017). Gecko feet as
a bio prototype for the use of
dry adhesion in engineering

decisions. Journal of
Biomimetics, Biomaterials &
Biomedical Engineering, 32, 1-
8. doi:
10.4028/www.scientific.net/JBBBE.32.1
Topmba. (2017). Five animated
seated figures [Illustration].
Retreived from
https://www.topmba.com/admissions/5-mba-interview-tips-impress-best-admissions-teams
Vickers, T. (2008). Giant leaf-tail
Uroplatus fimbriatus clinging
to glass [Photograph].
Retrieved from
https://commons.wikimedia.org/wiki/File:Uroplatus_fimbriatus_(3).jpg

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Although electronic tattoos are currently in the development phase and have not yet been implemented in medical institutions (Michard, Pinsky & Vincent, 2017), their applications in healthcare are promising. Perhaps the first step in implementing electronic tattoos is to start small with a practical application for the public. Currently, the Rogers Research Group is planning to commercialize an ultraviolet light detection tattoo and it will be the first electronic tattoo to be available to the public (Berger, 2016). Kim et al. (2016) describe the battery-free optoelectronic tattoo which indicates levels of ultraviolet light exposure by changing color and provides an exposure level through a phone application.

(Photograph: Berger, 2016)

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There are several disadvantages related to the electronic tattoo.  The following is a listing of those disadvantages:

1.  Although engineers and scientists are developing “skin-friendly” electronic tattoos to decrease irritation, the result of the tattoo application is unknown and could result in severe reactions.

2.   Electronic tattoos are not one-size-fits-all due to the varying of each individual’s skin surface (Ameri et al., 2017).  This could lead to inaccurate monitor readings and adversely affect patient care.

3.  The electronic tattoo can be expensive to produce (Ameri et al, 2017) causing an increase in cost to the patient and their caregivers.

4.  The electronic tattoo collects confidential patient information which then can be accessed with a smart device.  If the network of the electronic tattoo is not sufficiently secured, patient health information could be accessed by anyone leading to a HIPPA violation and harm to the patient.

5.  The skin naturally sheds skin cells.  This process interferes with the longevity of the electronic tattoo’s adherence and the accuracy of its monitoring capabilities.

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In relation to patient care, there are several advantages of the electronic tattoo.  The following is a listing of those advantages:

1.  The electronic tattoos are small and wireless compared to the current bulky and cumbersome monitors utilized in medical facilities (Michard et al., 2017).  This would allow for safer ambulation and transferring of patients.

2.  The electronic tattoo would not need to be removed during certain tasks such as showering, (Ameri, 2017) and transferring a patient.  This would allow for continuous patient monitoring, and increased safety for the patient.

3.  Continuous monitoring of different aspects of a patient’s condition including vital signs, and electrolytes levels in sweat may be possible with the electronic tattoos.  This would provide vital patient care information particularly for those on an intensive care unit (Michard et al., 2017).

4.  The design of the electronic tattoo may decrease the incidence of inflammation at the cite of skin contact (Miyamoto et al., 2017). This would decrease the risk of skin breakdown caused by conventional monitors.

5.  Patients could be discharged home with the electronic tattoo in place.  This would allow for continuous monitoring of the patient’s condition and early intervention. Patients and caregivers would also benefit from the device by obtaining patient assessment information, such as vital signs, faster and easier.

6.  The electronic tattoo is non-invasive which decreases the risk of thrombotic, hemorrhagic and infectious complications (Michard et al., 2017).

7.  The electronic tattoo is more comfortable to wear than conventional monitoring devices; therefore, patients are less likely to remove it.  This allows for continuous patient monitoring and improved safety for the patient.

8.  The electronic tattoo sensors would provide instant transfer of a patient’s condition such as vital signs, cardiac output, and electrolytes onto a transferrable device.  The information could then be sent to a physician to assist in predicting and preventing adverse events.

9.  The electronic tattoo can be scanned quickly on a smart device to obtain vital real-time patient information. This reduces the waiting time currently experienced with conventional monitoring devices, and would allow for prompt intervention if needed.

10.  As researchers continue to improve on the electronic tattoo, it may be available as an internal monitoring device.  Its hair-thin size and weight give it the potential to be better tolerated by the body’s organs.  Also, it may be placed in vital areas of the body which currently are not accessible to conventional monitoring devices.

11.  Work stress of those on the unit could potentially be reduced because the electronic tattoo stays in place more readily than conventional monitoring.

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Below is a 5.34 minute video from the National Science Foundation (2013) detailing the origin and use of the electronic tattoo:

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Science of Innovation (2013): Electronic Tattoos (Episode 5) | NSF - National Science Foundation

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In celebration of the 165th birthday of one of America's greatest innovators, Thomas Edison, the National Science Foundation, the U.S. Patent and Trademark Office, and NBC Learn produced this 11-part series narrated by Ann Curry highlighting innovators from across the country.